Access Partnership Project (APP) The Access to Care Survey is presently being administrated with all frontline staff managing referrals. Report to be provided August 2018. This will provide focus for the final steps for Path to Care implementation before 2019. The Connect Care – D group is creating a conversation about standardizing the Physician triage process integrating E-CLINICIAN. “The APP and CC-D project teams are moving the DoM to ConnectCare readiness in advance of the projected rollout in the Edmonton Zone”
2 Projects Presented: • Oral PresentationHigh system users • Poster PresentationUtilization of Prophylactic Azithromycin in Patients with Frequent COPD Exacerbations Congratulations
QI Grants- CMO Quality Innovation Projects 2018/19 Series SCIC Received grant funding for the following projects: 1. Appropriate Lab ordering-Creatinine 2. Access Partnership project 3. CAM tool 4. GI- Inpatient bowel prep 5. UAH- GIM ED Evening Service 6. Living Kidney donor Transplant 7. Improving care of patients with suspected TTP 8. RAH- Reducing Length-of-Stay for Stable Antepartum Patients Congratulations!
1. 2. 3. 4. 5. 6. 7.
Featured Quality Improvement Project Ensuring Adequate Nutritional Intake While Reducing Oral Nutritional Supplement (ONS) Wastage Problem: ONS accumulation and subsequent wastage continues to be seen on the UAH GIM units. The waste increases cost to the healthcare system with little impact on patients’ nutrition status. A baseline audit in the five GIM units on March 16th 2018 indicated there were 8 Ensure® bottles found unopened at bedside, which costs $135-195 monthly. Nutritional supplements stored in non-patient room areas on the unit were not accounted for during initial baseline audit. However, a random audit was conducted on two separate dates and a total of 8 bottles were found on the five units Plan: Unit discussions were held to increase awareness of this issue. Along with the following interventions 1. Prescribers will be educated to initially prescribe max 1 bottle of ONS daily and then order dietitian consult. Current practice was often to order initially more than once per day-i.e TID 2. UM/Nurse to flag patient for RD reassessment if accumulation noticed during Comfort Care Rounds. 3. UM/Nurse to notify team during rapid rounds if accumulation noticed. 4. RD to monitor census report for patients on supplements 5. Weekend process: nurse/MD can order max 1 bottle daily, then consult RD for Monday assessment
8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
2018 SCIC Project list: Appropriate Lab ordering-Creatinine Access Partnership Project CAM tool Usage Living Kidney donor Transplant Improving care of patients with suspected TTP RAH- Reducing Length-of-Stay for Stable Antepartum Patients Ensuring annual pap testing in HIV positive patients GNCH-ED triage and consultation SCH- ED triage and consultationPDSA#2 UAH- Pet Therapy program UAH- GIM ED Evening service UAH- Improving inpatient bowel preparation UAH- Improving GI resident handover Ensuring adequate nutritional intake while reducing oral nutritional supplement wastage Formalization of nutritional screening upon admission MIS- Ensuring appropriate lab ordering UAH- Ensuring correct biopsy ordering-risk mitigation UAH- Haematology MOU- Ensuring appropriate lab ordering GRH- Establishing a hospital site quality structure Acute Kidney Injury-Edmonton Zone
Results: Reduction of ONS ordered initially and stored at bedside. Observational audit indicates Minimal bottles stored and ordered
PDSA#2: ‘Medpass’ concept will be tested to decrease both nursing and RD double checks in PDSA#1
Contact: pam.mathura@albertahealthservices.ca for further questions/comments
Upcoming Events: SCIC Meetings: Quarterly going forward • NO July or August meeting • Sept 20, 2018