Bridging the language gap: a co-designed quality improvement project to engage professional interpreters for women during labour

2017 ◽  
Vol 41 (5) ◽  
pp. 499 ◽  
Author(s):  
Jane Yelland ◽  
Mary Anne Biro ◽  
Wendy Dawson ◽  
Elisha Riggs ◽  
Dannielle Vanpraag ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Professionals ◽  
High Intensity ◽  
Quality Improvement Project ◽  
Quality Improvement Initiative ◽  
Improvement Project ◽  
Supportive Leadership ◽  
Language Services ◽  
Interpreter Use ◽  
Multidisciplinary Group

Objective The aim of the study was to improve the engagement of professional interpreters for women during labour. Methods The quality improvement initiative was co-designed by a multidisciplinary group at one Melbourne hospital and implemented in the birth suite using the plan-do-study-act framework. The initiative of offering women an interpreter early in labour was modified over cycles of implementation and scaled up based on feedback from midwives and language services data. Results The engagement of interpreters for women identified as requiring one increased from 28% (21/74) at baseline to 62% (45/72) at the 9th month of implementation. Conclusion Improving interpreter use in high-intensity hospital birth suites is possible with supportive leadership, multidisciplinary co-design and within a framework of quality improvement cycles of change. What is known about the topic? Despite Australian healthcare standards and policies stipulating the use of accredited interpreters where needed, studies indicate that services fall well short of meeting these during critical stages of childbirth. What does the paper add? Collaborative approaches to quality improvement in hospitals can significantly improve the engagement of interpreters to facilitate communication between health professionals and women with low English proficiency. What are the implications for practice? This language services initiative has potential for replication in services committed to improving effective communication between health professionals and patients.

scholarly journals Assessing the practice of written referrals to neuroradiology and how this process can be improved and standardised

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S181-S182
Author(s):  
Fraser Currie ◽  
Rashi Negi ◽  
Hari Shanmugaratnam
Keyword(s):  
Quality Improvement ◽  
Scoring Systems ◽  
Quality Improvement Project ◽  
Cortical Atrophy ◽  
Secondary Outcome ◽  
Quality Improvement Initiative ◽  
Exclusion Criteria ◽  
Quality Of Information ◽  
Improvement Project

AimsThis quality improvement project aims to improve the quality of information provided in the referrals from the older adult psychiatry department to radiology when requesting neuroradiological imaging.The secondary outcome aims to standardise information on the referral proforma. We hypothesise that this improved referral proforma will lead to improved quality of reporting from the radiology department, which will form the second stage of this quality improvement project.A further area of interest of this exercise is to establish whether standardised radiological scoring systems are requested in the referral, as these can be utilised as a means to standardise reported information.MethodRetrospective electronic case analysis was performed on 50 consecutive radiology referrals for a period of 3 months from November 2019 to January 2020. Data were obtained from generic MRI and CT referral proforma and entered into a specifically designed data collection tool. Recorded were patient demographics, provisional diagnosis, modality of imaging, use of ACE-III cognitive score, radiological scoring systems, and inclusion and exclusion criteria.ResultResults from 50 referrals have shown: 60% were male, 40% female. Average patient age of 74, ranging from 49 to 95. 58% were referred for CT head with 42% for MRI head. More than half of referrals quoted the ACE-III score. 26% of referrals stated exclusion criteria such as space occupying lesions, haemorrhages or infarcts. 10% of referrals requested specific neuro-radiological scoring scales. Specific scales which were requested included GCA (global cortical atrophy), MTA scale (medial temporal atrophy), Koedam scale (evidence of parietal atrophy) and Fazekas (evidence of vascular changes). Only 80% of referrals included the patients GP details on the referral form.Conclusion1. This quality improvement initiative has highlighted that the current level of information in referring patient to radiology is variable and dependent on the referrer.2. All referrals should state exclusion criteria as per the NICE guidelines on neuroimaging in diagnosis of dementia.3. Preliminary evidence suggests that requesting specific radiological rating scales could improve the quality of information received in the imaging report. The second part of this quality improvement initiative will aim to explore the impact of requesting these scales routinely.

Abstract 184: Quality Improvement of Statin Therapy Appropriateness in Type 2 Diabetic Patients

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Dan L Li ◽  
Erika Diaz Narvaez ◽  
Chioma Onyekwelu ◽  
Eleanor M Weinstein ◽  
Robert T Faillace
Keyword(s):  
Quality Improvement ◽  
Statin Therapy ◽  
High Intensity ◽  
Quality Improvement Project ◽  
Planning System ◽  
Diabetic Patients ◽  
Improvement Project ◽  
Medicine Clinic ◽  
Ascvd Risk ◽  
Statin Dose

