Quality Improvement Commons^™

Reimagining Nurse Education: Virtual Reality & Didactic Education For Better Nurse Handoff And Documentation, Haley M. Whalen

Master's Projects and Capstones

Setting: The pediatric perianesthesia unit (pre-operative and post-anesthesia care unit). Problem: Gaps in perianesthesia documentation contribute to poor handoff communication, leading to adverse events and increased hospital costs. Additionally, inconsistent documentation reduces clarity and consistency during handoffs. Context: Staff in the microsystem reported low confidence scores with required OP-Time documentation, inconsistent workflows, and I-PASS handoff expectations. These factors contribute to incomplete charting and a lack of standardization across providers. Interventions: A two-part educational intervention was conducted, consisting of eight sessions. The first component is a Virtual Reality (VR) simulation that demonstrates an accurate perianesthesia I-PASS handoff. The second …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Disaster Risk Reduction In Rural Indonesia: Evaluation Of The Japan Red Cross Program In Pujiharjo Village, Meyralda Dara Adisa, Pujo Widodo, Anwar Kurniadi, Wilopo Wilopo

Preventia: The Indonesian Journal of Public Health

Pujiharjo Village in Malang Regency, Indonesia, is highly vulnerable to natural disasters. In 2021, the Indonesian Red Cross (PMI) partnered with the Japanese Red Cross Society (JRCS) to implement a community-based disaster preparedness program. This study evaluates the program's effectiveness in terms of community participation, institutional support, and alignment with the Sendai Framework for Disaster Risk Reduction 2015–2030. Using a qualitative case study, data were collected through document analysis of Vulnerability and Capacity Assessments (VCA), Community Action Plans (CAP), and local SOPs. Thematic analysis explored disaster risk perception, governance, mitigation investment, and emergency preparedness. The program successfully improved risk awareness, …

Quality Improvement (Qi) Project Aimed At Reducing 30-Day Hospital Readmissions For Patients With Congestive Heart Failure (Chf) Through Checklist Implementation, Gary Gutierrez

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Congestive Heart Failure (CHF) remains a leading cause of preventable 30-day hospital readmissions,

especially in outpatient and transitional care settings. This quality improvement (QI) initiative was

launched within a private internal medicine practice in Essex County, New Jersey, to address this issue

by implementing a standardized CHF management checklist. The checklist focused on four key

components: (a) comprehensive medication reconciliation, (b) tailored patient education, (c) timely

follow-up appointments, and (d) improved interdisciplinary communication. By integrating evidence-

based practices into a structured workflow, the QI project aimed to improve care coordination,

empower patients to manage their condition, and reduce preventable …

Standardizing Sepsis Care Across A Lifespan: A Multidisciplinary Approach To Reduce Variation, Vijayakrishnan Poondi Srinivasan, Jillian Gregory, Sarah Chang

MaineHealth Maine Medical Center

Sepsis is a life-threatening condition affecting patients of all ages and remains a leading cause of mortality, hospitalizations, and healthcare costs worldwide. In pediatrics, severe sepsis accounts for millions of deaths annually, with approximately 176,000 hospitalizations and an 8% mortality rate each year in the U.S. In adults, it contributes to 35% of in-hospital deaths and is the leading cause of readmissions. These data underscore the urgent need for timely recognition, standardized interventions, and consistent, evidence-based care across populations.

Enhancing Sepsis Prevention In Long-Term Care Facilities: Development Of An Infection Prevention Sepsis Toolkit, Emmalyn A. Tuhin

Student Scholarly Projects

Objectives: The purpose of this Doctor of Nursing Practice (DNP) project was to create, validate, and refine an Evidence-Based Sepsis Prevention Toolkit to enhanced early sepsis recognition and interprofessional coordination of care within long-term care facilities (LTCFs).

Background: Sepsis remains a leading cause of mortality and preventable transfer to the hospital for the elderly residents within the LTCFs. A significant practice gap persists because sepsis in this population often presents atypically, resulting in delayed or inaccurate diagnosis and treatment.

