scholarly journals Development and evaluation of a national gentamicin and vancomycin quality improvement programme

2020 ◽  
Vol 75 (7) ◽  
pp. 1998-2003 ◽  
Author(s):  
Yvonne Semple ◽  
Marion Bennie ◽  
Jacqueline Sneddon ◽  
Alison Cockburn ◽  
R Andrew Seaton ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Online Survey ◽  
Guideline Implementation ◽  
Mobile App ◽  
Multidisciplinary Teams ◽  
Point Prevalence Study ◽  
National Guidance ◽  
Improvement Programme ◽  
Long Term Impact

Abstract Background Scottish Antimicrobial Prescribing Group (SAPG) recommendations to reduce broad-spectrum antimicrobial use led to an increase in gentamicin and vancomycin prescribing. In 2009, SAPG introduced national guidance to standardize dosage regimens, reduce calculation errors and improve the monitoring of these antibiotics. Studies conducted in 2010 and 2011 identified limitations in guideline implementation. Objectives To develop, implement and assess the long-term impact of quality improvement (QI) resources to support gentamicin and vancomycin prescribing, administration and monitoring. Methods New resources, comprising revised guidelines, online and mobile app dose calculators, educational material and specialized prescribing and monitoring charts were developed in collaboration with antimicrobial specialists and implemented throughout Scotland during 2013–16. An online survey in 2017 evaluated the use of these resources and a before (2011) and after (2018) point prevalence study assessed their impact. Results All 12 boards who responded to the survey (80%) were using the guidance, electronic calculators and gentamicin prescription chart; 8 used a vancomycin chart. The percentage of patients who received the recommended gentamicin dose increased from 44% to 89% (OR 10.99, 95% CI = 6.37–18.95) between 2011 and 2018. For vancomycin, the correct loading dose increased from 50% to 85% (OR = 5.69, CI = 2.76–11.71) and the correct maintenance dose from 55% to 90% (OR = 7.17, CI = 3.01–17.07). Conclusions This study demonstrated improvements in the national prescribing of gentamicin and vancomycin through the development and coordinated implementation of a range of QI resources and engagement with local and national multidisciplinary teams.

Short- and Long-term Impact of an Inpatient Quality Improvement Initiative

2013 ◽  
Vol 33 (4) ◽  
pp. 212-219 ◽  
Author(s):  
Randal J. Thomas ◽  
Kashish Goel ◽  
Marwan Jumean ◽  
Charles Mullany ◽  
Brian Lahr ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Improvement Initiative ◽  
Short And Long Term ◽  
Long Term Impact

scholarly journals Monitoring and Evaluation of Union for International Cancer Control (UICC) Fellowships on Cancer Control

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 62s-62s
Author(s):  
S. Donaldson ◽  
M. Samson
Keyword(s):  
Professional Growth ◽  
Online Survey ◽  
Screening Program ◽  
Cancer Control ◽  
Fellowship Program ◽  
Moderate Amount ◽  
Cancer Society ◽  
Long Term Impact ◽  
Depth Interviews

