scholarly journals 1250 Introduction of a New Electronic System in Surgery during the COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Jacob ◽  
O Chaudhary ◽  
N Darwish ◽  
H Pardoe
Keyword(s):  
Quality Improvement ◽  
Current System ◽  
Electronic System ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Social Distancing ◽  
Surgical Department ◽  
Information Governance ◽  
Ward Rounds ◽  
The Impact

Abstract Aim The ongoing COVID-19 pandemic has impacted all aspects of clinical practice. Preventative measures to avoid spread of the virus has included maintaining social distancing, thus making surgical handovers and ward care particularly challenging. The surgical department at PAH were able to reflect on what improvements could be made to the current system during this time, with a particular focus on efficiency and information governance, while also maintaining social distancing. Due to the advancement in information technology, electronic systems have become widely used throughout the NHS and a quality improvement project was introduced to try and improve our department using an electronic handover Method A quality improvement project was carried out, with questionnaires sent out pre- and post-implementation to evaluate the impact of the new electronic handover. Results Implementation of the electronic handover improved the safety and efficiency of the surgical department, particularly with information governance (p < 0.001), efficiency of ward rounds (p = 0.002) and social distancing. Less doctors were taking lists home (p < 0.001) and fewer doctors needed to return to the MDT room during ward rounds to check key clinical information (p < 0.001). Close to 50% of doctors said that the implementation of an electronic system reduced the need to be in crowded MDT rooms to check patient information. Conclusions There were clear benefits to using an electronic healthcare system both for satisfaction of workers and for patient care. The project used pre-existing IT software that was modified through collaboration with the IT department and is something that will continue to be improved in the future.

SP2.1.5Does the introduction of ward round stickers improve surgical ward rounds?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Vivek Sharma ◽  
Emma Fitz-patrick ◽  
Dhiraj Sharma
Keyword(s):  
Quality Improvement ◽  
Good Practice ◽  
Ward Round ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Vte Prophylaxis ◽  
Baseline Performance ◽  
Surgical Ward ◽  
Ward Rounds ◽  
Surgical Teams

Abstract Aims With surgical teams in the NHS pushed to their limit under unprecedented demands, simple and effective ways for maintaining standards of patient care are necessitated. This quality improvement project aims to implement user-friendly and coherent ward round stickers as an adjunct to surgical ward rounds to deliver standardised care. Methods Baseline performance was measured against The Royal College of Surgeons of Edinburgh Surgical Ward Round Toolkit. Five recorded items were studied including: bloods, venous thromboembolism (VTE) prophylaxis, regular medications, observations, and handover to nursing staff. The surgical team was informed of the audit but not over which dates it would be conducted. In the first cycle, data was collected over a 4 week period. Ward round stickers were then implemented and a second cycle was completed 2 months later over another 4 week period. Results Baseline performance recorded from 74 ward round entries showed checking of bloods, VTE, regular medications, observations and handover ranged from 0% to 65%. After the introduction of ward round stickers, a second cycle was performed from 81 ward round entities. There was significant improvement from baseline with compliance in recording all five items > 85%. Conclusion This quality improvement project showed that the use of stickers as an adjunct to surgical ward round is a simple and effective way of evidencing good practice against recommended standards.

scholarly journals 0707 “What We’Ve Got Here Is Failure To Communicate”: Apnea Patients And Their DME Suppliers

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A269-A269
Author(s):  
S Thapa ◽  
S Agrawal ◽  
M Kryger
Keyword(s):  
Quality Improvement ◽  
Sleep Apnea ◽  
Quality Improvement Project ◽  
Timely Manner ◽  
Improvement Project ◽  
Therapy Initiation ◽  
Obstructive Sleep ◽  
Key Factor ◽  
The Impact ◽  
The Relationship

Abstract Introduction Successful treatment of obstructive sleep apnea requires adherence to positive airway pressure (PAP) therapy. A key factor is the relationship between the DME provider and the patient so that treatment can be initiated and continued in a timely manner. Our quality improvement project aims to empower and enable patients towards active participation in their sleep apnea care. Our goal is to ultimately increase patients’ knowledge of their Durable Medical Equipment (DME) supplies company, and thus improve their treatment. The first step was to determine patients’ familiarity with their DME. Methods Forty-one patients with sleep apnea on PAP therapy volunteered to be questioned about their DME company during clinic visits at the Yale North Haven Sleep Center, Connecticut, starting November 2019. Patients were asked if they knew the name or the contact of their DME; whether they received adequate training on PAP therapy initiation; if they were receiving timely and correct PAP therapy supplies. They were asked to rate their satisfaction with the DME on a scale of 1 to 5; one being very dissatisfied and five being very satisfied. Results Only 12 out of 41 patients (29.3 percent) knew the names of their DME companies. The average satisfaction rating was 3 (neutral); 44% of patients were dissatisfied, or very dissatisfied with the performance of their DME. Detailed comments were mostly related to poor contact and communication with the DME. Conclusion Most apnea patients had difficulty identifying and contacting their DME. As the next step of this quality improvement project we plan to intervene to ensure that the patients have the name and contact information of their DME available and attached to their PAP machine equipment. We plan to repeat this questionnaire after this intervention to study the impact of this quality improvement project. Support None

scholarly journals Meet your surgical team: The impact of a resident-led quality improvement project on patient satisfaction

