scholarly journals Real-Time Patient Survey Data During Routine Clinical Activities for Rapid-Cycle Quality Improvement

2015 ◽  
Vol 3 (1) ◽  
pp. e13 ◽  
Author(s):  
James Lucius Wofford ◽  
Claudia L Campos ◽  
Robert E Jones ◽  
Sheila F Stevens
Keyword(s):  
Quality Improvement ◽  
Real Time ◽  
Survey Data ◽  
Patient Survey

Identifying barriers to equitable biomarker testing in underserved patients with NSCLC: A mixed-methods study to inform quality improvement opportunities.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 123-123
Author(s):  
Leigh Boehmer ◽  
Upal Kunal Basu Roy ◽  
Janelle Schrag ◽  
Nikki A. Martin ◽  
Gregory D. Salinas ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Precision Medicine ◽  
Survey Data ◽  
Low Socioeconomic Status ◽  
Primary Source ◽  
Patient Survey ◽  
Underserved Patients ◽  
Education Levels ◽  
Biomarker Testing

123 Background: Despite recent advances in cancer precision medicine, patients from underserved communities do not have equal access to biomarker testing and targeted therapies. This study used a mixed-methods approach to identify barriers to equitable precision medicine access among underserved patients with non-small cell lung cancer (NSCLC). Methods: Paired national surveys (one clinician-facing and one patient-facing) were developed respectively by the Association of Community Cancer Centers (ACCC) and LUNGevity Foundation. Administered online in spring/summer 2020, the surveys were designed to identify key attitudes/barriers related to biomarker testing, resource needs, and current practice patterns for pertinent stakeholders. Survey data was triangulated with data from focus groups (2 clinician and 6 patient) conducted in fall 2020. The study was approved by Advarra IRB. Results: A total of 99 clinicians responded, with 67% (66/99) representing oncologists from community cancer programs. 248 patients responded to the LUNGevity survey, with 161 coming from the general population and 87 from the LUNGevity network (patients with relatively high income and education levels). Most clinicians surveyed indicated they were “very” (34%) or “extremely” likely (44%) to discuss biomarker testing with NSCLC patients. Academic clinicians, however, were more likely than community-based clinicians to order testing at the time of initial biopsy (76% vs 52%, P =.02). Academic clinicians were also more likely to involve the patient’s family in biomarker testing discussions (85% vs 59%, P =.009). Patient survey results identified that medical oncologists are the primary source of biomarker testing information; 64% of LUNGevity-connected and 37% of underserved patients. Eighty-five percent of LUNGevity-connected patients receive biomarker testing versus 52% for general patients (p < 0.05). Notably, more than a quarter (27%) of underserved patients who have undergone biomarker testing do not know their results. Clinician focus group participants corroborated survey findings that most clinicians receive testing results in 7-14 days, but for 23% of community and 6% of academic clinicians the process can take over 2 weeks. They identified disparities in offering biomarker testing and results to patients with known or presumed low socioeconomic status (SES) and/or health literacy. This was supported by patient survey data, which showed biomarker testing was proactively offered to only 40% of low-SES patients. Conclusions: This study identifies key areas of ongoing need related to equitable biomarker testing. Quality-improvement opportunities exist to address both clinician and patient barriers to guideline-concordant biomarker testing for underserved patients with NSCLC.

scholarly journals Adaptation of a quality improvement approach to implement eScreening in VHA healthcare settings: innovative use of the Lean Six Sigma Rapid Process Improvement Workshop

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
James O. E. Pittman ◽  
Borsika Rabin ◽  
Erin Almklov ◽  
Niloofar Afari ◽  
Elizabeth Floto ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Survey Data ◽  
Implementation Strategy ◽  
Scale Up ◽  
Implementation Process ◽  
Interview Data ◽  
Self Report ◽  
Veterans Health ◽  
Health Administration ◽  
Health Technologies

Abstract Background The Veterans Health Administration (VHA) developed a comprehensive mobile screening technology (eScreening) that provides customized and automated self-report health screening via mobile tablet for veterans seen in VHA settings. There is agreement about the value of health technology, but limited knowledge of how best to broadly implement and scale up health technologies. Quality improvement (QI) methods may offer solutions to overcome barriers related to broad scale implementation of technology in health systems. We aimed to develop a process guide for eScreening implementation in VHA clinics to automate self-report screening of mental health symptoms and psychosocial challenges. Methods This was a two-phase, mixed methods implementation project building on an adapted quality improvement method. In phase one, we adapted and conducted an RPIW to develop a generalizable process guide for eScreening implementation (eScreening Playbook). In phase two, we integrated the eScreening Playbook and RPIW with additional strategies of training and facilitation to create a multicomponent implementation strategy (MCIS) for eScreening. We then piloted the MCIS in two VHA sites. Quantitative eScreening pre-implementation survey data and qualitative implementation process “mini interviews” were collected from individuals at each of the two sites who participated in the implementation process. Survey data were characterized using descriptive statistics, and interview data were independently coded using a rapid qualitative analytic approach. Results Pilot data showed overall satisfaction and usefulness of our MCIS approach and identified some challenges, solutions, and potential adaptations across sites. Both sites used the components of the MCIS, but site 2 elected not to include the RPIW. Survey data revealed positive responses related to eScreening from staff at both sites. Interview data exposed implementation challenges related to the technology, support, and education at both sites. Workflow and staffing resource challenges were only reported by site 2. Conclusions Our use of RPIW and other QI methods to both develop a playbook and an implementation strategy for eScreening has created a testable implementation process to employ automated, patient-facing assessment. The efficient collection and communication of patient information have the potential to greatly improve access to and quality of healthcare.

