scholarly journals Case Study B Rail Improvement Project

2019 ◽  
pp. 403-407
Keyword(s):  
Improvement Project

scholarly journals Quality improvement primer part 2: executing a quality improvement project in the emergency department

CJEM ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 532-538 ◽  
Author(s):  
Lucas B. Chartier ◽  
Antonia S. Stang ◽  
Samuel Vaillancourt ◽  
Amy H. Y. Cheng
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Emergency Medicine ◽  
Quality Improvement ◽  
Improvement Project ◽  
Emergency Department Setting ◽  
Pdsa Cycle ◽  
Time To Antibiotics ◽  
Final Article

ABSTRACTThe topics of quality improvement (QI) and patient safety have become important themes in health care in recent years, particularly in the emergency department setting, which is a frequent point of contact with the health care system for patients. In the first of three articles in this series meant as a QI primer for emergency medicine clinicians, we introduced the strategic planning required to develop an effective QI project using a fictional case study as an example. In this second article we continue with our example of improving time to antibiotics for patients with sepsis, and introduce the Model for Improvement. We will review what makes a good aim statement, the various categories of measures that can be tracked during a QI project, and the relative merits and challenges of potential change concepts and ideas. We will also present the Model for Improvement’s rapid-cycle change methodology, the Plan-Do-Study-Act (PDSA) cycle. The final article in this series will focus on the evaluation and sustainability of QI projects.

Vacuum preloading consolidation of reclaimed land: a case study

1998 ◽  
Vol 35 (5) ◽  
pp. 740-749 ◽  
Author(s):  
J Q Shang ◽  
M Tang ◽  
Z Miao
Keyword(s):  
Land Reclamation ◽  
Soil Improvement ◽  
Large Area ◽  
Vacuum Preloading ◽  
Reclaimed Land ◽  
Improvement Project ◽  
Prefabricated Vertical Drains ◽  
Vertical Drains ◽  
Soft Clays

This case study presents the design, operation, and results of a soil improvement project using the vacuum preloading method on 480 000 m2 of reclaimed land in Xingang Port, Tianjing, China. The areas treated with vacuum ranged from 5000 to 30 000 m2. The effects of soil improvement are demonstrated through the average consolidation settlement of 2.0 m and increases in undrained shear strengths by a factor of two to four or more. The study shows that the vacuum method is an effective tool for the consolidation of very soft, highly compressive clayey soils over a large area. The technique is especially feasible in cases where there is a lack of surcharge loading fills, extremely low shear strength, soft ground adjacent to critical slopes, and access to a power supply.Key words: vacuum preloading consolidation, soil improvement, soft clays, land reclamation, prefabricated vertical drains.

Lessons learned in establishing a quality improvement project to reduce hospital acquired infections in the neonatology ward at a referral hospital in Rwanda

2016 ◽  
Vol 24 (4) ◽  
pp. 341-348 ◽  
Author(s):  
Naasson Gafirimbi ◽  
Rex Wong ◽  
Eva Adomako ◽  
Jeanne Kagwiza
Keyword(s):  
Quality Improvement ◽  
Lessons Learned ◽  
Referral Hospital ◽  
Quality Improvement Project ◽  
Injection Technique ◽  
Improve Quality ◽  
Improvement Project ◽  
Content Type ◽  
Hospital Acquired

Purpose Improving healthcare quality has become a worldwide effort. Strategic problem solving (SPS) is one approach to improve quality in healthcare settings. This case study aims to illustrate the process of applying the SPS approach in implementing a quality improvement project in a referral hospital. Design/methodology/approach A project team was formed to reduce the hospital-acquired infection (HAI) rate in the neonatology unit. A new injection policy was implemented according to the root cause identified. Findings The HAI rate decreased from 6.4 per cent pre-intervention to 4.2 per cent post-intervention. The compliance of performing the aseptic injection technique significantly improved by 60 per cent. Practical implications This case study illustrated the detailed application of the SPS approach in establishing a quality improvement project to address HAI and injection technique compliance, cost-effectively. Other departments or hospitals can apply the same approach to improve quality of care. Originality/value This study helps inform other hospitals in similar settings, the steps to create a quality improvement project using the SPS approach.

