Quality Improvement Commons^™

Improving Healthcare Team Recognition By Patients, Abhijit Marathe, Tin Pham, Semeon Tadesse, Franca Samoilovich, Manuel Egued, Joshua Shultz, Ashwini Komarla, Olga Karasik

North Florida Division GME Research Day 2022

No abstract available.

Increasing The Rate Of Pneumococcal Vaccination In Patients Over 65 At Hca Florida Osceola Primary Care, Ubaldo Gonzalez Morales, Muna Alhusban, Chelsea Guan, Natalia Cavin, Humeyra Dogan, Allison Ferrara

North Florida Division GME Research Day 2022

No abstract available.

Patient Centered Communication, Aelius Khan, Zhe Liu, Thomas Krajewski, Sean Gibbs

South Atlantic Division GME Research Day 2022

No abstract provided.

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

Impact Of A Multidisciplinary Nutritional Support Team On Quality Improvement For Patients Receiving Home Parenteral Nutrition, Michael Rothkopf, Mohan Pant, Rebecca Brown, Jaime Haselhorst, Francine Gagliardotto, Allison Tallman, Debbie Stevenson, Andrew Depalma, Michael Saracco, Dan Rosenberg, Vladimir Proudan, Kishwar Shareef, Nudrat Ayub

EVMS School of Health Professions Faculty Publications

Introduction Home parenteral nutrition (HPN) is essential for patients with intestinal failure requiring long-term nutritional support. The Amerita Quality Improvement Project for HPN Patients (QIP-PN) explored the effect of a physician nutrition expert (PNE)-led multidisciplinary nutritional support team (MNST) on HPN care for patients under its service.

Objective To determine an MNST effect on adherence to protocols, outcomes and quality of life (QOL) in HPN.

Methods The study was divided into three phases: data review (phases 1a and 1b), observation (phase 2) and intervention (phase 3). Seven Amerita locations were selected as ‘study branches’ (population), from which all study patients …

Exploring Predictors In The Receipt Of Patient/Family-Centered Care, Arami Anwell

Theses and Dissertations

Study 1

OBJECTIVES: The research aim of this study was to identify predictors associated with the receipt of PFCC among U.S. children/families

METHODS: Caregivers of 38,803 non-institutionalized children, aged 0 to 17 years, were surveyed by the National Survey of Children’s Health (NSCH) 2018–20019. Patient/family-centered care (PFCC) was measured using five components of health care delivery that were answered on a 4-point Likert scale. Logistic regression models were analyzed for the overall receipt of PFCC and each component of PFCC, with survey weighting added to adjust for complex sampling design.

RESULTS: Many predictors were associated with the receipt of PFCC. …

Why Do Family Members Reject Ai In Health Care? Competing Effects Of Emotions, Eun Hee Park, Karl Werder, Lan Cao, Balasubramaniam Ramesh

Information Technology & Decision Sciences Faculty Publications

Artificial intelligence (AI) enables continuous monitoring of patients’ health, thus improving the quality of their health care. However, prior studies suggest that individuals resist such innovative technology. In contrast to prior studies that investigate individuals’ decisions for themselves, we focus on family members’ rejection of AI monitoring, as family members play a significant role in health care decisions. Our research investigates competing effects of emotions toward the rejection of AI monitoring for health care. Based on two scenario-based experiments, our study reveals that emotions play a decisive role in family members’ decision making on behalf of their parents. We find …

Improving Code Status Discussion And Documentation For Patients 65 Years Or Older At Hca Fl Osceola Hospital, Taylor Murphy, Mark Duros, Faris Matanes, Keishla Garcia Fernandez, Raj Shah, Olga Karasik

North Florida Division GME Research Day 2022

No abstract available.

To Improve Quality, Leverage Design, Byron Crowe, Jessica Gaulton, Noah Minor, David A Asch, Jeff Eyet, Erin Rainosek, Kristen Flint, Joseph Joo, Chip Chambers, Sherry Bright, Julius J Yang, Gene Beyt, Read Pierce, James M Moses

Department of Medicine Faculty Papers

No abstract provided.

Redesigning Price Setting Under The Universal Health Insurance In Egypt / إعادة تصميم التسعير في ظل التأمين الصحي الشامل في مصر, Ahmed El Agamy, Hebatalla Ahmed Ismail, Hend Hassan, Reem Gouda, Samah El Sayed

Papers, Posters, and Presentations

Since the Sustainable Development Goals were adopted by the United Nations Development Programme, Universal Health coverage became the main target for many nations. One of the main challenges facing the governments to achieve universal health coverage is maintaining adequate policies to set fair pricing for the healthcare services. Each country has different strategies to apply fair pricing and this paper is discussing the current pricing methods in Egypt and suggesting three policies to tackle its challenges.

Implementation Of A Standardized Medication Reconciliation Protocol In A Psychiatric Stabilization Setting, Sara Robinson

DNP Scholarly Projects

BACKGROUND: Medication errors are a prevalent patient safety concern across healthcare settings. High-quality medication reconciliation is an intervention and expected standard of care that can help to prevent adverse drug events. This quality improvement project focused on implementing a standardized medication reconciliation protocol on a short-stay psychiatric unit.

INTERVENTION: An evidence-based toolkit supported by the Agency for Healthcare Research and Quality (AHRQ), Medications at Transitions and Clinical Handoffs (MATCH) was selected as the framework for developing and implementing this protocol.

