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Journal articles on the topic 'PDSA tool'

Author: Grafiati

Published: 5 June 2025

Last updated: 16 July 2025

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1

Milley-Daigle, Carissa, Celina Dara, Genevieve Bouchard-Fortier, et al. "Improving medication reconciliation in ambulatory cancer care." Journal of Clinical Oncology 38, no. 29_suppl (2020): 224. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.224.

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224 Background: Adverse drug events are common in ambulatory oncology where care spans multiple providers and medication documentation is often poor. We undertook a QI project with the aim of having 30% of patients have a best possible medication history (BPMH) or medication reconciliation (MedRec) documented within 30 days of starting systemic therapy. Methods: An Electronic Medical record-Integrated Tool (EMITT) was developed to facilitate documentation. 2 Plan-Do-Study-Act (PDSA) cycles have been completed to date; PDSA 1 consisted of piloting EMITT in 3 clinics run by physician champions.

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Hensing, Thomas A., Tyler Bauer, Anna Palafox, Margaret Whalen, and George W. Carro. "Addressing risk of financial toxicity in an ambulatory oncology practice: Our institutional experience with the ASCO Quality Training Program." Journal of Clinical Oncology 35, no. 8_suppl (2017): 114. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.114.

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114 Background: Due to escalating cost of cancer care, patients (PTs) with cancer are at increased risk for financial toxicity (FTOX) that can exacerbate disparities in care and lead to clinically relevant adverse PT outcomes; including quality of life; symptom burden; adherence; and survival. A review of our informed consent (IC) process demonstrated that PTs were not routinely informed of financial risks of high-cost (HC) cancer therapies at the time of IC. Methods: A multidisciplinary team was formed to conduct a rapid-cycle quality improvement project with the aim of reducing FTOX through

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Sayma, Meelad, George Nowell, Aedamar O’Connor, et al. "Improving the use of treatment escalation plans: a quality-improvement study." Postgraduate Medical Journal 94, no. 1113 (2018): 404–10. http://dx.doi.org/10.1136/postgradmedj-2018-135699.

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ObjectivesTreatment escalation plans (TEPs) are vital in communicating a ceiling of care. However, many patients still deteriorate and die without a pre-established ceiling of care for attending clinicians to rely on. We aimed to increase the proportion of suitable patients that have TEPs in place in a rural district general hospital.MethodsWe undertook three ‘Plan-Do-Study-Act’ (PDSA) cycles between 1 December 2016 and 9 June 2017. These cycles aimed to assess the problem, implement a solution and monitor its sustainability. We sampled all acute medical admissions at different time points, fo

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Hough, Katherine, Aliki Birkenbuel, John Griffin, Nancy Thompson, and Sara Jo Grethlein. "A multisite initiative to increase medical oncologists’ utilization of clinical pathways in the selection of systemic cancer treatment." JCO Oncology Practice 19, no. 11_suppl (2023): 575. http://dx.doi.org/10.1200/op.2023.19.11_suppl.575.

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575 Background: The Swedish Cancer Institute (SCI) recognizes that quality cancer care is a systemwide commitment. In 2020, SCI implemented ClinicalPath (formerly Via Oncology). The ClinicalPath tool assists in the selection of systemic treatment protocols. The protocols balance considerations of clinical efficacy, safety, toxicities, and cost. National utilization rate for ClinicalPath ranges between 50-70%. In 2021, ClinicalPath monthly utilization by SCI medical oncologists was 56%. This initiative aimed to increase utilization of ClinicalPath by SCI Medical Oncologists, across the three ma

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Alsuhaibani, Roaa Saleh, Hajer Alzahrani, Ghada Algwaiz, et al. "Enhancing the performance of gastrointestinal tumour board by improving documentation." BMJ Open Quality 7, no. 1 (2018): e000168. http://dx.doi.org/10.1136/bmjoq-2017-000168.

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Tumour board contributes to providing better patient care by using a multidisciplinary team approach. In the efforts of evaluating the performance of the gastrointestinal tumour board at our institution, it was difficult to assess past performance due to lack of proper use of standardised documentation tool. This project aimed at improving adherence to the documentation tool and its recommendations in order to obtain performance measures for the tumour board. A multidisciplinary team and a plan were developed to improve documentation. Four rapid improvement cycles, Plan–Do–Study–Act (PDSA) cyc

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Desanti de Oliveira, Beatriz, David DeStephano, Melissa Parsons Beauchemin, et al. "Implementation of EHR medication-adherence screening tool in breast cancer clinic." Journal of Clinical Oncology 40, no. 28_suppl (2022): 438. http://dx.doi.org/10.1200/jco.2022.40.28_suppl.438.

