scholarly journals The impact of an innovative curriculum to introduce patient safety and quality improvement content

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kelly T. Gleason ◽  
Brigit VanGraafeiland ◽  
Yvonne Commodore-Mensah ◽  
Jo Walrath ◽  
Susan Immelt ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Innovative Curriculum ◽  
The Impact

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 Are educational or quality improvement interventions delivered at the induction or orientation of junior doctors effective?

2014 ◽  
Vol 3 (5) ◽  
pp. 14
Author(s):  
Luke McMenamin ◽  
Natalie Blencowe ◽  
Damian Roland
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Health Care Professionals ◽  
Group Intervention ◽  
Junior Doctors ◽  
Or Education ◽  
Implementation Quality ◽  
Objective Outcomes ◽  
The Uk ◽  
The Impact

There has been significant media scrutiny in the UK of the period when doctors change over into new jobs, with a number of reports highlighting increased mortality. Starting work in a new hospital confers a potential patient safety risk and induction programmes are therefore designed to familiarise doctors with local policies. Little is known about using this time as an opportunity to improve patient outcomes or change practice. The aim was to review interventions which may aid hospital trusts during induction and a strategy to direct future educational and implementation research. A review of Medline, Embase, Cochrane, Scopus and ERIC databases with key terms (induction or orientation, junior doctor or intern, intervention or education or implementation, quality improvement or patient safety or outcome) extracted relevant abstracts. Articles of relevance were analysed and coded as to the type of patient or doctor group, intervention and outcome. Only seven studies were found which generally reported perceived benefits rather than objective outcomes. A significant opportunity to improve evidence based practice and patient safety is being missed by not thoroughly evaluating the impact of induction and orientation of health care professionals.

scholarly journals The impact of accreditation on healthcare quality improvement: a qualitative case study

2016 ◽  
Vol 30 (8) ◽  
pp. 1242-1258 ◽  
Author(s):  
Sara Melo
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Large Scale ◽  
Positive Impact ◽  
Healthcare Quality ◽  
Healthcare Services ◽  
Content Type ◽  
Healthcare Quality Improvement ◽  
The Impact

Purpose Research on accreditation has mostly focused on assessing its impact using large scale quantitative studies, yet little is known on how quality is improved in practice through an accreditation process. Using a case study of an acute teaching hospital in Portugal, the purpose of this paper is to explore the dynamics through which accreditation can lead to an improvement in the quality of healthcare services provided. Design/methodology/approach Data for the case study was collected through 46 in-depth semi-structured interviews with 49 clinical and non-clinical members of staff. Data were analyzed using a framework thematic analysis. Findings Interviewees felt that hospital accreditation contributed to the improvement of healthcare quality in general, and more specifically to patient safety, as it fostered staff reflection, a higher standardization of practices, and a greater focus on quality improvement. However, findings also suggest that the positive impact of accreditation resulted from the approach the hospital adopted in its implementation as well as the fact that several of the procedures and practices required by accreditation were already in place at the hospital, albeit often in an informal way. Research limitations/implications The study was conducted in only one hospital. The design of an accreditation implementation plan tailored to the hospital’s context can significantly contribute to positive outcomes in terms of quality and patient safety improvements. Originality/value This study provides a better understanding of how accreditation can contribute to healthcare quality improvement. It offers important lessons on the factors and processes that potentiate quality improvements through accreditation.

Building capacity and capability in patient safety, innovation and service improvement: an English case study

2011 ◽  
Vol 16 (3) ◽  
pp. 243-251 ◽  
Author(s):  
Tony Butterworth ◽  
Kate Jones ◽  
Simone Jordan
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Quality Improvement ◽  
Health Care Services ◽  
Health Care Systems ◽  
Future Research ◽  
Health Improvement ◽  
Service Improvement ◽  
Research Activity ◽  
The Impact

It is clear that for at least the next decade, funding for many health systems across the world will be challenged by serious uncertainties in country economies. In facing these challenges nurses have to respond positively to innovations in the delivery of care, increases in productivity and the eradication of errors that result in harm to patients. In committing to supporting this necessary change, quality improvement and innovation programmes are now available from national, not-for-profit organisations, such as the Health Foundation (UK) and the Institute for Health Improvement (USA) and the National Health Service Institute for Innovation an Improvement (UK) that specifically address these important issues. Although the targets for these programmes are often health care systems at the macro level, the role of nurses in understanding and delivering innovative practices at a more micro level is vital. Evidence is now available that demonstrates the outputs of such programmes and the impact from making consequent changes to nursing practice. Education programmes and research activity by nurses can also take advantage of this activity and begin to ask questions that focus on those subject areas, as well as adding positive value to people who use health care services. This paper briefly describes background developments during the last decade, offers one example of innovation programme content, describes the results of introducing patient safety, quality improvement and innovation into education curricula and suggests potential areas for future research by clinical academic nurse researchers.

