Pharmacist Calls to Older Adults with Cognitive Difficulties After Discharge in a Tertiary Veterans Administration Medical Center: A Quality Improvement Program

Abstract Context.—Autopsy rates continue to decline in the United States. Objective.—Although many of the causes of this decline are external to pathology departments, we hypothesized that intradepartmental efforts to improve the quality of the service we provide to our clinical colleagues could increase our autopsy rate. Method.—We developed a multifaceted quality improvement program for our autopsy service aimed at increasing the visibility of the service, improving the service's reporting, and increasing the amount and quality of data available from the service. Setting.—A large academic medical center that performs approximately 250 autopsies each year. Results.—After implementation of our quality improvement program, the decline in our autopsy rate has not only stopped, but rates have even begun to increase. Additionally, physician satisfaction surveys conducted before and after implementation of our quality improvement initiatives showed an across-the-board improvement in clinician perception of the service. Conclusion.—Pathologists can and should be proactive in addressing the declining autopsy rate, rather than viewing it as someone else's problem or hoping that someone else will protect this important quality assurance tool for medical care.

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Multidisciplinary Patient Management Improves Mortality in Geriatric Trauma Patients

The American Surgeon ◽

10.1177/000313481908500235 ◽

2019 ◽

Vol 85 (2) ◽

pp. 230-233 ◽

Cited By ~ 3

Author(s):

Joseph Losh ◽

Thomas K. Duncan ◽

Graal Diaz ◽

Hyesun Lee ◽

Javier Romero

Keyword(s):

Quality Improvement ◽

Medical Center ◽

Injured Patient ◽

Primary Objective ◽

Quality Improvement Program ◽

Geriatric Trauma ◽

Collaborative Management ◽

Trauma Patients ◽

Improvement Program ◽

Trauma Medicine

Improvement in the care of the traumatically injured patient should be a goal at all trauma centers. One purpose of the data generated by the Trauma Quality Improvement Program is to provide insight which will lead to quality improvement initiatives and to promote intrinsic improvement on a center by center basis. The primary objective of this study was to measure the efficacy of instituting a multidisciplinary Trauma Medicine (T-MED) program to improve geriatric mortality at Ventura County Medical Center (VCMC). Trauma Quality Improvement Program data at VCMC before October 2013 demonstrated poor performance in treating geriatric patients. To attempt to improve outcomes, a multidisciplinary T-MED program was instituted in October 2013, which included a mandatory consultation and collaborative management with hospitalist medicine physicians for all trauma patients 65 years of age or older. The T-MED program increased focus on preexisting conditions, medication management, and discharge planning, including rehabilitation and continuity of care. Institution of a T-MED program at VCMC resulted in significant improvement in mortality rates for geriatric trauma patients.

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