Quality Improvement Commons^™

Shared Equity Leadership In An Offshore Medical School: Distributing Responsibility For Equity, Vishal B. Surender, Sreekrishna Penna, Oluwabusola Osimosu

Journal of Comparative & International Higher Education

This essay applies the Shared Equity Leadership (SEL) framework to an offshore MD program at a private Caribbean medical school where students complete basic sciences on an island and clinical clerkships across multiple international sites. Using SEL scholarship and de-identified institutional data, we ask how equity work is currently distributed, where gaps emerge in assessment, remediation, and mobility for historically underrepresented students in medicine, and how responsibility for equity might be more deliberately shared. The Woven model of SEL provides a lens to map existing structures like curriculum committees, CQI dashboards, advising systems, and clinical site partnerships. We propose a …

Healthcare Access And The Persistent Racial Disparities In Low Birth Weight, Zaheda A. Hussain, Yadanar Moe

DePaul Discoveries

Low birth weight (LBW), defined as less than 2,500 grams, is an influential factor contributing to infant mortality in the United States, with significant racial disparities between Black and White mothers. This study analyzed data from 3,054 Black and White mothers collected from the 2018 National Health Interview Survey to explore the association between access to medical care and LBW within different racial groups. The prevalence of LBW was 8.0%. Overall, mothers without a usual place of medical care had, on average, an 18% higher risk of LBW than those with a usual place (OR = 1.18, 95% CI: 0.80–1.74). …

Exploring The Determinants Of Operating Room Utilization: A Scoping Review Of Influential Factors In Surgical Efficiency, Isma Sari Chumairah, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Optimal utilization of the operating room (OR) is a crucial element in improving the efficiency of surgical services and hospital performance. This scoping review aimed to identify and map the factors influencing OR utilization based on recent scientific literature. We conducted a scoping review using the Population–Concept–Context (PCC) framework and reported it according to the PRISMA-ScR guidelines. We systematically searched PubMed, Scopus, and ScienceDirect for articles published between 2015 and 2025. Eligible studies were screened, and information on study characteristics and reported determinants of OR utilization was extracted and summarized descriptively. Forty studies were included. The reported determinants clustered into …

Agreement Among Experienced Physical Therapist Clinicians In Naming Nystagmus: A Mixed-Methods Study Design, Lori Ann Leineke, Alessandra N. Garcia, Bridget Eubanks

Internet Journal of Allied Health Sciences and Practice

Purpose: Labeling nystagmus requires clinicians to consider multiple aspects of its presentation. The extent to which physical therapists (PTs) use consistent terminology for describing nystagmus is unknown. Recommendations for proper terminology exist, but adherence during clinical assessment has not been determined. This study investigated whether PTs with advanced vestibular rehabilitation skills and training consistently use standardized vocabulary to describe nystagmus patterns. Methods: This descriptive, cross-sectional, mixed-methods study utilized an online survey methodology, which included eight free-response questions. Participants viewed videos of nystagmus through Infrared or Frenzel goggles and documented their observations. A codebook of responses was created for each question, …

The Use Of Electronic Notifications To Improve Guideline Adherence In Amiodarone Adverse Reaction Monitoring, Naruepat Sangpornsuk, Teetouch Ananwattanasuk

Chulalongkorn Medical Journal

Background: Amiodarone is an antiarrhythmic drug that can cause side effects on the thyroid, liver, lungs, vision, and nervous system. Guidelines for monitoring and surveillance of these side effects have been established since 2000, but adherence to them is low in many countries including Thailand. An electronic alert system was implemented to remind physicians of the monitoring guideline at Vajira Hospital, Navamindradhiraj University, Thailand since 23 August 2023.

