scholarly journals 572 Closed-Loop Clinical Audit on Blood Results in Urology Department During Ward Rounds

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
D S Sahni ◽  
P Kosk
Keyword(s):  
Patient Care ◽  
Closed Loop ◽  
Royal Infirmary ◽  
Sustainable Change ◽  
Post Intervention ◽  
Induction Program ◽  
Ward Rounds ◽  
Enhance Patient Care ◽  
Affect Patient Care

Abstract Aim Clinical governance states that blood results should be flagged during ward rounds to enable better assessment of inpatients. As per our institutional Protocol, each patient is assigned a blood sheet which should be updated every day with outstanding bloods flagged with a circle. The aim of the audit was to evaluate the quality of blood result sheets and to discuss results in order to enhance patient care. Method Data was collected from the Urology ward at Glasgow Royal Infirmary continuously during November 2020. We reviewed the flagging of abnormal bloods and whether clear documentation of baseline eGFR was included. Intervention was carried out by series of discussion with the nursing and the medical staff along with display posters throughout the ward and staff rooms. Results Overall, first cycle assessed 65 folders and second assessed 79. We noticed that the flagging of outstanding blood results increased from 70% to 74%. Documentation of baseline eGFR raised from 32% to 44%. Initially, only 73% of results were appropriately placed in the correct patient nursing folder which improved and reached 100% on review. Conclusions The first cycle of the audit demonstrated serious breach of protocols which could delay and affect patient care. The re-audit cycle post intervention illustrated that active efforts on the part of medical and nursing staff can significantly improve the outcomes. However, sustained intervention in the form of audits and induction program is needed to bring a sustainable change in the departmental practice.

Analyzing Errors in Practice: A Vehicle for Assessing and Enhancing the Quality of Care

1992 ◽  
Vol 8 (1) ◽  
pp. 62-75 ◽  
Author(s):  
Susan S. Deusinger
Keyword(s):  
Health Care ◽  
Quality Assurance ◽  
Quality Of Care ◽  
Physical Therapy ◽  
Patient Care ◽  
Enhance Patient Care

AbstractFailures are inevitable in health care. When failure occurs as a result of practitioner error, quality in patient care may be compromised. This article proposes that analyzing clinical errors may contribute to quality assurance. Examples from physical therapy illustrate how information gained from analyzing errors can enhance patient care.

scholarly journals 1702 A Proforma To Improve Documentation of Surgical Ward Rounds

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
E Armstrong ◽  
M Koronfel
Keyword(s):  
District General Hospital ◽  
Ward Round ◽  
Post Intervention ◽  
Improvement Project ◽  
Vte Prophylaxis ◽  
Surgical Ward ◽  
Management Plans ◽  
Ward Rounds ◽  
Assess Quality

Abstract Aim The ward round is an important vehicle in the care of surgical inpatients. Good quality documentation is essential in recording patient progress over time and communicating clearly between multidisciplinary team (MDT) members. This quality improvement project aimed to implement a standardised proforma to improve the quality of ward round documentation, improving MDT communication and patient safety. Method Ward round entries from an elective surgical unit at a District General Hospital were retrospectively reviewed using a fifteen-item checklist to assess quality of documentation. These criteria were divided into: A re-audit was performed following introduction of a ward round proforma using the same criteria. Results The pre-intervention arm included 41 entries and the post-intervention arm included 27 entries. Improvements were seen in twelve of the fifteen criteria assessed. The greatest improvements were seen in documentation of management plans; documentation of discharge plan improved from 58.5% to 100%, VTE prophylaxis from 42% to 100% and drain/ catheter plan from 42 to 93%. Documentation of two criteria (signature and bleep) decreased and documentation of date remained at 100%. Conclusions The use of a standardised proforma improves documentation of surgical ward rounds, particularly patient’s’ onward management plans. Further modifications to the proforma could aim to improve documentation of bleep and signature.

scholarly journals 573 What's in A Name? An Audit of Correct Identification of Patients During Ward-Rounds in A Surgical and Urology Receiving Ward

