Organizational culture change

Innovations

Multidisciplinary Family Clinic Increases Access to Care for Inner-City Residents, Leading to Improved Outcomes and High Patient Satisfaction 07/11/08

To meet the needs of the surrounding community, 11th Street Family Health Services of Drexel University employs a multidisciplinary model of care, offering residents a wide variety of health and wellness services regardless of their ability to pay.

Baby-Friendly Hospital Initiative Leads to Sustained Increases in Breastfeeding Among Low-Income Whites and Minorities 07/11/08

Boston Medical Center adopted the Baby-Friendly ™ Hospital Initiative, a 10-step program that has led to sustained increases in the initiation of breastfeeding.

Priority-Based Hospital Order System Reduces Percentage of "STAT" Orders and Enhances Response Time--Especially for Clinical Results 05/02/08

Swedish Medical Center implemented a new service request system in which physicians and staff requesting services must prioritize the order into one of four categories. The four-category system applies to all hospital orders, including laboratory tests, requests for assistance from personnel, and facility repairs.

Formalized Communication Between Rural Home Health Agency Nurses and Physicians Leads to Increased Use of Home Health Services, Fewer Inpatient Admissions 04/28/08

A rural home health agency formalized oral and written communication processes with physicians, using specific communication tools to ensure that ongoing patient needs are being met; the program led to an increase in the use of home health services and a concomitant decline in inpatient admissions among home health patients.

Health Plan–Financed, Nurse-Led Care Coordination Improves Quality of Care and Reduces Costs for Latinos With Chronic Illnesses and Disabilities 04/21/08

A community-based primary care clinic uses nurses to provide culturally competent care coordination to Latino patients with chronic illnesses and disabilities, leading to greater provision of recommended care, lower health care costs, and enhanced self-management capabilities.

Voluntary Error Reporting Program Focusing on Systems Issues Increases Reporting and Contributes to Reduction in Liability Claims at Outpatient Clinic 04/03/08

A hospital outpatient clinic's confidential, voluntary error reporting system, which focuses on identifying faulty systems instead of individual mistakes, has substantially increased error reports and has been associated with a reduction in liability claims.

Integrating Behavioral Health and Nutrition Services Into Primary Care Clinics Significantly Reduces Mental Health-Related Hospitalizations for Staff-Model Health Maintenance Organization 03/28/08

A health maintenance organization integrated mental and behavioral health care and nutrition services with primary care delivery, leading to a more than 50-percent reduction in mental health–related hospitalizations.

Open Scheduling and Related Strategies Lead to Zero Wait Time for Appointments and Few No Shows at Family Practice 03/18/08

Community Physician Network Family Medicine Care–Saxony, a seven-physician family practice in the suburbs of Indianapolis, ensures maximum patient access through a variety of scheduling and related strategies, including same-day appointments, extended hours, direct telephone access to physicians after hours, and electronic visits.

Nursing Home "Neighborhoods" Emphasize Dignity and Independence, Leading to Improvements in Resident Health and Quality of Life and Lower Employee Turnover 03/17/08

Providence Mount St. Vincent (known as “The Mount”) developed and implemented a new model for nursing home care in which most residents live in a “neighborhood” of 20 to 23 residents; neighborhoods contain a cluster of private and semiprivate rooms and a large kitchen/dining area that serves as the central gathering spot for meals and activities. The Mount's approach also focuses on giving residents more independence, autonomy, and dignity than in a traditional nursing home, leading to a greater sense of community and a higher quality of life for residents, as well as a better work environment for employees.

Voluntary, Anonymous, Non-Punitive System Leads to a Significant Increase in Reporting of Errors in Ambulatory Pediatric Practice 03/13/08

A hospital's ambulatory pediatrics department developed a voluntary, anonymous, and nonpunitive medical error reporting system that includes a quick response team to review reports and enact interventions to prevent recurrences, leading to a significant increase in error reporting.

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