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https://www.readbyqxmd.com/read/28352467/electronic-printed-ward-round-proformas-freeing-up-doctors-time
#1
Darren Fernandes, Philip Eneje
The role of a junior doctor involves preparing for the morning ward round. At a time when there are gaps on rotas and doctors' time is more stretched, this can be a source of significant delay and thus a loss of working time. We therefore looked at ways in which we could make the ward round a more efficient place by introducing specific electronic, printed ward round proformas. We used the average time taken to write proformas per patient and the average time taken per patient on the ward round. This would then enable us to make fair comparisons with future changes that were made using the plan, do, study, and act principles of quality improvement...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28323686/applying-the-pdsa-framework-to-examine-the-use-of-the-clinical-nurse-leader-to-evaluate-pressure-ulcer-reporting
#2
Shea Polancich, Sarah Coiner, Rebekah Barber, Terri Poe, Linda Roussel, Kelley Williams, Heather Cumbest, Kristen Noles, Ashlea Herrero, Shannon Graham, Rebecca Miltner
The clinical nurse leader (CNL) role has been cited as an effective strategy for improving care at the microsystem level. The purpose of this article is to describe the use of the CNL role in an academic medical center for evaluating pressure ulcer reporting. The Plan-Do-Study-Act cycle was used as the methodological framework for the study. The CNL assessment of pressure ulcers resulted in a 21% to 50% decrease in the number of hospital-acquired pressure ulcers reported in a 3-month time period. The CNL role has potential for improving the validity and reliability of pressure ulcer reporting...
March 20, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28321300/identifying-highlighting-and-reducing-polypharmacy-in-a-uk-hospice-inpatient-unit-using-improvement-science-methods
#3
Alison Phippen, Jennie Pickard, Douglas Steinke, Matt Cope, Dai Roberts
Polypharmacy, the concurrent use of multiple medications by one individual is a growing global issue driven by an ageing population and increasing prevalence of multi-morbidity[1]. Polypharmacy can be problematic: interactions between medications, reduced adherence to medication, burden of medication to patients, administration time, increased risk of errors and increased cost. Quality improvement methods were applied to identify and highlight polypharmacy patients with the aim of reducing their average number of regular tablets/capsules per day by 25%...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28321298/reducing-falls-in-a-care-home
#4
Rosie Cooper
Care home residents are 3 times more likely to fall than their community dwelling peers and 10 times more likely to sustain a significant injury as a result. 2 A project commenced at a care home in Aberdeen with the aim of reducing the number of falls by 20% by 30st April 2016 using the model for improvement. Qualitative data was gathered to establish staff belief about falls and their level of knowledge& understanding about falls risks and how to manage these. This informed the training which was delivered and iterative testing commenced with the introduction of the Lanarkshire Falls Risk/Intervention tool - where the multifactorial nature of a resident's falls risks are explored and specific actions to manage these are identified and implemented...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28321297/knowledge-is-power-a-quality-improvement-project-to-increase-patient-understanding-of-their-hospital-stay
#5
Eleanor Nicholson Thomas, Lloyd Edwards, Paul McArdle
Patients frequently leave hospital uninformed about the details of their hospital stay with studies showing that only 59.9% of patients are able to accurately state their diagnosis and ongoing management after discharge. 1 2 This places patients at a higher risk of complications. Educating patients by providing them with accurate and understandable information enables them to take greater control, potentially reducing readmission rates, and unplanned visits to secondary services whilst providing safer care and improving patient satisfaction...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28253883/systematic-development-and-implementation-of-interventions-to-optimise-health-literacy-and-access-ophelia
#6
Alison Beauchamp, Roy W Batterham, Sarity Dodson, Brad Astbury, Gerald R Elsworth, Crystal McPhee, Jeanine Jacobson, Rachelle Buchbinder, Richard H Osborne
BACKGROUND: The need for healthcare strengthening to enhance equity is critical, requiring systematic approaches that focus on those experiencing lesser access and outcomes. This project developed and tested the Ophelia (OPtimising HEalth LIteracy and Access) approach for co-design of interventions to improve health literacy and equity of access. Eight principles guided this development: Outcomes focused; Equity driven, Needs diagnosis, Co-design, Driven by local wisdom, Sustainable, Responsive and Systematically applied...
