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Reducing Inappropriate Induction of Labor at Intermountain Health Care: Research suggests that induction of labor is a factor in escalating rates of cesarean deliveries, preterm births, and neonatal intensive care admissions. This case-study describes how one integrated health care system implemented a guideline-based program to reduce inappropriate elective labor induction.
The NASA/VA Patient Safety Reporting System: Drawing on the experience of the aviation industry, the Veterans Administration tapped NASA to create an external patient safety reporting system that serves as a "safety valve" for capturing information on adverse events and close calls that are not reported to the VA's internal reporting system.
Promoting High Reliability Surgery at Kaiser Permanente: Growing evidence suggests that assuring patient safety requires effective teamwork and communication among health professionals. This case-study describes the results of an operating room pilot project that reduced adverse events and enhanced team performance and attitudes toward safety.
Improving ICU Care at the Porter Valparaiso Hospital Campus: This community hospital dramatically improved the quality and safety of care for ICU patients through an evidence-based collaborative improvement model. The critical care team prevented many infections and achieved better glucose control in patients, resulting in fewer deaths and shorter hospital stays.
The Washington University Medicare Coordinated Care Demonstration Program: The federal government has launched several demonstration programs to find out whether chronic care management programs developed in the private sector also will be effective for the Medicare population. The early experience of a pilot program suggests that barriers to effective treatment and prevention faced by high-risk Medicare patients can be addressed through a holistic care management approach.
The National Surgical Quality Improvement Program: A century ago, Boston surgeon Ernest A. Codman recognized that hospitals need to track their surgical outcomes in order to make improvements. The American College of Surgeons is offering hospitals an opportunity to participate in a nationwide program that, through the measurement and improvement of risk-adjusted surgical outcomes, could finally realize Codman's vision.
Using Simulation-based Team Training to Improve Obstetrical Care: The Harvard Center for Medical Simulation developed an innovative Labor and Delivery Crisis Resource Management Course to help obstetrical professionals improve their teamwork, communication, and crisis management skills through a realistic simulation experience.
Applying the Baldrige Criteria to Achieve Performance Excellence: The Robert Wood Johnson University Hospital Hamilton embedded the Baldrige National Quality Award principles of performance excellence into its management and operations through a systematic process of self-assessment, external evaluation, and strategic organizational improvement.
Enhancing Rapid Response at Missouri Baptist Medical Center: Patients who experience a heart attack in the hospital have a poor chance of survival, even when they are resuscitated. Rapid response teams seek to reduce the incidence of in-hospital heart attacks and other significant events by empowering nurses to call a critical care team when a patient shows signs of clinical deterioration.
Front-Line Physicians and Their Patients Reap Benefits from Electronic Health Records: A rural Colorado physician practice successfully adopted electronic health records as part of its strategy to improve the quality and efficiency of care. The system achieved a positive return on investment within two years of implementation.
A Transformational Change Process to Improve Patient Safety at Ascension Health: A large nonprofit health system identified the most common causes of preventable injuries and deaths at its 67 hospitals and launched an initiative to eliminate them within five years.
The University of Tennessee Health Science Center Telehealth Network: This state university created a regional telehealth network to improve health care access and quality for nearby underserved and isolated populations through education, research, and service.
The Institute for Urban Family Health: Using IT and Community Action to Improve the Health of a Diverse Patient Population. A New York City network of community health centers implemented electronic health records to promote equitable access to high-quality care for a diverse patient population. It learned that ensuring equal treatment does not necessarily ensure equal outcomes, emphasizing the importance of broader community interventions in eliminating health disparities.
Summa Health System's Care Coordination Network. Increasing demand for acute care beds led an Ohio health system to establish a network that aimed to improve transitional care between its hospitals and local post-acute care facilities.
Achieving a Culture of Patient- and Family-Centered Care at Bronson Methodist Hospital. Describes a community hospital's experience in putting patients and their families at the center of its strategy for improving clinical outcomes, patient experience, and corporate performance.
The Marshfield Clinic: Improving Quality and Efficiency in Response to Pay-for-Performance Incentives. The early experience of one participant in a three-year Medicare demonstration program suggests that information systems, care management, process redesign, and physician involvement are important to improving the quality and efficiency of care in response to pay-for-performance incentives.
Is It Quality Improvement or Research? The Experiences of Intermountain Healthcare and Children's Hospital Boston. Case studies of two leading health care organizations show that they share a common perspective of quality improvement (QI) as integral to excellence in clinical practice and, therefore, subject to the same ethical obligation to deliver the best possible care to patients.
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