Methods: This project was guided by the following PICOT question: For healthcare professionals caring for patients aged 65 years and older …

The Effectiveness Of A Chronic Care Management Program On Hospitalization Rates And Quality Of Life In Chronic Kidney Disease Patients, Sophie Burris

Doctoral Projects

Chronic Kidney Disease (CKD) is a progressive condition that distinctively affects underserved rural communities due to limited access to healthcare, provider shortages, and transportation barriers. Chronic Care Management (CCM) has emerged as a patient-centered, initiative-taking approach that emphasizes care coordination and self-management support. The purpose of this doctoral project was to evaluate the impact of implementing a CCM program in Caucasian females over the age of 40 with CKD residing in an underserved rural community post hospitalization. The Chronic Care Model (CCM) is the framework that guides the doctoral project which compared outcomes in patients enrolled in a CCM program …

Enhancing End-Of-Life Quality In Hospice Care, Gerson Orellana Prudencio

Capstone Projects and Master's Theses

The‍‌‍‍‌ increasing demand for hospice care in Monterey County is a clear indicator of the rapid growth in the need for end-of-life services driven by the aging population. The project was developed at the Department of Hospice of the Central Coast, which is under the Montage Health Foundation, a non-profit organization. The community served consists of elderly people receiving hospice and end-of-life care, as well as volunteers who provide administrative and indirect support. The Volunteer Handbook aims to create a comprehensive procedural manual for hospice volunteers to improve administrative efficiency and ensure the quality of care. Interviews were conducted with …

Opportunities To Improve Continuity In Medicines Management For Aboriginal And Torres Strait Islander People Accessing Care In South Australian Hospitals: Coverage, Quality, Monitoring And Accountability, Annabelle Cranwell, Cheyne Sullivan, Kezia Daniel, Erik Cornelisse, Brianna Kinnear

Journal of the Australian Indigenous HealthInfoNet

This paper proposes that hospital admissions, which are traditionally considered high risk transitions, can be opportunities to strengthen continuity in medicines management (CMM) for Aboriginal and Torres Strait Islander patients and across the healthcare system. There are four key areas of focus in this paper including CMM coverage, CMM quality, health system monitoring of CMM, and health system accountability for CMM to Aboriginal and Torres Strait Islander people and communities. These areas for improvement are justified by the National Agreement on Closing the Gap (The National Agreement), the Guiding Principles to Achieving continuity in medication management, and Continuity in Medication …

Band-Aids And Backroads: Surviving Rural Healthcare In South-Central Mississippi, Cambry L. Craft

Honors Theses

Health is more than the absence of disease—it is the product of opportunity, trust, and access. Yet for millions living in rural areas of the United States, equitable healthcare remains out of reach. This thesis seeks to amplify the voices of rural residents in Mississippi and uncover how their experiences, beliefs, and cultural values shape their perception of their local hospital and the care that is provided there. This qualitative research study examines the experiences and opinions of a rural community in south-central Mississippi regarding their local hospital, as well as their perceptions of the most effective approach to prevent …

Development Of A Longitudinal, Small-Group Pocus Curriculum For Internal Medicine Residents, Shah N. Mahmud Do, Ammar W. Bhatti Do, Ariq Rahman Md, Omar Al Qassab Md, Fraser Mackay Md

The Lahey Journal

Development of a Longitudinal, Small-Group POCUS Curriculum for Internal Medicine Residents

Introduction

Point-of-Care Ultrasound (POCUS) is integral for clinicians to enhance their diagnostic and procedural skills. Unlike Emergency Medicine or Anesthesia training programs, Internal Medicine programs often lack a structured and standardized curriculum. We thus developed a longitudinal and multi-pronged POCUS curriculum aimed at building trainee competency when utilizing ultrasound for diagnostic and procedural work-up.

Methods

The curriculum encompasses the following: basics of ultrasound, ultrasound-guided procedures, thoracic ultrasound/Bed Lung Ultrasound in Emergency (BLUE), and cardiac ultrasound/Focus-Assessed Transthoracic Echocardiography (FATE). These modules were integrated into the residents’ clinic blocks. We utilized …

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

Impact And Effectiveness Of Phq-9 Training For School Counselors On Mental Health Referrals For High School Students, Sherikee Dorice Grim Bsn, Rn, Ja’Quay Brister Dnp, Pmhnp-Bc, Margaret Harvey Phd, Aprn, Acnp, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

Adolescents' mental health has worsened and become a public health issue, with depression being a primary concern. There is an urgent need for early screening, school-based referral pathways, and interventions to address common problems in high schools. Patient Health Questionnaire-9 (PHQ-9) is a validated, evidence-based tool for detecting depression; however, its systematic use in school-based counseling settings through organized training has not been studied for implementation in high schools. This review assesses the current literature on the impact and effectiveness of PHQ-9 training for school counselors on mental health referrals among high school students, with a focus on early …

Revolutionizing Dental Operatories: How Do We Do More Using Less?, Michael Zidile D.D.S., Brian Choi D.D.S.

