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https://www.readbyqxmd.com/read/29132455/going-beyond-the-9-1-1-call-what-bc-emergency-health-services-is-doing-to-improve-timely-access-to-emergency-care
#1
Kerry Campbell, Jessica Jaiven, Kimberly Banfield, Corinne Begg, Janice Butler, Leanne Thain
British Columbia Emergency Health Services (BCEHS) uses an internationally recognized Medical Priority Dispatch System to assign appropriate responses to 9-1-1 calls based on patients' clinical acuity. In 2015, 71% of Omega calls (classified as calls involving low acuity injuries) were assigned an ambulance. To better meet patients' needs, BCEHS collaborated with HealthLink BC's Nursing Services (HLBC NS) to audit over 2,000 calls. Based on the results, three Plan, Do, Study, Act (PDSA) cycles were implemented, yielding a 35% decrease in ambulances assigned and a 173% increase in referrals to HLBC NS to provide more suitable support...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29112028/implementation-of-an-electronic-checklist-to-improve-patient-handover-from-ward-to-operating-room
#2
Kristine H Münter, Thea P Møller, Doris Østergaard, Lone Fuhrmann
OBJECTIVE: Research has identified numerous safety risks in perioperative patient handover. In handover from ward to operating room (OR), patients are often transferred by a third person. This adds to the risk of loss of important information and of caregivers in the OR not identifying possible risk factors. The aim of this study was to describe the implementation process and completion rate of a new preoperative, ward-to-OR checklist. Our goal was a 90% fulfillment. METHOD: This study is a prospective, observational study in a Danish University Hospital including all patients undergoing surgery in 2013...
November 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29091240/learning-about-end-of-life-care-in-nursing-a-global-classroom-educational-innovation
#3
Cara Bailey, Alistair Hewison, Shelly Orr, Marianne Baernholdt
BACKGROUND: Teaching nursing students how to provide patient-centered end-of-life care is important and challenging. As traditional face-to-face classroom teaching is increasingly supplanted by digital technology, this provides opportunities for developing new forms of end-of-life care education. The aim of this article is to examine how a global classroom was developed using online technology to enhance nursing students' learning of end-of-life care in England and the United States. METHOD: The PDSA (Plan-Do-Study-Act) quality improvement approach was used to guide the design and delivery of this curriculum innovation...
November 1, 2017: Journal of Nursing Education
https://www.readbyqxmd.com/read/29055770/implementation-of-a-multidisciplinary-team-based-model-to-treat-chronic-hepatitis-c-in-the-primary-care-setting-lessons-learned
#4
Randi Sokol, Jessica Early, Amanda Barner, Sarah Gottfried, Richard Gumpert, Lorky Libaridian, Virginia Morrison, Alexandra Santamaria, Linda Shipton
Hepatitis C virus (HCV) is the most common blood-borne virus in the U.S., and its incidence continues to rise. With approval of direct-acting antiviral medications, treatment for Chronic Hepatitis C (CHC) has become highly efficacious with a minimal side effect profile. Primary care physicians are well-positioned to address this increased demand, yet most do not feel comfortable treating CHC. In this case report, we describe implementation of a multidisciplinary team-based approach for treating CHC at multiple primary care sites across a large safety net health system...
October 18, 2017: Healthcare
https://www.readbyqxmd.com/read/29038184/optimising-the-quality-of-antibiotic-prescribing-in-out-of-hours-primary-care-in-belgium-a-study-protocol-for-an-action-research-project
#5
Annelies Colliers, Samuel Coenen, Hilde Philips, Roy Remmen, Sibyl Anthierens
INTRODUCTION: Antimicrobial resistance is a major public health threat driven by inappropriate antibiotic use, mainly in general practice and for respiratory tract infections. In Belgium, the quality of general practitioners' (GPs) antibiotic prescribing is low. To improve antibiotic use, we need a better understanding of this quality problem and corresponding interventions. A general practitioners cooperative (GPC) for out-of-hours (OOH) care presents a unique opportunity to reach a large group of GPs and work on quality improvement...
October 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29027477/a-previsit-screening-checklist-improves-teamwork-and-access-to-preventive-services-in-a-medical-home-serving-low-income-adolescent-and-young-adult-patients
#6
Sophie H Allende-Richter, Sydney T Johnson, Mariam Maloyan, Patricia Glidden, Kerrilynn Rice, Alexandra Epee-Bounya
Publicly insured adolescents and young adults experience significant obstacles in accessing primary care services. As a result, they often present to their medical appointments with multiple unmet needs, adding time and complexity to the visit. The goal of this project was to optimize team work and access to primary care services among publicly insured adolescents and young adults attending an urban primary care clinic, using a previsit screening checklist to identify patient needs and delegate tasks within a care team to coordinate access to health services at the time of the visit...
