Quality Improvement Commons^™

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 …

The Power Of Proximity: Driving Hand Hygiene Compliance Through Sanitizer Placement, Jennifer E. Jones, Eric Van Middendorp, Leanne Wendt

Posters

Hand hygiene is the cornerstone of infection prevention in healthcare settings and is particularly critical in the Neonatal Intensive Care Unit (NICU) where patients are highly vulnerable due to immature immune systems and frequent exposure to invasive procedures. Healthcare associated infections (HAIs) remain a significant cause of morbidity and mortality among neonates. Evidence consistently identifies proper hand hygiene as the single most effective intervention to reduce HAIs in NICUs. Despite its simplicity, compliance among healthcare workers is often suboptimal, influenced by factors such as workload and accessibility of hand hygiene resources.

From Scenario To Safety: Simulation As A Catalyst For Infection Prevention, Brianne M. Bachman, Jennifer E. Jones, Jessica L. Mcclusky, Mallory Davis

Posters

Simulation-based education has emerged as a transformative tool in healthcare, bridging the gap between theoretical knowledge and clinical practice.

In the realm of infection prevention, simulation offers a controlled, risk-free environment to reinforce essential protocols, build competency, and identify system level vulnerabilities before harm occurs.

Operation No Noro: A Multidisciplinary Approach To Containing A Norovirus Outbreak In An Inpatient Rehabilitation Unit, Donika Marko, Roula Hilli, Priscila Bercea, Pamela S. Bozigar, Levi Launder, Stephanie Robertson, Trini A. Mathew

Conference Presentation Abstracts

Norovirus is a highly contagious viral gastroenteritis and can rapidly spread in healthcare settings, particularly in congregate environments such as inpatient rehabilitation units. In March 2025, a cluster of acute gastrointestinal illness was identified on a 34-bed inpatient rehabilitation unit within a 150-bed acute care hospital. Eight patients developed: • Nausea • Vomiting • Diarrhea • Abdominal pain Due to shared spaces, communal therapy activities, and high patient interaction, rapid intervention was initiated to prevent further spread.

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

The Role Of Project Managers And Pmp Principles In Improving Operational Efficiency In Healthcare Organizations, Karan Thakkar

Harrisburg University Dissertations and Theses

Healthcare organizations operate in increasingly complex, regulated, and resource-constrained environments while managing a growing volume of projects tied to digital transformation, process improvement, regulatory compliance, and infrastructure development. Despite the project-intensive nature of healthcare operations, many organizations do not formally employ trained project managers or consistently apply Project Management Professional (PMP) principles; project responsibilities are frequently absorbed by clinical or administrative leaders whose primary expertise lies outside formal project management. This qualitative study examined how the project manager role and PMP principles contribute to operational efficiency in healthcare organizations. The study was conducted as a qualitative document analysis and thematic …

Cesarean Births Among Non-Us Born Hispanic Women: A Qualitative Study, Linda Presson, Christopher Arzadon, Cecilia Bustamante-Pixa, Wally Mijangos, Trisha Saul

Publications 2026-present

No abstract provided.

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, …

Advance Care Planning In Metastatic Lung Cancer Patients: A Quality Improvement Initiative, Khanh H. Thai

Student Theses

Background: Advance care planning (ACP) is essential in achieving goal-concordant care for patients with metastatic lung cancer (MLC), yet it remains underutilized.

Local problem: Despite its benefits, ACP has been inconsistently integrated into outpatient oncology settings, and a baseline evaluation at the project site revealed that only 11% of patients with MLC had ACP documented in the outpatient care clinic.

Methods: This Quality Improvement initiative implemented a formal, Nurse Practitioner (NP)-led intervention into routine oncology care. Using a quasi-experimental nonrandomized design, 13 eligible patients diagnosed with MLC without prior ACP documentation were enrolled in a four-week study. These participants were …

Silent Bones, Visible Changes: Increasing Osteoporosis Screening At Swedish Fmr, Alissa Kummer, Devin Beecher, Tara Ahmadi, Amanda Maxwell

All Podium Presentations

No abstract provided.

