Creating a Quality Management Program

2016 ◽  
Author(s):  
Richard P. Dutton
Keyword(s):  
Quality Improvement ◽  
Continuous Improvement ◽  
Healthcare Providers ◽  
Management Program ◽  
Adverse Outcomes ◽  
Culture Of Safety ◽  
Anesthesia Practice ◽  
Reference Guide ◽  
Or Practice ◽  
High Level

This chapter provides an overview of how to create a quality improvement (QI) program. It is intended as a high-level reference guide for a department, division or practice quality improvement officer. It covers the topics of recruiting allies; finding, aggregating and creating data; basic analytic techniques; mechanisms for feedback of QI data to healthcare providers; implementing cyclical QI activities; managing individual adverse events and complications; and benchmarking to outside data sources. A template quality capture form for an anesthesia practice is included, and examples of reporting graphics and strategies are included. Woven throughout the chapter are specific thoughts on how the QI officer can create a “culture of safety” within the group, such that practitioners feel safe in reporting adverse outcomes and expect to see continuous improvement efforts within their systems.

Advanced Integrity Management Framework for Pipelines

2016 ◽  
Author(s):  
Len LeBlanc ◽  
Walter Kresic ◽  
Sean Keane ◽  
John Munro
Keyword(s):  
Continuous Improvement ◽  
Program Effectiveness ◽  
Level Structure ◽  
Management Program ◽  
Lessons Learned ◽  
Management Framework ◽  
Wide Range ◽  
Safety Case ◽  
Integrity Management ◽  
High Level

This paper describes the integrity management framework utilized within the Enbridge Liquids Pipelines Integrity Management Program. The role of the framework is to provide the high-level structure used by the company to prepare and demonstrate integrity safety decisions relative to mainline pipelines, and facility piping segments where applicable. The scope is directed to corrosion, cracking, and deformation threats and all variants within those broad categories. The basis for the framework centers on the use of a safety case to provide evidence that the risks affecting the system have been effectively mitigated. A ‘safety case’, for the purposes of this methodology is defined as a structured argument demonstrating that the evidence is sufficient to show that the system is safe.[1] The decision model brings together the aspects of data integration and determination of maintenance timing; execution of prevention, monitoring, and mitigation; confirmation that the execution has met reliability targets; application of additional steps if targets are not met; and then the collation of the results into an engineering assessment of the program effectiveness (safety case). Once the program is complete, continuous improvement is built into the next program through the incorporation of research and development solutions, lessons learned, and improvements to processes. On the basis of a wide range of experiences, investigations and research, it was concluded that there are combinations of monitoring and mitigation methods required in an integrity program to effectively manage integrity threats. A safety case approach ultimately provides the structure for measuring the effectiveness of integrity monitoring and mitigation efforts, and the methodology to assess whether a pipeline is sufficiently safe with targets for continuous improvement. Hence, the need for the safety case is to provide transparent, quantitative integrity program performance results which are continually improved upon through ongoing revalidations and improvement to the methods utilized. This enables risk reduction, better stakeholder awareness, focused innovation, opportunities for industry information sharing along with other benefits.

Critical incident stress management for care providers in the pediatric emergency department

1992 ◽  
Vol 12 (1) ◽  
pp. 78-79 ◽  
Author(s):  
KJ Back
Keyword(s):  
Emergency Department ◽  
Critical Incident ◽  
Healthcare Providers ◽  
Pediatric Emergency ◽  
Management Program ◽  
Pediatric Emergency Department ◽  
Care Providers ◽  
Critical Incident Stress Management ◽  
Critical Incident Stress ◽  
High Level

Critical Incident Stress (CIS) is any event that evokes a critically high level of stress and makes usual coping skills ineffective. Programs to manage this stress have been developed. Due to the unique stressors encountered in the pediatric emergency department, this article proposes a CIS management program for these healthcare providers.

Lower perception of pharmacological treatment increases risk of non-adherence to medication

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
CB Graversen ◽  
JB Valentin ◽  
ML Larsen ◽  
S Riahi ◽  
T Holmberg ◽  
...  
Keyword(s):  
Pharmacological Treatment ◽  
Poisson Regression ◽  
Drug Class ◽  
Angiotensin Receptor Blockers ◽  
Adverse Outcomes ◽  
Adherence To Medication ◽  
Increased Risk ◽  
Patient Reported ◽  
High Level

