scholarly journals Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 104-111 ◽  
Author(s):  
Lucas B. Chartier ◽  
Amy H.Y. Cheng ◽  
Antonia S. Stang ◽  
Samuel Vaillancourt
Keyword(s):  
Quality Improvement ◽  
Professional Training ◽  
Problem Statement ◽  
Improvement Project ◽  
Team Members ◽  
Root Cause ◽  
Change Team ◽  
Patient Safety Incidents

ABSTRACTEmergency medicine (EM) providers work in a fast-paced and often hectic environment that has a high risk for patient safety incidents and gaps in the quality of care. These challenges have resulted in opportunities for frontline EM providers to play a role in quality improvement (QI) projects. QI has developed into a mature field with methodologies that can dramatically improve the odds of having a successful project with a sustainable impact. However, this expertise is not yet commonly taught during professional training. In this first of three articles meant as a QI primer for EM clinicians, we will introduce QI methodology and strategic planning using a fictional case study as an example. We will review how to identify a QI problem, define components of an effective problem statement, and identify stakeholders and core change team members. We will also describe three techniques used to perform root cause analyses—Ishikawa diagrams, Pareto charts and process mapping—and how they relate to preparing for a QI project. The next two papers in this series will focus on the execution of the QI project itself using rapid-cycle testing and on the evaluation and sustainability of QI projects.

scholarly journals Quality improvement primer part 3: Evaluating and sustaining a quality improvement project in the emergency department

CJEM ◽  
2018 ◽  
Vol 21 (2) ◽  
pp. 261-268 ◽  
Author(s):  
Lucas B. Chartier ◽  
Samuel Vaillancourt ◽  
Amy H. Y. Cheng ◽  
Antonia S. Stang
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Stakeholder Engagement ◽  
Improvement Project ◽  
Cause Analysis ◽  
Root Cause ◽  
The Third ◽  
Academic Fields ◽  
Measurement And Evaluation

AbstractQuality improvement (QI) and patient safety are two areas that have grown into important operational and academic fields in recent years in health care, including in emergency medicine (EM). This is the third and final article in a series designed as a QI primer for EM clinicians. In the first two articles we used a fictional case study of a team trying to decrease the time to antibiotic therapy for patients with sepsis who were admitted through their emergency department. We introduced concepts of strategic planning, including stakeholder engagement and root cause analysis tools, and presented the Model for Improvement and Plan-Do-Study-Act (PDSA) cycles as the backbone of the execution of a QI project. This article will focus on the measurement and evaluation of QI projects, including run charts, as well as methods that can be used to ensure the sustainability of change management projects.

SEKOLAH GRATIS DAN MUTU SEKOLAH: STUDI KASUS DI SMAN 2 BABAT TOMAN MUSI BANYUASIN SUMSEL

2015 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Afriantoni Afriantoni ◽  
Ibrahim Ibrahim
Keyword(s):  
Quality Improvement ◽  
Qualitative Method ◽  
School Quality ◽  
School Policy ◽  
School Education ◽  
Education Quality ◽  
Free School ◽  
School Costs

This study aimed to describe in depth between the link of school policy and the school quality improvement. The method in this study is a qualitative method using the case study presented descriptively. This research was conducted at SMA Negeri 2 Babat Tomat Kabupaten Musi Banyuasin. Based on this study it was found that the First, free school policy can help the economy / ease the burden of school costs to be incurred by the parents. Second, the policy constraints of the application for free school educa-tion at SMAN 2 Babat Toman is not very effective, so that the students' interest is not increasing, infrastructure is one of the obstacles in the implementation of free school education, how the quality of schools will be increased if it is not supported by facilities and complete infrastructure. Third, the quality of school education free SMAN 2 Babat Toman already realized well with regard to input, input turns unselected maximum, that is the students. Fourth, the implementation of free school education in Banyuasin, the quality of school SMAN 2 Babat Toman Muba Sumsel was not increased. This means that the implementation for free school education quality of school SMAN 2 Babat Toman was not increased.Keywords : free schools, school quality, case studies

