Health and Medical Administration Commons^™

Mainehealth Cancer Care Network Ticket Intake Process, Lauren Couture, Brett Cropp, Gavin Carr, Ashok Kunche, Heather Boulier, Evelyn Taylor

Operations Transformation

The MaineHealth Cancer Care Network informatics team is manually submitting most reporting tickets for oncology customers. The current intake ticket process includes various communication channels to the business intelligence developers [BID] when a reporting need is identified resulting in workflow deficiencies and redundancies. As of FY23, MaineHealth has moved to a new ticket reporting system called ServiceHub which includes new customer self-service tools that have not yet been utilized.

Creating Capacity To Accommodate Additional Cardiac Catheterization Procedures, Kristin Anthony

Operations Transformation

Patient access to diagnostic outpatient (OP) cardiac catheterization is limited by a perceived lack of capacity. Outpatient cardiac cath pts flow through the ACU for pre/post procedure care. Current schedule limits pts that may be scheduled through the ACU to two OP procedures/day. Cardiologists request the ability to schedule beyond the two procedures/day allowed. Significant variation in pre/postoperative care orders exist amongst cardiologists resulting in variability in length of stay. Cardiac procedures are booked either as 60/90/120 minutes – Epic case averaging technology is not active in the cath lab. As a result, the case minutes in the cath lab …

Key Performance Indicator (Kpi) Development Pathway, Christopher Lloyd, Amy Giles, David Spaulding, Sarah Rines

Operations Transformation

In Q1 FY24 as more team members started to take Operational Excellence classes and subsequently become more engaged in quality improvement it was observed there was much enthusiasm but also some gaps in the understanding of available tools, resources, data collection strategies, and what elevates something to a KPI, etc. There is a need to create a guide that supported gaps, streamlined tracking process, and aligned teams in this new approach.

Restrictive Covenants In Surgical Care: Time To Reconsider, Andrew J. Malek, Ian L. Mcculloch, Alan Z. Yang, Goutam K. Gadiraju, Justin M. Broyles

School of Medicine Faculty Publications

No abstract provided.

Benefit Of Medication Reconciliation Practices On Patient Health Outcomes In A Healthcare Setting, Helen Harris, David Petrulis, Lauren Trepp, Bryan Chong, Jillian Haas, David Chan, Laura Ellwein Fix

Biology and Medicine Through Mathematics Conference

No abstract provided.

Approach To Pivie In Pediatrics: Standardization For Early Detection, Jamie Green, Jill Gregory, Elizabeth Murphy, Jessica Miller, Nicole Manchester, Frank Harris, Meaghan Wildes, Cecilia Inman, Jenn Paradis, Faye Weir

Operations Transformation

PIVIE (Peripheral Intravenous Infiltration & Extravasation) can have devastating effects, especially in the pediatric population. The condition may disrupt vasculature severe enough for permanent skin and tissue loss that can lead to impaired limb function due to severe scarring. Problem: No standardized process existed either to prevent or review these events at Barbara Bush Children’s Hospital at Maine Medical Center prior to the study. PIVIEs were measured through the event reporting platform and only severe PIVIEs were being documented in this report. All infiltrations (1-4 on the infiltration scale) should be measured for accurate benchmarking. Occurrences in the electronic medical …

Smart Meetings, Morgan Forster, Arthur Durity, Cathy Cole

Operations Transformation

A one year look at how the CHA executive team focused on opportunities to have fewer yet more productive meetings! In this presentation we will discuss the details that help shape improvement around the challenge of too many meetings and share the results from lessons learned at PBMC and Waldo.

