Health and Medical Administration Commons^™

Quality Improvement: Improving Discussion And Documentation Of Advance Directives In An Outpatient Setting, Amanda Brenner, Elizabeth J. Bogaty, Anjan Parghi

South Atlantic Division GME Research Day 2023

No abstract provided.

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative, Erick Hernandez Campos, Elizabeth Morse, David Phillippi

DNP Projects

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for …

Implementation Of A Patient Satisfaction Survey At A Free Community Clinic: A Quality Improvement Project, Nora O'Sullivan

DNP Projects

Background: The uninsured, underinsured, and underserved populations in the US are impacted by health disparities and have unique experiences with healthcare. Yet, settings which serve these populations – the “safety net”- are not adequately supported to gather patient experience data. In Connecticut, Fairfield County has a higher percentage of uninsured people than the overall state. Additionally, this population has demonstrated higher frequency of emergency department utilization than the overall population. Therefore, processes to measure the barriers to accessing quality care and patient experience and satisfaction with care are needed in safety net clinics to promote elimination of health disparities and …

Measuring The Patient Safety Culture At A Tertiary Care Hospital In Pakistan Using The Hospital Survey On Patient Safety Culture (Hsopsc), Fasih Ali Ahmed, Fozia Asif, Tahir Munir, Sohail Haleem, Zehra Feroze Ali, Asim Belgaumi, Hasnain Zafar, Asad Latif

Department of Anaesthesia

Background: Patient safety is a top priority for many healthcare organisations worldwide. However, most of the initiatives aimed at the measurement and improvement of patient safety culture have been undertaken in developed countries. The purpose of this study was to measure the patient safety culture at a tertiary care hospital in Pakistan using the Hospital Survey on Patient Safety Culture (HSOPSC).
Methods: The HSOPSC was used to measure the patient safety culture across 12 dimensions at Aga Khan University Hospital, Karachi. 2,959 individuals, who had been working at the hospital, were administered the HSOPSC in paper form between June and …

Improving Comfort And Confidence With Advance Care Planning In Primary Care, Thomas Krajewski, Donald Courtney, Tyler Kilgore

South Atlantic Division GME Research Day 2023

No abstract provided.

Quality Improvement: Implementation Of Rapid Mri Protocol At Gsmc For Further Evaluation Of Suspected Pediatric Appendicitis, Colin W. Woolard, Christian Salinas, Allison Hudak, Jeffery Durbin

South Atlantic Division GME Research Day 2023

No abstract provided.

Improving Group B Streptococcus Susceptibility Testing, Sofia Sarduy, Michelle Ozcan

North Florida Division GME Research Day 2023

No abstract provided.

Utilizing A Pre-Cesarean Checklist In Labor And Delivery, Randdie-Joyce Rameau, Frances Cintron, Veronica Figueroa, Margarita Olivares

North Florida Division GME Research Day 2023

No abstract provided.

Improving Patient Knowledge On Exercise And Dietary Recommendations: Quality Improvement In An Outpatient Setting, Shannon Mcmenamin, Nicky Chopra

TriStar Division Research Day 2023

No abstract provided.

Improving The Blood Product Administration Process At Hca Florida Osceola Hospital, Kar Shun Constant Mak, Neha Meda, Natalia Tejada, Parasto Asnaashari, Joshua Sutarwan, Joshua Shultz, Maria Wallis-Crespo, Sarah Tinsley

North Florida Division GME Research Day 2023

No abstract provided.

Utility Of Daily Cbc In Hospitalized Patients, Lauren Howard, Kayla Engstrom, Aisha Khan, Andrew Vest, Carlos Vargas

Gulf Coast Division GME Research Day 2023

No abstract provided.

Qi Project: Increasing Appropriate Use Of Osteopathic Manipulative Treatment As An Adjunctive Treatment For Patients With Musculoskeletal Pain In The Outpatient Setting, Zhe Liu, Aelius Khan, Derek Pride, Thomas Krajewski, Anthony Shadiack

South Atlantic Division GME Research Day 2023

No abstract provided.

Preventing Complications Of High Dose Steroids For Patients At The Orlando Va Healthcare System, Sriya Reddy, Sonia Alicea, Emmanuel Magsino, Alfredo Palomino Abella, Faris Abby Alamin, Ashwini Komarla

North Florida Division GME Research Day 2023

No abstract provided.