Edukasi dan Peningkatan Kualitas Pengelolaan Obat di Rumah Tangga: Studi Kasus di Dusun Sidasari Wetan Desa Kubangkangkung Kawunganten Cilacap (Education and Quality Improvement of Drug Management in Family: A Case Study at Dusun Sidasari Wetan, Kubang

2018 ◽  
Vol 2 (2) ◽  
pp. 93
Author(s):  
Hendri Wasito ◽  
Hening Pratiwi ◽  
Adi Wibowo ◽  
Nia Kurnia Solihat
Keyword(s):  
Quality Improvement ◽  
Home Visit ◽  
Behavioral Changes ◽  
Drug Management ◽  
Educational Effort ◽  
The Family ◽  
Service Activity ◽  
Knowledge And Attitude

Drugs are an important component of health services that are the needs of the community. There is still a lack ofcommunity knowledge of medicines and management especially for family members, hence an educational effort as well asimprovement of quality of drug management in family through training program and mentoring by pharmacist. Thiscommunity service activity aims to determine the knowledge and attitude of the community in managing drugs in the familyand improve the quality of drug management by the community in the family. The activity was conducted in SidasariWetanKubangkangkung Village Kawunganten Cilacap. The workshop on drug management in family was conducted by pharmaciststo the 33 participants. Data collection was done by using questionnaire and observation through home visit. The result of theactivity shows that the increase of knowledge and attitude of the society in managing drugs in the familywere 10% and 7%,respectively. Workshop activities and mentoring by pharmacists can provide benefits and behavioral changes in family drugsmanagement.

scholarly journals Quality improvement primer part 2: executing a quality improvement project in the emergency department

CJEM ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 532-538 ◽  
Author(s):  
Lucas B. Chartier ◽  
Antonia S. Stang ◽  
Samuel Vaillancourt ◽  
Amy H. Y. Cheng
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Emergency Medicine ◽  
Quality Improvement ◽  
Improvement Project ◽  
Emergency Department Setting ◽  
Pdsa Cycle ◽  
Time To Antibiotics ◽  
Final Article

ABSTRACTThe topics of quality improvement (QI) and patient safety have become important themes in health care in recent years, particularly in the emergency department setting, which is a frequent point of contact with the health care system for patients. In the first of three articles in this series meant as a QI primer for emergency medicine clinicians, we introduced the strategic planning required to develop an effective QI project using a fictional case study as an example. In this second article we continue with our example of improving time to antibiotics for patients with sepsis, and introduce the Model for Improvement. We will review what makes a good aim statement, the various categories of measures that can be tracked during a QI project, and the relative merits and challenges of potential change concepts and ideas. We will also present the Model for Improvement’s rapid-cycle change methodology, the Plan-Do-Study-Act (PDSA) cycle. The final article in this series will focus on the evaluation and sustainability of QI projects.

Lessons learned in establishing a quality improvement project to reduce hospital acquired infections in the neonatology ward at a referral hospital in Rwanda

2016 ◽  
Vol 24 (4) ◽  
pp. 341-348 ◽  
Author(s):  
Naasson Gafirimbi ◽  
Rex Wong ◽  
Eva Adomako ◽  
Jeanne Kagwiza
Keyword(s):  
Quality Improvement ◽  
Lessons Learned ◽  
Referral Hospital ◽  
Quality Improvement Project ◽  
Injection Technique ◽  
Improve Quality ◽  
Improvement Project ◽  
Content Type ◽  
Hospital Acquired

