scholarly journals Creating a culture of quality: our experience with providing feedback to frontline hospitalists

2021 ◽  
Vol 10 (1) ◽  
pp. e001141
Author(s):  
Brittany Becker ◽  
Sneha Nagavally ◽  
Nicholas Wagner ◽  
Rebekah Walker ◽  
Yogita Segon ◽  
...  
Keyword(s):  
Performance Feedback ◽  
Rank Order ◽  
Quality Metrics ◽  
Faculty Members ◽  
Feedback Report ◽  
Full Time ◽  
Academic Medical Centre ◽  
Improvement Project ◽  
Tract Infections ◽  
Culture Of Quality

BackgroundOne way to provide performance feedback to hospitalists is through the use of dashboards, which deliver data based on agreed-upon standards. Despite the growing trend on feedback performance on quality metrics, there remain limited data on the means, frequency and content of feedback that should be provided to frontline hospitalists.ObjectiveThe objective of our research is to report our experience with a comprehensive feedback system for frontline hospitalists, as well as report the change in our quality metrics after implementation.Design, setting and participantsThis quality improvement project was conducted at a tertiary academic medical centre among our hospitalist group consisting of 46 full-time faculty members.Intervention or exposureA monthly performance feedback report was distributed to provide ongoing feedback to our hospitalist faculty, including an individual dashboard and a peer comparison report, complemented by coaching to incorporate process improvement tactics into providers’ daily workflow.Main outcomes and measuresThe main outcome of our study is the change in quality metrics after implementation of the monthly performance feedback reportResultsThe dashboard and rank order list were sent to all faculty members every month. An improvement was seen in the following quality metrics: length of stay index, 30-day readmission rate, catheter-associated urinary tract infections, central line-associated bloodstream infections, provider component of Healthcare Consumer Assessment of Healthcare Providers and Systems scores, attendance at care coordination rounds and percentage of discharge orders placed by 10:00.ConclusionsImplementation of a monthly performance feedback report for hospitalists, complemented by peer comparison and guidance on tactics to achieve these metrics, created a culture of quality and improvement in the quality of care delivered.

scholarly journals 229. Hospitalists Antimicrobial Scorecard Improves Antibiotic Prescribing at a Community Teaching Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S116-S116
Author(s):  
Julia Sessa ◽  
Helen Jacoby ◽  
Bruce Blain ◽  
Lisa Avery
Keyword(s):  
Patient Care ◽  
Teaching Hospital ◽  
Antimicrobial Stewardship ◽  
Rank Order ◽  
Antibiotic Use ◽  
Outpatient Setting ◽  
Antibiotic Prescribing ◽  
Full Time ◽  
Days Of Therapy ◽  
The Impact

Abstract Background Measuring antimicrobial consumption data is a foundation of antimicrobial stewardship programs. There is data to support antimicrobial scorecard utilization to improve antibiotic use in the outpatient setting. There is a lack of data on the impact of an antimicrobial scorecard for hospitalists. Our objective was to improve antibiotic prescribing amongst the hospitalist service through the development of an antimicrobial scorecard. Methods Conducted in a 451-bed teaching hospital amongst 22 full time hospitalists. The antimicrobial scorecard for 2019 was distributed in two phases. In October 2019, baseline antibiotic prescribing data (January – September 2019) was distributed. In January 2020, a second scorecard was distributed (October – December 2019) to assess the impact of the scorecard. The scorecard distributed via e-mail to physicians included: Antibiotic days of therapy/1,000 patient care days (corrected for attending census), route of antibiotic prescribing (% intravenous (IV) vs % oral (PO)) and percentage of patients prescribed piperacillin-tazobactam (PT) for greater than 3 days. Hospitalists received their data in rank order amongst their peers. Along with the antimicrobial scorecard, recommendations from the antimicrobial stewardship team were included for hospitalists to improve their antibiotic prescribing for these initiatives. Hospitalists demographics (years of practice and gender) were collected. Descriptive statistics were utilized to analyze pre and post data. Results Sixteen (16) out of 22 (73%) hospitalists improved their antibiotic prescribing from pre- to post-scorecard (χ 2(1)=3.68, p = 0.055). The median antibiotic days of therapy/1,000 patient care days decreased from 661 pre-scorecard to 618 post-scorecard (p = 0.043). The median PT use greater than 3 days also decreased significantly, from 18% pre-scorecard to 11% post-scorecard (p = 0.0025). There was no change in % of IV antibiotic prescribing and no correlation between years of experience or gender to antibiotic prescribing. Conclusion Providing antimicrobial scorecards to our hospitalist service resulted in a significant decrease in antibiotic days of therapy/1,000 patient care days and PT prescribing beyond 3 days. 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.

