Quality Improvement Commons^™

Dermatology Resident Training On Depression Screening: A Cross-Sectional Survey, Kaitlyn L Streight, Harry Dao, Soo Jung Kim

Faculty, Staff and Students Publications

Background

Many dermatologic diseases are implicated in the development of depression. Currently, there is no literature addressing the extent of dermatology residency training on depression screening.

Objective

Our study aimed to determine the extent of dermatology residency training on depression screening to potentially improve education in this area.

Methods

We designed a 12-question survey to assess the level of resident training and comfort in depression screening for patients with acne vulgaris, atopic dermatitis, psoriasis, hidradenitis suppurativa, and skin cancer. Fifty-six residents completed the survey, and data for each question was analysed in aggregate.

Results

Participants found depression screening most important …

Efficacy Of Quality Improvement And Patient Safety Workshops For Students: A Pilot Study, Kevin P Shah, Shreya Goyal, Vignesh Ramachandran, Jaden R Kohn, Jonathan A Go, Zachary Wiley, Anoosha Moturu, Meera K Namireddy, Anjali Kumar, Ryan C Jacobs, Matthew Stampfl, Jesal R Shah, Justin Fu, Weijie V Lin, Brandon Ho, Grace Wey, Sophie Y Lin, Andrew C Caruso, Lindsey Jordan Gay, Diana E Stewart, Sara Andrabi

Faculty, Staff and Students Publications

BACKGROUND: While the Association of American Medical Colleges encourages medical schools to incorporate quality improvement and patient safety (QI/PS) into their curriculum, medical students continue to have limited QI/PS exposure. To prepare medical students for careers that involve QI/PS, the Institute for Healthcare Improvement chapter at an allopathic medical school and school of allied health professions initiated self-directed learning by offering student-led workshops to equip learners with skills to improve the quality and safety of healthcare processes.

METHODS: In this prospective cohort study, workshops were hosted for medical students between 2015 and 2018 on five QI/PS topics: Process Mapping, Root-Cause …

Can The Kanban Technique Reduce Medical Errors?, Juhi Hegde

Dissertations and Theses

This study discusses common medical errors and the extent of harm caused in the United States and explores the application of the Kanban technique of Lean Management in the healthcare industry to reduce medical errors. It also describes various scenarios of how the visual scheduling/ signaling system has been incorporated for continuous process improvement in the clinical and non-clinical sectors of the industry based on several review articles. Furthermore, a survey study was performed in order to assess whether ‘Kanban Visual Management System’ utilization in healthcare has the ability to reduce medical errors. A convenience sample of healthcare providers was …

Analysis Of Delays In Processing Times In An Ophthalmology Clinic, Kai Yung Natalie Lui

Dissertations and Theses

Efficiency is an important component of any medical practice. It facilitates quality care, reduction in wait time, patient and staff satisfaction, and decreased cost. The purpose of this study was to identify bottlenecks in the current processing system in the Eye Center at Hershey Penn State Medical Center. Data was obtained about patients arriving at the clinic for ancillary tests such as visual field testing and retinal imaging. Analysis of this data revealed a statistically significant longer average length of visit for patients who received testing in comparison to those who did not. However, due to the small sample size …

Impact Of Wait Times, Perception Of Care And Environment On Patient Satisfaction At Infusion Centers And Dialysis Centers, Ke Li Yew

Dissertations and Theses

Waiting time is a significant component of patient satisfaction. Patient satisfaction is an increasingly important parameter in assessing the quality of care. Understanding the most important factors impacting overall satisfaction can help health care administrators and providers improve patient care. Numerous studies showed that there is a strong and negative relationship between wait times and patient satisfaction at ambulatory clinics, orthopedic clinics, endocrinology clinics or emergency rooms. However, patient satisfaction at infusion centers and dialysis centers has not been widely studied. This study aimed to investigate relationships between perceived waiting times, perception of care and environment and patient satisfaction at …

Continuation Of Midodrine Upon Icu Discharge, Fahad Hussain, Deepti S. Rao

Quality Improvement/Patient Safety Symposium

Indications for Continuation of Alpha-1 Agonist Midodrine Upon ICU Discharge

Hussain, Fahad, MSII; Rao, Deepti, MD

Introduction:

Persistent hypotension in patients affected by circulatory shock is a common barrier to discharge in the ICU. Even after these patients have been otherwise stabilized, low-level hypotension often ensures that they remain in the ICU on IV vasopressors. Midodrine, an oral α1-agonist, has shown promise as an adjunct therapy to wean patients off IV vasopressors and facilitate earlier discharge from the ICU. According to a recent study done at the Mayo Clinic ICU, Rochester, discharge on Midodrine was associated with a shorter ICU …

