Clinical Scenario #6: Practice-Based Learning and Improvement

2018 ◽  
pp. 301-304
Author(s):  
Ruchir Gupta ◽  
Minh Chau Joe Tran
Keyword(s):  
Quality Improvement ◽  
Action Plan ◽  
Quality Improvement Project ◽  
Clinical Scenario ◽  
Improvement Project ◽  
Maximum Score ◽  
Learning Improvement ◽  
Stepwise Manner ◽  
Task Statement

In this chapter the essential aspects of practice-based learning improvement are discussed. The chapter begins with a mock scenario involving an initiative to design and implement a quality improvement project to improve the number of cases starting on time. The mock scenario is followed by a task statement that describes the specific action that the student must take. In this case, the task is to explain to a colleague the general steps of how to design and implement a quality improvement project. An action plan is then presented in a stepwise manner with mock responses and a discussion of the responses. Grading points are also discussed and how to achieve maximum score is presented.

Clinical Scenario #1: Informed Consent

2018 ◽  
pp. 279-284
Author(s):  
Ruchir Gupta ◽  
Minh Chau Joe Tran
Keyword(s):  
Informed Consent ◽  
Side Effects ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Action Plan ◽  
Left Knee ◽  
Clinical Scenario ◽  
Maximum Score ◽  
Stepwise Manner ◽  
Task Statement

In this chapter the essential aspects of informed consent are discussed. This chapter begins with a mock scenario of a patient who is scheduled for a left knee arthroplasty. The scenario is followed by a task statement that describes the specific action that the student must take. In this case, the task is to obtain informed consent for the nerve block. Included in this process is communicating to the patient the benefits, potential complications, and side effects of the procedure and alternatives to it. An action plan for the mock scenario is then presented in a stepwise manner with mock responses and a discussion of the responses. Grading points are also discussed and how to achieve a maximum score.

Clinical Scenario #5: Communication with Other Health Professionals

2018 ◽  
pp. 297-300
Author(s):  
Ruchir Gupta ◽  
Minh Chau Joe Tran
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Health Professionals ◽  
Action Plan ◽  
Clinical Scenario ◽  
Maximum Score ◽  
Stepwise Manner ◽  
Course Of Action ◽  
Task Statement

In this chapter the essential aspects of communication with other health professionals are discussed. The chapter begins with a mock scenario involving a patient undergoing an elective right inguinal hernia repair. The mock scenario is followed by a task statement that describes the specific action that the student must take. In this case, the task is to present a recommendation to the surgeon to postpone the surgery and determine the best course of action. An action plan is then presented in a stepwise manner with mock responses and a discussion of the responses. Grading points are also discussed and how to achieve maximum score is presented.

Clinical Scenario #3: Periprocedural Complications

2018 ◽  
pp. 289-292
Author(s):  
Ruchir Gupta ◽  
Minh Chau Joe Tran
Keyword(s):  
Patient Safety ◽  
Medication Error ◽  
Action Plan ◽  
Treatment Options ◽  
Clinical Scenario ◽  
Maximum Score ◽  
Stepwise Manner ◽  
Task Statement

In this chapter the essential aspects of treatment options regarding a clinical scenario are discussed. The chapter begins with a mock scenario concerning a patient with periprocedural complications. The mock scenario is followed by a task statement that describes the specific action that the student must take. In this case, the task is to discuss a medication error with the patient. Included in this process is demonstrating to the patient the physician’s understanding of and concern for the situation of the patient, as well as a commitment to patient safety. An action plan is then presented in a stepwise manner with mock responses and a discussion of the responses. Grading points are also discussed and how to achieve maximum score is presented.

Clinical Scenario #2: Treatment Options

2018 ◽  
pp. 285-288
Author(s):  
Ruchir Gupta ◽  
Minh Chau Joe Tran
Keyword(s):  
Action Plan ◽  
Treatment Options ◽  
Clinical Scenario ◽  
Maximum Score ◽  
Stepwise Manner ◽  
Task Statement

In this chapter the essential aspects of treatment options regarding a clinical scenario are discussed. The chapter begins with a mock scenario of a patient with lacerated multiple tendons in her hand. The mock scenario is followed by a task statement that describes the specific action that the student must take. In this case, the task is to discuss with the patient the anesthetic options given the patient’s specific concerns and agree upon an anesthetic plan. Included in this process is communicating to the patient the benefits and risks associated with each option, as well as concern for her safety. An action plan is then presented in a stepwise manner with mock responses and a discussion of the responses. Grading points are also discussed and how to achieve maximum score is presented.

Clinical Scenario #4: Ethical Issues

2018 ◽  
pp. 293-296
Author(s):  
Ruchir Gupta ◽  
Minh Chau Joe Tran
Keyword(s):  
Ethical Issues ◽  
Action Plan ◽  
Perioperative Period ◽  
Exploratory Laparotomy ◽  
Clinical Scenario ◽  
Ethical Practice ◽  
Do Not Resuscitate ◽  
Maximum Score ◽  
Stepwise Manner ◽  
Task Statement

In this chapter the essential aspects of ethical issues in relation to periprocedural complications are discussed. The chapter begins with a mock scenario of a patient with multiple serious comorbidities requiring an urgent exploratory laparotomy. The mock scenario is followed by a task statement that describes the specific action that the student must take. The task here is to discuss how to manage the patient’s Do-Not-Resuscitate (DNR) status in the perioperative period. An action plan is then presented in a stepwise manner with mock responses and a discussion of the responses. The plan here involves demonstrating behaviors consistent with application of the principles in the ASA Guideline for the Ethical Practice of Anesthesiology—the principles of (1) patient autonomy, (2) beneficence, and (3) nonmaleficence. Grading points are also discussed and how to achieve maximum score is presented.

