scholarly journals Factors facilitating a national quality registry to aid clinical quality improvement: findings of a national survey

BMJ Open ◽  
2016 ◽  
Vol 6 (11) ◽  
pp. e011562 ◽  
Author(s):  
Ann Catrine Eldh ◽  
Lars Wallin ◽  
Mio Fredriksson ◽  
Sofie Vengberg ◽  
Ulrika Winblad ◽  
...  
Keyword(s):  
Quality Improvement ◽  
National Survey ◽  
Clinical Quality ◽  
Quality Registry ◽  
National Quality ◽  
National Quality Registry ◽  
Clinical Quality Improvement

scholarly journals Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Ann Catrine Eldh ◽  
Mio Fredriksson ◽  
Christina Halford ◽  
Lars Wallin ◽  
Tobias Dahlström ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Stroke Care ◽  
Quality Registry ◽  
National Quality ◽  
Facilitators And Barriers ◽  
National Quality Registry

scholarly journals 1157. GET IT OUT! Nurses and Clinical Quality Improvement Specialists Drive Initiative to Reduce Standardized Utilization Ratios for Indwelling Urinary Catheters in Hospitalized Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S413-S414
Author(s):  
Aldo Martinez ◽  
Deborah Parilla ◽  
Melissa Green ◽  
Anne Murphy ◽  
Sylvia Suarez-Ponce ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Urinary Tract ◽  
Night Shift ◽  
Healthcare Research ◽  
Hospitalized Patients ◽  
Urinary Catheters ◽  
Clinical Quality ◽  
Tract Infections ◽  
Clinical Quality Improvement ◽  
Critical Reviews

Abstract Background Urinary tract infections (UTIs) account for 34% of all healthcare-associated infections (HAI). Urinary catheters (UC) are placed in 15–25% of hospitalized patients and >75% of HAI UTIs are UC-related. Bacteria introduced via UC can colonize the bladder within 3 days. So, the greatest risk factor for acquiring a catheter-associated urinary tract infection (CAUTI) is prolonged use of indwelling UC. Nursing (RN) staff noted inconsistency with appropriate use of UC and commonly UC remained in place well after their original indication had expired. Methods As part of a multi-faceted approach for quality improvement and patient safety, we rolled out an Agency for Healthcare Research and Quality (AHRQ)-based initiative to reduce UC days/Standardized Utilization Ratio (SUR). Daily critical reviews of the indication for UC were conducted by two groups. First, frontline night shift RN staff identified patients who no longer had a valid justification for continued UC. They handed-off the information to day-shift RNs, who recommend removal of UC during daily rounds with the physician teams. A second review was performed by Clinical Quality Improvement Specialists (CQIS) based on defined criteria from our nursing decatheterization protocol. Their discontinue UC recommendations were also sent to the care teams. The critical reviews of UC for CAUTI reduction started with 4 ICUs in August 2018, with additional ICUs added in December, January and March. Monthly UC SURs were tracked Results Figure 1 shows the number of UCs recommended for removal by RNs vs. CQIS (bars), as well as the percent discordance between RNs and CQIS (line). CQIS identified many more removable UCs than the RNs (888 vs. 256). 211 UC were removed after RN recommendations, and an additional 386 UCs were removed as a result of the CQIS audits. Figure 2 shows the marked corresponding decline in our SUR over this intervention. Conclusion As more units participated in the initiative, we saw increasing numbers of “discontinue UC” recommendations. Over time there was also a moderate decrease in the discordance between RN and CQIS recommendations for UC removal. CQIS routinely identified many more UCs to be removed compared with RNs, and more than doubled the number of discontinued UC. Notably, the UC SUR markedly improved, decreasing from 0.98 to 0.78. Disclosures All authors: No reported disclosures.

Clinical quality improvement project: finding a repeatable approach for improving STAT lab testing

2003 ◽  
Vol 16 (2) ◽  
pp. 1-5
Author(s):  
Lynette Lutes ◽  
Sarvesh Logsetty ◽  
Jan McGuinness ◽  
Joan M. Carlson
Keyword(s):  
Quality Improvement ◽  
Pilot Project ◽  
Improvement Project ◽  
Clinical Quality ◽  
University Of Alberta ◽  
Improved Performance ◽  
The University ◽  
Culture Of Quality ◽  
Quality Process ◽  
Clinical Quality Improvement

Explores the development of a clinical quality improvement pilot project at the University of Alberta Hospital and Stollery Children’s Hospital which aimed to establish a team of individuals that could disseminate a culture of quality improvement and develop a framework for a quality process that could be replicated and repeated. Outcomes of the clinical pilot project included improved performance as well as opportunities to learn some key lessons around team membership and involvement.

