Health and Medical Administration Commons^™

Implementation Of Home Blood Pressure Monitoring, Sarah Gutzke

Dissertations

Approximately 48.1% of adults in the United States have high blood pressure. Providers may encourage patients to monitor and log their blood pressure at home. Still, patients often fail to bring this information to appointments, leading to reliance on less comprehensive in-office measurements. This quality improvement project aimed to increase adherence to home blood pressure logs using a Blood Pressure Toolkit. A descriptive, observational design was utilized to record patient adherence of taking home blood pressure measurements and increase the number of patients who brought their blood pressure logs to their healthcare provider visits over two months. A convenience sample …

Early Identification Of Hospitalized Patients Lacking Prescription Drug Insurance, Nicholas Macdonald, Md, Matthew Tucker, Md, Phoebe Chun, Md, Liam Heneghan, Md, Sawyer Kieffer, Md, Megana Murugesh, Md, Yair Lev, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

According to 2021 data from the US Department of Health and Human Services, 16% of persons in the United States under the age of 65 do not have prescription drug insurance.1Unsurprisingly, prior investigations have shown that the presence of prescription drug insurance is associated with reduced probability of hospital admission and length of stay for many common medical conditions.2A large majority of hospitalized patients are started on at least one new medication at the time of hospital discharge. Increasing the proportion of individuals with prescription drug insurance would have a substantial benefit on our population's health.

One care gap …

Evaluating Nurses’ Turnover Intention And Organizational Commitment Following Stroke Unit Staffing Changes: An Evidence-Based Quality Initiative, Heather Tatusko

Doctor of Nursing Practice Scholarly Projects

Nurses are known to be overworked, overwhelmed, undervalued, and understaffed at dangerous levels throughout various inpatient hospital units across the United States (U.S.). Hospital registered nurse (RN) turnover is a significant issue that has accelerated since the COVID-19 pandemic, resulting in economic impacts and other burdens for organizations, individuals, and communities. Evidence suggests that evaluating Registered Nurses’ Turnover intention (NTI) and Organizational Commitment (OC) can help maintain a ready and capable team of skilled RNs; however, most healthcare organizations (HCOs) do not collect or analyze NTI and OC data and focus on staffing numbers and monetary incentives to get adequate …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Quality Improvement In Healthcare: A Practical Guide For Providers (Part 3), Jeremy Ellis

Transformative Medicine

No abstract provided.

Quality Improvement Protocol: Improving The Use Of Nonpharmacological Pain Management Strategies Within The Inpatient Hospital Setting, Katherine Salamon, Christina Russell, Dara Devinney, Catherine M Soprano

Department of Medicine Faculty Papers

Background: There are many nonpharmacological pain management services available to hospitalized youth; however, not all youth are offered these services. Lack of knowledge about resources, difficulty with the referral process, and lack of understanding about nonpharmacological pain management services and when to refer patients are among the main reasons for lack of utilization. Quality improvement (QI) initiatives have grown within hospital settings and can serve to create change in fast-paced environments. Methods: The current QI project aimed to pilot an educational program to increase the use of nonpharmacological pain management interventions. Staff located on one floor of a pediatric hospital …

Quality Improvement In Public-Private Partnerships In Low- And Middle-Income Countries: A Systematic Review, Cassandra Iroz, Rohit Ramaswamy, Zulfiqar Bhutta, Paul Barach

College of Population Health Faculty Papers

BACKGROUND: Public-private partnerships (PPP) are often how health improvement programs are implemented in low-and-middle-income countries (LMICs). We therefore aimed to systematically review the literature about the aim and impacts of quality improvement (QI) approaches in PPP in LMICs.

METHODS: We searched SCOPUS and grey literature for studies published before March 2022. One reviewer screened abstracts and full-text studies for inclusion. The study characteristics, setting, design, outcomes, and lessons learned were abstracted using a standard tool and reviewed in detail by a second author.

RESULTS: We identified 9,457 citations, of which 144 met the inclusion criteria and underwent full-text abstraction. We …

Timely Delivery Of Port For Head And Neck Squamous Cell Carcinoma In A County Hospital, Ana Maria Rosas Herrera, Angela D Haskins, Alexander N Hanania, Pavan M Jhaveri, Christina H Chapman, Quillan Huang, David J Hernandez

Faculty, Staff and Students Publications

OBJECTIVES: The objective of this study was to compare the rate of post-operative radiation therapy (PORT) initiation within 6 weeks for head and neck squamous cell carcinoma patients treated at a safety net, academic institutio between 2019 and 2021 versus those treated in 2022 after implementation of a new clinical pathway.

