Implementation of interdisciplinary neurosurgery morning huddle: cost-effectiveness and increased patient satisfaction

2018 ◽  
Vol 128 (1) ◽  
pp. 258-261 ◽  
Author(s):  
Alvin Y. Chan ◽  
Sumeet Vadera
Keyword(s):  
Patient Satisfaction ◽  
Patient Care ◽  
Direct Cost ◽  
Patient Flow ◽  
Hospital Costs ◽  
Significant Difference ◽  
Before And After ◽  
Flow Through ◽  
Step Down ◽  
Strongly Agree

OBJECTIVEMorning discharge huddles consist of multiple members of the inpatient care team and are used to improve communication and patient care and to facilitate patient flow through the hospital. However, the effect of huddles on hospital costs and patient satisfaction has not been clearly elucidated. The authors investigated how a neurosurgeryled interdisciplinary daily morning huddle affected various costs of patient care and patient satisfaction.METHODSHuddles were conducted at 8:30 am Monday through Friday, and lasted approximately 30 minutes. The authors retrospectively looked at the average monthly costs per patient for a variety of variables (e.g., average ICU days, average step-down days, average direct cost, average laboratory costs, average pharmacy costs, hospital ratings, and hospital recommendations) and compared the results from before and after implementation of the huddle.RESULTSThere was a significant decrease in the number of ICU days, average laboratory costs, and average pharmacy costs per patient after the huddle was implemented; decreased laboratory and pharmacy costs produced $1,408,047.66 in savings. There was no significant difference found for the average direct cost. The percentage of patients who rated the hospital as a 9 or 10 significantly increased. The percentage who answered “strongly agree” when asked whether they would recommend the hospital also significantly increased.CONCLUSIONSA short morning huddle consisting of key members of the inpatient team may result in substantial hospital savings derived from reduced ICU days and laboratory and pharmacy costs as well as increased patient satisfaction.

110 Neurosurgery Morning Huddle Reduces Costs and Increases Patient Satisfaction

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 222-223
Author(s):  
Alvin Chan ◽  
Sumeet Vadera
Keyword(s):  
Patient Satisfaction ◽  
Patient Care ◽  
Direct Cost ◽  
Inpatient Care ◽  
Patient Flow ◽  
Hospital Costs ◽  
Team Members ◽  
Before And After ◽  
Flow Through ◽  
Strongly Agree

Abstract INTRODUCTION Morning discharge huddles, consisting of inpatient care team members, improve communication and patient care, facilitating patient flow through the hospital. However, how huddles affect hospital costs and patient satisfaction is unclear. The aim was to investigate how a neurosurgery-led interdisciplinary daily morning huddle affected different costs of patient care and patient satisfaction. METHODS Data was collected retrospectively for average ICU days, average stepdown days, average direct cost, average laboratory costs, average pharmacy costs, hospital ratings, hospital recommendations. Then the data before and after implantation of the huddle were compared. RESULTS >There was a significant decrease in the number of ICU days, average laboratory costs, and average pharmacy costs per patient after the huddle was implemented (all P < 0.05), resulting in an estimated $1408,047.66 in savings. The percentage of patients who rated our hospital as a “9 or 10” significantly increased (P < 0.05). The percentage who answered “strongly agree” when asked whether they would recommend the hospital also significantly increased (P < 0.05). There was no difference for average direct cost. CONCLUSION Implementation of a morning huddle may result in significant hospital savings while simultaneously increasing patient satisfaction.

scholarly journals Evaluation of Patient Satisfaction in Implant-supported Dentures retained with Ball and Bar Attachment through Verbal Rating System

2017 ◽  
Vol 6 (1) ◽  
pp. 1-5
Author(s):  
Naresh Singla ◽  
Thiruvalluvan Nagarajan
Keyword(s):  
Patient Satisfaction ◽  
Treatment Outcome ◽  
Interval Data ◽  
Rating System ◽  
Traumatic Experience ◽  
Edentulous Mandible ◽  
Significant Difference ◽  
Before And After ◽  
Masticatory System ◽  
Edentulous Patients