Implicit Racial Bias In Physicians: Racial Disparity In Opioid Prescriptions In United States Emergency Departments, Anjali Ta

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Over the past 30 years, a documented racial disparity in opioid prescriptions in U.S. emergency care departments has persisted despite overall prescription trends fluctuating throughout the rise and fall of the early 2000’s opioid epidemic. Consistently, Blacks and other minorities receive lower levels of opioid analgesics when presenting with conditions or characterizing pain levels similar to white patients. This study focuses on identifying the mechanisms of implicit racial bias, quantified by scores on the Implicit Bias Association Test (IAT), that influences physicians’ abilities to equitably assess and treat pain of racially diverse patient populations. Research has shown that physicians with …

Survey Of Workplace Violence Perception, Prevention, Strategies, And Prevalence Of Weapons In Healthcare Facilities, James D. Blando, Marilyn Lou Ridenour, Daniel Hartley

Community & Environmental Health Faculty Publications

No abstract provided.

A Quality Improvement Initiative To Manage Shingrix Vaccine Inventory In Ambulatory Clinics, Tracy Colburn

DNP Scholarly Projects

Abstract

Background: Inventory control practices for adult vaccines, specifically Shingrix, in ambulatory clinics are not well known or researched. This quality improvement project takes place at a small healthcare organization consisting of a hospital and thirteen ambulatory clinics in Northern New England. Seven of the thirteen clinics have the Shingrix vaccine in their inventory.

Purpose: The aim of this quality improvement project was multifaceted. The first matter was the establishment of a two-week PAR level at seven of the thirteen ambulatory clinics connected to the organization. The second was the design and implementation of a Shingrix vaccine management program …

Attitude Towards Patient Undergraduate Medical Students In The University Of Malaya, Jeevitha Rajasingam

Student Works (2020-2029)

In the last two decades, patient safety awareness has become one of the emerging themes. To prevent from doing harm to patients, safe medical practices should be implemented and followed strictly. Therefore, a basic understanding of human factor principles need to be instilled into all health care workers. Medical universities play a vital role in fostering patient safety attitudes of their students towards the importance of patient safety during their practise. However, the medical curricula still face challenges regarding the correct timing and appropriate methods of instruction in their understanding of their principles. Experiments have shown that patient safety classes …

Development Of A Hybrid, Interprofessional, Interactive Quality Improvement Curriculum As A Model For Continuing Professional Development, Isabelle S Kusters, Megan E Gregory, Jennifer L Bryan, Sylvia J Hysong, Lechauncy D Woodard, Aanand D Naik, Kyler M Godwin

Faculty, Staff and Students Publications

Over the past 20 years, there has been an increased focus on quality improvement (QI) in health care, which is critical in achieving care that is patient-centered, safer, timelier, and more effective, efficient, and equitable. At the center of this movement is QI education, which is known to lead to learning, behavior change, and improved outcomes. However, there is a need for the development and provision of long-duration, interactive, interprofessional training in QI, to allow for in-depth learning and application of learned skills. To this end, we designed a curriculum for an established interprofessional, interactive, web-based QI fellowship for doctorally …

Performance Improvement In Healthcare: Integrating Gilbert's Behavior Engineering Model Within A Just Culture, Candice Freeman, Jill Erin Stefaniak

STEMPS Faculty Publications

Healthcare leadership and department management personnel are tasked with the responsibility of ensuring safe, high-quality patient care delivered by competent and proficient staff. This responsibility often comes in the form of identification of discrepant and erroneous practices that result in subsequent employee disciplinary action process improvement discussions and implementation. This case study presents an example of a sentinel event and how Gilbert's Behavior Engineering Model (BEM) was utilized in the context of a Just Culture to ensure both processes and personnel were adequately supported to meet expected task outcomes.

Data Science Methods For Standardization, Safety, And Quality Assurance In Radiation Oncology, Khajamoinuddin Syed

Theses and Dissertations

Radiation oncology is the field of medicine that deals with treating cancer patients through ionizing radiation. The clinical modality or technique used to treat the cancer patients in the radiation oncology domain is referred to as radiation therapy. Radiation therapy aims to deliver precisely measured dose irradiation to a defined tumor volume (target) with as minimal damage as possible to surrounding healthy tissue (organs-at-risk), resulting in eradication of the tumor, high quality of life, and prolongation of survival. A typical radiotherapy process requires the use of different clinical systems at various stages of the workflow. The data generated in these …

End Tidal Carbon Dioxide Monitoring (Capnography) In The Cardiac Intensive Care Unit, Madeline Elaine Huff, Kenneth T. Shelton

School of Medicine Publications

Background: Carbon dioxide levels can be monitored throughout the respiratory cycle via capnography. In this way, capnography allows healthcare professionals to follow several respiratory factors in real-time, including respiratory depression, apnea, and hypercapnia. Postoperative patients are subjected to significant harm while receiving sedating medications without appropriate monitoring and intervention. Earlier detection of alterations to ventilation status will better enable providers to more accurately dose medications during procedures, especially in high-risk patient populations.

Methods: Patient selection included post-operative patients in the intensive care unit that were receiving sedation/analgesia, high dose or high frequency opioids, epidural or intrathecal pain management, patients that …

Effective Communication: A Vital Skill In Healthcare, Allison Crabtree

Presentations, Proceedings & Performances

Members of the healthcare team conduct thousands of patient and peer interactions over the course of a career. The call to action from the Institute of Medicine (IOM) Report on Health Professions and Training stresses the importance of communication training for all members of the healthcare team. As with other healthcare procedures, communication skills can be learned and improved upon, but requires commitment and practice.

Given the wealth of evidence linking ineffective clinician-patient communication with increased malpractice risks, patient nonadherence, patient and clinician dissatisfaction, and poor patient health outcomes, the necessity of addressing communication skills deficits is of utmost importance

Facilitating Earlier Discharges To Decrease Avoidable Patient Days And Improve Flow For An Acute And Intermediate Care Unit, Natasha Bartlett

Operations Transformation

No abstract provided.

Optimizing Intraprofessional Communication At Patient Handover, Allison Crabtree

Doctor of Nursing Practice Projects

This performance improvement project aimed to increase the communication competency of nurses during intraprofessional interactions at patient handover. An educational program focused on optimizing communication among nurses was implemented in a community-based, not-for-profit, rural hospital. The course was designed to incorporate a variety of instructional strategies to meet learner needs. Consistency and standardization of the patient handover process was a central theme. Topics of the course focused on the use of a standardized communication tool, the relationship of communication on patient safety, the importance of clear and effective communication, the role of the nurse as gatekeeper and facilitator of patient-specific …

Death By Contamination, Syeda Sana Batool

MSJ Capstone Projects

This research was conducted by Centre for Excellence in Journalism, IBA, Karachi during 2019 as a capstone project for Master of Science in Journalism. The data and information regarding water contamination was obtained and compiled through a thorough reporting, researched articles and documents provided by concerned organization.

The water which is used for the drinking purpose in Karachi is the most polluted and contaminated one as compare to the other cities of Pakistan. The reason behind this water contamination is the industries disposition of waste, which has ruined the environment by polluting the water bodies with its toxic effluent.

The …

Strategies To Improve Timeliness For Cleaning Inpatient Rooms Following Patient Discharge, Lora Dixon, Mark Parker, Ruth Hanselman, Suneela Nayak, Amy Sparks

Operations Transformation

STRATEGIES TO IMPROVE THE TIME FRAME FOR CLEANING INPATIENT ROOMS BY ENVIRONMENTAL SERVICES

In an inpatient rehab hospital, it was noted that Environmental Services (EVS) was delayed in cleaning rooms between patient discharges and admissions. This resulted in the frequent use of a “stat clean” order that allows only 50% of the normal cleaning time , forcing patients to wait and impacting patient flow.

A root cause analysis demonstrated lack of communication between the rehab hospital and the contracted cleaning services. A number of counter measures were initiated with the goal that cleaning would be started within 20 minutes of …

Post-Concussion Symptom Score As A Possible Predictor Of Protracted Recovery In High School Athletes, Kimberly Dawn Phillips

Graduate Theses

As concussion research shifts from diagnostic to managing return to play (RTF), many studies have sought to establish safe guidelines for recovery. Computer-based neuropsychological programs measure cognitive function performance typically affected by brain injury and include a self-report post-concussion symptoms scale. The use of the total score of a post-concussion symptoms scale as a possible predictor of protracted recovery in high school athletes following injury is still being researched. This study used stored data obtained from the Vanderbilt Sports Concussion Center involving concussed high school athletes with a post-concussion symptom score and subsequent documentation of recovery time. A one-way ANOVA …