Effectiveness of Multifaceted Hospitalwide Quality Improvement Programs Featuring an Intervention to Remove Unnecessary Urinary Catheters at a Tertiary Care Center in Thailand

2007 ◽  
Vol 28 (7) ◽  
pp. 791-798 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
Kanokporn Thongphubeth ◽  
Sirinaj Sirinvaravong ◽  
Danai Kitkangvan ◽  
Chananart Yuekyen ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Care Center ◽  
Tertiary Care ◽  
Hospital Costs ◽  
Urinary Catheterization ◽  
Urinary Catheters ◽  
Improvement Program ◽  
Improvement Programs ◽  
Intervention Team ◽  
Quality Improvement Programs

Objective.To evaluate the efficacy of a multifaceted hospitalwide quality improvement program that featured an intervention to remind physicians to remove unnecessary urinary catheters.Methods.A hospitalwide preintervention-postintervention study was conducted over 2 years (July 1, 2004, through June 30, 2006). The intervention consisted of nurse-generated daily reminders that were used by an intervention team to remind physicians to remove unnecessary urinary catheters, beginning 3 days after insertion. Clinical, microbiological, pharmaceutical, and cost data were collected.Results.A total of 2,412 patients were enrolled in the study. No differences were found in the demographic and/or clinical characteristics of patients between the preintervention and postintervention periods. After the intervention, reductions were found in the rate of inappropriate urinary catheterization (mean rate, preintervention vs postintervention, 20.4% vs 11% [P = .04]), the rate of catheter-associated urinary tract infection (CA-UTI) (mean rate, 21.5 vs 5.2 infections per 1,000 catheter-days [P <.001]), the duration of urinary catheterization (mean, 11 vs 3 days [P < .001]), and the total length of hospitalization (mean, 16 vs 5 days [P < .001]). A linear relationship was seen between the monthly average duration of catheterization and the rate of CA-UTI (r = 0.89; P < .001). The intervention had the greatest impact on the rate of CA-UTI in the intensive care units (mean rate, preintervention vs postintervention, 23.4 vs 3.5 infections per 1,000 catheter-days [P = .01]). The monthly hospital costs for antibiotics to treat CA-UTI were reduced by 63% (mean, $3,739 vs $1,378 [P < .001]), and the hospitalization cost for each patient during the intervention was reduced by 58% (mean, $366 vs $154 [P < .001]).Conclusions.This study suggests that a multifaceted intervention to remind physicians to remove unnecessary urinary catheters can significantly reduced the duration of urinary catheterization and the CA-UTI rate in a hospital in a developing country.

The return of investment of hospital-based surgical quality improvement programs in reducing surgical site infection at a Canadian tertiary-care hospital

2018 ◽  
Vol 40 (2) ◽  
pp. 125-132 ◽  
Author(s):  
Sasha van Katwyk ◽  
Kednapa Thavorn ◽  
Doug Coyle ◽  
Husein Moloo ◽  
Alan J. Forster ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Surgical Site Infection ◽  
Return On Investment ◽  
Tertiary Care ◽  
Site Infection ◽  
Improvement Program ◽  
Surgical Quality ◽  
Improvement Programs ◽  
Quality Improvement Programs ◽  
Positive Return

AbstractObjectiveWe performed a return-on-investment analysis comparing the investment in surgical site infection (SSI) prevention programs in a hospital setting to the savings from averted SSI cases.DesignA retrospective case costing study using aggregated patient data to determine the incidence and costs of SSI infection in surgical departments over time. We calculated return on investment to the hospital and conducted several sensitivity and scenario analyses.SettingData were compiled for the Ottawa Hospital (TOH), a Canadian tertiary-care teaching institution.PatientsWe used aggregated records for all hospital patients who underwent surgical procedures between April 2010 and January 2015.InterventionWe estimated the potential cost savings of the hospital’s surgical quality improvement program, namely the Surgeons National Surgical Quality Improvement Program (NSQIP) and the Comprehensive Unit-based Safety Program (CUSP).ResultsFrom 2010 to 2016, TOH invested C$826,882 (US$624,384) in surgical quality improvement programs targeting SSI incidence and accrued C$1,885,110 (US$1,423,460) in cumulative savings from averted SSI cases, generating a return of $2.28 (US$3.02) per dollar invested (95% confidence interval [CI], −0.67 to 7.37). The study findings are sensitive to the estimated cost to the hospital per SSI case and the rate reduction attributable to the prevention program.ConclusionsThe NSQIP and CUSP have produced a positive return on investment at TOH; however, the result rests on several assumptions. This positive return on investment is expected to continue if the hospital can continue to reduce SSI incidence at least 0.25% annually without new investments. Findings from this study highlight the need for continuous program evaluation of the quality improvement initiatives.

scholarly journals Headmaster Management to Improve Teacher Performance in Singkawang Senior High Schools