METHODS: A retrospective case-control study was performed at a single tertiary care, safety-net, academic institution. Patient demographics, tumor characteristics, dates of surgery, and other treatment dates were collected from the electronic medical record. The time from surgery to PORT was calculated. Patients who started radiation treatment within 42 days …

Results Of A Needs Assessment: Use Of Sexual Orientation And Gender Identity Data In Health Systems In Maine, Lucy Soule, Melissa Fairfield, Sivana Barron, Natalie Kuhn, Brandy Brown

Journal of Maine Medical Center

Introduction: Lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) patients experience significantly more health care disparities than non-LGBTQ+ patients. Although sexual orientation and gender identity data (SOGI) would help quantify and track these known disparities, there are no standardized methods for routinely and consistently including SOGI into health care management in Maine. Our needs assessment (1) evaluates the comfort of health care professionals (HCPs) in collecting SOGI and incorporating it into the medical record and (2) identifies barriers to SOGI collection.

Methods: An interprofessional team conducted a survey of Maine HCPs who identified as working directly with patients or patient …

Quality Improvement: A1c Control And Phq-9 Scores In Adults With Diabetes Type 2, Kenoviah Heron, Julia Fashner

East Florida Division GME Research Day 2024

No abstract provided.

Increased Confidence And Knowledge Of Long-Acting Injectable Antipsychotics In Nursing, Improving The Timeliness To Intervention, Barbara Gracious, Marc Macaluso, Haryashpal Bhullar

South Atlantic Division GME Research Day 2024

No abstract provided.

Improving Depression Screening In Primary Care By Implementing A Systematic Annual Screening Protocol: A Quality Improvement Initiative, Trang Nguyen, Ian Whitaker, Danny Tran, Aidan Lum Kong, Nan Crossley

South Atlantic Division GME Research Day 2024

No abstract provided.

Early Implementation Of Chf Orders And Physician Education​, Qazi Haider, Tapannita Padhi, Hunter Thornberg, Barry Brown, Alexandra Villacres, Justin Roy P. Sanchez, Ashley Henderson

North Texas GME Research Forum 2024

Each year, 700,000 patients are hospitalized with acute decompensated congestive heart failure. In order to effectively treat these patients, they require delicate management of volume status. Measuring volume status incorporates the following components: recording strict inputs and outputs of urine/fluids, recording daily standing weights and fluid restriction. This project focused on recording daily weights as a measure of accurate volume status and how that affected length of hospital stay. Data will be gathered by patient chart review including patient's admitted from Jan 2023 -Jan 2024 at Medical City Weatherford admitted with a primary/admitting diagnosis of congestive heart failure. Using PDSA …

Increasing Online Reviews And New Patients In Clinic With Qr Codes, Tristan Fun, Danielle Ford

North Texas GME Research Forum 2024

Introduction: Patient census at the Medical City Internal Medicine Grand Prairie clinic has been lower comparatively to other HCA Healthcare clinics. Although the cause can be multifaceted, the clinic’s online presence (e.g. Google Maps) is minimal. One initial issue with the clinic’s online presence was the lack of reviews on the Google page for the clinic. One way to increase online reviews is to provide Quick Response (QR) codes in the clinic for patients to scan on their smartphone. The goal of this project is to increase the number of Google reviews for the clinic through QR codes to at …

Improving Rates Of Postpartum Depression Screening: A Quality Improvement Project, Sarah Chason, Keisha Reddick, Alexis Brown, Cassandra Hensel, Hannah Pittman, Jennifer Brown

South Atlantic Division GME Research Day 2024

No abstract provided.

Discharge Implementation Project: Ascertaining If Discharge Implementation Orders Overall Improves Discharge Metrics At A Texas Hospital, Zachary Paras, Omar Nawab, Komthorn Cunvong, Jackson V. Littlejohn, Sathish Karmegam

North Texas GME Research Forum 2024

There are several factors preventing discharges out of the hospital within 24 hours that ultimately affects metrics for both hospital systems and physicians. These factors include pending labs, imaging, or procedures; pending placement approval at a facility outside of the hospital upon discharge; notification of family and caretakers; secured funding for devices and medicines; and others. In an attempt to mitigate preventable extra days spent in the hospital once a patient is medically ready for discharge, a Texas hospital implemented a discharge order set for providers to utilize that informs all involved parties including case management, PT/OT, social work, nurses, …

Performance Improvement Project: Breast Cancer Screening, Manolo Torres, Julia Fashner, Warda Rana, Robert Chua

East Florida Division GME Research Day 2024

No abstract provided.

Improving Documentation Of Patients' Physical Activity In The Outpatient Setting, Jordan Price, Syed Abbas, William Bass, Rigoberto Hernandez, Abdullah Shuaib, Michele L. Mccarroll, Lindsay Porter

North Texas GME Research Forum 2024

Background: There is vast data on the health benefits of physical activity (PA) and the serious health consequences that are associated with a sedentary lifestyle. Research suggests that physicians who have meaningful conversations about exercise with their patients can be effective at increasing their patients' PA. In order to measure the effects of these discussions, the clinician must be able to document the baseline and subsequent PA of their patients. Our project seeks to improve the assessment and documentation of patient PA. Methods: Using Plan-Do-Study-Act (PDSA) quality improvement methodology, a multidisciplinary team was created to identify ways to improve documentation …

Decreasing Blood Culture Contamination At A Children’S Hospital, Taylor Pearl, Brittany Bare, Ricardo Zegarra-Linares, Jessica Lee

South Atlantic Division GME Research Day 2024

No abstract provided.