Congruent with the evidence-based toolkit recommendations, baseline data collection and needs assessment provided context for tailoring the intervention to the …

Qualitative Comparison Of The United States And United Kingdom Healthcare Systems, Rachel Cazzaniga

Graduate Theses/Dissertations

The United States and United Kingdom healthcare systems vary based on their public access, financial dependence, health outcomes, gross domestic product, and much more. The systems have continued to grow with different focuses of importance in the quality of care that is being distributed to their populations. The U.K. universal healthcare system represents their value of accessibility and affordability, while the U.S. privatized system(s) represents their value of economic growth. The study provided a qualitative analysis of the systems' differences by integrating real world experiences and perceptions of the systems from individuals that have encountered and interacted as a patient …

Assessing The Association Among Hospital Ownership Penalties Assessed Under The Hospital Readmissions Reduction Program And 30-Day Risk Standardized Mortality Rates For Selected Conditions, 2016-2018, Jennifer Carmona

Dissertations and Theses

Background: The Hospital Readmissions Reduction Program (HRRP) is an aspect of Patient Protection and Affordable Care Act (ACA) of 2010. HRRP requires Medicare to reduce payments to hospitals with relatively high readmission rates. While the implementation of the program has been accompanied by reductions in readmission rates, some have expressed concerns about unintended consequences, including harm to patient care and even death. Under HRRP, hospitals serving a high proportion of socioeconomically disadvantaged patients, like public hospitals, have been more likely to receive financial penalties, potentially impeding their ability to invest resources in improving patient outcomes. There is previous research …

Perception Of Health Care Access In Rural Georgia: Findings From A Community Health Needs Assessment Survey, Elisa M. Childs, Tiffany R. Washington

Journal of the Georgia Public Health Association

Background: Limited access to health care services has been cited as a barrier to care for individuals who live in rural areas, contributing to significant health disparities in this population. While perception of services has been cited as a determinant of utilization of health services, it is unknown how perception of services influences health care access in rural areas. The paucity of studies specific to areas in the United States that are medically underserved, necessitated this study and its quantification of the issues that are relevant to individuals living in rural Georgia.

Methods: This study examined the perception of health …

Medication Usage In Independent Living: A Continuing Care Retirement Community Aging In Place Initiative, Aarti Deshpande, Carrie B Rubenstein, Ruth Benfield, Lee Burnside

All Poster Presentations

Purpose: The purpose of the study was to identify medication use concerns in this community.

Background: In this study, Swedish Geriatric Medicine Fellow partnered with this community to identify medication use concerns in this population.

Continuing Care Retirement Communities (CCRCs) are intended to support residents as they age in place. These communities tend to be well resourced but less studied. This survey attempts to identify medication use concerns in this population. Mirabella CCRC has 324 Independent living (IL) residents, 82 of which are couples. The average age is 85 years. The current cost of an IL unit is from $4673- …

Implementation Of New Policy Software To Enable Quick Access To Best Practice Resources, Mary Alice Duthie, Debbie Shuster

All Poster Presentations

Purpose: Transition to a new policy software that would enable staff to quickly as easily locate Swedish policies and provide policy authors with a practical tool to work more efficiently on policy revisions.

Background/Significance: Existing policy software for Swedish had limited search functionality that caused issues with staff not being able to locate policies quickly or easily. This outdated software had been in place from 2007 – 2021 and contained only basic operations that remained unchanged during this time. If staff had difficulty finding policies in the software then there was the potential for either relying on others on the …

Blood Administration Documentation Audit Automation, Tonya Lawson, Harriette Lober, Andrea Nordmark

All Poster Presentations

Background: Blood administration is a high risk, low volume, complex procedure. It has strict regulatory requirements for documentation of at least 15 elements over the course of the procedure. There are frequently findings for deficient documentation during survey. Manual audits are time consuming and inaccurate. Every facility in the Providence system faces the same challenges to audit for compliance.

Problem: Detecting the rate of compliance for documentation of blood administration manually is difficult. Nursing documentation for blood administration is often incomplete. Manual audits are labor-intensive and have proven to have limited impact to increase documentation compliance.

Methods: We created an …

Developing An Evaluation Process For Telehealth In A Copd Clinic, Jodi H. Biller

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool.

Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) …

Implementation Of A Nonverbal Scrub Cap Identification System To Improve Communication And Perception Of Patient Safety Among Unfamiliar, De-Identified Staff Members In The Operating Room., Keri Ann Roskowinski

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Operating room (OR), professionals deliver patient care with brief introductions, and roles were not always identified, and although team members wear identification (ID) badges, they were usually covered by sterile gowns and other routine personal protective equipment (PPE). Purpose: The aim of this Doctor of Nursing Practice (DNP) project was to determine if a simple intervention to apply the individual’s name and role to a scrub cap could improve identification, OR team communication, and consequently, patient safety. The participants in this project consisted of nurses, physicians, anesthesia providers, scrub technicians, students, medical sales representatives, and those that identified as …

Improving Disinfectant Cap Use On Central Lines In The Icu To Reduce Patient Risk For Clabsi: A Quality Improvement Project, Tali Cherim

Master's Theses and Capstones

BACKGROUND: Central line-associated bloodstream infections (CLABSI) are the most common type of preventable healthcare-associated bloodstream infection, and may increase length of stay (LOS), facility treatment costs, and patient mortality rates. Intensive Care Unit (ICU) patients are especially vulnerable to CLABSI due to their critical health conditions and other comorbid factors. A literature review provided evidence supporting the use of alcohol-impregnated disinfectant caps, such as SwabCap®, on central line (CL) ports to significantly reduce patients’ risk for CLABSI. This quality improvement project took place within an adult ICU of a Level II trauma facility in New England, where the Infection Prevention …