Quality Improvement Commons^™

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 …

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. …

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 …

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 …

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.

Sistemas De Salud Público Y Privado En El Salvador, Ana Ledford

World Languages and Cultures Senior Capstones

This paper analyzes El Salvador’s healthcare system, divided into public and private sectors. The public system, managed by the government, provides accessible healthcare for most of the population, though it faces issues like long wait times. In contrast, the private sector offers faster, specialized services for those who can afford them. The study discusses the strengths and weaknesses of each system, highlighting the need to enhance public healthcare and address access disparities. Solutions include increasing healthcare facilities in underserved areas and fostering collaboration with national and international organizations to improve overall healthcare quality for Salvadorians.

Poner En Práctica Las Regulaciones Federales: Habilitando A Los Pacientes Dominio Limitado Del Inglés, Caitlyn Gailey

World Languages and Cultures Senior Capstones

This paper examines the gaps in the U.S. healthcare system that affect the Hispanic community, focusing on language barriers and cultural competence. It highlights the challenges faced by Limited English Proficiency (LEP) patients, who may struggle with medical terminology, leading to misdiagnosis and improper treatment. The paper advocates for culturally sensitive language services, including qualified interpreters, translated documents and signage in order to improve communication, patient satisfaction, and reduce medical errors. It calls for systemic changes to ensure equitable care for all patients, regardless of language or cultural background.

Utilizing Technology To Change Practice And Reduce Falls, John Brennan Dnp, Rn Cphq, Sopiko Baratashvili Bsn, Rn, Kara Burdick Msn, Rn, Andrew Quito Bsn, Mba

Posters

Historically, fall prevention has been primarily reactive, averting similar events from recurring. However, recent nursing research has focused on ensuring that appropriate resources are in place (Wilson et al., 2022; Zhao et al., 2019). To complement this aspect of evidence-based literature, the hospital has invested in innovative technology and practices to prevent falls.

Effective Communication In The Pronunciation Of Brain Death, Sumanth Reddy, Artur Amirkhanyan, Jeremiah Avarana, Praneetha Arge, Alicia Lay

North Texas Research Forum 2025

Background: Clinical brain death determination requires both technical proficiency and sensitive communication with families. However, residents often report inadequate training and confidence in performing and discussing these examinations. This study evaluated an educational intervention combining didactic training and simulation to improve residents’ competence in brain death protocols and family communication. Methods: A mixed-methods cohort study was conducted with resident physicians. Participants completed a pre-intervention questionnaire assessing baseline knowledge, experience, and confidence in brain death determination and communication. An educational session reviewed clinical criteria, examination protocols, and communication strategies. Residents then engaged in an in-person simulation with standardized actors portraying grieving …

Interprofessional Neonatal Resuscitation Simulations: An In-Situ Assessment Of Pediatric Readiness At A Multi-Site Academic Center, Jessyca C. Gibson, Petru C. Nemes

South Atlantic Division GME Research Day 2025

No abstract provided.

Enhancing Patient-Centered Efficiency: Reducing Cardiology Clinic No-Shows Using Technology, Pre-Visit Planning & Patient Resources, Pat Shirey

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Cardiovascular disease (CVD) affects 48% of U.S. adults, requiring regular cardiology visits to manage risk factors and the early detection of complications (American Heart Association, 2019). No-shows disrupt continuity of care, worsen health outcomes (Choi et al., 2020), and decrease clinic efficiency (Goossens et al., 2022). A North Texas cardiology clinic reported a 31.9% overall no-show rate and a 42.1% no-show rate for new patients, costing $1.3 million annually.

Purpose: This quality improvement project aimed to reduce no-show rates through a patient-centered cardiology appointment bundle to improve continuity, patient outcomes, and efficiency.

Methods: This eight-week project utilized the Plan-Do-Study-Act …

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

A Quality Improvement Approach To Reducing Post-Surgical Acute Care Falls, Tiffany C. Mitchell

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Inpatient falls remain one of the most preventable adverse events in hospitals. Falls result in serious injuries and increasing healthcare costs. This quality improvement project evaluates the implementation of Fall TIPS to reduce fall incidence and promote sustainable safety practices.