Background: UICC provides international fellowships to cancer professionals, with over 6000 to date, allowing them to learn new skills they can implement at home. It is crucial to monitor and evaluate the fellowship program so it remains in tune with the cancer community's needs and has a long term impact. Aim: To monitor and evaluate UICC fellowships to ensure they serve to reinforce the cancer care workforce worldwide. Methods: An online survey was performed in December 2017 as part of a larger mixed methods study to evaluate long term impact. 154 UICC fellows who had completed a fellowship between 2013 and 2016 were invited to take part. Participants were asked questions on their fellowship experience and more in depth interviews will be performed to further investigate impact. Results: The survey response rate was 75%, with 117 respondents. The vast majority of fellows work in hospitals, treatment centers and research institutes; 67% are academic cancer professionals and 35% clinicians, with most working in the fields of cancer detection, diagnosis and cancer treatment. Over 57% of respondents rated the training received as “extremely effective”, and 95% were still in contact with their host supervisors one year after their fellowship, with 28% copublishing with them. Over 80% estimated that their skills in cancer control had improved “a lot” or “a great deal” thanks to the fellowship training, with 12% saying “a moderate amount” and 1% “a little” or “none at all”. Initiatives taken by fellows upon returning home include the launching of a new cervical cancer screening program, the founding of a national cancer society and the organization of a conference with the host supervisor as an invited speaker. Challenges included the perceived short duration of one month to achieve all the objectives and the language barrier. 28% of respondents were able to apply the skills they learned on their fellowship “extremely effectively”, 44% “very effectively”, 28% “effectively” and 9% “slightly effectively”, with most giving a presentation to members of the home organization, or organizing a workshop or by personal demonstration. Over 43% were able to establish new collaborations in their country, 45% experienced professional growth and 27% increased their supervision of students “a great deal”. Over 90% of respondents would apply for another fellowship and would recommend it to their colleagues. Further results from in depth interviews with fellows will be presented. Conclusion: The majority of respondents were satisfied with their fellowship experience, and have been able to apply the knowledge gained and disseminated it to colleagues at their institutions. Fellowships have resulted in long term collaborations and have allowed fellows professional growth. Overall, the UICC fellowship program is successful in providing successful knowledge transfer to cancer professionals. Long term impact will be assessed in the next steps of the study.

Enhancing safety and delivery of oral chemotherapy utilizing lean methodology.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 266-266
Author(s):  
Debbie Fernandez ◽  
Kathy Hulen ◽  
Leigh Anne Scott ◽  
Kelsey Bambara ◽  
Gayle Creamer ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
Safety Data ◽  
Oral Chemotherapy ◽  
Multidisciplinary Teams ◽  
Safety Standards ◽  
Chemotherapy Agent ◽  
Safety Interventions ◽  
Long Term Impact ◽  
The Right

266 Background: An oral chemotherapy safety event prompted analysis of related workflows utilizing lean quality improvement methodology. This analysis identified high variation in prescription processing, lack of standardized safety checks, inefficient use of pharmacy time, and inadequate data collection. Our goal was to create an oral chemotherapy protocol that could ensure patients have the right oral chemotherapy agent, at the right dose, at the right time, with independent and efficient safety checks by nursing, pharmacy, and providers. Methods: Multidisciplinary teams participated in two kaizen workshops. utilizing lean methodology. Primary workshop objectives were (1) develop safety standards for oral chemotherapy similar to those for intravenous chemotherapy; (2) make workflows more efficient; and (3) have workflows that enable data collection and process control. The first workshop standardized oral chemotherapy prescription processing though a single workflow in the EMR. This enabled robust data collection and established a platform for safety interventions. The second workshop developed standardized safety checks for and integrated those into the EMR workflow. Given the rarity of serious safety events, a validation measurement was not feasible to track in 30-day PDCA cycles. Consequently, surrogate measures of utilization of the EMR prescribing algorithm and reduction of non-clinical pharmacy interventions were used to assess progress. Safety data were collected and correlated to surrogate outcomes for long-term impact assessment. Results: Interventions resulted in the following outcomes: 100% reduction in oral chemotherapy order defects reaching pharmacy; 97% improvement processing oral chemotherapy though a single EMR workflow; 23% reduction in oral chemotherapy processing time; In spite of a 51% increase in oral chemotherapy volume, no serious safety events have occurred in the last year. Conclusions: Comprehensive quality improvement in our oral chemotherapy process increased safety and efficiency while developing data collection systems for continuous improvement. Multidisciplinary workshops with key stakeholders using established lean methodology were critical to success.

scholarly journals British Thoracic Society survey of rehabilitation to support recovery of the post-COVID-19 population