ABSTRACT Teeth loss is a traumatic experience. It disturbs the total integrity of the masticatory system. Its successful rehabilitation should address a range of biomechanical problems, tolerances, and perceptions. Implant-supported overdenture with two implants placed in the interforamina region is a predictable treatment option in edentulous mandible rather than conventional complete denture as it offers increased stability, comfort, and patient compliance. Success in complete dentures is still an unanswered question as various authors have differing opinion. Patients and prosthodontists often disagree on a successful denture experience. Criteria for quality standards in denture fabrication have been articulated; however patients and prosthodontists often disagree on a successful denture experience. This study was carried out to determine patient satisfaction with implant-supported overdentures and its impact on the treatment outcome. Thirty edentulous patients were randomly divided into two groups to receive implant-supported overdentures supported with two implants in the interforamina region of mandibular arch retained with either ball or ball attachment. Questionnaires were given to the patient before and after treatment at 3- and 6-month interval. Data collected were statistically analyzed. Results obtained from this study show that patients with implant-supported overdentures were more satisfied with the treatment outcome, and there was no significant difference in patient satisfaction between the two groups. How to cite this article Singla N, Nagarajan T. Evaluation of Patient Satisfaction in Implant-supported Dentures retained with Ball and Bar Attachment through Verbal Rating System. Int J Experiment Dent Sci 2017;6(1):1-5.

The Impact of Hospital Accreditation on the Patients Satisfaction of Haemodialysis Department Services

2018 ◽  
Vol 6 (8) ◽  
pp. 384
Author(s):  
Zuber Mujeeb Shaikh
Keyword(s):  
Patient Satisfaction ◽  
Health Care Quality ◽  
Tertiary Care ◽  
Care Quality ◽  
Care Hospital ◽  
Significant Difference ◽  
Before And After ◽  
The Impact ◽  
Survey Questionnaires

The quality of hospital Haemodialysis Department Service is one of the most relevant items of health care quality perceived by patients and by their families. Patient satisfaction is considered a way of measuring the quality of services provided. Objectives: To study the impact of National Accreditation Board for Hospitals & Healthcare Providers (NABH) Accreditation, India on Haemodialysis Department Service patient satisfaction. Methods: It is a quantitative, descriptive and inferential research based case study in which sample of a population was studied by structured satisfaction survey questionnaires (before and after the accreditation) in a private tertiary care hospital at Secunderabad, Telangana State, India to determine its characteristics, and it is then inferred that the population has the same or different characteristics. Significance of Research: It was observed initially before the accreditation that there was a lower patient satisfaction rate of the hospital Haemodialysis Department Services, which was affecting the study hospitals’ business. Hypothesis: Null Hypothesis (Ho) and Alternative Hypothesis (H1) were used and tested to compare the before and after impact of accreditation by applying to each question in the questionnaire. Study Design: The closed ended questionnaire was developed considering the Haemodialysis Department Services and incorporated the six dimensions of quality Safe, Timely, Effective, Efficient, Equitable, and Patient-centred (STEEP) and tested prior to implementing. Questionnaires were given to the patients' families for completion upon using the Haemodialysis Department Services two months before and two months after the accreditation. The data were collected in order to cover all three shifts of the Haemodialysis Department Services. Study Population: Simple random sampling method was selected, the researcher had involved all conscious patients (clinical conditions) from all age groups. Data Collections: Primary data were collected from the survey questionnaires. Secondary data were collected from relevant published journals, articles, research papers, academic literature and web portals. Conclusion: At the 5 % level of significance, the t-test results indicate that there is a significant difference in the responses between before (M=51.11, SD=21.89) and after accreditation (M=58.56, SD=17.28) with p-value <0.001. The mean satisfaction score has improved from before accreditation compared to after accreditation.

scholarly journals Care coordination in the Emergency Department: improving outcomes for older patients

2005 ◽  
Vol 29 (1) ◽  
pp. 43 ◽  
Author(s):  
Helen M Corbett ◽  
Wen K Lim ◽  
Sandra J Davis ◽  
Ann M Elkins
Keyword(s):  
Quality Of Life ◽  
Emergency Department ◽  
Patient Satisfaction ◽  
Care Coordination ◽  
Baseline Measure ◽  
Significant Difference ◽  
Before And After ◽  
Patient Health ◽  
Related Quality

