Organizational culture change

Innovations

Improvement Projects Led by Unit-Based Teams of Nurse, Physician, and Quality Leaders Reduce Infections, Lower Costs, Improve Patient Satisfaction, and Nurse–Physician Communication 12/04/09

Unit-based teams of physicians, nurses, and quality leaders develop and implement unit-specific initiatives designed to improve quality and safety, leading to reductions in infections and pressure ulcers, increased adherence to medication reconciliation standards, more reporting of errors and near-misses, higher patient satisfaction, and better overall nurse/physician communication and teamwork.

Medical Home Features Small Panels, Long Visits, Outreach, and Caregiver Collaboration, Leading to Less Staff Burnout, Better Access and Quality, and Lower Utilization 11/18/09

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.

Full Disclosure of Medical Errors Reduces Malpractice Claims and Claim Costs for Health System 10/03/09

A multifaceted process for full disclosure of medical errors leads to a significant reduction in claims and claim costs for a health system.

Community- and Practice-Based Teams, Real-Time Information, and Financial Incentives Help Medical Homes Improve Care, Reduce Utilization and Costs 09/29/09

As part of a statewide, public-private initiative, a largely rural Vermont community supports its six medical patient-centered medical home practices with a multidisciplinary provider team, real-time electronic information, and insurer-funded financial incentives, leading to more appropriate care and services and lower utilization and growth in health care spending.

Intensive Care Units Participating in Hospital Collaborative Implement Multiple Improvement Strategies, Leading to Fewer Deaths and Lower Costs 09/29/09

As part of a hospital collaborative, intensive care units implemented a multifaceted safety program that reduced infections and hospital days, saved lives, and lowered health care costs.

Navy Medical Home Clinics, Staffed by Integrated Primary Care Teams and Supported by Web-Based Systems, Improve Screening Rates, Access to Care, and Patient-Provider Communication 08/17/09

Integrated primary care teams in medical home clinics, supported by a Web-based portal and personal health records, provide proactive, coordinated care, leading to higher screening rates, better access to care, and improved patient–provider communication.

Nursing Homes Create Home-Like, Resident-Focused Environment and Culture, Leading to Better Quality and Financial Performance, Higher Resident Satisfaction, and Lower Staff Turnover 07/29/09

Seven nursing homes adopted strategies to create a more homelike, resident-focused environment and culture, leading to better quality, higher resident satisfaction, lower staff turnover, and better financial performance.

Adding Nurse Practitioners and Creating a Multidisciplinary Care Team Reduce Length of Stay and Costs at Academic Medical Center 07/17/09

Adding a nurse practitioner and a multidisciplinary team reduced length of stay and costs at an academic medical center.

Creation of Unit-Based, Clinically Focused Nurse Leader Position Expedites Discharge, Improves Quality, and Reduces Turnover 07/14/09

A hospital created a new nursing position, the clinical resource nurse, to ensure continuity of care, facilitate care planning, coordinate with physicians, encourage adherence to evidence-based practices, and mentor less experienced nurses, leading to more timely discharges, fewer falls and pressure ulcers, lower nurse turnover, and higher patient, nurse, and physician satisfaction.

Comprehensive, Interdisciplinary Guidelines, Combined With Tools to Promote Adherence, Significantly Reduce Hospital-Acquired Pressure Ulcers 06/26/09

An interdisciplinary, comprehensive set of skin care guidelines, combined with support systems to encourage adherence, leads to a substantial reduction in facility-acquired pressure ulcers in hospitalized patients.

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