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438 Background: Nonadherence to prescribed medications occurs frequently in patient with breast cancer (BC) and can affect BC outcomes as well as outcomes for comorbid conditions. We implemented a process to screen for medication adherence in the electronic health record (EHR) in an urban outpatient BC clinic. Methods: Plan-Do-Study-Act (PDSA) methodology was used to implement a screening process for medication adherence for all patients seen in the outpatient breast oncology clinic. At check-in (via the patient portal or clinic based kiosks), patients were asked to complete an EHR adherence s

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King, Sharla, Melanie Garrison, Manon Fraser, et al. "Empowering Patients With a Shared Communication Tool: A Patient-Oriented Multimethods Pilot Study." Journal of Patient Experience 10 (January 2023): 237437352311604. http://dx.doi.org/10.1177/23743735231160421.

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Not all patients feel empowered to take on the expanding role as active members in their healthcare journey. Healthcare services must shift attention to supporting patients and families in this emerging role. This support includes providing communication tools designed for patients and families to empower them to speak up. Two Plan-Do-Study-Act (PDSA) cycles were conducted to test a communication tool, the Jargon Alert!/WAIT card, with patients/families and providers in a Canadian rehabilitation hospital. After the first PDSA cycle, feedback from patients/families (n = 24), and providers (n =

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Samuel, P., J. Park, F. Muckle, et al. "P036: A comprehensive quality improvement initiative to prevent falls in the emergency department." CJEM 19, S1 (2017): S90. http://dx.doi.org/10.1017/cem.2017.238.

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Introduction: Patients from all population groups visit the emergency department (ED), with increasing visits by elderly patients. Patient falls in the ED are a significant safety concern, and they can lead to serious injuries and worse outcomes. Toronto Western Hospital’s ED Quality Improvement (QI) team identified as a problem our assessment and management of patients at risk for falls. The aim of this project was to develop a comprehensive and standardized approach to patients at risk of falls in the ED, including implementing timely interventions for fall prevention. Methods: A literature

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Ranade, Mihir, Shuchi Jain, Poonam Varma Shivkumar, Subodh Gupta, and Manish Jain. "Quality improvement initiative: improving obstetric triaging practices in a rural maternal hospital in central India." BMJ Open Quality 13, Suppl 1 (2024): e001870. http://dx.doi.org/10.1136/bmjoq-2022-001870.

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Triaging of obstetric patients by emergency care providers is paramount. It helps provide appropriate and timely management to prevent further injury and complications. Standardised trauma acuity scales have limited applicability in obstetric triage. Specific obstetric triage index tools improve maternal and neonatal outcomes but remain underused. The aim was to introduce a validity-tested obstetric triage tool to improve the percentage of correctly triaged patients (correctly colour-coded in accordance with triage index tool and attended to within the stipulated time interval mandated by the

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Moon, Byungkyu, Jungyong “Joe” Kim, and Hosin “David” Lee. "Development of Smart Pavement Design Sensitivity Analysis Software for Asset Management System." Infrastructures 5, no. 7 (2020): 56. http://dx.doi.org/10.3390/infrastructures5070056.

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There are a number of pavement management systems, but most of them are limited in providing pavement design and pavement design sensitivity information. This paper presents efforts towards the integrated pavement design and management system, by developing smart pavement design sensitivity analysis software. In this paper, the sensitivity analyses of critical design input parameters have been performed to identify input parameters which have the most significant impacts on the pavement thickness. Based on the existing pavement design procedures and their sensitivity analysis results, a smart

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Velazquez Manana, Ana I., Rahul Banerjee, Vanessa Elaine Kennedy, August Reich Dietrich, Amy M. Lin, and Pelin Cinar. "Improving performance status documentation by hematology-oncology fellows." Journal of Clinical Oncology 38, no. 29_suppl (2020): 250. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.250.

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250 Background: Accurate performance status (PS) documentation is essential as poor PS is a strong predictor of treatment-related toxicity. At our institution, a baseline chart review revealed missing PS documentation in 28% of Fellow-seen new patient visits (NPV); PS documentation as unstructured text comprised the remainder. The lack of structured PS documentation represents a missed opportunity for accurate data in registries, trial registration, and supportive care referrals. Methods: To improve standardized documentation of PS for NPV, we designed a Fellow-led quality improvement (QI) ini

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Woolner, V., S. Ensafi, J. De Leon, L. George, and L. Chartier. "LO23: Reducing time to disposition for treat & release patients in the emergency department." CJEM 20, S1 (2018): S14. http://dx.doi.org/10.1017/cem.2018.85.

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Introduction: Treat and Release (T&R) patients are seen and discharged home from the emergency department (ED), and asked to return within 12-72 hours for follow-up care (e.g., ultrasound, repeat blood work). Our two academic teaching hospitals see approximately 2,000 T&R patients per year. Handover of care for T&R patientsdone through charting only and therefore dependent on the charts adequacy and completenessis crucial to the safety and quality of care they receive. An 18-month retrospective chart audit at our sites identified quality gaps, including suboptimal documentation tha

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Dorrington, Melanie S., Ana Herceg, Kirsty Douglas, Julie Tongs, and Marianne Bookallil. "Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement." Australian Journal of Primary Health 21, no. 4 (2015): 417. http://dx.doi.org/10.1071/py14088.

