scholarly journals An inter-agency expert panel’s prioritisation of clinical quality improvement topics in a paramedic system

2021 ◽  
Vol 18 ◽  
Author(s):  
Anthony Campeau ◽  
Maud Huiskamp ◽  
Nicole Sykes ◽  
Susan Kriening ◽  
Scott Bourn ◽  
...  

Introduction Quality improvement (QI) programs have become common in paramedic systems, but they are often limited to individual agencies. Modern paramedicine involves many different agencies and inter-agency QI programs would better reflect their co-operative efforts. Similarly, inter-agency use of clinical outcome measurements can offer system level performance data. This study’s intent was to explore the feasibility of planning an inter-agency QI program that uses outcome measures. Methods This study used a modified Delphi methodology. A 49-member panel of inter-agency representatives was convened to identify and prioritise clinical outcome-based topics. Over a 3-month period, two online surveys were conducted followed by a 1-day face-to-face meeting. Results The study demonstrated very high participation rates. Results progressed from an initial wide range of 38 topics to a final consensus of two: infection/sepsis and patient safety/care pathways, complete with outcome measures. Conclusion Inter-agency quality improvement planning is an under investigated area, but this study demonstrates that it is feasible. Additionally, this planning can incorporate clinical outcome measures that inform system level discussions about quality. Other paramedic agencies may draw on the study’s processes when planning their own quality improvement programs.

2007 ◽  
Vol 28 (7) ◽  
pp. 791-798 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
Kanokporn Thongphubeth ◽  
Sirinaj Sirinvaravong ◽  
Danai Kitkangvan ◽  
Chananart Yuekyen ◽  
...  

Objective.To evaluate the efficacy of a multifaceted hospitalwide quality improvement program that featured an intervention to remind physicians to remove unnecessary urinary catheters.Methods.A hospitalwide preintervention-postintervention study was conducted over 2 years (July 1, 2004, through June 30, 2006). The intervention consisted of nurse-generated daily reminders that were used by an intervention team to remind physicians to remove unnecessary urinary catheters, beginning 3 days after insertion. Clinical, microbiological, pharmaceutical, and cost data were collected.Results.A total of 2,412 patients were enrolled in the study. No differences were found in the demographic and/or clinical characteristics of patients between the preintervention and postintervention periods. After the intervention, reductions were found in the rate of inappropriate urinary catheterization (mean rate, preintervention vs postintervention, 20.4% vs 11% [P = .04]), the rate of catheter-associated urinary tract infection (CA-UTI) (mean rate, 21.5 vs 5.2 infections per 1,000 catheter-days [P <.001]), the duration of urinary catheterization (mean, 11 vs 3 days [P < .001]), and the total length of hospitalization (mean, 16 vs 5 days [P < .001]). A linear relationship was seen between the monthly average duration of catheterization and the rate of CA-UTI (r = 0.89; P < .001). The intervention had the greatest impact on the rate of CA-UTI in the intensive care units (mean rate, preintervention vs postintervention, 23.4 vs 3.5 infections per 1,000 catheter-days [P = .01]). The monthly hospital costs for antibiotics to treat CA-UTI were reduced by 63% (mean, $3,739 vs $1,378 [P < .001]), and the hospitalization cost for each patient during the intervention was reduced by 58% (mean, $366 vs $154 [P < .001]).Conclusions.This study suggests that a multifaceted intervention to remind physicians to remove unnecessary urinary catheters can significantly reduced the duration of urinary catheterization and the CA-UTI rate in a hospital in a developing country.


2005 ◽  
Vol 4 (1) ◽  
Author(s):  
Stefanus Budy Widjaja Subali ◽  
Yie Ke Feliana

Quality has become an important competitive dimension for all organization. Recently, -the emphasis on quality has shifted from a source of strategic advantage to a compepetive necessity As the companies implement quality-improvement programs,one of those is. ISO 9000, a need arises to monitor and report on the progress of these programs. Managers r need to know about the quality costs and the component of quality costs. The component of quality costs include prevention, appraisal, internal failure and external failure costs. This article describes how the companies that were awarded ISO 9000 define the quality costs, what items to be included in the each component of quality costs and how the composition of each component of quality activity cost driver is.


Injury ◽  
2017 ◽  
Vol 48 (9) ◽  
pp. 1985-1993
Author(s):  
Lacey N. LaGrone ◽  
Diego A. Romaní Pozo ◽  
Juan F. Figueroa ◽  
Maria A. Artunduaga ◽  
Eduardo Huaman Egoavil ◽  
...  

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