Quality Improvement Commons^™

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 …

A Reflection On What Pharmacists In Different Countries Can Learn From One Another, Aaryaman Khurana, Patricia Darbishire

Purdue Journal of Service-Learning and International Engagement

What would be the first words that come to mind if you were asked about the US health care system? I asked that question to several of my friends and pharmacy peers and received mixed responses such as “expensive,” “confusing,” “hard to navigate,” and “best in the world.” This was not surprising considering the many options and the varying quality of medical procedures, medical devices, and pharmaceuticals available. I wondered how responses might differ if I posed the same question about their health care to those in a third-world country. So, I asked the same question of friends and family …

Operational Factors Influencing Branch Revenue In Multi-Branch Child Therapy Services, Muhammad Luthfi

Jurnal Administrasi Bisnis Terapan

The management of multi-branch child therapy services requires a strong understanding of operational factors that contribute to revenue performance. This study aims to analyze the relationship between operational days, occupancy rate, service attendance, and the number of practitioners in relation to branch revenue within a child therapy service organization operating in urban areas in Indonesia. A quantitative cross-sectional design was employed using operational data collected from 24 child therapy services. This study employed a quantitative cross-sectional design using branch-level operational data collected in December 2025 from 24 child therapy service branches. Multiple linear regression analysis was conducted to examine the …

Analisis Pengaruh Patient-Perceived Hospital Service Quality Terhadap Customer Satisfaction Dan Behavioral Intention Pelayanan Rawat Inap, Launa Inayati Arlina, Dwiky Yuanasika, Mochammad Bagus Qomaruddin, Djazuly Chalidyanto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The Bed Occupancy Rate (BOR) of inpatient rooms at Mitra Sehat Mandiri Hospital Sidoarjo during 2019-2023 has not reached the ideal standard. The BOR values were 22%, 28%, 37%, 25%, and 20%, with an average of 26.4%, remaining below the ideal range of 60-85%. One of the most influential factors contributing to the low BOR is suboptimal service quality. This study aims to analyze the relationship between Patient-Perceived Hospital Service Quality, customer satisfaction , and behavioral intention among inpatients at Mitra Sehat Mandiri Hospital Sidoarjo. This study employed a quantitative method with an analytical approach and a cross-sectional design. The …

The Wear-Bot Checklist: A Risk Of Bias Tool For Evaluating Validity And Reliability Research In Wearable Technology, Bryson Carrier, Jennifer A. Bunn, Chris Eschbach, Joel D. Reece, Gregory J. Welk, Brett A. Dolezal, James W. Navalta

Kinesiology and Nutrition Sciences Faculty Research

This paper proposes an innovative tool designed to standardize the evaluation of validity and reliability studies in the rapidly evolving field of wearable technology. We introduce the WEArable Technology Risk of Bias and Objectivity Tool (WEAR-BOT), a tool that addresses the need for a comprehensive and systematic way to assess bias in studies examining consumer-grade and research-grade wearable devices. This is the first tool designed to evaluate the risk of bias in validation and reliability studies. Other risk of bias tools like the Cochrane ROB, COSMIN, or the many other risk of bias tools are designed for different study methodologies …

Skin Injury (Moisture-Associated Skin Damage, Skin Tears, And Pressure Injury) Prevention Education: An Evidence-Based Practice Project, Elizabeth Lopez

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Aims: Skin injuries, particularly pressure injuries, pose significant challenges in hospitals, especially for critically ill patients, leading to discomfort and increased healthcare costs. Such injuries profoundly impact patient outcomes, resulting in increased morbidity and mortality rates. Furthermore, these injuries can severely affect patients' quality of life, impeding their recovery. This project at LLUMC aims to address knowledge gaps among ED nursing staff regarding skin injury prevention through targeted education, thereby enhancing nurses' knowledge and confidence in managing these injuries.