Abstract T P278: HASTe: A Team Approach to Improving Pre-Hospital and ED Delays in Stroke Care

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Melissa Dofredo ◽  
Angela West
Keyword(s):  
Medical Record ◽  
Performance Improvement ◽  
Care Delivery ◽  
Stroke Care ◽  
Individual Case ◽  
Delivery Systems ◽  
Team Approach ◽  
Improvement Project ◽  
Transfer Processes

Background: Despite an array of available guidelines and research, many organizations continue to seek innovative ways to decrease time delays and enhance their stroke care delivery systems. After dissecting the case of an acute ischemic stroke (AIS) patient cared for in our facility, many delays were noted from onset of symptoms until admission to ED. Purpose: The purpose of the HASTe (Hyper Acute Stroke Team) initiative is to utilize a case-study approach to discover pre-hospital and ED delays, and offer quality improvement project ideas that can be used to enhance stroke-care delivery systems. Methods: With leadership from the Stroke Program Director, 15 neuro-critical care nurses formed the HASTe to ameliorate delays noted in AIS care. A case-study review of an AIS patient led to a schematic timeline map which demonstrated minutes lost at each area of delay. Identified areas of delay included lack of community knowledge on stroke, preventative delays in Emergency Medical System (EMS) on-scene time, lack of updated AHA/ASA guideline knowledge at an outside facility ED, inefficient transfer processes to our facility for endovascular intervention, and technical delays in electronic medical record entry. All of these factors contributed to time lost for reperfusion therapy. Results: Pre-hospital and ED delays contributed to approximately 120 minutes lost. After analyzing these delays, the HASTe initiated several performance improvement projects to address the delays. Community and EMS presentations covering the urgency of stroke were created. Connections were made with outside facility ED educators to offer in-services on AHA/ASA updates. Improved transfer processes were coordinated with local EMS administration and private ambulances. A pre-admitted “John Doe-Stroke” medical record was created for potential stroke patients coming in to our ED. Conclusions: A team approach such as the HASTe is an innovative way to integrate knowledge gleaned from individual case studies to induce coordinated performance improvement projects that affect the community, EMS, and ED. Further case study reviews can reveal other areas in which the HASTe can positively affect change in the continuum of stroke care.

Key Point of Bridge Damage Caused by Glacial Debris Flows along International Karakorum Highway, Pakistan

2012 ◽  
Vol 256-259 ◽  
pp. 2713-2723 ◽  
Author(s):  
Li Ping Liao ◽  
Ying Yan Zhu ◽  
D.H.Steve Zou ◽  
Zhi Quan Yang ◽  
Waseem Muhammad ◽  
...  
Keyword(s):  
Debris Flows ◽  
Northern Pakistan ◽  
Detailed Data ◽  
Prevention Measures ◽  
Improvement Project ◽  
Field Investigations ◽  
Abrasive Erosion ◽  
Bridge Damage ◽  
The Impact

Glacial debris flows along International Karakorum Highway (KKH) connecting northern Pakistan with China, are always causing so extreme threats to a majority of bridges built along KKH. So the improvement project of KKH has been being carried out by China Road & Bridge Corporation in 2008. However it is necessary to collect the detailed data about the damages to bridges and obtain the most dangerous key position. The series of field investigations from 2008 to 2011 demonstrate that the damages are classified into four categories: deposition under bridge, abrasive erosion, impact on piers or abutment and collapse due to buoyancy. Statistics indicate deposition under bridge is the most dominant damage whereas the most serious damage is the impact on piers or abutments. Therefore a case study on key point is made for the typical bridge subjected to impact from Ghulkin glacial debris flow. Finally prevention measures are given.

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