Medicine and Health Sciences Commons^™

Development And Testing Of The Stakeholder Quality Improvement Perspectives Survey (Squips), Eric Fris, Emily Sedlock, Jason Etchegaray, Madelene J Ottosen, Ronald Pucio, Tejal Mistry, Tamara Saunders, Andrada Tomoaia-Cotisel, Eric J Thomas

Journal Articles

BACKGROUND: To create a theory-informed survey that quality improvement (QI) teams can use to understand stakeholder perceptions of an intervention.

METHOD: We created the survey then performed a cross-sectional survey of QI stakeholders of three QI projects. The projects sought to: (1) reduce unplanned extubations in a neonatal intensive care unit; (2) maintain normothermia during colorectal surgery and (3) reduce specimen processing errors for ambulatory gastroenterology procedures. We report frequencies of responses to survey items, results of exploratory factor analysis, and how QI team leaders used the results.

RESULTS: Overall we received surveys from 319 out of 386 eligible stakeholders …

On The Road To Accreditation For Ambulatory Health Care- A College Health Center Quality Assurance And Improvement Program, Kathleen Hynes-Lifland

Seton Hall University Dissertations and Theses (ETDs)

The time has come for figureheads in higher education to address and strengthen Quality Assurance (QA) and Quality Improvement (QI) in college health. Goals and objectives should be designed to pursue better care and health. Quality Assurance (QA) strives to guarantee that health care providers are adhering to their policies, procedures, and protocols. Compliance may be monitored by intermittent audits, peer review activities, and inspections. QA answers the question, “are we meeting the standards?” This project attempted to provide these standards through the development of a QA/QI policy and procedure which reflects ideologies set forth by the Accreditation Association for …

The Advantages Of A Rural Resident Rotation In Otolaryngology Training: Comparing Surgical Case Volumes Of A Rural Rotation With A University Rotation, Mark Miller, Paul J. Brosnihan, Christie Barnes, Jayme Dowdall

Graduate Medical Education Research Journal

Objective: Rural residency rotations have played a significant role in encouraging surgical residents to pursue a career in a rural community. This study reviews the resident caseload of an otolaryngology residency rural rotation in comparison with a traditional primary university-based urban location.

Methods: The Accreditation Council for Graduate Medical Education (ACGME) case log system was used to review cases logged by residents during their rural rotations from July 2017 to December 2018. Case log data were compared with a matched resident of similar training experience on the university service during the same time period.

Results: Rural residents reported more cases …

Outpatient Prescription Practices In Patients With Atrial Fibrillation (From The Ncdr Pinnacle Registry), Jonathan C Hsu, Matthew R Reynolds, Yang Song, Gheorghe Doros, Steven A Lubitz, Anil K Gehi, Mintu P Turakhia, Thomas M Maddox

2020-Current year OA Pubs

This study sought to evaluate inappropriate prescribing practices in an atrial fibrillation (AF) population, as outlined by the 2016 ACC/AHA Clinical Performance and Quality Measures for Adults with Atrial Fibrillation or Atrial Flutter document. The 2016 AF quality measures document specified medications to avoid in certain AF populations, including aspirin and anticoagulant combination therapy in patients without cardiovascular disease, and non-dihydropyridine calcium channel blockers in patients with reduced ejection fraction. Using data from the NCDR PINNACLE registry, a national outpatient cardiology practice registry, we assessed rates of inappropriate prescription of two types of medications among AF outpatients from 5/1/2008-5/1/2016. Overall …

Investigating Adherence To Screening Guidelines For Cardiometabolic Disease In Persons With Spinal Cord Injury At The Parkwood Institute Outpatient Clinic, Luxshmi Nageswaran

Undergraduate Student Research Internships Conference

Persons with spinal cord injury (SCI) are at an increased risk of developing cardiometabolic disease (CMD) and related complications. To address this, the Paralyzed Veterans of America released a set of clinical practice guidelines with screening recommendations for CMD risk factors such as dyslipidemia, hypertension, obesity, and diabetes.