Quality Improvement: Referral Algorithm For Team-Based Care Of Blood Pressure Control, Hai-Yen Tang, Elise Gibson

All Podium Presentations

No abstract provided.

Optimizing Lactation Support: Enhancing Patient-Centered Care And Breastfeeding Self Efficacy Through Data-Driven Survey Analysis, Jessica L. Doshay

Doctor of Nursing Practice Final Manuscripts

Objective: The objective of this project was to implement evaluation of an integrated lactation support model within a multi‑site pediatric primary care organization to assess patient experience and breastfeeding confidence associated with a lactation consultation.

Background: Optimizing the patient experience is an indicator of healthcare quality. Improving breastfeeding outcomes remains a national priority. Structured lactation support delivered by International Board-Certified Lactation Consultants (IBCLCs) enhances breastfeeding outcomes, the impact of this is often undocumented in primary care settings.

Methods: This quality improvement project was conducted within the lactation department of a multicenter pediatric clinic in Southern California. Pediatric clinicians who were …

Exercise Prescription For Adults With Prediabetes In The Primary Care Clinic, Katherine W. Hall

Doctor of Nursing Practice Final Manuscripts

Prediabetes affects approximately one in three adults in the United States, with an estimated 10% progressing to Type 2 Diabetes Mellitus (T2DM) annually. Despite strong evidence supporting exercise as a first-line intervention to prevent disease progression, most patients in primary care settings do not receive structured physical activity counseling. This evidence-based project (EBP) aims to address this gap by implementing a standardized protocol to assess baseline physical activity levels and deliver individualized exercise prescriptions to adults with prediabetes in the primary care clinic.

Eligible participants, defined by HbA1c values between 5.70% and 6.49%, were identified during routine primary care visits …

Extending The Global Impact Of Dnp Education: Integrating Scholarly Dissemination And International Practice Projects, Cynthia Plonien, Pricilla Muisyo, Deborah Behan, Kristine Cope, Cathy Brown

Nursing Faculty Publications & Presentations

The Doctor of Nursing Practice (DNP) Program at the University of Texas at Arlington initiated a global outreach effort in 2024 through two complementary strategies: expansion of a digital repository to support dissemination of DNP scholarly work and implementation of pilot DNP projects in Kenya. Together, these initiatives represent an integrated model for global engagement that combines knowledge dissemination with application of practice-based scholarship. The repository has facilitated international access to DNP projects, demonstrating significant global reach across multiple countries. Concurrently, a pilot project in Kenya was established through a strategic in-country professional partnership, enabling culturally relevant and sustainable implementation …

Implementation Of A Language-Concordant Follow-Up Protocol To Reduce Percutaneous Nephrostomy Tube Complications: An Evidence-Based Practice Project, Marisol Ornelas

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims: Complications of percutaneous nephrostomy tubes (PCN) are common after discharge. Language barriers place patients at higher risk for misunderstanding discharge instructions. This evidence-based project evaluated whether a bilingual follow-up protocol three days post-discharge reduces PCN complications in patients.

Methodology: This project utilized the Johns Hopkins Nursing Evidence-Based Practice Model. The project leader reviewed the literature, synthesized the evidence, and developed a standardized PCN discharge training and bilingual PCN follow-up protocol.

