Development of Tool for Case Submission and Review as Foundation for Department Patient Safety / Quality Improvement Program

2021 ◽  
pp. 56-64
Author(s):  
Jennifer Brinkmeier
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Surgical Procedures ◽  
Clinical Work ◽  
Clinical Activity ◽  
Improvement Program ◽  
Online Tool ◽  
External Stakeholder ◽  
Time Period ◽  
Case Collection

Objective: Describe creation and implementation of secure case collection tool for the foundation of otolaryngology department Patient Safety/Quality Improvement (PSQI) program. Describe how tool decreased burden while fulfilling stakeholders’ reporting requirements. Methods: Incorporation of elements of required reports into online tool, facilitating improved case submission for Morbidity and Mortality conference (M&M) review. Reviewer commentary and conference discussion notes are recorded within the project. Regular reports tailored to each stakeholder were designed. Results: During first 8 months of implementation, 83 cases were submitted–5250 surgical procedures were performed by our department in that period—compared to 75 cases submitted via prior system in a same time period the year before (6930 surgical procedures performed). Elements of routine reports for interdepartmental use and external stakeholder requirements determined and reported. Discussion: Preliminary description of secure online tool with a single platform serving multiple stakeholders with unique reporting elements. This presents an opportunity to reduce the burden of essential administrative tasks while providing a reliable PSQI repository. Future metrics for ongoing evaluation will be identified and incorporated. Case submissions were maintained through a period of altered clinical activity (SARS-CoV-2 pandemic). Implications for Practice: This tool will allow our department to review cases for our required M&M with improved efficiency and efficacy, while supporting our PSQI program and generate necessary reports to stakeholders. Reduction of electronic task burden may reduce risk of physician burnout. Facilitating implementation of essential and required PSQI efforts will strengthen our curriculum and clinical work.

Implementation of a multimodal patient safety improvement program “SafetyLEAP” in intensive care units

2018 ◽  
Vol 31 (2) ◽  
pp. 140-149 ◽  
Author(s):  
Chantal Backman ◽  
Paul C. Hebert ◽  
Alison Jennings ◽  
David Neilipovitz ◽  
Omar Choudhri ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Quality Improvement ◽  
Intensive Care Units ◽  
Audit And Feedback ◽  
Improvement Program ◽  
Convenience Sample ◽  
Content Type ◽  
Safety Improvement ◽  
Patient Safety Improvement

Purpose Patient safety remains a top priority in healthcare. Many organizations have developed systems to monitor and prevent harm, and have invested in different approaches to quality improvement. Despite these organizational efforts to better detect adverse events, efficient resolution of safety problems remains a significant challenge. The authors developed and implemented a comprehensive multimodal patient safety improvement program called SafetyLEAP. The term “LEAP” is an acronym that highlights the three facets of the program including: a Leadership and Engagement approach; Audit and feedback; and a Planned improvement intervention. The purpose of this paper is to evaluate the implementation of the SafetyLEAP program in the intensive care units (ICUs) of three large hospitals. Design/methodology/approach A comparative case study approach was used to compare and contrast the adherence to each component of the SafetyLEAP program. The study was conducted using a convenience sample of three (n=3) ICUs from two provinces. Two reviewers independently evaluated major adherence metrics of the SafetyLEAP program for their completeness. Analysis was performed for each individual case, and across cases. Findings A total of 257 patients were included in the study. Overall, the proportion of the SafetyLEAP tasks completed was 64.47, 100, and 26.32 percent, respectively. ICU nos 1 and 2 were able to identify opportunities for improvement, follow a quality improvement process and demonstrate positive changes in patient safety. The main factors influencing adherence were the engagement of a local champion, competing priorities, and the identification of appropriate resources. Practical implications The SafetyLEAP program allowed for the identification of processes that could result in patient harm in the ICUs. However, the success in improving patient safety was dependent on the engagement of the care teams. Originality/value The authors developed an evidence-based approach to systematically and prospectively detect, improve, and evaluate actions related to patient safety.

Safety, Quality, and the National Surgical Quality Improvement Program

2006 ◽  
Vol 72 (11) ◽  
pp. 994-998 ◽  
Author(s):  
Shukri F. Khuri
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Conceptual Framework ◽  
Systems Of Care ◽  
Adverse Outcomes ◽  
Quality Improvement Program ◽  
Institute Of Medicine ◽  
Improvement Program ◽  
Surgical Quality

The Institute of Medicine 1999 publication, To Err is Human, focused attention on preventable provider errors in surgery, and prompted numerous new national initiatives to improve patient safety. It is uncertain whether these initiatives have actually improved patient safety, mainly because of the lack of a quantitative metric for the assessment of patient safety in surgery. A 15-year experience with the National Surgical Quality Improvement Program, which originated in the Veteran's Administration in 1991 and was recently made available to the private sector, prompts the surgical community to place patient safety in surgery within a much larger conceptual framework than that of the Institute of Medicine report, and provides a quantitative metric for the assessment of patient safety initiatives. This conceptual framework defines patient safety in surgery as safety from all adverse outcomes (not only preventable errors and sentinel events); regards safety as an integral part of quality of surgical care; recognizes that adverse outcomes, and hence patient safety, are primarily determined by quality of systems of care; and uses comparative risk-adjusted outcome data as a metric for the identification of system problems and for the assessment and improvement of patient safety from adverse outcomes.

