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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.

New @JC_Resources article on reducing #emergencydepartment crowding at Lakeland Regional Health  
 
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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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Joint Commission Resources, Inc.
Joint Commission Resources, Inc. (JCR), a wholly controlled, nonprofit affiliate of The Joint Commission, is the official publisher and educator of The Joint Commission. JCR is an expert resource for health care organizations, providing consulting services, educational services, and publications and software, to assist in improving safety and quality and to help in meeting the accreditation standards of The Joint Commission. JCR provides consulting services independently from The Joint Commission and in a fully confidential manner. Visit www.jcrinc.com for more information.

 

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IN THIS ISSUE:

Impact of a Hospitalwide Quality Improvement Initiative on Emergency Department Throughput and Crowding Measures

Three Quality Improvement Tactics to Help Ensure Success and Sustainability

Plus...

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

Improving the Patient Safety Culture in Nursing Homes Through WalkRounds

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

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

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

Journal on Quality and Patient Safety

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