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040213
Author(s):  
Sally J Singh ◽  
Amy C Barradell ◽  
Neil J Greening ◽  
Charlotte Bolton ◽  
Gisli Jenkins ◽  
...  
Keyword(s):  
Online Survey ◽  
Service Development ◽  
British Thoracic Society ◽  
Free Text ◽  
Discharge Process ◽  
Psychological Disturbances ◽  
Comprehensive Service ◽  
Continued Learning ◽  
Long Term Impact

ObjectiveA proportion of those recovering from COVID-19 are likely to have significant and ongoing symptoms, functional impairment and psychological disturbances. There is an immediate need to develop a safe and efficient discharge process and recovery programme. Established rehabilitation programmes are well placed to deliver a programme for this group but will most likely need to be adapted for the post-COVID-19 population. The purpose of this survey was to rapidly identify the components of a post-COVID-19 rehabilitation assessment and elements of a successful rehabilitation programme that would be required to deliver a comprehensive service for those post-COVID-19 to inform service delivery.DesignA survey comprising a series of closed questions and a free-text comment box allowing for a qualitative analysis.SettingOnline survey.ParticipantsMultiprofessional clinicians across specialties were invited to take part.Results1031 participants responded from a broad range of specialties. There was overwhelming support for an early posthospital discharge recovery programme to advise patients about the management of fatigue (95% agreed/strongly agreed), breathlessness (94%) and mood disturbances (including symptoms of anxiety and depression, 92%). At the time point of 6–8 weeks, an assessment was considered important, focusing on a broad range of possible symptoms and supporting a return to work. Recommendations for the intervention described a holistic programme focusing on symptom management, return of function and return to employment. The free-text comments added depth to the survey and the need ‘not to reinvent the wheel’ but rather adapt well-established rehabilitation services to individually tailor needs-based care with continued learning for service development.ConclusionThe responses indicate a huge interest and the urgent need to establish a programme to support and mitigate the long-term impact of COVID-19 by optimising and individualising existing rehabilitation programmes.

scholarly journals Virtual learning collaboratives to improve urine culturing and antibiotic prescribing in long-term care: controlled before-and-after study

2021 ◽  
pp. bmjqs-2020-012226
Author(s):  
Andrea Chambers ◽  
Cynthia Chen ◽  
Kevin Antoine Brown ◽  
Nick Daneman ◽  
Bradley Langford ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Long Term Care ◽  
Virtual Learning ◽  
Emergency Department Visits ◽  
Care Homes ◽  
Term Care ◽  
Quality Improvement Programme ◽  
Learning Collaboratives ◽  
Improvement Programme

BackgroundUrine culturing practices are highly variable in long-term care and contribute to overprescribing of antibiotics for presumed urinary tract infections. The purpose of this study was to evaluate the use of virtual learning collaboratives to support long-term care homes in implementing a quality improvement programme focused on reducing unnecessary urine culturing and antibiotic overprescribing.MethodsOver a 4-month period (May 2018–August 2018), 45 long-term care homes were self-selected from five regions to participate in virtual learning collaborative sessions, which provided an orientation to a quality improvement programme and guidance for implementation. A process evaluation complemented the use of a controlled before-and-after study with a propensity score matched control group (n=127) and a difference-in-difference analysis. Primary outcomes included rates of urine cultures performed and urinary antibiotic prescriptions. Secondary outcomes included rates of emergency department visits, hospital admission and mortality. An 18-month baseline period was compared with a 16-month postimplementation period with the use of administrative data sources.ResultsRates of urine culturing and urinary antibiotic prescriptions per 1000 resident days decreased significantly more among long-term care homes that participated in learning collaboratives compared with matched controls (differential reductions of 19% and 13%, respectively, p<0.0001). There was no statistically significant changes to rates of emergency department visits, hospital admissions or mortality. These outcomes were observed with moderate adherence to the programme model.ConclusionsRates of urine culturing and urinary antibiotic prescriptions declined among long-term care homes that participated in a virtual learning collaborative to support implementation of a quality improvement programme. The results of this study have refined a model to scale this programme in long-term care.

