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Posterboard Number:
377
Organization Name:
Geisinger Medical Center
Contact Name:
Michael
Contact Email:
mjrichardson@geisinger.edu
Description:
Historically, the mode of ventilation used for open heart patients was Pressure Regulated Volume Control (PRVC) or Volume Control. When patients began to spontaneously breathe they were switched to Pressure Support (PS) mode in preparation for extubation. Using this strategy, 60% of patients were extubated within six hours post operatively. Utilizing a dual mode of ventilation such as Adaptive Support Ventilation (ASV) increases awareness of patient readiness for extubation and decreases weaning prior to extubation. Using this new strategy our facility was able to decrease the time to extubation for post-operative cardiac patients.
Track(s):
Student
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Posterboard Number:
373
Organization Name:
Geisinger Medical Center
Contact Name:
Michael
Contact Email:
mjrichardson@geisinger.edu
Description:
Prior to the initiation of a volume re-expansion protocol, cardio-thoracic surgery patients in our facility used oxygen for > 3 days. Volume re-expansion therapy was performed > 3 days, or until discharge. Volume re-expansion therapy consisted of IPPB, CPT, and Flutter therapy and was performed QID. The utilization of a respiratory driven protocol has led to the development of an effective protocol geared towards optimization of bedside respiratory therapies. This optimization has resulted in decrease of oxygen utilization, a decrease in length of post-operative volume expansion therapy, improved workflow, and increased interdisciplinary collaboration at the bedside.
Track(s):
Student
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Posterboard Number:
372
Organization Name:
Geisinger Medical Center
Contact Name:
Michael
Contact Email:
mjrichardson@geisinger.edu
Description:
Prior to the initiation of a volume re-expansion protocol, cardio-thoracic surgery patients in our facility used oxygen for > 3 days. Volume re-expansion therapy was performed > 3 days, or until discharge. Volume re-expansion therapy consisted of IPPB, CPT, and Flutter therapy and was performed QID. The utilization of a respiratory driven protocol has led to the development of an effective protocol geared towards optimization of bedside respiratory therapies. This optimization has resulted in decrease of oxygen utilization, a decrease in length of post-operative volume expansion therapy, improved workflow, and increased interdisciplinary collaboration at the bedside.
Aim:
To optimize bedside volume re-expansion therapy provided to post-operative open heart patients.
Actions Taken:
Volume Re-Expansion Therapy is performed around the clock, in synchrony with the patient’s sleep protocol, and pain therapy. Volume re-expansion therapy is continued until the patient is back to baseline oxygen requirement, mobile, and achieving a minimal inspiratory capacity. Respiratory patient driven protocols are performed every 48- 72 hours.
Summary of Results:
Oxygen utilization days and volume expansion therapy days have decreased from an average of 3-4 days to an average of 2.12 days. In looking at 400 patients, the potential savings in patient oxygen consumption dropped from 3-4 days ($574,632 - $766,176) to 2.12 days ($406,073.28), yielding savings of $360,102.72.
Track(s):
Improvement Capability
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Posterboard Number:
513
Organization Name:
National University Hospital
Contact Name:
Sucharita
Contact Email:
sucharita_hota@nuhs.edu.sg
Description:
Patients come to hospital with the expectation of receiving the best possible care with nil harm. Despite best efforts, patients sometimes suffer unintentional iatrogenic injuries. These can be temporary or lead to permanent disabilities or even death. The National Healthcare Group conducted reviews to study the incidence of AEs in hospitals across Singapore in the years 2007 and 2010. NUH AE rates were noted to be 11.6% and 6.3% respectively. Trained staff continuously monitor AE rates using the IHI Global Trigger tool method to conduct retrospective chart reviews to identify AEs and implement patient safety initiatives to mitigate future occurrences.