Clinical data indicated that 25 patients out of a total of 48 (52%) are at an increased risk of developing cardiometabolic disease, as defined as having three or more risk factors present. In addition, a review of 30 intake forms from the Parkwood Institute Outpatient Clinic showed that hypertension and weight screenings …

The “Ok” Guideline: Implementing An Electronic Electrolyte Repletion Guideline For Improving Rates Of Oral Potassium And Magnesium Delivery, Joshua M. Riley, Jeffrey M. Riggio, Md, Alan A. Kubey, Md

Health Equity and Quality Improvement (HEQI) Summit

Nearly 500,000 doses of potassium (K) and magnesium (Mg) are given at Thomas Jefferson University Hospital (TJUH) each year. More than 80% of these doses are given intravenously.

Guidelines that encourage both intravenous and oral (PO) repletion options increase rates of PO dosing and more successfully attain goal levels than standard care.

Our goal was to increase the percent of K and Mg doses delivered by oral route to >50% of total doses distributed at TJUH within one year of implementation of an Epic-based electronic order set.

Improving Patient Experience And Staff Workflow During Ed To Inpatient Interfacility Transfers, Jonathan Nakagawa

Master's Projects and Capstones

ED overcrowding has been an issue for Facility X pre-COVID19 and has been exacerbated following the first shelter in place mandate around March 2020. Facility X had proposed to increase the amount of interfacility transfers (IFT) to mitigate overcrowding and, hopefully, improve patient outcomes. 2020 Census data had shown that patient satisfaction scores and Nurse Daily Engagement scores were down; leading Facility X to believe that there can be improvements made to the IFT workflow and communication. Patient interviews also revealed that not all patients were satisfied with how they were treated during the IFT process. This quality improvement project …

Dnp Final Report: Reducing The Rate Of Falls With A Stuctured Fall Program, Elanda L. Douglas

DNP Final Reports

Background: Fall rates continue to be a significant problem in health care facilities despite all the research and tool kits created to prevent falls. Hospitals that have successfully reduced fall rates find it challenging to sustain a reduction in the fall rates. During hospitalizations, 3%-20% of patients fall, with 30%-50% resulting in injury (Joint Commission, [JC], 2015).

Internal Evidence: Despite Medical City Alliance (MCA) having an evidence-based fall program, the fall rate has not decreased. Falls are one of the quality measures identified at the division level that needs improvement.

PICOT: In adult patients in a progressive care unit (P), …

The Impact Of Artificial Intelligence On Dental Care Delivery: A Comprehensive Review, Robert A. Faiella D.M.D., M.M.Sc., M.B.A., Shaju Puthussery M.S.

The Journal of the Michigan Dental Association

This comprehensive review explores the transformative role of Artificial Intelligence (AI) in the evolution of dental care delivery. As oral health specialists, dentists continually seek to enhance their ability to prevent, diagnose, and manage oral diseases while maintaining and improving patient oral health. The integration of AI offers unprecedented opportunities to revolutionize dental practice and patient care.

AI is rapidly advancing in healthcare, including dental care, with a projected global healthcare AI market value of $45.2 billion by 2026. This technology can potentially revolutionize prevention, diagnosis, treatment planning, and treatment outcomes.

Aspects of AI in dentistry include:

· Diagnostic Accuracy …

Improving Handover Process For Stroke Patients Transferring From Emergency Department To Interventional Radiology: A Quality Improvement Project, Megan Buchman

Doctoral Projects

Background: A standardized handover process is needed for stroke patients transferring from the Emergency Department to Interventional Radiology.

Local Problem: Emergency Department and Interventional Radiology had different handover processes.

Methods: A quality improvement project was conducted in a large Magnet® designated midwestern health system. Participants included emergency department and interventional radiology nurses and stroke patients. Pre/post-quality and post implementation measures were obtained.

