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https://www.readbyqxmd.com/read/28067569/optimizing-postoperative-handover-to-the-intensive-care-unit-at-a-tertiary-centre
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/27933155/a-quality-improvement-initiative-on-the-management-of-osteoporosis-in-older-people-with-parkinsonism
#5
Inderpal Singh, Rachel Fletcher, Linda Scanlon, Mandy Tyler, Shridhar Aithal
The risk of falls is higher in patients with people with Parkinsonism (PwP) compared to those without Parkinsonism, and leads to adverse outcomes including fragility fractures. Osteoporosis is under-recognised, and the prevalence of fragility fractures in not well studied. The primary aim of this project is for 100% of new patient referrals to, and 80% of follow up patients within the movement disorder (MD) service with osteoporosis to be treated in accordance with evidence based osteoporosis guidance. Routinely captured information regarding demographics and fragility fractures was retrospectively extracted from the clinical workstation, clinic letters, and clinical coding between July and November 2015...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933153/improving-pneumococcal-vaccination-rates-of-medical-inpatients-in-urban-nepal-using-quality-improvement-measures
#6
Allison Bock, Kathan Chintamaneni, Lisa Rein, Tifany Frazer, Gyan Kayastha, Theodore MacKinney
Streptococcus pneumoniae infection is associated with high morbidity and mortality in low income countries. In Nepal, there is a high lung disease burden and incidence of pneumonia due to multiple factors including indoor air pollution, dust exposure, recurrent infections, and cigarette smoking. Despite the ready availability of effective pneumococcal vaccines (PNV), vaccine coverage rates remain suboptimal globally. Quality Improvement (QI) principles could be applied to improve compliance, but it is a virtually new technology in Nepal...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933149/venous-thromboembolism-capture-on-electronic-systems-in-obstetrics-patients-at-st-thomas-hospital
#7
Aminah Noor Ahmad, Megan Leyla Byrne, Nazia Imambaccus, Dawid Hubert, Anna Gateley, Salwa Abdullahi Idle, Jilly Lloyd
Venous thromboembolism (VTE) is one of the leading causes of maternal mortality in the UK. Therefore, timely VTE risk assessment is essential in all obstetrics patients. The Commissioning for Quality and Innovation (CQUIN) payment framework set a target for trusts to complete a VTE risk assessment within 24 hours of admission for 95% of patients. A combination of factors, including lack of integration between multiple IT systems, means that this CQUIN target is currently not being met for obstetric patients in the Hospital Birth Centre at Guys and St Thomas' NHS Trust...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933148/role-of-peer-support-workers-in-improving-patient-experience-in-tower-hamlets-specialist-addiction-unit
#8
Wiktor Kulik, Amar Shah
The aim of the project was to improve patient experience for people in Tower Hamlets Specialist Addictions Unit in order to increase satisfaction by 25% in 12 months starting in August 2014. The team used the model for improvement as part of ELFT's quality improvement programme to support iterative cycles of testing and learning. This involved support from the Trust's quality improvement team. The theory of change was visualised through a driver diagram. A number of outcomes were measured and plotted over time - patient satisfaction, staff satisfaction, and attendance to peer support groups...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933147/large-scale-implementation-of-a-medicines-reconciliation-care-bundle-in-nhs-ggc-gp-practices
#9
Rachel Bruce
Medicines reconciliation (MR) is an essential process for patient safety, promoting safer use of medicines with effective communication at the interface, particularly when patients are admitted and discharged from hospital. Much of the work on MR has been focussed in secondary care, however, the principles are equally important in primary care. The aim of the work was to test the Scottish Patient Safety in Primary Care (SPSP-PC) MR care bundle and consider scale up and spread across all NHS Greater Glasgow and Clyde (NHS GGC) GP practices...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933145/ensuring-timely-thromboprophylaxis-on-a-medical-assessment-unit
#10
Oluwatosin Akinbobuyi, Louise Shalders, Tim Nokes
The Department of Health has defined hospital acquired venous thromboembolism (VTE) as any VTE event occurring within 90 days of hospital admission or surgery. (1) Hospital acquired thrombosis (HAT) is common during and after hospital admission and is considered a major patient safety issue. Current NICE guideline (CG 92) 2010, recommends that medical patients assessed at risk of VTE should have pharmacological prophylaxis commenced as soon as possible after risk assessment has been completed and continued until the patient is no longer at increased risk of VTE...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27899538/reducing-unplanned-extubations-in-the-nicu-using-lean-methodology
#11
EDITORIAL
Bonnie M Powell, Edeltraud Gilbert, Teresa A Volsko
BACKGROUND: Unplanned extubations can lead to iatrogenic injury and have the potential to contribute to serious safety events. We adopted lean methodology to reduce the unplanned extubation rate in a Level 3b NICU. We hypothesized that the use of a rapid-cycle PDSA (plan, do, study, act) initiative would reduce the unplanned extubation rate. METHODS: Baseline unplanned extubation data were collected from November 1, 2012 to June 6, 2014. A voice of the customer survey ascertained perceptions regarding unplanned extubation causes and impact on care...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27822372/improving-the-management-of-iron-deficiency-in-ambulatory-heart-failure-patients
#12
Carl Hayward, Hitesh Patel, Chris Allen, Ali Vazir
