Quality Improvement Commons^™

Improving Competence And Confidence In Outpatient Management Of Major Depressive Disorder, Anish Pal, Pavan Anand, Brett M. Garrett

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Screen It Out! Improving Colon Cancer Screening Among Kingwood Clinic Patients, Daniel J. Avila Castillo, Bhavin Patel, Dhruv Patel, Rajeev Raghavan, Zuhair Ali

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Enhancing Breast Cancer Screening In Kims Clinic: A Quality Improvement Initiative, Daniel J. Avila Castillo, Crystal Ike, Mina Choudhry

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Artificial Intelligence Response To Common Medication Concerns With Heart Failure Gdmt In Outpatient Setting, Dominique Pean, Laaraeb Nadeem, Suhas Kandimalla, Brotee Rahman

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Ed Procedural Supply And Operations, Alex Teshon, Konner Cue, Logan Prewitt, Anita Datta

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Targeted Procedure Lab To Improve Self-Identified Deficiencies Among Graduating Emergency Medicine Residents, Stephanie Cohen, Andrew Bobbett, Shayne Gue, Jeffrey Thompson

North Florida Division GME Research Day 2024

No abstract provided.

Quality Improvement To Optimize Pediatric Mri Efficiency In Hospitalized Patients:Improving The Ordering Process And Reducing Time To Mri Completion, Andrew Stack, John Adent, Eric Shaw

South Atlantic Division GME Research Day 2024

No abstract provided.

Enhanced Naloxone Prescribing For Opioid-Using Patients On Hospital Discharge, Dang Quang-Trung, Joan Hyland, Barbara Gracious, Robyn Meadows

South Atlantic Division GME Research Day 2024

No abstract provided.

Improving The Rates Of Diabetic Screening Exams In A Rural Outpatient Clinic, Sofia Rohde, Mohit Mathavan, Shalaka Venkatraman, David Nguyen, Gino Singer, Shivanie Ramdin, Jennifer Abernathy, Nicholas Dorsey

North Florida Division GME Research Day 2024

No abstract provided.

Implementing A Standardized Screening Algorithm For Iron Deficiency Anemia In Pregnancy, Ariel Moskowitz, Nicole Tenzel, Joshua Mangels, Lyndsay Millican

North Texas GME Research Forum 2024

OBJECTIVE: Anemia in pregnancy is a global health problem and complicates >40% of pregnancies. Anemia is associated with significant maternal and fetal complications including low birth weight, preterm delivery, postpartum hemorrhage, ICU admissions, need for blood transfusion, and maternal morbidity. The American College of Obstetricians and Gynecologists (ACOG) and the CDC recommend screening for anemia at the first prenatal visit and again between 24 and 28 weeks gestation. The aim of this quality improvement project is to improve compliance of screening for anemia in pregnancy amongst the providers of Medical City Women's Care. METHODS: Using the Plan-Do-Study-Act (PDSA) quality improvement …

Improving Clostridium Difficile Detection At Medical City Arlington: A Quality Improvement Project, Bremmy Alsbrooks, Nur-Alhuda Shahub, Shabaz Mallick, Jesse Brown, Afsha Rais, Afsha Rais

North Texas GME Research Forum 2024

INTRODUCTION: Hospital acquired Clostridium difficile infection are one of the costliest hospital acquired infections. Over the past year, there were 19 C diff cases. Reasons for this uptick in cases from previous years could be waiting too long for collection (where a patient has C diff on admission, but does not receive testing until several days later), antibiotics, environmental (for example, using the same toilet brush to clean bathrooms on the floor as well as the bathroom in a C diff patient's room, cleaning high touch areas less than two times during the day, etc.), or staff education. From our …

Reducing Broad-Spectrum Antibiotic Use By Appropriately Treating Community Acquired Pneumonia, Caleb I. Nieves-Velez, Richard Pieri, Miki Otta

Central & West Texas GME Research Day 2024

No abstract provided.

Improving Lesion Diameter Reporting On Skin Biopsy Requisition Forms: A Quality Improvement Project, Christopher Wong, Christian Scheufele, Marshall Hall, Henry Lim, Daniel A. Nguyen, Stephen Weis, Michael Carletti, Dustin Wilkes

North Texas GME Research Forum 2024

Background: Skin biopsy requisition forms (SBRFs) are the primary communication tool between dermatologists and dermatopathologists. Diameters of biopsied skin lesions are frequently omitted on SBRFs. This quality improvement project aimed to increase the rate of reporting diameters of neoplasms on SBRFs from an academic dermatology outpatient clinic to greater than 65% within three years. Methods: The Plan-Do-Study-Act model was utilized. An initial audit was performed for SBRFs of biopsies obtained between July 1, 2021, and February 4, 2022 (“Cycle 1”). On February 4, 2022, the authors discussed societal guidelines for lesion diameter reporting on SBRFs (“Intervention A”). Cycle 2 prospectively …

Utility Of Bedside Ultrasound In Identifying Undiagnosed Malpresentation Upon Admission To Labor And Delivery: A Quality Improvement Project, Kristen Daugherty, Gloria Wang, Samantha Mclean, Jeffrey Johnson, Kelly Mosher

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Qi On Addressing Bmi In The Outpatient Setting, A Shuravloff, Ryan Bradbury, Matthew Widdison, Teresa Johnson

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Quality Improvement Project Regarding Concomitant Administration Of Promethazine And Opioids In Hospitalized Patients Chronic Pain, Alexey Minevskiy, Wade Wyckoff, Corey Stone, Romil Patel, Shrikanth Parthasarathy, Denis Parinov

North Florida Division GME Research Day 2024

No abstract provided.

Single Question Survey Vs The Ongoing Violence Assessment Tool For Intimate Partner Violence Screening In The Ed, Zhengqiu Zhou, Donna Carden, Mariel Michaels, Gretchen Nonawzki, Saria Slowey, Maureen Mohan, Robyn Hoelle

North Florida Division GME Research Day 2024

No abstract provided.

Falls Quality Initiative Project, Sean O'Leary, Himat Gill, Steven Tran, Zeeshan Haque, Christopher Burton

North Florida Division GME Research Day 2024

No abstract provided.

Come One, Come All: Carnival Themed Gamification Of Emergency Medicine Board Review, Shayne Gue, Taylor Cesarz, Maria Tassone

North Florida Division GME Research Day 2024

No abstract provided.

Multiple Casualty Simulation Scenario Secondary To Natural Disaster At A Music Festival, Stephanie Cohen, Robert Pell, Casey Mcgillicuddy, Nidhi Sahi, Ariel Vera, Steven Nazario, Andrew Bobbett, Rebecca Beiler, Noe Navarro, Latha Ganti, Shayne M. Gue

North Florida Division GME Research Day 2024

No abstract provided.

Establishing A Protocol For Hospice Compassionate Withdrawal Of Ventilatory Support In The Home Setting, Georganna Rosel, Ana Sanchez, Reuben Smith

South Atlantic Division GME Research Day 2024

No abstract provided.

Introduction To Atls And Emergency Preparedness, Leon Gu, Urvashi Firozi, Pradeep D'Souza

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Learning Mass Casualty Incident Triage Via Role Play Simulation, Martin Morales-Cruz, Ayanna Walker, Drake Dixon, Latha Ganti, Shayne Gue

North Florida Division GME Research Day 2024

No abstract provided.

Implementation Of Viz.Ai Augmented Intelligence Software To Reduce Door To Puncture Times And Patient Outcomes At A Comprehensive Stroke Center, Cody Bryant, Brandon Womack, Mason Patel, Sanjay Sharma

North Texas GME Research Forum 2024

Introduction: Endovascular therapy (EVT) in the form of mechanical thrombectomy is the mainstay of treatment for acute large vessel occlusion (LVO) ischemic stroke, but its efficacy is highly time sensitive. It is crucial that stroke centers continue to implement process improvements that aim to streamline stroke workflow. Viz.AI is a platform that uses artificial intelligence to automatically detect LVOs with computed tomography (CT) imaging. It provides immediate access to the CT images as well as a platform for centralized communication through the mobile application. We sought to determine if the implementation of Viz.AI at our comprehensive stroke center improved stroke …

