Resident S Handbook Of Medical Quality And Safety

Drive to provide high value healthcare has created a field of medical quality improvement and safety. A Quality Improvement (QI) project would often aim in translate medical evidence (e.g. hand hygiene saves lives) into clinical practice (e.g. actually washing your hands before you see the patient, suffice it to say that not all hospitals are able to report 100% compliance with hand-hygiene). All doctoral residents in the United States must now satisfy a new requirement from the American College of Graduate Medical Education that they participate in a QI initiative. However, few departments are equipped to help their residents develop and implement a QI initiative. Resident’s Handbook is a short, not fussy, and practical introduction to developing a QI initiative. Meant not only for residents seeking to jump-start a QI initiative but also for attending physicians looking to improve their clinical practice, residency program directors and even medical students already eyeing what residency training holds for them; the book introduces and explains the basic tools needed to conduct a QI project. It provides numerous real-life examples of QI projects by the residents, fellows and attendings who designed them, who discuss their successes and failures as well as the specific tools they used. Several chapters provide a more senior perspective on resident involvement in QI projects and feature contributions from several QI leaders, a hospital administration VP and a residency program director. Though originally designed with physicians in mind, the book will also be helpful for physician assistants, nurses, physical, occupational and speech language pathology therapists, as well as students in these disciplines. Since no QI intervention is likely to be successful if attempted in isolation more non-physician clinicians are joining the ranks of quality and safety leadership. Therefore several non-physician clinician led initiatives included in the manuscript constitute an integral part of this book.The book serves as a short introduction to the field of medical quality improvement and safety emphasizing the practical pointers of how to actually implement a project from its inception to publication. To our knowledge this is the first concise do-it-yourself publication of its kind. Some of the topics covered include: how to perform an efficient literature search, how to get published, how to scope a project, how to generate improvement ideas, effective communication, team, project management and basic quality improvement tools like PDCA, DMAIC, Lean, Six Sigma, human factors, medical informatics etc.. Although no substitute for the services of a trained clinical statistician, chapters on statistics and critical assessment of the medical literature familiarizes residents with basic statistical methodologies, clinical trials and evidence based medicine (EBM). Since no QI project is complete without providing evidence for post-intervention improvement we provide a short introduction to the free statistical language R, which helps residents independently run basic statistical calculations. Because much of QI involves assessment of subjective human experiences, there is also a chapter on how to write surveys. Resident’s Handbook of Medical Quality and Safety is not an exhaustive QI textbook but rather a hands-on pocket guide to supplement formal training by other means.div

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Examines the newest scientific advances in the science of safety.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Patient safety and quality of care are critical concerns of healthcare consumers, payers, providers, organizations, health systems, and governments. Although a strong body of knowledge shows that high reliability methods enable the most efficient, safe, and effective care, these methods have yet to be completely implemented across healthcare. According to authors Cynthia Oster and Jane Braaten, nurses—who are on the frontline of providing safe and effective care—are ideally situated to drive high reliability. High Reliability Organizations: A Healthcare Handbook for Patient Safety & Quality, Second Edition, equips nurses and healthcare professionals with the tools necessary to establish an error detection and prevention system. This new edition builds on the foundation of the first book with best practices, relevant exemplars, and important discussions about cultural aspects essential to sustainability. New material focuses on: · High reliability performance during a pandemic · Organizational learning and tiered safety huddles · High reliability in infection prevention and ambulatory care · The emerging field of human factors engineering within healthcare · Creating a virtual resource toolkit for frontline staff

Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.

Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety.