A nurse-guided, patient-centered approach combines ongoing peer support from a trained elder with home visits and followup phone calls from an advanced practice nurse for unpartnered, elderly patients who are discharged from the hospital after a heart attack or bypass surgery. The program is intended to encourage compliance with medication regimens and recommended lifestyle changes, with the goal of reducing hospital readmissions. A 247-patient randomized controlled trial found that the program improved adherence to medical recommendations and reduced hospitalizations due to cardiac-related complications but failed to reduce overall hospital readmissions.
Sentara Healthcare launched a program designed to create a strong culture of safety. The initiative includes an assessment of the existing safety culture, establishment of goals related to improved safety, the development of specific strategies to identify and correct safety problems, and the use of ongoing processes and systems to monitor progress and encourage continued improvement.
The creation of a medical emergency team program at the University of Pittsburgh Medical Center Presbyterian Hospital has significantly reduced the number of cardiopulmonary arrests and unexpected mortality.
A comprehensive medical team training program supported by crew resource management principles adopted from the aviation industry was developed and implemented in 79 Veterans Affairs Medical Centers, resulting in a measurable improvement in communication and patient care in 10 participating facilities that have at least a year's experience with the program.
The implementation of daily multidisciplinary patient rounds and a bundle of best practice guidelines reduced the use of ventilators for patients in the intensive care unit.
The combination of multidisciplinary, physician-led rounds and a set of evidence-based best practices (known as “bundles”) decreased nosocomial infection rates and costs in the intensive care unit.
Three hospitals within the University of Pittsburgh Medical Center Health System developed and implemented a standing orders program to provide pneumococcal vaccinations to appropriate patients in the hospital.
A game to educate health care workers in intensive care units about appropriate hand hygiene increased awareness of and adherence to hand hygiene protocols at a major academic medical center, leading to increased compliance with appropriate hand hygiene protocols from 37 to 53 percent.
A multifaceted program called Practicing Safety helps pediatricians become more effective in screening for potential child abuse and providing support and other services to prevent such abuse.
Community clinics use the Toyota “Lean” rapid cycle process improvement system to enhance efficiency and productivity, leading to a significant increase in revenues.