Quality management in health care
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Qual Manag Health Care · Apr 2011
Handoff communication: using failure modes and effects analysis to improve the transition in care process.
Handoff communication is a high-risk process that causes errors that lead to ineffective care delivery and patient safety breaches. A failure modes and effects analysis was utilized to proactively evaluate handoff through a risk priority scoring process that focused the improvement plan on communication from shift to shift and between units. The electronic medical record was utilized to standardize the handoff tool in SBAR (situation, background, assessment, and recommendation) format for both nurses and patient care technicians. ⋯ Changes to the handoff process were piloted on the telemetry unit then launched on remaining nursing units over time. Data targeting patient satisfaction and nurse-sensitive outcomes were collected pre and post-implementation with notable gains. Sustaining change in light of care-related variables is a challenge leadership, quality, and patient care teams are committed to achieving.
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Concerns about both the cost and quality of health care have led to a growing interest in, and call for "pay for performance." Increasingly, as well, patient satisfaction is being viewed as an essential aspect of care that should be considered in judging performance. At the same time, there are concerns about the validity of patient satisfaction as a relevant quality measure. ⋯ As such, the 2 measures are evaluating different aspects of care that need not--but typically do--coincide. We also suggest that where patient satisfaction is utilized in pay for performance calculations, it constitutes a very small portion of the total money at stake and is unlikely to lead to "gaming" through acquiescence to patients' requests for unnecessary treatments.
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Qual Manag Health Care · Jan 2011
A standardized pain management protocol improves timeliness of analgesia among emergency department patients with renal colic.
Kidney stones are a common, and extremely painful, cause of emergency department (ED) visits. Pain management is a critical component of high-quality patient care. A pilot study at our institution found that only 69% of ED patients with renal colic had evidence of clinically significant analgesia. ⋯ Implementation of a standardized pain management protocol among ED patients with renal colic resulted in a marked improvement in quality of care as evidenced by a 49% reduction in time to effective analgesia.
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Qual Manag Health Care · Jan 2011
A healthcare Lean Six Sigma System for postanesthesia care unit workflow improvement.
The aim of this article is to propose a new model called Healthcare Lean Six Sigma System that integrates Lean and Six Sigma methodologies to improve workflow in a postanesthesia care unit. ⋯ The full benefits of the new model will be realized when applied at both strategic and operational levels. For further research, we will examine how the proposed model is used in different real-world case studies.