268. Increasing Immunization Uptake Among Recent Adolescent Immigrant Students: A Quality Improvement Project To Maximize Efficient Health Care Delivery

Background Appropriate use criteria (AUC) in echocardiography are essential tools for aligning the indications of echocardiography with the best clinical standards, improving clinical outcome, restraining abuse, and preserving health-care resources. Objectives The aim of this study was to ascertain the AUC for transthoracic echocardiography in a university hospital and create a quality improvement project (QIP). Methods The assessment of 501 inpatients who received transthoracic cardiac echo was conducted according to the 2011 AUC report. Indications were classified as appropriate, uncertain, or inappropriate, and patients not matching any of the abovementioned divisions were grouped in the nonfitting category. Results Of the 501 eligible patients, 374 patients (74.66%) were in the appropriate group, 85 patients (16.96%) in the inappropriate group, 20 patients (3.99%) in the uncertain group, and 22 patients (4.39%) in the nonfitting category. Discussion Interpretation and analysis of the obtained results are presented, along with the results of many comparable studies; moreover, a QIP was set up accordingly. Conclusion AUC are useful to assess local practice, preserve health-care resources, and improve clinical outcome.

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63 Quality Improvement Project: Should We be Doing More or Less Ct Head Scans in the Health Care of Older People Department?

Age and Ageing ◽

10.1093/ageing/afz187.04 ◽

2020 ◽

Vol 49 (Supplement_1) ◽

pp. i18-i20

Author(s):

M Munir ◽

T Shouter ◽

H S Tay

Keyword(s):

Health Care ◽

Quality Improvement ◽

Older People ◽

Management Plan ◽

Quality Improvement Project ◽

Improvement Project ◽

Number Of Patients ◽

New Findings ◽

New Finding ◽

Ct Head

Abstract Introduction Older people are likely to have more CT head scans given their multiple co- morbidities, being on anticoagulants, and increased falls. The aims of this quality improvement project (QIP) were to identify the number of patients who had CT head scan, the reason/indication of it, the number of patients who had new finding/s on it, actions taken on new findings, and whether the management plan was altered because of the CT scan. Methods Medical notes and CT head scan reports of all patients admitted to the Health Care of Older People department from April to September 2018 were reviewed to evaluate the indications of CT head scans, new findings, and management plans following the findings. Results 461 (10.7%) out of the 4323 patients discharged from the healthcare of older people department during April to September 2018 had CT head scans during admission. Frequent indications for CT head scans included delirium, falls and head injury. Only 46 (9.9%) patients had new finding/s on the CT head scan, and action was taken on 26 (56.5%) of these patients. The CT head scan changed the management plan of only 17 (3.6%) patients. Please see Table for more details. Conclusions By using our clinical judgement, following NICE guidelines on head injuries, educating our colleagues on the criteria for requesting a CT head scan, taking collateral histories about patients’ cognition and ascertaining the mechanism of fall, we can lessen the financial burden on the NHS and minimise the radiation exposure to our patients.

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Enhancing palliative care occupancy and efficiency: a quality improvement project that uses a healthcare pathway for service integration and policy development

BMJ Open Quality ◽

10.1136/bmjoq-2021-001391 ◽

2021 ◽

Vol 10 (4) ◽

pp. e001391

Author(s):

Sami Ayed Alshammary ◽

Yacoub Abuzied ◽

Savithiri Ratnapalan

Keyword(s):

Palliative Care ◽

Quality Improvement ◽

Multidisciplinary Team ◽

Policy Development ◽

Care Delivery ◽

Tertiary Care ◽

Business Case ◽

Quality Improvement Project ◽

Tertiary Care Centre ◽

Improvement Project

This article described our experience in implementing a quality improvement project to overcome the bed overcapacity problem at a comprehensive cancer centre in a tertiary care centre. We formed a multidisciplinary team including a representative from patient and family support (six members), hospice care and home care services (four members), multidisciplinary team development (four members) and the national lead. The primary responsibility of the formulated team was implementing measures to optimise and manage patient flow. We used the plan–do–study–act cycle to engage all stakeholders from all service layers, test some interventions in simplified pilots and develop a more detailed plan and business case for further implementation and roll-out, which was used as a problem-solving approach in our project for refining a process or implementing changes. As a result, we observed a significant reduction in bed capacity from 35% in 2017 to 13.8% in 2018. While the original length of stay (LOS) was 28 days, the average LOS was 19 days in 2017 (including the time before and after the intervention), 10.8 days in 2018 (after the intervention was implemented), 10.1 days in 2019 and 16 days in 2020. The increase in 2020 parameters was caused by the COVID-19 pandemic, since many patients did not enrol in our new care model. Using a systematic care delivery approach by a multidisciplinary team improves significantly reduced bed occupancy and reduces LOS for palliative care patients.

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Continuous Quality Improvement Applied to Outpatient Health Care Delivery in Displaced Persons Camps

Refuge ◽

10.25071/1920-7336.22050 ◽

2000 ◽

pp. 31-38

Author(s):

Paul B. Spiegel, ◽

Ellen Lynch ◽

Narendra M. Patel

Keyword(s):

Health Care ◽

Quality Improvement ◽

Quality Of Care ◽

Health Care Delivery ◽

Continuous Quality Improvement ◽

Care Delivery ◽

Developed Countries ◽

Less Developed Countries ◽

Continuous Quality

Continuous Quality Improvement (CQI) has been shown to be a highly effective approach for the evaluation and management of hospitals in developed countries, but it has barely begun to be utilised in less developed countries. This article defines the principles and the main tools of CQI and then applies them to the postemergency phase of a displaed persons camp situation, specifically towards improving the utilisation and the quality of care in an out patient department.

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