Featured Quality Improvement Projects
Sturgeon(SCH) Emergency Department (ED) Medicine Triage and Consultation Model
Dr. Hernando Leon, Dr Brian Deane, Dr Robert Daloise, Karen Maier, Nicola Stephens, Pamela Mathura and Claudia Salguero
Tableau Introduction Training
Tableau is a secure server based reporting platform that allows creation of online reports that are customizable by the user. Training sessions for DoM faculty and staff were held in April with positive reviews from the 19 attendees.
Quality Improvement (QI) Education Building Quality Improvement Capacity and Collaboration EPIQ 4 hr training session is now accredited! 4.00 Mainpro+ Assessment Credits (max of 4 hrs, 3 credits per hour) EPIQ and AHS AIW Fundamental course is now equivalent! What does that mean? After taking either EPIQ training or AHS AIW training complete 3 on-line modules via AHS MyLearningLink and obtain a QI-Yellow-belt which acknowledges that you have completed foundational training in QI Note: AIW Yellow belt will be a training requirement for all AHS medical leads in the near future
The SCH ED medicine triage consultation (consult request to decision to admit) is delayed (out of the 4 hours AHS target) and patients are often not assigned to the most appropriate medical service team. Approximately ~2 hours/day a Internal Medicine Physician is removed from the inpatient ward to perform ED consultations between the hours of 0700-1700, delaying inpatient care and discharge processes. ED physicians faced with highly complex patients often debate which medical service should be consulted resulting in batching of Medicine consultations requests. All of the mentioned , hinders the ED assessment timeframe, increases workload and increases admitted patient boarding time in the ED Goal: Improve the medicine patients flow in the SCH ED by expediting medical consultation/disposition and allocation of admitted patients to the most appropriate medical service team. May 31, 2017 develop an ED Medicine triage/consultation service impacting: a reduction in the total ED length of stay , reduce EDIS time stamp from “Consult request to decision to admit by 25%, reduce EDIS Time Stamp From Decision to Admit to bed assigned by 25%, reduction in batching of consultations/admissions during different times of the day Completed one plan do study act (PDSA) cycle (Feb 6-April 30, 2017) that identified key Physician scheduling components that have positive impact on ED triage, consultation and inpatient ward discharges. SCH is currently reviewing project learning and impact. Key model components determined, supporting a PDSA cycle #2-Fall of 2017 University of Alberta Hospital (UAH)-Acute Kidney Injury
Dr Neesh Pannu, Dr Cameron Herman and Pam Mathura At present, the burden of post-operative AKI on surgical wards at UAH is unknown. Many surgeons and surgical trainees at the UAH are unaware of the consequences of post-operative AKI, and current practice does not regularly involve nephrologists in post-operative care. The morbidity and mortality of post-operative AKI has been well documented, contributing both to future adverse events, costs and length of hospitalization. Goal: Reduce the incidence of severe (defined as ≥ Stage 2 AKI as per KDIGO) post-operative AKI by 30% on 3E2 and 3E4 by May 2017. Also, appropriate recognition of AKI in > 90% of cases; appropriate involvement of nephrology / internal medicine / critical care services for severe / refractory AKI in 80% of cases Project team has determined areas of opportunity and a PDSA is under development to be tested in June, 2017