Medication: ordering, transcription, administration, dispensing
A transitional care program that identifies frail elderly patients in the hospital and provides them with in-home support after discharge significantly reduces readmissions and emergency department visits.
A dementia care facility takes a person-centered approach to caring for residents who exhibit challenging, aggressive behavior, leading to less need for psychiatric hospitalizations and behavior-related medications.
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).
A large group practice operates an electronic health record system that is closely integrated with a personal health record system that gives patients (and authorized caregivers as proxy users) secure access to key components of their medical records and the ability to request appointments, renew prescriptions, and communicate with physicians electronically. The integrated system has generated high levels of satisfaction among patients and caregivers, who report increased involvement in their health care, and physicians who report being able to practice more efficiently.
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.
Trained dental practitioners in public health centers offered cessation assistance to low-income smokers as part of routine oral health visits in public health centers, leading to higher quit rates (especially among African-American smokers).
A combination of telephone-based nurse case management and automated symptom monitoring leads to significant reductions in the severity of pain and depression in cancer patients being treated in urban and rural oncology practices.
Health system pharmacists telephone recently discharged patients to complete medication reconciliation and provide medication-related education, leading to significant reductions in readmission rates and high levels of patient satisfaction.
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.