Training, knowledge management
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 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.
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.
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.
A diabetes disease management program provides remote education and eye screenings for low-income individuals in rural South Carolina, leading to increased eye examination rates, reduced blood glucose and cholesterol levels, improved self-management behaviors, and high levels of patient satisfaction.
Use of a four-step, standardized protocol to determine the appropriate level of physical therapy in intensive care unit patients with acute respiratory failure led to earlier ambulation and lower length of stay.
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.
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.