Medical record keeping
Guided by a health educator, medical assistants at an internal medicine practice are only modestly successful in encouraging diabetes patients to engage in goal setting, create personal action plans, and communicate home blood pressure and glucose measurements to physicians.
A hospital makes a telephone-based recording of discharge instructions available to non–English-speaking and low-literacy patients in their native language, leading to improved comprehension of discharge instructions and high levels of patient/family satisfaction.
Care staff use software-based protocols to screen older clients' medications and collaborate with pharmacists and physicians to reduce the risk of medication errors and adverse effects, leading to more appropriate medication use and fewer cases of duplicative medications.
Clinic providers compare patients' self-reported medication lists (generated through an easy-to-use automated system featuring a computer kiosk and simple touchscreen interface) to medications listed in the electronic medical record, allowing them to adhere more closely to established medication reconciliation practices and to identify and address more medication discrepancies, including potentially lethal ones.
A low-overhead medical home leverages information technology to produce a financially viable, high-quality primary care experience that proves to be attractive to both physicians and patients in an underserved rural area.
A comprehensive initiative to improve stroke care features protocols to facilitate faster evaluation and diagnosis, quick administration of tissue plasminogen activator when indicated, 24-hour access to a neurologist, enhanced discharge planning, improved documentation and data collection, continuous staff training, and community outreach, leading to more timely administration of appropriate diagnostic tests and treatment and to many more eligible patients receiving tissue plasminogen activator.
Process improvements in a hospital endoscopy department eliminated adverse incidents and near misses and led to anecdotal improvements in staff satisfaction.
Standardized, community-wide education, trained facilitators, and improved management processes lead to more advance care planning by patients, high levels of consistency between such plans and actual end-of-life decisions, and low care costs in the last 2 years of life.
A patient-centered medical home features smaller panel sizes and longer visits, pre- and postvisit outreach and care management, close communication and collaboration between physicians and other caregivers, upgrades to and better use of existing technology, and the elimination of productivity-based bonuses, leading to less staff burnout, fewer ambulatory sensitive admissions and emergency department visits, higher physician satisfaction, and improvements in access to and quality of care.
Clinicians on a surgical unit use a standardized communication process during daily rounds, leading to better nurse–physician communication and to higher nurse and patient satisfaction.