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https://www.readbyqxmd.com/read/29169818/introduction-of-a-horizontal-and-vertical-split-flow-model-of-emergency-department-patients-as-a-response-to-overcrowding
#1
Gregory Wallingford, Nikita Joshi, Patrice Callagy, Jamie Stone, Ian Brown, Sam Shen
INTRODUCTION: ED overcrowding is an issue that is affecting every emergency department and every hospital. The inability to maintain patient flow into and out of the emergency department paralyzes the ability to provide effective and timely patient care. Many solutions have been proposed on how to mitigate the effects of ED overcrowding. Solutions involve either hospital-wide initiatives or ED-based solutions. In this article, the authors seek to describe and provide metrics for a patient flow methodology that targets ESI 3 patients in a vertical flow model...
November 20, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29135754/implementation-of-a-pediatric-behavioral-staffing-algorithm-in-an-acute-hospital-a-best-practice-implementation-project
#2
Tamara O'Connor
BACKGROUND: A progressive decline in acute psychiatric facility beds has led to a steadily increasing number of pediatric psychiatric patients hospitalized on acute care medical-surgical units. Clinical nurses in this environment feel ill-equipped to provide quality behavioral health care. AIMS/OBJECTIVES: This project aimed to improve continuity of care as well as staff and patient safety in pediatric acute and transitional care units. The specific objectives related to implementation of a resource allocation algorithm for staffing behavioral health admissions and consistent use of an interdisciplinary psychiatric huddle...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29111835/improving-outcomes-in-adults-with-diabetes-through-an-interprofessional-collaborative-practice-program
#3
Jean Nagelkerk, Margaret E Thompson, Michael Bouthillier, Amy Tompkins, Lawrence J Baer, Jeff Trytko, Andrew Booth, Adam Stevens, Kayleah Groeneveld
In 2014, the Midwest Interprofessional Practice, Education and Research Center partnered with a Federally Qualified Health Center (FQHC) to implement an interprofessional collaborative practice (IPCP) education program to improve the health of adult patients with diabetes and to improve practice efficiency. This partnership included integrating an interprofessional team of students with the practice team. Twenty-five students and 20 staff engaged in the IPCP program, which included completion of educational modules on IPCP and implementation of daily huddles, focus patient visits, phone calls, team-based case presentations, medication reconciliation, and student-led group diabetes education classes...
January 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28657916/evaluation-of-huddles-a-multisite-study
#4
Leslie Melton, Alex Lengerich, Melanie Collins, Rita McKeehan, Denise Dunn, Phyllis Griggs, Theodore Davies, Brenda Johnson, Andrew Bugajski
Regular, interdisciplinary group meetings, "huddles," may be useful in improving communication among disciplines, resolving problems, and sharing information. Daily use of huddles may contribute to the development of a highly reliable health care organization. The purpose of this study was to describe safety huddles in relation to (1) problem type, (2) timeliness of resolution, (3) attendance of representatives from each discipline, (4) amount of information sharing, and (5) attendees' satisfaction with the process...
July 2017: Health Care Manager
https://www.readbyqxmd.com/read/28387619/implementation-of-interdisciplinary-neurosurgery-morning-huddle-cost-effectiveness-and-increased-patient-satisfaction
#5
Alvin Y Chan, Sumeet Vadera
OBJECTIVE Morning discharge huddles consist of multiple members of the inpatient care team and are used to improve communication and patient care and to facilitate patient flow through the hospital. However, the effect of huddles on hospital costs and patient satisfaction has not been clearly elucidated. The authors investigated how a neurosurgeryled interdisciplinary daily morning huddle affected various costs of patient care and patient satisfaction. METHODS Huddles were conducted at 8:30 am Monday through Friday, and lasted approximately 30 minutes...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28351066/bringing-rounds-back-to-the-patient-a-one-year-evaluation-of-the-chiefs-service-model-for-inpatient-teaching
#6
Nadia L Bennett, Judd D Flesch, Peter Cronholm, James B Reilly, Jack Ende
PURPOSE: The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. METHOD: The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/27902576/implementing-huddles-improves-care-coordination-in-an-academic-health-center
#7
Carolyn S Townsend, Mary McNulty, Adria Grillo-Peck
PURPOSE OF THE STUDY: To determine whether routinely scheduled, organized interdisciplinary huddles result in decreased length of stay and readmissions. PRIMARY PRACTICE SETTING: The study was conducted in an academic health center (AHC) that also fills a community hospital need for a diverse inner-city population. Results are applicable in other care settings. METHODOLOGY AND SAMPLE: Daily interdisciplinary huddles were piloted on 5 medical/surgical units...
