scholarly journals Implementation and effectiveness of drive-through medication pick-up and home delivery services. A patient safety initiative during COVID-19 pandemic

2021 ◽  
pp. 251604352110090
Author(s):  
Haneen K AlAbbasi ◽  
Shabeer A Thorakkattil ◽  
Syed I Mohiuddin ◽  
Habib S Nemr ◽  
Rita Jabbour ◽  
...  
Keyword(s):  
Patient Safety ◽  
Implementation Process ◽  
Home Delivery ◽  
Successful Implementation ◽  
Social Distancing ◽  
Pharmacy Department ◽  
Ensure Patient Safety ◽  
Number Of Patients ◽  
Delivery Services ◽  
Safety Initiative

Introduction With the emergence of the first COVID-19 case in Saudi Arabia, Johns Hopkins Aramco Healthcare has immediately executed the appropriate protocols in response to this severe global crisis. The pharmacy department at Johns Hopkins Aramco Healthcare continues to play an essential role in providing the safest, efficient, and effective service to its eligible patients. In response to the COVID-19 pandemic, the pharmacy department acted by implementing a drive-through pharmacy and home delivery services as new person-centered services to ensure patient safety. These two new services were initiated to protect both the pharmacist and the patient from COVID-19 infections as they ensure social distancing and reduce patients’ visits to the walk-in pharmacies, hence providing valuable and convenient services during this pandemic. Objective This article aims to describe the implementation processes and effectiveness of drive-through medication pick-up and home-delivery services as a patient safety initiative during the COVID-19 pandemic. Method The implementation process of the drive-through and home delivery services are explained in detail. The utilization of these two services is evaluated by measuring the number of patients and prescriptions between April 2020 and August 2020. Result The increased utilization of drive-through medication pick-up and home delivery services in terms of the number of patients and prescriptions ensures patient safety by minimizing infection risk. Conclusion The increase in the utilization of drive-through medication pick-up and home delivery services reflects its successful implementation during the COVID-19 pandemic. Both services meet the pandemic’s social-distancing requirements and minimize risks of infections, which will ensure patient safety during the COVID-19 pandemic.

Hourly Rounding for Falls Prevention: A Change Initiative

2013 ◽  
Vol 19 (3) ◽  
pp. 153-158 ◽  
Author(s):  
Daryl Dyck ◽  
Tracy Thiele ◽  
Rodney Kebicz ◽  
Michelle Klassen ◽  
Carly Erenberg
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Care Facility ◽  
Health Care Facility ◽  
Implementation Process ◽  
The Elderly ◽  
Falls Prevention ◽  
Fall Rates ◽  
Hourly Rounding ◽  
Safety Initiative

Fall-related injuries are a particular concern within the elderly population, and trends toward an aging demographic will keep this issue at the forefront in health care. We are challenged to develop creative strategies to significantly reduce harm and fall rates among the elderly. This article describes the process of establishing an hourly rounding initiative in a health care facility. Hourly rounding is supported by the literature as an effective strategy for falls prevention and patient safety. When the initiative was not successfully adopted initially, the implementation process was critically examined and an innovative sustainability plan was developed to ensure that the change would be embedded in the organization’s culture. Through this opportunity, nurses and allied health members from all levels were able to collaborate on strategies for this patient safety initiative.

scholarly journals 1508 Acute ENT Clinic Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Bondje ◽  
R Tanna ◽  
J Stephens
Keyword(s):  
Patient Safety ◽  
Referral System ◽  
Patient Demographics ◽  
Retrospective Audit ◽  
Ensure Patient Safety ◽  
Number Of Patients ◽  
Standard Operating