Transition To Adult Care For Bleeding Disorders: Building A Multidisciplinary Tool, Leslie Larson, Ekaterina Funk, Dana Grass, Felicia Munster, Eric Larsen, Louise Baca, Glen Roy, Sara Artinyan

Operations Transformation

Youth with chronic illnesses often have poorer health outcomes after transitioning to adult care. Maine Health Bleeding Disorders is a Health Resources and Services Administration (HRSA) grant funded Hemophilia Treatment Center (HTC) that serves patients with congenital bleeding disorders. We provide multidisciplinary specialty care throughout the lifespan which includes pediatric and adult hematologists, family nurse practitioners, nurses, physical therapists, social worker, dietitian, genetic counselor, and research coordinator. In 2022, HRSA mandated all federally funded HTCs increase by 25 percent from baseline the number of individuals ages 12 to 26 years seen in a comprehensive clinic that have a health care …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Enhancing Peripartum Care Through Standardized Nurse Knowledge Exchange, Gabriela Ochoa

Master's Projects and Capstones

Problem Inconsistent handoff practices during patient transfers can cause mistakes and adverse outcomes. Hospital A's peripartum unit has no set policy for Nurse Knowledge Exchange (NKE) during transfers. This project will introduce a standard handoff guide to enhance communication and prevent harmful results after patient transfers.

Context The quality improvement project was conducted in a peripartum mesosystem within an urban hospital in Northern California. This specific area of the hospital comprised 21 postpartum rooms and nine laboring rooms.

Intervention The project involved a methodical strategy that encompassed engaging stakeholders, conducting a literature review, and analyzing data to pinpoint areas for …

Increasing Palliative Care Team Involvement In Pediatric Hematopoietic Stem Cell Transplant Patients, Meagan Vacek, Lisa Tarbell, Melissa List, Erin Hall, Jennifer Linebarger, Kelstan Ellis, Gina Jones, Joel Thompson

Research Days

Early implementation of palliative care in pediatric oncology is well established but its role in pediatric hematopoietic stem cell transplant (HSCT) patients is yet to be fully determined. Multiple organizations encourage palliative care involvement in HSCT patients. Our aim was to increase palliative care team consults for patients receiving HSCT for our targeted diagnosis. Though we did not achieve this aim, we were able to increase the palliative care team's involvement in the total cohort of patients undergoing HSCT.

Development Of An Endometriosis Toolkit To Support Clinicians In Providing Quality Care For Women, Rachel Hasbun

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Endometriosis is the abnormal growth of endometrium-like tissue outside the uterine cavity, affecting approximately 11% of women in the United States during their reproductive years. Diagnostic challenges stem from its varied clinical presentations, reliance on laparoscopy for definitive diagnosis, and limited awareness among practitioners and patients, potentially leading to diagnostic delays of up to 13 years.

Problem: The complexities of diagnosing endometriosis in primary care and specialty settings, combined with limited provider awareness and a lack of comprehensive resources, hinder timely and accurate identification. This leads to suboptimal treatment and care for women affected by the condition.

Methods: …

Bilateral Corneal Perforations Due To Elder Neglect, Jaclyn Jordan, Katherine Selman, Richard Byrne

Journal of Geriatric Emergency Medicine

Introduction: Atraumatic corneal melting and perforation is a rare etiology of eye pain and visual loss in the Emergency Department (ED), and xerophthalmia from vitamin A deficiency is primarily described as a cause of blindness in pediatric patients.

Case: A 68-year-old female presented to the ED with worsening eye pain and months of clouding and vision loss. History was limited by cognitive impairment and was provided by spouse. On exam, she was found to have a body mass index of 13.7 kg/m², dry mucous membranes, purulent discharge from both eyes, and opacification and erosion of both corneas. She …

Institutional Pilot Changes Lead To A Reduction In Emergency Department Boarding Patients, Rohan Akhouri, Jennifer Watts, Christopher S. Kennedy, Kelly A. Sinclair, Bethany Bolt, Ashley Daly

Research Days

Background: Crowding and boarding pediatric emergency departments (ED) is an ongoing problem associated with a mismatch in resources and patient care demands. ED boarding can be defined as a patient admitted to an inpatient unit who remains in the ED. ED boarding occurs when there is limited availability of inpatient bed space – either due to patient volume or decreased staffing. ED boarding is associated with adverse events, and increased mortality. Few studies address the impact of inpatient strategies on ED boarding. The objective of our study was to evaluate hospital-based strategies within a single institution and their effect on …

Emergency Care Of An Older Adult With Complex Care Needs, Muhammad Adnan Khan, Himika Dalia, Michelle Dietz

Journal of Geriatric Emergency Medicine

In this case report, we demonstrate the application of a stepwise guiding approach for older adults with complex care needs who present to the emergency department. It also highlights the challenges encountered during the implementation of these principles, and sheds light on the factors affecting the management of complex older populations. This case report emphasizes the pressing need for the development of a standardized protocol tailored to emergency physicians, addressing the unique needs of complex-multimorbid older adults, and overcoming the system barriers in emergency care.

