scholarly journals An iterative process of global quality improvement: the International Standards for a Safe Practice of Anesthesia 2010

2010 ◽  
Vol 57 (11) ◽  
pp. 1021-1026 ◽  
Author(s):  
Alan F. Merry ◽  
Jeffrey B. Cooper ◽  
Olaitan Soyannwo ◽  
Iain H. Wilson ◽  
John H. Eichhorn
Keyword(s):  
Quality Improvement ◽  
Iterative Process ◽  
International Standards ◽  
Safe Practice ◽  
Global Quality

Improvement in the quality of patient notes: A report of a closed loop audit quality improvement project at a neurosurgical department in Pakistan.

2020 ◽  
pp. 1-17
Author(s):  
Mohammad Ashraf ◽  
Syed Shahzad Hussain ◽  
Usman Ahmad Kamboh ◽  
Mehreen Mehboob ◽  
Saman Shahid ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Audit Quality ◽  
Wound Care ◽  
International Standards ◽  
Neurosurgical Department ◽  
Post Intervention ◽  
Improvement Project ◽  
Audit Cycle ◽  
Patient Note ◽  
Operative Notes

Abstract Objective: To identify the deficiencies in patient note record-taking with the aim of improving the quality to meet international standards. Methods: The prospective clinical quality improvement audit study was conducted at the department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital Lahore from January 219 to February 2020. The first audit cycle was carried out in July 2019, after data anonymisation, the notes from 1st January to 31st June were analysed in the first audit cycle against a hybrid proforma containing entries deemed essential in operative notes according to the guidelines of the Royal College of Surgeons of England. The guidelines were subsequently disseminated among postgraduate trainees using various methods. Post-intervention, randomly selected patient-notes from 1st August to 31st December 2019 were analysed in the second audit which was done in February 2020. The result of the two audits were compared to assess significance of association between the cycles for each categorical variable. Results: Of the 100 patient-notes audited, 50(50%) were part of each of the two cycles. Significant improvements (p<0.05) were seen between the two cycles in time of operation, pre-op status, post-op care: monitoring instruction, mobilisation, feeding instructions, wound care and position. There was 100% improvement in entries including name, age and sex, date of operation, elective/emergency, name of the procedure and name of operating surgeon and assistant, and the name of anaesthetist. Overall, marked improvement was observed in all parameters except in ‘use of antibiotic prophylaxes’. Conclusion: Regular audits are needed to monitor and improve, Continuous..

scholarly journals Analisis Penggunaan Alat dan Teknik Pengendalian Mutu dalam Penerapan Sistem Manajemen Mutu pada Perusahaan Karet Bersertifikat ISO 9001:2008

2017 ◽  
Vol 15 (2) ◽  
pp. 203 ◽  
Author(s):  
Nofriani Fajrah ◽  
Nilda Tri Putri
Keyword(s):  
Quality Control ◽  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Global Market ◽  
International Standards ◽  
Iso 9001 ◽  
Success Factor ◽  
Sigma Level ◽  
Continuous Quality ◽  
West Sumatra

The increasing competition in the global market and high consumer expectations for quality products, encourage companies to be able to produce quality products which meets international standards. One of the activities in improving quality that conform to product specifications is applying appropriate quality control system involving all aspects of the company that are integrated with the standard ISO 9001: 2008 as a guide. However, the rubber industry in West Sumatra still faces obstacles in the implementation of quality control techniques and tools of as experienced by ABC and XYZ. This study aimed to evaluate the application of quality control tools and techniques in the manufacturing company which is certified ISO 9001: 2008, ABC and XYZ. This research was conducted by calculating the value of DPMO (Defect Per Million Opportunities). Based on the results found that the two companies have different DPMO value. PT ABC obtained by 5,2σ sigma level from DPMO value of 94.33 for the types of defects whitespot and sigma level of 4,2σ of DPMO value of 3365.096 to defect type of metal, while the XYZ obtain sigma level of 5,3σ from DPMO value of 728.697 for the types of defects whitespot and sigma level of 4,8σ of DPMO value of 425.441 for the type of metal defects. From the analysis it can be concluded that the two companies have not been effective in applying the techniques and tools of quality control in accordance with the standards ISO 9001: 2008 in order to achieve continuous quality improvement. This is indicated by the key success factor of the implementation techniques and tools of quality control is not applied appropriately in achieving continuous quality improvement.

