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Hospital Reduces Emergency Department Crowding With Quality Improvement Methodology

Added on November 29, 2016 in General News, Press Releases
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Media Contact:                                           FOR IMMEDIATE RELEASE

Katie Looze Bronk
Media Relations Specialist
(630) 792-5175
kbronk@jointcommission.org

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Hospital Reduces Emergency Department Crowding With Quality Improvement Methodology

New Article in December 2016 Issue of The Joint Commission Journal on Quality and Patient Safety

(OAK BROOK, Illinois, November 29, 2016) – In the December 2016 issue of The Joint Commission Journal on Quality and Patient Safety, James D. Melton III, MD, and colleagues, describe a quality improvement (QI) project on an emergency department’s throughput and crowding measures at Lakeland Regional Health (LRH), Lakeland, Florida. LRH had prolonged door-in to door-out times and an unacceptable rate of patients leaving without being seen, compared to national benchmarks.

During a 24-month period, LRH made changes in a variety of areas such as staffing and resources, door-in to physician time, and physician to disposition time. After implementation of these changes toward a goal of completing patient visits within three hours or less from the time of arrival to discharge, 81.4 percent of patients achieved this rate, compared to 46.5 percent prior to the interventions. The proportion of patients who left without being seen dropped from 4.0 percent to 0.49 percent.

In an accompanying editorial, “Three Quality Improvement Tactics to Help Ensure Success and Sustainability,” Marcy Carty, MD, MPH, and Emily S. Patterson, PhD, highlight key tactics used in the study to spread culture change, meet measurement goals, and sustain change: the roles of the board and the health care system, clinician incentives and tools to design the interventions.

Also featured in the December 2016 issue:

Methods, Tools and Strategies

“Feasibility and Added Value of Executive WalkRounds in Long Term Care Organizations in the Netherlands”

Loes van Dusseldorp, MSc, RN; Getty Huisman-de Waal, PhD, RN, FEANS; Hub Hamers, PhD; Gert Westert, PhD; and Lisette Schoonhoven, PhD, FEANS

WalkRounds were used as a leadership tool to detect “soft signals”—alerts of unsafe conditions or practices in nursing homes and other long term organizations in the Netherlands.

“Improving the Patient Safety Culture in Nursing Homes Through WalkRounds”

Laura M. Wagner, PhD, RN, GNP, FAAN

In an editorial, the author states, “The interventional research represented in the van Dusseldorp et al. article provides an important first step toward improving the patient safety culture in nursing home environments.”

“Design and Hospitalwide Implementation of a Standardized Discharge Summary in an Electronic Health Record”

Shannon M. Dean, MD; Andrea Gilmore-Bykovskyi, PhD, RN; Joel Buchanan, MD; Brad Ehlenfeldt, BBA; and Amy J.H. Kind, MD, PhD

Eighteen months after an electronic health record–based standardized discharge summary was implemented at an academic medical center, 90 percent of all hospital discharge summaries were written using the standardized template, with use at this level sustained.

“Development and Preliminary Testing of the Coordination Process Error Reporting Tool (CPERT), a Prospective Clinical Surveillance Mechanism for Teamwork Errors in the Pediatric Cardiac ICU”

Katherine E. Bates, MD; Judy A. Shea, PhD; Geoffrey L. Bird, MD, MSIS; Cynthia Field, RN, BSN, NE-BC; Deipanjan Nandi, MD, MS; Robert E. Shaddy, MD; and Joshua P. Metlay, MD, PhD

Across 10 shifts (218 patients), the Coordination Process Error Reporting Tool, developed as a prospective clinical surveillance mechanism for teamwork errors in the pediatric cardiac ICU, enabled the identification of errors for 51 (23 percent) of the patients; 43 (84 percent) of those errors were not documented in the patient safety reporting systems.

Medication Safety

“Determining Current Insulin Pen Use Practices and Errors in the Inpatient Setting”

Katelyn E. Brown, PharmD and John B. Hertig, PharmD, MS, CPPS

Given safety concerns regarding the use of insulin pens in the inpatient setting, a survey was completed by 474 respondents to assess insulin pen use. Some 332 (74 percent) of respondents indicated that insulin pens were on formulary at their institution, but 49

(15 percent) were no longer using them, primarily because of cost and safety concerns.

 

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