Methodology: To evaluate the effectiveness of the skin injury prevention education initiative, eight tools were utilized, including the …

Coaching In Undergraduate And Graduate Medical Education: A Scoping Review Of Success Factors, Barriers, And Outcomes Data File, Binata Mukherjee, Jenna Pfleeger, Haidee Custodio, Maria Renee Roca, Gurupreet Khalsa, Clista Clanton

University Research Data and Datasets

The data in this file support the findings of the following study.

Purpose: Wanting to implement a sustainable learner coaching program in academic medicine and prior exposure to coaching initiatives raised questions including planning, implementation and assessment, and resource allocation. This scoping review examines coaching across medical learners, reported program elements, success factors, and barriers.

Methods: Following PRISMA-ScR guidelines, informed by Levac et al. on Arskey and O’Malley’s framework and Braun and Clarke’s thematic analysis, PubMed, Scopus, and ERIC was searched through May 2024. Articles were screened, data extracted, and coded. A mixed methods analysis included descriptive statistics and thematic …

Patient Wait Time And Throughput Interventions In The Cardiology Outpatient Setting, Chioma Ohiri Tawose

Electronic Theses and Dissertations

Healthcare collaboration and patient care require effective communication. Poor communication impacts wait time. Inadequate communication in the outpatient cardiology clinic can lead to disruptive patient throughput, or workflow, and extend patient length of visit. The purpose of this project was to implement a means of communication for clinicians and healthcare assistants to improve patient flow and cut down idleness, ultimately reducing patient wait time. The project established the incorporation of a built-in electronic health record communication notification system, the Event Button, for asynchronous communication between staff. A quantitative quality improvement design was used to conduct this project. Inferential and descriptive …

American Dental Association And Academy For Sports Dentistry Announce Collaboration To Advance Oral Health And Athlete Safety

New Orleans Dental Association News

Article announcing a new collaboration between the American Dental Association (ADA) and the Academy for Sports Dentistry (ASD) on as-yet undecided initiatives that could include educational opportunities and broader professional awareness of sports dentistry topics among current and future dentists.

Enhancing Resilience And Reducing Burnout In Oncology Nurse Practitioners Through The “Three Good Things” Intervention, Ernestine A. Muanya

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Burnout among oncology nurse practitioners (NPs) threatens clinician well-being, care quality, and workforce retention. The World Health Organization (2019) defines burnout as a workplace condition caused by chronic unmanaged stress. Nationally, over half of healthcare professionals report burnout symptoms, with high rates in oncology (Deriglazov et al., 2025). In Texas, nearly 48% of advanced practice providers report emotional exhaustion and job-related stress (Patel et al., 2024). Objective: This single-group pre–post quality improvement project evaluated an eight-week, app-based Three Good Things (3GT) intervention to reduce burnout and enhance resilience among 19 breast medical oncology nurse practitioners at a comprehensive …

A Structured Discharge Bundle To Reduce Heart Failure Readmissions, Carolyn Hudson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Heart failure (HF) remains a major contributor to 30-day hospital readmissions, placing strain on patients, healthcare systems, and reimbursement structures tied to quality metrics. Inconsistent discharge practices and gaps in transitional care coordination increase the likelihood of preventable rehospitalizations.

Purpose: This project examined whether implementing a standardized, nurse-driven discharge bundle would improve transitional care outcomes and decrease 30-day readmissions among adults hospitalized with HF.

Methods: A practice-based quality improvement initiative was conducted in a 465-bed regional hospital over a 8-week period. Using iterative Plan-Do-Study-Act cycles, a structured discharge bundle was introduced for eligible HF patients discharged from medical-surgical and …

Nurse-Led Interventions To Reduce Occupational Hand Injuries In Manufacturing, Patti Harter

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Occupational hand injuries cause preventable morbidity, lost productivity, and workers’ compensation costs in manufacturing. Although safety policies and personal protective equipment (PPE) are in place, inconsistent glove use, slow hazard identification, and delayed response still cause injuries. This quality improvement (QI) project evaluated an eight-week, nurse-led injury-prevention bundle at a Texas heavy-vehicle manufacturing facility. The intervention required daily glove inspections, Safety Champion participation, real-time electronic hazard reporting, and corrective action within the shift. Injury outcomes were measured using Occupational Safety and Administration (OSHA) rates per 200,000 work hours and percentage change from baseline. After implementation, hand injury rates fell from …

Sexually Transmitted Infections And Screening: An Educational, Evidence-Based, Quality Improvement Bundle, Misty D. White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: With sexually transmitted diseases on the rise in central Texas, advance practice providers were not following evidence-based practice recommendations for sexually transmitted infection screening, treatment, and follow-up. Screening for sexually transmitted diseases occurred at a rate of less than one patient every 7.75 days.

