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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
#1
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
#2
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...
August 23, 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
#3
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
#4
(no author information available yet)
No abstract text is available yet for this article.
October 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28820763/concept-evaluation-using-the-pdsa-cycle-for-continuous-quality-improvement
#5
Delois Meyer Laverentz, Sharon Kumm
As concept-based nursing education gains popularity, there is little literature on how to sustain quality after initiation of the curriculum. Critical appraisal of concepts in a university program revealed varying definitions, attributes, and exemplars resulting in student confusion. The Plan, Do, Study, Act (PDSA) cycle for continuous quality improvement was used for concept evaluation. The goals of the evaluation project were: 1) to develop common definition and attributes for concepts and 2) to develop horizontal and vertical leveling of exemplars to build on prior student learning...
September 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/28775018/pdsa-forced-to-cut-services-as-economic-depression-takes-its-toll
#6
(no author information available yet)
No abstract text is available yet for this article.
August 5, 2017: Veterinary Record
https://www.readbyqxmd.com/read/28762577/assessing-barriers-to-adherence-in-routine-clinical-care-for-pediatric-kidney-transplant-patients
#7
Charles D Varnell, Kristin L Rich, Melissa Nichols, Devesh Dahale, Jens W Goebel, Ahna L H Pai, David K Hooper, Avani C Modi
Patient-identified barriers to immunosuppressive medications are associated with poor adherence and negative clinical outcomes in transplant patients. Assessment of adherence barriers is not part of routine post-transplant care, and studies regarding implementing such a process in a reliable way are lacking. Using the Model for Improvement and PDSA cycles, we implemented a system to identify adherence barriers, including patient-centered design of a barriers assessment tool, identification of eligible patients, clear roles for clinic staff, and creating a culture of non-judgmental discussion around adherence...
August 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28726791/implementation-of-a-multidisciplinary-guideline-improves-preterm-infant-admission-temperatures
#8
M W Harer, B Vergales, T Cady, A Early, C Chisholm, J R Swanson
BACKGROUND: Hypothermia is a common problem in preterm infants immediately following delivery.Local problem:The rate of admission hypothermia in our neonatal intensive care unit (NICU) was above the rate of comparable NICUs in the Vermont Oxford Network. METHODS: To reduce the rate of preterm admission hypothermia, a quality improvement (QI) project was implemented, utilizing the plan-do-study-act (PDSA) methodology. A guideline for delivery room thermoregulation management in <35-week infants at the University of Virginia was created and put into practice by a multidisciplinary team...
July 20, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28690941/a-simulation-based-quality-improvement-approach-to-improve-pediatric-resident-competency-with-required-procedures
#9
Michelle Starr, Taylor Sawyer, Maya Jones, Maneesh Batra, Heather McPhillips
INTRODUCTION: Pediatric residents report a lack of confidence and competence with procedural skills at graduation. Training programs could benefit from improved approaches to target these needs. Using the Institute for Healthcare Improvement (IHI) Model for Improvement and three Plan-Do-Study-Act (PDSA) cycles, we examined the impact of a procedure simulation boot camp on self-reported procedural confidence and competence as well as the longitudinal impacts of these sequential interventions on Accreditation Council for Graduate Medical Education (ACGME) Graduating Resident Survey (GRS) results...
June 3, 2017: Curēus
https://www.readbyqxmd.com/read/28674611/reducing-the-number-of-unnecessary-liver-function-tests-requested-on-the-paediatric-intensive-care-unit
#10
Lynn Sinitsky, Joe Brierley
Between January and October 2014, Great Ormond Street Hospital Paediatric Intensive Care Unit (PICU) was spending an average £23,392 on blood tests per month. Blood tests should be requested based on previous results and the patient's clinical condition, medication and nutritional status. However, more blood tests were being ordered than clinically indicated: an audit in October 2014 showed liver function tests (LFTs) were requested daily on most patients, even with previous normal results. A driver diagram identified three primary drivers for blood test requesting: decision-making, situational awareness and computer-based ordering...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28634517/introduction-of-a-quality-improvement-curriculum-in-the-department-of-internal-medicine-lincoln-medical-center
#11
Usha Venugopal, Moiz Kasubhai, Vikram Paruchuri
Community hospitals with limited resources struggle to engage physicians in Quality improvement initiatives. We introduced Quality Improvement (QI) curriculum for residents in response to ACGME requirements and surveyed the residents understanding of QI and their involvement in QI projects before and after the introduction of the curriculum. The current article describes our experiences with the process, the challenges and possible solutions to have a successful resident led QI initiative in a community hospital...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28629348/applying-the-plan-do-study-act-pdsa-approach-to-a-large-pragmatic-study-involving-safety-net-clinics
#12
Jennifer Coury, Jennifer L Schneider, Jennifer S Rivelli, Amanda F Petrik, Evelyn Seibel, Brieshon D'Agostini, Stephen H Taplin, Beverly B Green, Gloria D Coronado
BACKGROUND: The Plan-Do-Study-Act (PDSA) cycle is a commonly used improvement process in health care settings, although its documented use in pragmatic clinical research is rare. A recent pragmatic clinical research study, called the Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), used this process to optimize the research implementation of an automated colon cancer screening outreach program in intervention clinics. We describe the process of using this PDSA approach, the selection of PDSA topics by clinic leaders, and project leaders' reactions to using PDSA in pragmatic research...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28607684/a-multifaceted-quality-improvement-programme-to-improve-acute-kidney-injury-care-and-outcomes-in-a-large-teaching-hospital
#13