Objective: This study aimed to compare adherence with the amiodarone guideline before and after implementing an electronic notification system (primary outcome) and to assess the incidence of amiodarone-related adverse reactions (secondary outcome). …

Trauma-Informed Care (Tic) In Dental Settings, Kristi M. Soileau, Angeline Lee

New Orleans Dental Association News

Trauma-Informed Care (TIC) is an approach that recognizes the impact of trauma on patients, considering trauma to better utilize methods for more effective patient care. This approach contains the following ten implementation domains that serve as a guide in organizational change:

1. Governance and Leadership
2. Policy
3. Physical Environment
4. Engagement and Involvement
5. Cross-sector Collaboration
6. Screening, Assessment, and Treatment Services
7. Training and Workforce Development
8. Progress Monitoring and Quality Assurance
9. Financing
10. Evaluation

Implementing TIC will ensure that patients feel safe and autonomous in dental clinics, which results in increased trust between patient and provider, reduced patient anxiety during office visits, and therefore better oral …

Measuring Disability Prevalence In Healthcare: A Study Comparing Two Disability Measures, Kristen L. Milefchik, Rhonda K. Dailey, Sharon Milberger

Developmental Disabilities Network Journal

People with disabilities experience significant health disparities and interventions are needed to address them. Measuring disability prevalence is an essential aspect of designing effective, data-driven healthcare strategies. Accurately measuring disability prevalence is challenging given disability is a complex phenomenon, with biological, social, environmental, and cultural components. Previous studies have compared a variety of disability status measurements and found that measurements were incongruent with each other. This study examines the concordance between disability status using two different measures: the nationally recognized American Community Survey (ACS-6) functional difficulty questions and one disability identity question. We used data from 3,621 adult patients participating …

An Innovative Model For Graduate Medical Education Faculty Development Through Physician-In-Training Delivery, Daniel A. Nguyen, Dustin Wilkes, Marshall Hall, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Background

Faculty development is a core requirement for Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs. Successfully delivering content to faculty can be challenging. This pilot study aimed to assess expert-developed sessions delivered by resident physicians to faculty at the completion of their clinical rotations.

Methods

A prospective cohort project was conducted, involving precepting faculty and resident physicians in a dermatology residency program. Each resident, at the end of their rotation, delivered a faculty development program to their attending physician. Each resident participated in the program for 1-3 years. The faculty development programs were based on faculty development programs …

Optimizing Antibiotic Strategies With A Clinical Pathway Approach: Enhanced Initiation And De-Escalation In Community-Acquired Pneumonia, Ahmad Behzadpour

HCA Healthcare Journal of Medicine

Background

Community-acquired pneumonia (CAP) remains a leading cause of hospitalization, mortality, and health care expenditure worldwide. Inappropriate use of broad-spectrum antibiotics contributes to antimicrobial resistance, adverse drug events, and increased costs. Antibiotic stewardship and standardized clinical pathways are key strategies to improve prescribing practices.

Methods

This quality improvement (QI) initiative was conducted at a 240-bed tertiary care teaching hospital from January 2023 through January 2025. A CAP-specific digital clinical pathway was developed using Curbside Health® and integrated into the electronic health record (EHR), accessible through a structured order set to support real-time clinical decision-making. The intervention included provider education and …

Psychological Safety In Health Care: A Prerequisite For High Reliability, Sonali Thosani

Advances in Cancer Education and Quality Improvement

This paper presents a viewpoint on how psychological safety contributes to patient safety, teamwork, and high reliability.

Kobayashi Maru, Daniel Mahoney

Advances in Cancer Education and Quality Improvement

This poem invites the reader to consider the uncertainty of facing an unwinnable situation. Kobayashi Maru is a reference to a fictional leadership test from Star Trek, designed to confront participants with a no-win scenario. While the test is famously “beaten” by the show’s hero, this piece aspires to depict the often unwinnable circumstance of caring for a child with incurable illness. The reader is provided space to consider how the balance of emotions and values may shift when read through the eyes of a parent, clinician, or observer.

The Weight Of The White Coat, Jonathan Cunningham

Advances in Cancer Education and Quality Improvement

This is a poem reflecting on the mission of the medical provider through the image of the white coat.

