Organizational culture change

Innovations

Comprehensive Program Focused on Culture Change, Education and Training, and Solicitation of Employee Ideas Significantly Reduces Incidence of Common Hospital-Acquired Infection 01/25/08

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.

Hospital-Based Day Treatment Program Provides Family-Centered Services to Children With Chronic Illnesses and Emotional Issues as an Alternative to Outpatient and Inpatient Care 01/25/08

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.

Patient- and Family-Centered Care Initiative Is Associated With High Patient Satisfaction and Positive Outcomes for Total Joint Replacement Patients 01/24/08

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.

Community Collaborative Improves Accuracy of Medication Lists for Elderly Patients in Outpatient Clinic Setting 01/24/08

Aurora Health Care spearheaded a community-wide medication reconciliation initiative, involving health care consumers, providers, pharmacists, and community stakeholders, to improve the accuracy of elderly patients' medication lists.

Patient- and Family-Activated Response Team Averts Potential Problems and Generates High Levels of Patient, Family, and Staff Satisfaction 01/23/08

The University of Pittsburgh Medical Center Shadyside implemented a Condition Help program that patients or their family members can activate via a telephone call when the patient's condition is deteriorating; the call immediately brings in a rapid response team to assess and manage the situation and provide treatment as needed.

Medical Response Team Saves Lives by Empowering Nurses to Recognize and Act on Early Warning Signs of Trouble 01/23/08

The medical response team at Baptist Memorial Hospital in Memphis, TN, responds to early warning signs that patients are in cardiac or respiratory distress and moves quickly to rescue them before medical emergencies develop; the team has reduced cardiac arrests by 26 percent.

Two-Track ED Process Flow Reduces the Number of Untreated Patients, Lengths of Stay, and Waiting Times 01/22/08

A new change mode helps emergency departments redesign patient flow processes so that a clinical team rapidly triages each patient, allowing for accelerated treatment of less sick patients and faster admission for those who are very ill.

Periodic, Nurse-Initiated Telephone Contact Provides Quality Followup Care to Infants With Lung Disease in Rural Areas 01/22/08

A nurse specialist maintains regular telephone contact with the primary caregivers and health care providers of premature infants with chronic lung disease who are discharged from the hospital.

Alerts, Standing Orders, and Care Pathways Boost Quality of Care for Pneumonia, Heart Attack, and Heart Failure 01/18/08

Reid Hospital created a computer-based system of alerts, standing orders, and care pathways to eliminate gaps in the care of patients with pneumonia, acute myocardial infarction, and heart failure, and to address surgical complication and infection prevention, leading to significant improvements in quality of care.

Palliative Care Nurses in Primary Care Clinics Reduce Hospital Admissions, Increase Use of Hospice and Home Care for Patients Nearing End of Life 01/15/08

A partnership between a hospice organization and an 11-location multispecialty group practice places palliative care nurses in primary care clinics to monitor dying patients' medical and social care needs, coordinate community services, and discuss end-of-life issues.

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