P34 Quality improvement project aimed at reducing gentamicin errors in neonates

2018 ◽  
Vol 103 (2) ◽  
pp. e1.38-e1 ◽  
Author(s):  
Calvert Heather ◽  
Makhalira Aubrey
Keyword(s):  
Quality Improvement ◽  
Transitional Care ◽  
Action Plan ◽  
Quality Improvement Project ◽  
Time Interval ◽  
List Type ◽  
Open Communication ◽  
Monthly Basis ◽  
Improvement Project ◽  
High Dependency

AimA level 3 tertiary neonatal unit with a capacity of 40 cots providing intensive care, high dependency care, special care & transitional care services, had 18 gentamicin errors reported between January and June 2017, with 84% errors occurring at prescribing and 16% errors in administration. The majority of errors (67%) were due to the complexity of calculating a 36-hourly time interval between doses. A quality improvement project was undertaken with the aim of reducing the number of gentamicin errors on the unit over a 3 month period.MethodAn overview of all gentamicin errors were presented to the multidisciplinary team (MDT) with a view of gathering ideas for improvement to ensure a team based approach. An action plan was put in place in line with National Patient Safety Agency (NPSA) recommendations1 and initiated in July 2017 based on a plan-do-study-act (PDSA) model.ResultsThe PDSA cycles included:a simplified and standardised dosing interval for dosing of gentamicin after the first dose.an updated local monograph with dosing intervals and example prescription.posters displayed in prescribing areas to promote safe and focused prescribing.a feedback session to the full MDT team regarding improvements made and further feedback.ensure compliance with policy by promoting updated guideline & on going error monitoring.consideration of alternative lower risk antibiotic in low risk babies.incorporation of gentamicin prescribing exercise as part of the new doctor induction. The following interventions will be evaluated in 3 months using Datix reported errors before and after implementation. Sequential PDSA cycles will then be conducted for learning and improvement.ConclusionA team based approach, using open communication with regular feedback and review is essential in order to improve the quality of prescribing and gain engagement from medical and non-medical prescribing colleagues. Further audit will be undertaken on monthly basis to evaluate the implementation of improvement measures.

Effects of Simulation Video on Parental Recall of Seizure First Aid: A Quality Improvement Project

2020 ◽  
Vol 35 (13) ◽  
pp. 908-911
Author(s):  
Xinran Maria Xiang ◽  
Daniella Miller
Keyword(s):  
Quality Improvement ◽  
Action Plan ◽  
First Aid ◽  
Emergency Department Visits ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Face To Face ◽  
Counseling Group ◽  
Video Group ◽  
Parental Recall

Many parents of children do not recall anticipatory guidance on acute seizure management, which can lead to unnecessary emergency department visits. This quality improvement project evaluated if adding a video simulation of seizure first aid improved parental recall. Parents of children with seizures were randomized to standard verbal counseling or video group, which were shown a video simulation of seizure first aid. All families also received a standardized written action plan. Eighty-three patients were randomized from July to October 2018. Overall, 53% of families who received standard counseling accurately recalled seizure first aid compared with 31% in video group (χ2 = 3.24, P = .07). Among families without baseline knowledge of seizure first aid, 43% in the standard counseling group recalled accurately compared with 16% of video group (χ2 = 4.52, P = .03). These results underscore the importance of face-to-face patient education despite the popularity of video-based media. Future Plan-Do-Study-Act cycles will include piloting a hands-on seizure first aid simulation with mannequins.

scholarly journals Improving the patient involvement in research and development on acute psychiatric wards – an audit and quality improvement project

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S110-S110
Author(s):  
Ioana Varvari ◽  
Hany El – Sayeh ◽  
Shona McIlrae ◽  
Susan Bonner
Keyword(s):  
Quality Improvement ◽  
Research And Development ◽  
Action Plan ◽  
Opportunity To Learn ◽  
National Standards ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Development Policies ◽  
Inpatient Settings ◽  
Trainee Satisfaction

AimsThe local audit aimed at measuring awareness of research and development policies and implementation of local and national standards. Our findings generated a quality improvement project with two main objectives: first, improving patient approach and recruitment in research and second, improving trainee satisfaction within our trust.MethodA cohort of new inpatient admissions was identified over a period of 4 weeks, between October 2019 and November 2019, on the two psychiatric wards at the Briary Wing, Harrogate District Hospital. Based on local and national standards, we designed and developed a qualitative (questionnaire) and quantitative (audit tool) approach that was aimed at both staff and patients. Our steps included: assessing awareness and implementation of standards, a retrospective collection of data on the wards, and analysis of the data in Microsoft Excel.ResultOnly one ward implemented the local guidance from which we identified a sample of 14 consecutive new admissions that were currently present on the ward and were able to answer our questions. 13 of those patients were noted as ‘approached’ on our visual board from which only 3 patients remembered reading a leaflet about research options in the admission pack, however, they have not been verbally informed. There was no process in place to assure the re-approaching of initially unwell patients or to follow up on discharge for those interested. Documentation was available in only 9 of the cases and was nonspecific: ‘admission pack done’.ConclusionThe awareness and understanding of Research and Development policies are poor and they are difficult to apply in practice in a busy inpatient environment without a clear process in place. This results in patients missing the opportunity to learn and understand more about research or to participate in ongoing studies. Quality improvement work needs to be done to improve patient recruitment in research in inpatient settings. Simple flow charts and stepwise processes as exemplified by our action plan have the potential to improve service quality, as well as patient and trainee satisfaction.

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