The New York State Dental Journal

The authors present a transformative approach to modernizing dental operatories as part of their practice’s recent expansion. Aimed at enhancing efficiency and patient-centered care, the project reimagines traditional operatory design by eliminating ergonomic and hygienic barriers, notably, the use of keyboards and mice. Key innovations include the implementation of touchscreen PC displays, high-power PCs with graphics cards, magnetic USB cables for rapid data transfer, omnidirectional microphones linked to AI scribes and wireless intraoral scanning. The design prioritizes a standardized, clutter-free layout across eight operatories, utilizing A-Dec Inspire Series cabinets for ergonomic supply management. By removing countertops and pullout trays, the …

N Y State Dent J November 2025

The New York State Dental Journal

In the November 2025 issue, the reader will find the following feature articles:

• "Attitudes of New York State Pediatric Dentists Toward Treating Hasidic Patients"
• "A Qualitative Assessment of the Role of Dental Specialists in U.S. Opioid Epidemic"
• "Revolutionizing Dental Operatories"
• "An Update on Non-Cigarette Nicotine-Containing Products and the Periodontal Patient"

This issue includes regular columns with regional news impacting the New York membership including: editorial and legal columns, association activities, component news, continuing education opportunities, and classifieds.

Too Loud To Ignore: Knowledge, Attitudes, And Practices Regarding Hearing Protection In Student Musicians And Ensemble Directors, Lucile Donald, Ashley G. Flagge

Ashley Flagge Publications

Musicians are at an elevated risk for noise-induced hearing loss (NIHL) due to repeated exposure to sound levels exceeding occupational safety guidelines. Although many strides have been made in educating music students on the potential dangers of noise exposure and the mitigating effects of hearing protection devices, the current attitudes on this topic among high school and college-level student musicians remain largely unknown. An electronic survey was administered to high school (n = 195) and university (n = 161)-level band students and ensemble directors (n = 15) regarding knowledge of noise/music-induced hearing loss (MIHL), personal practices with HPDs, and types …

A Cancer Haiku Triptych, Larry C. Driver

Advances in Cancer Education and Quality Improvement

This trio of patient-inspired Haiku attempts to capture the joyful optimism of cancer-free life in the first pair of spring and summer, with a hint of transition in the second, and the final autumn into winter piece heralding the realization that smoldering cancer has flared-up with the possibility of the end of life.

Impact Of Clinical Decision Support Tool Implementation On Injectable Calcitonin Usage, Petar Jordanov, Ashley Crouch, William Towers

Advances in Cancer Education and Quality Improvement

Calcitonin injection is a high-cost medication used to treat hypercalcemia in hospitalized patients. Many institutions have implemented strategies to reduce unnecessary use or waste of calcitonin, including dose rounding, formulary restriction criteria, and limiting the number of doses a patient may receive. MD Anderson Cancer Center (MDACC) utilizes approximately 1200 calcitonin doses per year with no current formulary or dosing restriction criteria. The goal of this study was to evaluate patterns of use of calcitonin at MDACC and implement and evaluate the impact of clinical decision support tools to reduce unnecessary calcitonin use and waste. This is a single-center quality …

Streamlining Nuclear Theranostic Clinic Workflow, Charisma Desai, Anne Fisher

Advances in Cancer Education and Quality Improvement

Nuclear medicine clinic needs have drastically changed with the emergence of theranostics, exciting new agents in the fight against cancer. However, administering these agents is a resource-intensive task, increasing demand for physician consultation time with patients, clinic office space, and scanner time. We examined our institution’s nuclear medicine clinic workflow and interviewed the clinic’s front desk staff, technologists, nurses, managers, physicians, and patients to find sources of delays, dissatisfaction, and decreased efficiency. An Ishikawa diagram and decision matrix helped us determine the most impactful intervention with our available resources. For this cycle, we focused on the consent process. Theranostic patients …