January 2017: Professional Case Management
https://www.readbyqxmd.com/read/27858547/teams-and-teamwork-in-cancer-care-delivery-shared-mental-models-to-improve-planning-for-discharge-and-coordination-of-follow-up-care
#8
Jenna S Page, Lynne Lederman, Jamie Kelly, Maura M Barry, Ted A James
This article discusses the potential for shared mental models to improve teamwork during discharge planning and follow-up care. A 58-year-old inpatient on the hematology care unit of an academic medical center was discharged to his community after initial treatment of acute myeloid leukemia, without a clear plan for either discharge or follow-up. This case highlights the challenges faced by the primary oncology care team, the patient's community health-care team, the patient, and his caregiver, because a formal plan for follow-up care after discharge was not in place...
November 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27791449/lean-intervention-improves-patient-discharge-times-improves-emergency-department-throughput-and-reduces-congestion
#9
Michael J Beck, Davin Okerblom, Anika Kumar, Subhankar Bandyopadhyay, Lisabeth V Scalzi
OBJECTIVE: To determine if a lean intervention improved emergency department (ED) throughput and reduced ED boarding by improving patient discharge efficiency from a tertiary care children's hospital. METHODS: The study was conducted at a tertiary care children's hospital to study the impact lean that changes made to an inpatient pediatric service line had on ED efficiency. Discharge times from the general pediatrics' service were compared to patients discharged from all other pediatric subspecialty services...
December 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27658897/systematic-identification-and-management-of-barriers-to-vascular-surgery-patient-discharge-time-of-day
#10
Gaurav Sharma, Danny Wong, Dean J Arnaoutakis, Samir K Shah, Alice O'Brien, Stanley W Ashley, C Keith Ozaki
OBJECTIVE: Length of stay fails to completely capture the clinical and economic effects of patient progression through the phases of inpatient care, such as admission, room placement, procedures, and discharge. Delayed hospital throughput has been linked to increased time spent in the emergency department and postanesthesia care unit, delayed time to treatment, increased in-hospital mortality, decreased patient satisfaction, and lost hospital revenue. We identified barriers to vascular surgery inpatient care progression and instituted defined measures to positively impact standardized metrics...
January 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/25469582/mollie-s-story-a-case-and-a-place-that-exemplify-person-centered-care
#11
Eugene C Nelson, Joel Lazar
First we present a case vignette. Mollie is a 50-year-old woman with chronic, disabling back and knee pain, who has struggled with depression and alcohol misuse, is the primary caregiver for her ailing mother and a newcomer to the community. As a primary care patient at Dartmouth Health Connect, whose mission is "bringing humanity back to health care," Mollie receives exemplary person-centered care from her physician, health coach and behavioral health specialist. Second, we summarize the care model design features that enable care for people with challenging health and social circumstances...
January 2015: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/24968571/ct-hospital-slashes-door-to-balloon-times-to-reduce-patient-harm
#12
(no author information available yet)
A dramatic improvement in door-to-balloon times for STEMI patients is one example of how John Dempsey Hospital at the University of Connecticut Health Center in Farmington, CT, is using checklists and other tools for standardization to improve safety and care. The hospital is part of a three-year statewide initiative of the Connecticut Hospital Association to adopt high-reliability practices and eliminate errors that cause patient harm. The approach is enabling hospitals to learn from each other and share best practices that facilitate improvement...