October 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28969238/a-comprehensive-approach-towards-quality-and-safety-in-diagnostic-imaging-services-our-experience-at-a-rural-tertiary-health-care-center
#7
Viral Patel, Geetika Sindhwani, Monica Gupta, Sweta Arora, Arpita Mishra, Jayesh Bhatt, Manali Arora, Anisha Gehani
INTRODUCTION: An organization's transformation from imple-mentation of small, distinct Quality Improvement (QI) efforts to complete incorporation of Quality Improvement Program (QIP) into its culture occurs through a process of churning the foundational elements over time. AIM: To develop a quality culture across the employees, identify measurable indicators and various tools to impart effective quality care and develop a learning culture for continuous quality improvement in the field of imaging services...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28959786/a-quality-improvement-approach-to-cognitive-assessment-on-hospice-admission-could-we-use-the-4at-or-short-cam
#8
Lucy Baird, Juliet Anne Spiller
Background Prevalence studies show that 13%-42% of patients admitted to specialist palliative care inpatient units have delirium. Symptoms of delirium are often subtle and easily missed, or misdiagnosed as fatigue or depression, and so the use of a screening tool could improve early identification and management of delirium and lead to improved outcomes. Patients admitted to hospices are often frail and tired, therefore a quick and easy-to-use method of cognitive assessment is essential. Methods A quality improvement (QI) approach (PDSA: Plan, Do, Study, Act) was used to improve screening for delirium on admission to a hospice unit...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28959784/implementing-the-who-safe-childbirth-checklist-lessons-learnt-on-a-quality-improvement-initiative-to-improve-mother-and-newborn-care-at-gobabis-district-hospital-namibia
#9
Leonard Kabongo, Jonathon Gass, Beatrice Kivondo, Nabihah Kara, Katherine Semrau, Lisa R Hirschhorn
Background Although there are many evidence-based practices that reduce the risk of maternal and neonatal mortality around the time of birth, there remains a gap between what is known and the care received. This know-do gap is a source of preventable maternal and perinatal deaths and is the focus of improvement efforts in many countries. Following an increase in perinatal and maternal deaths, Gobabis District Hospital initiated a quality improvement (QI) initiative to increase adherence to these WHO Safe Childbirth Checklist (SCC)-targeted essential birth practices (EBPs)...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28959783/improving-access-to-the-kis-in-secondary-care
#10
Charlie Christopher Hall, Carey Lunan, Anne Finucane, Juliet Anne Spiller
BackgroundEffective communication of anticipatory care planning (ACP) discussions between patients and general practitioners across different healthcare settings is vital. In Scotland, the Key Information Summary (KIS) is a new piece of software that allows clinical data for selected patients to be shared electronically across the wider National Health Service from the primary care record. This can include details of ACP discussions and decisions. The KIS is now routinely accessible in secondary care and is available through the hospital electronic record in two formats (abbreviated and full versions)...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28959780/restructuring-hospitalist-work-schedules-to-improve-care-timeliness-and-efficiency
#11
Monika Wells, Evan Coates, Barbara Williams, Craig Blackmore
Background In 2014, we recognised that the pace of admissions frequently exceeded our ability to assign a hospitalist. Long patient wait times occurred at admission, especially for patients arriving in the late afternoon when hospitalist day shifts were ending. Our purpose was to redesign hospitalist schedules, duties and method of distributing admissions to match demand. Design We used administrative data to tabulate Hospital Medicine admission requests by time of day and identified mismatch between volume and capacity with the current staffing model...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28959778/improving-the-care-of-patients-with-cystic-fibrosis-cf
#12
Ahsan Aftab Khan, Edward F Nash, Joanna Whitehouse, Rifat Rashid
BACKGROUND: The West Midlands Adult Cystic Fibrosis (CF) Centre based at Birmingham Heartlands Hospital provides care for adults with CF in the West Midlands. People with CF are prone to pulmonary exacerbations, which often require inpatient admission for intravenous antibiotics. We observed that the admission process was efficient during working hours (9:00-17:00, Monday-Friday) when the CF team are routinely available, but out-of-working hours, there were delays in these patients being clerked and receiving their first antibiotic dose...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28959777/improving-mrcp-paces-pass-rates-through-the-introduction-of-a-regional-multifaceted-support-framework
#13
Richard Jerrom, Tayeba Roper, Narasimha Murthy
INTRODUCTION: Practical Assessment of Clinical Examination Skills (PACES) constitutes the final part of the mandatory Royal College of Physicians exam series for progression to higher specialty training. Pass rates were lower for core medical trainees (CMTs) in Coventry and Warwickshire in comparison to other regions within the West Midlands and nationally. OBJECTIVES: Our aim was to improve pass rates in the region through the introduction of a stimulating and supportive teaching framework, designed to enhance the quality and frequency of PACES teaching...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28959775/improving-health-maintenance-supervision-in-a-paediatric-ibd-clinic
