Delays and interruptions in the acute medical unit clerking process

"Interruptions and delays regularly occurred during the admission process in the study hospital which impacts adversely on patient experience and compliance with the recommended 4-h timeframe, further work is required to assess the impact on patient safety. Data obtained from this observational study were used to guide operational changes to improve the process."


Delays and interruptions in the acute medical unit clerking process: an observational study
AJ Basey, TD Kennedy, AJ Mackridge, J Krska
JRSM Open February 2016 vol. 7 no. 2 2054270415619323

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Reducing turnaround time of surgical pathology reports in pathology and laboratory medicine departments

"This project improvement idea of mapping out the workflow process has led to process and systems improvement. Focusing on fixing subprocesses within the sample flow process had led to more than 94% of all routine surgical pathology cases being reported within less than two days and meeting the CAP standards."

Reducing turnaround time of surgical pathology reports in pathology and laboratory medicine departments
Saeed Alshieban, Khaled Al-Surimi
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209223.w3773

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Meeting patients’ health information needs in breast cancer center hospitals

"We found differences in proportions of patients with unmet information needs between hospitals and that hospitals’ structure and process-related attributes of the hospitals were associated with these differences to some extent. Hospitals may contribute to reducing the patients’ information needs by means that are not necessarily resource-intensive."

Meeting patients’ health information needs in breast cancer center hospitals – a multilevel analysis

C Kowalski, SD Lee, L Ansmann, S Wesselmann, H Pfaff
BMC Health Services Research 2014, 14:601  doi:10.1186/s12913-014-0601-6

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Better Care and Better Value for Hip and Knee Replacement

"Robert Kaplan from the Harvard Business School explains the Time-Driven Activity-Based Costing (TDABC), a powerful way to capture and analyze every step and cost of the joint replacement process. IHI has been working with some 32 hip and knee replacement providers over the past year on TDABC and subsequent improvements as part of the IHI Joint Replacement Learning Community. We learn about them and their exciting work on this episode of WIHI."

WIHI: Better Care and Better Value for Hip and Knee Replacement (audio broadcast)
RS Kaplan, K Luther, C Abbott, J Rosengrant
Institute for Healthcare Improvement
October 2014

Listen to the recording here.

Safe staffing and escalation process

"Whilst it has not led to any cost savings, the consistent and robust focus on safe staffing has had a number of other benefits through a robust focus on safe staffing levels, e.g. a benefit to patient care through a consistent approach to staffing in clinical areas, empowering senior nurse leaders to make decisions about safe staffing."

St George's Healthcare NHS Trust Safe staffing and escalation process
St George's Healthcare NHS Trust
NICE Shared Learning
September 2014

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Identifying systems failures in the pathway to a catastrophic event

"We identified areas of concern even within the context of a highly controlled standardised national process. If incident reporting systems include and encourage reports of no-harm incidents in addition to actual patient harm, they can facilitate monitoring the resilience of healthcare processes. Patient safety incidents that produce the most serious harm are often rare, and it is difficult to know whether patients are adequately protected. Our approach provides a potential solution."

Identifying systems failures in the pathway to a catastrophic event: an analysis of national incident report data relating to vinca alkaloids
BD Franklin, SS Panesar, C Vincent, LJ Donaldson
BMJ Quality and Safety, 2014;23:765-772

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Team-training in healthcare

"Our synthesis suggests that there is moderate to high-quality evidence that team-training can positively impact healthcare team processes and, in turn, clinical processes and patient outcomes. These effects have been demonstrated across a variety of acute care areas."

Team-training in healthcare: a narrative synthesis of the literature
SJ Weaver, SM Dy, MA Rosen
BMJ Quality and Safety, 2014; 23: 359-372

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Going big: how major providers scale up their best ideas

"Three types of innovations - technical advances, process improvements, and business model innovations - have significant applicability to health care."

Going big: how major providers scale up their best ideas
C Hawn
California HealthCare Foundation
June 2012

Read more here.