Implementation: Unit nurses received training to standardize the PCN discharge process. Nurses educated PCN patients using the standardized process at the time of discharge. Three days …

Bridging Images And Language In Radiology: A Comprehensive Prisma Systematic Review Of Transformer Vision-Language Models And Clinical Readiness, Mohammad T. Khasawneh Dr., Sadaf Tabatabaee

Systems Science and Industrial Engineering Student Scholarship

Transformer vision-language models (VLMs) promise end-to-end automation of radiology reporting and related multimodal tasks. However, evidence remains fragmented across datasets, architectures, evaluation practices, and levels of clinical validation, limiting fair comparison and safe translation into practice. Following PRISMA 2020/PRISMA-S, search engines including PubMed, IEEE Xplore, Web of Science, and Google Scholar were systematically searched for peer-reviewed, English-language studies published between 2019 and 2025 that used paired radiology images and free-text reports. Dual reviewers screened records and extracted data using a locked schema covering datasets, modalities, architectures, training objectives, evaluation metrics, and indicators of clinical readiness. Free-text model descriptions were normalized …

Improving Medication Adherence In Mental Health Patients: A Quality Improvement Project, Ryan Oh

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction / Aims

Medication adherence among patients with mental health conditions is essential for quality of life, health outcomes, and longevity (Stewart et al., 2022). This quality-improvement project investigates whether a medication reminder app, supported by healthcare staff, effectively improves adherence and how it influences patients' perceptions of their health management.

Methods

Adult patients (aged 18-80) diagnosed with mental health disorders were identified at Orange County Health and Psychology Associates (OCHPA) in February 2026. All patients completed a PAM-10 survey both before and after the intervention, a mobile app called MyTherapy. Clinic staff received training on using MyTherapy to assist …

Implementing Cbt-I Coach App Education During Initial Psychiatric Evaluations At The Va Pec: A Provider-Facing Quality Improvement Initiative, Sarah J. Kang

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project aims to increase provider implementation of gold standard insomnia treatment, Cognitive Behavioral Therapy for Insomnia (CBT-I), by integrating CBT-I Coach app education into initial psychiatric evaluations within a VA psychiatric emergency clinic (PEC).

Background: Insomnia is highly prevalent among veterans and commonly co-occurs with PTSD, depression, and anxiety. National guidelines from the VA, DoD, and American Academy of Sleep Medicine endorse CBT-I as first-line treatment. Despite this, pharmacotherapy is the dominating intervention in psychiatric emergency settings. The CBT-I Coach app offers evidence-based CBT-I as a free, VA-developed digital tool, but it remains underutilized in acute …

Implementing Preoperative Anxiety Screening To Enhance Patient-Centered Care: A Quality Improvement Initiative, Adam Chaban, Abigail Limary, Amir Ghafarian, Joyce Li, George Mckelvey, Wael Saasouh

Medical Student Research Symposium

Background: Preoperative anxiety affects 40–80% of surgical patients and is associated with poorer perioperative experiences. Despite evidence linking preoperative anxiety to increase postoperative pain, sleep disturbances, morbidity and delayed recovery, structured anxiety assessment is not routinely integrated into outpatient pre-anesthesia workflows. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a validated tool that quantifies patient anxiety and information needs. This quality improvement (QI) project aims to implement APAIS screening in a Pre-Anesthesia Testing (PAT) clinic and evaluate its feasibility, workflow integration, and acceptability.

Methods: This QI initiative will be conducted in adult elective surgery patients at the Detroit Medical …

Evaluating Normothermic Machine Perfusion For Dcd Liver Transplants: Outcomes, Costs, And Value Implications, Meet S. Patel, Alisha Williams, Kyrillos Ayoub, Noor Kamaladin, Charles S. Day

Medical Student Research Symposium

Background: As liver transplantation expands to include marginal donor organs, technologies such as the TransMedics Organ Care System (OCS) offer the potential to improve graft viability and clinical outcomes. However, limited institution-level evidence exists evaluating the cost-outcomes balance of OCS use in Donation-After-Circulatory-Death (DCD) liver transplantation. This study assesses the clinical, operational, and economic value of OCS implementation within a high-volume transplant center.

