Joint Commission journal on quality and patient safety / Joint Commission Resources
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Operating rooms (ORs) contribute up to 30% of a hospital's waste, are very resource-intensive, and thus provide an opportunity for improvement. ⋯ Optimizing efficiency and decreasing waste generation can have a positive impact on the environment and can be accompanied by cost reduction. Because the field of sustainability in health care is young but burgeoning, increased research is needed to support evidence-based approaches.
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Jt Comm J Qual Patient Saf · Apr 2021
Interprofessional Training and Communication Practices Among Clinicians in the Postoperative ICU Handoff.
Operating room (OR)-to-ICU handoffs require coordinated communication between clinicians with different professional backgrounds. However, individual studies have not simultaneously evaluated handoff training and OR-to-ICU handoff practices among interprofessional clinicians that participate in these team-based handoffs. ⋯ Clinicians exhibit profession-based differences in OR-to-ICU handoff training, practices, and information needs. Education focused on interprofessional communication is a potential approach to facilitate improved OR-to-ICU handoff communication.
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Jt Comm J Qual Patient Saf · Feb 2021
Communication Tools to Support Advance Care Planning and Hospital Care During the COVID-19 Pandemic: A Design Process.
The COVID-19 pandemic has exposed the medical and social vulnerability of an unprecedented number of people. Consequently, there has never been a more important time for clinicians to engage patients in advance care planning (ACP) discussions about their goals, values, and preferences in the event of critical illness. An evidence-based communication tool-the Serious Illness Conversation Guide-was adapted to address COVID-related ACP challenges using a user-centered design process: convening relevant experts to propose initial guide adaptations; soliciting feedback from key clinical stakeholders from multiple disciplines and geographic regions; and iteratively testing language with patient actors. ⋯ To support use of these tools, publicly available implementation materials were also developed for clinicians to effectively engage high-risk patients and overcome challenges related to the changed communication context, including video demonstrations, telehealth communication tips, and step-by-step approaches to identifying high-risk patients and documenting conversation findings in the electronic health record. Well-designed communication tools and implementation strategies can equip clinicians to foster connection with patients and promote shared decision making. Although not an antidote to this crisis, such high-quality ACP may be one of the most powerful tools we have to prevent or ameliorate suffering due to COVID-19.
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Jt Comm J Qual Patient Saf · Aug 2020
A Comparison of Estimated Cost Savings from Potential Reductions in Hospital-Acquired Conditions to Levied Penalties Under the CMS Hospital-Acquired Condition Reduction Program.
The Hospital-Acquired Condition Reduction Program (HACRP) from the Centers for Medicare & Medicaid Services (CMS) reduces Medicare payments to hospitals with high rates of hospital-acquired conditions (HACs) by 1% each year. It is not known how the savings accruing to CMS from such penalties compare to savings resulting from a reduction in HACs driven by this program. This study compares the reported savings to CMS from financial penalties levied under the HACRP with savings resulting from potential reductions in HACs. ⋯ The penalties levied under the HACRP far exceed the potential cost savings accruing from a 1%-20% reduction in HACs that might result from hospitals' efforts in response to the program.
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Jt Comm J Qual Patient Saf · Aug 2020
Standardizing Point-of-Care Ultrasound Credentialing Across a Large Health Care System.
Point-of-care ultrasound (POCUS) is becoming prevalent in the daily practice of bedside clinicians. As large health care systems standardize practice patterns, an organized approach of credentialing physicians in POCUS is paramount for quality and patient safety. This study describes a systematic approach of credentialing a diverse group of community emergency physicians (EPs) across a large health care system. ⋯ A standardized POCUS credentialing initiative can be successfully implemented in large health care systems. Other specialties can use this initiative to implement POCUS into their daily practice.