The Joint Commission journal on quality improvement
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Jt Comm J Qual Improv · Mar 1994
Achieving sustained quantifiable results in an interdepartmental quality improvement project.
In the mid-1980s Beth Israel Hospital Boston began a participatory management approach that encourages all members of the organization to improve productivity, efficiency, and quality through interdepartmental and intradepartmental project teams. The CT [computerized tomography]-Nursing-Transport Team, the hospital's first quality improvement project Team, grew out of an organizational challenge to solve an interdepartmental problem. The goal of the project was to have inpatients arrive on time for their scheduled CT-Scan appointment. Prior to the project's inception, over 50% of all inpatients scheduled for CT-Scans arrived more than 20 minutes late. ⋯ The success of the project reinforced many well-known quality improvement conditions for success. These include (1) choosing a project that is "high pain, high drain," (2) having a committed project leader who can keep the team effort going, (3) using data to lead the team to the root cause of a problem by pointing out where, when, and why the problems occur, (4) utilizing flow-charting and shadowing to understand the process from a fresh perspective, and (5) holding well-facilitated meetings with a defined purpose, ground rules, and meaningful agenda.
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Jt Comm J Qual Improv · Aug 1993
Case ReportsDecision making with pregnant patients: a policy born of experience.
One hospital has developed an institutional policy to guide decision making between physicians and pregnant patients. Read the policy and a description of how it was developed by the ethics committee at the George Washington University Hospital.
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Jt Comm J Qual Improv · Aug 1993
Use of practice parameters as standards of care and in health care reform: a view from the American Medical Association.
Guidelines that are standards of care could limit the creative initiatives to find ways of caring for patients which do not conform to traditional medical practice but result in good outcomes. Physicians would likely feel hemmed in by guidelines that constitute an express legal standard of care and would be afraid to deviate from them except under the auspices of carefully controlled research protocols.