June 23, 2011
“Variability in admissions and lengths of stay inherently leads to variability in bed occupancy. The aim of this paper is to analyse the impact of these sources of variability on the required amount of capacity and to determine admission quota for scheduled admissions to regulate the occupancy pattern. For the impact of variability on the required number of beds, we use a heavy-traffic limit theorem for the G/G/∞ queue yielding an intuitively appealing approximation in case the arrival process is not Poisson. Also, given a structural weekly admission pattern, we apply a time-dependent analysis to determine the mean offered load per day. This time-dependent analysis is combined with a Quadratic Programming model to determine the optimal number of elective admissions per day, such that an average desired daily occupancy is achieved. From the mathematical results, practical scenarios and guidelines are derived that can be used by hospital managers and support the method of quota scheduling. In practice, the results can be implemented by providing admission quota prescribing the target number of admissions for each patient group.”
Posted in Journal Articles, READ Portal | Tagged with Efficiency, Health planning, Safety | No Comments
June 7, 2011
“Hoping to reduce medication errors and contain health care costs, policy makers are promoting electronic prescribing through Medicare and Medicaid financial incentives. Many e-prescribing systems provide electronic access to important information—for example, medications prescribed by physicians in other practices, patient formularies and generic alternatives—when physicians are deciding what medications to prescribe. However, physician practices with e-prescribing face challenges using these features effectively, according to a new qualitative study by the Center for Studying Health System Change (HSC) funded by the Agency for Healthcare Research and Quality (AHRQ).
While most of the 24 practices studied reported that physicians had access to patient formulary information, only slightly more than half reported physician access to patient medication histories, and many physicians did not routinely review these sources of information when making prescribing decisions. Study respondents highlighted two barriers to use: 1) tools to view and import the data into patient records were cumbersome to use in some systems; and 2) the data were not always perceived as useful enough to warrant the additional time to access and review them, particularly during time-pressed patient visits. To support generic prescribing, practices typically set their system defaults to permit pharmacist substitution of generics; many practices also used other tools to more proactively identify and select generic alternatives at the point of prescribing. Overall, physicians who more strongly perceived the need for third-party data, those in practices with greater access to complete and accurate data, and those with easier-to-use e-prescribing systems were more likely to use these features consistently.”
Posted in Journal Articles, READ Portal | Tagged with e-health, Health technology, Prevention and control, Safety, Technology | No Comments
June 6, 2011
“Partnering to Heal is a computer-based, video-simulation training program on infection control practices for clinicians, health professional students, and patient advocates.
The training highlights effective communication about infection control practices and ideas for creating a “culture of safety” in healthcare institutions to keep patients from getting sicker. Users assume the identity of the following five main characters and make decisions about preventing healthcare-associated infections (HAIs):
- A Physician, Nathan Green, Director of a Hospital Post-op Unit, ready to start new prevention efforts in the unit;
- A Registered Nurse, Dena Gray, working to learn effective communications skills that could make the difference for her patients;
- An Infection Preventionist, Janice Upshaw, a new employee charged with using a team-based approach to reducing infections;
- A Patient Family Member, Kelly McTavish, whose father was just admitted to the hospital;
- A third-year Medical Student, Manuel Hernandez, who wants to gain confidence to make a difference for his patients.”
Posted in Multimedia, READ Portal | Tagged with Health technology, Infection control, Information technology, Patient-centered care, Prevention and control, Safety | No Comments
May 30, 2011
“The lack of systematic oversight of physician performance has led to some serious cases related to physician competence and behaviour. We are currently implementing a hospital-wide approach to improve physician oversight by incorporating it into the hospital credentialing process. Our proposed credentialing method involves four systems: (1) a system for monitoring and reporting clinical performance; (2) a system for evaluating physician behaviour; (3) a complaints management system; and (4) an administrative system for maintaining documentation. In our method, physicians are responsible for implementing an annual performance assessment program. The hospital will be responsible for the complaints management system and the system for collecting and reporting relevant health outcomes. Physicians and the hospital will share responsibility for monitoring professional behaviour. Medical leadership, effective governance, appropriate supporting information systems and adequate human resources are required for the program to be successful. Our program is proactive and will allow our hospital to enhance safety through a quality assurance framework and by complementing existing safety activities. Our program could be extended to non-hospital physicians through regional health or provider networks. Central licensing authorities could help to coordinate these programs on a province- or state-wide basis to ensure uniformity of standards and to avoid duplication of efforts.”