Associations between Prior Disability-Focused Training and Disability-Related Attitudes and Perceptions among University Faculty

2009 ◽  
Vol 32 (2) ◽  
pp. 87-100 ◽  
Author(s):  
Christopher Murray ◽  
Allison Lombardi ◽  
Carol T. Wren ◽  
Christopher Keys
Keyword(s):  
Faculty Attitudes ◽  
Faculty Members ◽  
University Faculty ◽  
Full Time ◽  
Prior Training ◽  
Students With Learning Disabilities ◽  
Positive Attitudes ◽  
Students With Ld ◽  
The Relationship ◽  
Time Faculty

This investigation examined the relationship between prior disability-focused training and university faculty members' attitudes towards students with learning disabilities (LD). A survey containing items designed to measure faculty attitudes was sent to all full-time faculty at one university. Analyses of 198 responses indicated that faculty who had received some form of disability-focused training scored higher on factors pertaining to Willingness to Provide Exam Accommodations, Fairness and Sensitivity, General Knowledge About LD, Willingness to Personally Invest in Students with LD, and personal actions, such as Inviting Disclosure and Providing Accommodations, and lower scores on negatively valenced factors than did faculty who had not received prior training. Faculty who had previously attended disability-related workshops and courses reported the most positive attitudes, followed by faculty who had participated in “other” forms of training (i.e., reading books and articles or visiting websites) and faculty who had received no prior training. The total number of types of training experienced and time spent engaged in training was predictive of faculty attitudes as well as faculty-reported satisfaction with prior training. Implications of the findings are discussed.

scholarly journals Digital Images in Teaching and Learning at York University: Are the Libraries Meeting the Needs of Faculty Members in Fine Arts?

2012 ◽  
Vol 7 (2) ◽  
pp. 20 ◽  
Author(s):  
Mary Kandiuk ◽  
Aaron Lupton
Keyword(s):  
North America ◽  
Teaching And Learning ◽  
Electronic Mail ◽  
Digital Images ◽  
Fine Arts ◽  
Image Databases ◽  
Faculty Members ◽  
Full Time ◽  
Training And Support

Objective – This study assessed the needs for digital image delivery to faculty members in Fine Arts at York University in order to ensure that future decisions regarding the provision of digital images offered through commercial vendors and licensed by the Libraries meet the needs of teaching faculty. Methods – The study was comprised of four parts. A Web survey was distributed to 62 full-time faculty members in the Faculty of Fine Arts in February of 2011. A total of 25 responses were received. Follow-up interviews were conducted with nine faculty members. Usage statistics were examined for licensed library image databases. A request was posted on the electronic mail lists of the Art Libraries Society of North America (ARLIS-L) and the Art Libraries Society of North America Canada Chapter (CARLIS-L) in April 2011 requesting feedback regarding the use of licensed image databases. There were 25 responses received. Results – Licensed image databases receive low use and pose pedagogical and technological challenges for the majority of the faculty members in Fine Arts that we surveyed. Relevant content is the overriding priority, followed by expediency and convenience, which take precedence over copyright and cleared permissions, resulting in a heavy reliance on Google Images Search. Conclusions – The needs of faculty members in Fine Arts who use digital images in their teaching at York University are not being met. The greatest shortcomings of licensed image databases provided by the Libraries are the content and technical challenges, which impede the ability of faculty to fully exploit them. Issues that need to be resolved include the lack of contemporary and Canadian content, training and support, and organizational responsibility for the provision of digital images and support for the use of digital images.

scholarly journals Longitudinal Impact of APRNs on Nursing Home Quality Measures in the Missouri Quality Initiative

