scholarly journals Speed Mentoring: An Effective & Efficient Path to Development of Mentor Relationships in a Military Obstetrics & Gynecology Residency

2020 ◽  
Author(s):  
Allison A Eubanks ◽  
Rene M MacKinnon ◽  
Kelly H Shay ◽  
Lily T Criscione ◽  
Rhiana D Saunders
Keyword(s):  
Quality Improvement ◽  
Leadership Roles ◽  
Improvement Project ◽  
Mentorship Program ◽  
Mentor Relationships ◽  
Institutional Review ◽  
Wide Range ◽  
National Capital ◽  
New Research

Abstract Introduction With a deficit of effective military residency mentorships, a paucity of research on successful mentorship programs, and growing reports on innovative mentoring programs, we developed a “Speed Mentoring” event for the National Capital Consortium OBGYN Residency. Materials and Methods The development, implementation, and follow-up responses through participant surveys were designed as an institutional review board (IRB)-approved evidence-based quality improvement project at our institution. Our event coordinated mentorship opportunities between residents and faculty from a wide range of specialties, leadership roles, and research experiences. Residents were matched with faculty that aligned with self-identified goals. Surveys were distributed prior to the event and at follow-up intervals to demonstrate the lasting impact and areas for improvement. Results Prior to our first event, every resident reported by survey that they desired more mentorship opportunities. However, only 55% could identify a specific mentor, citing limited time and difficulty establishing a relationship. Immediately following the event, 90% of residents scheduled a follow-up with at least one mentor. Forty-seven percent of residents reported inspiration to initiate a new research project. Meanwhile, faculty felt valued and gained satisfaction by “giving back” to their profession. After 1 month, half of the residents and faculty had already conducted at least one meeting. At 3 months, 76% of meetings centered on research and 23% on quality improvement projects. Fifty-seven percent of participants reported future scheduled meetings. At 6 months, 75% of residents reported meaningful mentorship relationships. Conclusions After demonstrating a need for improved mentorship opportunities, we implemented an efficient way to foster mentorship while expanding resident involvement in research, QI projects, and fellowship applications. This “Speed Mentorship” program can be easily adapted to all residency programs.

69. A Quality Improvement Project to Increase Larc Follow-Up for Adolescents and Young Adults

2020 ◽  
Vol 66 (2) ◽  
pp. S36
Author(s):  
Sarah Pitts ◽  
Carly Milliren ◽  
Grace Berg ◽  
Danielle McPeak ◽  
Amy DiVasta
Keyword(s):  
Young Adults ◽  
Quality Improvement ◽  
Quality Improvement Project ◽  
Adolescents And Young Adults ◽  
Improvement Project

‘HINTS’ AT THE FRONT DOOR: AN ACUTE STROKE SERVICE QUALITY IMPROVEMENT PROJECT

2019 ◽  
Vol 26 (6) ◽  
pp. 5-5
Author(s):  
Rebecca Rayner ◽  
Chit Hmu
Keyword(s):  
Quality Improvement ◽  
Acute Stroke ◽  
Hospital Setting ◽  
Medical Setting ◽  
Improvement Project ◽  
Stroke Service ◽  
Early Results ◽  
Bedside Test ◽  
Vestibular Pathology

Background/Aims Differential diagnosis of acute vertigo syndrome is challenging. In the acute medical setting, it is difficult to ascertain whether a person has definite peripheral vestibular pathology or a posterior circulation stroke. Mismanagement of these groups within our service is costly, with regards to correct medical input, MRI scan use and bed use within acute stroke services and the hospital setting. Research has demonstrated that the Head Impulse, Nystagmus, and Test of Skew (HINTS) test is efficacious, specific and sensitive in non-UK countries in determining if acute vertigo patients have dangerous (stroke) or benign (peripheral vestibular) pathology. It is not widely used in the UK. This may be due to well-known themes in implementation evidence such as cultural and clinician factors, as well as the lengthy time it takes to embed research into clinical settings. Methods We have started exploring, using Plan Do Study Act cycles, if the HINTS test can be successfully used in a large acute stroke service and the quality improvement effects this may have for patients (correct diagnosis, education/management and follow-up), financially to the Trust (efficient use of MRI scanning) and to the Stroke Pathway (effective bed use/acute medical management). Results Early results in round one of the quality improvement plan show that HINTS is a feasible bedside test to complete with 100% accuracy in the patients it was used on within the acute stroke pathway. This involved one stroke consultant and the patients' diagnosis with HINTS was assessed against routine follow-up MRI as appropriate. HINTS training has now been provided to all the stroke consultant and registrar team, A&E registrars and A&E advanced clinical practitioners, to senior physiotherapists in the acute stroke pathway and to the stroke alert nurses. Data gathering has commenced for round two, focusing further on bed use effects, as well as consideration of staff satisfaction with HINTS, and development of a recommended pathway for acute vertigo syndrome patients.

scholarly journals A Clinical Training Program for Hybrid Closed Loop Therapy in a Pediatric Diabetes Clinic

2019 ◽  
Vol 14 (2) ◽  
pp. 290-296 ◽  
Author(s):  
Cari Berget ◽  
Sarah E. Thomas ◽  
Laurel H. Messer ◽  
Katelin Thivener ◽  
Robert H. Slover ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Clinical Training ◽  
Insulin Pump ◽  
Improvement Project ◽  
Quality Improvement Process ◽  
Pediatric Diabetes ◽  
Clinical Training Program