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
D S Sahni ◽  
G McCabe ◽  
R P Stevenson
Keyword(s):  
Patient Care ◽  
Improve Patient Care ◽  
Electronic System ◽  
Care Plan ◽  
Junior Doctors ◽  
Correct Identification ◽  
Patient Stay ◽  
Good Improvement ◽  
Ward Rounds

Abstract Aim Clinical governance states that patients should have a named Consultant during their in-patient stay. In our institution, every bed has a whiteboard above it, which mentions the name of the patient and the responsible Consultant. This should correspond with the electronic system, TrakCare. Ouraim was to audit and look into the accuracy of this practice, in order to improve the efficacy of ward-rounds and hence improve patient care and safety. Method Data was collected for general surgery and urology receiving wards over 3 consecutive days and was matched to the data available on the electronic system, TrakCare. Intervention was made in the form of verbal and written communication with the nursing staff and junior doctors. Effect of intervention was assessed 2 weeks later. Results n = 38 bed-boards were assessed. The first cycle of the audit demonstrated that 7 (18.4%) had either incorrect or no entries. The detailed analysis revealed that of these, 2 had no consultant names whereas 5 were incorrect. The second cycle demonstrated a good improvement with only 1(2.6%) bed-boards having incorrect or no names. The third cycle demonstrated sustainable impact with only 1 (2.6%) missing consultant’s name. Conclusions Ward-rounds have been an age-old practice to review patients and are vital to formulate a care plan for patients, particularly in acute settings. It is also important for the patient to know who is providing their care. Wrong or missing entries could compromise patient care and has implications in patient follow up and chasing results. A simple intervention by the nursing and medical staff can improve the quality of care.

scholarly journals TP9.2.27A closed loop audit looking at the use of a checklist in surgical ward rounds to improve ward round documentation. Can we improve patient safety?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Christopher Liao ◽  
Emma Sheaff ◽  
Harry Wilkins
Keyword(s):  
Closed Loop ◽  
Improve Patient Safety ◽  
Clinical Care ◽  
Ward Round ◽  
Clinical Notes ◽  
Legal Documents ◽  
Surgical Ward ◽  
Ward Rounds

Abstract Aims To assess if surgical ward rounds would improve through the use of a peri-operative ward round checklist in the clinical notes. Method We performed a closed loop audit with a different novel ward round checklist in each audit, the second made from improving the first, based on feedback. We looked at checklist utilisation, and the quality of documentation in notes. We compared the quality of documentation in notes with the checklist, to notes without the checklist. The data was then collated and analysed. Standards from the Royal College of Physicians’ “Ward Rounds in Medicine”. Results In the first audit, our sample was 68, in the second, our sample was 64. With the use of a checklist (M = 67%, SD = 22%) ward round documentation was significantly better than without the checklist (M = 26%, SD = 10%), t(64)=8.85, p<.00001. Ward documentation was especially improved regarding fluid balance, analgesia, and assessing physiotherapy needs. The second version of the checklist (M = 56%, SD = 28%) was used significantly more than the first checklist (M = 13%, SD = 22%), t(75)=7.59, p<.00001. Conclusions With the growing role of clinical notes as legal documents, handover tools, and pillars of care planning, and the move to use electronic patient record systems, improving the quality of documentation is imperative. This study shows that a systematic checklist significantly improves ward round documentation, and so can improve clinical care. We will follow-up this study with a third audit, focusing on patient satisfaction and determining reduction in harm caused to patients with a ward round checklist.

scholarly journals Reducing sitter use in acute medicine while maintaining safety and quality

2018 ◽  
Vol 9 (2) ◽  
pp. 61
Author(s):  
Delois Long ◽  
Janice Dennis
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Assessment Tool ◽  
Medical Center ◽  
Intervention Group ◽  
Post Intervention ◽  
Acute Medicine ◽  
Quality Of Patient Care ◽  
Interventional Group