scholarly journals Important Social and Academic Interactions in Supporting Gifted Youth in Non-Formal Education

2013 ◽  
Vol 1 (3) ◽  
pp. 279-298 ◽  
Author(s):  
Sakari Tolppanen ◽  
Maija Aksela
Keyword(s):  
Content Analysis ◽  
Educational Program ◽  
Online Survey ◽  
Formal Education ◽  
Formal Program ◽  
Youth Camp ◽  
Gifted Youth ◽  
Long Term Impact

This case study investigated how 16–19-year-old international gifted youth felt that a non-formal educational program in math, science and technology, called the Millennium Youth Camp, supported them and what kind of long-term impact did it have on their lives. In the first part of the research, 88 international students answered an open-ended questionnaire about their opinions on the non-formal program. According to content analysis, the two most important aspects of the non-formal educational program were (i) social interaction between each other and the experts and (ii) academic activity and support. The second part of the research was conducted a year after the camp by an online survey, in which the attendees wrote an essay on how the experience had affected their lives. The content analysis of the essays indicated that the experience had a long-term impact on how the students saw themselves and their future. Based on the findings, it is outlined what principles should be implemented into non-formal learning in order to support the gifted.  

Diabetes Inside—Following the Long-Term Impact of a Diabetes Quality Improvement (QI) Initiative in Primary Care

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 7-OR
Author(s):  
UMA GUNASEKARAN ◽  
ROY E. FURMAN ◽  
KELLIE M. RODRIGUEZ ◽  
E. ELIZABETH OBIALO ◽  
SENTAYEHU KASSA ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Long Term Impact

scholarly journals Participants’ perceptions of a residency teaching certificate program: the quality, impact and benefits

2021 ◽  
Vol 19 (3) ◽  
pp. 2423
Author(s):  
Lindsey Peters ◽  
Brittany Long ◽  
Emily Eddy ◽  
Kayli Kuhn ◽  
Chelsea Huppert
Keyword(s):  
Quality Improvement ◽  
Training And Development ◽  
Primary Objective ◽  
Mentor Training ◽  
Improvement Project ◽  
Certificate Programs ◽  
Hands On ◽  
Long Term Impact ◽  
Individual Interpretation

Background: Currently, there are no accreditation requirements for pharmacy resident teaching certificate programs (RTCPs) but rather suggested guidelines and documents for individual programs to follow. RTCP curriculums are often “handed-down” from past personnel and vary based on individual interpretation. Quality improvement may be overlooked when programs do not report to governing bodies. Objective: The primary objective of this quality improvement project was threefold: 1) to identify past RTCP participants’ perceptions regarding program seminars, activities, and requirements; 2) to determine the short-term and long-term impact on participant careers and interaction with learners; and 3) to improve the program to meet participants' needs. Methods: A 25 item Qualtrics survey was sent to 93 past pharmacy residents who completed the RTCP. Delivery of the survey was confirmed to 89 previous residents. Participants provided consent and were given 12 days to complete the survey. Data was collected and coded by the research team independently. Results: The participants hold positions in a variety of roles, with 68.3% of participants currently holding a non-academia position. The top five most beneficial activities during the RTCP were: giving a large room lecture, facilitating small group learning, developing test questions, delivering professional CE, and meeting with their teaching mentor. Most seminar topics were beneficial to residents during the RTCP, with over two-thirds of the topics (n=23) found beneficial by at least 90% of the participants. A total of 92.9% of respondents said that the most beneficial aspect of having an assigned mentor was the teaching advice and feedback provided. Conclusions: The perceptions and beliefs of past RTCP participants were obtained regarding how beneficial the programming, activities, and mentorship offered were during and after RTCP completion. Quality improvement ideas from this work include redistribution of time in seminars compared to hands-on activities, the adoption of tracks or concentrations within the RTCP, and the creation of mentor training and development.

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