Organizational culture change
A team-building program at the largest home care agency in the country integrated home health aides into the health care team and resulted in enhanced functional status for patients, including being better able to move independently from a bed to a wheelchair or chair and better able to walk without support.
The Marshfield Clinic is using electronic tools to facilitate care process redesign for patients with chronic illnesses, leading to enhanced quality and access to care, fewer hospitalizations and adverse events, and lower costs.
Hoag Memorial Hospital Presbyterian established a comprehensive end-of-life program that includes pain control and emotional support for patients unlikely to survive the next few days; a multidisciplinary palliative care that assists physicians who are treating dying patients; compassionate care for parents who lose children before or after birth; and support for hospital staff who work with dying patients.
Medical errors related to sleep deprivation may be reduced with a “strategic nap program,” resulting in improved performance-related factors (fatigue, sleepiness, energy) and improved task-related performance. Sleep deprivation is associated with increased medical errors, accidents, and provider mishaps.
Borrowing from other industries, a large hospital implemented principles of “flow management” to redesign the flow of operations in its surgical department, leading to enhanced quality of care, improved patient and provider satisfaction, and reductions in the frequency of delayed and canceled surgeries.
Teams of primary care providers, supported by information technology, address gaps in care for a defined panel of patients, leading to greater adherence to evidence-based practices and improved outcomes.
An evidence-based teamwork and communication program implemented in the labor and delivery unit of Madigan Army Medical Center led to an improved care process.
Virginia Mason Medical Center instituted a patient safety alert system that requires all staff who encounter a situation likely to harm a patient to make an immediate report and cease any activity that could cause further harm.
A multifaceted initiative known as the Good Catch Program dramatically increases the reporting of events that could potentially cause harm and spurs the development of action plans designed to address the common causes of potential errors.
In an approach to improving nursing home care known as the “Wellspring Program,” nursing homes join an alliance that allows participants to exchange performance experience and conduct interdepartmental group training for both frontline staff and leadership on quality improvement and culture change processes.