Aim:
To maintain NUH AE rates at below 6.3% (2010)
Actions Taken:
Initiatives undertaken addressed AE rates and enhanced the safety culture addressing issues of teamwork, co-ordination, handoffs, transitions, non-punitive response to errors and escalation, training and education of medical students, junior and senior doctors, credentialing/supervision, and maintaining accreditation standards. Introduction of the NUH Patient Safety Strategy instilled command/personal accountability to safety.
Summary of Results:
Sustained efforts have resulted in maintaining the NUH AE rate within 6.4% (Q22015) (Fig 1). Effective leadership at all levels has played a critical role in establishing a robust patient safety culture. Upholding safety standards at individual and team levels has been key to maintaining a low AE rate.
Track(s):
Patient Safety
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Posterboard Number:
448
Organization Name:
Portsmouth Hospitals NHS Trust
Contact Name:
Ross
Contact Email:
ross.sherrington@porthosp.nhs.uk
Description:
Set to enhance the experience of the patients living with dementia during their stay on a trauma orthopaedic unit. By utilising an 'Obseration of Care' tool and conducting semi-structured interviews with patient's relatives. Core themes were identified. Acting on these insights, an understanding of a range of issues relating to this patient group and care environment were established. This supported the staff to see the 'individual in the patient' and to value the patient's perspective. With such perception, the staff were able to adapt their approach to individual need when employing a range of activities to enhance socal interaction.
Aim:
For individuals living with dementia, to engage in social activitiies, whilst on an orthopaedic unit.
Actions Taken:
The following initiatives were instigated:- (1) The implementation of the 'Observation of Care' tool with a broad range of staff (2) Completing interviews with relatives (3) Ensuring that 'This is Me' support document is easily accessible to all and promoting staff engagement (4) Education boards located on wards.
Summary of Results:
Enhanced patient and relative engagement and social interaction based on the preferences of individuals. The continuing strategy affords a means of reflecting on issues affecting our approach to those living with dementia whilst staying on a trauma orthopaedic ward.
Track(s):
Person- and Family-Centered Care
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Posterboard Number:
81
Organization Name:
Toronto Rehabilitation Institute
Contact Name:
Carol
Contact Email:
carol.fancott@utoronto.ca
Description:
This demonstration project has developed, implemented, and evaluated ‘real-time patient advisory groups’, designed to better understand the patient experience of care, and to engage patients in quality and safety during their inpatient rehabilitation stay. These groups bring together two key strategies for engaging with patients and families: developing advisory groups with current patients, and seeking their experiences in real time to guide local improvement opportunities. Key learnings include strong leadership support and local champions to enable engagement and learning; creating a comfortable environment to generate open discussion about experiences; and the need to develop communication processes & accountabilities for action.
Aim:
To provide a structured method to better understand the patient experience to guide improvement opportunities.
Actions Taken:
Real-time groups were implemented and evaluated in one rehabilitation unit, with focused discussions of patients’ experiences on topics such as goal setting, the admission and discharge process, and pain management. Developmental evaluation using interviews, focus groups, and surveys of patients and staff examined the processes and outcomes of patient engagement.
Summary of Results:
To date, we have conducted 17 real-time groups with 139 inpatients and 39 family members. Group feedback has generated a number of improvements aimed to enhance the experience of care, including the development of many patient education materials, refinement of care processes, and increased patient activities during their inpatient stay.
Track(s):
Person- and Family-Centered Care
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Posterboard Number:
464
Organization Name:
The Aga Khan Secondary Hospital, Hyderabad.
Contact Name:
Saniya
Contact Email:
saniya.amar@aku.edu
Description:
With increasing demand of care in health care, the numbers of healthcare associated infections are also increasing which, compromise patient’s safety and quality care. It is important for all healthcare providers to understand the importance of hand-hygiene compliance. “Hand hygiene is at the heart of infection control, an essential procedure of universal relevance in health care” (WHO, 2009). In general, hand hygiene is to reduce germs by washing hands with soap and water or with alcohol based rubs. Initiating with the team using PDCA methodology, 2 brain storming sessions, and KAP survey was conducted and improvement-strategies were planned.
Aim:
To enhance hand-hygiene compliance among health care workers from 62.2% to 80% in 2014
Actions Taken:
Multiple strategies were conducted with multi-disciplinary teams in which availability equipment and material, Hand-hygiene flyer placement, patient/family education material, multiple awareness sessions conducted. With that hand hygiene week was celebrated with the theme "Clean Hands Save Lives". In the continuity reminders, awareness sessions for patients and HCWs are conducted regularly.
Summary of Results:
At grass root level all frontline staff, patients and their families were involved in project activity. With the time and continuous team efforts AKMCCC, Hyderabad has achieved and sustained 82% hand hygiene compliance in 2nd quarter 2015.
YEAR RESULTS
2013=66.20%
1st Qtr,2014=63.3%
2nd Qtr,2014=66%
3rd Qtr,2014=88.0%
4th Qtr,2014=82%
Track(s):
Patient Safety
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Posterboard Number:
193
Organization Name:
Baylor Scott and White Medical Center At Irving
Contact Name:
J. Brice
Contact Email:
brice.king@baylorhealth.edu
Description:
In the acute care setting, are high fall risk patients less likely to fall if multidisciplinary communication is increased with the use of a communication board and the catch phrase, “I Will Fall,” compared to fall rates on the unit prior to the creation of the communication board? The accompanying storyboard gives a brief overview of one fall reduction technique used and how the Progressive Care Unit eliminated patient falls.
Aim:
The aim was to reduce inpatient fall rates by improving communication across the care team.
Actions Taken:
Creation of a multidisciplinary communication board and a catch phrase "I Will Fall" in order to raise awareness of a patient's increased fall risk.
Summary of Results:
After implementation of the multidisciplinary communication board, fall rates on the unit were totally eliminated throughout the duration of the study.
Track(s):
Patient Safety
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Posterboard Number:
256
Organization Name:
London Health Sciences Centre
Contact Name:
K.
Contact Email:
jennifer.yoon@lhsc.on.ca
Description:
Effective patient-provider communication is essential to the patient experience and can impact patient safety, satisfaction and health outcomes. LHSC’s Speech-Language Pathology (S-LP) Service piloted use of iPads with speech generating programs to enable communication with ventilator dependent, stroke, medicine and surgical patients. A survey was developed asking patients and families to evaluate the impact of this quality improvement initiative.
The survey addressed two areas of effectiveness:
1) Technical components and training of the device, using a 3 point scale
2) Communication exchanges and ease of experience, using a 5 point scale
A space was also provided for free form comments.
Track(s):
Student
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Posterboard Number:
355
Organization Name:
Adventist HealthCare Physical Health and Rehabilitation
Contact Name:
Marya
Contact Email:
MSabalba@adventisthealthcare.com
Description:
According to the Center for Disease Control, “hand hygiene is the #1 way to prevent the spread of infections.” At Adventist HealthCare Physical Health & Rehabilitation (PH&R) our hand hygiene compliance has traditionally been around 95%. In October 2014, PH&R’s infection control nurse resigned and we began to experience a decline in both hand washing compliance scores and the observations being recorded. PH&R experienced its lowest compliance rate of 73% on December 2014. At this point, Lean Six Sigma Project was initiated to redesign the process into a more stable non-person dependent method.
Aim:
PH&R’s aim is to increase hand hygiene compliance rate and number of observations.
Actions Taken:
PH&R began to identify key areas of improvement and created a strategy.
- Reduce redundancies
- Create database that will highlight, filter, and analyze the data.
- Increase observers
- Begin coaching those who are non-compliant
- Communicate to all employees for the quest for hand hygiene compliance
Summary of Results:
As of March 2015, the number of observations increased and had its highest observation rate since 2014 of 295 in September 2015. PH&R’s compliance rate met the target in June 2015 at 95% and subsequently increased in August and September of 2015 to 96%.
Track(s):
Patient Safety
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