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Quality Improvement Activities (quality + improvement_activity)
Selected AbstractsEquipping patients for a time of helplessness: An educational interventionAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 5 2009Simon Holliday Abstract Objectives:,Quantify rates of awareness about, and ownership of, End-of-Life Planning (ELP) instruments. Examine whether this rate is increased by brief education during routine team care. Measure the time required by this exercise. Design:,Quality Improvement Activity. Setting:,General Practice on Mid-North Coast, New South Wales. Participants:,Forty-two consecutive, consenting elderly patients undertaking a Home Health Assessment. Main outcome measures:,This study assessed rates of ELP instruments at baseline, at 2 weeks, at 2 months and at 2 years following the provision and discussion of a fact sheet while measuring the clinicians' time required. Results:,This education exercise increased the number of patients with ELP instruments from one to ten (24%). On average it took 5.6 min of nursing time and 3.9 min for the GP. Conclusions:,Brief education during Home Health Assessments may empower patients to prepare for a scenario where they lost competency to make fully informed decisions. This may alleviate patient's fears about causing problems between those close to them and having treatments against their wishes. [source] Integrating pediatric hospitalists in the academic health science center: Practice and perceptions in a canadian center,,JOURNAL OF HOSPITAL MEDICINE, Issue 4 2010FRCPC, Sanjay Mahant MD Abstract BACKGROUND: The integration of hospitalists in academic settings has been identified as a challenge to the hospitalist movement. The Division of Pediatric Medicine, Hospital for Sick Children, Toronto, was established in 1981, providing a rich resource to examine this field in the academic context and inform academic program development. OBJECTIVES: To explore the characteristics, practice, perceptions, and contributions of pediatric hospital medicine in an academic health science center (AHSC). METHODS: A cross-sectional survey of physicians attending on the pediatric medicine inpatient unit (PMIU) (n = 20). RESULTS: Clinical activity included attending on the PMIU, consultation and comanagement outside the PMIU, and outpatient care of "hospital intense" patients. There was a high level of engagement in research, education, and quality improvement activities. Perceived advantages to a career as a hospitalist included: working in a team; generalist approach to care; stability relative to community practice; intellectually stimulating and rewarding work; and growing area for scholarship. Perceived disadvantages to a career as a hospitalist included: burnout; recognition and respect; and lack of long-term relationships with patients. Themes regarding barriers to establishing a career as a hospitalist in an AHSC were as follows: burnout; time and skills to develop an academic niche; balance between clinical and academic priorities; and system for career advancement. CONCLUSIONS: The contributions of pediatric hospitalists to the academic mission were diverse. Fellowship training, faculty development, and balance between time allocated to direct patient care and academic pursuits should be defined. This will help ensure career development, viability, and realization of excellence in the academic context. Journal of Hospital Medicine 2010;5:228,233. © 2010 Society of Hospital Medicine. [source] Relationships between patient-centered cancer nursing interventions and desired health outcomes in the context of the health care system,RESEARCH IN NURSING & HEALTH, Issue 1 2009Laurel E. Radwin Abstract A non-experimental longitudinal prospective study was conducted to examine the relationships between patient-centered nursing interventions (PCNIs), system characteristics, patient characteristics, and desired health outcomes (DHOs) for 173 hematology-oncology patients. Forty-nine nurse participants provided system characteristics data. Confirmatory factor analyses yielded parsimonious scales to operationalize the variables. In the path model, one PCNI,individualization,was positively related to three subsequent DHOs: authentic self-representation, optimism, and sense of well-being. Two additional PCNIs,responsiveness and proficiency,were positively related to subsequent trust in nurses. PCNIs did not vary with patient race, ethnicity, age, gender, or educational level. Patient-centeredness of care for cancer patients may be enhanced by quality improvement activities that measure and monitor these PCNIs and resultant outcomes. © 2008 Wiley Periodicals, Inc. Res Nurs Health 32:4,17, 2009 [source] Brief Report: Quality Improvement in Critical Access Hospitals: Addressing Immunizations Prior to DischargeTHE JOURNAL OF RURAL HEALTH, Issue 4 2003Edward F. Ellerbeck MD These hospitalizations may represent a missed opportunity to address immunizations. Addressing these missed immunizations could provide an opportunity for CAHs to gain practical experience in data-driven quality improvement. Purpose: To improve documentation and delivery of influenza and pneumococcal immunizations prior to hospital discharge and provide CAHs with quality improvement experience. Methods: We recruited 17 CAHs in Kansas to participate in a rapidcycle quality improvement project to address inpatient immunizations. Each hospital identified patient discharges on a monthly basis and abstracted medical records to see if the patient's immunization status had been assessed and if patients had been vaccinated prior to discharge. Findings: Documentation of influenza immunization status improved from 17% of admissions at baseline to 62% at follow-up (P<0.001). Documentation of pneumococcal immunization status increased from 36% at baseline to 51% at follow-up (P<0.001). Documentation of immunizations was significantly higher among the 8 hospitals that developed standard charting forms for recording immunization status (P<0.01). Despite improved documentation of immunization status, at remeasurement only 3.4% received an influenza vaccination and 1.3% received a pneumococcal vaccination prior to discharge. Conclusions: Critical access hospitals can effectively participate in quality improvement activities, but increased involvement of medical staff or standing immunization orders may be needed to improve actual vaccine administration prior to discharge. [source] | ||||||||||