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This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap

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Belova, Ksenia Y., and Olga B. Ershova. "The use of Plan-Do-Study-Act (PDSA) cycle in perfection of fracture liaison service work." Osteoporosis and Bone Diseases 22, no. 2 (2020): 4–13. http://dx.doi.org/10.14341/osteo10272.

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Background: Secondary fracture prevention services (FLS) have been established around the world during several last years. However, due to the differences of medical care organization in different regions, it is difficult to offer a unified approach of the structure and separate components of such services, which could be used everywhere. It is recommended to apply the Plan-Do-Study-Act (PDSA) cycle to evaluate the FLS in the institution. Aim: To study the application of the PDSA cycle in the optimization of FLS working in Yaroslavl. Materials and methods: We evaluated the effectiv

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Naxakis, Stelios, Megan Wafer, Syeda Gardezi, Aamina Sadia, Rimsha Mujahid, and Karen O’Connor. "NCHD handover in the acute mental health setting: a quality improvement initiative implementing an electronic handover tool." BMJ Open Quality 14, no. 1 (2025): e002978. https://doi.org/10.1136/bmjoq-2024-002978.

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BackgroundCork University Hospital, Ireland’s largest teaching hospital, faced challenges in maintaining consistent handover processes in its Acute Mental Health Unit (AMHU). Prior to 2019, handovers relied on informal methods, risking information loss and compromising patient care. This quality improvement (QI) initiative aimed to standardise handover practices using an electronic tool integrated with the ISBAR communication protocol.ObjectivesThe project aimed to ensure accurate clinical information recording, improve patient care and safety, centralise handover material, enhance clinical tr

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Taher, A., F. Webster Magcalas, V. Woolner, S. Casey, D. Davies, and L. Chartier. "LO92: Improving patient communication in an emergency department's rapid assessment zone." CJEM 21, S1 (2019): S41. http://dx.doi.org/10.1017/cem.2019.134.

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Background: Emergency Department (ED) communication between patients and clinicians is fraught with challenges. A local survey of 65 ED patients revealed low patient satisfaction with ED communication and resultant patient anxiety. Aim Statement: To increase patient satisfaction with ED communication and to decrease patient anxiety related to lack of ED visit information (primary aims), and to decrease clinician-perceived patient interruptions (secondary aim), each by one point on a 5-point Likert scale over a six-month period. Measures &amp; Design: We performed wide stakeholder engagemen

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Skogg, Annika, Alicia Zagel, R. May O'Donnell, et al. "Implementation of a Targeted Technologic Screening Tool to Increase Pneumococcal Vaccine Uptake in Health-System Retail Pharmacies: A Quality Improvement Initiative." INNOVATIONS in pharmacy 15, no. 4 (2024): 7. https://doi.org/10.24926/iip.v15i4.6345.

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Background/Purpose: Pneumococcal vaccine rates among eligible adults are lower than desired. Recently, pneumococcal vaccination guidelines for adults were updated to include new pneumococcal conjugate vaccines (PCV20), taking into consideration age, underlying risk factors, and previous vaccine status. To respond to PCV undervaccination and help clarify the new guidelines, this project sought to develop a targeted pneumococcal vaccine screening tool and pop-up alert within retail pharmacies across a large health system with the goal of increasing rates of PCV20 vaccination. Methods: A PDSA cyc

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Winnie, Kirsten, Christine Broszko, and Amy Whittle. "Plan-Do-Study-Act Cycles Applied to a Longitudinal Research Protocol in a Family Medicine Residency." Family Medicine 51, no. 9 (2019): 772–76. http://dx.doi.org/10.22454/fammed.2019.992839.

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Background and Objectives: Barriers to research in family medicine are common. Resident studies are at risk of remaining incomplete. This report describes a process improvement (PI) to optimize survey data collection in a longitudinal research protocol led by family medicine residents. The protocol subject to the process improvement sought to evaluate maternal outcomes in group prenatal care vs traditional care. In the months preceding the PI, the resident researchers noted many surveys were not completed in their intended timeframe or were missing, threatening study validity. We describe a pr

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Tyle, Madison R., Shainal Gandhi, Nikhita Nookala, et al. "Advocating for Our Children: An Initiative Utilizing Verbal and Video Education to Increase Adverse Childhood Experiences Questionnaire Form Response Rate." Pediatric Quality & Safety 10, no. 2 (2025): e801. https://doi.org/10.1097/pq9.0000000000000801.

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Introduction: Negative experiences in childhood, Adverse Childhood Experiences, significantly increase the risk of adverse health outcomes in adulthood. Obtaining a better understanding of the experiences a child has been through during development allows providers to connect them with resources to improve health outcomes. Methods: We performed problem identification via PubMed and the Florida Department of Health web page. We used the plan-do-study-act (PDSA) quality improvement method. Intervention one involved teaching clinic staff about distributing the Adverse Childhood Experiences Questi

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Levonyak, Nicholas, Mary P. Hodges, Nicole Broome, et al. "Clinical benefits of a nutrition-focused quality improvement intervention at a safety-net hospital gastrointestinal oncology clinic." Journal of Clinical Oncology 38, no. 15_suppl (2020): e19163-e19163. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e19163.