The Impact Of Electronic Health Record Unintended Consequences On Quality Of Care Within A High Complexity Healthcare Organization, Joetta Powell

ATU Theses and Dissertations 2021 - Present

“Unintended consequences are unexpected, and unwanted outcomes that can limit the value of EHR implementation and adversely affect quality of care and patient safety” (Lee & Kang, 2021, p. 898). Few organizations have redesigned the EHR to improve usability to mitigate potential patient safety concerns. This study aims to identify unintended consequences in patient care workflows and determine educational needs related to EHR usability. A mixed method approach was used to investigate unintended consequences in deidentified patient safety reports submitted Jan 1, 2020, through December 31, 2023. The data was analyzed to identify error types and educational deficits. The Acute …

An Examination Of Cardio-Vascular Patients’ Experiences In A Rural Food Prescription Program, Julia Hansen

Honors Theses

The burden of diet-related chronic diseases in rural communities has prompted the implementation of food prescription programs in rural areas to investigate the impact of more affordable and accessible fresh produce on these vulnerable populations. Because there is little research on the impact of food prescription programs on cardiovascular patients in rural areas, this study will focus on how food prescription programs can benefit this at-risk population. Another goal of this study is to receive feedback from participants to improve food prescription programs to better suit cardiovascular participant needs. To accomplish these goals, a series of questions were asked to …

Enhancing The Culture Of Safety Among Hospital Personnel By Implementing A Just Culture Program: A Quality Improvement Project, Lawson Stuart

Doctor of Nursing Practice (DNP) Manuscripts

Objectives

The purpose of this study was to assess employee perceptions of a healthcare organization’s existing climate of psychological safety regarding reporting patient care errors or near-miss events. Based on data obtained from the use of a valid and reliable survey tool, a plan was developed for the introduction and implementation of Just Culture throughout a large multi-hospital healthcare system.

Methods

Employee perceptions of the organization’s culture and current barriers to improving patient safety were identified by administering the JCAT survey to a population of 25,893 frontline staff, middle leaders, and senior leaders (clinical and non-clinical) at 26 separate hospitals …

A Visual Journey Of Diseases, Joanna Ni

Honors Theses

Patient journey maps serve as invaluable tools in healthcare to comprehend and enhance the patient experience. This research explores the significance of patient journey maps in understanding the diverse interactions between patients and healthcare systems. By visualizing each stage of the patient’s experience, from initial symptoms to post-treatment care, the journey maps offer insights into patient needs, preferences, and pain points.

Of the eight patient journey maps identified, most examined a patient’s journey through cancer, and concerned a Canadian patient. Evaluation of these maps revealed that there are many factors that can challenge and facilitate a patient’s journey through the …

Exploring The Cultural Influences On Sexual And Reproductive Health Behaviors: A Cross-Cultural Study Of Asian American And Caucasian Female College Students, Emilee Ly

Honors Theses

This capstone honors project aims to investigate the influence of cultural backgrounds on the healthcare behaviors of Asian American and Caucasian college students. The main research question of this focus group study is: “How do cultural backgrounds influence healthcare behaviors, including communication, seeking, and access to sexual and reproductive health, information, and services, among Asian American and Caucasian female college students?”

Drawing upon the World Health Organization’s 2003 Social Determinants of Health (SDOH) framework, this study explores how structural determinants, social networks, cultural backgrounds, and healthcare systems factors collectively influence the way female college students communicate, seek, and have access …