Louisville Lectures

Open Access Medical Education

Committed to sharing Internal Medicine focused lectures as free open access medical education.

Filtering by Tag: Policy/Admin

Hands On: A Good Patient Handoff

It is a common scene in the hospital at shift change: nurses giving report to the next shift; overnight residents relaying the events of an overnight rapid response to the daytime intern; OR staff calling report about the patient who is leaving surgery and headed to a room on the medical ward. At the end of a long shift it takes determination and a system dedicated to safety to consistently deliver a good patient handoff. But, it is essential to preventing avoidable errors!

There are also opportunities for ground-level employees and stakeholders to participate in QI. Kaizen is a LEAN approach that focuses on “Continuous Improvement” in small daily changes which support larger institutional initiatives.

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“Do you have any more questions for me today?”

Questions such as this are often a signal to the patient that the clinical encounter has come to an end. Yet, there are rarely any questions brought up by the patient. That does not necessarily mean that they understand or are equipped to participate in their healthcare. In fact, surveys show that over one-third of patients have poor health literacy and up to nearly 90% of patients do not have the health literacy that is needed to be able to navigate the complexities of our healthcare system. (1)

There are also opportunities for ground-level employees and stakeholders to participate in QI. Kaizen is a LEAN approach that focuses on “Continuous Improvement” in small daily changes which support larger institutional initiatives.

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Kaizen: Continuous Improvement

Previous blog posts have touched on reasons for Quality Improvement (QI) in healthcare as well as introductions to technical approaches such as Six Sigma that have been proven by industries to facilitate positive change. Technical approaches like Six Sigma rely on buy-in from upper management stakeholders as well as professionals with experience in statistics.

There are also opportunities for ground-level employees and stakeholders to participate in QI. Kaizen is a LEAN approach that focuses on “Continuous Improvement” in small daily changes which support larger institutional initiatives.

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IHI: A Multidisciplinary Approach to Improving Healthcare

The To Err Is Human report, published in 2000, was a landmark paper that spoke of the need for quality healthcare in America. There are organizations who were laying the foundations for improvements in healthcare even prior to this paper. In the 1980s, a project called the National Demonstration Project in Quality Improvement in Health Care enlisted help from industry leaders such as AT&T, Ford, and IBM to help healthcare organizations use industry-standard processes to improve quality and reduce costs in healthcare. This project had significant successes with over half of organizations achieving important outcomes such as reducing length of stay, fewer postoperative infections, and reducing waiting times in Emergency Departments. This project eventually became the Institute for Healthcare Improvement (IHI). They have established activities across Africa, Asia, Europe, and North America to become a leading international not-for-profit organization dedicated to improving healthcare. (1)

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Hospitals and Six Sigma

A previous blog post referenced the To Err is Human report that was published in 2000. This report was the inciting force behind improving healthcare quality in the United States. As payers and regulators become the stakeholders in the cost and outcomes of healthcare, healthcare systems must now approach quality improvement (QI) through many different experiences. These approaches may focus on reducing waste, making workflows more accommodating to employees, workplace standards of organization, or reducing the variability and results of practice and procedures.

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