Objective: The objective of this project was to develop and implement an advanced practice provider training tool to educate the clinic providers on sexually transmitted infections, collect pre- and post-data for the educational sexually transmitted infection bundle, and collect sexually transmitted infection screening, identification, treatment, and follow-up data generated by the clinic advanced practice providers …

After Hours, Faster Reperfusion: A Multidisciplinary Quality Improvement Initiative To Reduce Stemi Door-To-Balloon Time, Suhas Tatapudi, Aarohi Parikh, Jeffrey Lesser, Alexander Rhodes, M Daniel

Gulf Coast Division GME Research Day 2026

No abstract provided.

Making The Most Out Of Advanced Directives: A Qi Project, Brissa Mundo-Santacruz, Joseph Freeze, Jesus Dorado, Nina Ball

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Improving Sepsis Order Set Utilization Through Targeted Resident Education: A Lean Six Sigma Green Belt Quality Improvement Project, Sarah Sheikh, Puneeth Shridhar, Bushra Bangash, Valerie Chukelu, Tonya Meirhofer, Arunima Jose, Zainab Shakir, Shane Jenks, Augusto Sepulveda, Trung Nguyen, Rajeev Raghavan

Gulf Coast Division GME Research Day 2026

No abstract provided.

A Joint Effort: Quality Improvement Using Joint Injection Drawers, Grant Thomas, Brissa Mundo-Santacruz, Joseph Freeze, Talon Aitken, Nina Ball

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Qi: Improving Gdmt Among Discharge Patients With Heart Failure, Daniel Avila Castillo, Amar Kalidas, Parshvi Patel, Khaled Khalaf

Gulf Coast Division GME Research Day 2026

No abstract provided.

Reducing Pressure On Pressure Ulcers; A Study To Educate And Improve Skin Ulcers In The Hospital, Jakob Schnell, Victoria Suh, Peng Tang

Gulf Coast Division GME Research Day 2026

No abstract provided.

Tackling Tele Box Shortage Via Educational Initiative, Guntash Khasria, Bushra Ambreen

Gulf Coast Division GME Research Day 2026

No abstract provided.

Improving False Code Blue Rates In The Hospital, Edrianna Mae Ablola, Muhammad Siddiqi, Veronica Phung, Sivatej Sarva

Gulf Coast Division GME Research Day 2026

No abstract provided.

Dexmedetomidine Versus Propofol For Reducing Emergence Delirium In Pediatric Anesthesia: A Scoping Review, Hannah Laxton Bsn, Rn, Hannah Mclain Bsn, Rn, Robert Mohr Bsn, Rn, Sarah Rocha Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Dwanye Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background 

Propofol is widely regarded as the standard anesthetic agent for preventing and treating emergence delirium, particularly in pediatric patients. Emergence delirium presents as postoperative agitation that may escalate to self-injurious behavior that can lead to disruption of critical lines or equipment. Since its approval in 1999, dexmedetomidine has gained attention for its sedative and sympatholytic properties, offering potential advantages over propofol. This study compares the postoperative effects of propofol and dexmedetomidine in reducing emergence delirium in pediatric surgical patients.

Methods 

A scoping review was conducted using PRISMA guidelines to identify relevant literature published between 2000 and 2025. Databases searched …

Hca Florida Trinity Hospital Heart Failure Quality Improvement Project, Guillermo Gomez, Yuvedha Senthil, Ubaldo Gonzalez, Kero Hakim, Karo Hakim, Paras Shah, Dale Calixte, Chris Lane, Zach Sukin, Jordan Young

West Florida Division GME Research Day 2026

No abstract provided.

