Disrupting activities in quality improvement initiatives: a qualitative case study of the QuICR Door-To-Needle initiative

2019 ◽  
pp. bmjqs-2018-008898
Author(s):  
Jo-Louise Huq ◽  
Jaana Woiceshyn
Keyword(s):  
Quality Improvement ◽  
Qualitative Case Study ◽  
Healthcare Quality ◽  
Clinical Problem ◽  
Improve Quality ◽  
Modest Improvement ◽  
Semistructured Interviews ◽  
Specific Activities ◽  
Regular Work

BackgroundHealthcare quality improvement (QI) efforts are ongoing but often create modest improvement. While knowledge about factors, tools and processes that encourage QI is growing, research has not attended to the need to disrupt established ways of working to facilitate QI efforts.ObjectiveTo examine how a QI initiative can disrupt professionals’ established way of working through a study of the Alberta Stroke Quality Improvement and Clinical Research (QuICR) Door-to-Needle Initiative.DesignA multisite, qualitative case study, with data collected through semistructured interviews and focus groups. Inductive data analysis allowed findings to emerge from the data and supported the generation of new insights.FindingsIn stroke centres where improvements were realised, professionals’ established understanding of the clinical problem and their belief in the adequacy of existing treatment approaches shifted—they no longer believed that their established understanding and treating the clinical problem were appropriate. This shift occurred as participants engaged in specific activities to improve quality. We identify these activities as ones that create urgency, draw professionals away from regular work and encourage questioning about established processes. These activities constituted disrupting action in which both clinical and non-clinical persons were engaged.ConclusionsDisrupting action is an important yet understudied element of QI. Disrupting action can be used to create gaps in established ways of working and may help encourage professionals’ involvement and support of QI efforts. While non-clinical professionals can be involved in disrupting action, it needs to engage clinical professionals on their own terms.

Lessons learned in establishing a quality improvement project to reduce hospital acquired infections in the neonatology ward at a referral hospital in Rwanda

2016 ◽  
Vol 24 (4) ◽  
pp. 341-348 ◽  
Author(s):  
Naasson Gafirimbi ◽  
Rex Wong ◽  
Eva Adomako ◽  
Jeanne Kagwiza
Keyword(s):  
Quality Improvement ◽  
Lessons Learned ◽  
Referral Hospital ◽  
Quality Improvement Project ◽  
Injection Technique ◽  
Improve Quality ◽  
Improvement Project ◽  
Content Type ◽  
Hospital Acquired

Purpose Improving healthcare quality has become a worldwide effort. Strategic problem solving (SPS) is one approach to improve quality in healthcare settings. This case study aims to illustrate the process of applying the SPS approach in implementing a quality improvement project in a referral hospital. Design/methodology/approach A project team was formed to reduce the hospital-acquired infection (HAI) rate in the neonatology unit. A new injection policy was implemented according to the root cause identified. Findings The HAI rate decreased from 6.4 per cent pre-intervention to 4.2 per cent post-intervention. The compliance of performing the aseptic injection technique significantly improved by 60 per cent. Practical implications This case study illustrated the detailed application of the SPS approach in establishing a quality improvement project to address HAI and injection technique compliance, cost-effectively. Other departments or hospitals can apply the same approach to improve quality of care. Originality/value This study helps inform other hospitals in similar settings, the steps to create a quality improvement project using the SPS approach.

Cybersecurity

2020 ◽  
pp. 255-274
Author(s):  
Adel Ismail Al-Alawi ◽  
Arpita A. Mehrotra ◽  
Sara Abdulrahman Al-Bassam
Keyword(s):  
Qualitative Case Study ◽  
Research Data ◽  
Higher Learning ◽  
The Internet ◽  
Semistructured Interviews ◽  
Research Questions ◽  
Learning Institutions ◽  
The Way

The internet has revolutionized the way people communicate, how they manage their business, and even how they conduct their studies. Organizations can conduct meetings virtually and store all their data online. With this convenience, however, comes the risk of cybercrime (CC). Some of the world's most renowned organizations have found themselves having to incur huge recovery costs after falling prey to CC. Higher learning institutions' databases are increasingly falling victim to CCs, owing to the vast amounts of personal and research data they harbor. Despite this, the area of CCs in learning institutions remains understudied. This chapter seeks to identify how CC is manifested in such institutions and the specific cybersecurity measures that stakeholders could use to minimize their exposure to the same. The qualitative case study was designed to explore the research questions, and collected data through semistructured interviews. The findings showed hacking, phishing, and spoofing as the most common manifestations of cybercrime in higher learning institutions.

Children’s Social Relationships and Motivation in Sledge Hockey

2013 ◽  
Vol 30 (4) ◽  
pp. 299-316 ◽  
Author(s):  
Katrina Wynnyk ◽  
Nancy Spencer-Cavaliere
Keyword(s):  
Parental Involvement ◽  
Social Relationships ◽  
Thematic Analysis ◽  
Qualitative Case Study ◽  
Primary Data ◽  
Semistructured Interviews ◽  
Competence Motivation ◽  
Motivation To Participate ◽  
Competitive Nature

The purpose of this qualitative case study was to explore children with disabilities’ social relationships and motivation to take part in sledge hockey. Harter’s (1978) theory of Competence Motivation was used as the conceptual framework. Ten children (1 girl and 9 boys) between ages 11–16 years, who experienced a range of disabilities, participated. Primary data were collected using semistructured interviews, participant observations, and field and reflective notes. The thematic analysis led to four themes: (a) coach feedback, (b) parental involvement, (c) skill and belonging, and (d) (dis)ability sport. The findings revealed that interactions with significant others contributed extensively to the participant’s perceptions of competence and motivation to participate, as did the sport’s competitive nature. The findings are discussed in the context of Harter’s theory and the children’s sport and adapted physical activity inclusion literature.

