Effects of Simulation Video on Parental Recall of Seizure First Aid: A Quality Improvement Project

2020 ◽  
Vol 35 (13) ◽  
pp. 908-911
Author(s):  
Xinran Maria Xiang ◽  
Daniella Miller
Keyword(s):  
Quality Improvement ◽  
Action Plan ◽  
First Aid ◽  
Emergency Department Visits ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Face To Face ◽  
Counseling Group ◽  
Video Group ◽  
Parental Recall

Many parents of children do not recall anticipatory guidance on acute seizure management, which can lead to unnecessary emergency department visits. This quality improvement project evaluated if adding a video simulation of seizure first aid improved parental recall. Parents of children with seizures were randomized to standard verbal counseling or video group, which were shown a video simulation of seizure first aid. All families also received a standardized written action plan. Eighty-three patients were randomized from July to October 2018. Overall, 53% of families who received standard counseling accurately recalled seizure first aid compared with 31% in video group (χ2 = 3.24, P = .07). Among families without baseline knowledge of seizure first aid, 43% in the standard counseling group recalled accurately compared with 16% of video group (χ2 = 4.52, P = .03). These results underscore the importance of face-to-face patient education despite the popularity of video-based media. Future Plan-Do-Study-Act cycles will include piloting a hands-on seizure first aid simulation with mannequins.

P34 Quality improvement project aimed at reducing gentamicin errors in neonates

2018 ◽  
Vol 103 (2) ◽  
pp. e1.38-e1 ◽  
Author(s):  
Calvert Heather ◽  
Makhalira Aubrey
Keyword(s):  
Quality Improvement ◽  
Transitional Care ◽  
Action Plan ◽  
Quality Improvement Project ◽  
Time Interval ◽  
List Type ◽  
Open Communication ◽  
Monthly Basis ◽  
Improvement Project ◽  
High Dependency

AimA level 3 tertiary neonatal unit with a capacity of 40 cots providing intensive care, high dependency care, special care & transitional care services, had 18 gentamicin errors reported between January and June 2017, with 84% errors occurring at prescribing and 16% errors in administration. The majority of errors (67%) were due to the complexity of calculating a 36-hourly time interval between doses. A quality improvement project was undertaken with the aim of reducing the number of gentamicin errors on the unit over a 3 month period.MethodAn overview of all gentamicin errors were presented to the multidisciplinary team (MDT) with a view of gathering ideas for improvement to ensure a team based approach. An action plan was put in place in line with National Patient Safety Agency (NPSA) recommendations1 and initiated in July 2017 based on a plan-do-study-act (PDSA) model.ResultsThe PDSA cycles included:a simplified and standardised dosing interval for dosing of gentamicin after the first dose.an updated local monograph with dosing intervals and example prescription.posters displayed in prescribing areas to promote safe and focused prescribing.a feedback session to the full MDT team regarding improvements made and further feedback.ensure compliance with policy by promoting updated guideline & on going error monitoring.consideration of alternative lower risk antibiotic in low risk babies.incorporation of gentamicin prescribing exercise as part of the new doctor induction. The following interventions will be evaluated in 3 months using Datix reported errors before and after implementation. Sequential PDSA cycles will then be conducted for learning and improvement.ConclusionA team based approach, using open communication with regular feedback and review is essential in order to improve the quality of prescribing and gain engagement from medical and non-medical prescribing colleagues. Further audit will be undertaken on monthly basis to evaluate the implementation of improvement measures.

799 Free Transportation for Socioeconomically Disadvantaged Burn Patients: Quality Improvement Project

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S236-S236
Author(s):  
Laura Perez ◽  
Rebecca Castro ◽  
Steven E Wolf ◽  
Jong Lee
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Access To Care ◽  
Low Socioeconomic Status ◽  
Emergency Department Visits ◽  
Quality Improvement Project ◽  
Burn Patients ◽  
Socioeconomically Disadvantaged ◽  
Improvement Project ◽  
Transportation Program

Abstract Introduction Our Burn Center provides care to persons living in southeast area of our State. Patients residing in this area sometimes have low socioeconomic status (SES), and are often unable to return to burn clinic for continued care due to transportation barriers. Typically driving distance is over 80 miles involving ferry access, taking two or more hours each way. The aim of this quality improvement project was to examine the feasibility of a free transportation program for low SES patients who have barriers to transportation. Methods Our first step was to assess transportation needs. We started with a patient survey in clinic to determine if patients would be interested in free transportation and if the service would increase access to care. Survey with six questions was used to assess needs. Results We surveyed ten patients during burn clinic to determine if transportation would increase access to care. Nine patients responded positively and found transportation would be beneficial. One responded that he would not use it as he would use clinic appointment as opportunity to vacation in the area. Funding was secured from our School of Medicine. Community transportation providers were contacted and pricing was obtained. Transportation van was contracted with existing vender. Transportation is now available to patients with burn clinic appointments. We hope to expand to other clinics in the hospital in the future. The Transportation program will assist patients with access to care, compliance, decrease non-emergent Emergency Department visits and 30-day readmissions. Conclusions Transportation assistance for socioeconomically disadvantaged burn patients to follow up in clinic is needed. Nine out of ten patients surveyed were willing to use free transportation. We obtained funding to start a free transportation program once a month. This project began in October 2019. We have begun a once-a-month transportation assistance service to determine ridership and continued need. Twice monthly assistance may be needed and will be assessed over time. Our goal is ultimately to expand the program to include other clinics. Applicability of Research to Practice Free transportation program can assist patients with access to care, compliance, and decrease non-emergent Emergency Department visits and 30-day readmissions.

Abstract 34: Kentucky Stroke Encounter Quality Improvement Project Statewide Collaboration to Improve Alteplase Utilization, Decrease Door to Needle Times, and Impact Outcomes: A 10 Year Review

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Kari D Moore ◽  
Lynn Hundley ◽  
Polly Hunt ◽  
Bill Singletary ◽  
Allison Merritt ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Best Practices ◽  
Best Practice ◽  
Systems Of Care ◽  
Quality Improvement Project ◽  
Complication Rates ◽  
Improvement Project ◽  
Face To Face ◽  
Data Tracking ◽  
Stroke Systems Of Care

Background: Evidence shows systems change interventions improve care and outcomes for stroke patients. Geopolitical boundaries have been a barrier to improving regional systems of care. Despite efforts nationally, regionally, and locally alteplase use for ischemic stroke has remained low and door to needle (DTN) times exceeded 60 minutes. Kentucky created the Stroke Encounter Quality Improvement Project (SEQIP) in 2009 to share best practices and improve stroke systems of care across the Commonwealth. Purpose: The aim was to utilize and share best practice models among 23 SEQIP hospitals in KY to improve tPA utilization, decrease DTN times, and improve outcomes. Methods: Hospitals implemented a statewide quality improvement plan focused on identifying barriers, removing barriers, and implementing best practice strategies regarding thrombolytic therapy. Accountability was achieved with ongoing GWTG data tracking, teleconferences, and face to face meetings from January 2009 through December 2018 sharing strategies and solutions for best practice. Results: SEQIP’s participating hospitals achieved significant improvement in thrombolytic administration over 10 years. The percent of all AIS patients receiving tPA increased from 4.61% in 2009 to 8.80% in 2018 (OR=2.0, p <0.0001). Alteplase use in eligible patients arriving by 2 hours and treated by 3 hours improved from 59.6% to 88.5% (OR=5.2, p <0.0001). Alteplase use in eligible patients arriving by 3.5 hours to 4.5 hours increased from 24.9% to 55.1% (OR=5.0, p <0.0001). Median DTN times decreased from 74 minutes to 49 minutes (p<0.0001). Complication rates of symptomatic hemorrhage were consistent with NINDS data and < 6% from 2009-2018. The tPA in-hospital mortality rate in 2009 was 11.7% and by 2018, decreased to 3.6% (p=0.00016). In 2009, 28.4% of tPA patients were discharged home and by 2018, that had increased to 47.9% (p <0.00001). In 2009, 32.1% of tPA patients were able to walk independently at d/c and by 2018 had increased to 43.6% (p = 0.00359). Conclusions: Geopolitical boundaries can be overcome and collaboration can be sustained among competing hospitals through sharing of best practices to safely increase utilization of tPA in eligible patients, decrease DTN times, and improve outcomes.

