Policies and procedures
Researchers at the University of Michigan Medical School transformed the way services are delivered at their family practice clinics using an electronic clinical reminder and tracking system designed to support evidence-based quality improvement efforts.
A presurgical safety briefing held by the operating room team before every procedure has virtually eliminated wrong-site surgeries, enhanced operating room staff satisfaction and perceptions of safety, and reduced nurse turnover.
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.
The North Shore-Long Island Jewish Health System uses a standard, system-wide process to reduce central venous catheter–related infections, with a focus on adhering to evidence-based standards and protocols related to inserting, maintaining, and removing the catheters.
The Re-Engineered Discharge project at Boston Medical Center standardizes the hospital discharge process through use of 11 separate but mutually reinforcing steps that health care professionals follow from patient admission to postdischarge.
A comprehensive hospital program that includes standardized protocols and various support systems to encourage adherence to these protocols led to an 81-percent decline in serious narcotic oversedations.
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.
Mayo Clinic researchers developed a medication reconciliation intervention program for outpatient primary care settings that improved the accuracy of medication lists in the practice's electronic medical records.
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.
To improve emergency department patient satisfaction and throughput, St. Francis Medical Center in Los Angeles implemented a comprehensive bundle of interrelated strategies.