Immediate team debriefings after a cardiopulmonary resuscitation code event improve multiple aspects of the team's response to future codes and generate high levels of staff satisfaction.
A hospital uses a multidisciplinary team, standing orders and reminder systems, manual medication reconciliation, and system-wide quality improvement to significantly improve performance on core measures for heart attack, heart failure, pneumonia, and surgical care.
Using Toyota Production System principles, William Beaumont Hospitals implemented many small, rapid-cycle process improvement projects designed to improve workflow and patient flow; these projects have led to meaningful increases in nurse time spent with patients, shorter patient waiting times, faster radiology test turnaround, fewer missing and discarded medications, and greater staff engagement.
Pharmacy residents complete one 24-hour shift at a hospital approximately every 2 weeks, providing an array of services, including consultations and assistance with emergency situations; the program has led to low dosing error rates and to high levels of adherence to recommended guidelines for emergency stroke patients and has helped to produce more confident, capable pharmacists.
A rapid admission protocol streamlines the process between the decision to admit an emergency department patient and the arrival of the patient on the inpatient unit by reassigning care responsibilities and reducing process steps, leading to reduced emergency department boarding time.
A statewide program in North Carolina promotes early initiation of evidence-based heart attack treatment through collaboration with trained paramedics and partnerships between and within hospitals, leading to earlier initiation of therapy and faster transfer of patients.
A hospital-based telephone triage system allows patients to describe their symptoms to a nurse, who uses an algorithm to assess acuity and determine the best setting for treatment, leading to reductions in emergency department patient volumes, wait times, average length of stay, and walkouts.
In instances of institutional overcrowding, a protocol allows patients admitted to the hospital but boarded in the emergency department to be transferred to beds located in inpatient unit hallways, leading to expedited patient placement in a room, lower length of stay, and higher patient and staff satisfaction.
During peak census hours, phlebotomists are assigned to work in the emergency department to quickly collect blood specimens and label them for priority processing and analysis by laboratory staff, leading to faster turnaround times, lower rates of blood culture contamination, more than $400,000 in annual cost savings, and higher levels of patient satisfaction.
Inpatient capacity management strategies initially developed to accommodate the potential influx of patients during a natural or manmade disaster were adopted for everyday use by a capacity-constrained hospital, leading to earlier-in-the-day discharges, steady length of stay despite rising patient acuity, and a multimillion dollar financial return due to increased throughput, with no negative impact on quality or patient satisfaction.