Based on clinical trial data patients with heart failure (HF) and evidence of iron deficiency should be offered intravenous (iv) iron with the aim of improving exercise capacity and symptoms. Baseline measurement in outpatient HF clinics demonstrated that only 50% of patients who may be eligible for iv iron were investigated with iron studies. Our aim was to make sure that 90% of the patients attending our heart failure clinics who were symptomatic and had an ejection fraction (EF) ≤45% should have their iron studies checked within the last six months...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27752316/developing-quality-improvement-capacity-and-capability-across-the-children-in-fife-partnership
#13
Craig Morris, Ingrid Alexander
A Project Manager from the Fife Early Years Collaborative facilitated a large-scale Quality Improvement (herein QI) project to build organisational capacity and capability across the Children in Fife partnership through three separate, eight month training cohorts. This 18 month QI project enabled 32 practitioners to increase their skills, knowledge, and experiences in a variety of QI tools including the Model for Improvement which then supported the delivery of high quality improvement projects and improved outcomes for children and families...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27752313/understanding-and-overcoming-barriers-to-timely-discharge-from-the-pediatric-units
#14
Amira Mustafa, Samar Mahgoub
Delays in the discharge of hospital patients cause a backlog for new admissions from the Emergency Departments (ED), outpatient clinics, and transfers from the Intensive Care Units (ICU). A variety of initiatives have been reported on previously which aim to tackle this problem with variable success. In this quality improvement project, we aimed to increase the proportion of discharged patients who leave the paediatric unit by 12:00 Noon from 7% to 30% by May 2015. A baseline discharge process map was studied to understand the possible causes of the delays...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27752312/improving-emergency-department-flow-through-optimized-bed-utilization
#15
Lucas Brien Chartier, Licinia Simoes, Meredith Kuipers, Barb McGovern
Over the last decade, patient volumes in the emergency department (ED) have grown disproportionately compared to the increase in staffing and resources at the Toronto Western Hospital, an academic tertiary care centre in Toronto, Canada. The resultant congestion has spilled over to the ED waiting room, where medically undifferentiated and potentially unstable patients must wait until a bed becomes available. The aim of this quality improvement project was to decrease the 90th percentile of wait time between triage and bed assignment (time-to-bed) by half, from 120 to 60 minutes, for our highest acuity patients...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27752311/reducing-the-occurrence-of-errors-in-a-laboratory-s-specimen-receiving-and-processing-department
#16
Nouf Al Saleem, Khaled Al-Surimi
Frequent, preventable medical errors can have an adverse effect on patient safety and quality as well as leading to wasted resources. In the laboratory, errors can occur at any stage of sample processing; pre-analytical, analytical, and post analytical stages. However evidence shows most of the laboratory errors occur during the pre-analytical stage. The receipt and processing of specimens is one of the main steps in the pre-analytical stage. Errors in this stage could be due to mislabeling, incorrect test entry and entering the wrong location, among other reasons...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27686183/reducing-transfers-of-psychiatric-inpatients-to-emergency-rooms-of-general-hospitals-in-singapore-a-clinical-practice-improvement-project
#17
Tchern Kuang Lambert Low, Kai Hong Tay, Tina Fang, Daniel Shuen Sheng Fung
OBJECTIVE: Patients admitted to a psychiatric hospital commonly suffer from comorbid medical problems which sometimes require urgent medical attention. Twenty-two percent of emergency medical transfers from the Institute of Mental Health (IMH) to the emergency rooms of general hospitals were preventable and could be managed at IMH itself. We undertook a quality improvement project to understand the reasons behind such preventable referrals and implemented changes to address this. METHODS: Using the model for improvement, we deconstructed our processes and analysed root causes for such preventable referrals...
September 30, 2016: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/27669405/aberrant-adhesion-impacts-early-development-in-a-dictyostelium-model-for-juvenile-neuronal-ceroid-lipofuscinosis
#18
Robert J Huber, Michael A Myre, Susan L Cotman
Neuronal ceroid lipofuscinosis (NCL), also known as Batten disease, refers to a group of severe neurodegenerative disorders that primarily affect children. The most common subtype of the disease is caused by loss-of-function mutations in CLN3, which is conserved across model species from yeast to human. The precise function of the CLN3 protein is not known, which has made targeted therapy development challenging. In the social amoeba Dictyostelium discoideum, loss of Cln3 causes aberrant mid-to-late stage multicellular development...
September 26, 2016: Cell Adhesion & Migration
https://www.readbyqxmd.com/read/27593194/-pdsa-but-not-as-you-know-it
#19
EDITORIAL
A H A Dugdale
No abstract text is available yet for this article.
September 2016: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/27559471/improving-clinical-remission-rates-in-pediatric-inflammatory-bowel-disease-with-previsit-planning
#20
Jeffrey R Savarino, Jess L Kaplan, Harland S Winter, Christopher J Moran, Esther J Israel
Inflammatory Bowel Disease (IBD) is a chronic autoimmune inflammatory disease of the intestine which can lead to malnutrition, poor quality of life, and colon cancer.(1-4) Although there is no cure for the disease, clinical remission is the primary goal.(5) The Center for Inflammatory Bowel Disease at MassGeneral Hospital for Children (MGHfC) adopted a Previsit Planning (PVP) model to identify and discuss symptomatic patients prior to their appointments to identify specific issues that impact disease management...
2016: BMJ Quality Improvement Reports
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