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.
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Qual Manag Health Care · Oct 2011
Comparative StudyThe impact of a temporary medical ward closure on emergency department and hospital service delivery outcomes.
To describe the effect of a 3-week closure of a 28-bed medical ward on Emergency Department (ED) and hospital outcomes. ⋯ Temporarily closing a medical ward had a negative effect on some ED and hospital outcomes. When major refurbishments are required, alternative capacity measures need to be considered to minimize the impact on health service delivery and patient outcomes. Reducing elective surgery and opening replacement beds elsewhere in the hospital are possible solutions.
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Blood management is a concept that adopts a principle of improving patient outcome by integrating all available techniques to ensure safety, availability, and appropriate allocation of blood products. This constitutes a model of multidisciplinary care where the changes in culture are system directed on the basis of evidence-based medicine. ⋯ In this article, we have described our experience of creating a patient-centric, cost-effective, evidence-based, and multipronged program creation with scalable results. The use of data, education, process improvement, engagement, and accountability of caregivers have resulted in sustained results and helped in creating a comprehensive blood management program.