Abstract Introduction The acute ENT clinic is run by the ENT SHO’s and is used to assess and treat patients with a variety of everyday ENT pathology. As a department, we are seeing increasing numbers of patients who have been referred via the community for conditions that do not meet the departmental guidelines as well as noting our clinic is consistently overbooked and overrunning. Method A retrospective audit was performed analysing all clinic data between December 2019 and January 2020, specifically looking at patient demographics and reason for referral. The total number of patients per clinic was analysed and compared against ENT UK guidelines for safe clinic numbers, which state that an SHO led acute clinic should have 6 patients maximum. Results Over a two-month period, we looked at data from 35 clinics. As per our standard operating practice, children should be seen first in the clinic and this occurred in only 8 clinics (22.9%). Secondly, 8 clinics had appropriately booked a maximum of 6 patients, whilst in 27 clinics (77.2%) there were more than 7 patients booked. Finally, 69.8% of patients had unsuitable referrals as per the guideline. Conclusions It is clear from our data that the capacity of the acute clinic does not meet its current demand, and this is something that needs to be addressed to ensure patient safety and to adhere to ENT UK guidance. The implementation of a more stringent referral system will increase patient safety by ensuring patients with appropriate pathology are seen in this clinic.

Clinical Pharmacist Patient-Safety Initiative to Reduce Against-Label Prescribing of Statins With Cyclosporine

2016 ◽  
Vol 51 (2) ◽  
pp. 140-145 ◽  
Author(s):  
Donald G. Lamprecht ◽  
Brittany A. Todd ◽  
Anne M. Denham ◽  
Leslie K. Ruppe ◽  
Sheila L. Stadler
Keyword(s):  
Patient Safety ◽  
Health Care Providers ◽  
Clinical Pharmacist ◽  
Safety Concern ◽  
Care Providers ◽  
Clinical Pharmacists ◽  
Conversion Rates ◽  
Number Of Patients ◽  
The Mean ◽  
Safety Initiative

Background: Against-label prescribing of statins with interacting drugs, such as cyclosporine, represents an important patient safety concern. Objective: To implement and evaluate the effectiveness of a clinical pharmacist patient-safety initiative to minimize against-label prescribing of statins with cyclosporine. Methods: Kaiser Permanente Colorado clinical pharmacists identified patients receiving both cyclosporine and against-label statin through prescription claims data. Academic detailing on this interaction was provided to health care providers. Clinical pharmacists collaborated with physicians to facilitate conversion to on-label statin. Conversion rates along with changes in low-density lipoprotein cholesterol (LDL-C) were assessed. Results: Of the 157 patients identified as taking cyclosporine, 48 were receiving concurrent statin therapy. Of these 48 patients, 33 (69%) were on an against-label statin regimen; 25 (76%) of these patients were converted to on-label statin. Overall, patients converted to on-label statin had a mean LDL-C prior to conversion of 82.9 (±26.4) mg/dL and mean LDL-C after conversion of 90.7 (±31.2) mg/dL ( P = 0.21). In all, 17 patients (68%) were switched to pravastatin 20 mg daily and 8 patients (32%) to rosuvastatin 5 mg daily. In patients converted to pravastatin 20 mg daily, the mean LDL-C was 13.5 mg/dL higher than prior to conversion ( P = 0.066). In patients converted to rosuvastatin 5 mg daily, the mean LDL-C was 3.8 mg/dL lower than prior to conversion ( P = 0.73). Conclusion: Utilizing a patient-safety-centered approach, clinical pharmacists were able to reduce the number of patients on against-label statin with cyclosporine while maintaining a comparable level of LDL-C control.

Evidence-based eHealth interventions for caregivers of people with dementia (Myinlife and Partner in Balance): Evaluation of implementations in municipality contexts (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
Marjolein Elizabeth de Vugt
Keyword(s):  
Self Efficacy ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Successful Implementation ◽  
Evidence Based ◽  
Multiple Sources ◽  
Target Groups ◽  
Face To Face ◽  
People With Dementia ◽  
Implementation Context

BACKGROUND Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context to implement these interventions, due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in eight municipalities in the Euregion Meuse-Rhine. OBJECTIVE This study’s objectives were to (1.) evaluate this implementation and (2.) investigate determinants of successful implementation. METHODS This study collected eHealth usage data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials, based on the Measurement Instrument for Determinants of Implementation (MIDI). This data from multiple sources and perspectives was integrated and analysed to form a total picture of the municipality implementation process. RESULTS The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, three municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The two Partner in Balance municipalities that did not consider the implementation to be successful, viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and the target groups. Successful implementations were linked to implementer self-efficacy CONCLUSIONS The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols, as part of standard implementation materials for municipalities and organisations implementing Myinlife and Partner in Balance.