Interventions: The interventions included utilizing a standardized handover tool between departments, calling report prior to patient transfer, and turning in handover tool following stroke case to ensure compliance. Two cycles of the Plan-Do-Study-Act Cycle were completed.

Results: No …

Patient Satisfaction With Noise, Robert W. Kentner Ii

Student Scholarly Projects

Practice Problem: Noise on hospital units can interfere with patient rest, timely recovery, and statisfacton with care. Improvements in the reduction of hospital noise levels lead to improved patient satisfaction and improved rest. Patients were surveyed on their satisfaction with noise during the day and at night.

PICOT: In Acute Care Patients (P), does the implementation of a noise reduction program (I) compared to no noise reduction program (C), affect patient satisfaction with noise (O) over a six-week period (T)?

Evidence: Studies show that many hospitals have noise levels that exceed the World Health Organization’s recommended standards for noise …

Assessing Sentiment Towards Opioid Use Disorder At Jefferson: Characterizing Non-Clinical Emergency Department Staff, Joseph Arciprete, Benjamin Finard, Madalene Zale, Mph, Benjamin Slovis, Md, Hannah Smith

Phase 1

Purpose: To characterize emergency department (ED) staff regard toward opioid use disorder (OUD) and analyze variation based on job category. The closure of Hahnemann Hospital, in combination with the increasing prevalence of OUD, is exacerbating the previously inadequate network of resources for these patients. Jefferson is strategically positioned to improve the care provided to this patient population, especially in an ED setting, and ultimately increase linkage to long-term recovery programs.

Methods: Sentiment toward this patient population was measured utilizing the Medical Condition Regard Survey (MCRS). This questionnaire was previously validated to subjectively, but quantitatively, assess regard toward a defined patient …

Improving The Care Of Patients With Cirrhosis At Mmc, Lesley B. Gordon, Elizabeth Herrle, Matt Buttarazzi, Monica Thim, Jenna S. Ptaschinski, Victoria Molina, Natalie Channell

Costas T. Lambrew Research Retreat 2021

Purpose: Improve the rate and timeliness of paracenteses for patients with decompensated cirrhosis.

Naloxone Co-Prescribing Across A Large Health System: A Quality Improvement Project, Marc D. Kimball, Sarah Hemphill, Kristen Silvia

Costas T. Lambrew Research Retreat 2021

Introduction:

• Naloxone availability and administration saves lives

• The CDC recommends naloxone co-prescribing for patients with OUD and other eligibility criteria

• Maine Medical Center’s baseline was found to be 6% in one clinic. This held true across the entire MaineHealth system.

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff’s confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …

Leadership, Quality Improvement, Team Functionality, And Hiv Viral Load Suppression In Uganda, Esther Karungi Karamagi Nkolo

Walden Dissertations and Doctoral Studies

Low viral load suppression rate is a significant public health issue in Uganda and similar countries. A nationwide quality improvement (QI) initiative was implemented from January 2019 to improve viral load suppression. Although QI team characteristics have been shown to influence the success of such QI initiatives, no studies have been found to understand how they influence the success of QI efforts to improve HIV viral load suppression in Uganda. The purpose of this cross-sectional, quantitative study was to determine whether there is a significant association between HIV clinic leader involvement in QI teams, QI team functionality, QI team diversity, …

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff's confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …

Improving Multidisciplinary Adherence To A Daily Goals Checklist In The Icu: A Quality Improvement Initiative, Chelsea Mccarty

DNP Projects

Abstract

Background: In November 2019, the University of Louisville Hospital merged and assumed operations of all KentuckyOne facilities. During the transition, a spike in hospital acquired infection rates ensued at Jewish Hospital, notably amongst the critical care units. In January 2020, a daily checklist was introduced to the critical care department. A Daily Checklist is a tailored communication tool designed to reduce communication error and improve adherence to patient safety measures. There continues to be a gap in adherence to the U of L daily checklist from both nurses and providers. Purpose: The purpose of this project was to improve …