scholarly journals Early discharge planning in preterm low birth weight babies: A quality improvement project

2016 ◽  
Vol 26 (2) ◽  
pp. 98-101
Author(s):  
Amudha Jayanthi Anand ◽  
Mei Chien Chua ◽  
Siok Hong Khoo ◽  
Poh Leng Yuen ◽  
Mary Choi Wan Fong ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Phase 1 ◽  
Cost Savings ◽  
Early Discharge ◽  
Quality Improvement Project ◽  
Phase 2 ◽  
Low Birth Weight Infants ◽  
Improvement Project

Introduction: Extended hospitalization of low birth weight infants increases risk of medical and psychosocial complications. Our aim was to reduce the length of hospitalization and assess safety and cost savings of discharging infants at a weight of 1900 g instead of 2000 g, as has been the practice. Methods: This is a single-centre, nurse led quality improvement project done at a tertiary neonatal unit in Singapore with primary outcome of reducing average length of stay in selected low birth weight infants. In phase 1, infants with birth weight between 1000 and 1700 g were discharged at 1900 g, provided they met the discharge criteria. Interventions were introduced in phase 2 after interim analysis for the two most common causes for delayed discharge: poor bottling skills and waiting time for scheduled herniotomy. Results: In phase 1, the mean hospitalization stay was reduced by 5.5 days, with 21% of the babies discharged at 1900 g. The safety of the intervention was assessed by rehospitalization rates, and found to be negligible. Interventions introduced in phase 2 to address the two major causes of delayed discharge did not improve the outcome. The estimated cost savings for each subsidized patient after implementation of the interventions was S$340–1100 over the two phases. Conclusion: Though only 21% of eligible infants could be discharged early, the study helped us identify key areas of intervention to facilitate early discharge of preterm infants. These included improving babies’ sucking skills, planning for early surgery, and providing adequate parental training. Safety and cost savings appear to be promising as well.

Icy Infants Quality Improvement Project: Improving Admission Temperatures in Very Low Birth Weight Infants

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 78A-78A
Author(s):  
David L. Carola ◽  
Jennifer King ◽  
Susan M Jeffery ◽  
Lyn Kinkle ◽  
Nancy A Seraydarian ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Quality Improvement Project ◽  
Low Birth Weight Infants ◽  
Improvement Project

scholarly journals A Quality Improvement Project to Increase Breast Milk Use in Very Low Birth Weight Infants

PEDIATRICS ◽  
2012 ◽  
Vol 130 (6) ◽  
pp. e1679-e1687 ◽  
Author(s):  
H. C. Lee ◽  
P. S. Kurtin ◽  
N. E. Wight ◽  
K. Chance ◽  
T. Cucinotta-Fobes ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Quality Improvement Project ◽  
Low Birth Weight Infants ◽  
Improvement Project

scholarly journals Improving Timely Resident Follow-Up and Communication of Results in Ambulatory Clinics Utilizing a Web-Based Audit and Feedback Module

2017 ◽  
Vol 9 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Joel C. Boggan ◽  
Aparna Swaminathan ◽  
Samantha Thomas ◽  
David L. Simel ◽  
Aimee K. Zaas ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Phase 1 ◽  
Quality Improvement Project ◽  
Audit And Feedback ◽  
Phase 2 ◽  
Test Results ◽  
Improvement Project ◽  
Ambulatory Patients ◽  
Outpatient Settings

ABSTRACT Background Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. Objective This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. Methods We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback. Residents performed audits of ambulatory patients requiring laboratory or radiologic testing by means of a shared online interface. The intervention consisted of an educational module viewed with initial audits, development of a personalized improvement plan after Phase 1, and repeated real-time feedback of individual relative performance compared at clinic and program levels. Outcomes included results communicated within 14 days and prespecified “significant” results communicated within 72 hours. Results A total of 76 of 86 eligible residents (88%) reviewed 1713 individual ambulatory patients' charts in Phase 1, and 73 residents (85%) reviewed 1509 charts in Phase 2. Follow-up rates were higher in Phase 2 than Phase 1 for communicating results within 14 days and significant results within 72 hours (85% versus 78%, P < .001; and 82% versus 70%, P = .002, respectively). Communication of “significant” results was more likely to occur via telephone, compared with communication of nonsignificant results. Conclusions Participation in a shared audit and feedback quality improvement project can improve rates of resident follow-up and communication of results, although communication gaps remained.

Chlorhexidine-impregnated transparent dressings decrease catheter-related infections in hemodialysis patients: a quality improvement project

2017 ◽  
Vol 18 (2) ◽  
pp. 103-108 ◽  
Author(s):  
Ibironke W. Apata ◽  
John Hanfelt ◽  
James L. Bailey ◽  
Vandana Dua Niyyar
Keyword(s):  
Quality Improvement ◽  
Phase 1 ◽  
Insertion Site ◽  
Hemodialysis Patients ◽  
Quality Improvement Project ◽  
Study Phase ◽  
Phase 2 ◽  
Improvement Project ◽  
Hemodialysis Unit ◽  
Gauze Dressing

Purpose Central venous catheters (CVC) are associated with increased infection rates, morbidity and mortality compared to other hemodialysis vascular access. Chlorhexidine-impregnated transparent (CHG-transparent) dressings allow for continuous antimicrobial exposure and easy visibility of the CVC insertion site. We conducted a quality improvement project to compare catheter-related infection (CRI) rates in two dressing regimens – CHG-transparent dressings and adhesive dry gauze dressing in hemodialysis patients with tunneled CVCs. Methods The study was conducted in two phases. In phase 1, CHG-transparent dressing was introduced to EDC hemodialysis unit, while EDG and EDN hemodialysis units, served as the control sites and maintained adhesive dry gauze dressing. Phase 2 of the study involved replacing the adhesive dry gauze dressing with CHG-transparent dressing at EDG and EDN and maintaining CHG-transparent dressing at EDC. CRI rates at each hemodialysis unit during the 12-month intervention were compared to CRI rates for the 12-month pre-intervention period for each study phase. CRI rates were also compared between all three hemodialysis units. Results In phase 1, CRI rates (per 1000 days) in EDC (intervention site) decreased by 52% (1.69 vs. 0.82, p<0.05) and increased by 12% (1.80 vs. 2.02, p = 0.75) at EDG, and 35% (0.91 vs. 1.23, p = 0.40) at EDN. In phase 2, CRI rates at EDG and EDN (intervention sites) decreased by 86% (1.86 vs. 0.26 p<0.05), and 53% (1.89 vs. 0.88, p<0.05), respectively, and decreased by 20% at EDC (0.73 vs. 0.58, p = 0.65). Conclusions Replacing adhesive dry gauze dressing with CHG-transparent dressing for hemodialysis patients with tunneled CVC was associated with decreased CRI rates.

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