Quality Improvement Commons^™

Improving Emergency Department Throughput: Using A Pull Method Of Patient Flow, Jeffrey Collins

Student Scholarly Projects

Practice Problem: Overcrowding in the emergency department (ED) has been shown to increase the length of hospital stay, adversely impact patient outcomes, and reduce patient satisfaction. Problems with overcrowding and throughput are often thought of as an ED-specific inefficiency; however, the issue is indicative of hospital-wide inefficiencies.

PICOT: The PICOT question that guided this project was “For ED patients admitted to the medical-surgical unit at an acute medical center, will the implementation of a pull model for patient flow, when compared to the current push model, reduce admission delay and length of stay (LOS) within six weeks of implementation?

Evidence: …

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 …

Improve The Risk Of Central Line-Associated Bloodstream Infections With Central Line Dressing Changes Through A Team Approach, Jessica Comstock

Student Scholarly Projects

Practice Problem: Central Line Associated Bloodstream Infections (CLABSI) are a preventable hospital acquired infection which contributes to patient morbidity, mortality and rising healthcare costs.

PICOT: The PICOT question that guided this project was: In adult inpatients with central venous catheters, does the use of a two-person dressing change team, compared to a single person procedure, decrease the rate of central line associated bloodstream infections over the course of 8 weeks?

Evidence: The prevention of CLABSI is most effective when multifaceted line maintenance bundles are implemented and adherence to these bundles nears 100% (Schreiber et al. 2018).

Intervention: A two-person, …

Reducing Patient Falls Through Purposeful Hourly Rounding, Amanda Savage

Student Scholarly Projects

Practice Problem: Falls significantly affect patients, resulting in temporary or permanent harm, even death. In a large acute care facility, patient falls increased from 444 in 2016 to 556 falls in 2019.

PICOT: In an adult inpatient hospital setting, does purposeful hourly rounding (PHR), compared to no rounding, reduce patient falls over a period of 30 days during the same time period from the previous year?

Evidence: Of the 360 articles reviewed, 12 articles, varying from evidence levels two (1), level three (4), and level five (7), supported PHR as effective in reducing harm from falls in adult …

Decreasing Readmissions In Medically Complex Children, Colleen Bartlett

Student Scholarly Projects

Practice Problem: There was a report of an existing practice problem of increased 30-day readmission rates in medically complex children at an outpatient clinic within an extensive hospital system. Hospital readmissions can cause clinical, social, and financial burdens to the patients and their families and thus reflected a need for interventions to reduce readmissions.

PICOT: The PICOT question that guided this change project: In medically complex pediatric patients ages 0-17, what is the effect of a discharge intervention bundle in reducing all-cause 30-day hospital readmissions compared to current practice within an 8-week timeframe?

Evidence: The literature revealed 18 …

A Policy Change To Reduce Hospital-Acquired Clostridium Difficile Infection Rates: A Quality Improvement Project, Nia Hidalgo

Student Scholarly Projects

Practice Problem: At a small community facility in Los Angeles County, there was a reporting rate of hospital-acquired Clostridium difficile cases that was higher than both state and national benchmarks.

PICOT: The PICOT question that guided this project was: In acute care patients aged 18-90, does not retesting for CDI for at least seven days compared to retesting in less than seven days reduce the incidence of false positive CDI tests during the first seven days of the hospital stay?

Evidence: The evidence demonstrates that if patients are tested initially for Clostridium difficile and then retested seven days after, the …