scholarly journals COVID-19 Teleconferencing Experiences of Caregivers & Spouses with Dementia from QA/QI Support Group Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1006-1007
Author(s):  
Roscoe Nicholson ◽  
Maureen O'Connor ◽  
Andrew Nguyen ◽  
Rebecca Salant ◽  
Tiffany Donley ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Quality Improvement ◽  
Family Support ◽  
Support Groups ◽  
Support Group ◽  
Iterative Process ◽  
A Priori ◽  
Physical Contact ◽  
Framework Analysis ◽  
Spouse Caregivers

Abstract In summer 2020, researchers conducted a Quality Assurance and Quality Improvement (QA/QI) assessment of the NYU Langone Alzheimer’s Disease and Related Dementias Family Support Program’s adaptations in response to COVID by interviewing 10 participating spouse caregivers of persons with dementia (PWD). The primary adaptations were shifting from in-person to online services, changing support groups from biweekly to weekly, and offering an arts-based group for PWD daily rather than weekly . In the course of these interviews, all respondents described their adaptation to remote teleconferencing programming, and five also contrasted their experiences with those of the PWD. Methods After transcription and de-identification, a codebook was created from the transcript content that included a priori topics of interest as well as emergent themes using framework analysis. These transcripts were then coded by two independent coders through an iterative process and consultation with the codebook creator, who also resolved any discrepancies between coders. Results Respondents reported largely successful transitions to teleconferencing for themselves, though missing the physical contact afforded by meeting in-person. However, they also described some interactional challenges related to participants talking over one another, and suggested more active moderating to facilitate greater turn-taking. The respondents’ descriptions of the PWD’s response suggested a much less successful transition to teleconferencing. Challenges and barriers included lack of interest, difficulty following or participating in conversation, and teleconferencing creating confusion, such making it “hard for her to separate out when everybody's in the same place or not."

The cancer imaging program quality framework at Cancer Care Ontario: The first five years.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 244-244 ◽  
Author(s):  
Julian Dobranowski ◽  
Saul Melamed ◽  
Deanna Langer ◽  
Colleen Bedford
Keyword(s):  
Quality Improvement ◽  
Community Of Practice ◽  
Cancer Care ◽  
Cancer Imaging ◽  
International Standards ◽  
Evidence Based ◽  
Radiology Reporting ◽  
Time Data ◽  
Ct Guided ◽  
Geographical Regions

244 Background: The Cancer Imaging Program (CIP) at Cancer Care Ontario was established in 2009 to improve the quality of cancer imaging in Ontario. Methods: After initial selection of a Provincial clinical lead in 2009, fourteen regional clinical leads were selected to represent all geographical regions of the province. Through a stakeholder survey and a priority setting process the following four high-level areas of priority emerged to support quality improvement of cancer imaging: (1) Developing and Fostering an Imaging Community of Practice, (2) Imaging Appropriateness, (3) Timely Access to Imaging, and (4) Standardized/Synoptic Reporting. Results: (1) An Imaging Community of Practice was established with the regional clinical leads, who participate in monthly meetings to build and strengthen inter-regional relationships and share information on regional activities and priorities; (2) Best practice standards for imaging in lung and colorectal cancer have been developed by consolidating and endorsing national and international guidelines. New imaging guidelines are being developed by the Program in Evidence-Based Care. Evidence-based recommendations being developed for focal tumour ablation procedures; (3) Three Interventional Radiology procedures (CT-guided lung biopsies, peripherally inserted central catheters and portacaths) have been selected for an ongoing wait time collection that captures monthly point-in-time data. The data has initiated discussions on appropriate benchmarks and identification of factors that may contribute wait times; and (4) Synoptic Radiology Reporting enables the collection of uniform and complete data to improve the information available to referring clinicians for diagnosis and treatment planning. Work is underway in the development of: implementation roadmap, evidence-based clinical checklists, infrastructure to store and share synoptic reports, and international standards for synoptic radiology reporting. Conclusions: The establishment of the CIP as a clinical program under a provincial cancer agency has enabled the development of an Imaging Community of Practice and allowed for work on provincial-wide initiatives that enable quality improvement of cancer imaging.