Beyond Boundaries: A Model For Boosting Staff Retention And Morale Through Career Mobility, Tiffany Hughes, Abigail Caudle, Robert Ghafar, Brandon Freudensprung, Paloma Vasquez

Advances in Cancer Education and Quality Improvement

Retention and morale in health care are strategic imperatives that directly influence patient care, quality outcomes and operational stability. At The University of Texas MD Anderson Cancer Center, we found a significant gap in the career advancement opportunities for our clinical and administrative staff. Employees lacked visibility into career growth pathways, leaving them disengaged and increasing the overall turnover rate. In response, our division launched a structured, transparent Career Mobility Model to provide employees with the clarity and tools needed for advancement. This model integrates career mapping, shadowing programs, and leader-led career conversations, all of which led to measurable gains …

Advancing The Anesthesia Workforce: The Md Anderson Anesthesia Technology Fast Track Program, Miranda M. Phillips, Mary Sizemore, Sally Raty, Tanveer Khan, Homero Lozano

Advances in Cancer Education and Quality Improvement

The Anesthesia Technology Fast Track Program (ATFTP) at The University of Texas MD Anderson Cancer Center was initiated in 2024 to mitigate a significant national deficit of trained anesthesia technologists. This 40-hour continuing education program, developed in accordance with the American Society of Anesthesia Technologists & Technicians’ (ASATT) Practical Experience Pathway, assists experienced yet non-certified anesthesia technicians in obtaining the Certified Anesthesia Technologist (Cer.A.T.T.) credential. The fully online, asynchronous 10-week CEU program is tailored for working professionals. The course focuses on patient safety, evidence-based practice, and certification preparedness and concludes with two extensive practice examinations and an ASATT CEU requirement–aligned …

Clinical Medical Emergency Team Training Simulation (Cmetts): An Interprofessional Simulation For Medical Students And Nursing Residents, Allan John R. Barcena, Marvin R. Bernardino, Dominic Karl M. Bolinas, Kitz Paul D. Marco, Toni Edwards, Shelita Kimble, James Cavalier, Marites P. Melancon, Jillian R. Gunther

Advances in Cancer Education and Quality Improvement

Effective teamwork and communication are critical during medical emergencies, particularly in oncology, yet health care professionals are often trained separately, creating challenges for interprofessional collaboration. Evidence-based frameworks like Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) offer structured tools to optimize team performance. This study describes a simulation-based program, the Clinical Medical Emergency Team Training Simulation (CMETTS), designed to instill foundational teamwork skills in early-stage learners. First-year medical students and newly graduated nursing residents participated in an interprofessional simulation involving medical emergency scenarios followed by structured debriefing sessions guided by TeamSTEPPS principles. We evaluated the program’s effectiveness …

Lessons Learned For Improving Trainee Engagement And Utilization Of Education And Training Materials For Cancer Research, Katerina M. Santiago, Tania Galindo, Michaela A. Dinan

Advances in Cancer Education and Quality Improvement

Background: A core component of the National Cancer Institute Cancer (NCI) Cancer Center Support Grant requires cancer centers to coordinate research career enhancement and related activities. The Yale Cancer Center, an NCI-designated comprehensive cancer center, established the Cancer Research Training and Education Coordination (CRTEC) component in 2016. In response to the needs of trainees, CRTEC has developed several initiatives that we have identified and described here as best practices to engage and support trainees.

Methods: We had 2 aims to improve engagement: 1) increasing our visibility and trainee awareness of CRTEC and nurturing bidirectional communication and 2) offering …

Centralizing Communication Intake To Improve Workflow Visibility And Engagement: A Quality Improvement Project In A Cancer Center's Education Division, Menatalla El-Sharkawi, Mohamed Ait Aiss

Advances in Cancer Education and Quality Improvement

Background: In large or complex organizations, multiple teams may be charged with managing different components of a project, initiative, or administrative assignment. When these teams have overlapping needs for information, the absence of a structured intake and tracking process can limit transparency, reduce efficiency, and hinder coordination across communication channels.

Methods: Drawing on principles of strategic communications and project management, we created a structured and centralized information sharing process for teams within the education division of a comprehensive cancer center. The intervention included workflow redesign, development of a standardized intake system, and use of real-time dashboard analytics to support operation …

Icu Decision Tool Impact On Rebound Hyperglycemia, Daniel J. Donovan, Emily Highsmith, Sonya Khan, Michelle Horng

Advances in Cancer Education and Quality Improvement

Hyperglycemia, defined as a blood glucose level ≥180 mg/dL in the hospitalized patient, is linked to negative outcomes including longer hospital stays, increased infection risk, and higher morbidity and mortality rates. In addition to critically ill patients with diabetes, hyperglycemia can develop in individuals without diabetes due to factors such as steroid use, continuous tube feedings, and an elevated stress response. Patients who have uncontrolled hyperglycemia are often placed on continuous insulin infusions (CII), but rebound hyperglycemia frequently occurs after CII discontinuation if the maintenance insulin regimen (MIR) is insufficient. Implementation of a MIR decision support tool integrated within an …