This study aimed to evaluate the effectiveness of the care coordination (CC) program operating in the Emergency Department (ED) of The Northern Hospital in improving outcomes for older people and reducing ED admissions and re-presentations. This was achieved by comparing admissions from ED to wards pre and post commencement of the CC program, and measuring patient health-related quality of life pre and post CC intervention. Patient readmission rates and staff and patient satisfaction with the service were also investigated. Results indicate a statistically significant reduction in the proportion of patients admitted from the ED to a ward since the inception of the program, a significant difference in the mean-related quality of life scores before and after intervention by care coordination, and staff and patient satisfaction with the service. The readmission data collected in the present evaluation will serve as a baseline measure for future evaluations.

scholarly journals Time Spent on Dedicated Patient Care and Documentation Tasks Before and After the Introduction of a Structured and Standardized Electronic Health Record

2018 ◽  
Vol 09 (01) ◽  
pp. 046-053 ◽  
Author(s):  
Erik Joukes ◽  
Ameen Abu-Hanna ◽  
Ronald Cornet ◽  
Nicolette de Keizer
Keyword(s):  
Electronic Health Record ◽  
Patient Care ◽  
Time Distribution ◽  
Health Record ◽  
University Hospitals ◽  
Peer Communication ◽  
Significant Difference ◽  
Before And After ◽  
Electronic Health ◽  
Multilevel Linear Regression

Background Physicians spend around 35% of their time documenting patient data. They are concerned that adopting a structured and standardized electronic health record (EHR) will lead to more time documenting and less time for patient care, especially during consultations. Objective This study measures the effect of the introduction of a structured and standardized EHR on documentation time and time for dedicated patient care during outpatient consultations. Methods We measured physicians' time spent on four task categories during outpatient consultations: documentation, patient care, peer communication, and other activities. Physicians covered various specialties from two university hospitals that jointly implemented a structured and standardized EHR. Preimplementation, one hospital used a legacy-EHR, and one primarily paper-based records. The same physicians were observed 2 to 6 months before and 6 to 8 months after implementation.We analyzed consultation duration, and percentage of time spent on each task category. Differences in time distribution before and after implementation were tested using multilevel linear regression. Results We observed 24 physicians (162 hours, 439 consultations). We found no significant difference in consultation duration or number of consultations per hour. In the legacy-EHR center, we found the implementation associated with a significant decrease in time spent on dedicated patient care (−8.5%). In contrast, in the previously paper-based center, we found a significant increase in dedicated time spent on documentation (8.3%) and decrease in time on combined patient care and documentation (−4.6%). The effect on dedicated documentation time significantly differed between centers. Conclusion Implementation of a structured and standardized EHR was associated with 8.5% decrease in time for dedicated patient care during consultations in one center and 8.3% increase in dedicated documentation time in another center. These results are in line with physicians' concerns that the introduction of a structured and standardized EHR might lead to more documentation burden and less time for dedicated patient care.

Using Pocket PCs for Nurses' Shift Reports and Patient Care

2011 ◽  
pp. 313-329
Author(s):  
Karen Chang ◽  
Kyle D. Lutes ◽  
Melanie L. Braswell ◽  
Jacqueline K. Nielsen
Keyword(s):  
Pilot Study ◽  
Patient Care ◽  
Nursing Care ◽  
Patient Information ◽  
Easy Access ◽  
Access To Information ◽  
Significant Difference ◽  
Pocket Pc ◽  
Before And After ◽  
Nurses Perceptions

Nurses working in hospitals with paper-based systems often face the challenge of inefficiency in providing quality nursing care. Two areas of inefficiency are shiftto- shift communication among nurses, and access to information related to patient care. An integrated IT system, consisting of Pocket PCs and a desktop PC interfaced to a hospital’s mainframe system, was developed. The goal was to use mobile IT to give nurses easier access to patient information. This chapter describes the development of this system and reports the results of a pilot study: a comparison of time spent in taking and giving shift reports before and after the study and nurses’ perceptions of the mobile IT system. Results showed a significant difference in taking shift reports and no significant difference in giving shift reports. Nurses stated that quick and easy access to updated patient information in the Pocket PC was very helpful, especially during mainframe downtime.