Advancing Safe Medication Administration During Pediatric Emergency Care Through Nurse Education: A Quality Improvement Project, Ciera Hunter

Master's Theses and Capstones

Background: Due to the increased complexities of pediatric medication administration, preventable errors occur at a higher rate than in general adult populations. Rural emergency departments (EDs) often see fewer pediatric patients and have less specialized support available on-site. Nurse continuing education is an evidence-based intervention to reduce medication administration errors making it vital to supporting patient safety and maintaining pediatric readiness.

Local Problem: The microsystem is a rural, critical access hospital in northern New England. In 2021, the microsystem scored 66/81 on the National Pediatric Readiness Project’s (NPRP’s) ED Assessment. In 2026, the score dropped 11 points to 55/81. Contributing …

Improving Efficiency In The Intensive Care Unit Through Reduction Of Nurse Burnout: A Quality Improvement Initiative, Johanna Grace Koroma

Master's Theses and Capstones

Abstract

Background: Intensive care unit (ICU) nursing is prone to high levels of burnout, which poses concern for staff wellbeing, patient safety, and microsystem strain (Kerlin et al., 2020). Educational interventions may serve as a means of increasing awareness on the issue and reducing the effects of burnout, through promotion of evidence-based management strategies.

Local Problem: One ICU microsystem identified several key contributing factors to nurse burnout, including staffing shortages, limited resources, competing responsibilities within the macrosystem, and insufficient organizational support (Zhang et al., 2025). Baseline survey data of the population observed a prevalence of 50% “high” burnout profiles among …

Maintaining Trust In Uncertain Times: Funding Pauses And The Ethical Cost To Community-Engaged Research, Brynn E. Sheehan

Department Psychiatry & Behavioral Science Faculty Publications

Federal funding pauses, once considered rare, are increasingly disrupting the stability and continuity of community‐engaged research. Even projects with active, awarded grants are experiencing the strain of funding uncertainty, raising substantive concerns among research teams and community partners. These disruptions extend beyond operational delays; they jeopardize the continuity of relationships developed through sustained, collaborative engagement. In the absence of clear information about a project's future, uncertainty undermines trust and challenges the ethical principles that guide human subjects research, particularly beneficence and justice. This paper draws on direct experience and insights from the broader field to examine the practical and ethical …

Improving Pediatric Emergency Department Lethal Means Safety Documentation Rates For Adolescents With Mental Health Concerns, Cassandra L. Stegall, Ana-Maria Mcgill, John Fanton, Paul C. Mullan

Department Psychiatry & Behavioral Science Faculty Publications

Introduction:

Lethal means safety counseling (LMSC) is recommended for children presenting to the emergency department (ED) for a mental health (MH) evaluation. Currently, no gold-standard guidelines exist for documenting LMSC in the ED.

Methods:

This quality improvement project was conducted in the ED of a tertiary children's hospital. Baseline data were analyzed for access to any LMSC documentation (ALD) for "firearms/guns," "sharps," or "medication," and for complete LMSC documentation (CLD) if access to all 3 types was documented. The first intervention period added open-ended screening questions about access to lethal means to the MH-licensed clinical social worker note template. Intervention …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

The Financial Effects Of Clinically Significant Readmissions In Florida Hospitals, Brian Patrick Cotton

Doctor of Business Administration Dissertations

This study examines how the financial performance of hospitals in the state of Florida impacts the quality of care. This study used data from 2017-2019 to evaluate how the number of hospital readmissions – a proxy for care quality – are associated with and vary in relation to the stability of the financial resources held by the hospital. The Hospital Readmission Reduction Program (HRRP), a Medicare value-based purchasing program, uses a mandatory pay-for-performance process that was initiated to decrease the 30-day hospital readmission rate. Hospitals with high readmissions are held accountable and financially encouraged to increase their quality of care …

Education For Residents And Patients On Pain Management For Gyn Procedures, Claire Moen, Jeffrey Edwards, Dominique Rehl, Kenyon Weidle

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.