scholarly journals IMPROVING SYSTEM READINESS, STAFF PREPAREDNESS AND PATIENT SAFETY IN A NEW SINGLE FAMILY ROOM NICU THROUGH IN SITU SIMULATION

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e16-e16
Author(s):  
Ahmed Moussa ◽  
Audrey Larone-Juneau ◽  
Laura Fazilleau ◽  
Marie-Eve Rochon ◽  
Justine Giroux ◽  
...  
Keyword(s):  
Patient Safety ◽  
Repeated Measures ◽  
Large Scale ◽  
Multidisciplinary Teams ◽  
Single Family ◽  
In Situ Simulation ◽  
Ensure Patient Safety ◽  
System Readiness ◽  
Dependent Samples

Abstract BACKGROUND Transitions to new healthcare environments can negatively impact patient care and threaten patient safety. Immersive in situ simulation conducted in newly constructed single family room (SFR) Neonatal Intensive Care Units (NICUs) prior to occupancy, has been shown to be effective in testing new environments and identifying latent safety threats (LSTs). These simulations overlay human factors to identify LSTs as new and existing process and systems are implemented in the new environment OBJECTIVES We aimed to demonstrate that large-scale, immersive, in situ simulation prior to the transition to a new SFR NICU improves: 1) systems readiness, 2) staff preparedness, 3) patient safety, 4) staff comfort with simulation, and 5) staff attitude towards culture change. DESIGN/METHODS Multidisciplinary teams of neonatal healthcare providers (HCP) and parents of former NICU patients participated in large-scale, immersive in-situ simulations conducted in the new NICU prior to occupancy. One eighth of the NICU was outfitted with equipment and mannequins and staff performed in their native roles. Multidisciplinary debriefings, which included parents, were conducted immediately after simulations to identify LSTs. Through an iterative process issues were resolved and additional simulations conducted. Debriefings were documented and debriefing transcripts transcribed and LSTs classified using qualitative methods. To assess systems readiness and staff preparedness for transition into the new NICU, HCPs completed surveys prior to transition, post-simulation and post-transition. Systems readiness and staff preparedness were rated on a 5-point Likert scale. Average survey responses were analyzed using dependent samples t-tests and repeated measures ANOVAs. RESULTS One hundred eight HCPs and 24 parents participated in six half-day simulation sessions. A total of 75 LSTs were identified and were categorized into eight themes: 1) work organization, 2) orientation and parent wayfinding, 3) communication devices/systems, 4) nursing and resuscitation equipment, 5) ergonomics, 6) parent comfort; 7) work processes, and 8) interdepartmental interactions. Prior to the transition to the new NICU, 76% of the LSTs were resolved. Survey response rate was 31%, 16%, 7% for baseline, post-simulation and post-move surveys, respectively. System readiness at baseline was 1.3/5,. Post-simulation systems readiness was 3.5/5 (p = 0.0001) and post-transition was 3.9/5 (p = 0.02). Staff preparedness at baseline was 1.4/5. Staff preparedness post-simulation was 3.3/5 (p = 0.006) and post-transition was 3.9/5 (p = 0.03). CONCLUSION Large-scale, immersive in situ simulation is a feasible and effective methodology for identifying LSTs, improving systems readiness and staff preparedness in a new SFR NICU prior to occupancy. However, to optimize patient safety, identified LSTs must be mitigated prior to occupancy. Coordinating large-scale simulations is worth the time and cost investment necessary to optimize systems and ensure patient safety prior to transition to a new SFR NICU.

scholarly journals Adverse Events in Home-Care Nursing Agencies and Related Factors: A Nationwide Survey in Japan

2021 ◽  
Vol 18 (5) ◽  
pp. 2546
Author(s):  
Noriko Morioka ◽  
Masayo Kashiwagi
Keyword(s):  
Adverse Event ◽  
Patient Safety ◽  
Adverse Events ◽  
Home Care ◽  
Process Of Care ◽  
Related Factors ◽  
Cross Sectional ◽  
Home Care Nursing ◽  
Number Of Patients ◽  
Care Nursing

