Virtual

Most care delivery in the US is provided in ambulatory settings, yet quality improvement and patient safety efforts are heavily weighted towards inpatient settings. It is estimated that 5% of outpatient encounters result in an adverse event, however, efforts to...

For prescribing teratogenic medications to women Veterans, although both the national pharmacy Teratogenic Medication warning and national guidance regarding teratogenic clinical reminders were implemented, process was not optimal as most medications were prescribed in the specialty setting and processes implemented...

The study evaluates the process of providing hospital-grade breast pumps to NICU mothers at UCLA Ronald Reagan Medical Center, identifying inefficiencies and barriers in the current system. Problem: The problem tackled at UCLA Ronald Reagan Hospital’s NICU involved challenges NICU...

A multifactorial project focused on reducing Catheter-Associated Urinary Tract Infections (CAUTIs). This comprehensive approach included daily audits by the nursing department to prompt early removal recommendations, enhanced electronic health record (EHR) processes for specimen collection and Best Practice Alerts, staff...

This session will review the DMAIC process and tools used to improve handoff communication between departments, with transportation services and from the Emergency Department to inpatient nursing units. Problem: Patient handoffs are a well-known time of risk. A handoff contains:...

In 2019, our multi-facility System identified reduction of Broad Spectrum Antibiotics utilization rates, reduction of hospital acquired Clostridioides difficile and increasing rate of conversion from intravenous to oral antibiotics as a priority. A multidisciplinary team used Lean Six Sigma methodology...

The American Hospital Association (AHA)’s Quality Collective convened over 100 health care quality leaders nationwide to provide a collaborative platform to engage deeply with their peers, collectively strategizing on the most pressing health care quality-related issues. Over the course of...

Encouraging cessation and providing referrals to cessation treatment programs is an important aspect of high-quality cancer care for patients who smoke tobacco. The UMMC outpatient cancer care clinics did not have a highly reliable process for providing smoking cessation resources...

Cleveland Clinic Weston Hospital was experiencing increased cases of hospital onset Methicillin Resistant Staphylococcus Aureus (MRSA) bacteremia. Studies indicated that hand hygiene practices are highly effective in reducing cross transmission of MRSA to patients from healthcare workers. This transmission of...

The University of Colorado Department of Medicine Systems Improvement Conference analyzes safety cases within a Just Culture lens to discover system-based issues, rather than blaming providers, for errors that occur in our hospital system. This type of analysis, called Safety...