A patient safety and quality improvement curriculum for child and adolescent psychiatry fellows using the Learning from Defect Tool

2021 ◽  
pp. 251604352110449
Author(s):  
Elizabeth K Reynolds ◽  
Cheryl Connors ◽  
J Lynn Taylor ◽  
Roma A Vasa
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Adolescent Psychiatry ◽  
Curriculum Evaluation ◽  
Clinical Work ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
The Future ◽  
Intention To Participate ◽  
Safety Event

The purpose of this article is to describe the development and evaluation of an 11-session patient safety and quality improvement curriculum for first-year child and adolescent psychiatry fellows. The curriculum uses the Learning from Defects tool which teaches fellows how to conduct an analysis of a safety event they have encountered in their clinical work. The Learning from Defects tool provides a structured approach to address adverse clinical events and identify system failures by providing a framework to determine what happened, examine why it happened, implement interventions to reduce the probability that a similar event will recur, and evaluate whether the interventions were effective. Six fellows participated in the curriculum during their protected didactics time. Curriculum evaluation included an assessment of fellows’ knowledge, skills, and attitudes toward patient safety and quality improvement before and immediately after the curriculum, and 6-months later. Immediately upon completion of the curriculum, fellows reported more confidence and comfort with patient safety and quality improvement-related tasks in their clinical practice. Fellows reported a positive perception of the curriculum related to their learning objectives and utility in the future career. At the 6-month follow-up, the majority of fellows continued to work on their Learning from Defects project and endorsed the intention to participate in patient safety and quality improvement work in the future. This study provides preliminary support for implementing this patient safety and quality improvement curriculum utilizing the Learning from Defects tool in child and adolescent psychiatry fellowship programs. The Learning from Defects tool offers a practical way to teach patient safety and quality improvement skills that potentially can be generalized to future clinical work.

Pediatric Risk Stratification Is Improved by Integrating Both Patient Comorbidities and Intrinsic Surgical Risk

2019 ◽  
Vol 130 (6) ◽  
pp. 971-980 ◽  
Author(s):  
Viviane G. Nasr ◽  
Steven J. Staffa ◽  
David Zurakowski ◽  
James A. DiNardo ◽  
David Faraoni
Keyword(s):  
Quality Improvement ◽  
Risk Stratification ◽  
Surgical Procedures ◽  
External Validation ◽  
Quality Improvement Program ◽  
Current Procedural Terminology ◽  
Improvement Program ◽  
Surgical Quality ◽  
Surgical Risk ◽  
American College Of Surgeons

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Recently developed risk stratification models for perioperative mortality incorporate patient comorbidities as predictors but fail to consider the intrinsic risk of surgical procedures. In this study, the authors used the American College of Surgeons National Surgical Quality Improvement Program Pediatric database to demonstrate the relationship between the intrinsic surgical risk and 30-day mortality and develop and validate an accessible risk stratification model that includes the surgical procedures in addition to the patient comorbidities and physical status. Methods A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program Pediatric database was performed. The incidence of 30-day mortality was the primary outcome. Surgical Current Procedural Terminology codes with at least 25 occurrences were included. Multivariable logistic regression model was used to determine the predictors for mortality including patient comorbidities and intrinsic surgical risk. An internal validation using bootstrap resampling, and an external validation of the model were performed. Results The authors analyzed 367,065 surgical cases encompassing 659 unique Current Procedural Terminology codes with an incidence of overall 30-day mortality of 0.34%. Intrinsic risk of surgical procedures represented by Current Procedural Terminology risk quartiles instead of broad categorization was significantly associated with 30-day mortality (P < 0.001). Predicted risk of 30-day mortality ranges from 0% with no comorbidities to 4.7% when all comorbidities are present among low-risk surgical procedures and from 0.07 to 46.7% among high-risk surgical procedures. Using an external validation cohort of 110,474 observations, the multivariable predictive risk model displayed good calibration and excellent discrimination with area under curve (c-index) equals 0.95 (95% CI, 0.94 to 0.96; P < 0.001). Conclusions Understanding and accurately estimating perioperative risk by accounting for the intrinsic risk of surgical procedures and patient comorbidities will lead to a more comprehensive discussion between patients, families, and providers and could potentially be used to conduct cost analysis and allocate resources.

Sign in / Sign up

Export Citation Format

Share Document