Posted in Journal Articles, READ Portal | Tagged with Leadership, Process improvement, Quality control, Quality improvement, Safety | No Comments
May 20, 2011
“Health care organizations use Safety Briefings to help increase staff awareness of patient safety issues, create an environment in which staff share information without fear of reprisal, and integrate the reporting of medication safety issues into daily work. Over time, Safety Briefings help organizations create a culture of safety, reduce the risk of medication errors, and improve quality of care. The tool includes step-by-step instructions for conducting Safety Briefings, a data collection form, and a pre- and post-survey to evaluate the effectiveness of the tool.”
Posted in Multimedia, READ Portal | Tagged with Patient-centered care, Safety | No Comments
May 19, 2011
Electronic health records have the potential to help doctors with error reduction, reduce clutter, and improve patient care. They stand to lower overall administration costs and to improve operational safety as they offer better data tracking. Despite this, electronic health record adoption has sometimes been a slow process. Doctors cite a number of concerns about their implementation, including: the rapidity of technological obsolescence; the high cost of implementing systems and training staff in their use; lack of cross compatibility between systems; etc.
Posted in Journal Articles, READ Portal | Tagged with e-health, Safety, Technology | No Comments
May 11, 2011
“In 2000, the Institute for Healthcare Improvement (IHI) convened a group of patient safety experts to envision and specify the characteristics of an ideal medication system. An important element of such a system was the strong commitment of senior leadership to a culture that encouraged safety. The author conceived of WalkRounds™ during these IHI meetings, as a tool to connect senior leaders with people working on the front line — both as a way to educate senior leadership about safety issues and to signal to front-line workers the senior leaders’ commitment to creating a culture of safety.”
“This tool describes the format for WalkRounds™ and includes suggestions about questions for leaders to ask staff, which senior leaders should participate, and where to conduct WalkRounds™ in the organization. Review and modify the instructions as needed for your organization before initiating the WalkRounds™.”
Posted in Multimedia, READ Portal | Tagged with Management, Safety | No Comments
May 6, 2011
“As part of a systemwide transformation, the VA formed its National Center for Patient Safety to foster an organizational culture of safety within its nationwide network of hospitals and outpatient clinics. A recent medical team training program designed to improve communication among operating room staff was associated with a reduction in surgical mortality and improvements in quality of care, on-time surgery starts, and staff morale. The program is now being expanded to other clinical units, along with a patient engagement program that prevents errors by facilitating communication relating to patients’ daily care plans. A recognition program stimulated facilities to conduct timelier and higher-quality root-cause analyses of reported safety events to identify stronger actions for preventing their recurrence. Other initiatives have reduced rates of health care–associated infections, patient mortality, and post-operative complications. Success factors include leadership accountability for performance and organizational support for testing, expanding, and adopting improvements.”
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Efficiency, Mortality rates, Quality control, Quality improvement, Safety | No Comments
May 4, 2011
Health-care facilities can track their progress in hand hygiene promotion, plan their actions and aim for hand hygiene improvement and sustainability through the use of the WHO Hand Hygiene Self-Assessment Framework.
The Framework is a tool with which to obtain a situation analysis of hand hygiene promotion and practices within an individual health-care facility, according to a set of indicators. It also acts as a diagnostic tool, identifying key issues requiring attention and improvement. Repeated use of the Framework will allow documentation of progress with time.
By completing the Framework, you can:
- calculate the score of each section and the overall score to identify at what level of progress your facility stands;
- evaluate with your infection control committee and hospital administrators which areas need improvement and whether any of these can be targeted with specific approaches (e.g. staff education, preparation of new posters/reminders, etc);
- disseminate the results, in particular to share strengths and gaps of your facility in promoting hand hygiene.
Posted in Multimedia, READ Portal | Tagged with Indicators, Infection control, Safety | No Comments
May 2, 2011
Klein, S., & McCarthy, D. (2011). Sentara Healthcare: Making Patient Safety an Enduring Organizational Value. The Commonweatlh Fund. http://www.commonwealthfund.org/Content/Publications/Case-Studies/2011/Mar/Sentara-Healthcare.aspx. Sentara Healthcare, an integrated health care delivery system serving parts of Virginia and North Carolina, has developed a systematic program to foster a culture of safety throughout its member hospitals, with the aim of reducing the […]
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Efficiency, Policy, Quality assessment, Quality control, Quality improvement, Safety | No Comments