2021 ◽  
Author(s):  
Marilyn Rantz ◽  
G. F. Petroski ◽  
L. L. Popejoy ◽  
A. A. Vogelsmeier ◽  
K. E. Canada ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Phase 1 ◽  
Quality Measures ◽  
The State ◽  
Full Time ◽  
Improve Quality ◽  
Phase 2 ◽  
Intervention Phase ◽  
Tract Infections

Abstract Objectives To measure the impact of advanced practice nurses (APRNs) on quality measures (QM) scores of nursing homes (NHs) in the CMS funded Missouri Quality Initiative (MOQI) that was designed to reduce avoidable hospitalizations of NH residents, improve quality of care, and reduce overall healthcare spending. Design A four group comparative analysis of longitudinal data from September 2013 thru December 2019. Setting NHs in the interventions of both Phases 1 (2012–2016) and 2 (2016–2020) of MOQI (n=16) in the St. Louis area; matched comparations in the same counties as MOQI NHs (n=27); selected Phase 2 payment intervention NHs in Missouri (n=24); NHs in the remainder of the state (n=406). Participants NHs in Missouri Intervention: Phase 1 of The Missouri Quality Initiative (MOQI), a Centers for Medicare and Medicaid (CMS) Innovations Center funded research initiative, was a multifaceted intervention in NHs in the Midwest, which embedded full-time APRNs in participating NHs to reduce hospitalizations and improve care of NH residents. Phase 2 extended the MOQI intervention in the original intervention NHs and added a CMS designed Payment Intervention; Phase 2 added a second group of NHs to receive the Payment. Intervention Only. Measurements Eight QMs selected by CMS for the Initiative were falls, pressure ulcers, urinary tract infections, indwelling catheters, restraint use, activities of daily living, weight loss, and antipsychotic medication use. For each of the monthly QMs (2013 thru 2019) an unobserved components model (UCM) was fitted for comparison of groups. Results The analysis of QMs reveals that that the MOQI Intervention + Payment group (group with the embedded APRNs) outperformed all comparison groups: matched comparison with neither intervention, Payment Intervention only, and remainder of the state. Conclusion These results confirm the QM analyses of Phase 1, that MOQI NHs with full-time APRNs are effective to improve quality of care.

Successfully reducing newborn asphyxia in the labour unit in a large academic medical centre: a quality improvement project using statistical process control

2018 ◽  
Vol 27 (8) ◽  
pp. 633-642 ◽  
Author(s):  
Rikke von Benzon Hollesen ◽  
Rie Laurine Rosenthal Johansen ◽  
Christina Rørbye ◽  
Louise Munk ◽  
Pierre Barker ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Process Control ◽  
Statistical Process Control ◽  
Clinical Care ◽  
University Hospital ◽  
Vacuum Extraction ◽  
Statistical Process ◽  
Academic Medical Centre ◽  
Improvement Project ◽  
Care Bundles

BackgroundA safe delivery is part of a good start in life, and a continuous focus on preventing harm during delivery is crucial, even in settings with a good safety record. In January 2013, the labour unit at Copenhagen University Hospital, Hvidovre, undertook a quality improvement (QI) project to prevent asphyxia and reduced the percentage of newborns with asphyxia by 48%.MethodsThe change theory consisted of two primary elements: (1) the clinical content, including three clinical bundles of evidence-based care, a ‘delivery bundle’, an ‘oxytocin bundle’ and a ‘vacuum extraction bundle’; (2) an implementation theory, including improving skills in interpretation of cardiotocography, use of QI methods and participation in a national learning network. The Model for Improvement and Deming’s system of profound knowledge were used as a methodological framework. Data on compliance with the care bundles and the number of deliveries between newborns with asphyxia (Apgar <7 after 5 min or pH <7) were analysed using statistical process control.ResultsCompliance with all three clinical care bundles improved to 95% or more, and the percentages of newborns with pH <7 and Apgar <7 after 5 min were reduced by 48% and 31%, respectively. In general, the QI approach strengthened multidisciplinary teamwork, systematised workflow and structured communication around the deliveries. Changes included making a standard memo in the medical record, the use of a bedside whiteboard, bedside handovers, shared decisions with a peer when using an oxytocin infusion and the use of a checklist before vacuum extractions.ConclusionThis QI project illustrates how aspects of patient safety, such as the prevention of asphyxia, can be improved using QI methods to more reliably implement best practice, even in high-performing systems.

