scholarly journals A quality improvement project to improve handover in the integrated assessment liaison team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S192-S193
Author(s):  
Jemma Hazan ◽  
Kirtana Vallabhaneni
Keyword(s):  
Quality Improvement ◽  
Information Sharing ◽  
Multidisciplinary Team ◽  
Integrated Assessment ◽  
Staff Turnover ◽  
Liaison Psychiatry ◽  
Improvement Project ◽  
Team Meetings ◽  
Team Satisfaction ◽  
Interdisciplinary Teaching

BackgroundEfficient handovers are integral to patient care. Challenges to handover for liaison psychiatry included high patient and staff turnover and varied handover approaches across the multidisciplinary team (MDT).MethodMDT focus groups and questionnaires explored change ideas. PDSA cycles were used to design a structured handover.We aimed to:Reduce handover time to 30 minutes.Improve communication using the SBAR tool.Implement a multidisciplinary teaching schedule in the time saved.Daily measures:Handover timingTeam Satisfaction (Individuals ranked handover as ‘good’, ‘average’, or ‘poor’)Weekly measures:Semi-qualitative questionnaires triangulated areas for improvement.Emails, posters and team meetings provided team feedback regarding QI progress.ResultA structured twice-daily handover format incorporating SBAR, allocated handover coordinators and documentation was created. Weekly MDT teaching sessions were developed.Over 4 weeks, ‘good’ handover ratings increased from 22% to 65%; ‘poor’ ratings decreased from 25% to 8%. Mean handover time decreased from 37 minutes to 28.5.The team viewed SBAR as a positive efficiency-promoting tool. MDT teaching improved team communication and confidence. Documentation is an area to improve.ConclusionStructured handover has promoted efficiency and effective information-sharing amongst the liaison psychiatry team.Interdisciplinary teaching can promote inclusive team feeling and encourage confidence across the MDT.

261 Using Technology to Improve Inpatient Surgical Lists

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Gowda ◽  
Z Chia ◽  
T Fonseka ◽  
K Smith ◽  
S Williams
Keyword(s):  
Quality Improvement ◽  
Patient Care ◽  
Junior Doctors ◽  
Research Projects ◽  
Point Scale ◽  
Improvement Project ◽  
Surgical Department ◽  
Team Meetings ◽  
And Training ◽  
Multi Disciplinary Team

Abstract Introduction Every day in our surgical department; prior to our quality improvement project, Junior Doctors spent on average 3.26 clinical hours maintaining 5 surgical inpatient lists of different specialities with accessibility of lists rated as “neutral” based on a 5-point scale from difficult to easy. Our hospital previously had lists stored locally on designated computers causing recurrent difficulties in accessing and editing these lists. Method We used surveys sent to clinicians to collect data. Cycle 1: Surgical Assessment Units list on Microsoft Teams Cycle 2: Addition of surgical specialities and wards lists onto Microsoft Teams. Cycle 3 (current): expand the use of Microsoft Teams to other specialities. Results Utilising technology led to a 25% reduction in time spent on maintaining inpatient lists, to 2.46 hours a day, and an improvement in the accessibility of lists to “easy”. Across a year, this saves over 220 hours clinician hours which can be used towards patient care and training. Furthermore, use of Microsoft Teams has improved communication and patient care, in the form of virtual regional Multi-Disciplinary Team meetings and research projects. Conclusions Microsoft Teams is currently free to all NHS organisations in England so there is potential for these efficiency savings to be replicated nationwide.

scholarly journals Enhancing palliative care occupancy and efficiency: a quality improvement project that uses a healthcare pathway for service integration and policy development

2021 ◽  
Vol 10 (4) ◽  
pp. e001391
Author(s):  
Sami Ayed Alshammary ◽  
Yacoub Abuzied ◽  
Savithiri Ratnapalan
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Multidisciplinary Team ◽  
Policy Development ◽  
Care Delivery ◽  
Tertiary Care ◽  
Business Case ◽  
Quality Improvement Project ◽  
Tertiary Care Centre ◽  
Improvement Project

This article described our experience in implementing a quality improvement project to overcome the bed overcapacity problem at a comprehensive cancer centre in a tertiary care centre. We formed a multidisciplinary team including a representative from patient and family support (six members), hospice care and home care services (four members), multidisciplinary team development (four members) and the national lead. The primary responsibility of the formulated team was implementing measures to optimise and manage patient flow. We used the plan–do–study–act cycle to engage all stakeholders from all service layers, test some interventions in simplified pilots and develop a more detailed plan and business case for further implementation and roll-out, which was used as a problem-solving approach in our project for refining a process or implementing changes. As a result, we observed a significant reduction in bed capacity from 35% in 2017 to 13.8% in 2018. While the original length of stay (LOS) was 28 days, the average LOS was 19 days in 2017 (including the time before and after the intervention), 10.8 days in 2018 (after the intervention was implemented), 10.1 days in 2019 and 16 days in 2020. The increase in 2020 parameters was caused by the COVID-19 pandemic, since many patients did not enrol in our new care model. Using a systematic care delivery approach by a multidisciplinary team improves significantly reduced bed occupancy and reduces LOS for palliative care patients.

scholarly journals Optimization of transmural care by implementation of an online expert panel to assess treatment strategy in patients suffering from colorectal cancer liver metastases: A prospective analysis