Leonard Ebah, Prasanna Hanumapura, Deryn Waring, Rachael Challiner, Katharine Hayden, Jill Alexander, Robert Henney, Rachel Royston, Cassian Butterworth, Marc Vincent, Susan Heatley, Ged Terriere, Robert Pearson, Alastair Hutchison
Acute kidney injury (AKI) is now widely recognised as a serious health care issue, occurring in up to 25% of hospital in-patients, often with worsening of outcomes. There have been several reports of substandard care in AKI. This quality improvement (QI) programme aimed to improve AKI care and outcomes in a large teaching hospital. Areas of documented poor AKI care were identified and specific improvement activities implemented through sequential Plan-Do-Study-Act (PDSA) cycles. An electronic alert system (e-alert) for AKI was developed, a Priority Care Checklist (PCC) was tested with the aid of specialist nurses whilst targeted education activities were carried out and data on care processes and outcomes monitored...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28607679/proper-electronic-order-linkage-of-electrocardiograms-at-a-large-children-s-hospital-improves-reporting-and-revenue
#14
David S Spar, Wayne A Mays, David S Cooper, Lucille Sullivan, Terra Hicks, Jeffrey B Anderson
Electrocardiograms (ECGs) are performed to determine an individual's cardiac rhythm. Approximately 25,000 ECGs are performed yearly throughout our hospital system. Historically only 68% of all ECGs were performed with the proper order linked to the electronic ECG reading system (MUSE). Failure to link the orders to the electronic reading system leads to problems in patient safety, reporting and hospital revenue. Our aim was to increase the percentage of linked ECG orders in MUSE compared to total ECGs performed from 68% to 95%...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28607678/choosing-wisely-a-quality-improvement-initiative-to-decrease-unnecessary-preoperative-testing
#15
John Matulis, Stephen Liu, John Mecchella, Frederick North, Alison Holmes
Dartmouth-Hitchcock Medical Center is a rural, academic medical center in the northeastern United States; its General Internal Medicine (GIM) division performs about 900 low and intermediate surgical risk preoperative evaluations annually. Routine preoperative testing in these evaluations is widely considered a low-value service. Our baseline data sample showed unnecessary testing rates of approximately 36%. A multi-disciplinary team used a micro-systems approach to analyze the existing process and formulate a rapid cycle improvement strategy...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28607676/evaluating-the-quality-improvement-impact-of-the-global-tracheostomy-collaborative-in-four-diverse-nhs-hospitals
#16
Brendan A McGrath, James Lynch, Barbarella Bonvento, Sarah Wallace, Val Poole, Ann Farrell, Cristina Diaz, Sadie Khwaja, David W Roberson
Tracheostomies are predominantly used in Head & Neck Surgery and the critically ill. The needs of these complex patients frequently cross traditional speciality working boundaries and locations and any resulting airway problems can rapidly lead to significant harm. The Global Tracheostomy Collaborative (GTC) was formed in 2012 with the aim of bringing together international expertise in tracheostomy care in order to bring about rapid adoption of best practices and to improve the quality and safety of care to this vulnerable group...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28583180/improving-hospital-at-home-for-frail-older-people-insights-from-a-quality-improvement-project-to-achieve-change-across-regional-health-and-social-care-sectors
#17
M Pearson, A Hemsley, R Blackwell, L Pegg, L Custerson
BACKGROUND: Against a background of rising numbers of frail older people, there is a need to improve quality and safety of services whilst containing costs. Improving patient outcomes requires change across hospital and community systems. Our objective was to change practice in order to deliver a Hospital at Home programme (admission avoidance and early supported discharge) for frail older people across a regional commissioning area. The programme, undertaken within the Northern, Eastern & Western Devon Clinical Commissioning Group (CCG) sub-localities of Exeter (population 120,000) and Woodbury, Exmouth and Budleigh Salterton (towns with populations of around 10,000), involved reconfiguration of existing services rather than being a stand-alone intervention...
June 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28556935/values-virtues-and-initiatives-time-for-a-conversation
#18
EDITORIAL
Brendan McCormack, Roger Watson
In the last 10 years or more there has been a proliferation of 'innovations' under the guise of improving patient safety and quality improvement. Service and quality improvements have a dominant focus on small-scale projects, incorporating locally collected 'evidence' and engaging in small 'tests of change' usually using PDSA (Plan, Do, Study, Act) cycles that get scaled up across organisations if considered to be successful. This article is protected by copyright. All rights reserved.
May 30, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28493771/introducing-a-device-to-assist-in-the-application-of-anti-embolism-stockings
#19
Nicola Thomas, Neomi Bennett
Using a device to help with the application and removal of anti-embolism stockings, often called thromboembolic deterrent stockings (TEDS), can potentially facilitate greater adherence to the use of stockings, and potentially reduce the risk of deep-vein thrombosis (DVT). This article describes a quality improvement project which used the Plan, Do, Study, Act (PDSA) cycle to facilitate the introduction of a device to aid in the application of thromboembolic deterrent stockings in an orthopaedic ward. The project findings showed that Neo-slip®, a product designed to facilitate the use of compression stockings, can be effectively introduced into an orthopaedic ward, with positive feedback from both staff and patients...
May 11, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28469911/improving-antimicrobial-prescribing-practice-for-sore-throat-symptoms-in-a-general-practice-setting
#20
Mohammad Razai, Kamal Hussain
Acute sore throat is a common presentation in primary care settings. We aimed to improve our compliance with national antibiotic guidelines for sore throat symptoms to 90% in 3 months' time period. The national guidelines are based on Centor criteria. A retrospective audit of 102 patient records with sore throat symptoms presenting between 1 January to 30 December 2015 showed that over 50% were given antibiotics. Those who were prescribed antibiotics, 27% did not meet NICE criteria and 85% of patients were given immediate antibiotic prescription...
2017: BMJ Quality Improvement Reports
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