INTERDISCIPLINARY POINT OF CARE SIMULATION: A QUALITY IMPROVEMENT INITIATIVE TO ENHANCE STAFF CONFIDENCE AND SKILL

Abstract Most public health sectors in many countries were heavily burdened both financially and operationally as a result of the pandemic's new changes. Organizations have been pushed to develop innovative solutions to balance expenses and revenues through value-for-money initiatives as a result of erratic economic conditions.Purchasing and supply distribution to the point of care account for approximately 30–40% of the hospital's operating budget. The demand-based ordering system, also known as the par system, has inherently resulted in increased waste due to obvious estimations for the quantity of items. Increased waste and costs have become a widespread issue in the healthcare supply chain, which was identified as a priority for improvement.The project is aimed to reduce the costs by 50% by implementing the Kanban system in the unit storeroom of medical units within three months. The IHI Model of Improvement was undertaken to go through the implementation of the project. Several quality improvement tools were used to test different ideas of change and measurement of improvements were also made.Following the adoption of the modified Kanban System, the costs of consumable item supply decreased by 69% from 16,000 QAR to 5,000 QAR. The percentage of wastes has reduced significantly to 0% while limiting the percentage of out stocking to a median of 1%.Kanban as a lean method, reduces wastes by controlling the flow of consumables within a supply chain. Eliminating or reducing waste is a cornerstone of lean management. The project’s new evidence demonstrated significant and sustainable cost saving strategy by reducing waste and pre-quantifying items based on their usage and flow. The Kanban system ultimately improved nurses’ productivity, streamlined the unit’s stock supply, promoted value improvement, and helped increased end-user satisfaction.

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Reduction of Wastes and Costs Through the Modified Kanban System in Unit Storerooms of HGH: A Value-for-Money Quality Improvement Initiative

10.21203/rs.3.rs-1070569/v1 ◽

2021 ◽

Author(s):

KENNETH JUN LOGRONO ◽

BELAL SALEM ZU'BI

Keyword(s):

Supply Chain ◽

Quality Improvement ◽

User Satisfaction ◽

Point Of Care ◽

Quality Improvement Initiative ◽

Value For Money ◽

End User ◽

A Value ◽

Kanban System ◽

New Evidence

Abstract Most public health sectors in many countries were heavily burdened both financially and operationally as a result of the pandemic's new changes. Organizations have been pushed to develop innovative solutions to balance expenses and revenues through value-for-money initiatives as a result of erratic economic conditions. Purchasing and supply distribution to the point of care account for approximately 30–40% of the hospital's operating budget. The demand-based ordering system, also known as the par system, has inherently resulted in increased waste due to obvious estimations for the quantity of items. Increased waste and costs have become a widespread issue in the healthcare supply chain, which was identified as a priority for improvement. The project is aimed to reduce the costs by 50% by implementing the Kanban system in the unit storeroom of medical units within three months. The IHI Model of Improvement was undertaken to go through the implementation of the project. Several quality improvement tools were used to test different ideas of change and measurement of improvements were also made. Following the adoption of the modified Kanban System, the costs of consumable item supply decreased by 69% from 16,000 QAR to 5,000 QAR. The percentage of wastes has reduced significantly to 0% while limiting the percentage of out stocking to a median of 1%. Kanban as a lean method, reduces wastes by controlling the flow of consumables within a supply chain. Eliminating or reducing waste is a cornerstone of lean management. The project’s new evidence demonstrated significant and sustainable cost saving strategy by reducing waste and pre-quantifying items based on their usage and flow. The Kanban system ultimately improved nurses’ productivity, streamlined the unit’s stock supply, promoted value improvement, and helped increased end-user satisfaction.