Despite the importance of patient safety in home-care nursing provided by licensed nurses in patients’ homes, little is known about the nationwide incidence of adverse events in Japan. This article describes the incidence of adverse events among home-care nursing agencies in Japan and investigates the characteristics of agencies that were associated with adverse events. A cross-sectional nationwide self-administrative questionnaire survey was conducted in March 2020. The questionnaire included the number of adverse event occurrences in three months, the process of care for patient safety, and other agency characteristics. Of 9979 agencies, 580 questionnaires were returned and 400 were included in the analysis. The number of adverse events in each agency ranged from 0 to 47, and 26.5% of the agencies did not report any adverse event cases. The median occurrence of adverse events was three. In total, 1937 adverse events occurred over three months, of which pressure ulcers were the most frequent (80.5%). Adjusting for the number of patients in a month, the percentage of patients with care-need level 3 or higher was statistically significant. Adverse events occurring in home-care nursing agencies were rare and varied widely across agencies. The patients’ higher care-need levels affected the higher number of adverse events in home-care nursing agencies.

scholarly journals As predicted by theory: choice and competition in a publicly funded and regulated regional health system yield improved access and cost control

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jonas Wohlin ◽  
Clara Fischer ◽  
Karin Solberg Carlsson ◽  
Sara Korlén ◽  
Pamela Mazzocato ◽  
...  
Keyword(s):  
Cost Control ◽  
Care Quality ◽  
Patient Choice ◽  
Public Healthcare ◽  
Successful Implementation ◽  
Publicly Funded ◽  
Public And Private ◽  
Bundled Payment ◽  
Private Providers ◽  
Number Of Patients

Abstract Background New Public Management (NPM) has been widely used to introduce competition into public healthcare. Results have been mixed, and there has been much controversy about the appropriateness of a private sector-mimicking governance model in a public service. One voice in the debate suggested that rather than discussing whether competition is “good” or “bad” the emphasis should be on exploring the conditions for a successful implementation. Methods We report a longitudinal case study of the introduction of patient choice and allowing private providers to enter a publicly funded market. Patients in need of hip or knee replacement surgery are allowed to choose provider, and those are paid a fixed reimbursement for the full care episode (bundled payment). Providers are financially accountable for complications. Data on number of patients, waiting lists and times, costs to the public purchaser, and complications were collected from public registries. Providers were interviewed at three points in time during a nine-year follow-up period. Time-series of the quantitative data were exhibited and the views of actors involved were explored in a thematic analysis of the interviews. Results The policy goals of improving access to care and care quality while controlling total costs were achieved in a sustained way. Six themes were identified among actors interviewed and those were consistent over time. The design of the patient choice model was accepted, although all providers were discontent with the level of reimbursement. Providers felt that quality, timeliness of service and staff satisfaction had improved. Public and private providers differed in terms of patient-mix and developed different strategies to adjust to the reimbursement system. Private providers were more active in marketing and improving operation room efficiency. All providers intensified cooperation with referring physicians. Close attention was paid to following the rules set by the purchaser. Discussion and conclusions The sustained cost control was an effect of bundled payment. What this study shows is that both public and private providers adhere long-term to regulations by a public purchaser that also controls entrance to the market. The compensation was fixed and led to competition on quality, as predicted by theory.

scholarly journals Acceptability of remote prescribing and postal delivery services for contraceptive pills and treatment of uncomplicated Chlamydia trachomatis

2020 ◽  
pp. bmjsrh-2020-200687
Author(s):  
Tom Nadarzynski ◽  
Ynez Symonds ◽  
Robert Carroll ◽  
Jo Gibbs ◽  
Sally Kidsley ◽  
...  
Keyword(s):  
Online Survey ◽  
Home Delivery ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Contraceptive Pills ◽  
Remote Management ◽  
Delivery Services ◽  
The Cost ◽  
To Receive

