Quality management in health care
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Qual Manag Health Care · Jan 2012
Randomized Controlled TrialReduction in hypoglycemic events in critically ill patients on continuous insulin following implementation of a treatment guideline.
Hyperglycemia is common in critically ill children and appears to be associated with poor outcomes. However, the incidence of hypoglycemia while attempting glycemic control using an insulin infusion may be as high as 25% and hypoglycemia may be an independent risk factor for mortality in critically ill children. ⋯ Implementation of a guideline to manage critical illness hyperglycemia in nondiabetic, critically ill pediatric patients resulted in a reduction in hypoglycemic events and a sustained increase in the days between such events.
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Qual Manag Health Care · Jan 2012
Using quality improvement methods at the system level to improve hospital emergency department treatment times.
Because the reason for long waits in emergency departments often arises outside the emergency department, addressing the problem of long waits requires a system or hospital-wide response. This, in turn, requires mobilization of management and clinicians from across a hospital and often from outside the hospital. This article describes how the causes of long waits were presented to obtain "buy-in" from a wide variety of stakeholders and how strategies to address causes were linked in a large multihospital system.