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Implementing pregnancy screening prior to chemotherapy: A quality improvement initiative.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e18274 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e18274-e18274

Author(s):

Brittany Kayla Rogers ◽

Andrew Kolarich ◽

Merry Jennifer Markham

Keyword(s):

Quality Improvement ◽

Radiation Oncology ◽

Medical Oncology ◽

Point Of Care ◽

Surgical Oncology ◽

Tubal Ligation ◽

Quality Improvement Initiative ◽

Screening Rate ◽

Childbearing Potential ◽

Treatment Start

e18274 Background: ASCO’s QOPI sets standards for excellence in oncologic care. One standard is screening appropriate female patients for pregnancy prior to chemotherapy. No guidelines exist regarding screening protocols or timing. Prior data collection at our institution from 2012-2014 revealed that 35% of women of childbearing potential were screened prior to chemo, with medical oncology performing only 7% of screening. Less than half (48%) of those tests were ordered within 14 days prior to treatment start. Methods: A quality improvement (QI) intervention was implemented at UF Health outpatient infusion center on 8/15/16 based on the above data. A checkbox was added to the pre-chemo checklist used by infusion nurses. For eligible patients (women ages 18-55 without prior tubal ligation or hysterectomy), a point of care pregnancy test, included in standing orders, was recommended. We reviewed data for women who received outpatient chemo during 9/16-11/16 to determine rates of pregnancy screening (PS) after intervention. Results: 49 women, ages 18-55, of childbearing potential were identified and presented for 174 chemo cycles from 9/1/16 to 11/30/16. Of these, 15 (30.6%) received PS before chemo. Fifty pregnancy tests were ordered during this period; all were negative. Of the 50 tests, 42 (84%) were ordered by medical oncology, 3 (6%) by a surgical oncology, 3 (6%) by radiation oncology, and 1 (2%) by emergency medicine. Of the PS tests ordered by medical oncology, 64.2% were within 14 days of chemotherapy. Conclusions: In three months of QI intervention, PS prior to chemo increased from 7% to 30.6%. Screening was 13% in women older than 45, but higher in women age 25-34 (60%) and 35-44 (67%). Although the screening rate improved, it remains below our goal of 80%. Possible explanations for low rates are inclusion of postmenopausal women and those older than 50. Excluding these patients could reduce screening burden while identifying appropriate patients. [Table: see text]

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Use of point of care quality improvement methodology to improve newborn care, immediately after birth, at a tertiary care teaching hospital, in a resource constraint setting

BMJ Open Quality ◽

10.1136/bmjoq-2021-001445 ◽

2021 ◽

Vol 10 (Suppl 1) ◽

pp. e001445

Author(s):

Ravi Sachan ◽

Himsweta Srivastava ◽

Sushil Srivastava ◽

Sanjeeta Behera ◽

Promilla Agrawal ◽

...

Keyword(s):

Quality Improvement ◽

Teaching Hospital ◽

Point Of Care ◽

Tertiary Care ◽

Care Quality ◽

Quality Improvement Initiative ◽

Evidence Based ◽

Observation Area ◽

Breast Feed ◽

Successful Change

After birth, separation of mothers and newborn is a common practice in many hospitals in our country. After delivery, we take the normal newborn to the radiant warmer in the resuscitation area for routine care. This was the existing process of care at our hospital. The frontline delivery team undertook quality improvement initiative to understand and document factors creating challenges in delivering evidence-based practice of providing immediate skin-to-skin care (SSC), delayed cord clamp (DCC) and early breast feeding within 1 hour of birth. Some of the barriers identified were early newborn mother separation and late transfer of mother from delivery room to the observation area. Additionally, there was a challenge of high delivery load with variation in understanding and provision of SSC and drying on mother’s abdomen. These made sustenance of improved care practices difficult. Using the Plan-Do-Study-Act (PDSA) approach some successful change ideas tested were pre-delivery counselling, avoiding separation of mother and newborn at birth by providing SSC and continuing it in the post-delivery observation area and getting family member’s help in first breast feed. The delivery team adapted these successful change ideas by multiple iterations, group discussions and feedback. This resulted in improved and sustained compliance of pre-delivery counselling, SSC, DCC and initiating breast feed within 1 hour, from minimal compliance to a median compliance of 51%, 56%, 59% and 61%, respectively, over 36 months period. We undertook this quality improvement initiative at Delhi (India) at a tertiary care teaching hospital. The implementation of WHO recommended evidence-based practices benefitted more than 10 000 mother–newborn dyads annually over 2 years, using Point of Care Quality Improvement method. Implementation of evidence-based practice is possible in challenging situations using PDSA approach. The resultant contextualised processes are convenient and have better success at sustainability.

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