Development And Implementation Of An Educational Prenatal Packet To Improve Obstetric Management And Patient Education Within A Family And Community Medicine Residency Program, Jalicia Sturdivant, Julianna Snow, Esther Piervil, Erica Paulos, Kimberly Mathurin

South Atlantic Division GME Research Day 2024

No abstract provided.

A Quality Improvement Study On Increasing Rates Of Lung Cancer Screening, Arpit Arora, Crystal Bharat, Sophia Zia, Pooja Paunikar, Dana Simpson

South Atlantic Division GME Research Day 2024

No abstract provided.

Quality Improvement Project: Compliance Of Antenatal Testing In Patients With Class Iii Obesity, Isabella L. Sciacca, Timothy Kremer, Nicole Tenzel

North Texas GME Research Forum 2024

The prevalence of obesity in women of reproductive age (20 to 39) in the US is 39.7%. It has been estimated that one-quarter of pregnancy complications are attributable to maternal obesity. Comprehensive prenatal care is imperative to achieving positive health outcomes. This quality improvement (QI) initiative aimed to improve antenatal fetal surveillance rates in patients with class III obesity. Evidence based interventions to test fetal wellbeing were implemented and examined over a 7 month time period to evaluate physician compliance of the standard of care for antenatal surveillance starting at 34 weeks gestation. Following implementation of this initiative, compliance with …

The Impact Of Tamsulosin And Duration In Catheter-Associated Uti (Cauti) At Weatherford, Feeza Hasan, Diana Steedley, Maria Guerrero, Muhammad Siddique

North Texas GME Research Forum 2024

Among Catheter-Associated Urinary Tract Infections (CAUTI) acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay. A urinary tract infection (UTI) is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidney. UTIs are the most common type of healthcare-associated infection reported to the National Healthcare Safety Network (NHSN). The most important risk factor for developing a CAUTI is prolonged use of the urinary catheter. Therefore, catheters …

Investigating And Addressing Deficiencies In Our Current Urinalysis Reflex Program, Alexander Duggan, Megan Hobbs, Cameron Holsomback

South Atlantic Division GME Research Day 2024

No abstract provided.

Improvement Of Diabetes Mellitus Management In A Resident-Run Clinic By Using Continuous Glucose Monitoring (Cgm), Janet Tam, Nathan Holt, Rakahn Haddadin, Ranier Rivera, Yasra Badi, Esar Dini, Andrey E. Manov

Far West Division GME Research Day 2024

No abstract provided.

Improvement Project: Improving Cervical Cancer Screening, Warda A. Rana, Julia Fashner, Manolo Torres

East Florida Division GME Research Day 2024

No abstract provided.

Standardization Of Operating Room (Or) Formalin Fixation Time Reporting In Breast Cancer Cases. An Institutional Experience., Cameron Summers, Astrid Sacasa, Nicole Sant Elia, Susana Ferra

East Florida Division GME Research Day 2024

Background: The current guidelines of the American society of Clinical Oncology (ASCO) and College of American Pathologists (CAP) regarding laboratory testing of estrogen receptor (ER), progesterone receptor (PR) and HER-2 in breast cancer have been in place since 2010. Optimal tissue handling requires a cold ischemic time of less than 1 hour and a formalin fixation time between 6 and 72 hours. In July 2023 HCA Westside hospital implemented a new Formalin Fixation Time documentation protocol. The data is presented quarterly at the Cancer Committee meeting.

Goal: To standardized the cold ischemic time and formalin fixation time reporting and measure …

Bridging The Gap For Hiv Education In Primary Care Setting, Oregon Mcdiarmid, Lindsay Porter

North Texas GME Research Forum 2024

No abstract provided.

Current Trends In School Nursing In Musculoskeletal Injuries And Concussions, Christoffer Amdahl, Hans Drawbert, Sadra Forati, Joshua Allen, Sana Qureshi, Afsha Rais

North Texas GME Research Forum 2024

Background: School nurses are on the front lines of assessing, identifying and treating school age children with a number of health complications. Implementing nursing services in schools have previously demonstrated improved medical care costs for students, less productivity loss for parents, and less productivity loss for teachers. As a result, nursing services in schools provide a cost-beneficial investment of public money, and warrant both financial support from policy makers as well as educational support from local healthcare services. Communicable disease, asthma, musculoskeletal injuries, concussions are common conditions seen in school aged children and a fundamental understanding of these issues …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …