The Surgical Initiative concluded on March 31, 2014; the first system Hoshin to “graduate” to everyday work. Join us for an interactive discussion of the lessons learned over four years of transformational change.
An opportunity to hear how service redesign positively impacts on the patient experience and improves outcomes for both the patient and NHSScotland. Showcasing examples of changes to pathways of care in orthopaedics and community support for people with complex and chronic conditions.
This document discusses a project to improve patient wait times and satisfaction scores at an ambulatory surgery center. Studies found actual surgery start times ranged from 6 minutes to 2 hours and 50 minutes later than scheduled. The average registration wait was 17 minutes and preparation time was 33 minutes. Recommendations include changing scheduling practices based on average surgeon times, dedicating registration staff, and educating staff on updating patients about delays every 15 minutes. Implementing these measures could increase satisfaction scores and the center's preference among patients.
The Broad Picture - recent developments in long-term condition managmentepicyclops
This lecture was given by Dr Aileen Keel, Deputy Chief Medical Officer for Scotland, to the North British Pain Association Spring Scientific Meeting on Friday 18th May, 2007 and forms part of a conference "Blurring the Boundaries - Managing Pain in Primary Care and Secondary Care".
Reproduced with permission.
This document summarizes a webinar for selecting topics for a national ICU collaborative initiative in 2016-17. It discusses the results of a survey where pain, agitation, and delirium (PAD) and end-of-life care were the top choices. Potential Topic 1 provides an overview of how end-of-life care could be improved across the ICU continuum. Potential Topic 2 reviews evidence that consistent pain assessment and management paired with sedation protocols can reduce length of stay and complications. The webinar participants then decided to focus on improving PAD management in 2016-17.
DASH - does arthritis self-management help?epicyclops
This lecture was given by Dr Marta Buszewicz, General Practitioner from North London and Senior Lecturer in Community Based Teaching & Research at UCL, to the North British Pain Association Spring Scientific Meeting in Edinburgh on Friday 18th May, 2007. Her lecture forms part of a conference "Blurring the Boundaries - Managing Pain in Primary Care and Secondary Care".
This webinar provides an overview of key frameworks for identifying barriers and enablers to implementation, with a focus on the Theoretical Domains Framework (TDF). The TDF synthesizes 128 constructs from 33 theories of behavior change into 12 domains to understand factors influencing healthcare professionals' behaviors. The webinar uses a case study of improving physician hand hygiene to demonstrate how the TDF can be applied to identify potential barriers within domains like Knowledge, Skills, Social Influences, and Environmental Context & Resources.
his is the first in a series of interactive webinars designed to build capacity in the basic principles of knowledge translation and implementation science.
WATCH-ON DEMAND: https://goo.gl/hnp8gi
This final webinar will emphasise the importance of understanding the problem before brainstorming solutions to better ensure a match between barriers and the solutions.
MORE INFO: http://bit.ly/2KctiLH
An opportunity to hear how service redesign positively impacts on the patient experience and improves outcomes for both the patient and NHSScotland. Showcasing examples of changes to pathways of care in orthopaedics and community support for people with complex and chronic conditions.
This document discusses a project to improve patient wait times and satisfaction scores at an ambulatory surgery center. Studies found actual surgery start times ranged from 6 minutes to 2 hours and 50 minutes later than scheduled. The average registration wait was 17 minutes and preparation time was 33 minutes. Recommendations include changing scheduling practices based on average surgeon times, dedicating registration staff, and educating staff on updating patients about delays every 15 minutes. Implementing these measures could increase satisfaction scores and the center's preference among patients.
The Broad Picture - recent developments in long-term condition managmentepicyclops
This lecture was given by Dr Aileen Keel, Deputy Chief Medical Officer for Scotland, to the North British Pain Association Spring Scientific Meeting on Friday 18th May, 2007 and forms part of a conference "Blurring the Boundaries - Managing Pain in Primary Care and Secondary Care".
Reproduced with permission.
This document summarizes a webinar for selecting topics for a national ICU collaborative initiative in 2016-17. It discusses the results of a survey where pain, agitation, and delirium (PAD) and end-of-life care were the top choices. Potential Topic 1 provides an overview of how end-of-life care could be improved across the ICU continuum. Potential Topic 2 reviews evidence that consistent pain assessment and management paired with sedation protocols can reduce length of stay and complications. The webinar participants then decided to focus on improving PAD management in 2016-17.
DASH - does arthritis self-management help?epicyclops
This lecture was given by Dr Marta Buszewicz, General Practitioner from North London and Senior Lecturer in Community Based Teaching & Research at UCL, to the North British Pain Association Spring Scientific Meeting in Edinburgh on Friday 18th May, 2007. Her lecture forms part of a conference "Blurring the Boundaries - Managing Pain in Primary Care and Secondary Care".
This webinar provides an overview of key frameworks for identifying barriers and enablers to implementation, with a focus on the Theoretical Domains Framework (TDF). The TDF synthesizes 128 constructs from 33 theories of behavior change into 12 domains to understand factors influencing healthcare professionals' behaviors. The webinar uses a case study of improving physician hand hygiene to demonstrate how the TDF can be applied to identify potential barriers within domains like Knowledge, Skills, Social Influences, and Environmental Context & Resources.
his is the first in a series of interactive webinars designed to build capacity in the basic principles of knowledge translation and implementation science.
WATCH-ON DEMAND: https://goo.gl/hnp8gi
This final webinar will emphasise the importance of understanding the problem before brainstorming solutions to better ensure a match between barriers and the solutions.
MORE INFO: http://bit.ly/2KctiLH
Presentation describing the DMA INSIGHT programme and its use in collaboration with St Andrews Hospital Charity to develop person centred integrated care pathways - presented at International Forensic Conference - UCLAN
Patient satisfaction & quality in health care (16.3.2016) dr.nyunt nyunt waiMmedsc Hahm
This document discusses patient satisfaction and quality in healthcare. It defines patient satisfaction as how an individual regards healthcare services as useful, effective or beneficial. Patient satisfaction is important for public accountability and quality improvement at both the system and individual provider levels. The document outlines factors that influence patient satisfaction, including quality and competency of providers, effectiveness and appropriateness of care, and interpersonal relationships. It also discusses the importance of a client-centered approach that prioritizes patients' needs and rights.
Delegate pack from the Patient Safety Collaborative launch event held in London on 14 October 2014
Includes agenda, speaker biographies and AHSN plans
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
An Evironmental Scan of Interprofessional Collaborative Practice and EducationEvan C. Marlatt
This document summarizes an environmental scan of interprofessional collaborative practice and education conducted by Evan C. Marlatt. It begins by thanking the committee members and providing background on interprofessional education and collaborative practice. The research question aims to understand how healthcare programs are aligned with the WHO framework. Surveys were conducted to assess interprofessional education and practice at an academic health sciences campus. The results provide insight into educator mechanisms, curricula, institutional support, working culture, and environmental factors related to interprofessional collaboration. Challenges and implications for further ensuring interprofessional efforts are operationalized are discussed.
As part two of the Human Factors Call Series, CPSI is pleased to invite you to attend When being present isn't enough – Improving patient safety through situational awareness!
Patient Reported Outcomes (PROs) in Care Managed Patients: Potential and Chal...dylanturner22
This document discusses a study examining the use of patient-reported outcome measures (PROs) in a care management program. It finds that while PROs can provide useful information, their use also faces challenges. Care managers reported that PROs were not always practical for their complex patient population. Additionally, high rates of missed appointments and low health literacy made data collection difficult. Overall, PROs showed little change over time and did not significantly correlate with changes in clinical outcomes. The study concludes that more needs to be done to effectively incorporate PROs into care management workflows.
Guidelines - what difference do they make? A Dutch perspectiveepicyclops
This lecture was given by Dr Raymond Ostelo of the EMGO Institute, VU University Medical Center, Amsterdam, to the North British Pain Association Spring Scientific Meeting in Edinburgh on Friday 18th May, 2007. His lecture forms part of a conference "Blurring the Boundaries - Managing Pain in Primary Care and Secondary Care".
Evidence demonstrates that communication is one of the leading contributors to adverse events. Transitions of care epitomize this challenge.
WATCH ON DEMAND: https://goo.gl/M1ovsS
This document outlines the Master in Hospital Administration and Health Management course at Dr. Kyawt Sann Lwin's university. It discusses the course objectives, core faculty members, topics that will be covered in health management and hospital management. The topics include health systems, quality management, human resources, health policy, and more. The course will involve lectures, assignments, tests and a final exam. Students will also complete a health systems research project involving protocol development, data collection and analysis.
Overview of Patient Experience Definitions and Measurement ToolsInnovations2Solutions
This publication will provide an overview of patient experience, how it is measured, and how to achieve it optimally within the healthcare setting. Sodexo’s definition of Patient Experience will also be explored.
An integrated model of psychosocial cancer care: a work in progress…Cancer Institute NSW
Cancer patients are faced with a multitude of stressors, from diagnosis, through treatment, at recurrence, in the stages following treatment completion, and in the terminal phase. Psychosocial care has been highlighted as a critical aspect of providing comprehensive patient-focused care. Specifically, one of the goals of The NSW Cancer Plan 2011-2015 is to improve the quality of life of people with cancer and their carers. This project was initiated to improve the current psychosocial model of care at The Kinghorn Cancer Centre (TKCC), to better reflect an integrated, holistic and comprehensive model of patient-centred care.
•Understand the Accreditation Canada requirements for medication reconciliation at discharge
•Learn from the experience of patients and receiving healthcare providers
•Gain insight into practical strategies for communicating accurate medication information at discharge
READ MORE: http://bit.ly/1ja1gxY
Evidence-Based Practice Guidelines and Shared Decision Making: Conflicting or...Zackary Berger
How can we bridge physician guidelines, based on the best available evidence, and patient preferences? This workshop was given at the Society of General Internal Medicine 2015 Annual Meeting in Toronto, Canada.
Session Coordinator: Zackary Berger, MD, PhD
Additional Faculty: Michael J. Barry, MD, Kathleen Fairfield, MD, Leigh H. Simmons, MD, James Yeh, MD, Daniella A. Zipkin, MD, Dave deBronkart
A dissertation report on analysis of patient satisfaction max polyclinic by ...Mohammed Yaser Hussain
Hospitals are increasingly becoming sensitive to the needs of the patients as will the community. It is no longer the sellers [providers] market. Except for the totally free service provided by the Government run hospitals and a few hospitals run by the civic hospitals.
According to Dona Bedian
“Patient satisfaction may be considered to be one of the desired outcomes of care, even on element of health status itself” and that “information about patient satisfaction should be as indispensable to assessment of quality as to the design and management of health care system.
During the recent years the use of patient satisfaction surveys has increased in health care industry due in part to the belief that perception of quality is an important factor in demand for services and that survey result may have significant effect on provider behaviour. According to Ware “patient satisfaction is a determinant of a healthcare provider or system. Use of services complaints and malpractice suits”.
Use of patient satisfaction survey as a tool for quality improvement has become extensive in almost all western countries. Most hospital have a system of obtaining routine feedback from all the discharge patients. The quality improvement task force of the joint commission of accreditation of the health care organization in USA is also encouraging hospitals to mandate surveys are conducted in private hospitals.
This document summarizes the results of an analysis of the 2007-08 UK GP Patient Survey, which assessed patient satisfaction with access to primary care. The analysis found that while overall satisfaction was high, it varied based on patient, practice, and location characteristics. Patient age, ethnicity, and employment status most impacted satisfaction levels. Having the ability to take time off work greatly improved satisfaction for employed patients. Practice size also had a strong influence, with smaller practices receiving higher satisfaction ratings. Geographic location made a difference, as patients in northeast England reported the best experiences.
BPS DCP SIGOPAC Good Practice Guidance in Demonstrating Quality and Outcomes ...Alex King
This report outlines a rigorous, multidimensional framework for evaluating quality and outcomes in psycho-oncology services, which can be flexibly adapted to local needs and priorities.
It aims to challenge psycho-oncology services to develop and standardise procedures that address the clinical and operational aspects of quality, while maintaining a firm focus on the experiential.
The proposed framework focuses on six key domains of service quality:
- Is this service safe?
- Is this service equitable, while also focused on those most in need?
- Is this service timely and responsive?
- Is this service respectful, collaborative and patient-centred?
- Is this service offering effective interventions?
- Is this service contributing to efficient multidisciplinary care?
To address these domains, psycho-oncology services need to draw on multiple, convergent sources of data, including key performance indicators, activity levels, patient self-report measures, feedback from professional colleagues, etc.
Think Human factors doesn't have an impact on clinical outcomes like infection rates? Guess again! According to the World Health Organization (2017), infections acquired in healthcare settings represent the most frequent adverse event occurring in the delivery of healthcare and no institution or country has solved the problem yet.
Full Details: https://goo.gl/Z7Mhuy
The development of a Patient Safety Programme for Primary Care is being informed by the learning from two ongoing primary care safety projects. This session highlights the approaches used, the early findings and describes how to sustain and spread the success of this work.
Access the webinar here:
http://bit.ly/1eio3ka
Purpose of the Call:
1.Discuss the results of the pan-Canadian survey of existing practices with respect to the use of technology to support Medication Reconciliation (MedRec)
2.Describe the steps and considerations for transitioning to electronic MedRec (eMedRec)
3.Identify factors that support and impede successful migration of paper MedRec to eMedRec.
4.Discuss the lessons learned from research and other organizations.
5.Introduce the toolkit to support healthcare providers in making a safe and effective transition from paper MedRec to eMedRec.
The emerging healthcare environment requires expanded patient access while delivering optimal outcomes and cost. As healthcare moves form a fee for service model to alternative delivery and payment models, there are opportunities for physical therapy to revolutionize the delivery of musculoskeletal medicine. Physical therapists are uniquely qualified to spearhead musculoskeletal care through direct access with the potential to improve patient satisfaction and outcomes while limiting unneeded medical care. While this model has been described in the military, there are few descriptions of this PT First approach in the private payer arena. This session will provide the attendee with a multifaceted perspective on the impact of physical therapy in emerging, collaborative healthcare models. Approaches to payers and employers with the business implications will be presented that influence these new models. Key strategies to implement a scalable, best practice model will be discussed including the logistical challenges and corollary solutions in the private arena. We will discus our experience implementing novel delivery models for management of neck, back, shoulder and knee pain. The session will deliver practical solutions to the challenges of implementing, assessing, and adapting a theoretical construct to a working viable program. Finally, the session will discuss how the use of a a large Patient Outcomes Registry and analysis of “big data” can drive best practice and inform development of the program.
4-Continuous Quality Improvement (CQI) is defined by the Americabartholomeocoombs
4-Continuous Quality Improvement (CQI) is defined by the American Society for Quality (ASQ) as “a philosophy and attitude for analyzing capabilities and processes and improving them repeatedly to achieve customer satisfaction”. (Huber 292) CQI is something that is relevant to all nurses as we all need to be responsible for continual improvement at work. As professionals we should always have this as a top priority. There are many challenges in the workplace, and by looking for ways to improve, we are constantly learning and growing as a profession, this is a large piece of evidence-based practice, which is something we all hold as a standard in healthcare today.
An example of how I would apply CQI in my current position working as a nurse circulator in the operating room, is to ensure that the time out procedure is followed every single case I circulate. This is important as we often get complacent in rules and regulations, as do surgeons that we are trying to keep happy as they are customers just as much as our patients are.
I had circulated a case with another nurse during orientation in which not all implants for a total knee replacement were in the room. I was not notified of this until after the case started, the patient was anesthetized, and time out had been completed though this requirement was not stated/asked. Later the rep for the implants then stated the implants were in route from another location. This is unacceptable, and I am glad that I was still in orientation at the time this occurred as it was a great learning experience for me. I learned how to write an incident report that day, and why the time out procedure is so important.
Resources
Huber, Diane.
Leadership and Nursing Care Management, 5th Edition
. Saunders, 10/2013. VitalBook file.
5-Health care delivery requires structure (staff, education, equipment, prospective data collection), and process (policies, procedure, protocols), which when integrated provide a system (programs, organizations, cultures) leading to outcomes (patient safety, quality, satisfaction). An effective health care system has all of these elements – structure, process, system, and patient outcomes in a framework of continuous quality improvement, or CQI (Kronich et al., 2015).
The purpose of QCI is to improve health care by identifying problems, implementing and monitoring corrective action and evaluating its effectiveness. Hospitals use a specific process to find areas in the health care delivery system that need improvement. When an area has been found, staff develop and implement strategies for improvement. General areas that are being studied include access to care, continuity of care, the intake process upon admission, emergency care, and adverse patient events, including all deaths (National Commission on Correctional Care, 2018).
In my previous position, working as a NICU RN, we initially did not use two RN’s to verify the content in the TPN-bags for each patient. Shortly after I ...
Presentations from the patient safety conference held at Teesside University on 1 and 2 September 2014 - Students at the forefront of continuing and improving our culture of safe care
Presentation describing the DMA INSIGHT programme and its use in collaboration with St Andrews Hospital Charity to develop person centred integrated care pathways - presented at International Forensic Conference - UCLAN
Patient satisfaction & quality in health care (16.3.2016) dr.nyunt nyunt waiMmedsc Hahm
This document discusses patient satisfaction and quality in healthcare. It defines patient satisfaction as how an individual regards healthcare services as useful, effective or beneficial. Patient satisfaction is important for public accountability and quality improvement at both the system and individual provider levels. The document outlines factors that influence patient satisfaction, including quality and competency of providers, effectiveness and appropriateness of care, and interpersonal relationships. It also discusses the importance of a client-centered approach that prioritizes patients' needs and rights.
Delegate pack from the Patient Safety Collaborative launch event held in London on 14 October 2014
Includes agenda, speaker biographies and AHSN plans
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
An Evironmental Scan of Interprofessional Collaborative Practice and EducationEvan C. Marlatt
This document summarizes an environmental scan of interprofessional collaborative practice and education conducted by Evan C. Marlatt. It begins by thanking the committee members and providing background on interprofessional education and collaborative practice. The research question aims to understand how healthcare programs are aligned with the WHO framework. Surveys were conducted to assess interprofessional education and practice at an academic health sciences campus. The results provide insight into educator mechanisms, curricula, institutional support, working culture, and environmental factors related to interprofessional collaboration. Challenges and implications for further ensuring interprofessional efforts are operationalized are discussed.
As part two of the Human Factors Call Series, CPSI is pleased to invite you to attend When being present isn't enough – Improving patient safety through situational awareness!
Patient Reported Outcomes (PROs) in Care Managed Patients: Potential and Chal...dylanturner22
This document discusses a study examining the use of patient-reported outcome measures (PROs) in a care management program. It finds that while PROs can provide useful information, their use also faces challenges. Care managers reported that PROs were not always practical for their complex patient population. Additionally, high rates of missed appointments and low health literacy made data collection difficult. Overall, PROs showed little change over time and did not significantly correlate with changes in clinical outcomes. The study concludes that more needs to be done to effectively incorporate PROs into care management workflows.
Guidelines - what difference do they make? A Dutch perspectiveepicyclops
This lecture was given by Dr Raymond Ostelo of the EMGO Institute, VU University Medical Center, Amsterdam, to the North British Pain Association Spring Scientific Meeting in Edinburgh on Friday 18th May, 2007. His lecture forms part of a conference "Blurring the Boundaries - Managing Pain in Primary Care and Secondary Care".
Evidence demonstrates that communication is one of the leading contributors to adverse events. Transitions of care epitomize this challenge.
WATCH ON DEMAND: https://goo.gl/M1ovsS
This document outlines the Master in Hospital Administration and Health Management course at Dr. Kyawt Sann Lwin's university. It discusses the course objectives, core faculty members, topics that will be covered in health management and hospital management. The topics include health systems, quality management, human resources, health policy, and more. The course will involve lectures, assignments, tests and a final exam. Students will also complete a health systems research project involving protocol development, data collection and analysis.
Overview of Patient Experience Definitions and Measurement ToolsInnovations2Solutions
This publication will provide an overview of patient experience, how it is measured, and how to achieve it optimally within the healthcare setting. Sodexo’s definition of Patient Experience will also be explored.
An integrated model of psychosocial cancer care: a work in progress…Cancer Institute NSW
Cancer patients are faced with a multitude of stressors, from diagnosis, through treatment, at recurrence, in the stages following treatment completion, and in the terminal phase. Psychosocial care has been highlighted as a critical aspect of providing comprehensive patient-focused care. Specifically, one of the goals of The NSW Cancer Plan 2011-2015 is to improve the quality of life of people with cancer and their carers. This project was initiated to improve the current psychosocial model of care at The Kinghorn Cancer Centre (TKCC), to better reflect an integrated, holistic and comprehensive model of patient-centred care.
•Understand the Accreditation Canada requirements for medication reconciliation at discharge
•Learn from the experience of patients and receiving healthcare providers
•Gain insight into practical strategies for communicating accurate medication information at discharge
READ MORE: http://bit.ly/1ja1gxY
Evidence-Based Practice Guidelines and Shared Decision Making: Conflicting or...Zackary Berger
How can we bridge physician guidelines, based on the best available evidence, and patient preferences? This workshop was given at the Society of General Internal Medicine 2015 Annual Meeting in Toronto, Canada.
Session Coordinator: Zackary Berger, MD, PhD
Additional Faculty: Michael J. Barry, MD, Kathleen Fairfield, MD, Leigh H. Simmons, MD, James Yeh, MD, Daniella A. Zipkin, MD, Dave deBronkart
A dissertation report on analysis of patient satisfaction max polyclinic by ...Mohammed Yaser Hussain
Hospitals are increasingly becoming sensitive to the needs of the patients as will the community. It is no longer the sellers [providers] market. Except for the totally free service provided by the Government run hospitals and a few hospitals run by the civic hospitals.
According to Dona Bedian
“Patient satisfaction may be considered to be one of the desired outcomes of care, even on element of health status itself” and that “information about patient satisfaction should be as indispensable to assessment of quality as to the design and management of health care system.
During the recent years the use of patient satisfaction surveys has increased in health care industry due in part to the belief that perception of quality is an important factor in demand for services and that survey result may have significant effect on provider behaviour. According to Ware “patient satisfaction is a determinant of a healthcare provider or system. Use of services complaints and malpractice suits”.
Use of patient satisfaction survey as a tool for quality improvement has become extensive in almost all western countries. Most hospital have a system of obtaining routine feedback from all the discharge patients. The quality improvement task force of the joint commission of accreditation of the health care organization in USA is also encouraging hospitals to mandate surveys are conducted in private hospitals.
This document summarizes the results of an analysis of the 2007-08 UK GP Patient Survey, which assessed patient satisfaction with access to primary care. The analysis found that while overall satisfaction was high, it varied based on patient, practice, and location characteristics. Patient age, ethnicity, and employment status most impacted satisfaction levels. Having the ability to take time off work greatly improved satisfaction for employed patients. Practice size also had a strong influence, with smaller practices receiving higher satisfaction ratings. Geographic location made a difference, as patients in northeast England reported the best experiences.
BPS DCP SIGOPAC Good Practice Guidance in Demonstrating Quality and Outcomes ...Alex King
This report outlines a rigorous, multidimensional framework for evaluating quality and outcomes in psycho-oncology services, which can be flexibly adapted to local needs and priorities.
It aims to challenge psycho-oncology services to develop and standardise procedures that address the clinical and operational aspects of quality, while maintaining a firm focus on the experiential.
The proposed framework focuses on six key domains of service quality:
- Is this service safe?
- Is this service equitable, while also focused on those most in need?
- Is this service timely and responsive?
- Is this service respectful, collaborative and patient-centred?
- Is this service offering effective interventions?
- Is this service contributing to efficient multidisciplinary care?
To address these domains, psycho-oncology services need to draw on multiple, convergent sources of data, including key performance indicators, activity levels, patient self-report measures, feedback from professional colleagues, etc.
Think Human factors doesn't have an impact on clinical outcomes like infection rates? Guess again! According to the World Health Organization (2017), infections acquired in healthcare settings represent the most frequent adverse event occurring in the delivery of healthcare and no institution or country has solved the problem yet.
Full Details: https://goo.gl/Z7Mhuy
The development of a Patient Safety Programme for Primary Care is being informed by the learning from two ongoing primary care safety projects. This session highlights the approaches used, the early findings and describes how to sustain and spread the success of this work.
Access the webinar here:
http://bit.ly/1eio3ka
Purpose of the Call:
1.Discuss the results of the pan-Canadian survey of existing practices with respect to the use of technology to support Medication Reconciliation (MedRec)
2.Describe the steps and considerations for transitioning to electronic MedRec (eMedRec)
3.Identify factors that support and impede successful migration of paper MedRec to eMedRec.
4.Discuss the lessons learned from research and other organizations.
5.Introduce the toolkit to support healthcare providers in making a safe and effective transition from paper MedRec to eMedRec.
The emerging healthcare environment requires expanded patient access while delivering optimal outcomes and cost. As healthcare moves form a fee for service model to alternative delivery and payment models, there are opportunities for physical therapy to revolutionize the delivery of musculoskeletal medicine. Physical therapists are uniquely qualified to spearhead musculoskeletal care through direct access with the potential to improve patient satisfaction and outcomes while limiting unneeded medical care. While this model has been described in the military, there are few descriptions of this PT First approach in the private payer arena. This session will provide the attendee with a multifaceted perspective on the impact of physical therapy in emerging, collaborative healthcare models. Approaches to payers and employers with the business implications will be presented that influence these new models. Key strategies to implement a scalable, best practice model will be discussed including the logistical challenges and corollary solutions in the private arena. We will discus our experience implementing novel delivery models for management of neck, back, shoulder and knee pain. The session will deliver practical solutions to the challenges of implementing, assessing, and adapting a theoretical construct to a working viable program. Finally, the session will discuss how the use of a a large Patient Outcomes Registry and analysis of “big data” can drive best practice and inform development of the program.
4-Continuous Quality Improvement (CQI) is defined by the Americabartholomeocoombs
4-Continuous Quality Improvement (CQI) is defined by the American Society for Quality (ASQ) as “a philosophy and attitude for analyzing capabilities and processes and improving them repeatedly to achieve customer satisfaction”. (Huber 292) CQI is something that is relevant to all nurses as we all need to be responsible for continual improvement at work. As professionals we should always have this as a top priority. There are many challenges in the workplace, and by looking for ways to improve, we are constantly learning and growing as a profession, this is a large piece of evidence-based practice, which is something we all hold as a standard in healthcare today.
An example of how I would apply CQI in my current position working as a nurse circulator in the operating room, is to ensure that the time out procedure is followed every single case I circulate. This is important as we often get complacent in rules and regulations, as do surgeons that we are trying to keep happy as they are customers just as much as our patients are.
I had circulated a case with another nurse during orientation in which not all implants for a total knee replacement were in the room. I was not notified of this until after the case started, the patient was anesthetized, and time out had been completed though this requirement was not stated/asked. Later the rep for the implants then stated the implants were in route from another location. This is unacceptable, and I am glad that I was still in orientation at the time this occurred as it was a great learning experience for me. I learned how to write an incident report that day, and why the time out procedure is so important.
Resources
Huber, Diane.
Leadership and Nursing Care Management, 5th Edition
. Saunders, 10/2013. VitalBook file.
5-Health care delivery requires structure (staff, education, equipment, prospective data collection), and process (policies, procedure, protocols), which when integrated provide a system (programs, organizations, cultures) leading to outcomes (patient safety, quality, satisfaction). An effective health care system has all of these elements – structure, process, system, and patient outcomes in a framework of continuous quality improvement, or CQI (Kronich et al., 2015).
The purpose of QCI is to improve health care by identifying problems, implementing and monitoring corrective action and evaluating its effectiveness. Hospitals use a specific process to find areas in the health care delivery system that need improvement. When an area has been found, staff develop and implement strategies for improvement. General areas that are being studied include access to care, continuity of care, the intake process upon admission, emergency care, and adverse patient events, including all deaths (National Commission on Correctional Care, 2018).
In my previous position, working as a NICU RN, we initially did not use two RN’s to verify the content in the TPN-bags for each patient. Shortly after I ...
Presentations from the patient safety conference held at Teesside University on 1 and 2 September 2014 - Students at the forefront of continuing and improving our culture of safe care
Rob Reid: Redesigning primary care: the Group Health journeyThe King's Fund
Rob Reid, Senior Investigator at Group Health Research Institute, explains the journey taken by Group Health in support of integrated primary care. A case study in how primary care can be delivered effectively and efficiently to a population, Rob laid out the challenges facing general practice in the States, and how Group Health worked to improve the situation for both patients and the workforce.
This document discusses evidence-based practice and provides examples of how it is implemented in nursing. It begins by defining evidence-based practice as integrating the best research evidence, clinical expertise, and patient values and preferences. It emphasizes using scientific evidence to inform decision-making and eliminate outdated practices. Several examples are then given of evidence-based practices in nursing related to infection control, oxygen use for COPD patients, measuring blood pressure in children, and intravenous catheter size. The document stresses the importance of following evidence-based protocols for patient health and safety.
This document provides an overview of basic concepts in healthcare quality. It defines quality as meeting standards and doing things right the first time. Healthcare organizations are described as complex adaptive systems. The dimensions of healthcare quality are discussed, including safety, effectiveness, patient-centeredness, timeliness, efficiency, equity, and more. Quality is said to have measurable, perceptive, and appreciative aspects from the perspective of providers, patients, and experts. Key resources in healthcare quality include clinical practice guidelines, quality indicators, and accrediting bodies. Careers in healthcare quality are also mentioned.
Dr Brent James: quality improvement techniques at the frontlineNuffield Trust
Dr Brent James, Intermountain Institute for Healthcare Delivery Research, presents to the Health Policy Summit 2015 on delivering quality improvement techniques at the frontline.
This document summarizes a transitional care workgroup meeting held on July 12, 2013. The meeting included introductions and presentations on transitional care evidence and measuring patient-centered outcomes. Participants discussed a vignette about a patient being discharged from the hospital to identify questions patients would have about participating in a new transitional care program. The group's objectives were to understand transitional care broadly and narrow the topic by prioritizing important questions from multiple stakeholder perspectives. Breakout sessions allowed for submitted questions and discussion of proposed research topics. The meeting concluded with recapping next steps and welcoming further input.
As new payment models emerge that emphasize value over volume, providers are being compelled to look more closely at how to motivate patients—especially those with multiple chronic conditions—to actively manage their care, make better decisions and change behaviors. This editorial webinar will explore the relationships between engagement and improved health outcomes, greater patient satisfaction and better resource utilization. Our panel of experts will share proven strategies for building patients' confidence, disseminating self-management tools and making the best use of your care team.
Engines of Success for U.S. Health Reform?
Eric B. Larson, MD, MPHVice President for Research, Group Health Executive Director, Group Health Research Institute
Presentation on Teamwork for Avoiding Potentially Avoidable ReadmissionsCJ Fulton
This document discusses strategies for reducing avoidable hospital readmissions. It begins by posing key questions around barriers to care transitions and potential interventions. It then lists common drivers of readmissions such as fragmented care, medication issues, and lack of follow up. The document outlines various evidence-based intervention models and provides a template for selecting interventions that address specific drivers. It emphasizes the importance of monitoring progress through data collection and engaging stakeholders. Finally, it stresses that reducing readmissions requires collaboration across providers.
The third interactive webinar in the series builds on the second session by focusing on the question: once we have evidence to justify implementing a new patient safety initiative, what next?
Utilización de la evidencia cualitativa para mejorar la inclusión de las pref...GuíaSalud
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The Saskatchewan Surgical Initiative: Lessons Learned
1. 1
The Saskatchewan
Surgical Initiative:
Lessons Learned
Health Quality Summit, Saskatoon, May 7th 2014
Presenters: Donna Davis, Dr. Peter Barrett, Terry Blackmore
(Patient & Family Advisor) (Physician Leader) (A/Exec. Director, Saskatchewan Health)
2. 2
Where we were: March 31, 2010:
Backlog of 27,580
patients awaiting
surgery
1 in 5 waited > 1 year
for surgery
Pace of improvements
was very slow (no real
change in previous
year)
Patients deserved
better!
3. 3
The Environment
Sept. 2008 – “Releasing Time to Care” work
leads health leaders to Britain’s National
Health Service; see the 18-week wait time
work first-hand.
May 2009 – Best Brains exchange on
Managing Wait Times.
Change management principles.
IHI model for improvement.
5. 5
September 2009 – First Surgical Guiding Coalition and Executive
Sponsorship Group meeting held in Saskatoon
A biannual event
Shared ownership
Building the Team
6. 6
Guiding Coalition
RHA reps from across value stream, physicians, health provider
organizations, unions, academics, Ministry reps and patients.
Champions combining expertise, enthusiasm,
Started with 30; now approx. 90 people
7. 7
Executive Sponsorship Group
Leaders from Ministry, RHAs, HQC, provider orgs (SMA, SRNA,
SUN), physician leaders, patients
20-25 participants
Established the broad vision and objectives
Ongoing role included:
Breaking down barriers
Win hearts and minds in system – highly visible
Make it uncomfortable to maintain status quo
Demonstrate courage and commitment – stay the course
Create incentives; remove disincentives
Establish mandates and directives
Support physician leadership and engagement
Bring resources to the table; investments and disinvestments
9. 9
March 2010 – The Plan is Announced
Sooner, Safer, Smarter: A Plan to Transform the
Surgical Patient Experience
Developed collaboratively (Guiding Coalition and
Executive Sponsorship Group included over 80
individuals)
Clear, Publicly-Stated Goal: “No one will wait more than
3 months for surgery by March 31, 2014”
Incremental targets – 18 months, 12 months, 6
months…
Safety and quality remain priorities, not to be
jeopardized at the expense of “Sooner”
11. 11
What was different?
Emphasis on patient experience, quality, safety, access and
sustainability
Looking at every stage of the patient journey
Diagnostics
Laboratory
Diagnostics
Laboratory
Referral to
Specialist Home
Rehab
Health
Promotion
Prevention
Post-Op
Recovery/
Ward
Therapies
Primary
Care
Pre-Op
/ PAC
Surgery
12. 12
“Listening doesn’t mean you
have heard, and looking
doesn’t mean you have seen.”
Involving Patients and Families
14. 14
Lesson Learned: Patient Representation
“Nothing about me without me.”
The means may be debated, but the end goal is shared
by all: improve the experience of our surgical patients.
The most powerful motivator is a patient’s story.
Patient involvement must be meaningful.
Patient Safety is paramount.
Patients and Families included in Guiding Coalition and
Executive Sponsorship Group from the very beginning.
15. 15
SAFER
“Sooner, Safer, Smarter” should have been re-ordered.
Ministry established the Patient Safety Unit to dedicate resources
to safety initiatives.
Focus on Safety included:
Surgical Safety Checklist
Surgical Site Infection Bundle
Medication Reconciliation
Falls prevention
Stop the Line being piloted
Many Mistake-Proofing projects completed, more underway
The acceptable defect rate is ZERO. It is possible.
16. 16
SAFER – Results:
Surgical Volume and Checklist Compliance (Saskatchewan)
0
1,000
2,000
3,000
4,000
5,000
6,000
Apr-12
M
ay-12Jun-12Jul-12Aug-12Sep-12O
ct-12Nov-12
Dec-12Jan-13Feb-13M
ar-13Apr-13
M
ay-13Jun-13Jul-13Aug-13Sep-13O
ct-13Nov-13
Dec-13Jan-14Feb-14M
ar-14
Date
#ofSurgeries
Performed
0
10
20
30
40
50
60
70
80
90
100
ChecklistCompliance
(%)
# of surgeries performed
Checklist Compliance (%)
Data Source:
Saskatchewan
Health Quality
Council website
17. 17
SAFER: Good Catches!
Decision made to
perform a different
procedure following
Briefing.
Identified that a patient
was on Warfarin. The
procedure was
cancelled.
Identified abnormal
bloodwork at the
Briefing and surgery
was cancelled.
Identified that a
medication
administered pre-op
was not documented
on the anesthesia
record.
Identified incorrect
patient chart
brought into OR.
Found more than
one operative site
listed in the
documentation.
Identified that a patient
was positive for MRSA
but this was not
indicated in the chart.
Identified that
patient consent
was missing.
Identified that blood type
and screen had been
done but results not
ready.
Two procedures
scheduled; OR
slate only listed one.
Patient did not have
ID wristband.
Identified that
patient was allergic
to skin preparation
prior to surgery.
18. 18
“Insanity is doing the same
thing over and over again and
expecting different results”
– Albert Einstein
The Surgical Initiative asked “How can we work differently?”
20. 20
SMARTER – Continuous Improvement
Surgical Initiative the first system-wide project to benefit
from Lean methodology:
Standardized process
Visible targets and results
Replicating results
21. 21
SMARTER - Appropriateness
Appropriateness work is underway.
Appropriateness is conceptually tied to “clinical variation”.