Background: Hybrid closed loop (HCL) therapy is now available in clinical practice for treatment of type 1 diabetes; however, there is limited research on how to educate patients on this new therapy. The purpose of this quality improvement project was to optimize a HCL education program for pediatric patients with type 1 diabetes (T1D). Methods: Our multidisciplinary team developed a novel HCL clinical training program for current insulin pump users, using a quality improvement process called the Plan-Do-Study-Act model. Seventy-two patients participated in the HCL training program, which included (1) an in-person group class to reinforce conventional insulin pump and CGM use on the new system, (2) a live video conference class to teach HCL use, and (3) three follow-up phone calls in the first 4 weeks after HCL training to assess system use, make insulin adjustments, and provide targeted reeducation. Diabetes educators collected data during follow-up calls, and patients completed a training satisfaction survey. Results: The quality improvement process resulted in a training program that emphasized education on HCL exits, CGM use, and optimizing insulin to carbohydrate ratio settings. Patients successfully sustained time in HCL in the initial weeks of use and rated the trainings and follow-up calls highly. Conclusions: Ongoing educational support is vital in the early weeks of HCL use. This quality improvement project is the first to examine strategies for implementation of HCL therapy into a large pediatric diabetes center, and may inform best practices for implementation of new diabetes technologies into other diabetes clinics.

scholarly journals P065: Development and implementation of a postpartum hypertension recognition and management protocol for use in the emergency department

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S80-S80
Author(s):  
T. Hawkins ◽  
S. K. Dowling ◽  
D. Wang ◽  
A. Mahajan ◽  
A. Mageau ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Quality Improvement ◽  
Clinical Care ◽  
Population Characteristics ◽  
Improvement Project ◽  
Protocol Implementation ◽  
Management Protocol ◽  
Order Set

Introduction: Hypertensive disorders of pregnancy (HDP), including preeclampsia, can develop or worsen in the early postpartum period, often following discharge from hospital, resulting in severe preventable maternal morbidity and mortality. Due to a lack of routine early out-patient follow-up, many women with postpartum HDP present to the emergency department (ED) with severe hypertension or symptoms of preeclampsia (e.g., headache). In the ED, postpartum HDP can be difficult for clinicians to recognize (due to vague presenting symptom) and manage (due to lower blood pressure targets and concern of medication safety). ED clinicians recognized a need for timely recognition and effective treatments for postpartum HDP in the ED to improve maternal outcomes. As such, as part of a multi-step quality improvement initiative, an interdisciplinary team developed and implemented a postpartum HDP management protocol (consisting of nursing and physician protocols and an electronic order set embedded in the electronic medical record). The aims of this specific project were to assess: 1) the use of this clinical management protocol in the ED; and 2) its impacts on clinical care. Methods: This quality improvement project used electronic medical records to identify: 1) ED visits for postpartum HDP for postpartum women ages 20-50; 2) utilization of the postpartum HDP order set; and 3) clinical care outcomes (consultation and admission). Patient population characteristics and clinical care measures were summarized with descriptive statistics and compared using a before and after design. Changes in the utilization of the protocol were assessed using run charts. Results: 540 women with postpartum HDP were seen in the four Calgary EDs in the 16-month period following protocol implementation compared with 335 women in the preceding 12 months. The protocol was used in 46% of these 540 women, and increased over the 16 month follow-up period. We found an increase in the frequency of consultation of specialists (47% to 52%) and admissions (26% to 29%) amongst these women after protocol implementation. Conclusion: This initial assessment demonstrated good uptake of a postpartum HDP management protocol including referral for consultation and admission to hospital for blood pressure management. Future steps include evaluation of the impacts of this management protocol on important patient outcomes.

scholarly journals Histology Slide Quality Improvement Project Utilizing DMAIC principle of Six Sigma Quality Improvement Methodology

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S111-S112
Author(s):  
Y Wang ◽  
A Loboda ◽  
M Chitsaz ◽  
S Ganesan
Keyword(s):  
Quality Improvement ◽  
Six Sigma ◽  
Business Processes ◽  
Endometrial Biopsy ◽  
Improvement Project ◽  
Histology Slide ◽  
Six Sigma Methodology ◽  
And Control

Abstract Introduction/Objective DMAIC (an acronym for Define, Measure, Analyze, Improve and Control) refers to a data- driven improvement cycle used for improving, optimizing, and stabilizing business processes and designs. Our goal was to utilize DMAIC principle of six sigma quality to improve histology slide quality. Methods/Case Report We “defined” the problem as suboptimal quality in endometrial biopsy slides (defects). Utilizing the DMAIC principle and adhering to a strict timeline, the defects found during baseline slide quality review were “measured” by linking the defects to specific histology competencies, which were addressed systematically for process improvement (PI). After PI, a follow up review (“improve” and “control” phases) was carried out to identify measurable outcomes as a testament to quality. Results (if a Case Study enter NA) During the problem “measurement” phase, the defects found in the baseline review of 175 slides were linked to four specific histology competencies (fixation, embedding, cutting, and staining). Processing was excluded as it is completely automated and standardized. Our analysis showed that 83.3 % of defects were linked to embedding (“tissue too dispersed”). As embedding competency depends on the size and nature of the tissue (e.g. mucus and blood admixed with tissue), grossing competency was also addressed along with embedding at the respective workstations. Recommendations were offered to the grosser, embedder, and cutter to reduce variables during the “improvement” phase. Follow up review was done on 196 slides. The number of defective slides decreased and the defects that linked to “tissue too dispersed” had an overall improvement of 91.3%. Once the PI is proven to be effective, in service to histotechnology personnel biannually were also offered during “control” phase. Conclusion We have demonstrated successful methods for improving histology slide quality utilizing DMAIC principle of quality improvement by six sigma methodology DMAIC principle can be creatively adapted in laboratory practice management to enhance quality.

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