Background and objective: Sitters are commonplace in acute care facilities throughout the country. Sitters are used to provide close observations and ensure safety for patients who are at risk for falls. These patients suffer from cognitive impairment, inability to follow instructions, and causing harm to themselves or others. The literature shows that one requirement for an effective sitter process is the use of an assessment tool. Sitter usage at the Louis Stokes Cleveland VA Medical Center (LSCVAMC) has escalated to the point that sitters are causing an overall shortage of nursing staff.  This shortage causes excessive overtime, staff burnout, and reduces the quality of patient care provided to non-sitter patients. The purpose of this case-control descriptive pilot study was to reduce sitter usage on an inpatient acute medicine unit, by implementing the Patient Attendant Assessment Tool (PAAT), without reducing patient safety and quality of patient care. The PAAT was developed and utilized by a Midwest hospital for data collection and to assess the need for sitters.Methods: Patients were placed into the Pre- and Post-implementation cohorts, according to the order of their admission. Pre-interventional data was collected from the study group, using the Sitter Justification Form, the 24-hour nursing report and the electronic medical record. The intervention consisted of staff education on the use of a new tool, the PAAT. Following implementation of the tool, the data was collected and analyzed using the SPSS 20 for windows (SPSS.INC), over an 8-month period.Results and conclusions: Sitter usage was reduced without reducing patient safety or quality of care, with the implementation of the PAAT. Among individuals having at least one sitter day, patients in the post intervention group, were less likely to have as many sitter shifts (n = 343, 58.0%) as compared to patients in the Pre-interventional group (n = 451, 75.9%) (Chi Square = 42.88; df = 1, p < .001). As can be seen, there was a significant decrease in the number of sitter shifts after the implementation of the PAAT, as compared to the pre-interventional group. There was a slight increase in the quality of patient care.

scholarly journals 642 A Closed Loop Audit Looking at The Use of a Checklist in Surgical Ward Rounds to Improve Documentation. Can We Improve Patient Safety?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Christopher Liao ◽  
Emma Sheaff ◽  
Harry Wilkins
Keyword(s):  
Patient Safety ◽  
Closed Loop ◽  
Improve Patient Safety ◽  
Clinical Care ◽  
Ward Round ◽  
Clinical Notes ◽  
Surgical Ward ◽  
Legal Document ◽  
Ward Rounds

Abstract Introduction Ward rounds are essential in assessing and planning patient care, but they are often subject to variable quality and structure. A ward round checklist could improve documentation and patient safety. Method We performed a closed-loop audit with a different novel ward round checklist in each audit, the second made from improving the first, based on feedback. We looked at checklist utilisation, and the quality of documentation in notes. We compared the quality of documentation in notes with the checklist, to notes without the checklist. The data was then collated and analysed. Standards from the Royal College of Physicians’ “Ward Rounds in Medicine”. Results In the first audit, our sample was 68, in the second, it was 64. With the use of a checklist (M = 67%, SD = 22%) documentation was significantly better than without (M = 26%, SD = 10%), t(64)=8.85, p&lt;.00001. Ward documentation was especially improved regarding fluid balance, analgesia, and assessing physiotherapy needs. The second version of the checklist (M = 56%, SD = 28%) was used significantly more than the first checklist (M = 13%, SD = 22%), t(75)=7.59, p&lt;.00001. Conclusions With the growing role of clinical notes as a legal document, a tool for handover, and a pillar of care planning, improving the quality of the documentation is imperative. This study shows that a systematic checklist significantly improves ward round documentation, which has already established in an improvement in clinical care. We hope to follow-up this study with a third audit, focusing on patient satisfaction and determining reduction in harm caused to patients with a ward round checklist.

