Performance Improvement Utilizing Multidisciplinary Collaborations and Analytics Are the Key Drivers in Paradigm Shift From Volume to Value in Improving Test Utilization, Patient Safety, and Quality of Care

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S143-S144
Author(s):  
Sachin Gupta ◽  
Jo Bean ◽  
Maura Pieretti ◽  
Larry Bischof ◽  
Victor Hruszczyk ◽  
...  
Keyword(s):  
Patient Safety ◽  
Best Practices ◽  
Performance Improvement ◽  
Clinical Excellence ◽  
Multidisciplinary Teams ◽  
Blood Contamination ◽  
Rapid Pcr ◽  
Specimen Collection ◽  
Admission Screening ◽  
Enterprise Data Warehouse

Abstract Objectives The objective of this session is to understand the value of performance improvement, teamwork, and laboratory analytics to improve test utilization, quality, and patient safety. This presentation will highlight BayCare Health System’s journey to achieve clinical excellence. Methods Laboratory performance improvement team collaborated with the Enterprise Data Warehouse team to build in-house Laboratory Analytics dashboards. The dashboard reports were used to identify opportunities and to implement best practices in collaboration with multidisciplinary teams. The improvements were achieved by using performance improvement tools and were measured by various process and outcome metrics. Results: ( 1) Lab collaborated with the infection prevention team and standardized the admission screening policies for rapid PCR testing. This has resulted in 50% and 85% reduction in MRSA and VRE testing, respectively, which led to annual savings of over $1 million/year. (2) Collaborating with the antibiotic stewardship team and introducing new urinalysis reflex criteria resulted in an about 18,000 fewer urines reflexed to culture per year. This change led to about $190,000 per year reduction in expense of reagents and labor. (3) Collaborating with the team of nursing, as well as monitoring and implementing best practices to reduce the blood contamination rates, has resulted in <1.4% blood contamination rates. (4) Multidisciplinary teams were able to reduce transfusion rates for various blood products in our hospitals to less than 7%, which brings us to top-decile performers in Premier database. (5) Collaboration with nursing and lab, by using lab analytics, was able to reduce emergency department lab orders result time by 21% and improve patient throughput. (6) The analytics reports also improved staff planning and efficiencies in specimen collection. Conclusion Performance improvement utilizing multidisciplinary collaborations and Lab Analytics are the key players in shifting the paradigm from volume to value, which eventually helps in appropriate test utilization and better patient care.

scholarly journals IMPROVING SYSTEM READINESS, STAFF PREPAREDNESS AND PATIENT SAFETY IN A NEW SINGLE FAMILY ROOM NICU THROUGH IN SITU SIMULATION

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e16-e16
Author(s):  
Ahmed Moussa ◽  
Audrey Larone-Juneau ◽  
Laura Fazilleau ◽  
Marie-Eve Rochon ◽  
Justine Giroux ◽  
...  
Keyword(s):  
Patient Safety ◽  
Repeated Measures ◽  
Large Scale ◽  
Multidisciplinary Teams ◽  
Single Family ◽  
In Situ Simulation ◽  
Ensure Patient Safety ◽  
System Readiness ◽  
Dependent Samples