scholarly journals Rapid conversion of Tai Chi classes from face‐to‐face to virtual during the COVID‐19 pandemic: A quality improvement project

Nursing Forum ◽  
2022 ◽  
Author(s):  
Linda M. Sawyer ◽  
Lana M. Brown ◽  
Shelly Y. Lensing ◽  
Donna McFadden ◽  
Melinda M. Bopp ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Tai Chi ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Face To Face ◽  
Rapid Conversion

scholarly journals Development and implementation of a Telenephrology dashboard for active surveillance of kidney disease: a quality improvement project

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa L. Swee ◽  
M. Lee Sanders ◽  
Kantima Phisitkul ◽  
George Bailey ◽  
Angie Thumann ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Kidney Disease ◽  
Early Detection ◽  
Lean Six Sigma ◽  
Iowa City ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Face To Face ◽  
Detection And Identification ◽  
Control Framework

Abstract Background Kidney disease accounts for more than 49 billion dollars in healthcare expenditures annually. Early detection and intervention may reduce the burden of disease. We describe a quality improvement project to develop a telenephrology dashboard that proactively monitors kidney disease. Methods One hundred eighty-four thousands Veterans within the Iowa City Veterans Affairs Health Care System were eligible for telenephrology consultation. The dashboard accessed the charts of 53,085 Veterans at risk for kidney disease. We utilized Lean-Six Sigma tools and principles and the Define-Measure-Analyze-Improve-Control Framework to develop and deploy a telenephrology dashboard in 4 community-based outpatient clinics (CBOCs). The primary measure was the number of days to complete consultation. Secondary measures included number of electronic consultations per month, distance and cost of Veteran travel saved, and number of steps for completion of consult. Results The data of 1384 Veterans at the 4 CBOCs were analyzed by the telenephrology dashboard, of which 459 generated telenephrology consults. The number of days to complete any type of consultation was unchanged (48.9 days in 2019, compared to 41.6 days in 2017). The average Veteran saved between $21.60 to $63.90 per trip to Iowa City. Between March 2019 and August 2019, there were 27.3 telenephrology consults per month. The number of steps needed to complete the consult request was decreased from 13 to 9. Conclusions Utilization of the telenephrology dashboard system contributed to an increase in consultations completed through electronic means without decreasing face-to-face consults. Electronic consults now outnumber traditional face-to-face consultations at our institution. Telenephrology consultation improved early detection and identification of kidney disease and saved time and costs for Veterans in travel, but did not decrease the average number of days to complete consultation requests.

Clinical Scenario #6: Practice-Based Learning and Improvement

2018 ◽  
pp. 301-304
Author(s):  
Ruchir Gupta ◽  
Minh Chau Joe Tran
Keyword(s):  
Quality Improvement ◽  
Action Plan ◽  
Quality Improvement Project ◽  
Clinical Scenario ◽  
Improvement Project ◽  
Maximum Score ◽  
Learning Improvement ◽  
Stepwise Manner ◽  
Task Statement

In this chapter the essential aspects of practice-based learning improvement are discussed. The chapter begins with a mock scenario involving an initiative to design and implement a quality improvement project to improve the number of cases starting on time. The mock scenario is followed by a task statement that describes the specific action that the student must take. In this case, the task is to explain to a colleague the general steps of how to design and implement a quality improvement project. An action plan is then presented in a stepwise manner with mock responses and a discussion of the responses. Grading points are also discussed and how to achieve maximum score is presented.

scholarly journals Development and Implementation of a Telenephrology Dashboard for Active Surveillance of Kidney Disease: A Quality Improvement Project