2019 ◽  
Vol 4 (2) ◽  
pp. 305
Author(s):  
Syahrudin Syahrudin
Keyword(s):  
High School ◽  
Quality Improvement ◽  
High Schools ◽  
School Principals ◽  
Teacher Performance ◽  
Improvement Program ◽  
School Work ◽  
Improvement Programs ◽  
Quality Improvement Programs

The progress of education of a school as an educational institution is influenced by the role of the principal as an education manager. It is very much determined by the principal's ability to manage human resources from the planning to evaluation aspects. This study aims to reveal the management of school principals to improve the performance of teachers in Singkawang State High School 3 with a focus on 1) The description of the planning of quality improvement programs for teacher performance by the headmaster of State High School 3 Singkawang, 2) The implementation of programs to improve the quality of teacher performance by principals in State High Schools 3 Singkawang, 3) Program evaluation activities to improve the quality of teacher performance carried out by school principals in SMA 3 Singkawang. The research method used is descriptive research with a qualitative approach. Data collected by in-depth interviews, participant observation, documentation, and analyzed through data reduction, data presentation, conclusions or verification. Data reliability testing is done by extending the period of observation, and triangulation and member checking. The results of the study conclude 1) planning of quality improvement programs for teacher performance is carried out with reference to the vision and mission and school work plans. 2) implementation of improving the quality of teacher performance is carried out by holding a program of continuous professional development in the form of technical guidance (BIMTEK) learning development activities, In House Training (IHT) and workshops aimed at improving teacher competence and quality of learning, 3) Evaluation of teacher performance is carried out by carrying out activities academic supervision of teachers and managerial supervision of administration. Based on the results of the study suggested the following things: 1) planning for improving the quality of teacher performance, especially in school work plans need to be improved in a continuous professional improvement program. 2) The form of carrying out continuous professional improvement activities should be adjusted to what is required by the teacher. 3) Evaluation activities should be carried out consistently to improve teacher quality.

Catheter-Associated Urinary Tract Infections in Intensive Care Units Can Be Reduced by Prompting Physicians to Remove Unnecessary Catheters

2004 ◽  
Vol 25 (11) ◽  
pp. 974-978 ◽  
Author(s):  
Wei-Chun Huang ◽  
Shue-Ren Wann ◽  
Shoa-Lin Lin ◽  
Calvin M. Kunin ◽  
Ming-Ho Kung ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Intensive Care Units ◽  
Tertiary Care ◽  
Common Source ◽  
Urinary Catheterization ◽  
Urinary Catheters ◽  
Improvement Program ◽  
Intervention Phase ◽  
Tract Infections

AbstractObjective:Indwelling urinary catheters are the most common source of infections in intensive care units (ICUs). The aim of this study was to evaluate the efficacy of nurse-generated daily reminders to physicians to remove unnecessary urinary catheters 5 days after insertion.Design:A time-sequence nonrandomized intervention study.Setting:Adult ICUs (medical, surgical, cardiovascular surgical, neurosurgical, and coronary care) of a tertiary-care university medical center.Patients:All patients admitted to the adult ICUs during a 2-year period. The study consisted of a 12-month observational phase (15,960 patient-days) followed by a 12-month intervention phase (15,525 patient-days).Intervention:Daily reminders to physicians from the nursing staff to remove unnecessary urinary catheters 5 days after insertion.Results:The duration of urinary catheterization was significantly reduced during the intervention phase (from 7.0 ± 1.1 days to 4.6 ± 0.7 days; P < .001). The rate of catheter-associated urinary tract infection (CAUTI) was also significantly reduced (from 11.5 ± 3.1 to 8.3 ± 2.5 patients with CAUTI per 1,000 catheter-days; P = .009). There was a linear relationship between the monthly average duration of catheterization and the rate of CAUTI (r = 0.50; P = .01). The excess monthly cost of antibiotics for CAUTI was reduced by 69% (from $4,021 ± $1,800 to $1,220 ± $941; P = .004).Conclusion:This study demonstrated that a simple measure instituted as part of a continuous quality improvement program significantly reduced the duration of urinary catheterization, rate of CAUTI, and additional costs of antibiotics to manage CAUTI.

