scholarly journals 1394 Hydroxycarbamide therapy amongst children with homozygous sickle cell disease in large district general hospital – a quality improvement project

2021 ◽  
Author(s):  
Omotayo Adesanya ◽  
Claire Stockley ◽  
Obi Anuruegbe ◽  
Bindu Koodiyedath
Keyword(s):  
Quality Improvement ◽  
Sickle Cell Disease ◽  
General Hospital ◽  
Sickle Cell ◽  
District General Hospital ◽  
Quality Improvement Project ◽  
Cell Disease ◽  
Improvement Project ◽  
Homozygous Sickle Cell Disease

scholarly journals 1473 Urology Consent Forms at a District General Hospital – a Quality Improvement Project

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
D Bernstein ◽  
A West ◽  
E Preston ◽  
P Premakumaran ◽  
N Suleyman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
General Hospital ◽  
District General Hospital ◽  
Quality Improvement Project ◽  
Consent Form ◽  
National Guidelines ◽  
Improvement Project ◽  
Consent Forms ◽  
Carbon Copy

Abstract Aim Consent is a core component of interaction between patients and healthcare professionals. Prior to surgery, forms are completed to record patient consent. As well as containing risks and benefits of the procedure, the consent form, as per guidelines1,2, must be legible and suitable to a patient’s capacity. To evaluate compliance with local and national guidelines, a quality improvement project was undertaken at a district general hospital. Method Over a three-week period 30 urology consent forms were selected to assess adherence to local and national guidelines. The appropriateness of consent form, patient signature, legibility, acronym use and whether the patient was offered a carbon copy were assessed. After initial data collection, all urology staff consenting patients were notified of the findings and how best to improve guideline adherence. A further three-week data collection was undertaken, though the sample set was small due to Coronavirus and Christmas. Results The results confirmed that patients had appropriate consent forms filled out and were signed appropriately. After intervention, there was clear improvement in legibility, with no low legibility consent forms, and 100% vs 83% high or moderate legibility between data sets. Intervention also resulted in significant reduction of acronym use; 33% vs 60%. More patients were also offered to retain a carbon copy; 89% vs 40%. Conclusions Through this intervention of highlighting local and national guidance as compared to current practice, compliance drastically improved. As the pandemic subsides, we hope regular emails to surgical teams will improve consent form completion to better patient care.

A Clinic to Improve Care of Patients with Sickle Cell Disease and the Role of Medical Students in Quality Improvement

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5586-5586
Author(s):  
Annie Press ◽  
Robert Lucito ◽  
Ilene Friedman ◽  
Samara Ginzburg
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Medical Students ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Cell Disease ◽  
Improvement Project ◽  
Clinical Microsystems ◽  
One Year

Abstract Background: At Hofstra-North Shore LIJ School of Medicine, we have opportunities for our medical students to participate in experiential quality improvement projects. As part of this initiative, some students participate on health-care improvement teams using a Clinical Microsystems approach. This approach is a conceptual framework that has been applied to various departments in the North Shore-LIJ Health System in order to improve quality and patient safety. The basis of Clinical Microsystems is to identify a need in the hospital that may be targeted in order to improve the efficacy of healthcare quality and delivery. Once the objective for healthcare improvement is determined, a multidisciplinary team is created spanning one or more microsystems to target the specific barrier. One of the multidisciplinary teams focuses on the care of patients with sickle cell disease. LIJ Hospital admits between 150 and 200 patients with sickle cell disease a year primarily due to recurrent pain crises. The initial sickle cell multidisciplinary improvement team included physicians, patients, nurses, social workers and two medical students. The role of the students on this team included literature searches and survey administration. The team's initial analysis found that a lack of consistent outpatient follow up was resulting in frequent readmissions for this population to acute care facilities for pain control. To address this, the team was instrumental in establishing a primary care outpatient clinic focused exclusively on caring for patients with sickle cell disease, run by a primary care physician, in 2012. The current study was conducted by a medical student, and her mentor, who were original members of the sickle cell improvement team. The study tested the hypothesis that enrolling patients with sickle cell disease in an outpatient clinic with a dedicated physician focused on sickle cell disease management and pain control would decrease the number of admissions this population has for acute care at LIJ. The study also highlights the opportunity to involve medical students in a meaningful way in hands-on quality improvement projects in the early stages of training. Methods: This was a retrospective study of all adults with sickle cell disease, 21 years or older, who were seen at the primary care outpatient sickle cell clinic. We compared the rates of hospital admissions and length of stay in the one-year prior and one-year after their establishment of care at the clinic. All data was identified through manual and automated searches of the Electronic Health Record. Results: Since the opening of the clinic in 2012, 107 adults established care at the clinic. Within the first year that a patient began being cared for by the clinic, their admission rate dropped 27%, from an average of 3.775 to 2.75 admissions per year (p=0.0003). There were a total of 151 admissions one-year pre-intervention and 110 admissions one-year post-intervention. Conclusion: This project supports the value of a dedicated primary care outpatient sickle cell clinic on decreasing the admission rates for patients with sickle cell disease. Within one year of establishing care at the clinic, admissions rates decreased significantly, emphasizing the role of dedicated outpatient primary care in the management of patients with sickle cell disease. This study also highlights the importance and feasibility of integrating medical students into a quality improvement project early on during medical school. There are opportunities for students to have meaningful roles on hospital based improvement projects and learn quality improvement methodologies. An important component to this success is faculty mentoring to support a student's involvement in the project. The student involved in this study experientially participated in multidisciplinary team-based rapid cycles of change, process mapping, data collection and analysis. Similar projects could offer students an opportunity to participate during medical school in a longitudinal quality improvement project to develop skills they will need as physicians to identify, participate and measure the effects of improvement efforts. Disclosures No relevant conflicts of interest to declare.

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