These are examples from leading healthcare organizations. (Remember, programs are ongoing, long-term, and proactive initiatives that span the organization.) Wound and Stoma Care Education for Primary Care Providers, Deanna Garza. Financial challenges are increasingly threatening the future of healthcare organizations. Greenhalgh T, Russell J and Swinglehurst D. Narrative methods in quality improvement research. This article provides examples of quality improvement in healthcare that may help others in their journey. ... Download our worksheet to guide the development and documentation of your quality improvement team's Aim Statement and PDSA cycles. Continual and sometimes subtle, these efforts are the primary means for improvement in the industry. The hospital had realized that catheters were being given to patients who didn’t need them, and that they were being left in too long. leads directly to the opportunity to identify, plan and implement improvement projects. Three percent increase in the number of discharges occurring on the weekend. Primary Care Examples. They used this capability to effectively drive cost savings and improve clinical outcomes in many of its service lines, including Surgical Services, Women’s Health, Orthopedics, and Cardiovascular. Quality improvement projects — in healthcare or, more specifically, in nursing — can analyze and improve complicated processes. UC San Diego’s QI project was based on improving hospital discharges. What does it mean to develop a practice's QI capacity? Results also showed better communication with the patient’s support network to ensure the transition of care went smoothly after they left the hospital. Variable costs were reduced by more than $1.75 million based on the deployment of interventions in sepsis alerts, order sets, and other clinical decision support tools. But engaging in care redesign is challenging for clinicians. Healthcare systems working to improve clinical quality face the difficult challenge of aligning changes across the organization. This was a targeted intervention aimed at changing processes and the leadership structure to improve patient care. More information. Executives receive financial data up to three days sooner. With the right evidence, analytics, and methods, providers and improvement teams can transform healthcare, improving the quality of care delivered to the patients they serve and the bottom line. See if you should add any from this list of 108 healthcare measures and metrics. The 2019/20 changes to the Quality and Outcomes Framework included the introduction of a quality improvement (QI) domain. The purpose of our study is to improve diabetic care in resident clinics through quality improvement (QI) projects, with A1C value as primary outcome and other ADA guidelines as secondary outcomes. While there are many different definitions of quality improvement, the Health Resources and Services Administration (HRSA) defines it as “systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups.” In addition to a practical definition, health systems need a roadmap to help guide successful quality improvement projects forward. diabetes care from secondary to primary care, ... commonly encountered by project teams when doing improvement. Additionally, using a data-driven approach can help engage stakeholders and make a … In 2011, AHRQ launched the Infrastructure for Maintaining Primary Care Transformation (IMPaCT) initiative, awarding four cooperative grants to support State-level QI efforts. [1–3] It is also evident that higher cost does not equate to better care. For its 8th annual QI plan, Sunnybrook Health had four strategic goals that were supported by multiple activities to improve the quality of service. With lives at stake and specific standards that must be met, hospitals are held more accountable for excellence than your typical organization. Enterprise Data Warehouse / Data Operating system, Leadership, Culture, Governance, Diversity and Inclusion, Patient Experience, Engagement, Satisfaction. Introduction. By consistently integrating information from a readiness assessment, an opportunity analysis, and expert resources, the health system was able to establish a prioritization and implementation approach to outcomes improvement that produced the following results: The health system plans to continue identifying large improvement opportunities aligned with its strategic planning cycle and the priorities identified by clinical and operational leadership. The health system leveraged its analytics platform and Health Catalyst professional services to perform a comprehensive analysis. Make sure you customize each program and process that you implement based on your organization's goals. As a result of its renewed efforts, process re-design, stakeholder engagement, and improved analytics, The University of Kansas Health System achieved impressive savings in just eight months, including: Healthcare systems working to improve care, reduce expenses, and improve the patient experience face many challenges, including the need to align changes across many levels of an organization. System leaders recognized the importance of reducing clinical variation and the need to have strong physician champions and robust analytics to effectively support improvement efforts. PDF. Quality Improvement in Family Practice: ... • Describe practical examples of QI initiatives that have made a measurable difference in quality of care of a family practice clinic. In comparison to the programs above, the following are examples of quality improvement projects in hospitals. Health Catalyst. PDF. Research in healthcare involves changing processes and creating better ones. Health Quality Ontario supports quality improvement in all primary care practice models. Enter: quality improvement projects in healthcare. Beth Israel was able to reduce readmissions, lengths of stay, incidents of deep vein thrombosis, infections, and complications, as well as patient mortality rates. Examples of Quality Improvement Projects in Reducing Medical Errors, Medication Errors, and Adverse Drug Events; Examples of Quality Improvement Projects in Reducing Hospital-Acquired Infections, Injuries, and Other Illnesses; Improving the Treatment of Sepsis; Examples of Quality Improvement Projects in the Continuity of Care for Patients What you SHOULD do once you’ve implemented those quality improvement programs, is find a way to report on them. Despite their proliferation and importance, quality improvement programs aren’t something a patient would necessarily notice or observe in a hospital. In order to thrive in an increasingly complex environment, financial and operational improvement projects are more important than ever. Click To Tweet. Hospital leaders embraced the challenge of reducing LOS to lower costs and lessen risk for its patients. Improved care coordination and physician engagement have successfully reduced LOS. Aimed at addressing fragmentation and gaps in the care pathway for people with dementia, the ‘Golden Ticket’ is an innovative composite model of intervention delivered in primary care and the community. Keywords. Successfully partnered with clinical leadership to transition ongoing denial reduction efforts to operational leaders. This program is effectively reducing the total cost of care. Posted in quality in primary care and insufficient keeping to standards of good care (Seddon et al., 2001; Kirk et al., 2003). An efficient accounting closing process delivers timely and accurate information to guide decisions and operational adjustments. Not all healthcare organizations operate in the same way, so there's never a one-size-fits-all approach. Despite previous initiatives, The University of Kansas Health System’s claim denial rate of 25% was higher than best practice (five percent). The RCGP has created a simple visual representation of quality improvement for primary care to give you an overview of your quality improvement journey. • Primary care practices handle a large variety oftests that involve both onsite and offsite ... guiding questions, examples, and links to additional resources. In order to help in the design, delivery and evaluation of your project they have put together a simple visual representation to … To help with this, there are growing numbers of evidence-based Quality Improvement (QI) methods that can help practitioners to assess and improve the care they provide. Here are some articles we suggest: Join our growing community of healthcare leaders and stay informed with the latest news and updates from Health Catalyst. Reduced 60 human touchpoints and opportunity for error. May we use cookies to track what you read? In many cases, organizations will choose to focus their energy and resources on one or two indicators. 4% relative reduction in emergency department (ED) length of stay (LOS) for patients with severe sepsis and septic shock. By adopting a systematic, data-driven, and multi-pronged approach, Memorial has achieved significant results in one year, including: The last example of financial and operational quality improvement projects comes from The University of Kansas Health System. PDF These hospitals have different focuses and priorities, but the QI programs for both reflect the overarching goal of improving the quality of care (encompassing patient experience, safety, and hygiene). Are you tracking the right KPIs? At the 2015 IHI National Forum in December, the IHI Open School selected four student and resident projects from close to 100 submissions to highlight in a special storyboard session. By gathering and analyzing data in key areas, a hospital can effectively implement change. Unlocking the Power of Patient-Reported Outcome Measures (PROMs), How to Evaluate Emerging Healthcare Technology With Innovative Analytics, Emergency Department Quality Improvement: Transforming the Delivery of Care, Improving Quality Measures Can Lead to Better Outcomes, I am a Health Catalyst client who needs an account in HC Community. UC San Diego was able to improve the quality and consistency of discharge instructions. Implementation of a health teaching intervention aimed at aiding in the recovery from acute myocardial infarction. QI requires 1901 N. Moore Street, Suite 502 | Arlington, VA 22209 | 866-568-0590 | [email protected], Copyright © 2020 Ascendant Strategy Management Group LLC d/b/a ClearPoint Strategy |. $3 million in recurring benefit, the direct result of denials reduction. Statistically significant decreases in average medication count. You can find more information on quality improvement projects in the s tudent handbook. Examples of prior quality improvement and research projects: Increasing access to naloxone in Primary Care for patients on chronic opioid therapy; Implementation of integrated Behavioral Health in a rural Primary Care clinic; Reducing inappropriate prescribing of proton pump inhibitors in Primary Care 4. More information on QI Ready Gaps in the quality of medical care in the United States and evidence of significant variation in medical prac-tice are well documented. Many programs are organization-wide, ongoing, and long-term (as you’ll see in some of the quality improvement examples later in this article). We take pride in providing you with relevant, useful content. The resulting report provides an engaging and cogent analysis of the key ... Getting leadership for quality improvement right requires a delicate combination of setting out . The outcomes were nothing but positive. Quality in Primary Care 2008; 16:387–9. Now more than ever, government and insurance reimbursement for patient care are based on health outcomes rather than procedures undertaken. We've defined QI programs and provided some current examples of quality improvement in leading healthcare organizations in the US and Canada. 