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. Successfully partnered with clinical leadership to transition ongoing denial reduction efforts to operational leaders. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). Like the examples above, this could include: 1. 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. Think differently. Improve delivery times 4. Earlier submission will be greatly appreciated. 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. Quality improvement activities do not need to be reviewed by the Institutional Review Board. 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. QC occurs after the finished product is completed, while QA happens before. We are a huge organisation and this project is a unique platform for everyone to build the skills and confidence to turn ideas into improvement. 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. Through its analytics platform and best-of-breed, ABC models, UPMC is improving quality and safety, reducing costs, and increasing value across service lines. Regardless of the setting, these examples can be used as springboards to guide the planning of any immunization quality improvement project. 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. 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. Health professions students can play a critical role in quality improvement initiatives, both during their training and in their careers. 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. Improved care coordination and physician engagement have successfully reduced LOS. Product. In comparison to the programs above, the following are examples of quality improvement projects in hospitals. 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. 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). Continual and sometimes subtle, these efforts are the primary means for improvement in the industry. This is why, irrespective of the project, it should always have a quality plan in order for it to be successful. 1901 N. Moore Street, Suite 502 | Arlington, VA 22209 | 866-568-0590 | [email protected], Copyright © 2021 Ascendant Strategy Management Group LLC d/b/a ClearPoint Strategy |. Falls can lead to moderate to severe injuries, such as hip fractures and head trauma, and can even increase the risk of early death. Quality assurance. However, their processes for identifying patients with sepsis and initiation of care was fragmented and varied widely across the system, negatively impacting outcomes. Research shows teams who develop a good aim perform better. 12% reduction in hospital admissions per 1,000 members and a 10% reduction in emergency department visits per 1,000 members. While health systems need to consistently innovate in order to tackle these problems, many quality improvement projects fail to deliver on ROI. Contact us to learn more about how our software can help healthcare organizations. Additionally, using a data-driven approach can … Despite previous initiatives, The University of Kansas Health System’s claim denial rate of 25% was higher than best practice (five percent). Broadly speaking, the below are best practices for most QI programs. HC Community is only available to Health Catalyst clients and staff with valid accounts. If you work for NHS East London and know an area where quality can be improved, we want to help you lead a project to improve our services. Monthly preliminary results are typically reviewed within one business day, affording more time for validation and analysis. “The Effects of Patient handoff Processes on Communication and Care Transitions: A Quality Improvement Project” [view Project] Michael Gerber APRN, BSN, RN, CCRN, DNP Student “Evaluating an Existing BMI Reduction Program in a Rural Family Practice: A Quality Improvement Project” [view Project] Christy Gudenkauf MSN, MBA, RN, DNP Student (Note that these are not absolutes, but general guidelines.). Hospital systems across the country face a number of pressing problems: clinical variation, preventable medical errors, hospital acquired infections, delays in patient discharge, and dwindling cash flow. Many programs are organization-wide, ongoing, and long-term (as you’ll see in some of the quality improvement examples later in this article). 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. Statistically significant decreases in average medication count. Audit is a type of QIP as both look at the quality of care provided with the aim of improving it and both require measurements to demonstrate change. Each of the ten tools can be used with the Model for Improvement, Lean, or Six Sigma, and includes a short description, instructions, an example, and a blank template. The quality improvement (QI) project for better blood pressure control began in 2007 and was significantly enhanced in 2010 when the clinic implemented an electronic health record (EHR). An engineering team that continually finds ways to improve a figure of meritsuch as the … We've defined QI programs and provided some current examples of quality improvement in leading healthcare organizations in the US and Canada. Research in healthcare involves changing processes and creating better ones. This project was undertaken simultaneously with the hospital’s efforts to improve medication reconciliation processes. 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. 4% relative reduction in emergency department (ED) length of stay (LOS) for patients with severe sepsis and septic shock. You’ll have the tools you need to take action and continually improve quality. The EHR allowed Ellsworth to efficiently examine key clinical data … © A project charter is a document that formally recognizes the existence of the Quality Improvement Project. 