scholarly journals Modeling the impact of COVID-19 on Retina Clinic Performance

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karan Sethi ◽  
Emily S. Levine ◽  
Shiyoung Roh ◽  
Jeffrey L. Marx ◽  
David J. Ramsey
Keyword(s):  
Patient Satisfaction ◽  
Patient Flow ◽  
Wait Time ◽  
High Volume ◽  
Clinical Encounter ◽  
Operational Performance ◽  
Discrete Events ◽  
Flow Through ◽  
The Impact ◽  
Total Visit

Abstract Background COVID-19, a highly contagious respiratory virus, presents unique challenges to ophthalmology practice as a high-volume, office-based specialty. In response to the COVID-19 pandemic, many operational changes were adopted in our ophthalmology clinic to enhance patient and provider safety while maintaining necessary clinical operations. The aim of this study was to evaluate how measures adopted during the pandemic period affected retina clinic performance and patient satisfaction, and to model future clinic flow to predict operational performance under conditions of increasing patient and provider volumes. Methods Clinic event timestamps and demographics were extracted from the electronic medical records of in-person retina encounters from March 15 to May 15, 2020 and compared with the same period in 2019 to assess patient flow through the clinical encounter. Patient satisfaction was evaluated by Press Ganey patient experience surveys obtained from randomly selected outpatient encounters. A discrete-events simulation was designed to model the clinic with COVID-era restrictions to assess operational performance under conditions of increasing patient and provider volumes. Results Retina clinic volume declined by 62 % during the COVID-19 health emergency. Average check-in-to-technician time declined 79 %, total visit length declined by 46 %, and time in the provider phase of care declined 53 %. Patient satisfaction regarding access nearly doubled during the COVID-period compared with the prior year (p < 0.0001), while satisfaction with overall care and safety remained high during both periods. A model incorporating COVID-related changes demonstrated that wait time before rooming reached levels similar to the pre-COVID era by 30 patients-per-provider in a 1-provider model and 25 patients-per-provider in a 2-provider model (p < 0.001). Capacity to maintain distancing between patients was exceeded only in the two 2-provider model above 25 patients-per-provider. Conclusions Clinic throughput was optimized in response to the COVID-19 health emergency. Modeling these clinic changes can help plan for eventual volume increases in the setting of limits imposed in the COVID-era.

Nurses' Perceptions of Using a Pocket PC for Shift Reports and Patient Care

2011 ◽  
pp. 799-810
Author(s):  
Karen Chang
Keyword(s):  
Pilot Study ◽  
Patient Care ◽  
Nursing Care ◽  
Patient Information ◽  
Easy Access ◽  
Access To Information ◽  
Significant Difference ◽  
Pocket Pc ◽  
Before And After ◽  
Nurses Perceptions

Nurses working in hospitals with paper-based systems often face the challenge of inefficiency in providing quality nursing care. Two areas of inefficiency are shift-to-shift communication among nurses and access to information related to patient care. An integrated IT system, consisting of Pocket PCs and a desktop PC interfaced to a hospital’s mainframe system, was developed. The goal was to use mobile IT to give nurses easier access to patient information. This paper describes the development of this system and reports the results of a pilot study: a comparison of time spent in taking and giving shift reports before and after the study and nurses’ perceptions of the mobile IT system. Results showed significant difference in taking shift reports and no significant difference in giving shift reports. Nurses stated that quick and easy access to updated patient information in the Pocket PC was very helpful, especially during mainframe downtime.

