A framework for quality improvement: An analysis of factors responsible for improvement at hospitals participating in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) quality improvement initiative

2007 ◽  
Vol 154 (6) ◽  
pp. 1206-1220 ◽  
Author(s):  
Seth W. Glickman ◽  
William Boulding ◽  
Richard Staelin ◽  
Jyotsna Mulgund ◽  
Matthew T. Roe ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Risk Stratification ◽  
Unstable Angina ◽  
Adverse Outcomes ◽  
Quality Improvement Initiative ◽  
Early Implementation

scholarly journals Improving Respiratory Rate Accuracy in the Hospital: A Quality Improvement Initiative

2019 ◽  
Vol 14 (11) ◽  
pp. 673-677 ◽  
Author(s):  
Neil Keshvani ◽  
Kimberly Berger ◽  
Arjun Gupta ◽  
Sheila DePaola ◽  
Oanh Kieu Nguyen ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Respiratory Rate ◽  
Low Cost ◽  
Blood Pressure Measurement ◽  
Vital Signs ◽  
Safety Net ◽  
Adverse Outcomes ◽  
Quality Improvement Initiative ◽  
Safety Net Hospital ◽  
Automated Blood Pressure Measurement

Respiratory rate (RR) is a predictor of adverse outcomes. However, RRs are inaccurately measured in the hospital. We conducted a quality improvement (QI) initiative using plan-do-study-act methodology on one inpatient unit of a safety-net hospital to improve RR accuracy. We added time-keeping devices to vital sign carts and retrained patient-care assistants on a newly modified workflow that included concomitant RR measurement during automated blood pressure measurement. The median RR was 18 (interquartile range [IQR] 18-20) preintervention versus 14 (IQR 15-20) postintervention. RR accuracy, defined as ±2 breaths of gold-standard measurements, increased from 36% preintervention to 58% postintervention (P < .01). The median time for vital signs decreased from 2:36 minutes (IQR, 2:04-3:20) to 1:55 minutes (IQR, 1:40-2:22; P < .01). The intervention was associated with a 7.8% reduced incidence of tachypnea-specific systemic inflammatory response syndrome (SIRS = 2 points with RR > 20; 95% CI, –13.5% to –2.2%). Our interdisciplinary, low-cost, low-tech QI initiative improved the accuracy and efficiency of RR measurement.

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