47-day percentage point reduction in LOS. Four percent relative reduction in ICU LOS for patients with severe sepsis and septic shock admitted from the ED. T … Grants were awarded to projects in New Mexico, North Carolina, Oklahoma, and Pennsylvania. We take your privacy very seriously. To use this guide effectively, first identify the lab testing improvement “champion” or ... your quality improvement work around laboratory testing processes. Contact us to learn more about how our software can help healthcare organizations. practice management, quality improve-ment, small primary care practices. 9% relative difference in mortality for patients that received the evidence-based protocols compared to those who did not—the evidence-based protocols substantially reduce mortality. In order to reduce medication-related adverse events the health system initially considered expanding the involvement of pharmacists performing medication therapy management (MTM) to a group of Medicaid patients covered by a shared-risk contract. For example a ‘SMART’ aim looking at doing 6 week baby checks in a timely manner could be ‘To improve the percentage of 6 week baby checks performed between the start of week 6 and by end of week 8’. Emergency Department quality improvement is a journey that takes time and improving ED performance is much more than an emergency department initiative–it must involve the entire system of care. There are many quality improvement activities that take place in general practice, including audit, significant event analysis, analysing prescribing and referral data, and the Quality and Outcomes Framework. This project was undertaken simultaneously with the hospital’s efforts to improve medication reconciliation processes. Outcomes Improvement Healthcare Mergers, Acquisitions, and Partnerships, Health Resources and Services Administration. Embracing practice-based quality improvement (QI) represents one way for clinicians to improve the care they provide to patients while also improving their own professional satisfaction. Health professions students can play a critical role in quality improvement initiatives, both during their training and in their careers. Provided support for new data-driven governance structure. The project successfully reduced CAUTI rates from 2.67/month to .2/month. Quality Improvement Examples: Organization-Wide, Ongoing Programs. Davidoff F, Batalden P, Stevens D, Ogrinc G and Mooney S. Publication guidelines for quality improvement in health care: evolution of the SQUIRE project. Quality and Safety in Health Care 2005:14: 443–449. What is quality improvement? Improving Tobacco Use Screening and Smoking Cessation in a Primary Care Practi; Los Angeles Practice Uses EHR Functions for Quality Improvement; MedAllies and the Direct Project Support Secure Exchange of Clinical Information in EHR Systems; Meeting the Needs of a Diverse Patient Population through Patient Portals However, health systems have the ability to improve care, patient experience, and save lives through quality improvement projects that reduce clinical variation, preventable medical errors, hospital acquired infections, delays in patient discharge, and improve the bottom line. improving patient safety or lowering patient mortality). The analysis showed the following results: The analysis demonstrated the unique, positive impact pharmacist medication therapy management program is making on patient outcomes in the six-month period following the pharmacist MTM. The first example comes from UPMC, an academic medical center affiliated with the University of Pittsburgh. Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. Through its analytics platform and best-of-breed, ABC models, UPMC is improving quality and safety, reducing costs, and increasing value across service lines. Everyone involved in improvement projects from doctors and nurses, to data analysts and administrators are busy with other projects. 1% relative reduction in mortality for patients with severe sepsis and septic shock. QI Ready is a free online tool to support GPs and practice teams in better understanding QI methodologies and undertaking QI activities, including an online learning network and a series of QI learning modules. To effectively reduce revenue cycle and implement effective change, the health system needed to proactively identify issues that occurred early in the revenue cycle process. In an effort to create a high-quality health care system in the United States, many payers, providers, delivery systems, and other organizations are supporting the use of quality improvement (QI) 1initiatives to improve the performance of primary care practices. Mount Sinai’s “Lose the Tube” project focused on improving metrics around one specific medical device: catheters. The second example of a clinical quality improvement project deals with an issue well-known to hospital systems. There has been much developed on how to assure quality and effectiveness when making changes in clinical and non-clinical settings. It is your starting place for all QI tools, guidance and case studies. Health system leaders recognized that the common denominator to addressing threats to sustainability is to fully understand and effectively manage costs. However, they also realized that without understanding organizational strengths and weaknesses related to adopting change and improving outcomes, they would struggle to successfully implement initiatives that delivered the desired benefits and sustained improvements over time. 2020 HC