Care management processes
The Billings Clinic, an integrated health system in Billings, MT, addressed its rising rate of methicillin-resistant Staphylococcus aureus infections by making infection control a top institutional priority and by creating a comprehensive package that combines adoption and monitoring of strict infection control protocols, active surveillance, training and education, and the solicitation and implementation of employee ideas through an approach known as “positive deviance.” This term refers to the focus on uncommon strategies that lead to positive changes and results.
The Hasbro Children's Partial Hospital Program—a medical treatment day program for children ages 6 to 18 years old who have chronic medical illnesses and emotional issues—has demonstrated sustained positive outcomes of treatment on several measures, including quality of life, emotional symptoms, and family beliefs about illness.
The North Shore-Long Island Jewish Health System uses a standard, system-wide process to reduce central venous catheter–related infections, with a focus on adhering to evidence-based standards and protocols related to inserting, maintaining, and removing the catheters.
The Re-Engineered Discharge project at Boston Medical Center standardizes the hospital discharge process through use of 11 separate but mutually reinforcing steps that health care professionals follow from patient admission to postdischarge.
A comprehensive hospital program that includes standardized protocols and various support systems to encourage adherence to these protocols led to an 81-percent decline in serious narcotic oversedations.
Practice enhancement assistants improve patient care through practice audits and feedback, staff training, sharing of innovative ideas, and support in the development of systems and infrastructure.
The Comprehensive Unit-Based Safety Program (CUSP) improves patient safety awareness and quality of care by empowering staff to take charge, create partnerships between units, improve organizational culture, and obtain resources for unit efforts.
A county health department implemented disease management programs for uninsured and underinsured, low-income diabetes, asthma, and heart failure patients, leading to improved outcomes.
Researchers at the University of Michigan Medical School transformed the way services are delivered at their family practice clinics using an electronic clinical reminder and tracking system designed to support evidence-based quality improvement efforts.
Magee-Womens Hospital of the University of Pittsburgh Medical Center implemented the Patient and Family Centered Care Methodology and Practice, a low-technology, systems-based approach to inpatient care that focuses on providing care from the patient's and family's perspective; the program is associated with high rates of patient satisfaction, functional status, and adherence to evidence-based care protocols, along with low infection rates and length of stay.