scholarly journals Patient safety and quality improvement: Ethical principles for a regulatory approach to bias in healthcare machine learning

2020 ◽  
Vol 27 (12) ◽  
pp. 2024-2027 ◽  
Author(s):  
Melissa D McCradden ◽  
Shalmali Joshi ◽  
James A Anderson ◽  
Mjaye Mazwi ◽  
Anna Goldenberg ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Patient Safety ◽  
Quality Improvement ◽  
Performance Metrics ◽  
Ethical Principles ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Regulatory Approach ◽  
The Impact

Abstract Accumulating evidence demonstrates the impact of bias that reflects social inequality on the performance of machine learning (ML) models in health care. Given their intended placement within healthcare decision making more broadly, ML tools require attention to adequately quantify the impact of bias and reduce its potential to exacerbate inequalities. We suggest that taking a patient safety and quality improvement approach to bias can support the quantification of bias-related effects on ML. Drawing from the ethical principles underpinning these approaches, we argue that patient safety and quality improvement lenses support the quantification of relevant performance metrics, in order to minimize harm while promoting accountability, justice, and transparency. We identify specific methods for operationalizing these principles with the goal of attending to bias to support better decision making in light of controllable and uncontrollable factors.

scholarly journals 2510

2017 ◽  
Vol 1 (S1) ◽  
pp. 20-21
Author(s):  
Amber L. Allen ◽  
Christopher Barnes ◽  
Kevin S. Hanson ◽  
David Nelson ◽  
Randy Harmatz ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Open Source ◽  
Web Sites ◽  
Hospital System ◽  
Improvement Project ◽  
Clinical Quality ◽  
Development Framework ◽  
The Creation ◽  
The Impact

OBJECTIVES/SPECIFIC AIMS: To create a searchable public registry of all Quality Improvement (QI) projects. To incentivize the medical professionals at UF Health to initiate quality improvement projects by reducing startup burden and providing a path to publishing results. To reduce the review effort performed by the internal review board on projects that are quality improvement Versus research. To foster publication of completed quality improvement projects. To assist the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety in managing quality improvement across the hospital system. METHODS/STUDY POPULATION: This project used a variant of the spiral software development model and principles from the ADDIE instructional design process for the creation of a registry that is web based. To understand the current registration process and management of quality projects in the UF Health system a needs assessment was performed with the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety to gather project requirements. Biweekly meetings were held between the Quality Improvement office and the Clinical and Translational Science – Informatics and Technology teams during the entire project. Our primary goal was to collect just enough information to answer the basic questions of who is doing which QI project, what department are they from, what are the most basic details about the type of project and who is involved. We also wanted to create incentive in the user group to try to find an existing project to join or to commit the details of their proposed new project to a data registry for others to find to reduce the amount of duplicate QI projects. We created a series of design templates for further customization and feature discovery. We then proceed with the development of the registry using a Python web development framework called Django, which is a technology that powers Pinterest and the Washington Post Web sites. The application is broken down into 2 main components (i) data input, where information is collected from clinical staff, Nurses, Pharmacists, Residents, and Doctors on what quality improvement projects they intend to complete and (ii) project registry, where completed or “registered” projects can be viewed and searched publicly. The registry consists of a quality investigator profile that lists contact information, expertise, and areas of interest. A dashboard allows for the creation and review of quality improvement projects. A search function enables certain quality project details to be publicly accessible to encourage collaboration. We developed the Registry Matching Algorithm which is based on the Jaccard similarity coefficient that uses quality project features to find similar quality projects. The algorithm allows for quality investigators to find existing or previous quality improvement projects to encourage collaboration and to reduce repeat projects. We also developed the QIPR Approver Algorithm that guides the investigator through a series of questions that allows an appropriate quality project to get approved to start without the need for human intervention. RESULTS/ANTICIPATED RESULTS: A product of this project is an open source software package that is freely available on GitHub for distribution to other health systems under the Apache 2.0 open source license. Adoption of the Quality Improvement Project Registry and promotion of it to the intended audience are important factors for the success of this registry. Thanks goes to the UW-Madison and their QI/Program Evaluation Self-Certification Tool (https://uwmadison.co1.qualtrics.com/SE/?SID=SV_3lVeNuKe8FhKc73) used as example and inspiration for this project. DISCUSSION/SIGNIFICANCE OF IMPACT: This registry was created to help understand the impact of improved management of quality projects in a hospital system. The ultimate result will be to reduce time to approve quality improvement projects, increase collaboration across the UF Health Hospital system, reduce redundancy of quality improvement projects and translate more projects into publications.