Transforming Patient Safety And Care Practices Through Interprofessional Education, Kaleena Ramirez, Claudia C. Tamara, Jennifer Sells, Karen Clatt, Banan Abuharb, Mary Coolbaugh-Murphy, Iris Culwell, Anca Fumurescu, Mary Gust, Lori Simmons, Delores Whiteing, Annie Koenig, Sara Martinez, Wilton Muriithi, Shaun T. Caldwell, Susan Lee, Mary Sizemore, Kimberly Ann H. Krumwiede

Advances in Cancer Education and Quality Improvement

As healthcare increasingly relies on interdisciplinary teams to deliver safe and effective care, the development of interprofessional collaboration competencies among students in health care professions has become an educational priority. In response, The University of Texas MD Anderson Cancer Center School of Health Professions integrated a longitudinal interprofessional education curriculum to foster collaborative practice readiness and prepare students for team-based interdisciplinary environments that ensure safe and patient-centered care. The curriculum was guided by the Interprofessional Education Collaborative 2016 and 2023 core competencies for interprofessional collaborative practice, reinforced with the Real Colors® Personality Instrument and Team Strategies and Tools to Enhance …

Viral Hepatitis Screening In Early Breast Cancer Patients Receiving Cancer Therapy: A Quality Improvement Initiative, Katherine Klein, Jessica Hwang, Vicente Valero, David Ramirez, Jaime Kaushik

Advances in Cancer Education and Quality Improvement

American Society of Clinical Oncology guidelines recommend screening all patients for hepatitis B virus (HBV) and hepatitis C virus (HCV) before initiation of cancer therapy. Cancer patients receiving cancer therapy represent a vulnerable population, and reactivation of undetected hepatitis virus can lead to devastating consequences. At MD Anderson Cancer Center, rates of hepatitis screening for all cancer patients have been historically low. The overall aim of this quality improvement (QI) study was to increase rates of HBV and HCV screening to at least 50% in early-stage breast cancer patients before cancer therapy in the Breast Medical Oncology clinic at MD …

Interprofessional Education Development In An Oncology-Focused Healthcare Institution, Mary Sizemore, Michael Morris, Mohamed Ait Aiss, Gregory Botz, Jolyn Taylor, Joshua Kuban, Diane C. Bodurka

Advances in Cancer Education and Quality Improvement

Background: Despite growing recognition of the value of interprofessional education (IPE), most IPE work has focused on undergraduate learners, leaving a critical gap in postgraduate and clinical environments. This report describes a phase 1, formative, pre-implementation quality improvement (QI) initiative to establish an institution-wide IPE program at an oncology center without a traditional medical school.

Methods: We used a developmental, multiphase mixed methods design integrating 3 inputs: (1) Virtual Interprofessional Teaching and Learning (VITAL) faculty-development feedback, (2) IPE Steering Committee feedback, and (3) simulation evaluation used as an applied context (not the sole focus). Surveys were administered to VITAL participants, …

Spatial Computing With The Apple Vision Pro In Minimally Invasive Procedure Simulation: A Randomized Crossover Feasibility Study, Sydney Cooper, Aaron Kyle Jones, Rahul Anil Sheth, Koustav Pal, Bruno Odisio, Mark Blaylock, Shelita Kimble, Justin Bird, David Rice, Daniel Shoenthal, Emil Patel, Vipin Kamath, Sanjay Gupta, Jeffrey Siewerdsen, Joshua Kuban

Advances in Cancer Education and Quality Improvement

Purpose: This study aimed to evaluate the feasibility of wearing the Apple Vision Pro (AVP), a mixed-reality headset that integrates augmented and virtual reality, while performing minimally invasive procedures. While studies have demonstrated that spatial computing technology can improve surgical precision and reduce the risks of surgical complications, to our knowledge, no studies have specifically addressed the impact of the AVP on task performance during simulated image-guided procedures.