Methods: A retrospective cohort analysis was conducted of all DCD liver transplants performed at Henry Ford Hospital from January 2021 to April 2024. Outcomes were compared between traditional cold storage (2021; n=23) and OCS perfusion (2023–2024; n=82). …

Transforming Obesity Management In Primary Care: Shared Medical Appointments (Smas) – An Evidence-Based Practice Project, Glendy Chen

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose/Aims

The purpose of this DNP project is to implement a 10-week Lifestyle Intervention Shared Medical Appointment (LISMA) program in primary care to improve obesity outcomes. Aims include increasing structured visit frequency, enhancing multidisciplinary engagement, and improving metabolic indicators, mindful eating behaviors, and self-efficacy.

Background of Problem & Description of Current Practice

Obesity affects over 40% of U.S. adults and is associated with cardiometabolic morbidity, reduced quality of life, and rising healthcare costs. Guidelines recommend intensive, multicomponent behavioral interventions with frequent contact. Current practice primarily offers one-on-one visits at insufficient frequency with limited team integration, contributing to suboptimal management. LISMAs …

“There Was Nothing Left To Give”: Experiences Of Compassion Fatigue Among Former In-Patient Psychiatric Clinicians, Katie Ladner

Counseling and Psychology Dissertations

Compassion Fatigue (CF) is a state of emotional and physical exhaustion resulting from prolonged exposure to stressful or traumatic experiences, specifically among healthcare workers, and it negatively impacts their ability to provide care to their patients and perform their jobs effectively (Singh et al., 2020). The purpose of this qualitative study is to explore the lived experiences of compassion fatigue in mental health clinicians who previously worked in in-patient psychiatric hospitals and their subsequent resignations. This phenomenological research explored participants' understanding and descriptions of their CF experiences in their roles within psychiatric hospitals and how CF contributed to their leaving …

Exploring Practicing Registered Eeg Technologies' Opinions And Preferences Regarding Electroencephalographic Scope Of Practice Standard Forms Of Occupational Regulations, Richard A. Steer

Seton Hall University Dissertations and Theses (ETDs)

Abstract Background: Neurodiagnostic (NDT) is the study and recording of electrical activity in the central and peripheral nervous systems, it is essential for providing critical information that can aid in the diagnosis and treatment of neurological disorders. EEGs are the most frequently performed NDT procedures. The proportion of hospitalizations involving EEG use increased by 122.7% from 2003 to 2014, an average increase of 11.2% annually and continues to grow. The rate of rEEG use increased by 49.4% over 11 years (4.5% annually), while cEEG use increased by 302.3% (27.5% annually) (Bernheimer et al., 2018). Under existing law, the EEG profession …

Exploring Health Insurance’S Role In Chronic Disease Management Among Hispanics, Romelyn Dones

Seton Hall University Dissertations and Theses (ETDs)

This qualitative study examined how insured non-English- and English-speaking Hispanic adults perceive the role of health insurance in the management of chronic disease. Chronic conditions remain a leading cause of morbidity in the United States, and although prior research suggests that insurance coverage improves access to care, it does not always enhance how individuals understand or utilize support for chronic disease management. Limited research has explored how individuals with chronic conditions interpret the role of insurance in their daily self-management practices, particularly among Hispanic populations. Guided by Andersen’s Behavioral Model of Health Services Use, this study explored how contextual, enabling, …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

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). …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

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 …

Implementation Of A Planned Extubation Nurse-Led Safety Bundle In A Pediatric Cardiac Intensive Care Unit, Broderick Sutton

Doctor of Nursing Practice Final Project Abstract

Purpose: To implement and evaluate a nurse-led planned extubation safety bundle designed to improve nurse preparedness, interdisciplinary communication, workflow consistency, and confidence during planned extubation events in a pediatric Cardiac Intensive Care Unit (CICU).

Background: Planned extubation in critically ill pediatric cardiac patients requires effective interdisciplinary coordination. Variability in nurse preparation, communication, and knowledge of sedation pharmacokinetics contributed to workflow inefficiencies and patient safety concerns. Evidence supports standardized nurse-led protocols to improve extubation readiness and reduce practice variability.

Methodology: A prospective pre-post quality improvement project was conducted over eight weeks in a pediatric CICU. The intervention included a nurse-led planned …