Spiritual Reflections Concerning End of Life Caring Decisions: A Qualitative Case Study

2003 ◽  
Vol 7 (2) ◽  
pp. 14-27
Author(s):  
Nancy Maldonado, ◽  
Kate Callahan, ◽  
Joan Efinger,
Keyword(s):  
Content Analysis ◽  
End Of Life ◽  
Qualitative Case Study ◽  
Spiritual Support ◽  
Spiritual Experiences ◽  
Life After Death ◽  
Semistructured Interviews ◽  
Eol Care

This qualitative case study investigated the lived spiritual experiences of participants who attend a Five Weeks seminar about holistic and end of life (EOL) care decisions. Auditaped, semistructured interviews recorded participants’ responses. Content analysis was the central technique used to identify themes. Four themes emerged. These included perspectives, life after death, reflective insights, and rituals. Implications and recommendations are included for caring practices related to EOL care and spiritual support.

scholarly journals Combined quality function deployment and logical framework analysis to improve quality of emergency care in Malta

2016 ◽  
Vol 29 (2) ◽  
pp. 123-140 ◽  
Author(s):  
Sandra Catherine Buttigieg ◽  
Prasanta Kumar Dey ◽  
Mary Rose Cassar
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Quality Management ◽  
Quality Function Deployment ◽  
Patient Flow ◽  
Healthcare Quality ◽  
Improve Quality ◽  
Logical Framework ◽  
Content Type

Purpose – The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A & E) unit of a Maltese hospital. Design/methodology/approach – The study adopts a case study approach. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients’ requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A & E unit of the hospital. Findings – The major and related problems being faced by the hospital under study were overcrowding at A & E and shortage of beds, respectively. The combined framework ensures better A & E services and patient flow. QFD identifies and analyses the issues and challenges of A & E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage and shorter waiting times at the A & E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A & E unit. Practical/implications – The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of Six Sigma and other quality initiatives. Originality/value – Although QFD has been extensively deployed in healthcare setup to improve quality of care, very little has been researched on combining QFD and LFA in order to identify issues, prioritise them, derive improvement measures and implement improvement projects. Additionally, there is no research on QFD application in A & E. This paper bridges these gaps. Moreover, very little has been written on the Maltese health care system. Therefore, this study contributes demonstration of quality of emergency care in Malta.

Distinguishing Spastic and Dystonic Features in a Patient With a History of Brainstem Encephalitis: A Clinical Case Study

2021 ◽  
pp. 1-11
Author(s):  
Heather M. Clark
Keyword(s):  
Clinical Problem ◽  
Management Plan ◽  
Speech Disorders ◽  
Neurological Deficits ◽  
Brainstem Encephalitis ◽  
Motor Speech ◽  
Modest Improvement ◽  
Clinical Problem Solving ◽  
History Of

Purpose One role of a speech-language pathologist (SLP) is to differentially diagnose motor speech disorders to aid physicians, typically neurologists, in establishing a medical diagnosis. The present case study describes the clinical problem solving undertaken by the SLP to characterize the nature of neurological deficits to develop an appropriate management plan. Method The patient is a 29-year-old man with a history of brainstem encephalitis who presented for evaluation of dysarthria, dysphagia, and gait difficulties. The neurological exam characterized a spastic dysarthria. The SLP conducted a motor speech examination expressly for the purpose of differential diagnosis. Results The patient exhibited features of spastic dysarthria including strained phonation and hypernasality, equivocally slow rate associated with intermittent interword pauses rather than lengthened segments, and articulatory imprecision in the absence of weakness or slowness of the articulators. Defining features of spastic dysarthria absent from his speech were monopitch and monoloudness, as well as slow alternate motion rates. A diagnosis of hyperkinetic dysarthria associated with dystonia was informed by (a) hypernasality disproportionate to other deviant speech features, with preserved reflexive velar movements and nonspeech movements; (b) adventitious lip pursing; (c) modest improvement in speech with sensory tricks; (d) mild and intermittent phonatory strain; and (e) normal nonspeech oral motor function. Conclusions This case demonstrates the role speech-language pathology can play in the neurological assessment and management process. The recognition by the SLP of hyperkinetic dysarthria led to additional diagnostic tests and to a broader range of options for medical management.

scholarly journals Competition in collaborative clothing: a qualitative case study of influences on collaborative quality improvement in the ICU

2013 ◽  
Vol 22 (4) ◽  
pp. 317-323 ◽  
Author(s):  
Katie N Dainty ◽  
Damon C Scales ◽  
Tasnim Sinuff ◽  
Merrick Zwarenstein
Keyword(s):  
Quality Improvement ◽  
Qualitative Case Study

scholarly journals Vietnamese University Staffs’ Perceptions of Lecturer Professional Development During the CDIO-Based Curriculum Implementation

2021 ◽  
Vol 32 (1-3) ◽  
Author(s):  
Ngoc Hai Tran
Keyword(s):  
Professional Development ◽  
Student Achievement ◽  
Quality Improvement ◽  
Curriculum Implementation ◽  
Qualitative Case Study ◽  
Case Study Research ◽  
Education Quality ◽  
Study Research ◽  
Study Programs

Lecturer professional development (LPD) plays an important part in promoting student achievement and education quality improvement. At Ha Tinh Univerisity (HTU), Vietnam, the CDIO - based curriculum has been implemented since 2016 in different study programs. In order to make it succeed, LPD is considered a key measure. This qualitative case-study research aims to investigate the perceptions of HTU managers and the lecturers on LPD related to the CDIO based curriculum implementation using the data from the interviews, questionnaires and the documents. Significance of LPD related closely to the CDIO-based curriculum implementation is highly appreciated by HTU managers and lecturers.

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