Quality Improvement Commons^™

Colorectal Cancer Screening And Correlating Gender Disparities, Kara Marr, Megan Janssen, Margaret Payne, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

In 2023, colorectal cancer (CRC) was the second leading cause of cancer-related deaths in the US, equating to approximately 50,000 total deaths (National Cancer Institute, 2024). Further, it is estimated that an additional 1.4 million Americans are living with CRC (National Cancer Institute, 2024). Early detection screening modalities remain imperative since the NIH has released a combined survival rate of 70% when utilized (National Cancer Institute, 2024). Different derivatives of CRC develop from pre-cancerous polyps and are often without signs or symptoms of disease progression; this asymptomatic period emphasizes the importance of early detection and prevention of colorectal cancer …

Unveiling The Stigma: Doctor Mental Health And Intervention Strategies, Joseph Heirigs

Honors Program: Senior Projects (Public)

Background

The mental health of physicians is a pressing issue that has received increasing attention in recent years. The alarmingly high suicide rates for physicians underscores the critical need to address the mental health challenges that doctors face. Physicians are exposed to stressors that are unique to their profession, including high-stakes decision making, long work hours, traumatic patient situations, and the emotional toll of patient care. These challenges contribute to high rates of anxiety, depression, burnout, and other mental health issues. However, despite these factors, physicians are often reluctant to seek mental health treatment due to fears of professional repercussions, …

Primary Care Physicians' Perspectives On Clinical Integration And Performance Metrics In A Medically Underserved Area., Kern Kumar

MUSC Theses and Dissertations

With the national movement toward improving population health and helping combat the rising costs in healthcare, there are still assumed challenges and barriers concerning performance among healthcare organizations that impact costs and health outcomes. The Physician Hospital Organization (PHO) site within this study has been plagued with poor performance with assumed challenges and barriers for years. In this mixed-methods study leveraging the qualitative approach to support existing data, all primary care physicians within the PHO under study were interviewed, and by following the inductive approach and thematic analysis, valuable themes arose. It was found that due to patient education lacking …

Operating Room Acquired Pressure Injury Prevention, Audrey E. Dillon, Lexi K. Johnston, Grace L. Johnston, Amy N. Cochran

SPARK Symposium Presentations

Our change project focuses on preventing pressure injuries in OR patients using an alternating pressure overlay and gel pad system during surgery and recovery. Pressure injuries cost the healthcare system upwards of $26 billion annually, and surgery patients are at high risk due to prolonged immobility, constant pressure on one area, hemodynamic changes, and excessive moisture. Nurses can play a critical role in reducing healthcare costs and improving patient outcomes by utilizing proper training and outcome tracking. The estimated cost of implementing this system is $37,000, significantly lower than the long-term cost of pressure injuries. Key
stakeholders include nurse managers, …

Written Reminders For Mammogram Compliance, Kristine Cholly, Marcus Barksdale, Rachel Gates, Mabel Olaya, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Breast cancer remains the second leading cause of cancer death among women in the United States, with a median age of mortality at 68 years old. Mammography has been shown to improve early detection and reduce mortality rates. Current United States Preventive Services Task Force (USPSTF) recommends biennial mammograms for women aged 50-74. However, compliance with biennial mammogram screenings remains inconsistent. This project aims to evaluate the effectiveness of written reminder letters in improving mammogram compliance among women aged 50-74 years old. The study focuses on comparing mammogram adherence rates among patients who received reminder letters compared to those …

Hospital Re-Admission, Length Of Stay, And Chief Complaints Of Patients Experiencing Housing Instability, Andrew S. Leavitt, Jainaha K. Srikumar, Rizwan M. Siddiqui, Luke R. Siedhoff, Jennifer Liu, Jenenne Geske

EMET Projects

No abstract provided.