EP.TU.560Improving surgical handover by implementing a dynamic handover sheet

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Roxane Stienstra ◽  
Michael Wilson ◽  
James Kynaston
Keyword(s):  
Post Intervention ◽  
Microsoft Excel ◽  
Perceived Safety ◽  
Safety Issues ◽  
Inherent Risk ◽  
Good Patient Care ◽  
Key Issues ◽  
Ward Rounds ◽  
Surgery Department

Abstract Aim Safe and effective handover is paramount to ensuring good patient care and patient safety. The aim of this study was to identify key issues with the current handover sheets and implement a new comprehensive sheet aimed to improve quality of handover and reduce safety issues within a busy DGH general surgery department. Methods A prospective dynamic study was performed. Retrospective data was obtained by sending out questionnaires to all junior and senior staff. The questionnaire aimed to assess key issues with the original handover sheets and collect qualitative data of perceived safety and efficiency. A dynamic handover sheet was developed using Microsoft Excel and Microsoft Visual Basic. After 2 months of using the new handover sheet, repeat questionnaires were sent out to assess its impact. Results There were 26 responses to the pre-intervention and 14 to the post-intervention questionnaire. 14/26 (54%) reported safety issues, mainly patients being missed at weekend ward rounds or missing handovers from elective teams. Post introduction of the comprehensive sheet 6/14 (43%) reported safety issues, mostly related to user error. Subjective list accuracy improved from 59.0% to 65.3% and accuracy for weekend wardrounds improved from 58.4% to 61.3%. Subjective efficiency of the list improved from 52.5% to 71.5%. Conclusion The new, dynamic handover sheet has led to an overall improvement in safety and efficiency of handover. An easy to understand instruction sheet has been designed to further improve usability and to ensure a lasting effect to mitigate against the inherent risk of junior doctor change-over.

scholarly journals Engaging in Collaborative Research: Focus on the Pharmacy Practitioner

2017 ◽  
Vol 52 (1) ◽  
pp. 33-43 ◽  
Author(s):  
Melissa Badowski ◽  
Joseph E. Mazur ◽  
Simon W. Lam ◽  
Marta Miyares ◽  
Lucas Schulz ◽  
...  
Keyword(s):  
Patient Care ◽  
Health Care Professionals ◽  
Collaborative Research ◽  
Medical Center ◽  
Care Quality ◽  
Teaching Methodology ◽  
Organizational Goals ◽  
Patient Care Quality ◽  
Enhance Patient Care

Research offers an opportunity for investigators to explore unanswered questions, highlight best practices, and engage in collaboration. Clinical research can engage health care professionals to identify treatments or procedures to enhance patient care, quality of life, and outcomes. Research may also include experiences in a unique practice site or teaching methodology of trainees, staff, or patients. The goal of research is to improve individual patient care via dissemination of knowledge through publications. This article aims to highlight the importance of pharmacist-led research in the academic or community medical center and the need for resident-based research and mentorship for the integration of collaborative research and achievement of organizational goals.

scholarly journals 342 A Closed Loop Audit on The Quality of Documented Consent in Orthopaedic Procedures

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Bakhiet
Keyword(s):  
Closed Loop ◽  
Consent Form ◽  
Post Intervention ◽  
Prospective Data ◽  
Consent Forms ◽  
Crucial Component ◽  
Local Trauma ◽  
Legal Document ◽  
British Orthopaedic Association

Abstract Aim A thorough discussion of associated risks is essential when obtaining informed consent for any surgery. The consent form serves as a permanent record of the conversation and can have implications as a legal document in court. The aim of this audit was to assess the quality of documentation on consent forms for Orthopaedic procedures. Method Prospective data was collected from consent forms for patients undergoing 6 prespecified procedures and compared to British Orthopaedic Association (BOA) guidelines for consent. We analysed how many of the risks had been documented on the form, and whether the incidence of these risk was emphasised. The data was then collated, analysed and presented at a local trauma meeting. Templates for consent were printed and inserted into consent booklets on the ward to serve as a memory aid. Data was prospectively collected again to complete the audit cycle. Results Prior to the implementation of the consent templates, 8% of consent forms mentioned all possible complications, with 12% emphasising the incidence of the main risks. Post intervention, all significant risks were listed in 29% of forms, with 33% listing the risks in a logical order and emphasising their incidence. Conclusions The process of obtaining consent is a complex but crucial component of surgical practice, with the consent form serving as an important medicolegal document. This study shows that the use of pre-printed consent templates to aid memory can improve documentation and can be adapted and individualised accordingly for each patient.

Sign in / Sign up

Export Citation Format

Share Document