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e19163 Background: Patients with GI cancer have high rates of malnutrition related poor outcomes. In the GI Oncology clinic at Parkland Health and Hospital System (PHHS), a safety net hospital, the number of GI cancer patients with a documented nutrition assessment by a registered dietitian was 5-7%. The aim of QI project was to increase the rate of documented nutrition assessment by a registered dietitian to 25%. Methods: Three PDSA cycles were conducted after identifying barriers to nutritional interventions. A registered dietitian was assigned to the GI oncology clinic during the 1st PDSA c

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Baird, David Paul, Fraser Rae, Christina Beecroft, et al. "Introducing an AKI predictive tool for patients undergoing orthopaedic surgery." BMJ Open Quality 8, no. 1 (2019): e000306. http://dx.doi.org/10.1136/bmjoq-2017-000306.

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Patients undergoing surgery are at increased risk of acute kidney injury (AKI). AKI is associated with adverse outcomes such as increased mortality and future risk of developing chronic kidney disease. We have developed a validated preoperative scoring tool to predict postoperative AKI in patients undergoing orthopaedic surgery using seven readily available parameters. The aim of this project was to establish the use of this scoring tool with a target compliance of 80% in patients undergoing orthopaedic surgery requiring an overnight stay at Perth Royal Infirmary, a district general hospital i

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Levonyak, Nicholas, Mary P. Hodges, Nicole Broome, et al. "A nutrition-focused quality improvement program to improve rate of documented nutrition plan at a safety-net hospital gastrointestinal (GI) oncology clinic." Journal of Clinical Oncology 37, no. 27_suppl (2019): 289. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.289.

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289 Background: Patients with GI cancer have amongst the highest rates of malnutrition, which contributes to decreased quality of life, increased morbidity and mortality, as well as higher healthcare costs. In the GI Oncology clinic at Parkland Health and Hospital System (PHHS), the number of patients with a documented nutritional plan by a registered dietitian was 7%, and there was no standardized screening method for malnutrition in place. Methods: The aim was to increase the rate of documented nutritional assessment by a registered dietitian to 25%. Multidisciplinary sessions involving phys

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Velazquez Manana, Ana I., Piera Wong, Katherine Pang, Pelin Cinar, and Niharika Dixit. "Improving oral oncolytic education in a safety-net outpatient hematology-oncology practice." Journal of Clinical Oncology 39, no. 28_suppl (2021): 266. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.266.

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266 Background: Oral oncolytics (OO) offer convenient administration and reduce the burden of cancer treatment, while creating particular challenges regarding safety monitoring and adherence. A baseline review of oral oncolytic education (OOE) at our safety-net institution identified that none of the patients who started OO therapy from September to December 2019 had complete documentation of OOE and a care plan. This results in potential increased risk of toxicity, non-adherence to therapy, and poor adherence to follow-up schedule for lab monitoring, dose adjustment, and toxicity assessment.

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Deasy, James, Josephine Griffin, Mary Hayes, and Suzanne Cotter. "50 My Healthcare Information Folders." Age and Ageing 48, Supplement_3 (2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.27.

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Abstract Background For many people an admission to an acute hospital can be a stressful and overwhelming experience. During admission it can be difficult to process and understand the information provided by members of the multi-disciplinary team (MDT). Patient information leaflets (PILS) are important in educating and empowering patients in the management of their own health and wellbeing. PILs are frequently provided to patients by MDT members during their admission. These valuable resources are not always consulted by patients or their families and in many cases are not brought home from h

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Chan, M., C. W. Tan, and P. Mathew. "60 Post Inpatient Fall Medical Assessment (PIFMA) Performa Quality Improvement Project." Age and Ageing 49, Supplement_1 (2020): i18—i20. http://dx.doi.org/10.1093/ageing/afz187.01.

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Abstract Introduction Inpatient falls are the most commonly reported patient safety incidents and in the United Kingdom, there are 250,000 reported falls per year 1. A rapid response report (RRR) issued in 2011 by the NPSA highlighted need for improvement in identifying fractures and neurological observations. These figures reflect significant implications to patients’ health and financial burden to the NHS. Aims To improve assessment and documentation of inpatient falls assessment. Methods Two PDSA cycles were completed. First PDSA cycle established a baseline of post fall assessment and docu

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Ramsay, Neil, Gianluca Maresca, Vicki Tully, and Kevin Campbell. "Does a multidisciplinary approach have a beneficial effect on the development of a structured patient handover process between acute surgical wards in one of Scotland’s largest teaching hospitals?" BMJ Open Quality 7, no. 3 (2018): e000154. http://dx.doi.org/10.1136/bmjoq-2017-000154.