The Impact of Hospital Accreditation on the Patient Satisfaction of In-Patient Department Services

2018 ◽  
Vol 6 (8) ◽  
pp. 368
Author(s):  
Zuber Mujeeb Shaikh
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Care Delivery ◽  
Tertiary Care ◽  
Care Hospital ◽  
Significant Difference ◽  
Before And After ◽  
The Impact ◽  
Survey Questionnaires ◽  
Patient Department

Patient satisfaction is as important as other clinical health measures and is a chief means of assessing the strength of health care delivery. The current competitive environment has driven health care organisations to concentrate on patient satisfaction as a means to acquire and keep market share. If you don’t recognise what your strengths and weaknesses are, you can’t compete effectively. Objectives: To study the impact of National Accreditation Board for Hospitals & Healthcare Providers (NABH) Accreditation, India on the patient satisfaction of In-Patient Department Services. Methods: It is a quantitative, descriptive and inferential research based case study in which sample of a population was studied by structured satisfaction survey questionnaires (before and after the accreditation) in a private tertiary care hospital in Secunderabad, Telangana State, India to determine its characteristics, and it is then inferred that the population has the same or different characteristics. Significance of Research: It was observed initially before the accreditation that there was a lower satisfaction rate in in-patient department services, which was affecting the study hospitals’ business. Hypothesis: Null Hypothesis (H0) and Alternative Hypothesis (H1) were used and tested to compare the before and after impact of accreditation by applying to each question of the questionnaire. Study Design: The closed ended questionnaire was developed considering the in-patient services process by incorporating the six dimensions of quality Safe, Timely, Effective, Efficient, Equitable, and Patient-centred (STEEP) and tested prior to implementing. Questionnaires were given to the patients for completion upon discharge two months before and two months after the accreditation. Study Population: Simple random sampling method was selected, and the researcher had involved conscious patients of all age groups and gender. Data Collections: Primary data were collected from the survey questionnaires. Secondary data were collected from relevant published journals, articles, research papers, academic literature and web portals. Conclusion: It is very evident from this research that at the 5 % level of significance, the chi-square test indicates that there is a significant difference in the satisfaction with respect to the overall experience in the hospital between before the accreditation group and after accreditation group with p-value <0.001.The responses of satisfaction has improved from N=421 (Satisfied=245, Highly satisfied= 176) from N=241 (Satisfied = 124, Highly satisfied= 117).

scholarly journals P064: Effect of increased availability of pre-authorized radiological test ordering on CT scan utilization in the emergency department

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S100-S100
Author(s):  
K. Huszarik ◽  
K. Wood ◽  
M. Columbus ◽  
A. Dukelow
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Ct Scan ◽  
Patient Flow ◽  
Tertiary Care ◽  
Ct Scans ◽  
Significant Difference ◽  
Implementation Period ◽  
Flow Through ◽  
The Impact

Introduction: Computed tomography (CT) scan utilization has increased dramatically over the past 25 years. This has sparked concern for potential overuse leading to unnecessary radiation exposure for patients and increased health care costs, without any improvement in health outcomes. In order to improve workflow through the Emergency Department (ED) at our institution, an existing pre-authorization policy during weekday business hours allows emergency physicians to order CT scans directly without the need for approval from a radiologist. This policy was recently expanded on September 28, 2015 to allow pre-authorized CT scan orders during weekday evening hours. The objective of our study is to evaluate the impact of increased availability of pre-authorized CT scan ordering on CT scan utilization and patient flow through the ED at two tertiary care hospitals in London, Ontario. Methods: This is a retrospective review comparing monthly CT scan utilization rates in the pre-implementation period from September 28, 2014 to February 28, 2015, to rates in the post-implementation period from September 28, 2015 to February 28, 2016. Length of stay parameters including time from physician initial assessment to CT scan order, completion, report and patient discharge will also be compared between the groups. Results: Results will be presented at CAEP 2016. No significant difference is expected in the monthly number of CT scans ordered per registered ED visits between the pre- and post-implementation groups. We also anticipate a significantly shorter average length of stay for patients receiving a CT scan in the post-implementation group. Conclusion: We expect there will be no significant increase in CT scan utilization with increased availability of pre-authorized CT scan ordering in our EDs. We also anticipated decreased patient length of stay leading to improved patient flow through the ED. Findings may offer support for organizations to safely implement or increase availability of pre-authorized CT scan orders to help improve patient flow and decrease costs in the ED.

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