Hospital Admissions Of Patients Experiencing Housing Instability, Rizwan M. Siddiqui, Jainaha K. Srikumar, Andrew S. Leavitt, Luke R. Siedhoff, Jenenne Geske, Jennifer Liu

EMET Projects

No abstract provided.

Using Ehr Reminders To Control Hypertension, Umme Kulsoom Ghous, Logan Mcculley, Danielle C. Hall, Linda Katherine Lambert, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Hypertension is a significant risk factor for cardiovascular and kidney diseases but is often under-diagnosed and poorly managed. Electronic Health Records (EHR) can help by providing automated reminders to recheck elevated blood pressure (BP) readings, ensuring accurate measurements, and guiding clinical interventions. This study aims to determine if EHR-based reminders improve BP control in adult patients aged 21 and older, focusing on hypertension diagnosis accuracy and timely management.

Methods

After a literature review, the study took place in a primary care clinic and only included patients with an existing diagnosis of hypertension. Thirty patients were included in the study. …

Shorter Surveys, Better Insights: The Role Of Patient Reported Outcome Surveys In Value-Based Care, Paul Bonilla, Anesu Karen Murambadoro, Victoria Elizondo, Juan Pablo Flanagan

Research Symposium

Background: Patient-reported outcomes (PROs) are essential for tracking patient progress, but lengthy surveys, such as the 40 question Knee Injury and Osteoarthritis Outcome Score (KOOS), create time and cost challenges for private practice. Starting July 2024, the Centers for Medicare and Medicaid (CMS) now require hospitals to collect pre surgery and one year post surgery (9-15 months) HOOS JR and KOOS JR scores for total replacement surgeries, with public reporting set for 2027. Non-reporting carries financial penalties, underscoring the need for streamlined solutions. As value-based care becomes a priority, practical strategies are needed to reduce the burden on providers …

Assessing Patient Satisfaction: The Role Of Net Promoter Scores In Healthcare, Paul Bonilla, Victoria Elizondo, Juan Pablo Flanagan

Research Symposium

Background: The Net Promoter Score (NPS) is a widely used tool for measuring customer satisfaction and loyalty through a simple question: “How likely are you to recommend [company name] to a friend or colleague?” Responses categorize individuals as Promoters (9–10), Passives (7–8), or Detractors (0–6), with the final score calculated by subtracting the percentage of Detractors from Promoters. Introduced in 2003, NPS has become popular across industries for its simplicity, predictive value, and benchmarking capabilities. In healthcare, NPS adoption is increasing as hospitals seek concise, standardized tools to assess patient satisfaction—an essential metric in the shift toward value-based care. …

Analyzing The Impact Of Surgery On Reducing Missed Workdays, Paul Bonilla, Victoria Elizondo, Juan Pablo Flanagan

Research Symposium

Background: Managing patient expectations before surgery is essential to improving the surgical experience. A key aspect of this is understanding the impact of surgery on work attendance. While patient-reported outcomes (PROs) are commonly used to assess health conditions, less attention has been given to how work attendance, both before and after surgery, can inform preoperative counseling. This is especially relevant for patients concerned about taking time off work. Analyzing work attendance can reveal patterns that help patients make informed decisions, improve long-term outcomes, and enhance satisfaction by setting achievable recovery timelines. This study aims to explore how this data can …

Patterns And Outcomes In Urotrauma: An Analysis Of Fatality Trends And Contributing Factors, Neharika Penmetcha, Aun Bangash, Kelsey Baker

Research Symposium

Background: Urotrauma, involving injuries to the kidneys, ureters, and bladder, represents a critical subset of trauma cases, significantly impacting patient morbidity and mortality. Renal and urogenital injuries account for 10–20% of abdominal trauma in adults and children. Understanding urotrauma's epidemiology is vital for improving care protocols and resource allocation. Despite its impact, data on injury mechanisms, intent, and care modalities specific to urotrauma remain limited. This study investigates patterns in injury mechanisms, intent, transport modalities, and facility transfer status to identify factors influencing patient outcomes and inform trauma care improvements.