July 2014: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/24864522/as-good-as-it-gets-managing-risks-of-cardiovascular-disease-in-california-s-top-performing-physician-organizations
#13
Hector P Rodriguez, Susan L Ivey, Brian J Raffetto, Jennifer Vaughn, Margae Knox, Hattie Rees Hanley, Carol M Mangione, Stephen M Shortell
BACKGROUND: The California Right Care Initiative (RCI) accelerates the adoption of evidence-based guidelines and improved care management practices for conditions for which the gap between science and practice is significant, resulting in preventable disability and death. METHODS: Medical directors and quality improvement leaders from 11 of the 12 physician organizations that met the 2010 national 90th percentile performance benchmarks for control of hyperlipidemia and glycated hemoglobin in 2011 were interviewed in 2012...
April 2014: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/24783385/multiple-or-multidisciplinary-team-huddles-promote-ownership-of-process-improvements
#14
Cynthia Saver
No abstract text is available yet for this article.
April 2014: OR Manager
https://www.readbyqxmd.com/read/24325038/using-huddles-to-enhance-patient-experience-organizational-huddles-improve-teamwork-and-patient-care
#15
Robert L Cooper, James Y Lee
No abstract text is available yet for this article.
November 2013: Healthcare Executive
https://www.readbyqxmd.com/read/24261433/practice-improvement-part-ii-collaborative-practice-and-team-based-care
#16
REVIEW
Michelle A Roett, Mary Thoesen Coleman
The Institute of Medicine recommends interprofessional teams to address patients' complex needs. Team care should be structured in a way that uses the highest training levels of its members. Team communication is enhanced through regular meetings (eg, team huddles), and office efficiency is improved through identifying and solving underlying system-level issues (ie, second-order problem solving). Inclusive leadership principles are used to strengthen team practices and meet chronic care model goals. Setting clear goals with measurable outcomes, creating clinical and administrative systems, establishing a clear division of labor among team members who have occupational diversity, and providing ongoing training all facilitate team building...
November 2013: FP Essentials
https://www.readbyqxmd.com/read/24062473/a-qualitative-study-examining-the-influences-on-situation-awareness-and-the-identification-mitigation-and-escalation-of-recognised-patient-risk
#17
Patrick W Brady, Linda M Goldenhar
BACKGROUND: Situation awareness (SA)-the perception of data elements, comprehension of their meaning and projection of their status in the near future-has been associated with human performance in high-risk environments, including aviation and the operating room. The influences on SA in inpatient medicine are unknown. METHODS: We conducted seven focus groups with nurses, respiratory therapists and resident physicians using a standardised semistructured focus group guide to promote discussion...
February 2014: BMJ Quality & Safety
https://www.readbyqxmd.com/read/24048607/improvement-of-medication-event-interventions-through-use-of-an-electronic-database
#18
Jenna Merandi, Shelly Morvay, Dorcas Lewe, Barb Stewart, Char Catt, Phillip P Chanthasene, Richard McClead, Karl Kappeler, Jay M Mirtallo
PURPOSE: Patient safety enhancements achieved through the use of an electronic Web-based system for responding to adverse drug events (ADEs) are described. SUMMARY: A two-phase initiative was carried out at an academic pediatric hospital to improve processes related to "medication event huddles" (interdisciplinary meetings focused on ADE interventions). Phase 1 of the initiative entailed a review of huddles and interventions over a 16-month baseline period during which multiple databases were used to manage the huddle process and staff interventions were assigned via manually generated e-mail reminders...
October 1, 2013: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/23744537/huddling-for-high-reliability-and-situation-awareness
#19
Linda M Goldenhar, Patrick W Brady, Kathleen M Sutcliffe, Stephen E Muething
BACKGROUND: Studies show that implementing huddles in healthcare can improve a variety of outcomes. Yet little is known about the mechanisms through which huddles exert their effects. To help remedy this gap, our study objectives were to explore hospital administrator and frontline staff perspectives on the benefits and challenges of implementing a tiered huddle system; and propose a model based on our findings depicting the mediating pathways through which implementing a huddle system may reduce patient harm...
November 2013: BMJ Quality & Safety
https://www.readbyqxmd.com/read/23274389/tumor-boards-team-huddles-aren-t-enough-to-reach-the-goal
#20
EDITORIAL
Douglas W Blayney
No abstract text is available yet for this article.
January 16, 2013: Journal of the National Cancer Institute
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