Materials and Methods: Thirteen diagnostic and interventional radiology residents performed image-guided central venous catheter placement, thoracentesis, and paracentesis on simulation models. Each participant completed a non-timed practice followed by the procedures once …

Utilization Of Hybrid Angiography-Ct Suites In An Interventional Oncology Practice, David Irwin, Kiyoyuki Minamiguchi, Ryosuke Taiji, Aaron Kyle Jones, Gouthami Chintalapani, Roland Bassett, Steven Y. Huang, Sanjay Gupta

Advances in Cancer Education and Quality Improvement

Purpose: To evaluate operational trends in an interventional oncology practice at a tertiary academic center before and after the addition of hybrid angiography–computed tomography (Angio-CT) rooms.

Materials and Methods: The procedure volumes and types performed in the hybrid Angio-CT rooms were retrospectively collected from 2016 to 2020. Procedures were divided into categories, including arteriography, endovascular interventional oncology, ablation, venous intervention, non-vascular catheter placement (biliary, nephrostomy, gastrostomy, etc.), and osseous interventions. Procedural trends in the Angio-CT rooms and the frequencies of combination procedures that used both CT and angiography were assessed.

Results: A major shift of catheter-based tumor-directed cases to Angio-CT …

A Performance And Quality Improvement Intervention Integrating Molecular Testing To Support Personalized Cancer Care In Lung And Thyroid Cancers, Suzanne Murray, Monica Augustyniak, John Vu, Elbert Y. Kuo, Manolo G. Pasia Jr., Sheri L. Rivera, Kelly M. Rodriguez, Vivek Subbiah, Patrice Lazure, Ecaterina E. Dumbrava

Advances in Cancer Education and Quality Improvement

Introduction: Molecular testing has been underutilized in the diagnosis and treatment of cancer patients, despite its potential to significantly impact clinical decision-making and resulting health outcomes.

Objectives: This project aimed to evaluate the process and impact of a performance/quality improvement (PI/QI) intervention to optimize the integration of molecular testing for patients with non-small cell lung cancer (NSCLC) or thyroid cancer (TC).

Methods: Physicians, advanced practice providers, and nurses were engaged in the PI/QI at 2 cancer centers (Site A and Site B) for up to 18 months following a pre-intervention needs assessment. Gaps identified at baseline informed …

Tom: Treatment Outcome Monitor - A Web-Based Tool Designed Specifically For Clinics With Limited Resources, Saurabh Shashikumar Nair, Alba Kihn Alarcon, Maritza Elodia Cupil Barrios, Milton Estuardo Ixquiac Cabrera, Mynor Villeda, Joseph Steyn, Anneray Richards, Ricardo Ruggeri, Loida Orozco, Angel Velarde, Indranil Mallick, Graeme Lazarus, Christoph Trauernicht, Vicky De Falla, Tim Edwards, Johnny Inthaphone, Adenike Olanrewaju, Laurence E. Court, Joshua Niedzielski

Advances in Cancer Education and Quality Improvement

Background: Although three-fourths of cancer deaths are expected to occur in low- and middle-income countries (LMICs) by 2030, most cancer research still comes from high-income countries. One barrier to cancer research in LMICs is lack of infrastructure for systematic data collection, including electronic medical record systems. We developed Treatment Outcome Monitor (TOM), a cloud-based tool for tracking cancer patient outcomes, designed specifically for resource-limited settings.

Methods: TOM was developed through iterative design cycles with continuous feedback from health care providers from across the world. We focused on creating a simple, web-based solution that addresses real-world challenges in resource-limited …

Development Of The U.S. Academic Ophthalmology Faculty Database (Us-Aofd): A Cross-Sectional Descriptive Analysis, Brenton T. Bicknell, Josephine M. Rudd Zhong Manis, Haley Chishom, Yejin Heo, Lance Dzubinski, Alvina Liang, Taylor L. Aaserud, Shayan Massoumi, Thanushri Srikantha, John Stoffer, Emily Mccourt, Sruthi Arepalli, Beeran Meghpara, Ayan Chatterjee, Basil K. Williams, Janice Law, Steven E. Brooks, Robert Tauscher

Journal of Academic Ophthalmology

Background: Academic ophthalmology plays a critical role in advancing eye care and training the next generation of ophthalmologists. However, comprehensive data on the U.S. academic ophthalmology workforce remains limited. Existing databases focus on individual subspecialties or specific demographics, without capturing a national, integrated perspective.

