scholarly journals Improving Respiratory Rate Accuracy in the Hospital: A Quality Improvement Initiative

2019 ◽  
Vol 14 (11) ◽  
pp. 673-677 ◽  
Author(s):  
Neil Keshvani ◽  
Kimberly Berger ◽  
Arjun Gupta ◽  
Sheila DePaola ◽  
Oanh Kieu Nguyen ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Respiratory Rate ◽  
Low Cost ◽  
Blood Pressure Measurement ◽  
Vital Signs ◽  
Safety Net ◽  
Adverse Outcomes ◽  
Quality Improvement Initiative ◽  
Safety Net Hospital ◽  
Automated Blood Pressure Measurement

Respiratory rate (RR) is a predictor of adverse outcomes. However, RRs are inaccurately measured in the hospital. We conducted a quality improvement (QI) initiative using plan-do-study-act methodology on one inpatient unit of a safety-net hospital to improve RR accuracy. We added time-keeping devices to vital sign carts and retrained patient-care assistants on a newly modified workflow that included concomitant RR measurement during automated blood pressure measurement. The median RR was 18 (interquartile range [IQR] 18-20) preintervention versus 14 (IQR 15-20) postintervention. RR accuracy, defined as ±2 breaths of gold-standard measurements, increased from 36% preintervention to 58% postintervention (P < .01). The median time for vital signs decreased from 2:36 minutes (IQR, 2:04-3:20) to 1:55 minutes (IQR, 1:40-2:22; P < .01). The intervention was associated with a 7.8% reduced incidence of tachypnea-specific systemic inflammatory response syndrome (SIRS = 2 points with RR > 20; 95% CI, –13.5% to –2.2%). Our interdisciplinary, low-cost, low-tech QI initiative improved the accuracy and efficiency of RR measurement.

scholarly journals Smoking Cessation at a Safety-Net Hospital: A Radiation Oncology Resident-Led Quality Improvement Initiative

2020 ◽  
Vol 5 (5) ◽  
pp. 1061-1065
Author(s):  
Stephen J. Ramey ◽  
Benjamin Silver ◽  
Dayssy A. Diaz ◽  
Akul Munjal ◽  
Shahil Mehta ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Quality Improvement ◽  
Radiation Oncology ◽  
Safety Net ◽  
Quality Improvement Initiative ◽  
Safety Net Hospital

ChemoPalRx: Development and implementation of a chemotherapy mobile provider order entry system in a safety net hospital.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18071-e18071
Author(s):  
Kin Wai (Tony) Hung ◽  
Natasha Banerjee
Keyword(s):  
Los Angeles ◽  
Mobile Application ◽  
Medical Center ◽  
Hospital Setting ◽  
Safety Net ◽  
Quality Improvement Initiative ◽  
Order Entry ◽  
Development Environment ◽  
Safety Net Hospital ◽  
Safety Parameters

e18071 Background: Computerized provider order entry (CPOE) systems have been shown to enhance the safety and efficiency of prescribing chemotherapy over the handwritten ordering process. However, many institutions lack the financial ability, technological capability, or operational flexibility to invest in and implement such a system. In particular, Olive View-UCLA Medical Center (OVMC), a Los Angeles County safety net hospital, is among these institutions with unique restrictions that preclude the use of chemotherapy CPOE and mandate handwritten orders. Methods: In an effort to bridge the gap for safe chemotherapy prescribing, we aimed to develop and implement an effective, scalable, and sustainable chemotherapy provider order entry solution that was operationally sensitive to institutions without a chemotherapy CPOE. The solution was designed as a mobile application using Xcode, the integrative development environment of Apple Inc., with the Swift programing language. Results: On September 5th, 2018, we launched a free, chemotherapy provider order entry solution on the worldwide Apple App Store – ChemoPalRx. Using ChemoPalRx, providers can search, customize, and print common chemotherapy regimens in prescription format. Along with a reference library of over 120 order set and 450 medications, ChemoPalRx is equipped with the functions to automate dosage calculation, suggest pre-medications and safety parameters, and trigger alerts for missing prescribing information. As a quality improvement initiative, we implemented ChemoPalRx at OVMC. Implementation stages include obtaining administrative buy-in, consulting with multidisciplinary staffs, investing $100 USD for a prescription printer, and encouraging providers to download ChemoPalRx on their own mobile devices. An ongoing prospective cohort study is being conducted to determine ChemoPalRx effectiveness in reducing errors compared to handwritten orders. Conclusions: ChemoPalRx is developed to enhance the safety and efficiency of chemotherapy prescribing. Implementation of this mobile application is feasible in the safety-net hospital setting and has the potential to transform oncology practices globally.

