2.50
Hdl Handle:
http://hdl.handle.net/10755/203231
Type:
Presentation
Title:
Provider Communication Impacts Quality Outcomes
Abstract:
(Summer Institute) Problem: A large teaching hospital’s Cardiac Surgery Quality Committee tried many different initiatives to meet and/or surpass their quality metrics. While many initiatives resulted in short term improvements, it was difficult to sustain these improvements. Like most teaching hospitals, residents and fellows provide a substantial amount of the patients’ care during their hospitalization. The Cardiovascular Nurse Practitioner working with these residents and fellows reported that many of them did not seem the committee’s quality initiatives. Evidence: Research suggests that effective communication about patient care between healthcare providers improves patient outcomes.1 In July 2010, the Joint Commission released the National Patient Safety Goals (NPSGs) one of which is to improve the effectiveness of communication among caregivers. Strategy: The Cardiovascular (CV) Nurse Practitioner initiated a monthly meeting with the CV Fellows to improve communication of the hospitals’ quality goals and changes in practice. Practice Change: In a thirty-minute monthly meeting culturally diverse practitioners are encouraged to communicate expectations and personal strengths and weaknesses which improve colleague and patient engagement. Discussion of hospital quality initiatives, the meeting’s focus, include topics like: core measure compliance; a sedation order-set to decrease intubation time post-cardiovascular surgery; and post-operative bleeding management and hypotension algorithms designed to decrease blood usage. Evaluation: Significant improvement in hospital quality metrics: 60% increase in meeting attendance; 33% increase in preop beta blocker; 25% decrease patients receiving <4 RBC intraop; 14% decrease in patients receiving <4 RBC postop length of stay; 55% increase in postop extubation <6 hours; 16% decrease in prolonged postoperative intubation (ventilation >24 hours). Results: Communication of clear expectations and a better understanding of hospital quality goals and initiatives resulted in improved patient outcomes. Recommendations: Make sure that all healthcare practitioners are included when planning and communicating quality initiatives. Lessons Learned: Significant improvement in hospital quality metrics can be achieved by: Improving communication between healthcare practitioners; Ensuring that all the members of the healthcare team understand hospital policy, practice guidelines, and quality metrics. Bibliography: Pronovost, P., Berenholtz, S., Dorman, T., Lipsett, P. A., Simmonds, T., & Haraden, C. (2003). Improving communication in the ICU using daily goals. Journal of Critical Care, 18(2), 71-75. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]
Keywords:
Communication; Outcomes
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Summer Institute

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleProvider Communication Impacts Quality Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/203231-
dc.description.abstract(Summer Institute) Problem: A large teaching hospital’s Cardiac Surgery Quality Committee tried many different initiatives to meet and/or surpass their quality metrics. While many initiatives resulted in short term improvements, it was difficult to sustain these improvements. Like most teaching hospitals, residents and fellows provide a substantial amount of the patients’ care during their hospitalization. The Cardiovascular Nurse Practitioner working with these residents and fellows reported that many of them did not seem the committee’s quality initiatives. Evidence: Research suggests that effective communication about patient care between healthcare providers improves patient outcomes.1 In July 2010, the Joint Commission released the National Patient Safety Goals (NPSGs) one of which is to improve the effectiveness of communication among caregivers. Strategy: The Cardiovascular (CV) Nurse Practitioner initiated a monthly meeting with the CV Fellows to improve communication of the hospitals’ quality goals and changes in practice. Practice Change: In a thirty-minute monthly meeting culturally diverse practitioners are encouraged to communicate expectations and personal strengths and weaknesses which improve colleague and patient engagement. Discussion of hospital quality initiatives, the meeting’s focus, include topics like: core measure compliance; a sedation order-set to decrease intubation time post-cardiovascular surgery; and post-operative bleeding management and hypotension algorithms designed to decrease blood usage. Evaluation: Significant improvement in hospital quality metrics: 60% increase in meeting attendance; 33% increase in preop beta blocker; 25% decrease patients receiving <4 RBC intraop; 14% decrease in patients receiving <4 RBC postop length of stay; 55% increase in postop extubation <6 hours; 16% decrease in prolonged postoperative intubation (ventilation >24 hours). Results: Communication of clear expectations and a better understanding of hospital quality goals and initiatives resulted in improved patient outcomes. Recommendations: Make sure that all healthcare practitioners are included when planning and communicating quality initiatives. Lessons Learned: Significant improvement in hospital quality metrics can be achieved by: Improving communication between healthcare practitioners; Ensuring that all the members of the healthcare team understand hospital policy, practice guidelines, and quality metrics. Bibliography: Pronovost, P., Berenholtz, S., Dorman, T., Lipsett, P. A., Simmonds, T., & Haraden, C. (2003). Improving communication in the ICU using daily goals. Journal of Critical Care, 18(2), 71-75. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]en_GB
dc.subjectCommunicationen_GB
dc.subjectOutcomesen_GB
dc.date.available2012-01-16T11:04:44Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T11:04:44Z-
dc.description.sponsorshipUTHSCSA Summer Instituteen_GB
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