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BackgroundEffective handover is key in preventing harm. 1 In the Acute Surgical Receiving Unit of Ninewells Hospital, Dundee, large numbers of patients are transferred daily. However, lack of medical handover during transfer means important tasks are missed. Our aim was to understand and reflect on the current system and test changes to improve medical handover.AimOur aim was to ensure that 95% of patients being transferred from the Acute Surgical Receiving Unit receive a basic medical handover within 2 months.MethodsInitially, we collated issues that were missed when patients were transferred

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Jackson, Jennifer, Kelley D. Tealer, Laura Wakefield Kaufman, et al. "Improving influenza vaccination assessment and uptake, one step at a time in a cancer center." JCO Oncology Practice 20, no. 10_suppl (2024): 280. http://dx.doi.org/10.1200/op.2024.20.10_suppl.280.

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280 Background: Influenza immunization has shown to decrease morbidity and mortality of influenza infections. From September to December 2022, at the infectious diseases (ID) clinic at our institution, 73% of the patients did not undergo influenza immunization assessment during their clinical encounters and only 3% of the patients had the influenza vaccine administered. Furthermore, documentation of vaccine discussion was done in 73% of cases. Our aim was to improve vaccination assessment from 73% noncompliant to 50%. Methods: A multidisciplinary team of nurses, nurse leaders, pharmacists, and

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Adhikari, Sunil, and Suraj Rijal. "Quality improvement of triage accuracy in the Emergency Department." Journal of General Practice and Emergency Medicine of Nepal 7, no. 9 (2020): 6–9. http://dx.doi.org/10.59284/jgpeman88.

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Introduction: Triage is the sorting of patients into priority groups according to their need and severity of clinical condition. The study aims to present outcome of complete audit cycle of triage by the triage nurse for quality improvement of triaging in Emergency. Method: 150 patients were randomly selected over 2 weeks who were triaged by the Emergency triage nurse into Emergency (Red), Priority (Yellow) and Queue (Green) in the Emergency Department at Patan Hospital.We followed the WHO quick check triage and assessed those who were accurately triaged, over triaged and those who were

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Shahid, Rabia, Malone Chaya, Ian Lutz, Brian Taylor, Lily Xiao, and Gary Groot. "Exploration of a quality improvement process to standardised preoperative tests for a surgical procedure to reduce waste." BMJ Open Quality 10, no. 3 (2021): e001570. http://dx.doi.org/10.1136/bmjoq-2021-001570.

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BackgroundPreoperative tests are done to determine a patient’s fitness for anaesthesia and surgery.Local problemAlthough routine tests before surgery in the absence of specific clinical indications are not recommended, we observed high volumes of routine preoperative tests were performed in our institution. We describe a process to implement a standardised preoperative investigational approach to reduce unnecessary testing before surgeries.MethodsA series of six Plan-Do-Study-Act (PDSA) cycles was conducted for root cause analysis and process mapping, development of standardised tool (GRID), c

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Goldraij, Gabriel, Vilma Adriana Tripodoro, Melisa Aloisio, et al. "One chance to get it right: improving clinical handovers for better symptom control at the end of life." BMJ Open Quality 10, no. 3 (2021): e001436. http://dx.doi.org/10.1136/bmjoq-2021-001436.

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Poor communication contributes to morbidity and mortality, not only in general medical care but also at the end oflife. This leads to issues relating to symptom control and quality of care. As part of an international project focused on bereaved relatives’ perceptions about quality of end-of-life care, we undertook a quality improvement (QI) project in a general hospital in Córdoba city, Argentina.By using two iterative QI cycles, we launched an educational process and introduced a clinical mnemonic tool, I-PASS, during ward handovers. The introduction of the handover tool was intended to impr

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Jain, Shuchi, Pramod Kumar, Manish Jain, et al. "Increasing adherence to plotting e-partograph: a quality improvement project in a rural maternity hospital in India." BMJ Open Quality 10, Suppl 1 (2021): e001404. http://dx.doi.org/10.1136/bmjoq-2021-001404.

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Abnormal prolonged labour and its effects are important contributors to maternal and perinatal mortality and morbidity worldwide. E-partograph is a modern tool for real-time computerised recording of labour data which improves maternal and neonatal outcome. The aim was to improve the rates of e-partograph plotting in all eligible women in the labour room from existing 30% to achieve 90% in 6 months through a quality improvement (QI) process.A team of nurses, obstetricians, postgraduates and a data entry operator did a root cause analysis to identify the possible reasons for the drop in e-parto

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John, Balidawa. "Application of the Deming PDSA Cycle as a Patient Experience Management Tool to Improve HIV Care. An Action Research in Under-Resourced Settings of Jinja-Uganda." TEXILA INTERNATIONAL JOURNAL OF MANAGEMENT 8, no. 1 (2022): 67–88. http://dx.doi.org/10.21522/tijmg.2015.08.01.art006.