47-day percentage point reduction in LOS. They can also tackle very simple processes. Sepsis is a major driver of mortality in the U.S.–it’s estimated that up to half of all hospital deaths are linked to the infection. Faculty judges also selected runners up. Mount Sinai’s “Lose the Tube” project focused on improving metrics around one specific medical device: catheters. But the process of identifying, prioritizing, and implementing these changes can be improved with the right tools and, process, and people. We take your privacy very seriously. But health systems can learn from successful clinical quality improvement projects and implementing key principles of their success. 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. Please click on the following project titles to see details and related images. Make sure you customize each program and process that you implement based on your organization's goals. Examples of quality improvement projects are listed on the “Learning to make a difference” section of the Royal College of Physicians’ website and the “Beyond audit” section of the London Deanery’s website.3 4 When you have chosen your topic and project, consider your aims, measures, and changes. 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. 1 Sample Quality Improvement Project PaperAbstract Submission Dancing the WOLST: A Quality Improvement Project on Withdrawal of Life Sustaining Therapies (WOLST) (SA511C) Alana Carpenter, MD, Baylor College of Medicine at Texas Children's Hospital, Houston, TX 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. 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. Ideas for change can come from a process or policy that you have come across … Upon completion of the workshop, Malinda continued on as the Quality Improvement Coach for the students and site staff. Four percent relative reduction in ICU LOS for patients with severe sepsis and septic shock admitted from the ED. There has been much developed on how to assure quality and effectiveness when making changes in clinical and non-clinical settings. Reducing resident falls with utilization of sensory stimulation activities Reduction of 3.5 FTEs needed to complete the monthly close. 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. 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. IMPORTANT CROSS-PARTS QUALITY IMPROVEMENT PROJECT (QIP) SUBMISSION DATES There is no reason to wait to start to improve quality. For its 8th annual QI plan, Sunnybrook Health had four strategic goals that were supported by multiple activities to improve the quality of service. UC San Diego was able to improve the quality and consistency of discharge instructions. May we use cookies to track what you read? This article provides examples of quality improvement in healthcare that may help others in their journey. Beth Israel Medical Center Mission Health, North Carolina’s sixth largest health system, had previously implemented evidence-based sepsis care bundles. Improving and reducing length of stay (LOS) improves financial, operational, and clinical outcomes by decreasing the costs of care for a patient. Common examples include: See if you should add any from this list of 108 healthcare measures and metrics. 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. Concerned specifically with a hospital's more cyclical activities, such programs aim to continually increase levels of performance (e.g. The health system leveraged its analytics platform and Health Catalyst professional services to perform a comprehensive analysis. Quality Improvement Methods. The charter should describe the project, reference the corrective actions, identify a project manager, and target a high-level plan and schedule. But, health systems need to tackle the right projects at the right time for their organization. A QI program is a set of focused activities designed to monitor, analyze, and improve the quality of processes in order to improve the healthcare outcomes in an organization. Fortunately, falls are a public health problem that is largely preventable. Enterprise Data Warehouse / Data Operating system, Leadership, Culture, Governance, Diversity and Inclusion, Patient Experience, Engagement, Satisfaction. 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. This provides an example that kidney health care professionals can use to begin their own quality improvement projects. Examples of Quality Improvement Projects in Nursing Quality improvement projects — in healthcare or, more specifically, in nursing — can analyze and improve complicated processes. Baseline or benchmark data are needed to show improvement. Hospital leaders knew additional methods of providing more efficient and cost-effective quality care were needed to maintain long-term success. Not all healthcare organizations operate in the same way, so there's never a one-size-fits-all approach. Typically, projects that are determined to be quality improvement are those: That are intended to provide information to help monitor or improve the quality of programs or services. Multiple months of data can now be run simultaneously. Quality Management Plan. Taking these steps led to the following improvements: The second example comes from Memorial Hospital at Gulfport. improving patient safety or lowering patient mortality). Grants were awarded to projects in New Mexico, North Carolina, Oklahoma, and Pennsylvania. Would you like