scholarly journals Identifying human body states by using a flexible integrated sensor

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Ying Jin ◽  
Guoning Chen ◽  
Kete Lao ◽  
Songhui Li ◽  
Yong Lu ◽  
...  
Keyword(s):  
Body Temperature ◽  
Respiratory Rate ◽  
Human Body ◽  
Low Cost ◽  
Vital Signs ◽  
Force Sensor ◽  
Diagnostic Methods ◽  
Body Parts ◽  
Integrated Sensor ◽  
Flexible Sensors

Abstract Flexible sensors are required to be lightweight, compatible with the skin, sufficiently sensitive, and easily integrated to extract various kinds of body vital signs during continuous healthcare monitoring in daily life. For this, a simple and low-cost flexible temperature and force sensor that uses only two carbon fiber beams as the sensing layer is reported in this work. This simple, flexible sensor can not only monitor skin temperature changes in real time but can also extract most pulse waves, including venous waves, from most parts of the human body. A pulse diagnostic glove containing three such flexible sensors was designed to simulate pulse diagnostic methods used in traditional Chinese medicine. Wearable equipment was also designed in which four flexible sensors were fixed onto different body parts (neck, chest, armpit, and fingertip) to simultaneously monitor body temperature, carotid pulse, fingertip artery pulse, and respiratory rate. Four important physiological indicators—body temperature (BT), blood pressure (BP), heart rate (HR), and respiratory rate (RR)—were extracted by the wearable equipment and analyzed to identify exercise, excited, tired, angry, and frightened body states.

Themes of Worry Among Psychiatric Inpatients That Persist Through Acute Hospitalization

2020 ◽  
pp. 107839032097376
Author(s):  
Pia Engstrom ◽  
Matthew Bolton ◽  
Cynthia Bautista ◽  
Todd Barnes
Keyword(s):  
Quality Improvement ◽  
Behavioral Health ◽  
Medical Center ◽  
Academic Medical Center ◽  
Psychiatric Inpatient ◽  
Safety Net ◽  
Health Staff ◽  
Improvement Project ◽  
Safety Net Hospital ◽  
Psychiatric Units

INTRODUCTION Problems that worry patients throughout hospitalization are complex and varied, but they fall within the scope of safe, effective, patient-centered care. To our knowledge, there is no evidence describing the problems that worry patients in inpatient psychiatric units. AIM The purpose of this quality improvement project was to describe common themes of worry experienced by individuals in psychiatric inpatient units in order to improve patient experience. METHOD This project took place at an urban, safety net hospital at an academic medical center in the northeastern United States between March and December 2019. All patients across five inpatient psychiatric units were offered the Combined Assessment of Psychiatric Environments (CAPE) survey as they approached the end of their stay. RESULTS A total of 1,800 patients took the survey. Of these patients, 36% (650/1,800) patients responded never/sometimes to “During my hospitalization, I found solutions to problems that worried me,” and 46% (297/650) patients provided a response to the follow-up question “What are the problems that worry you the most?” Common themes of worry for inpatient behavioral health patients include (a) life in the hospital, (b) self, and (c) outside life. CONCLUSION Each of these worry themes that emerged from this thematic analysis has implications for behavioral health staff who are preparing the psychiatric/behavioral health inpatient for discharge. These themes can also be used to focus on a variety of quality improvement initiatives to improve the patients experience while in an inpatient psychiatric/behavioral health unit.

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