Methods: A retrospective review analyzed 3,492 trauma cases, filtered for …

Guardians Of The Catheters, Interprofessional Collaboration Reduced Cauti Rates At Phfh, Dawn Doud, Angie Shemwell, Stephanie Brown, Tobi Bryan, Georgia Gauron, Tasha Anisimov, Peter Weitzman, Emma Peterson, Tiffanie Rampley

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Intraoperative Imaging In Orthopedic Settings: An Assessment Of Changes In Adherence To Imaging Guidelines, Emmanuel Franco, Tabitha Abraham, Zayd Ayas, Frank Gerold

Research Symposium

Background: High-quality intraoperative photography is vital for treatment planning, patient counseling, and surgical education. Inconsistencies in image quality are prevalent in orthopedic literature due to the absence of formalized criteria specific to orthopedic settings. In 2014, "Medical Photography: Principles for Orthopedics" introduced guidelines intending to standardize protocols for capturing clinical images. By comparing the quality of images taken both before and after these proposed guidelines, this project aims to evaluate whether this has influenced a trend toward standardization and consistency in intraoperative orthopedic photography.

Methods: To assess quality differences in orthopedic images before and after the 2014 guidelines, 60 intraoperative …

Impact Of Proviq Process Confirmations And Daily Management Systems On Catheter Associated Urinary Tract Infection Rates, Missy Thingelstad, Caitie Van Eerden, Travis Scott, Tiara L. Benson, Allison Engle, Shih-Ting Chiu, Ma Fe Chase, Melissa Scheck, Cecilia Malama, Brooke Higgins

Articles, Abstracts, and Reports

Problem Statement: Our 539-bed tertiary care center observed an increase in the Catheter Associated Urinary Tract Infection (CAUTI) Standardized Infection Ratio (SIR) from 0.88 to 1.28 when comparing October to December of 2023 to 2024. CAUTIs are associated with increased patient discomfort, mortality, morbidity, length of stay, and cost. Methods: Using ProvIQ methodology, process confirmation cards were introduced in eight pilot units, including critical care, medical-surgical, and maternal-child specialties, from October to December 2024. ProvIQ is an evidence-based quality improvement methodology including a basket of measures from Lean, Six Sigma, and change management. This program was developed by Quality Management …

Preserving Privacy In Senior Care At Home Monitoring Systems, Sam Russel, Ryan Benton, Amy Campbell, Scott Sittig

Shelby Hall Graduate Research Forum Posters

Many seniors prefer to live at home which necessitates research into the application of technologies to provide a safer environment with less caregiver resources. However, the application of home health care (HHC) monitoring for seniors is still in an evolutionary stage. Present HHC systems are produced by private companies with general regulatory guidelines lacking specific care of the elderly. As such, each company that produces such a system claims to have better safety, privacy, and security that their competitors. A pressing issues is devising and applying a general framework for the application of technologies that delivers safety while preserving privacy. …

A New Paradigm In Hospital Medicine: Evaluating The Effects Of Geographical Cohorting On Health Care Delivery, Vasu Gupta, Bhupinder Singh, Kanishk Aggarwal, Ayushi Garg, Rhea Kanwar, Fnu Anamika, Inder Preet Kaur, Rohit Jain

HCA Healthcare Journal of Medicine

Background

Geographical cohorting in hospital settings represents a significant shift from traditional patient rounding practices and aims to enhance the efficiency of health care delivery. This model assigns hospitalists to a particular inpatient unit, where most of their patients are located. While this model has several benefits, including streamlining health care procedures, optimizing resource allocation, and fostering better provider communication, its implementation is not without its challenges.