March 3, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28243441/improving-theatre-turnaround-time
#7
Daniel Fletcher, David Edwards, Stephen Tolchard, Richard Baker, James Berstock
The NHS Institute for Innovation and Improvement has determined that a £7 million saving can be achieved per trust by improving theatre efficiency. The aim of this quality improvement project was to improve orthopaedic theatre turnaround without compromising the patient safety. We process mapped all the stages from application of dressing to knife to skin on the next patient in order to identify potential areas for improvement. Several suggestions arose which were tested in multiple PDSA cycles in a single theatre...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28174657/improving-physician-s-hand-over-among-oncology-staff-using-standardized-communication-tool
#8
Ashwaq Alolayan, Mohammad Alkaiyat, Yosra Ali, Mona Alshami, Khaled Al-Surimi, Abdul-Rahman Jazieh
Cancer patients are frequently admitted to hospital for many reasons. During their hospitalization they are handled by different physicians and other care providers. Maintaining good communication among physicians is essential to assure patient safety and the delivery of quality patient care. Several incidents of miscommunication issues have been reported due to lack of a standardized communication tool for patients' hand over among physicians at our oncology department. Hence, this improvement project aims at assessing the impact of using a standardized communication tool on improving patients' hand over and quality of patient care...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28152936/improving-transitions-of-care-through-implementation-of-a-standardized-handoff-at-a-comprehensive-cancer-center
#9
Mohamed Ait Aiss, Helene P Phu, Lakeisha R Day, Varkey Abraham, Karen Chen, Mejia Rodrigo, Shehla Razvi, Carmen E Gonzalez, Norman Brito-Dellan, Srinivas Banala, David Rubio, Nicole Vaughan-Adams, Debra S Ruiz, Tan Jens, Charles F Levenback, Michael M Frumovitz, Behrouz Zand, Carmelita P Escalante
242 Background: Communication failures cause two-thirds of sentinel events in hospitals. These adverse occurrences are often both fatal and preventable. Consequently, improving the quality of handoffs has been identified by multiple accreditation constituents as a top priority patient safety goal. This project was part of an institutional initiative to standardize handoffs among physicians, trainees, and midlevel providers. METHODS: Four subgroups were identified as pilot areas: Gynecologic Oncology (Gyn Onc) fellows to nocturnalists, Surgical Oncology fellows, Pediatric Oncology residents and fellows, and Emergency Center attending staff to inpatient hospitalists...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152813/early-discussion-of-advance-directives-for-patients-with-newly-diagnosed-cancer
#10
Suvarna Sundaram, Andrea Finlay, Natalia Romanova, Laura Knopp, Chiara Pierattini, Jenny Fuentes, Emily Hidalgo, Marian Daye, Megan Kokon, Christina Gustavson, Pamela Radomsky, Josefina Buras, Jennifer DeSimone, Suraj S Venna, John F Deeken, Donald L Trump
91 Background: Although advance care planning and the completion of advance directives (ADs) are important methods to prevent unwanted aggressive care once patients have lost their decision-making capacity, only a minority of patients have ADs at the time of cancer diagnosis. METHODS: We established a new multidisciplinary outpatient clinic to provide comprehensive care to patients with newly diagnosed cancer at the Inova Dwight and Martha Schar Cancer Institute in Northern Virginia. Improvement in advance care planning was chosen as one of the first quality improvement initiatives for 2015...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152806/reducing-patient-wait-time-on-an-inpatient-hematology-and-transplant-unit
#11
Rory Joseph Makielski, Kurt Osterby, Mike Fallon, Nicole Domask, Vicki Hubbard, Eva Allen, Blythe Gage, Gail Hettrick, Jessica Fischer, Andrew Brown, Brianna Grahn, Brett Welhouse, Hannah Draayers, Mark Juckett, Jean Ligocki, Ruth O'Regan, Laurie Kaufman
87 Background: The University of Wisconsin Hematology and Bone Marrow Transplant services admit 250 patients per year for scheduled treatment. Time from patient arrival to chemotherapy initiation averages 7 hours. This long time leads to patient dissatisfaction and prolonged length of stay. Chemotherapy often begins in the evening when physicians and pharmacists are not on site to clarify treatment questions. METHODS: A multidisciplinary team was formed in April 2015 as part of the ASCO Quality Training Program...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152756/making-steps-to-decrease-emergency-room-visits-in-patients-with-cancer-our-experience-after-participating-in-the-asco-quality-training-program
#12
Alvaro Jose Alencar, Aurelio Bartolome Castrellon, Luis E Raez, Vedner Guerrier
51 Background: Overutilization of emergency room services by oncology patients is a known problem associated with increased admission rates and health care expenditure. A review of our oncology patients' emergency room (ER) visits from January to May 2015 demonstrated that 48% of ER visits happened during office hours. Consequently a rapid cycle quality improvement project was developed with an aim to decrease ER visits by 30% by September 2015. METHODS: A multidisciplinary team completed an action plan, starting with a project charter and definition of aim statement...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152726/reducing-the-percent-of-icu-deaths-of-patients-with-advanced-cancer-at-stanford
#13
Zarrina Bobokalonova, Eric Hadhazy, Sandy Chan, Holley Stallings