Community is only available to Health Catalyst clients and staff with valid accounts. When the pub-lic is alerted to quality failures, such as prevent-able medication errors resulting in patient harm or death, concerns about the quality of health-care arise. You need to be able to complete your project in your primary care placement. Identifying sepsis early can be challenging, as the patient’s physical response presents as a syndrome of non-specific symptoms, which delays recognition, diagnosis, and treatment–all of which increases mortality rates. The second example of a clinical quality improvement project deals with an issue well-known to hospital systems. Include project AIM statement • Example: By December 2012, ABC Health Center will achieve 70% of eligible patients screened for colorectal cancer. QI projects are reactive and more focused on intervention. It’s important to note that QI programs are distinct from process-specific QI projects, which are designed to address and intervene on a specific issue. It … To address this, they implemented activity-based costing (ABC), facilitated by the Health Catalyst CORUS™ Suite, to deliver detailed and actionable cost data across the analytics environment, and support service line reporting, contract modeling, and clinical process improvement. Quality Improvement T H E A S H P D I S C U S S I O N G U I D E O N EXECUTIVE SUMMARY Providing high-quality, safe medical care is the primary goal of health systems. Before making this decision and developing a comprehensive business plan, the health system wanted to better demonstrate the unique impact pharmacists were making on patient outcomes. System leaders realized that, in order to provide its patients with world-class financial and clinical outcomes, it would need to engage differently with its clinical partners. Get a general overview of the Model for Improvement. They can also tackle very simple processes. QI capacity involves a deep understanding of and commitment to improvement to undertake ongoing, continuous QI work beyond any particular project. Compared to hospitals, so far there have been less requirements on primary care to demonstrate quality. For a practice, this requires (1) knowledge and understanding of QI approaches, and how to use data and feedback for QI; and (2) commitment of practice leadership and staff to dedicate time and resources to QI activities. Multiple months of data can now be run simultaneously. In this section, we provide two examples of quality improvement in healthcare that are specifically related to programs. Over five months, a new system of nursing documentation and physician orders was implemented that ensured patients in need of catheters were appropriately cared for. December 2011 . With lives at stake and specific standards that must be met, hospitals are held more accountable for excellence than your typical organization. quality improvement in primary care settings to better understand the nature and magnitude of adverse patient outcomes and how they can be addressed in these settings.5 The Commission’s role is to lead and coordinate national improvements in the safety and quality of health care. Improving and reducing length of stay (LOS) improves financial, operational, and clinical outcomes by decreasing the costs of care for a patient. Something as simple as more regular and systematic check-ins was able to dramatically reduce infection for Mount Sinai. Annual COPC QI Reports Memo . Primary Care Quality Improvement Toolkit . Learn more about our work with primary care practices through the Practice Innovation Network. Sepsis order set utilization in the ED has increased by more than 185 percent. Integrating autism screening into well child visits in a primary care clinic. Quality Improvement Methods. Broadly speaking, the below are best practices for most QI programs. Is a Medical Writer the Missing Accelerant to Your Outcome Improvement Efforts? Please see our privacy policy for details and any questions. Primary Care Quality Improvement Plans ... For example, an ... organizations will be able to prioritize QI projects and develop improvement plans for the year. By using a comprehensive data-driven approach to facilitate early sepsis identification and standardize the treatment of sepsis, including the addition of evidence-based alerts, Mission Health gained insights into sepsis performance to drive improvements. Targeting processes such as chronic obstructive pulmonary disorder readmissions and medication reconciliation at discharge, these quality initiative examples are very different from SHSC, but still focused on improving care overall. In this section, we provide two examples of quality improvement in healthcare that are specifically related to programs. Improve care through adopting the Chronic Care Model (CCM) and implementing practice redesign and quality improvement (QI) -Includes 3 major educational activities: (a) pre-course intro to QI and CCM; (b) 2-day forum on topic including QI, IT, chronic care model; (c) 6-month QI project with help of QI mentor - But health systems can learn from successful clinical quality improvement projects and implementing key principles of their success. $2,085 mean total cost of care reduction per patient in the six-month period after the first pharmacist MTM encounter; over $590,000 extrapolated out over 283 MTM patients. Would you like to learn more about this topic? QI projects are shorter term and more reactive than programs. 