Another look at the culture-quality-performance link

2008 ◽  
Vol 14 (2) ◽  
pp. 35 ◽  
Author(s):  
Shandell Elmer ◽  
Sue Kilpatrick
Keyword(s):  
Quality Improvement ◽  
Organisational Learning ◽  
Quality Improvement Program ◽  
Quality Improvement Initiative ◽  
Improvement Program ◽  
Quality Performance ◽  
Organisational Capacity ◽  
Improvement Programs ◽  
Quality Improvement Programs ◽  
The Impact

Quality improvement is usually driven by quality, safety and risk agendas leading to a focus on measurements of the outputs of care; outputs such as fewer complaints, fewer accidents and adverse events. An oft-neglected theme is the impact of the quality improvement initiative within the organisation itself. This paper presents the findings of the first stage of an evaluation that has examined the changes which have occurred within organisations since participating in a quality improvement initiative. These findings indicate that engaging with a quality improvement program can change the nature of social interactions within the organisation. In this way, quality improvement programs can impact on organisational culture, particularly in relation to organisational learning. Thus, this paper argues that successful engagement with a quality improvement program can enhance organisational learning, and, in turn, build organisational capacity.

scholarly journals Quality improvement programs and the professional nursing practice environment: an integrative review

2021 ◽  
Vol 74 (1) ◽  
Author(s):  
Camila Hidemi Danno ◽  
Larissa Sapucaia Ferreira Esteves ◽  
Elena Bohomol
Keyword(s):  
Quality Improvement ◽  
Latin American ◽  
Nursing Practice ◽  
Practice Environment ◽  
Improvement Program ◽  
Professional Nursing ◽  
Professional Nursing Practice ◽  
Nursing Practice Environment ◽  
Improvement Programs ◽  
Quality Improvement Programs

ABSTRACT Objectives: to analyze the knowledge produced regarding the practice environment in hospitals with quality improvement programs. Methods: integrative literature review performed in the Latin American and Caribbean Literature in Health Sciences databases, US National Library of Medicine/National Institutes of Health, Web of Science, Scopus and CINAHL, consisting in 10 articles. Results: data were presented and discussed using categories: Measures for the professional nursing practice environment; Hospital accreditation as an improvement program; Nursing autonomy, interpersonal relationship between nurse and doctor and the nurse as a manager and leader. Final Considerations: it was possible to analyze that the influence of quality improvement programs can be considered as favorable in the professional nursing practice environment. The survey also brings contributions to administration in implementing strategies aiming at continuous improvement in the environment characteristics.

Models of Care Delivery and Quality Measurement

2019 ◽  
pp. 19-33
Author(s):  
Katherine Lee ◽  
Zara Cooper
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Care Delivery ◽  
Quality Measurement ◽  
Models Of Care ◽  
Integrative Model ◽  
Surgical Patients ◽  
Improvement Program ◽  
Improvement Programs ◽  
Quality Improvement Programs

Two main models of care delivery have emerged for palliative care delivery to surgical patients: the consultative model, which relies on triggers for palliative care consultations, and the integrative model, which delivers palliative care alongside standard treatments. While both these models have shown success among nonsurgical populations, only a few studies have examined their utilization among surgical patients. Even though these models provide palliative care delivery to patients, indicators of quality are also necessary to ensure that palliative delivery improves quality of care. However, the most relevant and important indicators of quality for surgical palliative care remain undefined. Presently, there is no national surgical quality improvement program for palliative care, hindering attempts to measure quality and improve performance. However, the surgical specialties can adapt and learn from related specialties, such as critical care, geriatrics, oncology, and palliative and hospice medicine, to develop quality indicators for surgical palliative care. Capitalizing on existing quality structures, such as the American College of Surgeons quality improvement programs, can also help ensure integration of quality improvement efforts into standard practice.

scholarly journals Strategic Management in Quality Improvement at State Madrasah

2021 ◽  
Vol 13 (3) ◽  
pp. 2699-2710
Author(s):  
Mustapid Mustapid ◽  
Syafaruddin Syafaruddin ◽  
Candra Wijaya
Keyword(s):  
Quality Improvement ◽  
Strategic Planning ◽  
Central Government ◽  
Continuous Process ◽  
Strategy Selection ◽  
Improvement Program ◽  
Process Improvements ◽  
Use Of Data ◽  
Improvement Programs ◽  
Quality Improvement Programs

This study aims to analyze strategic planning, policy implementation and evaluation of quality improvement programs at a State Madrasah Aliyah Medan. This study uses a qualitative approach with data collection techniques through interviews, observation and documentation. While strengthening the validity of the data from research findings, the use of data validity standards based on Lincoln Guba consists of credibility, transferability, dependability, and confirmability. The results of this study indicate that; 1) strategic planning in quality improvement is carried out by deliberation and teamwork to formulate the madrasa's vision and mission, analysis of the internal environment of the resources owned by the madrasa and the external environment of the madrasa environment both geographically, socio-culturally and economically, analysis of strategy selection and the key to success appropriate, and strategy selection; 2) Implementation of madrasa policies in quality improvement is carried out by implementing education quality improvement programs and adopting policies to carry out continuous process improvements, establishing quality assurance and quality standards for quality improvement, creating a madrasa culture or culture, making organizational changes and maintaining good relations with stakeholders both central government, regional and community; and 3) Evaluation of the quality improvement program is carried out through monitoring all the results of planning and implementation, measuring the performance of individuals and madrasah institutions, compiling reports on the implementation of activities and taking corrective steps.

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