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation Background A large proportion of patients fail to reach optimal adherence to medication following incident ischemic heart disease (IHD) despite amble evidence of the beneficial effect of medication. Non-adherence to medication increases risk of disease-related adverse outcomes but none has explored how perception about pharmacological treatment detail on non-adherence using register-based follow-up data. Purpose To investigate the association between patients’ perception of pharmacological treatment and risk of non-initiation and non-adherence to medication in a population with incident IHD. Methods This cohort study followed 871 patients until 365 days after incident IHD. The study combined patient-reported survey data on perception about pharmacological treatment (categorised by ‘To a high level’, ‘To some level’, and ‘To a lesser level’) with register-based data on reimbursed prescription of cardiovascular medication (antithrombotics, statins, ACE-inhibitors/angiotensin receptor blockers, and β-blockers). Non-initiation was defined as no pick-up of medication in the first 180 days following incident IHD and analysed by Poisson regression. Two different measures evaluated non-adherence in patients initiating treatment: 1) proportion of days covered (PDC) analysed by Poisson regression, and 2) risk of discontinuation analysed by Cox proportional hazard regression. All analyses were adjusted for confounding variables (age, sex, ethnicity, income, educational level, civil status, occupation, charlson comorbidity index, supportive relatives, and individual consultation in medication) identified by directed acyclic graph and obtained from national registers and the survey. Item non-response was handled by multiple imputation and item consistency was evaluated by McDonalds omega. Results Lower perceptions about pharmacological treatment was associated with increased risk of non-initiation and non-adherence to medication irrespectively of drug class and adherence measure in the multiple adjusted analyses (please see figure illustrating results on antithrombotics). A dose-response relationship was observed both at 180- and 365-days of follow-up, but the steepest decline in adherence differed when comparing the two adherence measures (results not shown). Moderate internal consistency was found for the summed measure of perception (McDonalds omega = 0.67). Conclusion Lower perception of pharmacological treatment was associated with subsequent non-initiation and non-adherence to medication, irrespectively of measurement method and drug class. Abstract Figure. Figre: Multiple adjusted analyses

scholarly journals 407 - The Baycrest Quick-Response Caregiver Tool: The Role for a New Tool for Caregivers of Persons with Dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 123-123
Author(s):  
Ken Schwartz ◽  
Robert Madan ◽  
Anna Berall ◽  
Marsha Natadira ◽  
Anna Santiago
Keyword(s):  
Family Caregivers ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Well Being ◽  
Moderate Degree ◽  
Quick Response ◽  
Care Providers ◽  
High Level ◽  
Person With Dementia ◽  
The Impact

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.

scholarly journals Early essential newborn care is associated with improved newborn outcomes following caesarean section births in a tertiary hospital in Da Nang, Vietnam: a pre/post-intervention study

2021 ◽  
Vol 10 (3) ◽  
pp. e001089
Author(s):  
Hoang Thi Tran ◽  
John Charles Scott Murray ◽  
Howard Lawrence Sobel ◽  
Priya Mannava ◽  
Le Thi Huynh ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Relative Risk ◽  
Caesarean Section ◽  
Environmental Changes ◽  
Newborn Care ◽  
Adverse Outcomes ◽  
National Guidelines ◽  
Post Intervention ◽  
Essential Newborn Care ◽  
Newborn Outcomes

BackgroundTo improve maternal and neonatal outcomes, Vietnam implemented early essential newborn care (EENC) using clinical coaching and quality improvement self-assessments in hospitals to introduce policy, practice and environmental changes. Da Nang Hospital for Women and Children began EENC with caesarean section births to inform development of national guidelines. This study compared newborn outcomes after caesarean sections pre/post-EENC introduction.MethodsMaternity records of all live in-born hospital caesarean births and separate case records of the subpopulation admitted to the neonatal intensive care unit (NICU) were reviewed pre-EENC (November 2013–October 2014) and post-EENC (November 2014–October 2015) implementation. NICU admissions and adverse outcomes on NICU admission were compared using descriptive statistics.FindingsA total of 16 927 newborns were delivered by caesarean section: 7928 (46.8%) pre-EENC and 8999 post-EENC (53.2%). Total NICU admissions decreased from 16.7% to 11.8% (relative risk 0.71; 95% CI 0.66 to 0.76) after introduction of EENC. Compared with the pre-EENC period, babies with hypothermia on admission to the NICU declined from 5.0% to 3.7% (relative risk 0.73; 95% CI 0.63 to 0.84) and cases of sepsis from 3.2% to 0.8% (relative risk 0.26; 95% CI 0.20 to 0.33) post-EENC implementation. While more than half of all newborns in the NICU were fed something other than breastmilk pre-EENC introduction, 85.8% were exclusively breast fed post-EENC (relative risk 1.86; 95% CI 1.75 to 1.98). Preterm newborns <2000 g receiving kangaroo mother care (KMC) increased from 50% to 67% (relative risk 1.33; 95% CI 1.12 to 1.59).ConclusionThe EENC quality improvement approach with caesarean section births was associated with reduced NICU admissions, admissions with hypothermia and sepsis, and increased rates of exclusive breast feeding and KMC in the NICU.

scholarly journals Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

2021 ◽  
Vol 18 (9) ◽  
pp. 5018
Author(s):  
Ik-Whan G. Kwon ◽  
Sung-Ho Kim ◽  
David Martin
Keyword(s):  
Precision Medicine ◽  
Social Determinants Of Health ◽  
Population Health ◽  
Social Determinants ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Determinants Of Health ◽  
Collaborative Tools ◽  
High Level

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed.