234 Background: Intensive care at the end of life, for patients with advanced cancer can compromise quality of life and result in excessive costs for patients and their families. In 2014, 40% of patients with solid tumors admitted to the Stanford Health Care ICU died with advanced stage disease. Sixty-five percent of the patients with advanced stage saw palliative care (PC) < 7 days of life. The aim was to decrease the percent of advanced solid tumor ICU deaths by 25%, through early palliative care intervention...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152716/documentation-of-pharmacist-provided-patient-education-for-oral-chemotherapy
#14
Neeta K Venepalli, Patrick Joseph Fleming, Christina Haaf, Adam Bursua, Little Irene Park, Sandra Cuellar
237 Background: Pharmacist-provided patient education for oral chemotherapy is poorly documented in patient electronic medical records (EMR) at UIC Oncology Pharmacy. At baseline, 41% of patients who started new therapy with selected oral chemotherapies had a patient education note documented by a pharmacist in their EMR. Our aim is to provide and document patient education for at least 90% of patients who start new oral chemotherapy and fill their prescriptions at UIC Oncology Pharmacy over three months. The importance of patient counseling and documentation is recognized by the Quality Oncology Practice Initiative (QOPI) group...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28141600/preventing-pressure-injuries-in-neonates-undergoing-therapeutic-hypothermia-for-hypoxic-ischemic-encephalopathy-an-interprofessional-quality-improvement-project
#15
Alexandra Luton, Jae Hernandez, Clive Robert Patterson, Jill Nielsen-Farrell, Anita Thompson, Jeffrey R Kaiser
BACKGROUND: Hospital-acquired pressure injuries (HAPIs) can be caused by multiple factors including pressure, shear, friction, moisture/incontinence, device-related pressure, immobility, inactivity, and nutritional deficits. Along with immobility, medical device-related (MDR) HAPIs are a primary cause of pressure injury in neonates, as the clinical practice setting has become increasingly technologically advanced. It is estimated that up to 50% of HAPIs are MDR in pediatric patients. Neonates are at particular risk for HAPI because of their specific anatomical, physiological, and developmental vulnerabilities...
January 30, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28114987/study-protocol-for-evaluating-the-implementation-and-effectiveness-of-an-emergency-department-longitudinal-patient-monitoring-system-using-a-mixed-methods-approach
#16
Marie Ward, Eilish McAuliffe, Abel Wakai, Una Geary, John Browne, Conor Deasy, Michael Schull, Fiona Boland, Fiona McDaid, Eoin Coughlan, Ronan O'Sullivan
BACKGROUND: Early detection of patient deterioration is a key element of patient safety as it allows timely clinical intervention and potential rescue, thus reducing the risks of serious patient safety incidents. Longitudinal patient monitoring systems have been widely recommended for use to detect clinical deterioration. However, there is conflicting evidence on whether they improve patient outcomes. This may in part be related to variation in the rigour with which they are implemented and evaluated...
January 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28067569/optimizing-postoperative-handover-to-the-intensive-care-unit-at-a-tertiary-centre
#17
Shankar Kumar, Andrew R McKean, Andrew Ramwell, Carolyn Johnston, Susannah Leaver
BACKGROUND: Comprehensive handover of patients transferred from operating theatre to the intensive care unit is crucial in ensuring ongoing quality and safety of care. Handover in this setting poses unique challenges, yet few studies have considered or tested approaches to improve the process. A quality improvement project was undertaken to assess and improve the quality of information transfer during the handover of postoperative patients to the general intensive care unit at a tertiary centre...
January 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28035039/learning-from-the-design-development-and-implementation-of-the-medication-safety-thermometer
#18
Paryaneh Rostami, Maxine Power, Abigail Harrison, Kurt Bramfitt, Steve D Williams, Yogini Jani, Darren M Ashcroft, Mary P Tully
QUALITY ISSUE: Approximately 10% of patients are harmed by healthcare, and of this harm 15% is thought to be medication related. Despite this, medication safety data used for improvement purposes are not often routinely collected by healthcare organizations over time. INITIAL ASSESSMENT: A need for a prospective medication safety measurement tool was identified. CHOICE OF SOLUTION: The aim was to develop a tool to allow measurement and aid improvement of medication safety over time...
December 29, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27986900/a-primer-on-pdsa-executing-plan-do-study-act-cycles-in-practice-not-just-in-name
#19
Jerome A Leis, Kaveh G Shojania
No abstract text is available yet for this article.
December 16, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27933157/absconding-reducing-failure-to-return-in-adult-mental-health-wards
#20
Jill Bailey, Bethan Page, Nokuthula Ndimande, Julie Connell, Charles Vincent
Failing to return from leave from acute psychiatric wards can have a range of negative consequences for patients, relatives and staff. This study used quality improvement methodology to improve the processes around patient leave and time away from the ward. The aim of this study was to improve rates of on-time return from leave by detained and informal patients by 50%. Following a baseline period, four interventions were implemented and refined using PDSA cycles. The main outcome measure was the proportion of periods of leave where the patient returned on time...
2016: BMJ Quality Improvement Reports
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