Operating room/surgical suite
The California Public Employees' Retirement System generated significant cost savings by adopting reference pricing for hip and knee replacement procedures, causing enrollees to migrate to high-value facilities and encouraging high-price hospitals to lower their fees.
As mandated by State law, the California Department of Health Services requires acute care hospitals to maintain minimum nurse-to-patient staffing ratios and to develop various systems to ensure adequate nurse coverage and quality, leading to more reasonable workloads, lower patient mortality, and higher job satisfaction.
Nurses perform a baseline skin assessment on every newly admitted patient, leading to improvements in the identification and documentation of pressure ulcers on admission and to lower incidence of pressure ulcers.
Nurses at Aultman Hospital assess patients preoperatively for risk of pressure ulcers, carefully monitor and address risk factors during surgery, and complete a communication tool to inform postoperative surgical care; the program led to the elimination of Stage 3 and 4 pressure ulcers hospital-wide and very low incidence of Stage 1 and 2 pressure ulcers in surgical patients.
A checklist-guided process helps to ensure that surgical teams perform all appropriate care and necessary processes before and after surgery, leading to reductions in surgery-related mortality and complications.
A multifaceted program in a rural, community hospital reduced mean decision-to-incision time for emergency cesarean deliveries and increased adherence to guidelines that recommend that such deliveries begin in less than 30 minutes.
Clinicians follow algorithms that lay out a standardized process for ensuring that surgical inpatients and outpatients receive beta blockers as appropriate, leading to near universal compliance with recommended therapy.
A hospital uses a clinical microsystem improvement process to quality improvement, leading to significant enhancements in efficiency and reductions in care delays.
A hospital implemented new processes to increase the provision of recommended care for heart failure, acute myocardial infarction, pneumonia, and surgery patients, leading to significant improvements in quality and a 25 percent reduction in mortality.
The ProvenCare program uses guideline-based “bundles” of discrete clinical care elements to guide surgical care delivery, a fixed per-case rate for inpatient and followup care, and a “patient compact” and other educational activities to encourage patients to become more engaged in their care.