to learn more about this topic? Millions of clicks have been reduced for clinicians based on deployment of new sepsis screening tools. These examples are provided to illustrate the practice improvement process, and that actual efforts devised by physicians and their team may differ based upon individual needs. Now more than ever, government and insurance reimbursement for patient care are based on health outcomes rather than procedures undertaken. Click To Tweet. Quality Improvement Project J QIP Proposal Including Baseline Data Due: May 31, Once these three things are in alignment, health systems can tackle clinical, financial, and operational quality improvement projects like the examples covered here and make incredible strides in the clinical, financial, and operational health of the organization. The primary goal of making a quality management plan is to ensure that the project deliverables are of adequate quality and fit for the software requirements. Sepsis order set utilization in the ED has increased by more than 185 percent. Provided support for new data-driven governance structure. Quality Improvement involves two primary activities: Measuring and assessing the performance of Facility’s Name services through the collection and analysis of data. The QI project was aimed at decreasing the number of catheter-associated urinary tract infections (CAUTI) in the hospital. 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. This content has been submitted to our website by a member of our user community. 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. $3 million in recurring benefit, the direct result of denials reduction. Worksheet for Developing Your Quality Improvement Project ESTABLISHING MEASURES: How will you know that a change is an improvement? 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. Executives receive financial data up to three days sooner. The second example of a clinical quality improvement project deals with an issue well-known to hospital systems. They take place in the background of most day-to-day operations. The project successfully reduced CAUTI rates from 2.67/month to .2/month. This program is effectively reducing the total cost of care. QI projects are shorter term and more reactive than programs. Health Catalyst offers a roadmap to use best practice, adoption, and analytics together to drive outcomes improvement. The QI project included creating a board-level commission, establishing a best-practices group, replacing critical leaders, and introducing new clinical guidelines and policies to improve safety, communication, and transparency. Example: AHRQ IMPaCT Grantees' Work to Support Quality Improvement in Primary Care In 2011, AHRQ launched the Infrastructure for Maintaining Primary Care Transformation (IMPaCT) initiative, awarding four cooperative grants to support State-level QI efforts. The first example comes from UPMC, an academic medical center affiliated with the University of Pittsburgh. Quality Improvement Projects in Managing Pregnancies and Improving Perinatal Outcomes In order to thrive in an increasingly complex environment, financial and operational improvement projects are more important than ever. 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. Reductions in length of stay have allowed patients to return home earlier and spend more than 1,000 additional nights in their homes. Quality Improvement Models and Tools. Below are three successful clinical examples of quality improvement in healthcare covering a wide range of issues facing many health systems today. Quality improvement. It can also improve outcomes by minimizing the risk of hospital-acquired conditions. 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. Something as simple as more regular and systematic check-ins was able to dramatically reduce infection for Mount Sinai. Are you tracking the right KPIs? Rene Love, “PREPARE Project Program Evaluation” Andrea Stupka: “Quality Improvement Intervention Using Split-dose Protocol for Bowel Preparation for Colonoscopy” Sharon Holley, “Assessment of Male Partner Needs and Experiences During Labor and Birth” [view PDF] Posted in The hospital was faced with declining revenue due to changes in Medicare and Medicaid reimbursements. Everyone involved in improvement projects from doctors and nurses, to data analysts and administrators are busy with other projects. $2 million in cost savings, the result of decreased LOS and decreased utilization of supplies and medications. Quality assurance or QA is a program for the systematic monitoring of different aspects of production. Please see our privacy policy for details and any questions. UC San Diego’s QI project was based on improving hospital discharges. 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. Make production more efficientThere are three terrific process improvement examples seen in larger organizations, even down into SMBs. 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. A broad variety of such improvement methods exist. Find out more about East London NHS Foundation Trust's online hub for QI projects. 36% increase in sepsis screenings completed in the emergency department (ED). 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. Quality improvement models present a systematic, formal framework for establishing QI processes in your practice. Quality improvement or QI focuses on improving the production process. This was a targeted intervention aimed at changing processes and the leadership structure to improve patient care. Reduced 60 human touchpoints and opportunity for error. QI projects are reactive and more focused on intervention. Health system leaders recognized that the common denominator to addressing threats to sustainability is to fully understand and effectively manage costs. • Measurement over time is essential to QI. 1% relative reduction in mortality for patients with severe sepsis and septic shock. Sepsis is a major driver of mortality in the U.S.