Care Alert Program In Chronic Recurrent Ed Utilizing Patients: Expanded Study, Jonathan Leggett, Kaitlyn Phelps, Erica Gibbons, Jonathan Bryan, Brent Wright, Daniel Nunez, Brian Griggs

South Atlantic Division GME Research Day 2023

No abstract provided.

Implementing The Erac Protocol For Cesarean Sections, Olga Hawkins, Michelle Ozcan, Jose Rojas

North Florida Division GME Research Day 2023

No abstract provided.

Improving Use Of A Standardized Medical Icu Order Set, Ernesto Munoz-Pena, Sesha Sai Kanakamedala, Ramzy Daoud, Suhail Saad-Omer, Aarushi Varshney, Tristan Tanner, Alexander Kong, Joshua Shultz, Ashwini Komarla

North Florida Division GME Research Day 2023

No abstract provided.

Improving Accurate Documentation Of Appearance Within The Mse Based On Bmi, Shaina Aifuwa, Sampreeth Murali, Valerie Cordero, Nadia Jacob, Cristobal Cintron, Almari Ginory, Sarah Fayad

North Florida Division GME Research Day 2023

No abstract provided.

Descriptive Assessment Of The Pediatric Emergency Team System: The Memorial Health University Medical Center Experience, Ashley Cheek, Lauren Hebert, Sunil Keshwah, Jessica Lee

South Atlantic Division GME Research Day 2023

No abstract provided.

Improving Patient Access To Gastroenterology Through A Nurse-Practitioner-Led Clinic: A Quality Improvement Project, Kayla Northam

DNP Scholarly Projects

The United States has a critical healthcare access issue for gastroenterology patients. Delays in treatment can lead to expensive complications, including emergency room visits, hospitalization, and surgery. Creating a rapid-access clinic (RAC) for gastroenterology so that patients can obtain a quick and efficient evaluation of their symptoms in a shorter appointment time can help decrease the delay in care and generate more revenue for the hospital. Over 8 weeks in 2023, Dartmouth Hitchcock Medical Center Department of Gastroenterology used a telemedicine-only RAC to see patients for 20 minutes rather than the traditional 60-minute period. As a result, the RAC saw …

Organizational Characteristics As Predictors Of Hospital Accreditation, Rebecca B. Graystone

Walden Dissertations and Doctoral Studies

Abstract Hospital accreditation has had wide and longstanding acceptance as a key quality tool to drive efficient, effective healthcare. Researchers have more recently questioned factors commonly related with accreditation achievement given accreditation’s general association to better patient care, risk management, and cost reduction. Even less information was known about predictors of accreditation failure, which could be addressed by hospital administrators in advance of seeking application. Accordingly, the purpose of this cross-sectional study was to examine if hospital structures and processes were predictors of accreditation failure. The research questions explored hospital size, ownership status, geographic location, hospital leadership, empowerment, practice, and …

Sepsis Inservice And Video At An Urban Hospital In California, Angela T. Ho

Master's Projects and Capstones

The emergency department at an urban hospital in California was performing below institutional goals related to sepsis protocols over the past few months. This intervention was targeted at nurses and was composed of a PowerPoint in-service on compliance to SEP-1 protocols and follow-along video on using the correct sepsis order set and documentation in the electronic health record (EHR). Goals included increased compliance to the SEP-1 protocol and documentation, (2) reduced time between the onset of symptoms, recognition, and intervention, (3) decline in sepsis rates and mortality rates, and (4) lower cost of care. Data was collected from the EHR …

Nurse-Initiated Treatment Reduces Costs For Acute Asthma In A Pediatric Emergency Department, Michael D. Johnson Md, Ms, Minkyoung Yoo Phd, Richard E. Nelson Phd, Amanda K. Nielson Md, Lauren Allen Mas, Nanette Dudley Md, Brandon Andersen Rrt, Amanda Orme Dnp, Cpnp-Ac, Cameron Mcfarland Np-C, Michael Mundorff Mba, Mhsa