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The study to determine the effect of patient experience management using the Deming PDSA cycle on the quality of HIV care was conducted in under-resourced settings of Uganda. The interventional study had 437 files studied, and 224 adult HIV clients with poor HIV care outcomes of; missed appointments for more than two weeks, poor adherence to treatment of < 85%, and unsuppressed viral load of > 1000 viral copies per milliliter were interviewed at baseline and end line. The study revealed a 13.6% prevalence of the study HIV care outcomes among all the client files, the majority of which we

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Joshi, Neha, Rakhi Wadhwani, Jitender Nagpal, and Saru Bhartia. "Implementing a triage tool to improve appropriateness of care for children coming to the emergency department in a small hospital in India." BMJ Open Quality 9, no. 4 (2020): e000935. http://dx.doi.org/10.1136/bmjoq-2020-000935.

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BackgroundIn 2015, senior consultants at Sitaram Bhartia Institute of Science and Research saw several sick children in their outpatient clinics for which they had been seen in the emergency department the previous day. These children seemed to require admission but were sent home. This prompted us to review the paediatric care provided in our emergency department.MethodsA multidisciplinary team was formed to run this improvement initiative. Review of literature suggested that establishing a triage system around a prevalidated triage tool would help us deliver more appropriate care. The South

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Dhali, Arkadeep, Christopher D'Souza, and B. Rathna Roger. "Standard operating procedure for the management and prevention of post-partum haemorrhage in a public general hospital in rural South India: a quality improvement project." International Journal Of Community Medicine And Public Health 8, no. 6 (2021): 2897. http://dx.doi.org/10.18203/2394-6040.ijcmph20211991.

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Background: The Obstetrician stationed in a Public General Hospital noticed that there were no standard guidelines nor any assessment tool for the management of post-partum hemorrhage (PPH). This developed the idea to prepare a standard protocol.Methods: Aiming to ensure prevention and proper management of PPH in the Maternity ward, a team was formed to perform a Quality improvement project (QIP). A Standard operating procedure (SOP) was formulated referring to the National Health Mission (NHM). Outcome indicators were defined. A series of interventions were implemented and assessed using Plan

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Mohamed, Ashraf Mahmoud, Christine Marie Bolen, Jennifer Morgan, Patricia Rice, Meredith Speas, and Carolyn Russo. "A quality improvement initiative for reducing morning hypoglycemia in children undergoing treatment for acute lymphoblastic leukemia." Journal of Clinical Oncology 37, no. 27_suppl (2019): 240. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.240.

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240 Background: Hypoglycemia has been observed in children receiving Acute Lymphoblastic Leukemia (ALL) therapy. It affects patients’ outcome. The current quality initiative was piloted at two of the St Jude affiliate clinics. Each month about 10% of children with ALL develop hypoglycemia in those two clinics. Methods: Data was collected for the eight months prior to intervention. Root Cause Analysis (RCA) using fish bone diagram, and Pareto chart to find out the most likely causes of hypoglycemia. Prolonged hours of fasting for procedures, giving 6MP at night on empty stomach, seem to further

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Kingdon, J., H. Aadan, S. Husain, C. Atkinson, C. Thomson, and P. Braude. "22 Design and Implementation of A Nutrition Clinical Pathway for Patients with Fractured Neck of Femur." Age and Ageing 49, Supplement_1 (2020): i1—i8. http://dx.doi.org/10.1093/ageing/afz183.22.

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Abstract Background Patients with a fractured neck of femur (FNOF) are commonly malnourished pre-admission, have reduced oral intake in hospital and a hypermetabolic state up to three months postoperatively (E Paillaud 2000). Malnutrition is associated with functional deterioration, higher morbidity and mortality. Evidence suggests nutritional supplementation post-surgery can reduce postoperative complications. As a result, nutritional assessment is included in the National Hip Fracture Database best practice tariff (Avenell, Cochrane Database of Systematic Reviews 2016). Introduction Our aim

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Baguneid, C. L., K. L. Millington, J. Pattinson, G. Ogden, F. Malcolm, and A. L. Gordon. "59 Improving the Identification and Management of Delirium in Older Surgical Patients." Age and Ageing 50, Supplement_1 (2021): i12—i42. http://dx.doi.org/10.1093/ageing/afab030.20.

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Abstract Local Problem A multidisciplinary team comprising a consultant geriatrician and nurse consultant reviews all patients aged ≥70 years who have an emergency laparotomy at Royal Derby Hospital. Anecdotally there is a high incidence of delirium but retrospective casenote audit found only 19% of patients admitted for emergency laparotomy July 2018–July 2019 were identified as having delirium by the surgical team. Method A first PDSA cycle showed that the 4AT was feasible for use by healthcare assistants on the surgical assessment unit (SAU). A second PDSA cycle, described here, sought to d

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Howarth, Harrison, Jonathan Pass, Fahel Ahmed, and Sarah Wiethoff. "Improving cardiometabolic screening on an inpatient psychiatric ward: a quality improvement project." BJPsych Open 7, S1 (2021): S194. http://dx.doi.org/10.1192/bjo.2021.522.