Abstract BACKGROUND Transitions to new healthcare environments can negatively impact patient care and threaten patient safety. Immersive in situ simulation conducted in newly constructed single family room (SFR) Neonatal Intensive Care Units (NICUs) prior to occupancy, has been shown to be effective in testing new environments and identifying latent safety threats (LSTs). These simulations overlay human factors to identify LSTs as new and existing process and systems are implemented in the new environment OBJECTIVES We aimed to demonstrate that large-scale, immersive, in situ simulation prior to the transition to a new SFR NICU improves: 1) systems readiness, 2) staff preparedness, 3) patient safety, 4) staff comfort with simulation, and 5) staff attitude towards culture change. DESIGN/METHODS Multidisciplinary teams of neonatal healthcare providers (HCP) and parents of former NICU patients participated in large-scale, immersive in-situ simulations conducted in the new NICU prior to occupancy. One eighth of the NICU was outfitted with equipment and mannequins and staff performed in their native roles. Multidisciplinary debriefings, which included parents, were conducted immediately after simulations to identify LSTs. Through an iterative process issues were resolved and additional simulations conducted. Debriefings were documented and debriefing transcripts transcribed and LSTs classified using qualitative methods. To assess systems readiness and staff preparedness for transition into the new NICU, HCPs completed surveys prior to transition, post-simulation and post-transition. Systems readiness and staff preparedness were rated on a 5-point Likert scale. Average survey responses were analyzed using dependent samples t-tests and repeated measures ANOVAs. RESULTS One hundred eight HCPs and 24 parents participated in six half-day simulation sessions. A total of 75 LSTs were identified and were categorized into eight themes: 1) work organization, 2) orientation and parent wayfinding, 3) communication devices/systems, 4) nursing and resuscitation equipment, 5) ergonomics, 6) parent comfort; 7) work processes, and 8) interdepartmental interactions. Prior to the transition to the new NICU, 76% of the LSTs were resolved. Survey response rate was 31%, 16%, 7% for baseline, post-simulation and post-move surveys, respectively. System readiness at baseline was 1.3/5,. Post-simulation systems readiness was 3.5/5 (p = 0.0001) and post-transition was 3.9/5 (p = 0.02). Staff preparedness at baseline was 1.4/5. Staff preparedness post-simulation was 3.3/5 (p = 0.006) and post-transition was 3.9/5 (p = 0.03). CONCLUSION Large-scale, immersive in situ simulation is a feasible and effective methodology for identifying LSTs, improving systems readiness and staff preparedness in a new SFR NICU prior to occupancy. However, to optimize patient safety, identified LSTs must be mitigated prior to occupancy. Coordinating large-scale simulations is worth the time and cost investment necessary to optimize systems and ensure patient safety prior to transition to a new SFR NICU.

Abstract 218: Expanding a Learning Collaborative Model in Chicago to Improve Door to Needle for Stroke Thrombolysis: Raising the Bar

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Shyam Prabhakaran ◽  
Renee M Sednew ◽  
Kathleen O’Neill
Keyword(s):  
Best Practices ◽  
Performance Improvement ◽  
Best Practice ◽  
Learning Collaborative ◽  
Collaborative Model ◽  
Stroke Registry ◽  
Chicago Area ◽  
Regional Collaboration ◽  
Content Expert ◽  
And Performance

Background: There remains significant opportunities to reduce door-to-needle (DTN) times for stroke despite regional and national efforts. In Chicago, Quality Enhancement for the Speedy Thrombolysis for Stroke (QUESTS) was a one year learning collaborative (LC) which aimed to reduce DTN times at 15 Chicago Primary Stroke Centers. Identification of barriers and sharing of best practices resulted in achieving DTN < 60 minutes within the first quarter of the 2013 initiative and has sustained progress to date. Aligned with Target: Stroke goals, QUESTS 2.0, funded for the 2016 calendar year, invited 9 additional metropolitan Chicago area hospitals to collaborate and further reduce DTN times to a goal < 45 minutes in 50% of eligible patients. Methods: All 24 hospitals participate in the Get With The Guidelines (GWTG) Stroke registry and benchmark group to track DTN performance improvement in 2016. Hospitals implement American Heart Association’s Target Stroke program and share best practices uniquely implemented at sites to reduce DTN times. The LC included a quality and performance improvement leader, a stroke content expert, site visits and quarterly meetings and learning sessions, and reporting of experiences and data. Results: In 2015, the year prior to QUESTS 2.0, the proportion of patients treated with tPA within 45 minutes of hospital arrival increased from 21.6% in Q1 to 31.4% in Q2. During the 2016 funded year, this proportion changed from 31.6% in Q1 to 48.3% in Q2. Conclusions: Using a learning collaborative model to implement strategies to reduce DTN times among 24 Chicago area hospitals continues to impact times. Regional collaboration, data sharing, and best practice sharing should be a model for rapid and sustainable system-wide quality improvement.