Quality Improvement Initiatives in Sonography Education: A Review of the Literature

2021 ◽  
pp. 875647932110186
Author(s):  
Kimberly Sorrentino
Keyword(s):  
Quality Improvement ◽  
Literature Review ◽  
Educational Research ◽  
Continuous Improvement ◽  
Current Literature ◽  
English Language ◽  
Allied Health ◽  
Health Science ◽  
Review Of The Literature ◽  
Educational Literature

Objective: Continuous improvement is vital to ensuring quality in sonography education. The aim of this literature review was to compile and summarize the current literature on accreditation, credentialing, and quality improvement initiatives in sonography education. Materials & Methods: Four sonography-specific journals and six health science/academic databases were searched using the terms education, sonography, ultrasound, accreditation, credential, and quality. The search was limited to findings in the English language, from 2000 to 2020. Results: The search uncovered only 19 articles on this topic in sonography education. The vast majority of papers focused on quality improvement initiatives, while just a few concentrated on accreditation or credentialing. Conclusion: Much of the contemporary sonography educational literature focuses on clinical, lab, or didactic quality improvement initiatives. Overall, it is clear that more research is needed in the field of sonography education. This review provides examples of quality initiative research in other allied health fields that can be useful guides for future sonography educational research.

To err is system; a comparison of methodologies for the investigation of adverse outcomes in healthcare

2021 ◽  
pp. 251604352199026
Author(s):  
Peter Isherwood ◽  
Patrick Waterson
Keyword(s):  
Patient Safety ◽  
System Performance ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Real Life ◽  
Adverse Outcomes ◽  
System Level ◽  
Future Performance ◽  
System A ◽  
Regulatory Bodies

Patient safety, staff moral and system performance are at the heart of healthcare delivery. Investigation of adverse outcomes is one strategy that enables organisations to learn and improve. Healthcare is now understood as a complex, possibly the most complex, socio-technological system. Despite this the use of a 20th century linear investigation model is still recommended for the investigation of adverse outcomes. In this review the authors use data gathered from the investigation of a real life healthcare near incident and apply three different methodologies to the analysis of this data. They compare both the methodologies themselves and the outputs generated. This illustrates how different methodologies generate different system level recommendations. The authors conclude that system based models generate the strongest barriers to improve future performance. Healthcare providers and their regulatory bodies need to embrace system based methodologies if they are to effectively learn from, and reduce future, adverse outcomes.

scholarly journals Military spouses with deployed partners are at greater risk of poor perinatal mental health: a scoping review

2019 ◽  
Vol 165 (5) ◽  
pp. 363-370 ◽  
Author(s):  
Lauren Rose Godier-McBard ◽  
L Ibbitson ◽  
C Hooks ◽  
M Fossey
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Scoping Review ◽  
Healthcare Providers ◽  
Well Being ◽  
Perinatal Period ◽  
Poor Mental Health ◽  
Adverse Outcomes ◽  
Military Spouses ◽  
Perinatal Mental Health

BackgroundPoor mental health in the perinatal period is associated with a number of adverse outcomes for the individual and the wider family. The unique circumstances in which military spouses/partners live may leave them particularly vulnerable to developing perinatal mental health (PMH) problems.MethodsA scoping review was carried out to review the literature pertaining to PMH in military spouses/partners using the methodology outlined by Arksey and O’Malley (2005). Databases searched included EBSCO, Gale Cengage Academic OneFile, ProQuest and SAGE.ResultsThirteen papers fulfilled the inclusion criteria, all from the USA, which looked a PMH or well-being in military spouses. There was a strong focus on spousal deployment as a risk factor for depressive symptoms and psychological stress during the perinatal period. Other risk factors included a lack of social/emotional support and increased family-related stressors. Interventions for pregnant military spouses included those that help them develop internal coping strategies and external social support.ConclusionsUS literature suggests that military spouses are particularly at risk of PMH problems during deployment of their serving partner and highlights the protective nature of social support during this time. Further consideration needs to be made to apply the findings to UK military spouses/partners due to differences in the structure and nature of the UK and US military and healthcare models. Further UK research is needed, which would provide military and healthcare providers with an understanding of the needs of this population allowing effective planning and strategies to be commissioned and implemented.

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