Immediate team debriefings after a cardiopulmonary resuscitation code event improve multiple aspects of the team's response to future codes and generate high levels of staff satisfaction.
A hospital uses a multidisciplinary team, standing orders and reminder systems, manual medication reconciliation, and system-wide quality improvement to significantly improve performance on core measures for heart attack, heart failure, pneumonia, and surgical care.
Nurses and medical assistants use electronic tools and standardized workflows and processes before, during, and after the patient encounter to identify and address preventive, screening, and chronic care needs at every primary and specialty care visit, leading to greater adherence to recommended care processes and better blood pressure control in those with diabetes and hypertension.
Using Toyota Production System principles, William Beaumont Hospitals implemented many small, rapid-cycle process improvement projects designed to improve workflow and patient flow; these projects have led to meaningful increases in nurse time spent with patients, shorter patient waiting times, faster radiology test turnaround, fewer missing and discarded medications, and greater staff engagement.
Pharmacist coaches meet periodically with employees who have diabetes to assess health, monitor medications, and strengthen self-management skills, leading to better blood glucose and blood pressure control, greater adherence to recommended care processes, and lower overall health care costs.
An electronic medical record–based system features “soft” and “hard” stop functions designed to ensure that clinicians perform medication reconciliation, leading to a rapid, significant, and sustained increase in adherence rates.
An adjustable “diet wheel” posted on each inpatient's doorway indicates which of 15 physician-ordered diets a patient should receive and prompts dietary staff to check that food trays match the ordered diet, leading to fewer diet-related miscommunications, mistakes, and interruptions.
A rapid admission protocol streamlines the process between the decision to admit an emergency department patient and the arrival of the patient on the inpatient unit by reassigning care responsibilities and reducing process steps, leading to reduced emergency department boarding time.
A Medicare Advantage plan uses employed “extensivists” who perform traditional hospitalist functions for a smaller-than-average caseload of patients, and then continue to follow and care for these patients after discharge until their condition becomes stabilized, leading to low length of stay and fewer readmissions.
An automated reporting system communicates critical laboratory test results to physicians via pager, allowing the vast majority of results to be quickly communicated to and acknowledged by physicians, and virtually eliminating thousands of calls historically made by laboratory technologists to relay such information.