Thinking Different Approach to Optimize Your Treaters

2021 ◽  
Author(s):  
Anand Kumar Singh ◽  
Aysha Alobeidli ◽  
Venugopal Bakthavachsalam
Keyword(s):  
Natural Gas ◽  
Best Practices ◽  
Performance Improvement ◽  
Change Process ◽  
Molecular Sieve ◽  
Critical Parameter ◽  
Treatment Process ◽  
Feasibility Studies ◽  
Management Change ◽  
And Performance

Abstract Natural gas coming from the well contains hydrocarbons, CO2, H2S, and water together with many other impurities. Molecular sieve treatment of the gas is required to make it suitable for the various applications. The several process and parameters considerations contribute to the reliable and optimized operation of molecular sieve natural gas treaters. The journey of this molecular sieve treater optimization commenced by conducting a thorough systematic study of all existing treater performance by considering various operating critical parameter. The technical feasibility studies were completed covering all the aspects like evaluating current performance of treater, conducting simulation for future capacity, licensor endorsement, conducting breakthrough test. Finally, study outcomes were implemented through management change process. The main benefits of optimization of molecular sieve treater process are to extend the service life of molecular sieve which enable us to increase the turnaround cycle of NGL trains. Significant reduction in CAPEX and OPEX cost were realized by reducing new fresh molecular sieve procurement, reducing disposal of molecular sieve waste material and expense of shutdown, achieving 100% HSE. This paper presents the typical operation issues and challenges in molecular sieve treatment process, best practices adopted for maximizing of existing assets considering the current and design scenarios, and performance improvement, which result to extend molecular sieve life, increase of NGL shutdown cycle and flaring reduction in trains.

Abstract 62: A Statewide Cooperative Motivational Strategy Significantly Improves IV Alteplase Rates in Maryland: Golden Brain Award

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Karen L Yarbrough ◽  
Anna Aycock ◽  
Chad Schrier ◽  
Marcella Wozniak ◽  
Keyword(s):  
Best Practices ◽  
Performance Improvement ◽  
Health Care Facilities ◽  
Phase Iii ◽  
Improvement Project ◽  
Care Facilities ◽  
Regional Conference ◽  
Special Programs ◽  
Stroke Center ◽  
Expert Faculty

Introduction: The Maryland Stroke Coordinators Consortium and the Maryland Institute for Emergency Medical Services Systems, Health Care Facilities formed the Maryland Stroke Coalition (MSC) to improve stroke practices in Maryland. The aim of this performance improvement project was to determine if a motivational strategy improves thrombolytic metrics. Methods: In 2018 a stroke summit for Maryland stroke centers with expert faculty discussed thrombolytic best practices. Then MSC members met bimonthly to discuss how to implement AHA’s Target: Stroke Phase III. In October 2018 a motivational strategy was implemented to improve thrombolytic benchmarks. Quarterly, the stroke center with the fastest median door to needle time was awarded a Golden Brain trophy and a monetary award. After four quarters the stroke center with the fastest door to needle time will be recognized at a regional conference. Stroke coordinators voluntarily submitted quarterly data to the Chief of Special Programs, MIEMSS. Data submitted: quarterly rates IV Alteplase, median door to needle time, and % of IV Alteplase < 45 minutes. Results: Seventeen out of 39 possible stroke centers participated during the study period. Baseline data for the quarter prior to implementation revealed 84 pts received IV Alteplase. For the next three quarters IV Alteplase rates increased from baseline, respectively by 52% (n=128), 54% (n=129) and 65% ( n=139); and the median door to needle time was 48 minutes. The winning centers for each quarter reported median door to needle times < 30 minutes. From baseline (36%, 42/114) to quarter 3 there was a 15.5% (51.5%, =49/95) increase in patients being treated with IV Alteplase in < 45 minutes. Conclusion: Implementation of a motivational strategy and sharing best practices appears to be associated with increasing IV Alteplase administration volumes. The results of this PI project will be used to engage stakeholders to develop strategies to assist stroke centers remove barriers to improve door to needle times. The limitations of this project may be the small number of stroke centers participating and the effect of highly functioning centers participating.