2020 ◽  
Author(s):  
Melissa L Swee ◽  
M. Lee Sanders ◽  
Kantima Phisitkul ◽  
George Bailey ◽  
Angie Thumann ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Kidney Disease ◽  
Early Detection ◽  
Lean Six Sigma ◽  
Iowa City ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Face To Face ◽  
Detection And Identification ◽  
Control Framework

Abstract Background : Kidney disease accounts for more than 50 billion dollars in healthcare expenditures annually. Early detection and intervention may reduce the burden of disease. We describe a quality improvement project to develop a telenephrology dashboard that proactively monitors kidney disease. Methods : 184,000 Veterans within the Iowa City Veterans Affairs Health Care System were eligible for telenephrology consultation. The dashboard accessed the charts of 53,085 Veterans at risk for kidney disease. We utilized Lean-Six Sigma tools and principles and the Define-Measure-Analyze-Improve-Control Framework to develop and deploy a telenephrology dashboard in 4 community-based outpatient clinics (CBOCs). The primary measure was the number of days to complete consultation. Secondary measures included number of electronic consultations per month, distance and cost of Veteran travel saved, and number of steps for completion of consult. Results : The data of 1,384 Veterans at the 4 CBOCs were analyzed by the telenephrology dashboard, of which 459 generated telenephrology consults. The number of days to complete any type of consultation was unchanged (48.9 days in 2019, compared to 41.6 days in 2017). The average Veteran saved between $21.60 to $63.90 per trip to Iowa City. Between March 2019 and August 2019, there were 27.3 telenephrology consults per month. The number of steps needed to complete the consult request was decreased from 13 to 9. Conclusions : Utilization of the telenephrology dashboard system contributed to an increase in consultations completed through electronic means without decreasing face-to-face consults. Electronic consults now outnumber traditional face-to-face consultations at our institution. Telenephrology consultation improved early detection and identification of kidney disease and saved time and costs for Veterans in travel, but did not decrease the average number of days to complete consultation requests.

scholarly journals Improving the patient involvement in research and development on acute psychiatric wards – an audit and quality improvement project

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S110-S110
Author(s):  
Ioana Varvari ◽  
Hany El – Sayeh ◽  
Shona McIlrae ◽  
Susan Bonner
Keyword(s):  
Quality Improvement ◽  
Research And Development ◽  
Action Plan ◽  
Opportunity To Learn ◽  
National Standards ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Development Policies ◽  
Inpatient Settings ◽  
Trainee Satisfaction

AimsThe local audit aimed at measuring awareness of research and development policies and implementation of local and national standards. Our findings generated a quality improvement project with two main objectives: first, improving patient approach and recruitment in research and second, improving trainee satisfaction within our trust.MethodA cohort of new inpatient admissions was identified over a period of 4 weeks, between October 2019 and November 2019, on the two psychiatric wards at the Briary Wing, Harrogate District Hospital. Based on local and national standards, we designed and developed a qualitative (questionnaire) and quantitative (audit tool) approach that was aimed at both staff and patients. Our steps included: assessing awareness and implementation of standards, a retrospective collection of data on the wards, and analysis of the data in Microsoft Excel.ResultOnly one ward implemented the local guidance from which we identified a sample of 14 consecutive new admissions that were currently present on the ward and were able to answer our questions. 13 of those patients were noted as ‘approached’ on our visual board from which only 3 patients remembered reading a leaflet about research options in the admission pack, however, they have not been verbally informed. There was no process in place to assure the re-approaching of initially unwell patients or to follow up on discharge for those interested. Documentation was available in only 9 of the cases and was nonspecific: ‘admission pack done’.ConclusionThe awareness and understanding of Research and Development policies are poor and they are difficult to apply in practice in a busy inpatient environment without a clear process in place. This results in patients missing the opportunity to learn and understand more about research or to participate in ongoing studies. Quality improvement work needs to be done to improve patient recruitment in research in inpatient settings. Simple flow charts and stepwise processes as exemplified by our action plan have the potential to improve service quality, as well as patient and trainee satisfaction.

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