scholarly journals Ethical, Compassionate, and Cost-Effective Approach to Health Care Decisions of Unrepresented Patients: A Bioethics Quality Improvement Project

2020 ◽  
Author(s):  
Saba Syed ◽  
Nikhil Barot ◽  
Jacqueline Lazo-Belangue
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Cost Effective ◽  
Quality Improvement Project ◽  
Health Care Decisions ◽  
Improvement Project ◽  
Cost Effective Approach

scholarly journals Appropriate Use Criteria in Echocardiography: An Observational Institutional Study with the Perspective of a Quality Improvement Project

2016 ◽  
Vol 10 ◽  
pp. CMC.S36504 ◽  
Author(s):  
Vanessa Rameh ◽  
Antoine Kossaify
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Clinical Outcome ◽  
Quality Improvement Project ◽  
University Hospital ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Improvement Project ◽  
Health Care Resources ◽  
Set Up

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.

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

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.

scholarly journals 78 A Quality Improvement Project on Oxygen Administration Within the Geriatrics COVID-19 Cohort Ward

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L Hickson ◽  
A K L Liu ◽  
G Bailey ◽  
S Bruce ◽  
K Kawafi ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Flow Rate ◽  
Cost Effective ◽  
Quality Improvement Project ◽  
Education Session ◽  
Improvement Project ◽  
Oxygen Administration ◽  
Number Of Patients ◽  
Oxygen Requirements

Abstract Introduction Due to the COVID-19 pandemic, many medical and surgical wards were reassigned as COVID-19 cohort wards to accommodate the number of patients admitted with the virus. Nurses and healthcare assistants (HCAs) from various departments and backgrounds were redeployed to these areas. Within the geriatrics population, patients with severe COVID-19 often have high oxygen requirements and can rapidly deteriorate. Therefore, we conducted a quality improvement project within the geriatrics COVID-19 ward focused on improving patient safety by improving oxygen administration to patients. We also aimed to enhance the knowledge and confidence levels of nurses and HCAs in regards to oxygen administration. Method From April–July 2020, we compared the oxygen that was administered to COVID-19 patients against the oxygen therapy that was documented on observation charts. This included whether the correct type of device, flow rate and target oxygenation saturations were used. We carried out multiple Plan-Do-Study-Act (PDSA) cycles including a staff education session on oxygen administration, placed an oxygen guidelines poster on each patient’s bedside, administered a short quiz and distributed reminder lanyard cards. We also conducted a staff survey comparing knowledge and confidence on oxygen administration before and after an education session. Results Overall there has been an improvement in oxygen charting and administration after 4 PDSA cycles. There is 100% correct use of oxygen device and correct setting of oxygen flow rate after the 2nd and 3rd PDSA cycles. After the teaching session, all staff reported feeling more confident in oxygen management. Based on the audit data and quiz results, there was an improvement in knowledge of oxygen administration. Conclusions We have demonstrated that by using simple time-efficient and cost-effective interventions, improvements can be made in oxygen administration and subsequently patient safety. This has the potential to influence prognostic outcomes among the geriatrics population with COVID-19.

scholarly journals Improving diabetic foot screening at a primary care clinic: A quality improvement project

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Michelle L. Allen ◽  
Albertine M.B. Van der Does ◽  
Colette Gunst
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Diabetic Foot ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Care Clinic ◽  
Screening Practices ◽  
Primary Health ◽  
Diabetic Foot Screening

Background: Foot screening is an important part of diabetic care as it prevents significant morbidity, loss of function and mortality from diabetic foot complications. However, foot screening is often neglected.Aim: This project was aimed at educating health care workers (HCWs) in a primary health care clinic to increase diabetic foot screening practices. Setting: A primary health care clinic in the Western Cape province of South AfricaMethods: A quality improvement project was conducted. HCWs’ needs were assessed using a questionnaire. This was followed by focus group discussions with the HCWs, which were recorded, transcribed and assessed using a general inductive approach. An intervention was designed based on common themes. Staff members were trained on foot screening and patient information pamphlets and screening tools were made available to all clinic staff. Thirty-two consecutive diabetic patient folders were audited to compare screening in 2013 with that in 2014 after initiation of the quality improvement cycle.Results: HCWs’ confidence in conducting foot screening using the diabetic foot assessment questionnaire improved markedly after training. Diabetic foot screening practices increased from 9% in 2013 to 69% in 2014 after the first quality improvement cycle. A strengths, opportunities, aspirations and results (SOAR) analysis showed promise for continuing quality improvement cycles.Conclusion: The findings showed a significant improvement in the number of diabetic patients screened. Using strategic planning with appreciative intent based on SOAR, proved to be motivational and can be used in the planning of the next cycle.

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