scholarly journals Improving turnaround times for HLA-B*27 and HLA-B*57:01 gene testing: a Barts Health NHS Trust quality improvement project

2021 ◽  
Vol 10 (3) ◽  
pp. e001538
Author(s):  
Emma White ◽  
Nathan Proudlove ◽  
Delordson Kallon
Keyword(s):  
Quality Improvement ◽  
Turnaround Time ◽  
Quality Improvement Project ◽  
Return Of Results ◽  
Gene Detection ◽  
Improvement Project ◽  
Gene Testing ◽  
Genetic Medicine ◽  
The Impact

Among other tests, Barts Health NHS Trust clinical transplantation laboratory conducts two important gene-detection tests: human leucocyte antigen (HLA)-B*27 (‘B27’, associated with the diagnosis of ankylosing spondylitis) and HLA-B*57:01 (‘B57’, associated with prediction of abacavir hypersensitivity disorder). The turnaround time (TaT) from sample receipt to return of results is important to clinicians and their patients but was not monitored. Furthermore, we anticipated an imminent increase in demand from a forthcoming pathology service merger, together with long-term increases with the rise of personalised genetic medicine.In this quality improvement project, we identified current TaT performance and sources of delay. Over three plan-do-study-act (PDSA) cycles, we tested three change ideas, two involving using IT to remove manual administrative steps and alert us to samples needing progressing; both were retained. The other change involved separating out the targeted tests; we judged this not worthwhile with current demand levels, although something to be re-examined when volumes increase. During the project, we reduced mean TaT from 3.8 to 3.3 days and increased the proportion within our 5-day target from 78% to 100%. These have been sustained (at 3.4 days and 97%) for the 3 months following our PDSA cycles and illustrate that reducing variation can be as impactful as reducing the mean.We conducted this project during the COVID-19 disruption, which reduced demand substantially. We took advantage of this to allow staff to spend time on these improvement activities. Another interesting feature of the work is that during the project, we compared changes in performance on our targeted B27/B57 tests with that on another comparable test as a control, to consider the impact of the general increased attention (the Hawthorne effect). We found that performance on this control also increased comparably, but then fell away after our project finished, while it did not for B27/B57.

scholarly journals 0707 “What We’Ve Got Here Is Failure To Communicate”: Apnea Patients And Their DME Suppliers

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A269-A269
Author(s):  
S Thapa ◽  
S Agrawal ◽  
M Kryger
Keyword(s):  
Quality Improvement ◽  
Sleep Apnea ◽  
Quality Improvement Project ◽  
Timely Manner ◽  
Improvement Project ◽  
Therapy Initiation ◽  
Obstructive Sleep ◽  
Key Factor ◽  
The Impact ◽  
The Relationship

Abstract Introduction Successful treatment of obstructive sleep apnea requires adherence to positive airway pressure (PAP) therapy. A key factor is the relationship between the DME provider and the patient so that treatment can be initiated and continued in a timely manner. Our quality improvement project aims to empower and enable patients towards active participation in their sleep apnea care. Our goal is to ultimately increase patients’ knowledge of their Durable Medical Equipment (DME) supplies company, and thus improve their treatment. The first step was to determine patients’ familiarity with their DME. Methods Forty-one patients with sleep apnea on PAP therapy volunteered to be questioned about their DME company during clinic visits at the Yale North Haven Sleep Center, Connecticut, starting November 2019. Patients were asked if they knew the name or the contact of their DME; whether they received adequate training on PAP therapy initiation; if they were receiving timely and correct PAP therapy supplies. They were asked to rate their satisfaction with the DME on a scale of 1 to 5; one being very dissatisfied and five being very satisfied. Results Only 12 out of 41 patients (29.3 percent) knew the names of their DME companies. The average satisfaction rating was 3 (neutral); 44% of patients were dissatisfied, or very dissatisfied with the performance of their DME. Detailed comments were mostly related to poor contact and communication with the DME. Conclusion Most apnea patients had difficulty identifying and contacting their DME. As the next step of this quality improvement project we plan to intervene to ensure that the patients have the name and contact information of their DME available and attached to their PAP machine equipment. We plan to repeat this questionnaire after this intervention to study the impact of this quality improvement project. Support None

scholarly journals Meet your surgical team: The impact of a resident-led quality improvement project on patient satisfaction

2018 ◽  
Vol 216 (4) ◽  
pp. 793-799
Author(s):  
Rebecca Craig-Schapiro ◽  
Sandra R. DiBrito ◽  
Heidi N. Overton ◽  
James P. Taylor ◽  
Ryan B. Fransman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Satisfaction ◽  
Quality Improvement Project ◽  
Surgical Team ◽  
Improvement Project ◽  
The Impact

The impact of operative timing on outcomes of appendicitis: a National Surgical Quality Improvement Project analysis

2015 ◽  
Vol 209 (3) ◽  
pp. 498-502 ◽  
Author(s):  
Brett A. Fair ◽  
John C. Kubasiak ◽  
Imke Janssen ◽  
Jonathan A. Myers ◽  
Keith W. Millikan ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Improvement Project ◽  
Surgical Quality ◽  
Improvement Project ◽  
Project Analysis ◽  
The Impact

scholarly journals An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department

2017 ◽  
Vol 32 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Jason M. Moss ◽  
William E. Bryan ◽  
Loren M. Wilkerson ◽  
Heather A. King ◽  
George L. Jackson ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Quality Improvement ◽  
Older Adult ◽  
Quality Improvement Project ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Academic Detailing ◽  
Improvement Project ◽  
The Impact

Objective: To evaluate the impact of an academic detailing intervention delivered as part of a quality improvement project by a physician–pharmacist pair on (1) self-reported confidence in prescribing for older adults and (2) rates of potentially inappropriate medications (PIMs) prescribed to older adults by physician residents in a Veteran Affairs emergency department (ED). Methods: This quality improvement project at a single site utilized a questionnaire that assessed knowledge of Beers Criteria, self-perceived barriers to appropriate prescribing in older adults, and self-rated confidence in ability to prescribe in older adults which was administered to physician residents before and after academic detailing delivered during their emergency medicine rotation. PIM rates in the resident cohort who received the academic detailing were compared to residents who did not receive the intervention. Results: Sixty-three residents received the intervention between February 2013 and December 2014. At baseline, approximately 50% of the residents surveyed reported never hearing about nor using the Beers Criteria. A significantly greater proportion of residents agreed or strongly agreed in their abilities to identify drug–disease interactions and to prescribe the appropriate medication for the older adult after receiving the intervention. The resident cohort who received the educational intervention was less likely to prescribe a PIM when compared to the untrained resident cohort with a rate ratio of 0.73 ( P < .0001). Conclusion: Academic detailing led by a physician–pharmacist pair resulted in improved confidence in physician residents’ ability to prescribe safely in an older adult ED population and was associated with a statistically significant decrease in PIM rates.

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