Collaborative Clinical Quality Improvement for Pressure Ulcers in Nursing Homes

2007 ◽  
Vol 55 (10) ◽  
pp. 1663-1669 ◽  
Author(s):  
Joanne Lynn ◽  
Jeff West ◽  
Susan Hausmann ◽  
David Gifford ◽  
Rachel Nelson ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Homes ◽  
Pressure Ulcers ◽  
Clinical Quality ◽  
Clinical Quality Improvement

The Savings Illusion — Why Clinical Quality Improvement Fails to Deliver Bottom-Line Results

2011 ◽  
Vol 365 (26) ◽  
pp. e48 ◽  
Author(s):  
Stephen S. Rauh ◽  
Eric B. Wadsworth ◽  
William B. Weeks ◽  
James N. Weinstein
Keyword(s):  
Quality Improvement ◽  
Bottom Line ◽  
Clinical Quality ◽  
Clinical Quality Improvement

scholarly journals Lessons learnt during the implementation of a web-based triage tool for Dutch intensive care follow-up clinics

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021249 ◽  
Author(s):  
Ilse van Beusekom ◽  
Ferishta Bakhshi-Raiez ◽  
Nicolette F de Keizer ◽  
Dave A Dongelmans ◽  
Marike van der Schaaf
Keyword(s):  
Intensive Care ◽  
Health Professionals ◽  
Web Based ◽  
Quality Registry ◽  
Email Address ◽  
National Quality ◽  
The Web ◽  
Screening Software ◽  
National Quality Registry

ObjectivesScreening for symptoms of postintensive care syndrome is based on a long list of questionnaires, filled out by the intensive care unit (ICU) survivor and manually reviewed by the health professional. This is an inefficient and time-consuming process. The aim of this study was to evaluate the feasibility of a web-based triage tool and to compare the outcomes from web-based questionnaires to those from paper-based questionnaires.DesignA mixed-methods study.SettingNine Dutch ICU follow-up clinics.Participants221 ICU survivors and 14 health professionals.InterventionsA web-based triage tool was implemented by nine ICU follow-up clinics. End users, that is, health professionals were interviewed in order to evaluate the feasibility of the triage tool. ICU survivors were invited to fill out web-based questionnaires 3 months after hospital discharge.Primary outcomesOutcomes of the questionnaires were merged with clinical data from a national quality registry to assess the differences in outcomes between paper-based and web-based questionnaires.Results221 ICU survivors received an invitation to fill out questionnaires, 93 (42.1%) survivors did not respond to the invitation. Respondents to the web-based questionnaires (n=54) were significantly younger and had a significantly longer ICU stay than those who preferred the paper-based questionnaires (n=74). The prevalence of mental, physical and nutritional problems was high, although comparable between the groups. Health professionals’ interviews revealed that the software was complex to use (n=8) and although emailing survivors is very convenient, not all survivors have an email address (n=7).ConclusionsWeb-based screening software has major benefits compared with paper-based screening. However, implementation has shown to be rather difficult and there are important barriers to consider. Although different in age, the health status is comparable between the users of the web-based questionnaire and paper-based questionnaire.

scholarly journals Data quality audit of a clinical quality registry: a generic framework and case study of the Australian and New Zealand Hip Fracture Registry

2019 ◽  
Vol 8 (3) ◽  
pp. e000490 ◽  
Author(s):  
Aidan Christopher Tan ◽  
Elizabeth Armstrong ◽  
Jacqueline Close ◽  
Ian Andrew Harris
Keyword(s):  
Quality Improvement ◽  
New Zealand ◽  
Hip Fracture ◽  
Data Quality ◽  
Data Abstraction ◽  
Data Set ◽  
Clinical Quality ◽  
Data Completeness ◽  
Quality Registry ◽  
Generic Framework

ObjectivesThe value of a clinical quality registry is contingent on the quality of its data. This study aims to pilot methodology for data quality audits of the Australian and New Zealand Hip Fracture Registry, a clinical quality registry of hip fracture clinical care and secondary fracture prevention.MethodsA data quality audit was performed by independently replicating the data collection and entry process for 163 randomly selected patient records from three contributing hospitals, and then comparing the replicated data set to the registry data set. Data agreement, as a proxy indicator of data accuracy, and data completeness were assessed.ResultsAn overall data agreement of 82.3% and overall data completeness of 95.6% were found, reflecting a moderate level of data accuracy and a very high level of data completeness. Half of all data disagreements were caused by information discrepancies, a quarter by missing discrepancies and a quarter by time, date and number discrepancies. Transcription discrepancies only accounted for 1 in every 50 data disagreements. The sources of inaccurate and incomplete data have been identified with the intention of implementing data quality improvement.ConclusionsRegular audits of data abstraction are necessary to improve data quality, assure data validity and reliability and guarantee the integrity and credibility of registry outputs. A generic framework and model for data quality audits of clinical quality registries is proposed, consisting of a three-step data abstraction audit, registry coverage audit and four-step data quality improvement process. Factors to consider for data abstraction audits include: central, remote or local implementation; single-stage or multistage random sampling; absolute, proportional, combination or alternative sample size calculation; data quality indicators; regular or ad hoc frequency; and qualitative assessment.

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