Hospital inpatient—hospital type
Providers use a computerized algorithm to classify inpatients as low, moderate, or high risk, and then prescribe anticoagulant (blood thinner) medication and/or mechanical devices as appropriate, leading to reduced incidence of venous thromboembolism.
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.
Norman Regional Health System uses an expanded role for pharmacists and nurses, ongoing monitoring and reporting, physician peer review, and financial incentives to improve performance on core measures, achieving adherence rates of 96 percent or more on 17 of 25 measures (above both State and national averages).
An inpatient psychiatric unit holds regular 30-minute “community” meetings focused on violence prevention, with all on-duty unit staff and patients attending; the meetings—which serve as a forum for expressing concerns, reviewing recent episodes, and brainstorming prevention strategies—reduced violent episodes by 85 percent.
Rather than being placed on a specialized meal plan, diabetic inpatients order meals from an unrestricted (patient-controlled) menu after receiving education from nutrition staff about how to make appropriate food selections, with additional education provided to those consistently making “incorrect” choices. The program increased patient satisfaction without having a negative impact on the ability to achieve consistent carbohydrate intake and blood glucose control.
Behavioral health clinicians led weekly sessions for parents and children that combined nutrition education with the teaching of practical strategies for managing the eating-related behaviors of children with cystic fibrosis, resulting in increases in caloric intake and weight in these children.
An electronic medical record–based system features “soft” and “hard” stop functions designed to ensure that clinicians perform medication reconciliation, leading to a rapid, significant, and sustained increase in adherence rates.
An adjustable “diet wheel” posted on each inpatient's doorway indicates which of 15 physician-ordered diets a patient should receive and prompts dietary staff to check that food trays match the ordered diet, leading to fewer diet-related miscommunications, mistakes, and interruptions.