Objectives: The 2013 ACC/AHA guidelines recommend statin therapy for all diabetic patients between the ages of 40 to 75. The intensity of statin therapy is guided by the 10-year atherosclerosis cardiovascular disease (ASCVD) risk for a given patient. A quality-improvement project was carried out in the Jacobi Medical Center (JMC) Primary Care Medicine clinic to help clinicians improve statin therapy appropriateness. Interventions included: Intense education to house staff and clinic faculty members beginning in November 2015; Establishment of a pre-visit planning system beginning in August 2016 whereby nursing staff would preview the lipid panel of diabetic patients and alert providers when the LDL was above 100 mg/dl. A retrospective study was carried out to evaluate statin therapy appropriateness before and after this quality improvement project. Methods: Type 2 Diabetes Mellitus (T2DM) patients (age between 40-75) were selected from the JMC Medicine Clinic visits in September 2015 (baseline), May 2016 (after intense education), and September 2016 (after launching the pre-visit planning system). Exclusion criteria included: heart failure, ESRD on hemodialysis, active malignancy, and missing information for ASCVD risk calculation. In patients with LDL > 70 and with no history of CVD, the 10-year ASCVD risk was calculated and statin appropriateness was determined by comparing the actual statin prescription with the statin intensity suggested by the 2013 ACC/AHA guidelines. For patients who had an established diagnosis of CVD, statin therapy appropriateness was evaluated by whether the patients were on high-intensity statin therapy. Comparisons among groups were performed using chi-square analysis. Results: The numbers of patients in each of the three months after the exclusions were 371, 346 and 358; among which, 68, 70 and 77 patients had existing CVD respectively. Overall, 38.8% of the patients seen in September 2015 were prescribed an appropriate statin dose; the number rose to 42.2% in May 2016, and further to 50.0% in September 2016 ( p = 0.0086). For primary prevention of CVD, 35.3% of patients received an appropriate statin dose in September 2015; this number improved to 38.5% in May 2016, after intense education; and to 44.2% in September 2016. ( p = 0.089) For secondary prevention of CVD events in patients with clinical CVD, 54.4% of the patients in September 2015 were given high-intensity statins. The high-intensity statin prescription rate was 57.1% in May 2016, and subsequently increased to 70.1% in September 2016. ( p = 0.11) Conclusions: Significant improvement in compliance with the 2013 ACC/AHA guideline-based statin dose for lipid management in the JMC Primary Care Medicine Clinic was found to be associated with the implementation of a quality-improvement project consisting of intense physician education and a pre-visit planning system.

A quality improvement project to reduce restrictive interventions in a mental health service

2021 ◽  
pp. 1-12
Author(s):  
Darren Savarimuthu ◽  
Katja Jung
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Positive Impact ◽  
Essential Elements ◽  
Quality Improvement Project ◽  
Psychiatric Ward ◽  
Quality Improvement Initiative ◽  
Successful Implementation ◽  
Evidence Based ◽  
Improvement Project

Background/aims This article describes a quality improvement project that aimed to reduce restrictive interventions on an acute psychiatric ward. In light of a service level agreement and based on a trust-wide target, the purpose of the project was to reduce restrictive interventions by 20% within a period of 6 months. It was also anticipated that a least restrictive environment could have a positive impact on patient experience. Methods Three evidence-based interventions were introduced to the ward during the quality improvement project. These included positive behaviour support, the Safewards model and the productive ward initiative. Results There was a 63% reduction in restrictive interventions over a 6-month period through the successful implementation of a series of evidence-based interventions to manage behaviours that challenge on the mental health ward. Conclusions The project identified collaborative team working, staff training and adequate resources as essential elements in the success of the quality improvement initiative. However, co-production was found to be crucially significant in bringing sustainable changes in ward environment and in addressing restrictive practices.

scholarly journals A Quality Improvement Project to Increase the Rate of HPV Vaccination Initiation in Adolescents

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Quality Improvement ◽  
Hpv Vaccination ◽  
Vaccination Rate ◽  
Quality Improvement Project ◽  
Human Papilloma Virus Vaccine ◽  
Quality Improvement Initiative ◽  
Initiation Rate ◽  
Improvement Project ◽  
Vaccination Rates ◽  
Implementation Period

The vaccination rate of the human papilloma virus vaccine [9vHPV] is low, with only 63% of eligible females and 50% eligible males receiving the vaccine in 2016. The aim of this quality improvement project was to increase the initiation rate of HPV vaccination at Smyrna Pediatrics by 20%, from 3.6% to 4.3% over four weeks. Two physicians, one nurse practitioner, and two medical assistants implemented this quality improvement initiative. There is a lack of education and standardized communication about HPV and 9vHPV to prevent against the virus. A standardized script was created so that all conversations between healthcare professionals and patients and their parents or guardians included the wording of the 9vHPV being recommended rather than optional. Educational material from the CDC was the standard handout given to each adolescent and their parent or guardian. Standardized education and communication was to be provided at each adolescent visit of the 125 eligible adolescents seen during the four-week implementation period, 4% (n = 5) agreed to receive the 9vHPV vaccine. With a baseline of 3.6% (n = 4), there was an 11.1% increase of initiation of 9vHPV. The use of standardized education documents presented to all patients and their parents or guardians established health education as the mainstay of the project and provided information about the importance of prevention and protection from the virus that the vaccine prevents. The implementation of results over a longer period of time may prove to be more effective for the practice’s increase of vaccination rates overall.