Reducing Medication Barriers Before Patient Check-Out At A Student Run Free Clinic, Jenna D. Reisler, Daniel Bao, Alison Zill, Marysuna Wilkerson

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Engaging Chief Medical Officers To Improve Multidisciplinary Rounds, Gregory Mccormack, Pranav C. Mehta

HCA Healthcare Journal of Medicine

Background

Multidisciplinary rounds (MDRs), a model of care in which multiple members of the care team, representing different disciplines, come together to discuss the care of a patient in real-time. MDRs are a valuable tool for clinical teams to improve patient length of stay (LOS), reduce healthcare-associated infections, and increase care coordination. HCA Healthcare’s data science and performance improvement teams created a data visualization tool called Next-gen Analytics for Treatment and Efficiency (NATE) Tempo to support care teams in managing rounds and barriers.

Methods

A pilot implementation of MDRs using the NATE Tempo tool was initiated in 10 hospitals, accompanied …

Who Left The Hospital Against Medical Advice During The Early Covid-19 Pandemic?, Bryan Werner, Se Won Lee

HCA Healthcare Journal of Medicine

Background

Patients leaving against medical advice (AMA) presents a challenge to hospitals as they try to manage costs and improve patient outcomes in an ever-increasing competitive market. Investigating AMA discharges that occurred during the early COVID-19 pandemic presents a unique opportunity to better understand this phenomenon and be better prepared for the future.

Methods

This retrospective analysis of 34 379 patients from a nationwide private healthcare system across 20 states analyzed patients during the early stages of the pandemic who chose to leave against medical advice (AMA) after being admitted with COVID-19 infection and identified several patient characteristics associated with …

Video Documentation As A Measure Of Written Documentation Accuracy In Emergency Medical Service Field Intubations, Christopher S. Keller, Christopher Dilger, Shih-Chin Chou, Rasheed Lawal, Shane Jenks

HCA Healthcare Journal of Medicine

Introduction

Quality improvement (QI) is a major focus of all departments and fields of health care, including emergency medical services. The chaotic and rapidly evolving atmosphere in which paramedics must practice can lead to inconsistency between what is documented and the actual events. This leads to difficulty when trying to evaluate the practitioners and when implementing a QI program. In this study, we evaluated the prevalence of discrepancy between the video and written record for Rapid Sequence Intubation (RSI) performed in the field as a demonstration of the utility of video documentation in QI.

Methods

We used a systematic retrospective …

Demonstration Of The Managing For Daily Improvement Quality Improvement Methodology In An Alcohol Withdrawal Protocol Audit, Alex Stephens, Diana Hoot, Amy Cain

HCA Healthcare Journal of Medicine

Background

The Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) is an assessment tool designed to standardize care and minimize the risk of complications in patients experiencing alcohol withdrawal. After discovering an increase in medication errors and late assessments under this protocol, pharmacists at a 218-bed community hospital performed an audit of protocol compliance using a performance improvement methodology known as Managing for Daily Improvement (MDI).

Methods

A daily audit of CIWA-Ar protocol compliance was performed across all hospital units, followed by discussions with frontline nurses regarding barriers to compliance. The daily audit included assessments of appropriate monitoring frequency, medication …

Operationalizing A Medication Safety Gap Assessment For A Large Health System, Carley Warren, Joan Kramer, L Hayley Burgess

HCA Healthcare Journal of Medicine

Background

Medication errors continue to be a leading cause of medical errors. In the United States alone, 7000 to 9000 people die annually due to a medication error, and many more are harmed. Since 2014, the Institute for Safe Medication Practices (ISMP) has advocated for several best practices in acute care facilities derived from reports of patient harm.

Methods

The medication safety best practices chosen for this assessment were based on the 2020 ISMP Targeted Medication Safety Best Practices (TMSBP) and health system-identified opportunities. Each month, for 9 months, select best practices were covered with associated tools to assess the …