Abstract W MP100: Applying Real-Time Location Systems to Acute Stroke Workflow: A Novel Quality Improvement Tool

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Adam Prater ◽  
Meredith Bowen ◽  
Emily Pavich ◽  
Thomas Loehfelm ◽  
Aaron M Anderson ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Acute Stroke ◽  
Real Time ◽  
Human Observer ◽  
Ct Scanner ◽  
Urban Hospital ◽  
Ir Detectors ◽  
Arrival Times ◽  
Patient Arrival ◽  
Location Systems

Background: Real-Time Location Systems (RTLS) utilize tracking tags and detectors to locate objects or people. This technology has been implemented in healthcare, chiefly to track hospital assets, and a few healthcare systems have applied this technology to track patients in the emergency department. This pilot study tested the feasibility of RTLS to monitor the acute stroke workflow in a large, urban hospital. Methods: An asset tracking RTLS was installed in a large, urban hospital. A series of 21 acute stroke patients were tracked throughout the workflow process by a human observer and via RTLS asset tag attached to the patient’s hospital equipment. A Wi-Fi detector documented initial patient arrival times in the ER Hallway, radiofrequency/infrared (RFID/IR) detectors documented ER CT scanner and ER patient room times. Patient Arrival and departure times in the emergency room (ER) and radiology CT scanner were measured. Time differences between human observer and RTLS were calculated. Results: A total of 21 patients were tracked with RTLS. The mean time difference, interquartile range and standard deviation in minutes are as follows: initial arrival (mean 106, IQR 112, SD 197); CT arrival ( mean 1, IQR 1, SD 0.86); CT departure (mean 2, IQR 2, SD 1.13); patient return to ED (mean 1, IQR 1, SD 0.94). Discussion: Our data demonstrate that RTLS can provide accurate, real-time patient location information, and has the potential to provide data for quality improvement. Combination RFID/IR detectors provided accurate time information while the Wi-Fi detector, proved unreliable for initial arrival times. Our preliminary data supports the development of an unique RTLS system specifically designed to allow for complete visualization of the stroke workflow from patient arrival to treatment along with a dashboard user interface to facilitate treatment team coordination.

Demystifying Essential Containers and Places for Aedes Mosquito Control in Thailand

2020 ◽  
Author(s):  
Naiyana Sahavechaphan ◽  
Asamaporn Chatrattikorn ◽  
Pongsakorn Sadakorn ◽  
Darin Areechokechai ◽  
Sopon Iamsirithaworn
Keyword(s):  
Real Time ◽  
Survey Data ◽  
Prevention And Control ◽  
Mosquito Control ◽  
Control Program ◽  
Water Tank ◽  
Effective Prevention ◽  
Larval Survey ◽  
Public Health Officials ◽  
And Control

Abstract Background: The strategy for prevention and control of Aedes-borne diseases relies on timely elimination of key breeding containers. There is thus a crucial need to identify key breeding containers to enhance vector control activities. The visual larval survey of wet containers has then been conducted as a routine mission of the Department of Disease Control (DDC). To facilitate this, DDC has deployed a mobile application, namely TanRabad SURVEY, since May 2016. As per an inspected place, TanRabad SURVEY supports the real-time collection of its larval survey data and processing of its larval indices and key breeding containers. Methods: Larval survey data from 2017 to 2019 were spatially and temporally collected by public health officials via TanRabad SURVEY. Several measurements were computed to identify the overall and regional key breeding containers and places; and the regional transmission potentiality of Aedes-borne diseases. The measurements for identifying essential containers were breeding potentiality, productivity, contribution and preference ratio. As for places, the larval productivity of places based on larval indices was employed. Such place productivity was also implemented for discovering the regional transmission potentiality of Aedes-borne diseases. Results: The overall essential breeding containers were water tank, unused containers, other used containers, old tyres, anti-ant bowls, drip tray of water dispensers, pet bowls and plant leaves. As for regional aspects, different regions had different essential breeding containers wherein their most common containers were unused containers, other used containers, old tyres and drip tray of water dispensers. All regions had similar experiences that villages and temples were the top two riskiest places, followed by schools, factories, hotels and hospitals. Additionally, all regions had high transmission potentiality of Aedes-borne disease as above 30 of all their places were moderate and high risk places. Conclusions: This study identified the overall and regional key breeding containers and places along with the regional transmission potentiality of Aedes-borne diseases. Beside this, the empirical evidence had shown that the breeding productivity of most containers and places in each type was gradually decreased from time to time. This was mainly because TanRabad SURVEY supported real-time risk communication to community participants and effective prevention and control program development.

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