CODE FAST: a quality improvement initiative to reduce door-to-needle times

2015 ◽  
Vol 8 (7) ◽  
pp. 661-664 ◽  
Author(s):  
Leslie Busby ◽  
Kumiko Owada ◽  
Samish Dhungana ◽  
Susan Zimmermann ◽  
Victoria Coppola ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Univariate Analysis ◽  
Substantial Reduction ◽  
Heart Association ◽  
Time Of Day ◽  
Quality Improvement Project ◽  
Quality Improvement Initiative ◽  
Improvement Project ◽  
Process Improvements ◽  
Before And After

BackgroundRapid delivery of IV tissue plasminogen activator (tPA) in qualifying patients leads to better clinical outcomes. The American Heart Association has reduced target door-to-needle (DTN) times from 60 to 45 min in the hopes of continued process improvements across institutions.ObjectiveTo start a quality improvement project called CODE FAST in order to reduce DTN times at our institution.Materials and methodsWe retrospectively reviewed data from our internally maintained database of patients treated with intravenous tPA before and after implementation of the CODE FAST protocol. We assessed demographic information, time of day and times of arrival to first image and delivery of tPA in patients from February 2014 to February 2015. Outcomes were assessed based on discharge to home. Univariate analysis was performed to assess for improvement in DTN times before and after implementation of the protocol.ResultsA total of 93 patients (41 pre-CODE FAST and 52 post-CODE FAST) received IV tPA during the study period. Patients were equally matched between the two groups except that in the pre-CODE FAST era patients receiving tPA were younger and more likely to be men. There was a substantial reduction in door-to-imaging time from a median of 16 to 8 min (p<0.0001) and DTN time with a reduction in the median from 62 to 25 min (p<0.0001). In logistic regression modeling, there was a trend towards more discharges to home in patients treated during the CODE FAST era.ConclusionsWe present a quality improvement project that has been overwhelmingly successful in reducing DTN time to <30 min. The template we present may be helpful to other institutions looking to reduce their DTN times and may also reduce costs as we note a trend towards more discharges to home.

A report on a quality improvement initiative to increase midwives' confidence in attending home birth

2020 ◽  
Vol 28 (4) ◽  
pp. 260-267
Author(s):  
Angela Lynn Horler
Keyword(s):  
Quality Improvement ◽  
Birth Rate ◽  
Home Birth ◽  
Quality Improvement Project ◽  
Quality Improvement Initiative ◽  
Improvement Project ◽  
Leadership Model ◽  
Community Midwives ◽  
Long Course

Since the dissolvement of the ‘supervisor of midwives’ role, NHS England has introduced a new midwifery role: the professional midwifery advocate (PMA) via the advocating for education and quality improvement (A-EQUIP) model. The author undertook the long course PMA study, which is a six-month module. A requirement of the module was to implement a quality improvement project within the student PMA NHS Trust. As part of a wider project under the ‘Better Births Maternity Transformation Programme’ (2016) to increase the home birth rate for the trust, the author chose to implement a quality improvement project to improve the (shared) home birth equipment available to community midwives, aiming to increase midwives’ confidence in attending home birth. Through the use of quality improvement tools and utilising a compassionate leadership model, the project aim was met: 75% of midwives reported they felt increased confidence in attending home birth with the new equipment offering.

Quality Improvement Project: Implementing Guidelines Supporting Noninvasive Respiratory Management for Premature Infants

2014 ◽  
Vol 33 (5) ◽  
pp. 245-254 ◽  
Author(s):  
Aksana Waskosky ◽  
Tricia K. Huey
Keyword(s):  
Quality Improvement ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Quality Improvement Project ◽  
Control Group ◽  
Quality Improvement Initiative ◽  
Improvement Project ◽  
Respiratory Management ◽  
Intensive Care Nursery

Purpose: Based on research evidence, the purpose was to implement noninvasive approaches in the initial respiratory stabilization of preterm infants.Design: Quality improvement project.Sample: One hundred fourteen infants admitted to the neonatal intensive care nursery (NICN) from January 1, 2012 to May 31, 2012 served as a historical control group. Ninety-four infants admitted from January 1, 2013 to May 31, 2013 served as the intervention group.Results: After implementation of the quality improvement initiative, there was a statistically significant increase in the rate of using continuous positive airway pressure (CPAP) by 65.3 percent for initial respiratory stabilization of preterm infants.

Sign in / Sign up

Export Citation Format

Share Document