Purpose Improving healthcare quality has become a worldwide effort. Strategic problem solving (SPS) is one approach to improve quality in healthcare settings. This case study aims to illustrate the process of applying the SPS approach in implementing a quality improvement project in a referral hospital. Design/methodology/approach A project team was formed to reduce the hospital-acquired infection (HAI) rate in the neonatology unit. A new injection policy was implemented according to the root cause identified. Findings The HAI rate decreased from 6.4 per cent pre-intervention to 4.2 per cent post-intervention. The compliance of performing the aseptic injection technique significantly improved by 60 per cent. Practical implications This case study illustrated the detailed application of the SPS approach in establishing a quality improvement project to address HAI and injection technique compliance, cost-effectively. Other departments or hospitals can apply the same approach to improve quality of care. Originality/value This study helps inform other hospitals in similar settings, the steps to create a quality improvement project using the SPS approach.

scholarly journals Madrasah Quality Improvement Evaluation Strategic Management Based

2020 ◽  
Vol 8 (2) ◽  
pp. 137-145
Author(s):  
Hary Priatna Sanusi
Keyword(s):  
Quality Improvement ◽  
Program Implementation ◽  
Maximum Score ◽  
Implementation Evaluation ◽  
Descriptive Research ◽  
Analysis Technique ◽  
Implementation Program ◽  
Research Type

This study was motivated by a phenomenon that appears in madrasa, namely: 1) the low quality of graduates, in MAN 1 with an average result of UAN 58.5 and MAN 2 57.8 from a maximum score of 100; 2) inconsistency in planning, implementing, evaluating programs to improve quality. The purpose of this study was to identify: work programs, program implementation, evaluation of program implementation, program impacts, and supporting factors inhibiting the improvement of the quality of madrasa. The approach of this study was qualitative-naturalistic, with a descriptive research type. This research method was a case study, with data collection techniques through interviews, observation, and documentation study. Meanwhile, the data analysis technique used the interactive Miles model. The results of this study showed: evaluation of quality improvement which is carried out through an evaluation of needs assessment, assessment of input, assessment of processes and assessment of results.

scholarly journals Improving The Quality of Process Standard Based on School-Based Management

2018 ◽  
Vol 3 (2) ◽  
pp. 252
Author(s):  
Anang Taufik Karunia ◽  
Maswardi M. Amin ◽  
M. Chiar
Keyword(s):  
Quality Improvement ◽  
Junior High School ◽  
Case Study Method ◽  
Quality Improvement Process ◽  
School Based ◽  
Improvement Process ◽  
Standard Quality ◽  
School Based Management

<p>The purpose of this research is to understand and describe in detail and depth about 1) Planning of standard quality improvement process based on school-based management at State Junior High School 3 Singkawang (SMPN 3 Singkawang); 2) Organizing the improvement of process standard quality based on school-based management in SMP N 3 Singkawang; 3) Implementation of standard quality improvement process based on school-based management in SMP N 3 Singkawang; 4) Supervision of standard quality improvement process based on school-based management at SMP N 3 Singkawang; 5) obstacles and efforts in improving the quality of process standards based on School-based<br />management in SMPN 3 Singkawang. The approach used in this research is qualitative research using case study method. then the results obtained in this study as follows 1) Planning standard quality improvement process based on the<br />school-based management SMPN 3 Singkawang in good categorize; 2) Organizing the improvement of process standard quality based on school-based management of SMPN 3 Singkawang is categorized well; 3) Implementation of standard quality improvement process based on school-based management of SMPN 3 Singkawang is categorized quite well; 4) Supervision of standard quality improvement process based on school-based management of SMPN 3 Singkawang is categorized quite well; 5) Obstacles in improving the quality of process standards based on the school-based management of SMPN 3 Singkawang is the condition of facilities still not meet the standards, especially the land or building, the physical condition of teachers caused by the age factor but the quality improvement of educators developed through certification of educators and other activities that support the learning process as well as the establishment of harmonious relationships between schools, parents and alumni.</p>

scholarly journals Assessing the practice of written referrals to neuroradiology and how this process can be improved and standardised