#14
Dana M H Dykes, Marie Raphaelle Jean, Pamela Morgan, Denise Hill, Elizabeth Williams, Lisa Opipari-Arigan, Jennifer Huggins, Shehzad A Saeed
BACKGROUND: Previsit planning (PVP) has been an integral part of clinical care for paediatric patients with inflammatory bowel disease (IBD) at Cincinnati Children's Hospital Medical Center since 2007. Over the past years, we have adopted several programmes to improve health maintenance supervision for our paediatric patients with IBD but did not have a sustainable way to provide health maintenance updates for every patient at every encounter that was concise and complete in the setting of an increasing patient population and fewer support staff to complete the work...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28959774/reducing-dnacpr-complaints-to-zero-designing-and-implementing-a-treatment-escalation-plan-using-quality-improvement-methodology
#15
Elizabeth Shermon, Laura Munglani, Sarah Oram, Linda William, Julian Abel
INTRODUCTION: Do Not Attempt Resuscitation (DNAR)decisions have traditionally formed the basis of ceiling of care discussions. However, poor quality discussions can lead to high patient and relative dissatisfaction, generating hospital complaints. Treatment escalation plans (TEPs) aim to highlight the wider remit of treatment options with a focus on effective communication. We aimed to improve TEP discussions and documentation at Weston General Hospital by introducing a standardised form...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28934995/quality-improvement-primer-part-2-executing-a-quality-improvement-project-in-the-emergency-department
#16
Lucas B Chartier, Antonia S Stang, Samuel Vaillancourt, Amy H Y Cheng
The topics of quality improvement (QI) and patient safety have become important themes in health care in recent years, particularly in the emergency department setting, which is a frequent point of contact with the health care system for patients. In the first of three articles in this series meant as a QI primer for emergency medicine clinicians, we introduced the strategic planning required to develop an effective QI project using a fictional case study as an example. In this second article we continue with our example of improving time to antibiotics for patients with sepsis, and introduce the Model for Improvement...
September 22, 2017: CJEM
https://www.readbyqxmd.com/read/28872987/using-quality-improvement-methods-to-implement-an-early-childhood-oral-health-initiative-a-federally-qualified-health-center-pilot-study
#17
Rocio B Quinonez, Elizabeth Consky, Katrina Mattison, Greg Randolph
OBJECTIVES: To assess the use of quality improvement (QI) methods to implement an early childhood oral health program (Baby Oral Health Program-bOHP) in four federally qualified health center (FQHC) dental clinics. STUDY DESIGN: Using a mixed-methods study design, survey responses, administrative data, QI project templates, and focus group measures were collected. Plan-Do-Study-Act (PDSA) cycles as mini-projects to improve the implementation of bOHP were examined...
2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28854507/improving-handover-between-the-transport-team-and-neonatal-intensive-care-unit-staff-in-neonatal-transports-using-the-plan-do-study-act-tool
#18
M J Kresch, S Christensen, M Kurtz, J Lubin
OBJECTIVES: The aim was to achieve 100% effective handover from the critical care transport team to the neonatal intensive care unit (NICU) medical team. STUDY DESIGN: All patients transferred from referring hospitals by the critical care transport team to the Level IV NICU were included. Data for each infant was collected prospectively. The percentage of transported patients for which medical team and nursing handover occurred was recorded. A quality improvement project was launched using the Plan-Do-Study-Act (PDSA) tool...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28839884/integration-of-palliative-and-supportive-care-in-the-management-of-advanced-liver-disease-development-and-evaluation-of-a-prognostic-screening-tool-and-supportive-care-intervention
#19
Benjamin E Hudson, Kelly Ameneshoa, Anya Gopfert, Rachael Goddard, Karen Forbes, Julia Verne, Peter Collins, Fiona Gordon, Andrew J Portal, Colette Reid, C Anne McCune
BACKGROUND AND OBJECTIVES: Patients with decompensated cirrhosis rarely receive palliative and supportive care interventions, which are routine in other life-limiting diseases. We aimed to design and evaluate a prognostic screening tool to routinely identify inpatients with decompensated cirrhosis at high risk of dying over the coming year, alongside the development of a supportive care intervention. DESIGN: Clinical notes from consecutive patients admitted as an emergency to University Hospitals Bristol with a diagnosis of cirrhosis over two distinct 90-day periods were scrutinised retrospectively for the presence or absence of five evidence-based factors associated with poor prognosis...
January 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28832405/applying-the-pdsa-framework-to-examine-the-use-of-the-clinical-nurse-leader-to-evaluate-pressure-ulcer-reporting
#20
(no author information available yet)
No abstract text is available yet for this article.
October 2017: Journal of Nursing Care Quality
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