scholarly journals Post-discharge care following acute kidney injury: quality improvement in primary care

2020 ◽  
Vol 9 (4) ◽  
pp. e000891
Author(s):  
Susan J Howard ◽  
Rebecca Elvey ◽  
Julius Ohrnberger ◽  
Alex J Turner ◽  
Laura Anselmi ◽  
...  
Keyword(s):  
Primary Care ◽  
Acute Kidney Injury ◽  
Patient Safety ◽  
Quality Improvement ◽  
Health Outcomes ◽  
Kidney Injury ◽  
Audit And Feedback ◽  
Improvement Project ◽  
General Practices ◽  
The Impact

BackgroundOver the past decade, targeting acute kidney injury (AKI) has become a priority to improve patient safety and health outcomes. Illness complicated by AKI is common and is associated with adverse outcomes including high rates of unplanned hospital readmission. Through national patient safety directives, NHS England has mandated the implementation of an AKI clinical decision support system in hospitals. In order to improve care following AKI, hospitals have also been incentivised to improve discharge summaries and general practices are recommended to establish registers of people who have had an episode of illness complicated by AKI. However, to date, there is limited evidence surrounding the development and impact of interventions following AKI.DesignWe conducted a quality improvement project in primary care aiming to improve the management of patients following an episode of hospital care complicated by AKI. All 31 general practices within a single NHS Clinical Commissioning Group were incentivised by a locally commissioned service to engage in audit and feedback, education training and to develop an action plan at each practice to improve management of AKI.ResultsAKI coding in general practice increased from 28% of cases in 2015/2016 to 50% in 2017/2018. Coding of AKI was associated with significant improvements in downstream patient management in terms of conducting a medication review within 1 month of hospital discharge, monitoring kidney function within 3 months and providing written information about AKI to patients. However, there was no effect on unplanned hospitalisation and mortality.ConclusionThe findings suggest that the quality improvement intervention successfully engaged a primary care workforce in AKI-related care, but that a higher intensity intervention is likely to be required to improve health outcomes. Development of a real-time audit tool is necessary to better understand and minimise the impact of the high mortality rate following AKI.

Demonstrating the value of postgraduate fellowships for physicians in quality improvement and patient safety

2019 ◽  
Vol 29 (8) ◽  
pp. 645-654 ◽  
Author(s):  
Jennifer S Myers ◽  
Meghan Brooks Lane-Fall ◽  
Angela Ross Perfetti ◽  
Kate Humphrey ◽  
Luke Sato ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Goal Attainment ◽  
Clinical Care ◽  
Individual Interviews ◽  
Academic Medical ◽  
Fellowship Programme ◽  
Institutional Impact ◽  
Training Programmes ◽  
The Impact

BackgroundAcademic fellowships in quality improvement (QI) and patient safety (PS) have emerged as one strategy to fill a need for physicians who possess this expertise. The authors aimed to characterise the impact of two such programmes on the graduates and their value to the institutions in which they are housed.MethodsIn 2018, a qualitative study of two US QIPS postgraduate fellowship programmes was conducted. Graduates’ demographics and titles were collected from programme files,while perspectives of the graduates and their institutional mentors were collected through individual interviews and analysed using thematic analysis.ResultsTwenty-eight out of 31 graduates (90%) and 16 out of 17 (94%) mentors participated in the study across both institutions. At a median of 3 years (IQR 2–4) postgraduation, QIPS fellowship programme graduates’ effort distribution was: 50% clinical care (IQR 30–61.8), 48% QIPS administration (IQR 20–60), 28% QIPS research (IQR 17.5–50) and 15% education (7.1–30.4). 68% of graduates were hired in the health system where they trained. Graduates described learning the requisite hard and soft skills to succeed in QIPS roles. Mentors described the impact of the programme on patient outcomes and increasing the acceptability of the field within academic medicine culture.ConclusionGraduates from two QIPS fellowship programmes and their mentors perceive programmatic benefits related to individual career goal attainment and institutional impact. The results and conceptual framework presented here may be useful to other academic medical centres seeking to develop fellowships for advanced physician training programmes in QIPS.

scholarly journals MP25: The quality improvement and patient safety curriculum for emergency medicine residents at the University of Toronto: results from the first cohort