Purpose: To develop and analyze the U.S. Academic Ophthalmology Faculty Database (US-AOFD), a comprehensive, national resource that characterizes the demographic composition, academic ranks, leadership roles, and research productivity of ophthalmology faculty at Accreditation Council for Graduate Medical Education (ACGME)–accredited programs in the United States.

Methods: This cross-sectional descriptive study compiled data for 4,028 …

Evaluation Of Pinhole Castration Techniques Compare With Traditional Method For Castration In Rabbits, Wakash Oad, Faiz Muhammad Khand, Habibullah Janyaro, Muhammad Mohsen Rahimoon, Muhammad Ramzan, Dilpat Rai Menghwar, Benazir Sahito

Journal of Bioresource Management

Castration is a routine surgical intervention used to sterilize animals. Among the different conventional methods, the pinhole castration provides offer significant advantages. This study was conducted on 12 healthy male domestic rabbits at Shaheed Benazir Bhutto University of Veterinary and Animal Sciences, Sakrand, to evaluate the physiological impacts of traditional versus pinhole castration techniques. The rabbits were randomly divided into group A and group B with six rabbits per group. Key parameters included preoperative vital signs, intraoperative monitoring at 5, 10, and 15 minutes, intra- and postoperative complications, serum cortisol levels (preoperative, 24 hours, 5 and 10 days post-surgery) and …

Pedaling Through Discomfort: A Feasibility Study Of Faculty-Led Spin Classes And Their Impact On Student Engagement, Resilience, And Faculty-Student Relationships, Gabriela Baza, Elizabeth Hathaway

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

This study explored the feasibility and impact of faculty-led Spin classes on college students’ engagement, well-being, and connection with faculty. Offered twice weekly at 7 AM during Fall 2024, the classes aimed to promote physical activity, resilience, and faculty-student relationships. Twenty-six students attended at least one class, with a median attendance of 4.5 sessions. Post-semester surveys (88% response rate) assessed perceived exertion, interest, enjoyment, challenge, improvement, and instructor encouragement. Students reported high levels of engagement and positive challenge (RPE = 15.3; challenge = 6.4/7). Those attending 7 or more sessions reported significantly greater perceived improvement than those attending fewer sessions …

Rural Georgia Hospital Covid-19 Virus Patient Outcomes, Susan P. Smith, Neeraj Dayama, Morgan E. House, Debra Flores, Sharon Hunt, April Dukes, Steven Gautney

Journal of the Georgia Public Health Association

Background: The Coronavirus disease 2019 (COVID-19) has led to over 1.2 million deaths in the United States. Given the staggering scale of the pandemic, rural hospitals faced heightened challenges due to limited resource availability and underlying patient characteristics.

Methods: In this context, we examined patient and hospital-related factors associated with inpatient mortality due to COVID-19. This study is a retrospective chart review of patient outcomes of patients who were hospitalized in a Southwest Georgia rural hospital with COVID-19 during the initial onset of the outbreak and over the following 23 months of the pandemic. Patient demographics, other characteristics, …

Expanding Waste Segregation Initiatives To Reduce Regulated Medical Waste: A Multi-Departmental Quality Improvement Project, Emily M. Su, Anuja L. Sarode, Mohammed Sami, David R. Nehring, Erica L. Laipply, Mustafa Culcuoglu

HCA Healthcare Journal of Medicine

Background

Regulated medical waste (RMW) drives up health care costs, largely due to misclassification of general waste, especially in operating rooms (ORs), intensive care units (ICUs), and obstetrics and gynecology (OBGYN) departments. This study aimed to reduce RMW volume and costs at Akron City Hospital (ACH) through department-specific interventions aligning with Occupational Safety and Health Administration (OSHA) and Ohio Environmental Protection Agency guidelines.

Methods

Periodic analyses compared hospital-wide aggregate RMW volume, pick-up frequency, and disposal costs before and after interventions. The ORs initiated interventions in October 2022, expanding to ICUs and OBGYN by February 2024. Strategies included staff education, flyers …