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https://www.readbyqxmd.com/read/29333496/improving-the-wait-time-to-consultation-at-the-emergency-department
#1
Yuzeng Shen, Lin Hui Lee
Prolonged wait times at the emergency department (ED) are associated with increased morbidity and mortality, and decreased patient satisfaction. Reducing wait times at the ED is challenging. The objective of this study is to determine if the implementation of a series of interventions would help decrease the wait time to consultation (WTC) for patients at the ED within 6 months. Interventions include creation of a common board detailing work output, matching manpower to patient arrivals and adopting a team-based model of care...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29333494/ensuring-adequate-vascular-access-in-patients-with-major-trauma-a-quality-improvement-initiative
#2
Kevin Verhoeff, Rachelle Saybel, Pamela Mathura, Bonnie Tsang, Vanessa Fawcett, Sandy Widder
Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29315077/improved-medical-alert-id-ownership-and-utilization-in-youth-with-congenital-adrenal-hyperplasia-following-a-parent-educational-intervention
#3
Alaina P Vidmar, Jonathan F Weber, Christina M Koppin, Roshanak Monzavi, Mimi S Kim
BACKGROUND: Classical congenital adrenal hyperplasia (CAH) is a potentially life-threatening condition, and adrenal crisis is a major cause of morbidity and mortality in affected children. Medical-alert identification (ID) could prevent complications of adrenal crisis by identifying the need for time-sensitive, critical treatment. Our objectives were to evaluate usage of medical-alert IDs by CAH youth, ownership and awareness of IDs amongst their parents, and the effect of an in-clinic educational intervention on ID utilization...
January 9, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29236623/group-based-acceptance-and-commitment-therapy-act-for-older-veterans-findings-from-a-quality-improvement-project
#4
M Lindsey Jacobs, Katherine Luci, Lauren Hagemann
OBJECTIVES: The purpose of this project was to develop, implement, and evaluate a 12-session Acceptance and Commitment Therapy (ACT) for Older Veterans group protocol. METHODS: The Plan-Do-Study-Act (PDSA) quality improvement model was the foundational process for this project. Veterans age 55 years and older participated in an ACT for Older Veterans group in an outpatient geropsychology clinic at a Veterans Affairs Medical Center. Study methods included analysis of participant feedback gathered in a focus group, process measures (i...
October 27, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/29236097/a-randomized-cohort-controlled-trial-to-compare-intern-sign-out-training-interventions
#5
Soo-Hoon Lee, Christopher Terndrup, Phillip H Phan, Sandra E Zaeh, Kwame Atsina, Nicole Minkove, Alexander Billioux, Souvik Chatterjee, Idoreyin Montague, Bennett Clark, Andrew Hughes, Sanjay V Desai
BACKGROUND: Although previous studies have investigated the efficacy of specific sign-out protocols (such as the illness severity, patient summary, action list, situation awareness and contingency planning, and synthesis by reviewer [I-PASS] bundle), the implementation of a bundle can be time consuming and costly. We compared 4 sign-out training pedagogies on sign-out quality. OBJECTIVE: To evaluate training interventions that best enhance multidimensional sign-out quality measured by information exchange, task accountability, and personal responsibility...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29175915/pdsa-marks-a-century-of-care-for-vulnerable-pets
#6
(no author information available yet)
No abstract text is available yet for this article.
November 25, 2017: Veterinary Record
https://www.readbyqxmd.com/read/29170350/53%C3%A2-piloting-patch-providing-assessment-and-treatment-for-children-at-home-and-piecing-together-what-works
#7
Caroline Ward, Katie Knight, Mary-Rose Ballard, Georgina Keogh, Miriam Samuel, Sara Buttle, Claire Robb, Francesca Cleugh
AIMS: PATCH is a pilot acute community children's nurse led service delivering assessment and treatment for children at home who are moderately unwell and might otherwise be admitted to hospital or attend Paediatric Emergency Department (PED). Children are referred by PED or GP and followed up via telephone support and home visits depending on clinical need for duration of acute illness. METHODS: Pilot year funded by Imperial Charity. Using evaluation to build business case for sustained commissioned service...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29159992/clinical-and-histopathologic-features-of-antibody-mediated-rejection-among-pediatric-renal-transplant-recipients-with-preformed-vs-de-novo-donor-specific-antibodies
#8
Justin A Steggerda, Irene K Kim, Mark Haas, Xiaohai Zhang, Alexis Kang, Helen Pizzo, Elaine Kamil, Stanley Jordan, Dechu Puliyanda
Preformed and de novo donor specific antibodies (pDSA and dnDSA) are risk factors for ABMR. This study compares the effects of pDSA vs dnDSA in pediatric kidney transplant recipients. Sixteen pediatric patients with biopsy-proven ABMR were evaluated. Strong DSA (MFI >10 000) was recorded at transplant, rejection, and follow-up. DSAs with the highest MFI were termed iDSAs. Allograft biopsies were scored according to Banff 2013 criteria. Seven of 16 (44%) patients had pDSA at transplant; 9 (56%) developed dnDSA...
December 2017: Pediatric Transplantation
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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 Quality
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
#17
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 Quality
https://www.readbyqxmd.com/read/28959783/improving-access-to-the-kis-in-secondary-care
#18
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 Quality
https://www.readbyqxmd.com/read/28959780/restructuring-hospitalist-work-schedules-to-improve-care-timeliness-and-efficiency
#19
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 Quality
https://www.readbyqxmd.com/read/28959778/improving-the-care-of-patients-with-cystic-fibrosis-cf
#20
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 Quality
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