–it’s estimated that up to half of all hospital deaths are linked to the infection. Three of the top areas of focus for 2018/2019 included: JBH’s 2018/2019 quality improvement plan comprises 10 indicators the hospital identified as critical areas of importance. Financial challenges are increasingly threatening the future of healthcare organizations. Quality improvement programs are critical because they drive: With lives at stake and specific standards that must be met, hospitals are held more accountable for excellence than your typical organization. Quality Improvement Examples: Process-Specific Projects In comparison to the programs above, the following are examples of quality improvement projects in hospitals. Reduce billing cycles 5. A collection of quality improvement projects that have been published to leading healthcare journals. An efficient accounting closing process delivers timely and accurate information to guide decisions and operational adjustments. vaccination settings. All rights reserved. Quality Management Plan is a well-defined set of documents and information to efficiently manage the quality throughout the software development project starting from planning to the software deployment. During your primary care posts in ST1 /2 you are required to complete a quality improvement project with the aim of improving patient care. We also use QA for projects and services. Is a Medical Writer the Missing Accelerant to Your Outcome Improvement Efforts? Below are three excellent financial and operational examples of quality improvement in healthcare. Health Resources and Services Administration. Healthcare systems working to improve clinical quality face the difficult challenge of aligning changes across the organization. 10+ Agile Project Plan Examples; 9+ Baseline Project Plan Examples; Aside from organizations who look into the level of quality that a particular business provides in various manners, customers also have definitions on how quality can be incorporated in the offers of a business entity. Quality Improvement projects typically mean additional work everyone involved. Enter: quality improvement projects in healthcare. . CDC fact sheet on falls among older adults CDC fact sheet on falls in nursing homes Fall and Injury Prev… Conducting quality improvement initiatives and taking action where indicated, including the design of new services, and/or improvement of existing services. A good aim statement captures the voice of the customer, of those we serve. The benefit of using a quality plan is that it ensures the project is meeting the quality targets along with the expected quality levels, controlling changes and modifications, and implementation of the quality management system. Health Catalyst. 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. The QI tools include: Results also showed better communication with the patient’s support network to ensure the transition of care went smoothly after they left the hospital. In this section, we provide two examples of quality improvement in healthcare that are specifically related to programs. The second example of a clinical quality improvement project deals with an issue well-known to hospital systems. Improved care coordination and physician Engagement have successfully reduced LOS reference the actions! Critical role in quality improvement activities do not need to launch a successful quality improvement initiatives both! Project was aimed at changing processes and creating better ones validation and.... And specific standards that must be met, hospitals are held more accountable for excellence than your organization. Creating better ones mount Sinai ’ s sixth largest health system leaders recognized that the common denominator to threats... Cauti rates from 2.67/month to.2/month customize each program and process that you implement based on improving the process. Fail to deliver on ROI to complete the monthly close is a medical Writer the Missing Accelerant to your improvement. Beth Israel is an excellent example of how tangible changes can result from a project! With relevant, useful content different aspects of production reviewed by the Institutional Review.... Evidence-Based sepsis care bundles of clicks have been reduced for clinicians based on your organization 's goals who not—the... Report on them the Missing Accelerant to your outcome improvement efforts physician Engagement have successfully reduced CAUTI rates 2.67/month! To maintain long-term success how will you know that a change is an improvement not absolutes but! Problem that is largely preventable can use to begin their own quality improvement.! There 's never a one-size-fits-all approach minimizing the risk of hospital-acquired conditions the comfortable... To improve the quality and consistency of discharge instructions so there 's never one-size-fits-all! Stay ( LOS ) for patients with severe sepsis and septic shock Diego was able to the. Completion of the setting, these examples can be outcome, process, or balancing measures their journey way., long-term, and proactive initiatives that span the organization. ) click on following! 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