Interprofessional Education Commons^™

Quality? Safety? Stop Being Naïve., Rana K. Zaban Do, Steven Istephan, Jonathan Serman Md

Clinical Research in Practice: The Journal of Team Hippocrates

The first day of our inpatient medicine rotation, the Emergency Department (ED) admitted a patient to a general medical floor without notifying our rounding team. We used the institution’s system improvement tracking software to draw attention to communication breakdown in the interest of patient safety. This piece illustrates how there is a prominent hierarchy in medicine; it is inherent to the framework of the way in which hospitals function. A discussion ensues with our attending physician supervisor on our patient medicine service. During this discussion, we ponder whether it is possible to impact quality and safety from our position as …

Improving Type And Screen Specimen Collection Prior To Elective Surgery, Nordx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

To avoid delays in the availability of compatible blood for elective surgery patients requiring transfusion, a type and screen specimen should be completed at least 24 hours prior to surgery. Baseline metrics in an acute care inpatient blood bank demonstrated a significant number of cases with no type or screen completed.

The objective of this KPI was to prevent any delays in providing compatible blood products to scheduled surgical patients. Several internal and external system issues were identified as a result of a root cause analysis and a number of actions were initiated.

Outcomes have been positive. Data collection post …

Improving Cardiology Patient Flow In Nuclear Medicine, Kelly Haar, Hannah Sullivan, Kathryn Laverdiere, Nuclear Medicine Department, Haley Pelletier, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

At baseline, a nuclear medicine department found it difficult to complete cardiac stress tests within scheduled times. Using the performance improvement process, a nuclear medicine department looked to improve patient experience related to wait times for this test.

Two goals were identified and a root cause analysis was initiated. After identifying some process issues, two KPIs were developed to address them.

A root cause analysis identified some processing issues and two KPIs were instituted to address them.

As a result, one outcome was to hire an additional physician assistant to address the barrier of inadequate cardiology coverage. Next steps include …

Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Maine Medical Center Operational Excellence

MaineHealth Maine Medical Center

STRATEGIES FOR IMPROVING COMMUNICATION BETWEEN DOCTORS AND NURSES IN AN ACUTE CARE HOSPITAL

Effective interdisciplinary communication is imperative for safe patient care in an acute care hospital environment.

A surgical unit used their HCAHPs scores to assess how often patients perceived there was good communication between different doctors and nurses during their hospital stays. The data demonstrated that this occurred 22% less often than the national average.

As a result of a root cause analysis, a number of countermeasures were initiated with the goal of achieving scores greater than the national average. Post KPI inception in the second quarter of …

Driving Organizational Change From The Bedside: The Aacn Clinical Scene Investigator Academy., Susan R. Lacey, Caryl Goodyear-Bruch, Adrienne Olney, Dave Hanson, Marian S. Altman, Natasha S. Varn-Davis, Debbie Brinker, Ramón Lavandero, Karen S. Cox

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Staff nurses are pivotal in leading change related to quality improvement efforts, although many lack skills to steer change from the bedside. The American Association of Critical-Care Nurses (AACN) staff nurse leadership program, Clinical Scene Investigator (CSI) Academy, teaches and empowers staff nurses in leadership skills and change concepts to translate evidence into practice affecting patient outcomes.

OBJECTIVES: To describe the curriculum of the AACN CSI Academy that provides staff nurses with the leadership skills required to create unit-based change projects that positively impact patient/family outcomes.

METHODS: The curriculum of the Academy included leadership topics, communication, change concepts, quality …

Physician Orders For Life-Sustaining Treatment (Polst) Utilization In A Skilled Nursing Facility: An Educational Quality Initiative, Ryan Hazley Bsn, Rn, Dnp Student, Karl Steinberg Md, Cmd, Joseph Burkard Dnsc, Crna

Doctor of Nursing Practice Final Manuscripts

According to expert reports and recent research, frequent clinician-patient conversations about individual end-of-life preferences are necessary to avoid unwanted treatment and to ensure that desired treatments are received. The ongoing diffusion of Physician Orders for Life-Sustaining Treatment (POLST) educational initiatives in skilled nursing facilities (SNFs) are vital to success of California’s POLST program, which is now recognized as only 1 of 3 mature POLST programs in the country. The purpose of this evidence-based practice project was to answer the question: Among staff in a skilled nursing facility, does implementing a formal POLST education program compared to current practice improve staff …

Education Of Nurse Practitioners And Physician Assistants; What Role, If Any, For Physicians In Determining Their Scope Of Practice?, Joseph I. Shapiro

Marshall Journal of Medicine

Recent changes in legislation allow for non-physicians to independently perform many of the duties previously restricted to physicians. There are potentially benefits to these changes, but the author is concerned that some of the attributes of physicians induced by the long and rigorous training embedded in the profession may be absent in this new, independent health-care work force.

Exploring Job Satisfaction And Preceptorship Capacity Among Applied Epidemiologists, Jessica C. Arrazola

College of Graduate Studies: Theses & Dissertations

Job satisfaction is important to consider when developing strategies for recruitment and retention. The Public Health Workforce Interests and Needs Survey (PH WINS) conducted in 2014 was the first nationally representative assessment of the state public health workforce. Prior to this assessment, the job satisfaction of state agency public health workers and preceptor capacity had not been measured. This study fills the current research gaps by studying the job satisfaction among the applied epidemiology workforce, identifying factors influencing job satisfaction, and the describing the preceptorship capacity among epidemiologists. This research is based on the 2014 PH WINS data. The analysis …

Benefit Of Report Card Feedback After Point-Of-Care Assessment Of Communication Quality Indicators, Michael H. Farrell, Clair R. Sprenger, Shelbie L. Sullivan, Bree A. Trisler, Jessica J.F. Kram, Erin K. Ruppel

Journal of Patient-Centered Research and Reviews

Background: Communication in health care is crucial for patient experience and biomedical outcomes, but problems with communication are often seen in health care. Training can improve communication, but skills must be reinforced after graduation to remain improved. Since educational methods are too resource intensive for sustained use throughout the Aurora Health Care system, it is necessary to develop affordable, quantitative methods. The first author has developed necessary techniques, including behavior-specific measures called communication quality indicators.

Purpose: To demonstrate secure audio recording in an outpatient visit and to use communication quality indicators with a heterogenous set of patient-clinician conversations.

Methods: Thirty …

Population Health Improvement Through Coordination Of Care, Trevey Davis

Muskie School Capstones and Dissertations

The objective of this Capstone Project is to work with the Mercy Gap in Care Coordinators (GCCs) to document the value of the care coordination at Mercy Health System. A key element of this project was to develop a workflow diagram alongside the GCC in order to track patient outcomes. Additionally, the team developed a system for documenting patient outcomes that is crucial to measuring the impact of care coordination. From the data collected there are a number of outcomes that can be measured. The number of patients who are contacted for screening is measurement of patient experience. Following initial …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

Exploring The Importance Of Team Psychological Safety In The Development Of Two Interprofessional Teams, Denise O'Leary

Articles

It has been previously demonstrated that interactions within interprofessional teams are characterised by effective communication, shared decision-making, and knowledge sharing. This article outlines aspects of an action research study examining the emergence of these characteristics within change management teams made up of nurses, general practitioners, physiotherapists, care assistants, a health and safety officer, and a client at two residential care facilities for older people in Ireland. The theoretical concept of team psychological safety (TPS) is utilised in presenting these characteristics. TPS has been defined as an atmosphere within a team where individuals feel comfortable engaging in discussion and reflection without …

10 Steps To Medical-Dental Collaboration, American Dental Association

Action for Dental Health

No abstract provided.