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Standardized emergency department (ED) pathways can improve care delivery to children with acute asthma, though their impact on hospitalization and costs is unclear. An Acute Asthma Care Pathway (AACP) that facilitates nurse initiation of treatment was implemented at a tertiary care pediatric ED using standard quality improvement methodology. The impact of implementation was assessed using process control methodology and multivariable time series analyses between pre- and post-implementation periods. Provision of a steroid within 30 minutes and 60 minutes of arrival increased by 21 and 22 percentage points respectively, IV magnesium sulfate administration increased by 30 percentage points, the proportion hospitalized …

Outcomes Of Asthma Quality Improvement In Pediatric Patients, Kathryn M. Murray Md, Faap

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. The Utah Pediatric Partnership to Improve Healthcare Quality (UPIQ) and Utah Department of Health (UDOH) Asthma Program Learning Collaborative is a quality improvement initiative designed to standardize asthma care in pediatric patients and improve the overall assessment and patient education process for both healthcare providers and patients. The aim of the Asthma QI Project was to improve the diagnosis and management of asthma for patients in the state of Utah by implementing a standardized approach to the identification and treatment of patients with asthma.

Methods. Patients scheduled to see a healthcare provider at our pediatric clinic were screened for …

Improving The Accuracy Of Interactive Voice Response (Ivr) Technology For Pediatric Experience Scores, Elizabeth Spaargaren Ms, Mph, Cpxp, Abigail Kozak Mba, Cpxp, Cara Herbener Cpxp, Barbara Lawlor Burke Ma, Cpxp

Patient Experience Journal

The increased use of interactive voice response (IVR) in assessing patient and family experience should be paired with evidence-based practices on how to obtain the most accurate information via this survey mode. We added a brief clarification sentence of the survey scale at the start of the IVR call to improve our experience data both qualitatively and quantitatively. Our setting was an urban pediatric hospital. We gathered lived experiences from our patients, families, and providers to understand and design a change to the IVR survey mode that would reduce survey inaccuracies. Outcome measures were assessed by baseline measurement and post-intervention …

Multicomponent Approach To Delirium Prevention In The Acute Care Setting: An Evidence-Based Quality Improvement Project., Kelley James

Doctor of Nursing Practice Papers

Background: Acutely ill, hospitalized individuals are at an increased likelihood of developing delirium. Between 30-35% of those patients admitted to the hospital will develop delirium, and as a result, these individuals will face an increased risk of mortality, adverse medical events, restraint usage, and incur a more extended hospitalization. The literature supports early screening utilizing the Confusion Assessment Method (CAM) tool and nurse-driven, multicomponent interventions to aid in preventing its development.

Environment: This project was implemented in a long-term, acute care facility specializing in patients requiring long-term mechanical ventilation, advanced wound care, pulmonary and respiratory care, and the rehabilitation of …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

Care Alert Program In Chronic Recurrent Ed Utilizing Patients, Kaitlyn Phelps, Jonathan Bryan, Jonathan Leggett, Erica Gibbons, Brian Griggs

HCA Healthcare Journal of Medicine

The Care Alert program is designed to help navigate encounters with patient populations that are high utilizers of emergency department (ED) resources. These populations often have chronic medical conditions, have a poor understanding of their conditions, are unfamiliar with the EDs’ role in the management of these conditions, and commonly lack outpatient resources. The Care Alert program intends to address the needs of this challenging patient population by designing individualized care plans that are approved through a multidisciplinary committee. Data from this study showed a 37% decrease in ED visits and a 47% decrease in hospitalizations during the initial 8 …

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up identified in …

Optimizing Oxygen Therapy, Gizam Gokalp, Ramez Massoud, Jopher Bernal, Guru Chinnaraj, Michael Delzoppo, Nicole Brenner

North Florida Division GME Research Day 2022

No abstract available.

Bedside Shift Report And Patient Satisfaction, Kasandra R. Johnson

Electronic Theses and Dissertations

Each year, millions of deaths worldwide are caused by medication errors in hospitals. Some of these errors are accounted for through miscommunication during the change of the nurse shift report. One of the Joint Commission’s 2019 national patient safety goals for hospital programs was to improve communication effectiveness among caregivers since mistakes in a caregiver’s communication accounted for 37% of severe patient injuries. Safety is threatened by patients not being included. Therefore, adopting the bedside shift report allows patients to be actively engaged, reinforcing nurse-patient communication. The bedside shift report enables nurses to provide safe, high-quality, patient-centered care at the …