Joint Commission journal on quality and patient safety / Joint Commission Resources
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Mercy & Unity Hospitals of Minnesota implemented the ventilator bundle concept as part of an Institute for Healthcare Improvement (IHI) collaborative on improving care in the intensive care unit (ICU). ⋯ The decrease in VAP provides a promising example of the potential of intervention techniques and bundle implementation in a community hospital.
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Jt Comm J Qual Patient Saf · Apr 2007
Providing timely access to care: what is the right patient panel size?
Delays for appointments are prevalent, resulting in patient dissatisfaction, higher costs, and possible adverse clinical consequences. A "just-in-time" approach to patient scheduling, called advanced access, has been effective in reducing delays in multiple clinical settings. Offering most patients appointments on the same day requires achieving an appropriate balance between supply of and demand for appointments, but no methods have been previously proposed to determine what this balance should be. ⋯ The simple probability model can be used to improve the timeliness of care while considering the constraints on physicians' working hours.
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Waits and delays plague health care systems worldwide, and wait times for most specialists exceed those for primary care practices. In office-based practices, the provider office presence is not diluted by competing indispensable activities, and the demand for service is most often for a single type, or stream, of office-based appointment demand. In the more complex specialty practices, however, the demand streams for office visits and other services compete for provider time and dilute the supply of office visits. ⋯ Specialists support various, distinct demand streams that require demand/supply balance to achieve optimal system performance. If demand/supply balance exists within any stream, waits can be minimized, and the practice can choose time frames within which to balance workload.
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Jt Comm J Qual Patient Saf · Nov 2006
ReviewRedesigning health systems for quality: Lessons from emerging practices.
It has been five years since the Institute of Medicine (IOM) report, Crossing the Quality Chasm, proposed systemwide changes to transform our health care system. What progress has been made? What lessons have been learned? How should we move forward? ⋯ Successful system redesign requires coordinating and managing a complex set of changes across multiple levels rather than isolated projects.
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In the case of an 11-year-old boy with stable physiological parameters, the deterioration in condition was so sudden that only a rapid response system could ensure any chance of survival.