Hepatitis C Screening Among Baby Boomers in a Community Hospital: A Quality Improvement Project

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S624-S625
Author(s):  
Tsujung Yang ◽  
Harshil Shah ◽  
Subash Ghimire ◽  
Marcelle Meseeha ◽  
John Pamula
Keyword(s):  
Quality Improvement ◽  
Hepatitis C ◽  
Baby Boomers ◽  
Community Hospital ◽  
Quality Improvement Project ◽  
Improvement Project

524 QUALITY IMPROVEMENT PROJECT: INCORPORATING COMPREHENSIVE GERIATRIC ASSESSMENT INTO COMMUNITY HOSPITAL CLERKING

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
A Oates
Keyword(s):  
Quality Improvement ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Community Hospital ◽  
Quality Improvement Project ◽  
Junior Doctors ◽  
Medical Team ◽  
Improvement Project ◽  
Efficient Detection ◽  
User Friendly

Abstract Elderly patients transferred to community hospitals often have complex medical, social, psychological, functional and pharmacological backgrounds that require careful assessment in order to create and deliver a high quality, patient-centred care plan. Unfortunately, time pressures experienced by staff in acute hospitals can make Comprehensive Geriatric Assessment (CGA) unfeasible for every patient. Moreover, junior members of the medical team may be unsure as to which aspects of a patient’s background and presentation constitute important elements of a CGA. Failure to recognise and document pertinent issues can lead to prolonged admissions, disjointed care and failed discharges. Admission to a community hospital presents a convenient ‘checkpoint’ in the patient’s hospital journey at which to undertake a CGA. Recording the relevant information in an effective clerking proforma when the patient is admitted ensures that this information is displayed clearly and in a way that is accessible to all members of the multidisciplinary team. The pre-existing clerking proforma at Amersham Community Hospital omitted several important elements of CGA (such as examination of feet and gait, assessment of mood, FRAX-UK score, creation of a problem list etc.) The aim of this quality improvement project was to create a thorough, yet user-friendly and time-efficient clerking proforma which incorporated the important components of CGA. Using BGS guidance and NICE quality standards, alongside suggestions from the medical team, the existing clerking proforma was adapted and reformed. After one month, feedback from the team was used to further improve the clerking proforma, ensuring that it was user-friendly, whilst meeting the standards set out by NICE and BGS. This was repeated as part of a second PDSA cycle. The improved clerking proforma enables junior doctors to undertake a thorough and holistic assessment, promoting efficient detection of issues and the delivery of a higher quality of care.

scholarly journals Sustainability and Effectiveness of a Quality Improvement Project to Improve Handoffs to Night Float Residents in an Internal Medicine Residency Program

2013 ◽  
Vol 5 (2) ◽  
pp. 303-308 ◽  
Author(s):  
Cemal Yazici ◽  
Hany Abdelmalak ◽  
Shanu Gupta ◽  
Anna Shmagel ◽  
Eman Albaddawi ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Quality Improvement ◽  
Community Hospital ◽  
Quality Improvement Project ◽  
Teaching Hospitals ◽  
Improvement Project ◽  
Night Float ◽  
Continuous Quality ◽  
Copy And Paste

Abstract Background Handoff is the process in which patient care is transitioned from one provider to another. In teaching hospitals, handoffs are frequent, and resident duty hour restrictions have increased the use of night float staff. To date, few studies have focused on long-term sustainability and effectiveness of a handoff quality improvement project. Objective The objective of our resident-driven quality improvement project was to evaluate the effectiveness and sustainability of a standardized template for handoff quality in a community hospital internal medicine program. Methods We used a multistep continuous quality improvement approach. Problems in the handoff process were identified through process mapping and anonymous needs assessment of the residents. A group of residents and faculty identified problems during biweekly discussions, created a standardized template, and adopted a new handoff process. We audited handoffs and surveyed residents at 3 and 9 months after implementation to assess effectiveness and sustainability. Results Before the intervention, only 40% of residents reported regular morning handoff. Using the standardized template, statistically significant, sustained improvements were seen in morning handoff frequency (59% preintervention, 90% at 3 months, 89% at 9 months), along with decreases in unreported overnight events (84% preintervention, 58% at 3 months, 50% at 9 months) and uncertainty about decisions because of poor handoffs (72% preintervention, 49% at 3 months, 37% at 9 months). Statistically significant decreases in missed content (69%–46%) and copy-and-paste behavior (78%–38%) at 3 months were not sustained. Conclusions We demonstrated sustained improvements in unreported events and uncertainty caused by poor handoffs. Initial improvements in missed content and copy-and-paste behavior that were not sustained suggest a need for ongoing reinforcement and monitoring of handoff quality.

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