36% increase in sepsis screenings completed in the emergency department (ED). Faculty judges also selected runners up. Having a strategic management system like ClearPoint in place allows you to track your metrics for patient outcomes and patient care, identify areas that need improvement, and measure QI efforts and the resulting changes. These examples are provided to illustrate the practice improvement process, and that actual efforts devised by physicians and their team may differ based upon Using this comprehensive approach for early recognition and treatment, they achieved substantial improvements in sepsis outcomes, including the following: The health system will continue to use this proven plan to improve sepsis outcomes and enhance care for patients with sepsis and they are laying the groundwork to move the early identification screening tools to the outpatient setting, including urgent care centers and physician offices. Hospital leaders knew additional methods of providing more efficient and cost-effective quality care were needed to maintain long-term success. We develop, support and facilitate ways for primary care providers to build capacity and share knowledge to improve the quality of patient care. 12% reduction in hospital admissions per 1,000 members and a 10% reduction in emergency department visits per 1,000 members. To rethink its denials process, it simultaneously increased organizational commitment, refined its improvement task force structure, developed new data capabilities to inform the work, and built collaborative partnerships between clinicians and the finance team. It endeavours to improve quality of life for the whole dementia journey, supporting the patient and carer. Required Annual Reports PCC Scope of Service Statement . Extended Examples of Quality Improvement Projects in Adult Immunization These extended examples will highlight the Residency Clinic and the Private Practice as vaccination settings. But, health systems need to tackle the right projects at the right time for their organization. . USP 800> Compliance: A Hazardous Drug Safe Handling PPE Toolkit for Infusion Nurses, Cynthia Huff. This booklet contains three case studies developed by the Royal College of General Practitioners, National Institute for Health and Care Excellence and the Health Reductions in length of stay have allowed patients to return home earlier and spend more than 1,000 additional nights in their homes. Health Catalyst offers a roadmap to use best practice, adoption, and analytics together to drive outcomes improvement. Ensuring patients receive care that is safe and of high quality is an essential part of modern healthcare. On quality improvement programs, is find a way to report on.... Is only available to health Catalyst offers a roadmap to use best practice, adoption, and Pennsylvania Clinic. Use cookies to track what you read delivers timely and accurate information guide. And accreditation requirements section, we provide two examples of quality improvement project with... Ed ) length of stay ( LOS ) for patients with severe sepsis and shock... As more regular and systematic check-ins was able to dramatically reduce infection for Sinai! Are increasingly threatening the future of healthcare organizations operate in the background of day-to-day! Visual representation of quality improvement in healthcare that may help others in their careers a quality improvement programs, find! To guide the development and documentation of your quality improvement for primary care with other.! 4 % relative reduction in mortality for patients with severe sepsis and shock. This program is effectively reducing the total cost of care to lower and... With other projects on helping health systems need to tackle these problems, many quality improvement leading. Writer the Missing Accelerant to your Outcome improvement efforts operational improvement projects in hospitals benefit, result! Build capacity and share knowledge to improve patient care are based on organization... That higher cost does not equate to better care the tools you need to take action and improve! To drive outcomes improvement from the ED has increased by more than 1,000 additional nights in careers! Reactive than programs an excellent example of how tangible changes can result from a QI project aimed! A roadmap to use best practice, adoption, and Partnerships, health care:! Implemented those quality improvement team 's Aim Statement and PDSA cycles from this list of 108 measures. Process that you implement based on health outcomes rather than procedures undertaken assure quality and consistency of discharge instructions place. Is find a way to report on them awarded to projects in the recovery from acute myocardial infarction 's! Project teams when doing improvement improvement to undertake ongoing, long-term, and proactive initiatives that span organization. Previously implemented evidence-based sepsis care bundles despite their proliferation and importance, improve-ment! Concerned specifically with a hospital can effectively implement change the examples of quality improvement projects in primary care time for their organization )... The right projects at the right time for their organization. ) our large primary care, commonly... The hospital ’ s sixth largest health system leveraged its analytics platform and health Catalyst a! Health systems can learn from successful clinical examples of quality improvement in healthcare or, specifically! Results are typically reviewed within one business day, affording more time for their.! Qi ) domain in improvement projects since 2008 take pride in providing you with relevant, content! At stake and specific standards that must be met, hospitals are held more accountable for excellence than your organization. Clinicians based on your organization 's goals and outcomes Framework included the introduction of a clinical face. From doctors and Nurses, Cynthia Huff than procedures undertaken play a critical element of a improvement. The below are three excellent financial and operational examples of quality improvement ( )!