Unexplained variation implies a quality problem.
Working to understand variation and reduce clinical variation in 4
clinical groups (Variation and Appropriateness Working Groups)
“Variation is the breeding ground for error.”
Dr. Richard Shannon
Quality Summit, April 2011
22. 22
Dr. Brent James – Intermountain, Utah
1. Well-documented, massive, variation in practices
(beyond the level where it is even remotely possible that all patients are receiving good care)
2. High rates of inappropriate care (2 - 32% of all care delivered, depending on specific
condition examined)
3. Unacceptable rates of preventable care-associated patient injury and death
4. A striking inability to "do what we know works"
5. Huge amounts of waste ( >50%, by best recent measures), spiraling prices, and limited
access
SMARTER - Appropriateness
23. 23
SMARTER – Clinical Pathways
Pathways promote timely and appropriate care aligned with the
patient’s preference.
Clinical pathways implemented:
1. Hip/knee
2. Spine
3. Pelvic floor
4. Prostate
5. Bariatric Surgery
Acute Stroke Care and Lower Extremity Wound Care pathways
are in development
24. 24
“Only those that provide the
care can improve the care.”
- Don Berwick, IHI, Orlando; Dec 7, 2011
25. 25
Lesson Learned – Physician Engagement
Critical to engage physicians in improvement work.
We’re learning how to do a better job of physician
engagement.
Accurate, meaningful data is persuasive.
27. 27
Laurel Trujillo, M.D., Medical Director of Quality
Palo Alto Medical Foundation
Create a dataset about costs for common problem
Present data to MDs with goal of triggering conversation
Allow group to define their own practice standard
Communicate standard to all
Provide follow-up data to track changes
Lesson Learned – Physician Engagement
28. 28
Lesson Learned – Shared Vision
Committed, consistent leadership:
Drive it
No other option
Provide the tools and resources
But, those closest to the work must fix it
Own it
Drive it
Celebrate the successes
Learn from the failures
31. 31
SOONER
RHAs implemented many improvements – OR allocation, case
cart standardization, better patient flow, better communication,
better relationships.
Pooled referrals and the Specialist Directory have helped level the
workload amongst specialists, allowing patients to accept the first
available appointment if they choose.
Third party service delivery offered additional surgical capacity.
Mid size regions are offering surgery as close to home as
possible.
Additional perioperative nurse training.
32. 32
Lesson Learned: Importance of Leadership
Executive Sponsorship Group & Guiding Coalition
Committed leadership – senior leaders, physicians
and front-line
Common vision – Think and Act as One
Patient and family involvement in decision-making
Bold, clear goals
Transparent results, shared widely
33. 33
Lesson Learned: Transition Planning
Keep it Visible
Consultations across the system on:
Design of future governance;
Ensuring continuous improvement; and
How to engagement system partners.
Provincial Surgical Oversight Team established
Patients, physician leaders and system administration involved
Will monitor results and report to Provincial Leadership Team
34. 34
Results for the Health System
More than shortening wait times
System wide culture shift to patient-centred care and
continuous improvement
Simultaneously improved quality, safety and efficiency
Serve the patient as a whole person – consider the entire
patient journey
Visible incremental targets and measures
35. 35
Results for the Health System
Strengthened partnerships and relationships
Patient advisors have become the norm
Province wide approach to safety and continuous
improvement
Willingness to share results and learn from each other as well
as high performing organizations
Introduction of speakers
Outline:
Context and background
Governance structure
The Plan
Impact of Patient Advisors
Necessity of engaging physicians
Results
Lessons learned throughout the four year initiative.
TERRY…
With any large scale change initiative there must be a sense of urgency
Our burning platform: Create a better system for our patients. Despite efforts, there had been no real change in previous 6 years.
TERRY…
TERRY…
Minister Don McMorris announced the plan, with Dr. Peter Barrett participating in the announcement as the physician lead.
Objectives:
Shorten wait time for surgery
Better patient experience
Safer, higher quality of care
Support for good health
Patient and family-centred providers.
TERRY…
Looked at entire patient journey
TERRY…
The “Driver Diagram” was a useful tool because it showed visually how the work fit together
Should have led out with SAFER.
DONNA…
DONNA…
DONNA…
DONNA…
DONNA…
Safety initiatives grouped together within the Ministry for the first time.
Four examples of safety initiatives under the Surgical Initiative
Other work includes Stop the Line (which requires cultural change to enforce that it’s everyone’s responsiblity to speak up if there’s a safety issue.
Senior Leaders are being trained in how to conduct Mistake Proofing Projects. It’s important to first identify where mistakes can happen, and then work to fix the processes that allow mistakes to occur. Blame is never placed on an individual – it’s the process that needs to be fixed.
The system shouldn’t tolerate any rate of defects greater than zero.
- Share your story. What is at stake? Safety is paramount.
DONNA…
In the 24 months shown, surgical volumes increased fairly steadily, nearly doubling (from 2,822 in April 2012 to 5,118 in March 2014).
At the same time, Surgical Checklist Compliance increased from 80% to 97% today.
Goal is 100%, so there is still room for improvement.
DONNA…
Real Saskatchewan examples of how the Surgical Safety Checklist has protected patients from harm.
From patient’s perspective, safety is the most important factor.
PETER…
PETER…
PETER…
PETER…
PETER…
PETER…
TERRY…
4,380 patients waiting >3 months for surgery compared to 15,353 when the initiative began.