2018 ◽  
Vol 216 (4) ◽  
pp. 793-799
Author(s):  
Rebecca Craig-Schapiro ◽  
Sandra R. DiBrito ◽  
Heidi N. Overton ◽  
James P. Taylor ◽  
Ryan B. Fransman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Satisfaction ◽  
Quality Improvement Project ◽  
Surgical Team ◽  
Improvement Project ◽  
The Impact

The impact of operative timing on outcomes of appendicitis: a National Surgical Quality Improvement Project analysis

2015 ◽  
Vol 209 (3) ◽  
pp. 498-502 ◽  
Author(s):  
Brett A. Fair ◽  
John C. Kubasiak ◽  
Imke Janssen ◽  
Jonathan A. Myers ◽  
Keith W. Millikan ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Improvement Project ◽  
Surgical Quality ◽  
Improvement Project ◽  
Project Analysis ◽  
The Impact

scholarly journals An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department

2017 ◽  
Vol 32 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Jason M. Moss ◽  
William E. Bryan ◽  
Loren M. Wilkerson ◽  
Heather A. King ◽  
George L. Jackson ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Quality Improvement ◽  
Older Adult ◽  
Quality Improvement Project ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Academic Detailing ◽  
Improvement Project ◽  
The Impact

Objective: To evaluate the impact of an academic detailing intervention delivered as part of a quality improvement project by a physician–pharmacist pair on (1) self-reported confidence in prescribing for older adults and (2) rates of potentially inappropriate medications (PIMs) prescribed to older adults by physician residents in a Veteran Affairs emergency department (ED). Methods: This quality improvement project at a single site utilized a questionnaire that assessed knowledge of Beers Criteria, self-perceived barriers to appropriate prescribing in older adults, and self-rated confidence in ability to prescribe in older adults which was administered to physician residents before and after academic detailing delivered during their emergency medicine rotation. PIM rates in the resident cohort who received the academic detailing were compared to residents who did not receive the intervention. Results: Sixty-three residents received the intervention between February 2013 and December 2014. At baseline, approximately 50% of the residents surveyed reported never hearing about nor using the Beers Criteria. A significantly greater proportion of residents agreed or strongly agreed in their abilities to identify drug–disease interactions and to prescribe the appropriate medication for the older adult after receiving the intervention. The resident cohort who received the educational intervention was less likely to prescribe a PIM when compared to the untrained resident cohort with a rate ratio of 0.73 ( P < .0001). Conclusion: Academic detailing led by a physician–pharmacist pair resulted in improved confidence in physician residents’ ability to prescribe safely in an older adult ED population and was associated with a statistically significant decrease in PIM rates.

485 Optimisation of The Evening Surgical Handover Process in A Large Tertiary Surgical Department - A Quality Improvement Project

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
P Brennan ◽  
D Holroyd
Keyword(s):  
Quality Improvement ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Team Members ◽  
Surgical Department ◽  
Significant Variability ◽  
Standard Operating ◽  
Handover Process ◽  
Audit Standards ◽  
Standard Operating Protocol

Abstract Introduction The aim of the project was to improve the quality and effectiveness of the evening surgical handover in a large tertiary surgical department, incorporating up to 150 patients. Method Audit standards were derived from GMC and RCSEng guidelines. An initial audit of the evening handover was conducted over a period of two weeks. Following this, a standard operating protocol (SOP) was introduced, with re-audit 4-weeks following implementation. Results The initial audit identified an inconsistent format and significant variability. Few handovers commenced with all team members present (11%) and were uninterrupted (33%). A laminated handover SOP checklist was produced and a new proforma was introduced to document tasks or reviews required overnight. A mandatory evening surgical HDU round was invoked and a “watchers” system was introduced to identify patients at highest risk of deterioration. Re-audit demonstrated significant improvements in all domains to &gt; 85%. ICU referrals overnight decreased from 6% to 2%. Further improvements measures were implemented in the form of a dynamic virtual handover document. Conclusions A structured SOP improved the consistency of the handover process. A night review of all HDU patients reduced the rate of ICU referrals. Implementation of virtual handover processes may be required in the COVID-era.

scholarly journals Emergency Department Nurses Ability to Identify ST-Elevation Myocardial Infarction in Electrocardiogram: A Quality Improvement Project

2020 ◽  
Author(s):  
Bruce Gillard
Keyword(s):  
Quality Improvement ◽  
Educational Program ◽  
Quality Improvement Project ◽  
Test Design ◽  
Improvement Project ◽  
Emergency Department Nurses ◽  
Post Test ◽  
Baseline Knowledge ◽  
St Elevation ◽  
The Impact

A quality improvement project was developed using a pre-test, education intervention, post-test design to assess nurse’s ability identify STEMI ECGs from non-STEMI ECGs and to assess the impact of a brief educational program on nurses’ performance. The pre-tests were available to nursing staff over a two-week period to obtain the nurses’ baseline knowledge. Following the pre-test period nurses were provided the educational sessions followed immediately by distribution of the post-test. The pre-tests were then compared to the post-tests to assess whether or not the education improved nurses’ performance in STEMI recognition.

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