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AimsPrimary aim: To increase the proportion of patients receiving a full cardiometabolic screen whilst on the ward to 75%.Secondary aims: To improve communication with GPs regarding cardiometabolic health, to improve the rates of intervention when abnormalities are found to 75%.BackgroundPeople with serious mental illness are known to have significantly increased risk of cardiometabolic syndrome than the general population. Estimates suggest there would be up to 12,000 fewer deaths from cardiovascular disease if people with serious mental illness had the same outcomes as the general population

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Sudhanthar, Sathyanarayan, Zile-e.-huma Sheikh, and Kripa Thakur. "Postpartum depression screening: are we doing a competent job?" BMJ Open Quality 8, no. 4 (2019): e000616. http://dx.doi.org/10.1136/bmjoq-2018-000616.

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Postpartum depression (PPD) is one of the most common and severe postpartum morbidity, affecting 10%–20% of mothers within the first year of childbirth. The adverse effects of PPD, namely, prevention of mother-baby bonding and early cessation of breastfeeding, adversely affects infant growth and brain development. Studies have found that up to 50% of women with PPD go undiagnosed. Despite the American Academy of Pediatrics (AAP) recommendations, only a small percentage of paediatricians are currently screening for PPD. This project aimed to improve PPD screening using a validated tool to 75% i

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Vardy, Emma, Niamh Collins, Umang Grover, et al. "Use of a digital delirium pathway and quality improvement to improve delirium detection in the emergency department and outcomes in an acute hospital." Age and Ageing 49, no. 4 (2020): 672–78. http://dx.doi.org/10.1093/ageing/afaa069.

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Abstract Background delirium is a common condition associated with hospital admission. Detection and diagnosis is important to identify the underlying precipitating cause and implement effective management and treatment. Quality improvement (QI) methodology has been applied in limited publications. There are even fewer publications of the role of development of the electronic health record (EHR) to enhance implementation. Methods we used QI methodology to improve delirium detection in the emergency department (ED). Plan Do Study Act (PDSA) cycles could be broadly categorised into technology, t

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Tarigan, Dhea Benedikta, and Inge Dhamanti. "QUALITY IMPROVEMENT FOR MATERNAL AND CHILD HEALTH IN PRIMARY HEALTH CARE: A SCOPING REVIEW." Journal of Public Health Research and Community Health Development 6, no. 2 (2023): 144–52. http://dx.doi.org/10.20473/jphrecode.v6i2.34624.

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ABSTRACT Background: Primary Health Care (PHC) is a gatekeeper in providing comprehensive services for maternal and child health (MCH). MCH services in PHC remain limited and have not been entirely handled and distributed. Based on this, MCH in PHC requires Quality Improvement (QI) interventions. Purpose: Identify the implementation of QI in maternal and child health in PHC and identify the most QI tools or approaches used. Methods: This is a scoping review of the qualitative and quantitative results of studies that focused on Quality Improvement for maternal and child health in Primary Health

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Nechowska, Aoife, and Rebecca Holman. "Quality Improvement Project: Lithium Monitoring in an Older Adult Community Mental Health Team." BJPsych Open 10, S1 (2024): S155. http://dx.doi.org/10.1192/bjo.2024.402.

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AimsThe aim of this project is to improve the monitoring of patients on lithium under the South Gloucestershire Later Life Community Mental Health Team and to clarify the process for this monitoring with the aim of improving patient care and safety. We aim to try to achieve 100% compliance with agreed standards based on NICE and Trust guidelines.MethodsFollowing a meeting with team medics we agreed a series of nine standards derived from local and national guidelines. We then used a locally held database of patients on the later life CMHT caseload on lithium therapy to identify our sample and

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Philip, Tony, Karen Gleason, Claire Nekola, et al. "Reducing emergency department utilization by improving patient access to their oncology care team." Journal of Clinical Oncology 37, no. 27_suppl (2019): 77. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.77.

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77 Background: At Monter Cancer Center, we observed that when patients on active intravenous chemotherapy presented to our local ED about 70% arrived during the hours of 8am and 6pm. ED utilization by active chemotherapy patients results in cancer care by providers not familiar with their disease or treatment, increased costs, poor patient experience and potential treatment delays. Our goal was to create 20% reduction in daytime ED utilization, compared to Q4 2018, by patients that received intravenous chemotherapy within 30 days of their ED visit. Methods: Through the ASCO Quality Training pr

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Chubey, Rebecca, Deb Fraser, Veronica Braganza, et al. "Quality Improvement Initiative: Identifying Barriers to Reducing Time to First Feed With Human Milk in Low Birth Weight Infants." Neonatal Network 43, no. 5 (2024): 305–16. http://dx.doi.org/10.1891/nn-2023-0067.