NEWS AND ANNOUNCEMENTS

PEDIATRICS ◽  
1970 ◽  
Vol 46 (4) ◽  
pp. 653-658
Keyword(s):  
Clinical Teaching ◽  
Medical Science ◽  
Faculty Members ◽  
University Of Pennsylvania ◽  
Full Time ◽  
Physical Medicine ◽  
Basic Sciences ◽  
Senior Faculty ◽  
School Of Medicine ◽  
Basic Medical

MEDICAL SCIENCE COURSE: University of Pennsylvania School of Medicine announces a correlated basic medical science course for the fall of 1970. The program, of one semester duration designed to provide a background in the basic sciences, lasts 15 weeks and includes 3 hours per day of formal teaching by senior faculty members and 4 hours per day of clinical teaching by discipline (medicmne, surgery, physical medicine, pediatrics, cardiology, gastroenterology, and dermatology.) This course affords a unique opportunity to participate in an informative and stimulating full time, full semester program directed to the clinical correlation of the basic sciences in a medical practice setting.

The Possibility of Promotion: How Race and Gender Predict Promotion Clarity for Associate Professors

2019 ◽  
Vol 121 (5) ◽  
pp. 1-28
Author(s):  
Amanda M. Kulp ◽  
Lisa E. Wolf-Wendel ◽  
Daryl G. Smith
Keyword(s):  
Research Question ◽  
The United States ◽  
Associate Professor ◽  
Faculty Members ◽  
Academic Disciplines ◽  
Full Professor ◽  
National Study ◽  
Institutional Characteristics ◽  
Full Time ◽  
Underrepresented Minority

Background/Context The research on promotion to full professor is sparse. Research that does exist has largely emerged from single campuses and studies conducted through disciplinary associations. Extant studies strongly suggest the presence of equity issues in advancement throughout the academic pipeline. Our study uses cross-institutional results to offer analysis of and potential solutions for the problem. Purpose/Objective/Research Question We explore the extent to which tenured faculty members at four-year postsecondary institutions are clear about their prospects of being promoted to full professor and how their background characteristics, institutional characteristics, and satisfaction with various aspects of academic work predict their perceptions of promotion clarity. We are focused on whether cultural taxation in the form of heavy service and advis-ing—often associated with underrepresented minority faculty and women faculty—is a factor. We examine the influence of ideal-worker norms and work/family demands on perceptions of promotion clarity. Lastly, we focus on the structural elements of the academy to frame the topic, rather than focusing on individual agency. Population/Participants/Subjects This study uses data from the Collaborative on Academic Careers in Higher Education (COACHE) survey, a large, national study of postsecondary faculty. Our sample consists of 3,246 individuals who held full-time, tenured positions as associate professor at four-year institutions when they responded to the surveys between 2010 and 2012. The sample was roughly divided between males (54%) and females (46%), and most faculty were employed at research institutions (59%). The sample was predominantly White (82%). The characteristics of the associate professors in the sample are representative of the larger U.S. faculty population at the time of the survey. Research Design This quantitative study uses descriptive statistics to examine patterns in promotion clarity across various demographic and institutional characteristics. We examine how satisfaction variables intersect with perceptions of promotion clarity for associate professors. Then we conduct a series of linear regression analyses to explore the influence of predictors on associate professors’ sense of clarity about promotion. Conclusions/Recommendations Being unclear about expectations of promotion to full professor is clearly of concern to faculty members at four-year universities in the United States, but it is especially of concern to women. Satisfaction with service is a very important variable in predicting perceptions of promotion clarity. For all associate professors, working at certain types of institutions or in particular academic disciplines had an inverse relationship with promotion clarity. The factors associated with lack of clarity about promotion are more structural than individual.

Academic Longevity and Attrition of Full-Time Orthopaedic Faculty Members*

2000 ◽  
Vol 82 (7) ◽  
pp. 1042-1048 ◽  
Author(s):  
Roy A. Meals ◽  
Hugh L. Bassewitz ◽  
Frederick J. Dorey
Keyword(s):  
Faculty Members ◽  
Full Time
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