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S181-S182
Author(s):  
Fraser Currie ◽  
Rashi Negi ◽  
Hari Shanmugaratnam
Keyword(s):  
Quality Improvement ◽  
Scoring Systems ◽  
Quality Improvement Project ◽  
Cortical Atrophy ◽  
Secondary Outcome ◽  
Quality Improvement Initiative ◽  
Exclusion Criteria ◽  
Quality Of Information ◽  
Improvement Project

AimsThis quality improvement project aims to improve the quality of information provided in the referrals from the older adult psychiatry department to radiology when requesting neuroradiological imaging.The secondary outcome aims to standardise information on the referral proforma. We hypothesise that this improved referral proforma will lead to improved quality of reporting from the radiology department, which will form the second stage of this quality improvement project.A further area of interest of this exercise is to establish whether standardised radiological scoring systems are requested in the referral, as these can be utilised as a means to standardise reported information.MethodRetrospective electronic case analysis was performed on 50 consecutive radiology referrals for a period of 3 months from November 2019 to January 2020. Data were obtained from generic MRI and CT referral proforma and entered into a specifically designed data collection tool. Recorded were patient demographics, provisional diagnosis, modality of imaging, use of ACE-III cognitive score, radiological scoring systems, and inclusion and exclusion criteria.ResultResults from 50 referrals have shown: 60% were male, 40% female. Average patient age of 74, ranging from 49 to 95. 58% were referred for CT head with 42% for MRI head. More than half of referrals quoted the ACE-III score. 26% of referrals stated exclusion criteria such as space occupying lesions, haemorrhages or infarcts. 10% of referrals requested specific neuro-radiological scoring scales. Specific scales which were requested included GCA (global cortical atrophy), MTA scale (medial temporal atrophy), Koedam scale (evidence of parietal atrophy) and Fazekas (evidence of vascular changes). Only 80% of referrals included the patients GP details on the referral form.Conclusion1. This quality improvement initiative has highlighted that the current level of information in referring patient to radiology is variable and dependent on the referrer.2. All referrals should state exclusion criteria as per the NICE guidelines on neuroimaging in diagnosis of dementia.3. Preliminary evidence suggests that requesting specific radiological rating scales could improve the quality of information received in the imaging report. The second part of this quality improvement initiative will aim to explore the impact of requesting these scales routinely.

Networked improvement communities

2017 ◽  
Vol 25 (1) ◽  
pp. 5-25 ◽  
Author(s):  
Paul G. LeMahieu ◽  
Alicia Grunow ◽  
Laura Baker ◽  
Lee E. Nordstrum ◽  
Louis M. Gomez
Keyword(s):  
Quality Improvement ◽  
Social Systems ◽  
New Teacher ◽  
Added Value ◽  
Content Type ◽  
Public School Systems ◽  
The Usa ◽  
Theoretical Foundations

Purpose The purpose of this paper is to delineate an approach to quality assurance in education called networked improvement communities (NICs) that focused on integrating the methodologies of improvement science with few of the networks. Quality improvement, the science and practice of continuously improving programs, practices, processes, products and services within organized social systems, is a still-evolving area in education. This paper is the first of seven elaborating upon different approaches to quality improvement in education[1]. It delineates a new methodology called the NICs model. Developed by the Carnegie Foundation for the Advancement of Teaching, the approach is aimed at continuously improving the quality of practices, processes and outcomes in targeted problem areas in education systems. Design/methodology/approach The paper presents the historical development, theoretical foundations, core principles and adaptation of key elements of the NICs model for quality improvement in education. A case study specifically examines the problem of fostering new teacher effectiveness and retention in large public school systems in the USA. Findings The six principles underlying the NICs model are as follows: make the work problem-specific and user-centered, focus on variation in performance, see the system that produces outcomes, improve at scale what you can measure, use disciplined inquiry to drive improvement and accelerate learning through networked communities. Originality/value Few theoretical treatments and demonstration cases are currently available that examine the application of common models of quality improvement in education. This paper elaborates on one promising approach. In addition to examining the NICs model, the paper derives added value by allowing comparisons with seven widely used quality improvement approaches treated in this volume.

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