Patient Safety Best Practices Model

2004 ◽  
pp. 241-243
Author(s):  
Paul Vegoda ◽  
Carl Abramson
Keyword(s):  
Patient Safety ◽  
Best Practices

scholarly journals A tool to improve the performance of multidisciplinary teams in cancer care

2019 ◽  
Vol 8 (2) ◽  
pp. e000435 ◽  
Author(s):  
Lynleigh Evans ◽  
Brendan Donovan ◽  
Yiren Liu ◽  
Tim Shaw ◽  
Paul Harnett
Keyword(s):  
Performance Improvement ◽  
Team Performance ◽  
Cancer Care ◽  
Assessment Tool ◽  
Multidisciplinary Teams ◽  
Self Assessment ◽  
Team Members ◽  
Innovative Methodology ◽  
Improvement Strategies ◽  
The Matrix

IntroductionWhile multidisciplinary teams (MDTs) are well established in many healthcare institutions, both how they function and their role in decision-making vary widely. This study adopted an innovative methodology to assess multidisciplinary team performance and engage teams in performance improvement strategies.MethodsThe study comprised a survey to evaluate MDT members’ perceptions of their team’s performance before the implementation of the programme and annually thereafter, and a maturity matrix designed as a self-assessment tool. Each MDT used the matrix to collectively assess its performance and identify areas for improvement.ResultsIn the first cycle, 180 member surveys from 19 MDTs were completed. This provided insights into team members’ perceptions of performance. 12 of these teams continued with the study and all 12 completed the matrix. Most teams rated themselves at level one or two (low) on a scale of five for most items.ConclusionsThe MDT survey and maturity matrix have the potential to be useful for cancer care teams to identify their strengths and weaknesses and monitor performance over time and also for management to review its performance against standard criteria and to identify priority areas for improvement and further support.

scholarly journals Safe use of the EHR by medical scribes: a qualitative study

2020 ◽  
Author(s):  
Joan S Ash ◽  
Sky Corby ◽  
Vishnu Mohan ◽  
Nicholas Solberg ◽  
James Becton ◽  
...  
Keyword(s):  
Patient Safety ◽  
Best Practices ◽  
Clinical Training ◽  
Rapid Assessment ◽  
Data Gathering ◽  
Assessment Process ◽  
Healthcare Organizations ◽  
Safety Risks ◽  
The Us ◽  
Medical Scribes

Abstract Objective Hiring medical scribes to document in the electronic health record (EHR) on behalf of providers could pose patient safety risks because scribes often have no clinical training. The aim of this study was to investigate the effect of scribes on patient safety. This included identification of best practices to assure that scribe use of the EHR is not a patient safety risk. Materials and Methods Using a sociotechnical framework and the Rapid Assessment Process, we conducted ethnographic data gathering at 5 purposively selected sites. Data were analyzed using a grounded inductive/hermeneutic approach. Results We conducted site visits at 12 clinics and emergency departments within 5 organizations in the US between 2017 and 2019. We did 76 interviews with 81 people and spent 80 person-hours observing scribes working with providers. Interviewees believe and observations indicate that scribes decrease patient safety risks. Analysis of the data yielded 12 themes within a 4-dimension sociotechnical framework. Results about the “technical” dimension indicated that the EHR is not considered overly problematic by either scribes or providers. The “environmental” dimension included the changing scribe industry and need for standards. Within the “personal” dimension, themes included the need for provider diligence and training when using scribes. Finally, the “organizational” dimension highlighted the positive effect scribes have on documentation efficiency, quality, and safety. Conclusion Participants perceived risks related to the EHR can be less with scribes. If healthcare organizations and scribe companies follow best practices and if providers as well as scribes receive training, safety can actually improve.

Sign in / Sign up

Export Citation Format

Share Document