Methods

Our methodology for researching geographical cohorting involved a comprehensive literature review of peer-reviewed studies, surveys, and retrospective analyses. We utilized academic databases, such as PubMed, JSTOR, and Google Scholar, to identify relevant …

A Narrative Review Of Barriers To Utilization Of Surgical Risk Assessment Calculators, Jacob Lahti, Kaiya A. Noe, Abigail Veenstra, Sarah Gallitto, Victoria I. De Leon, Thomas C. Varkey, Nimit Agarwal

Annual Research Symposium

Over the last several decades, it has become the desire of surgical and medical teams to decrease risk levels involved for patients undergoing surgery. However, despite the advent of risk assessment calculators to help physicians obtain more accurate and objective judgements for postoperative complications, these tools are underutilized in standard clinical practices in comparison to other methods of risk assessment. This is likely due at least in part to certain barriers that decrease their functionality and ease of use. This review discusses the major barriers to the utilization of current risk calculators so as to allow for a better understanding …

The Effectiveness Of Cochlear Implants On Cognitive Function In Children And Adolescents With Hearing Loss: A Systematic Review, Harshita Sarambale, Joshua Ahdout, Srinija Balabhadra, Yesenia Valle Ramirez, John V. Rider Phd, Otr/L, M. De Armond Mfa, Mslis, S. Koshy-Chenthittayil Phd

Annual Research Symposium

This ongoing research project is a medical student led systematic review on cognitive function in pediatric cochlear implant patients.

Podcasting Towards Togetherness: Utilizing Podcasts To Improve Departmental Camaraderie And Well-Being, Michael Petrauskis, Colleen Gutman, Rosemarie Fernandez

Journal of Wellness

Introduction: Physician burnout is on the rise, and this is of particular concern in emergency medicine. Burnout is associated with medical errors, adverse events, poor professionalism, and litigation. A sense of community can build engagement and mitigate workplace stressors on well-being. Emergency physicians may have trouble connecting due to the nature of shift-work and various practice settings. Communication technology, and particularly podcasting, has the potential to help overcome these barriers and positively impact relatedness and well-being.

Approach: We developed an inward-facing podcast, “The ER Break Room” within the Department of Emergency Medicine at the University of Florida. Through the …

Acute Care For Elders Unit Implementation At Banner Health: A Quality Improvement Analysis, Jacob Lahti, Tony Gaidici, Shreya Bharath, Esha Saraswat, Nimit Agarwal

Annual Research Symposium

There is an increasing need to optimize hospital care for older adults as Age Friendly Health Systems (AFHS) become increasingly popular. Geriatric patients may often be subject to extended hospital stays, which can result in functional decline, increases in hospital-acquired injury, infections, and neurocognitive deterioration. Early acute inpatient rehabilitation (IRF) is known to improve functional optimization of older adults as compared to therapy in a skilled nursing facility (SNF). In this study we demonstrate the effect of a structured program based on the 4Ms of AFHS in our newly established Acute Care for Elders (ACE) unit, a first in Arizona. …

The Opportunities And Barriers Surrounding The Use Of Digital Health And Telemedicine In Sub-Saharan Africa, Aveline Langmead, Afua Osei-Wusu, Erica Tutuwan, Sara Mcmahon, Porter Biggs

Annual Research Symposium

No abstract provided.

One Center's Experience Of Pulmonary Embolism After Covid-19: Impact Of Vaccination Status, Cara Gose, Kaylee Dixon, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

Background: The incidence of pulmonary embolism (PE) has increased since the outbreak of the COVID-19 pandemic and may be due to the observed hypercoagulable state. There is conflicting evidence that thromboembolism risk increases after vaccination and that vaccines decrease the probability of having a thromboembolic event. This study aimed to explore how vaccination status impacts occurrence of PE after a positive COVID-19 test. The hypothesis was that vaccinated, immunocompetent patients have a lower incidence of PE after COVID-19 compared to unvaccinated patients.