Abstract 267: A Single-page Best Practice Algorithm Reduces Stroke Risk and Improves Arrhythmia Management Decisions in Patients With Acute Atrial Fibrillation: A Quality Improvement Project

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Edd Maclean ◽  
Shreena Patel ◽  
Olaminposi Joseph ◽  
Daniella de Block Golding ◽  
Samantha Maden ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Quality Improvement ◽  
Best Practice ◽  
Stroke Risk ◽  
International Standards ◽  
Quality Improvement Project ◽  
Management Decisions ◽  
Improvement Project ◽  
Management Algorithm ◽  
Arrhythmia Management

Objectives: In response to a serious incident involving an atrial fibrillation (AF) associated stroke, a quality improvement project was established to examine and abrogate unnecessary thromboembolic risk in patients presenting with acute AF to London’s North Middlesex University Hospital (NMUH). Methods: The presenting complaint was examined for 2,105 consecutive medical admissions to identify 100 patients (4.7%) with acute AF. For each patient, 36 indices and performance indicators were collected and analysed against international standards and the collective best practice of the local Cardiology team. Deficiencies were identified throughout the inpatient experience, including documentation, risk stratification, anticoagulation and arrhythmia management decisions. With cross-specialty collaboration, a single-page AF management algorithm was subsequently established using sequential PDSA methodology, and following its introduction a further 100 consecutive patients with acute AF were analysed prospectively. Results: Algorithm implementation significantly reduced the proportion of patients exposed to unnecessary stroke risk (30% -> 4%, p<0.0001); improved identification and documentation of thromboembolic potential (50% -> 88%, p<0.0001), reduced incorrect drug decisions (12% -> 2%, p=0.01), reduced contraindicated rhythm control (8% -> 0%, p=0.007), and increased direct oral anticoagulant (DOAC) prescribing (38% -> 86%, p<0.0001) over warfarin. There was a trend towards reduced mean inpatient stay (4.7 -> 3.5 days, p=0.11). Conclusions: Using established quality improvement methodology and cost-neutral multi-disciplinary expertise, this novel management algorithm has significantly improved the quality and safety of care for patients with acute AF at NMUH. Prospective analysis of long-term adverse outcomes is now required to establish morbidity or mortality benefit.

scholarly journals Reducing the Incidence of Exposure to Blood and Body Fluids

2020 ◽  
Author(s):  
Naglaa Sallam ◽  
Reham Hassan ◽  
Alaedine Shurrab ◽  
Yasser Al Deeb ◽  
Mujahed Shraim
Keyword(s):  
Quality Improvement ◽  
Median Number ◽  
Staff Satisfaction ◽  
Risk Awareness ◽  
Improvement Project ◽  
Pareto Chart ◽  
Safe Practice ◽  
Priority Areas ◽  
Hemodialysis Unit ◽  
Exposure Prevention

Methods: We used a Pareto chart to identify priority areas for our project based on magnitude of incidence of BBF exposures. A driver diagram was developed with four main primary drivers including risk awareness, attitudes and practice, staff experience, and leadership engagement. Intervention ramps and changes were implemented using multiple PDSA cycles addressing staff knowledge and awareness about BBF exposure prevention and management using surveys and learning brochures and assessment of staff compliance with safe practice. The project included the following measures (i) outcome measure: number of days between BBF exposure incidents; (ii) Process measures: BBF exposure risk awareness score, attitude and practice score, and proportion of staff compliant with BBF exposure safe practice; (iii) BBF reporting exposure score and proportion of staff satisfied with BBF exposure prevention and management policy. Ethical approval of the project was not required. Results: About 80% of BBF exposure incidents were due to needlestick injuries. Emergency unit, operating theatre, hemodialysis unit, laboratory unit, and utility services accounted for 80% of all BBF exposure incidents. Around 47% of the incidents occurred among nurses. Our project was associated with increase in attitude and safe practice score form 75% to 100%. The compliance with safe practice increased from 77% to 86%, and reporting of exposure increased from 75% to 100%. Staff satisfaction increased from 65% at baseline to 96%. Knowledge about prevention and management of BBF exposure (safe practice) increased from 60% to 92% in the hemodialysis unit. However, the median number of days between BBF exposures increased from 13 days at baseline to 18 days in May 2019. Conclusion: Our quality improvement project has identified the priorities clinical areas accounting for the majority of BBF exposure incident. The initial phase of the project in hemodialysis unit was associated with significant increase in knowledge scores about prevention and management of BBF exposure, compliance with safe practice, and staff satisfaction. In addition, the project was associated with significant increase in reporting of BBF exposure, which explains why we were not able to increase the median number of days between BBF exposures to 50 days. We have started spreading our interventions and change ideas to other units in Al-Khor general Hospital. Quality improvement projects can reduce the incidence of BBF exposure having the priority areas identified and the relevant drivers are addressed appropriately

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