2020 ◽  
pp. 1357633X2095713
Author(s):  
Tessa Hellingman ◽  
Merijn E de Swart ◽  
Martijn R Meijerink ◽  
Wilhelmina H Schreurs ◽  
Barbara M Zonderhuis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Improvement ◽  
Liver Metastases ◽  
Multidisciplinary Team ◽  
Treatment Strategy ◽  
Expert Panel ◽  
Local Treatment ◽  
Colorectal Cancer Liver Metastases ◽  
Team Meetings ◽  
Multidisciplinary Team Meetings

Introduction Centralization of oncological care results in a growing demand for specialized consultations and referrals. Improved telemedicine solutions are needed to facilitate access to specialist care and select patients eligible for referral. The purpose of this quality improvement initiative was to optimize transmural care for patients suffering from colorectal cancer liver metastases through implementation of an online expert panel. Methods A digital communication platform was developed to share medical data, including high-quality diagnostic imaging of patients suffering from colorectal cancer liver metastases. Feasibility of local treatment strategies was assessed by a panel of liver specialists to select patients for referral. After implementation, an observational cohort study was conducted to evaluate quality improvement in transmural care using revised Standards for Quality Improvement Reporting Excellence guidelines. Results From September 2016–September 2018, eight hospitals were connected to the platform, covering a population of 3 m. In total, 123 cases were assessed, of which 54 (43.9%) were prevented from needless physical referral. Assessment of treatment strategy by an online expert panel significantly reduced the average lead time during multidisciplinary team meetings from 3.73 min to 2.12 min per patient ( p < 0.01). Conclusions Implementation of an online expert panel is an innovative, accessible and user-friendly way to provide cancer-specific expertise to regional hospitals. E-consultation of such panels may result in more efficient multidisciplinary team meetings and prevent fragile patients from needless referral. Sustainability of these panels however is subject to structural financial compensation, so a cost-effectiveness analysis is warranted.

The Structured Multidisciplinary work Evaluation Tool (SMET) as an occupational health service method for systematic work environment management. Evaluating the effect of SMET on the work environment, sick leave, staff turnover, patient satisfaction and patient safety. A protocol paper. (Preprint)

2021 ◽  
Author(s):  
Patrik Haraldsson ◽  
Axel Ros ◽  
Dirk Jonker ◽  
Kristina Areskoug Josefsson
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Patient Satisfaction ◽  
Work Environment ◽  
Quality Improvement Project ◽  
Health Staff ◽  
Staff Turnover ◽  
Improvement Project ◽  
Environment Management ◽  
Environment Quality

BACKGROUND The work environment is a complex phenomenon in which many factors interact. Scientific research indicates a relation between the work environment and employee health, staff turnover, patient satisfaction and patient safety. There is a great need for knowledge on how to conduct work environment interventions and practical work environment management to maximize benefits to the employees. OBJECTIVE The aim of this study is to explore how occupational health service support will affect the work environment, sick leave, staff turnover, patient satisfaction and patient safety during and following the Covid-19 pandemic in a medical ward setting. METHODS Mixed methods evaluation of a concurrent work environment quality improvement project at the Department of Internal Medicine and Geriatrics in a local hospital in the south of Sweden. RESULTS The mixed methods evaluation of the quality improvement project received funding from FUTURUM – Academy for Health and Care Jönköping County Council and Region Jönköping County and the study protocol was approved by the Swedish Ethical Review Authority. The work environment quality improvement project will continue between May 2020 and December 2021. CONCLUSIONS The study might contribute to increased knowledge of how work environment interventions and practical work environment management can impact the work environment and employee health, staff turnover, patient satisfaction and patient safety. There is a need for knowledge in this area for OHS management to provide increased benefits to employees, employers and society as a whole.

scholarly journals Piloting A Self-Reported Symptom Assessment Tool In Three Outpatient Oncology Palliative Care Clinics

2021 ◽  
Author(s):  
Mallikaben Bhanubhai Patel ◽  
Ashley Leak Bryant ◽  
Deborah K Mayer ◽  
Gary Winzelberg
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Quality Improvement ◽  
Symptom Assessment ◽  
Comprehensive Cancer Center ◽  
Staff Turnover ◽  
Improvement Project ◽  
Pdsa Cycle ◽  
Edmonton Symptom Assessment Scale

Abstract Background: Palliative care outpatient clinics should assess patients’ symptoms and quality of life prior to visits to guide care and response to treatments. We describe the implementation of a quality improvement initiative to increase symptom and quality of life screening in the outpatient oncology palliative care (OOPC) clinics of one National Cancer Institute-designated Comprehensive Cancer Center. Method: Our quality improvement project structure was based on the RE-AIM framework. Guided by the Plan-Do-Study-Act (PDSA) approach, we focused on assessing effective implementation of the Edmonton Symptom Assessment Scale (ESAS-r ) and one Quality of Life (QoL) question at each OOPC visit. At the end of each 3-week PDSA cycle, barriers and facilitators were recognized and addressed. The implementation’s effectiveness was determined by percentage of adherence using the following formula: [(number of ESAS-r +1 QoL forms completed per clinic/Number of OOPC completed patient appointments per clinic) x 100].Results: A total of 372 patient appointments were completed during the four PDSA cycles, with overall 59% adherence. The first PDSA cycle compliance was 69%, 58% in the second, 52% in the third, and 65% at the last PDSA cycle. The primary barrier was staff turnover.Conclusion: We were able to implement the ESAS-r + 1 QoL form in a complex clinical outpatient setting. We identified barriers for sustainability, including staff turnover. We addressed these barriers by providing robust instructions that outlined an overview of the clinic workflow and education for all staff members involved in the implementation process. Based on our experience, we suggest integrating this form into the electronic medical record to monitor patient outcomes in the outpatient oncology clinics.

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