Methods: This was a retrospective chart review at a teaching hospital in New England from 1/01/2021 to 3/31/2023 …

Wearable Penile Devices: The Techring, Gal Saffati, Daniela Orozco Rendon, Riley Daily, Mohit Khera, John P Mulhall

Faculty, Staff and Students Publications

The integration of wearable technology into healthcare has transformed patient monitoring, particularly in urology. Wearable penile devices (WPDs), such as the FirmTech TechRing, offer real-time data on erectile function, providing critical insights into nocturnal penile tumescence (NPT) patterns that can indicate underlying health issues. This piece highlights the potential of the FirmTech TechRing, a WPD, to advance erectile function monitoring by providing real-time data on NPT and intra-coital activity. It explores its promise in detecting early dysfunction, assessing cardiovascular risk, and enhancing proactive health management. By measuring parameters like firmness, girth expansion, and the frequency of erections, the TechRing enables …

Clinician Attitudes And Experiences In Screening Patients For Social Determinants Of Health Using Prapare, Pranav Rane, Mathew B. Weimer M.D., Adam Baus

Journal of Appalachian Health

Introduction: Social Determinants of Health (SDOH) are the conditions in which people are born, grow, live, work, and age. SDOH significantly influence health outcomes; as such, healthcare systems should screen for patients’ social needs. PRAPARE is standardized screening tool designed to assess and address patients’ social needs.

Purpose: This study examines SDOH screening at Valley Health Systems, a federally qualified health center based in Huntington, West Virginia. The aim of this research is to assess clinician attitudes and experiences in using the PRAPARE tool to screen for SDOH.

Methods: A self-administered online survey was conducted from April to May 2022 …

Implementation Of Endometriosis Toolkit: A Quality Improvement Project To Enhance Nurse Practitioners’ Knowledge And Management, Hasbun Rachel

DNP Qualifying Manuscripts

Abstract

Background: Endometriosis, characterized by the ectopic growth of endometrial-like tissue, affects approximately 11% of reproductive-aged women in the United States. Diagnosing endometriosis is challenging due to its diverse clinical presentations, reliance on laparoscopic procedures, absence of biomarkers, and limited awareness among healthcare providers and patients.

Local Problem: The diagnostic complexity of endometriosis, compounded by reduced provider awareness and a lack of comprehensive resources, leads to delayed and suboptimal care for affected women.

Methods: This Doctor of Nursing Practice quality improvement project aimed to enhance nurse practitioners’ (NPs) knowledge and management of endometriosis through a 1-hour educational session at the …

Strategies For Optimizing Female Athlete Health: A Multidisciplinary Approach To Mitigate Stress Fractures And Minimize Missed Participation In Collegiate Sports, Natalie B. Allen, Melissa R. Penkalski, Shannon M. Hauschildt, Kristin A. Paloncy-Patel

Internet Journal of Allied Health Sciences and Practice

Background: If not recognized early, low energy availability, along with overtraining, may result in stress fractures and significant time lost from sports participation for athletes at any level. Objective/Aim: The multidisciplinary collegiate medical team plays a key role in early identification of Female Athlete Triad (Triad) and Relative Energy Density in Sport (RED-S). To help with early identification, which may in turn lead to fewer stress fractures and less time missed from sports participation, this study’s objective was to implement the use of the 2014 Female Athlete Triad Cumulative Risk Assessment (FACTRA) and test early identification. The first …

Factors Associated With Std Hospital Admissions In South Carolina Hospitals (2020-2024), Darrell Holmes, Dennis Besong

South Atlantic Division GME Research Day 2025

No abstract provided.

Approach To Documenting Weight Loss Efforts And Lifestyle Modifications Within Hca Florida Oak Hill Family Care, Daisy Gandhi, Jenna Latona, Cheyenne Pirrello, Taylor Butts

West Florida Division GME Research Day 2025

No abstract provided.

Arts In Medicine: Created To Heal, Gbemisola Johnson, Dusk Gosney, Jessica Klingensmith, Akil Augustus

West Florida Division GME Research Day 2025

No abstract provided.