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S49-S50
Author(s):  
A. H Y. Cheng ◽  
S. Vaillancourt ◽  
M. McGowan ◽  
A. Verma ◽  
A. McDonald ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Patient Safety ◽  
Quality Improvement ◽  
Practical Skills ◽  
Absolute Increase ◽  
Educational Methods ◽  
University Of Toronto ◽  
Curriculum Changes ◽  
The University ◽  
The Impact

Introduction: The 2015 CanMEDS framework requires all residency programs to increase their focus on Quality Improvement and Patient Safety (QIPS). We created a longitudinal (4-year), modular QIPS curriculum for FRCP emergency medicine residents at the University of Toronto (UT) using multiple educational methods. The curriculum addresses three levels of QIPS training: knowledge, practical skills at the microsystem level, and practical skills at the organization level. Aim Statement: To increase the UT FRCP emergency medicine residents absolute score on the QIKAT-R (Quality Improvement Knowledge Application Tool Revised) by 10% after the completion of the QIPS curriculum. Methods: Physicians and other healthcare professionals with QI expertise collaboratively designed and taught the curriculum. We used the QIKAT-R as the outcome measure to evaluate QI knowledge and its applicability. The QIKAT-R is a validated measure that assesses an individuals ability to decipher a QI issue within the healthcare context, and propose a change initiative to address it. The first cohort of residents completed the QIKAT-R prior to the first session in 2014 (pre) and at the completion of the curriculum in 2017 (post). Each response was anonymized and scored by physicians with QI expertise. The QIKAT-R scores and comments from course evaluations are used to make yearly iterative curriculum changes. Results: The QIPS curriculum was implemented in September 2014. All nine residents in the first cohort completed the curriculum; they demonstrated an absolute increase of 19.6% (5.3/27) in the mean QIKAT-R score (13.0 +/− 3.3 pre vs. 18.3 +/− 3.8 post, p=0.001). Of the pre-test responses, 26% were categorized as poor, 70% as good, and 4% as excellent, whereas of the post-test 11% of responses were categorized as poor, 37% as good, and 52% as excellent (p<0.001). Two iterative curriculum changes were made at the end of each academic year since 2014: (1) The time between sessions were decreased to promote knowledge retention, and (2) different PGY3 QI practical project options were provided to suit residents individual QI interests. QIKAT-R scores and resident feedback were used to evaluate the impact of the curriculum changes. Conclusion: A collaborative, modular, longitudinal QIPS curriculum for UT FRCP emergency medicine residents that met CanMEDS requirements was created using multiple educational methods. The first resident cohort that completed the curriculum demonstrated an absolute increase in QI knowledge and its applicability (as measured by the QIKAT-R) by 19.6%. Two PDSA cycles were completed to improve the curriculum with the change ideas generated from resident feedback. Ongoing challenges include limited staff availability to teach and supervise resident QI projects. Future directions include incentivising staff participation and providing mentorship for residents with a career interest in QI beyond what is offered by the curriculum.

Enhancing generational change in patient safety attitudes through peer leadership

2016 ◽  
Vol 2 (3) ◽  
pp. 87-89 ◽  
Author(s):  
Ramesh L Walpola ◽  
Romano A Fois ◽  
Andrew J McLachlan ◽  
Timothy F Chen
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Peer Leaders ◽  
Safety Education ◽  
Generational Change ◽  
Safety Attitudes ◽  
Open Disclosure ◽  
Patient Safety Education ◽  
The Impact ◽  
Peer Leader

BackgroundDespite peer-led teaching demonstrating benefits in patient safety education, few studies have evaluated these programmes from the perspective of peer leaders.ObjectiveTo evaluate the impact of peer leader participation in a patient safety education workshop in improving their patient safety attitudes.Participants34 final year pharmacy student peer leaders.MethodsAn interactive peer-led patient safety workshop was delivered to 249 first year pharmacy students. Peer leaders' attitudes were assessed 2 months prior to and immediately after peer leader training; and immediately after and 1 month following the workshop. Using a validated patient safety attitudinal survey, repeated measures analysis of variance and pairwise comparisons were used to evaluate changes in four key attitudes over time: being quality improvement focused; internalising errors; questioning more senior healthcare professionals' behaviours; and attitudes towards the open disclosure of errors.ResultsCompared to baseline, peer leaders' attitudes towards open disclosure significantly improved immediately following the workshop (p=0.010) and were sustained after 1 month (p=0.028). Attitudes towards being quality improvement focused also improved significantly 1 month after the workshop (p=0.003).ConclusionsParticipation in a peer-led patient safety education programme benefits both students and peer leaders, enabling further mastery of concepts and enhancing generational change in patient safety practices.

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