Motivation for change in the health care of children with developmental disabilities: Pilot continuing professional development‐quality improvement project

2020 ◽  
Author(s):  
Natalie Ong ◽  
Roxanne Goff ◽  
Valsamma Eapen ◽  
Gail Tomsic ◽  
Loretta Moore ◽  
...  
Keyword(s):  
Professional Development ◽  
Health Care ◽  
Quality Improvement ◽  
Developmental Disabilities ◽  
Continuing Professional Development ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Motivation For Change ◽  
Children With Developmental Disabilities

scholarly journals Appropriate Use Criteria in Echocardiography: An Observational Institutional Study with the Perspective of a Quality Improvement Project

2016 ◽  
Vol 10 ◽  
pp. CMC.S36504 ◽  
Author(s):  
Vanessa Rameh ◽  
Antoine Kossaify
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Clinical Outcome ◽  
Quality Improvement Project ◽  
University Hospital ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Improvement Project ◽  
Health Care Resources ◽  
Set Up

Background Appropriate use criteria (AUC) in echocardiography are essential tools for aligning the indications of echocardiography with the best clinical standards, improving clinical outcome, restraining abuse, and preserving health-care resources. Objectives The aim of this study was to ascertain the AUC for transthoracic echocardiography in a university hospital and create a quality improvement project (QIP). Methods The assessment of 501 inpatients who received transthoracic cardiac echo was conducted according to the 2011 AUC report. Indications were classified as appropriate, uncertain, or inappropriate, and patients not matching any of the abovementioned divisions were grouped in the nonfitting category. Results Of the 501 eligible patients, 374 patients (74.66%) were in the appropriate group, 85 patients (16.96%) in the inappropriate group, 20 patients (3.99%) in the uncertain group, and 22 patients (4.39%) in the nonfitting category. Discussion Interpretation and analysis of the obtained results are presented, along with the results of many comparable studies; moreover, a QIP was set up accordingly. Conclusion AUC are useful to assess local practice, preserve health-care resources, and improve clinical outcome.

scholarly journals 63 Quality Improvement Project: Should We be Doing More or Less Ct Head Scans in the Health Care of Older People Department?

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i18-i20
Author(s):  
M Munir ◽  
T Shouter ◽  
H S Tay
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Older People ◽  
Management Plan ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Number Of Patients ◽  
New Findings ◽  
New Finding ◽  
Ct Head

Abstract Introduction Older people are likely to have more CT head scans given their multiple co- morbidities, being on anticoagulants, and increased falls. The aims of this quality improvement project (QIP) were to identify the number of patients who had CT head scan, the reason/indication of it, the number of patients who had new finding/s on it, actions taken on new findings, and whether the management plan was altered because of the CT scan. Methods Medical notes and CT head scan reports of all patients admitted to the Health Care of Older People department from April to September 2018 were reviewed to evaluate the indications of CT head scans, new findings, and management plans following the findings. Results 461 (10.7%) out of the 4323 patients discharged from the healthcare of older people department during April to September 2018 had CT head scans during admission. Frequent indications for CT head scans included delirium, falls and head injury. Only 46 (9.9%) patients had new finding/s on the CT head scan, and action was taken on 26 (56.5%) of these patients. The CT head scan changed the management plan of only 17 (3.6%) patients. Please see Table for more details. Conclusions By using our clinical judgement, following NICE guidelines on head injuries, educating our colleagues on the criteria for requesting a CT head scan, taking collateral histories about patients’ cognition and ascertaining the mechanism of fall, we can lessen the financial burden on the NHS and minimise the radiation exposure to our patients.

scholarly journals Improving diabetic foot screening at a primary care clinic: A quality improvement project

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Michelle L. Allen ◽  
Albertine M.B. Van der Does ◽  
Colette Gunst
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Diabetic Foot ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Care Clinic ◽  
Screening Practices ◽  
Primary Health ◽  
Diabetic Foot Screening

Background: Foot screening is an important part of diabetic care as it prevents significant morbidity, loss of function and mortality from diabetic foot complications. However, foot screening is often neglected.Aim: This project was aimed at educating health care workers (HCWs) in a primary health care clinic to increase diabetic foot screening practices. Setting: A primary health care clinic in the Western Cape province of South AfricaMethods: A quality improvement project was conducted. HCWs’ needs were assessed using a questionnaire. This was followed by focus group discussions with the HCWs, which were recorded, transcribed and assessed using a general inductive approach. An intervention was designed based on common themes. Staff members were trained on foot screening and patient information pamphlets and screening tools were made available to all clinic staff. Thirty-two consecutive diabetic patient folders were audited to compare screening in 2013 with that in 2014 after initiation of the quality improvement cycle.Results: HCWs’ confidence in conducting foot screening using the diabetic foot assessment questionnaire improved markedly after training. Diabetic foot screening practices increased from 9% in 2013 to 69% in 2014 after the first quality improvement cycle. A strengths, opportunities, aspirations and results (SOAR) analysis showed promise for continuing quality improvement cycles.Conclusion: The findings showed a significant improvement in the number of diabetic patients screened. Using strategic planning with appreciative intent based on SOAR, proved to be motivational and can be used in the planning of the next cycle.

Welsh dental trainees’ confidence and competence in completing orthodontic assessments and referrals

2021 ◽  
pp. 146531252110194
Author(s):  
Emma Foster-Thomas ◽  
Jacob Curtis ◽  
Charlotte Eckhardt ◽  
Philip Atkin
Keyword(s):  
Quality Improvement ◽  
Orthodontic Treatment ◽  
Continuing Professional Development ◽  
The Self ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Treatment Need ◽  
Hands On ◽  
E Learning ◽  
Stage 1

Objective: To improve the confidence and competence of newly qualified dentists in Wales in undertaking orthodontic assessments and making orthodontic referrals. Design: Quality improvement project. Setting: Study days arranged by the Wales Deanery. Participants: The 2018–2019 cohort of dental foundation trainees (DFTs) and dental core trainees (DCTs) in Wales. Methods: Data were collected prospectively between January and February 2019 utilising a 20-item questionnaire based around knowledge and clinical ability in orthodontic assessment and referrals (Stage 1). In May 2019, the trainees were provided with an e-learning package tailored to the results of the clinical questions and the feedback received in Stage 1. After this, trainees repeated the questionnaire with a simplified Index of Orthodontic Treatment Need (IOTN; Stage 2). Results: There was increased self-reported confidence in ‘conducting orthodontic assessments’ from 67% to 95% and ‘competence in completing orthodontic referrals’ from 81% to 92%. At baseline, this cohort were only able to correctly determine dental age and orthodontic treatment need for 40.7% (mean) of the presented linical cases. Following the teaching intervention, this was improved with an average of 70.9% of clinical cases answered correctly. Conclusion: Despite the noted improvement in the self-reported confidence and competence in undertaking orthodontic assessments and referrals in this cohort, there is still room for improvement. Hands-on orthodontic experience during dental training improved the self-reported confidence and competence with assessments and referrals. The results of this quality improvement project emphasise the need for regular continuing professional development in the field of orthodontics to maintain competence in utilising IOTN and referring appropriately.

scholarly journals Outsourcing the Remote Management of Cardiac Implantable Electronic Devices: Medical Care Quality Improvement Project

JMIR Cardio ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. e9815
Author(s):  
Gabriele Giannola ◽  
Riccardo Torcivia ◽  
Riccardo Airò Farulla ◽  
Tommaso Cipolla
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Remote Monitoring ◽  
Electronic Devices ◽  
Care Quality ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Cardiac Implantable Electronic Devices ◽  
Remote Management

Background Remote management is partially replacing routine follow-up in patients implanted with cardiac implantable electronic devices (CIEDs). Although it reduces clinical staff time compared with standard in-office follow-up, a new definition of roles and responsibilities may be needed to review remote transmissions in an effective, efficient, and timely manner. Whether remote triage may be outsourced to an external remote monitoring center (ERMC) is still unclear. Objective The aim of this health care quality improvement project was to evaluate the feasibility of outsourcing remote triage to an ERMC to improve patient care and health care resource utilization. Methods Patients (N=153) with implanted CIEDs were followed up for 8 months. An ERMC composed of nurses and physicians reviewed remote transmissions daily following a specific remote monitoring (RM) protocol. A 6-month benchmarking phase where patients’ transmissions were managed directly by hospital staff was evaluated as a term of comparison. Results A total of 654 transmissions were recorded in the RM system and managed by the ERMC team within 2 working days, showing a significant time reduction compared with standard RM management (100% vs 11%, respectively, within 2 days; P<.001). A total of 84.3% (551/654) of the transmissions did not include a prioritized event and did not require escalation to the hospital clinician. High priority was assigned to 2.3% (15/654) of transmissions, which were communicated to the hospital team by email within 1 working day. Nonurgent device status events occurred in 88 cases and were communicated to the hospital within 2 working days. Of these, 11% (10/88) were followed by a hospitalization. Conclusions The outsourcing of RM management to an ERMC safely provides efficacy and efficiency gains in patients’ care compared with a standard in-hospital management. Moreover, the externalization of RM management could be a key tool for saving dedicated staff and facility time with possible positive economic impact. Trial Registration ClinicalTrials.gov NCT01007474; http://clinicaltrials.gov/ct2/show/NCT01007474

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