ObjectivesThe digitalisation of sexual and reproductive health (SRH) services offers valuable opportunities to deliver contraceptive pills and chlamydia treatment by post. We aimed to examine the acceptability of remote prescribing and ‘medication-by-post’ in SRH.Study designAn online survey assessing attitudes towards remote management was distributed in three UK SRH clinics and via an integrated sexually transmitted infection (STI) postal self-sampling service. Logistic regressions were performed to identify potential correlates.ResultsThere were 1281 participants (74% female and 49% <25 years old). Some 8% of participants reported having received medication via post and 83% were willing to receive chlamydia treatment and contraceptive pills by post. Lower acceptability was observed among participants who were: >45 years old (OR 0.43 (95% CI 0.23–0.81)), screened for STIs less than once annually (OR 0.63 (0.42–0.93)), concerned about confidentiality (OR 0.21 (0.90–0.50)), concerned about absence during delivery (OR 0.09 (0.02–0.32)) or unwilling to provide blood pressure readings (OR 0.22 (0.04–0.97)). Higher acceptability was observed among participants who reported: previously receiving medication by post (OR 4.63 (1.44–14.8)), preference for home delivery over clinic collection (OR 24.1 (11.1–51.9)), preference for home STI testing (OR 10.3 (6.16–17.4)), ability to communicate with health advisors (OR 4.01 (1.03–15.6)) and willingness to: register their real name (OR 3.09 (1.43–10.6)), complete online health questionnaires (OR 3.09 (1.43–10.6)) and use generic contraceptive pills (OR 2.88 (1.21–6.83)).ConclusionsPostal treatment and entering information online to allow remote prescribing were acceptable methods for SRH services and should be considered alongside medication collection in pharmacies. These methods could be particularly useful for patients facing barriers in accessing SRH. The cost-effectiveness and implementation of these novel methods of service delivery should be further investigated.

Patient Safety/Quality Improvement Primer, Part III: The Role of Simulation

2021 ◽  
pp. 019459982110133
Author(s):  
Ellen S. Deutsch ◽  
Sonya Malekzadeh ◽  
Cecelia E. Schmalbach
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Control Charts ◽  
Neck Surgery ◽  
Resident Training ◽  
Statistical Process ◽  
Ensure Patient Safety ◽  
Statistical Process Control Charts ◽  
The Individual ◽  
The Impact

Simulation training has taken a prominent role in otolaryngology–head and neck surgery (OTO-HNS) as a means to ensure patient safety and quality improvement (PS/QI). While it is often equated to resident training, this tool has value in lifelong learning and extends beyond the individual otolaryngologists to include simulation-based learning for teams and health systems processes. Part III of this PS/QI primer provides an overview of simulation in medicine and specific applications within the field of OTO-HNS. The impact of simulation on PS/QI will be presented in an evidence-based fashion to include the use of run and statistical process control charts to assess the impact of simulation-guided initiatives. Last, steps in developing a simulation program focused on PS/QI will be outlined with future opportunities for OTO-HNS simulation.

scholarly journals 598 Patients’ Knowledge and Compliance with Government Guidelines for COVID 19

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Eskander ◽  
A Khallaf ◽  
S Zaki ◽  
M Elkawafi ◽  
R Makar
Keyword(s):  
Cognitive Impairment ◽  
Hospital Stay ◽  
Safe Distance ◽  
Essential Information ◽  
Social Distancing ◽  
Viral Spread ◽  
Information Leaflets ◽  
Number Of Patients ◽  
Male Patients ◽  
The Government

Abstract Background Since the outbreak of COVID-19; social distancing and recognized effective precautions were recommended by various governments to fight the viral spread. Our aim was to assess the inpatient knowledge and compliance with the government guidelines during their hospital stay and at their discharge in two different NHS hospitals. Method The study took place in two hospitals: Berrywood hospital, UK and Countess of Chester hospital, UK. We invited inpatients to answer an anonymized questionnaire which was designed to include the contemporary government guidelines. We excluded patients with cognitive impairment and those who were not expected to be discharged within days. Results Out of 209 patients, 50% were male. Patients showed good awareness of the main symptoms of the virus (90%). However, A significant number of patients were not fully aware of the recommended precautions to minimize viral spread (28%) and the method of spread (43%). About 41% did not know the recommended safe distance. Conclusions Despite being aware of the main symptoms of COVID-19, a significant number of patients lack essential information needed to minimize the spread of the virus in the society and hospital. We recommend providing patients with information leaflets and direct advice on admission and discharge.

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