Medicine and Health Sciences Commons^™

Assessment Of Quality Improvement In Ontario Public Health Units, Madelyn P. Law, J. Ross Graham, Erica Bridge

Frontiers in Public Health Services and Systems Research

Background: Quality Improvement (QI) approaches are used extensively in healthcare settings and increasingly in public health. However, the proliferation of QI in Canadian public health settings is unknown.

Purpose: The purpose of this study was to (a) assess the QI maturity in Ontario local public health units in Canada, and (b) to determine the relevance of the QI Maturity Tool in a Canadian setting

Methods: The QI Maturity Tool (Version 5) was used to conduct a cross-sectional assessment of the QI maturity of 36 local public health units in Ontario, Canada. After tool items were reviewed for relevance, individuals most …

Applying Failure Modes And Effects Analysis To Public Health Models: The Breathe Easy At Home Program, Johnna S. Murphy, Margaret Reid, Amanda Ali, Laura Harrington, Megan Sandel

Frontiers in Public Health Services and Systems Research

Failure Modes and Effects Analysis (FMEA) is a structured process used to identify and prioritize risks by ranking them based on severity, occurrence, and detectability. Historically, FMEA has been used within industries, including automotive and health care. This project explored the adaption of the FMEA template to a small public health program designed to improve asthma outcomes. The Breathe Easy at Home (BEAH) program is a multi-sector partnership that uses a web-based system to link clinical sites with housing code inspections and enforcement for patients with asthma.

In July and August 2014, an FMEA was conducted to uncover risks within …

Implementing Shared Decision-Making: Consider All The Consequences, Glyn Elwyn, Dominick L. Frosch, Sarah Kobrin

Dartmouth Scholarship

The ethical argument that shared decision-making is “the right” thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The …

Measuring Patient Experience In A Safety Net Setting: Lessons Learned, Nina Shabbat, Katy Dobbins, Sonja Seglin, Kristin Davis

Patient Experience Journal

Safety net providers have faced barriers in administering patient experience surveys due to a lack of resources and survey expertise, but this problem has received little attention in the literature. In this manuscript, we offer lessons learned from the administration of a patient experience survey at a mid-size behavioral health care agency serving a safety net population. Specifically, we discuss resource needs, methods of increasing response rate among transient populations, methods for engaging stakeholders and clinical staff in quality improvement initiatives, and considerations for responding to setbacks and challenges dynamically. We also offer insight on the effective dissemination of results …

Reframing The Work On Patient Experience Improvement, Jocelyn Cornwell

Patient Experience Journal

In reframing the work on patient experience improvement Dr. Jocelyn Cornwell, chief executive of The Point of Care Foundation, challenges us to broaden our view on what is necessary to impact patient experience efforts. From a defined need to reduce avoidable suffering associated with health care delivery dysfunction, she suggests we extend the discussion in two ways: First, to include a concern for staff engagement, experience and well-being, and second, to position patient experience improvement as one type of quality improvement (QI) in healthcare, and urge practitioners to pay more attention to the lessons from QI in other domains. High …

The Gas Cylinder, The Motorcycle And The Village Health Team Member: A Proof-Of-Concept Study For The Use Of The Microsystems Quality Improvement Approach To Strengthen The Routine Immunization System In Uganda, Dorothy A. Bazos, Lea R. Ayers Lafave, Gautham Suresh, Kevin C. Shannon, Fred Nuwaha, Mark E. Splaine

Dartmouth Scholarship

Although global efforts to support routine immunization (RI) system strengthening have resulted in higher immunization rates, the World Health Organization (WHO) estimates that the proportion of children receiving recommended DPT3 vaccines has stagnated at 80% for the past 3 years (WHO Fact sheet-Immunization coverage 2014, WHO, 2014). Meeting the WHO goal of 90% national DPT3 coverage may require locally based strategies to support conventional approaches. The Africa Routine Immunization Systems Essentials-System Innovation (ARISE-SI) initiative is a proof-of-concept study to assess the application of the Microsystems Quality Improvement Approach for generating local solutions to strengthen RI systems and reach those unreached …

Evidence-Based Hospitals, David R. Bardach

Theses and Dissertations--Epidemiology and Biostatistics

In 2011 the University of Kentucky opened the first two inpatient floors of its new hospital. With an estimated cost of over $872 million, the new facility represents a major investment in the future of healthcare in Kentucky. This facility is outfitted with many features that were not present in the old hospital, with the expectation that they would improve the quality and efficiency of patient care. After one year of occupancy, hospital administration questioned the effectiveness of some features. Through focus groups of key stakeholders, surveys of frontline staff, and direct observational data, this dissertation evaluates the effectiveness of …