scholarly journals Regionalization of EMS Medical Direction for Naval Medical Forces Pacific

2021 ◽  
Author(s):  
Emily Raetz ◽  
Elliot Ross ◽  
Brittany Dickerson ◽  
Benjamin Walrath
Keyword(s):  
Continuous Quality Improvement ◽  
Medical Director ◽  
Military Leadership ◽  
Institutional Review Board ◽  
Care Providers ◽  
Regional Office ◽  
Continuous Quality ◽  
Institutional Review ◽  
Medical Directors ◽  
Insight Into

ABSTRACT Introduction Medical direction has been the cornerstone to safe and effective prehospital and enroute care since the establishment of emergency medical services (EMS). Medical oversight by a physician has been shown to improve clinical outcomes in both settings. When the Navy Regional Office of the EMS Medical Director was established in 2016, it brought additional resources, including the addition of a paramedic and nurse EMS analyst and recruitment of additional local medical directors (LMDs). This, combined with the engagement of military leadership, allowed for expansion and improvement of medical direction in our prehospital and enroute care system and the establishment of a continuous quality improvement (CQI) program. Materials and Methods In 2017, a database was created to collect total run volume, acuity of calls, number of certain time-sensitive conditions, and CQI performance. A retrospective review of this database was conducted. This project was deemed institutional review board exempt. Results LMD reports that submission went from 17% for 2017 to 64% for 2018, 91% for 2019, and 79% for 2020. In 2019, 67% of the sites had verifiable CQI programs and, in 2020, this improved to 80% of sites. The review also revealed insight into levels of acuity seen by prehospital and enroute care providers. Conclusion Our results demonstrate that improvement in medical oversight in a large regional prehospital system can be achieved through persistence and engagement of nonmedical leadership.

scholarly journals Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Jean-Bosco Ndihokubwayo ◽  
Talkmore Maruta ◽  
Nqobile Ndlovu ◽  
Sikhulile Moyo ◽  
Ali Ahmed Yahaya ◽  
...  
Keyword(s):  
Quality Improvement ◽  
World Health Organization ◽  
Continuous Quality Improvement ◽  
World Health ◽  
Regional Office ◽  
Quality Improvement Process ◽  
Continuous Quality ◽  
The World ◽  
Health Organization ◽  
World Health Organization Regional

Background: The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis, management and treatment of diseases. In response, the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program.SLIPTA implementation process: WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1–5 stars were issued.Preliminary results: By March 2015, 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3), French (12) and English (83) languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62–77). Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action), which both had mean scores below 50%.Conclusion: The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process.

Use of Patient Satisfaction Data in a Continuous Quality Improvement Program for Endoscopic Sinus Surgery

2003 ◽  
Vol 129 (3) ◽  
pp. 210-216 ◽  
Author(s):  
Chih-Jaan Tai ◽  
Chia-Chen Chu ◽  
Shu-Cheng Liang ◽  
Ting-Fu Lin ◽  
Zu-Jin Huang ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Satisfaction ◽  
Continuous Quality Improvement ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Care Providers ◽  
Improvement Program ◽  
Continuous Quality ◽  
Septal Surgery

OBJECTIVE: Continuous quality improvement (CQI) is an effort by health care providers to improve the quality of service by continuously exceeding patients' expectations. Patient satisfaction is one of the measures of the quality of care. The aims of this study were to report the patients' evaluation of endoscopic sinus surgery (ESS) and to explore the feasibility in using patient satisfaction data in the CQI program for ESS. METHODS: Eighty-three patients completed a validated patient satisfaction survey (PSS) 1 month after undergoing ESS. Logistic regression models were applied to determine the confounders of patient satisfaction. RESULTS: In general, 72% of patients were very satisfied with the services. Education level and milder disease correlated with higher overall satisfaction levels ( P ≤ 0.01). Anesthesia, the addition of nasal septal surgery, intranasal packing, and postoperative sinuscopy had significant impacts on patient satisfaction ( P < 0.05). CONCLUSION: ESS is a good technique to evaluate for implementing efforts in quality improvement. Confounding factors need to be adjusted before patient satisfaction data can be used in a CQI program.

scholarly journals Patient Perceptions of Barriers to Self-Management of Breast Cancer–Related Lymphedema

2017 ◽  
Vol 40 (12) ◽  
pp. 1800-1817 ◽  
Author(s):  
Pamela L. Ostby ◽  
Jane M. Armer ◽  
Kandis Smith ◽  
Bob R. Stewart
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Breast Cancer Survivors ◽  
Institutional Review Board ◽  
Self Management ◽  
Care Providers ◽  
Perceived Needs ◽  
Institutional Review ◽  
Breast Cancer Related Lymphedema

Breast cancer survivors are at lifetime risk for the development of breast cancer–related lymphedema, a chronic, potentially debilitating condition that requires life-long symptom management. Suboptimal self-management rates suggest that health care providers may not be offering educative-support options that are customized to patient-perceived needs. An Institutional Review Board–approved focus group ( N = 9) and mailed surveys ( N = 15) were used to identify (a) barriers to lymphedema self-management, (b) how breast cancer survivors with lymphedema defined education and support, (c) what type of education and support they had received, and (d) what kind of education and support they wanted. Physiological, psychological, and psychosocial factors were identified as barriers to successful lymphedema self-management. One of the main barriers identified was lack of education about lymphedema treatment and risk reduction. In addition, more than half defined support as “prescriptions” and “referrals”; therefore, it is unclear whether patients were exposed to support other than medical treatment.

