Community-based physicians send an electronic handoff note with pertinent information to Northwestern Memorial Hospital's emergency department personnel when referring patients for emergency care, leading to improvements in physician efficiency and satisfaction, care coordination, and the quality and timeliness of care.
A hospital emergency department triages moderately acute patients to a “midtrack” area where a nurse practitioner further evaluates them and provides treatment under a physician's supervision, leading to lower length of stay and fewer patient walkouts.
A dedicated team of nurses and clerks provides followup support for patients discharged from the emergency department, leading to better quality care, high satisfaction among patients and primary care providers, and fewer patient walkouts.
A multifaceted strategy that includes ongoing auditing of adherence to established protocols and daily performance feedback to staff improved hand hygiene in a busy, urban emergency department.
Emergency medical technicians screen rural-dwelling older adults for depression, medication-related problems, and falls. A case manager follows up with at-risk individuals to conduct an in-home assessment and provide needed referrals, leading to enhanced access to medical and social services and high levels of 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.
A joint case management program sponsored by two competing hospitals addresses the health and social needs of uninsured and underinsured individuals who have a history of using the emergency department for nonemergent issues. The program has led to enhanced access to appropriate care and to a significant decline in emergency department use and costs for nonemergent conditions.
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.