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Early exposure to human milk and time to first trophic feed in low birth weight (LBW) infants (<2 kg) is associated with a decreased risk of mortality, sepsis, and length of hospital stay. This project, focused on infants born at less than 2 kg, aimed to identify the mean time to first feed after birth, identify barriers to initiation of the first feed, and meet the target of having 90% of infants receive their first feed within the first 6 hours of life. This quality improvement (QI) project occurred in a thirty-bed level III NICU over 29 months using two Plan-Do-Study-Act (PDSA) cycles. A

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Myers, Sybilla, and Christopher Kennedy. "Improving the Perception of Patient-Centered Wellness in a Virtual Population During the COVID-19 Pandemic." Journal of Doctoral Nursing Practice 14, no. 2 (2021): 115–21. http://dx.doi.org/10.1891/jdnp-d-20-00078.

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BackgroundPerceived health-related quality of life (HRQOL) is fundamental to well-being and is a meaningful way to measure physical and mental health.Local ProblemNo standard method exists for measuring perceived HRQOL during the COVID-19 pandemic in participants as they attempt to improve their self-determined wellness goals. An implementation plan that considers the social distancing limitations imposed can be used to predict an individual's likelihood of long-term success.MethodsDuring the four, 2-week plan-do-study-act (PDSA) cycles, the Social Cognitive Theory model informed the implement

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Knight, Thomas Gregory, Beth York, Sangita Paul, Kayla Barlow, and Declan Walsh. "Continuous financial toxicity screening in community oncology." Journal of Clinical Oncology 43, no. 16_suppl (2025): 1588. https://doi.org/10.1200/jco.2025.43.16_suppl.1588.

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1588 Background: Financial Toxicity (FT) has been repeatedly linked with adverse cancer clinical outcomes. However, screening practices vary widely, especially in community settings where < 50% routinely proactively engage patients to discuss care costs. This quality improvement pilot examined the feasibility and impact of continuous FT screening in a community-based clinical practice. Methods: Using PDSA methodology, an electronic distress screening (EDS) tool was implemented at each visit at two rural oncology practices. Evidence of FT was defined as answering “yes” to the question “Do yo

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Al-Alousi, S., A. U. Khan, and E. Laithwaite. "573 DELIRIUM SCREENING QUALITY IMPROVEMENT PROJECT." Age and Ageing 50, Supplement_2 (2021): ii8—ii13. http://dx.doi.org/10.1093/ageing/afab116.22.

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Abstract Introduction Delirium is a common neuropsychiatric syndrome in patients over the age of 65 presenting to medical admissions units yet remains under-diagnosed despite significant associated mortality and morbidity. Our trust's delirium screening tool incorporates a four-step approach, with completion of validated 4AT test warranted in all those over 65 years of age admitted with increased confusion or social withdrawal. Our aim was to measure current uptake of this delirium screening and introduce measures to improve practice. Method We retrospectively collected data from medical recor

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Vas, Venessa, Loretta Gyambibi, Linda Eftychiou, et al. "Identifying value in healthcare transformation initiatives: an evaluation of an approach to benefits realisation." BMJ Open Quality 12, no. 4 (2023): e002349. http://dx.doi.org/10.1136/bmjoq-2023-002349.

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Benefits realisation management (BRM) aims to facilitate the process of identifying, measuring and tracking desired benefits derived from a project. Improvement methodology frameworks often describe BRM as integral to identifying and measuring value derived from transformation initiatives within the National Health Service and beyond. Despite this, reporting of benefits realisation plans and methodological approaches to identifying and measuring benefits remains surprisingly scarce.This project aimed to pilot and evaluate the application of a purpose-designed benefits mapping template with sev

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Talmadge, Clair, Glen Lewis, Benjamin Gold, Samantha Gomez, Bonney Reed, and Dana Dykes. "P040 DEPRESSION SCREENING IN A PEDIATRIC IBD CENTER." Inflammatory Bowel Diseases 26, Supplement_1 (2020): S62. http://dx.doi.org/10.1093/ibd/zaa010.157.

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Abstract Introduction Depression is a common pediatric problem affecting approximately 25% of U.S. adolescents and up to 35% of patients with Inflammatory Bowel Disease (IBD). Suicide is associated with mood disorders and is a leading cause of death for youth ages 10–25. Despite known risks of depression, up to 75% of depressed youth go unrecognized. Recently published guidelines recommend annual screening for youth 12 and older diagnosed with IBD (Mackner et al., 2019). We sought to implement these guidelines in a large outpatient pediatric gastroenterology practice. Methods We used quality i

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Onyi Asiji Nwogu. "Implementation of aseptic technique training and assessment to reduce the incidence of chorioamnionitis in laboring patients." International Journal of Science and Research Archive 6, no. 2 (2022): 110–14. http://dx.doi.org/10.30574/ijsra.2022.6.2.0159.

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Chorioamnionitis may significantly affect the outcome of positive birth experiences for expecting mothers. The purpose of this quantitative, quasi-experimental quality improvement project was to determine if the implementation of the University of Michigan’s Assessment Tool for Aseptic Technique and Assessment would impact the rate of maternal chorioamnionitis among laboring women admitted in a labor and delivery unit in a local Californian hospital over 30 days. Neuman’s system theory, Watson’s caring theory, and the plan, do, study, act (PDSA) cycle were the theoretical and conceptual underp

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