scholarly journals Continuous Quality Improvement in Orthopaedic Surgery: Improving Patient Experience, Safety and Outcomes

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Kathleen Gartke ◽  
Darren M. Roffey ◽  
Johanna Dobransky ◽  
Frank Devine ◽  
Sean Denroche ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Patient Experience ◽  
Health Care Providers ◽  
Continuous Quality Improvement ◽  
Orthopaedic Surgery ◽  
Healthcare Services ◽  
Care Providers ◽  
Continuous Quality ◽  
Patient Reported

As the demand for accountability and transparency surrounding the supply of increasingly expensive medical services grows, health- care providers have put continuous quality improvement (CQI) programs in place to optimize care and improve efficiencies. CQI pro- grams that rigorously evaluate healthcare services can lead to informed decisions about the direction of planned improvements through evolving knowledge translation. Successful end products may include better patient satisfaction, improved patient-reported outcomes, highly-efficient care pathways, and overall cost-savings. There are numerous steps involved in implementing CQI programs that require collaboration and cooperation from physicians, allied health care workers, support staff and hospital management in order to achieve desirable goals. The Division of Orthopaedic Surgery at The Ottawa Hospital (TOH) has initiated a CQI program which is designed as a classic Donabedian Construct with a triple aim framework of: 1. improving care, 2. improving patient experience, and 3. lowering cost. The development of our electronic CQI database will be a key component in the 5-year (2015-2020) Strategic Plan for the Division, and is in keeping with the goal of TOH becoming a top 10% performer in quality and safety of patient care in North America. The aim of this paper is to outline our compliance with the ongoing activities required to meet clearly delineated quality metrics, and the development of the many facets of our CQI program. RÉSUMÉ En réponse à la demande croissante de transparence et de responsabilité concernant les services de santé dispendieux, les fournis- seurs de soins de santé ont mis sur pied des programmes d’amélioration continue de la qualité (ACQ) pour optimiser les soins et l’efficience. Les programmes d’ACQ qui évaluent rigoureusement les services de santé permettent des décisions plus éclairées quant aux améliorations à apporter, grâce au transfert de connaissances. Parmi les résultats positifs de ces programmes, on peut compter une plus grande satisfaction et une amélioration des résultats rapportés par les patients, des plans d’intervention particulièrement efficients, et une réduction des coûts. De nombreuses étapes dans la mise en place des programmes d’ACQ nécessitent une collabora- tion entre les médecins, le personnel de soutien, les gestionnaires de l’hôpital et les autres professionnels de la santé afin d’atteindre les objectifs désirés. La Division de chirurgie orthopédique de l’Hôpital d’Ottawa a lancé un programme d’ACQ conçu selon le modèle classique Donabedian, qui poursuit un triple objectif : 1. améliorer les soins, 2. améliorer l’expérience des patients, et 3. minimiser les coûts. La création d’une base de données électronique pour l’ACQ sera une composante clé du plan stratégique de 5 ans (2015-2020) de la Division, et se conforme à l’objectif de l’Hôpital d’Ottawa de devenir l’un des plus performants en Amérique du Nord, sur le plan de la qualité et de la sécurité des soins aux patients. Le but de cet article est de décrire brièvement le développement de nombreuses facettes de notre programme d’ACQ, et notre conformité aux normes de la qualité. 

Pelaksanaan Continuous Quality Improvement(CQI) dalam Kalangan Pensyarah di Kolej Kemahiran Tinggi Mar

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Lyssa Daud ◽  
◽  
Faizal Amin Nur Yunus ◽  
Mohd Bekri Rahim ◽  
Mohd. Zulfadli Rozali ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Continuous Quality

scholarly journals The Impact of NORTH STAR on Suicidality, Substance Problems, Intimate Partner Violence, and Child Abuse

2020 ◽  
Author(s):  
Amy M Smith Slep ◽  
Richard E Heyman ◽  
Michael F Lorber ◽  
David J Linkh
Keyword(s):  
Intimate Partner Violence ◽  
Child Abuse ◽  
Air Force ◽  
Partner Violence ◽  
Absolute Risk ◽  
Intimate Partner ◽  
Institutional Review Board ◽  
Cross Sectional ◽  
Institutional Review ◽  
The Impact

Abstract Introduction We evaluated the effectiveness of New Orientation for Reducing Threats to Health from Secretive-problems That Affect Readiness (NORTH STAR), a community assessment, planning, and action framework to reduce the prevalence of suicidality, substance problems, intimate partner violence, and child abuse. Materials and Methods One-third of U.S. Air Force bases worldwide were randomly assigned to NORTH STAR (n = 12) or an assessment-and-feedback-only condition (n = 12). Two Air Force-wide, cross-sectional, anonymous, web-based surveys were conducted of randomly selected samples assessing risk/protective factors and outcomes. This study was reviewed and approved by the institutional review board at the investigators’ university and by the institutional review board at Fort Detrick. Results NORTH STAR, relative to control, bases experienced a 33% absolute risk reduction in hazardous drinking rates and cumulative risk, although, given the small number of bases, these effects were not statistically significant. Conclusions Given its relatively low cost, use of empirically supported light-touch interventions, and emphasis on sustainability with existing resources, NORTH STAR may be a useful system for prevention of a range of adult behavioral health problems that are difficult to impact.

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