Global journal on quality and safety in healthcare最新文献

Introduction: The outpatient oncology infusion unit is very busy, serving 60 to 70 patients per day. Due to a limited number of nurses, treatment chairs, only one pharmacy hood for bio-hazardous drug preparation, and other factors, patients wait a long time before starting their treatment, which affects the patient experience negatively. We conducted a quality improvement project to reduce the waiting time before starting the treatment, improve the patients' experience, and allow the unit to work more effectively through better resource utilization and accommodating more patients.

Methods: A committee was formed with representatives from oncology nursing and the quality specialist, chemotherapy pharmacy supervisor, data manager, and a medical consultant (team leader). We studied baseline data of patient waiting times from January to March 2019 and the factors that contributed to delays before starting the treatment. The charge nurse identified patients who could safely have their medication released early in the morning at 7 am, enabling the pharmacy to dispense at 8 am without their actual presence being required in the infusion suite (i.e., medication early release program or MERP). Multiple plan-do-study-act (PDSA) cycles were implemented to achieve a wait time from check-in to medication administration of less than 60 minutes. Data collected included check-in time, chair time, vital signs time, administration time, and discharge time. Additionally, reasons for drug wastage were assessed for patients who did not receive the prepared medication. A patient satisfaction survey was conducted with the patients before and after being enrolled in the program.

Results: At baseline, average waiting time for patients receiving similar medications in the MERP was 2 hours and 27 minutes. After the first intervention, average waiting time was reduced to 1 hour and 24 minutes, and small improvements were observed after each PDSA cycl. A major breakthrough occurred after an intensive patient education program and enforcement of strict compliance with the criteria in selecting the patients appropriate for theMERP. Average waiting time wasreduced to ≤ 60 minutes, and in November 2022, it was 30 minutes on average. Drug wastage was identified as a balancing measure. We were successful in reducing drug wastage by implementing several changes and patient education measures and achieved zero wastage. The patient satisfaction survey showed better satisfaction with the new changes.

Conclusion: A positive impact was achieved in this quality improvement project, with a significant reduction in the average waiting time for patients to start receiving chemotherapy. The outcome of this project has been maintained for 4 years and is still ongoing.

Introduction: Hospital food service is a key patient experience domain in an inpatient setting, which also plays an important role in responding to clinical and nutritional needs by providing food that is acceptable to patients. To achieve the strategic objective of a "distinguished patient experience," a Food Service Patient Experience Improvement Project was implemented at Al Hada Armed Forces Hospital during the second quarter of 2021 (Q2-2021) to improve the patient experience of meals at inpatient units.

Methods: A quasi-experimental study design was used to assess the improvements in the inpatient meal experience by implementing an experience-based codesign approach. Improvements in the inpatient setting patient experience survey (Press Ganey) meals domain were measured. SQUIRE 2.0 guidelines were used to report this quality improvement project.

Results: A significant improvement was observed in the inpatient meals patient experience mean score before (Q1-2021, 68.75) versus after (Q3-2021, 81.93) the implementation of the Food Service Patient Experience Improvement Project.

Conclusion: Food services are an important element in the patient recovery process and experience. The experience-based codesign is an effective coproduction approach to improve the patient experience and promote patient-centered care.

Introduction: Every organization needs well-trained employees to perform job activities effectively and efficiently. Training and development is a continuous process that helps to develop skills, knowledge, and abilities in its workers, which leads to better performance of employees. This study aims to assess the effectiveness of an induction training program for hospital employees as well as the impact on employee knowledge and performance in the clinical field according quality indicator benchmarks.

Methods: A sample of individuals (N = 775) who were newly hired, promoted, or re-categorized at our institution in 2021 were included in the program. The effectiveness of the induction training program was assessed with a pre- and post-test and feedback form. Topics covered in the training program will help employees know about the institute and increase knowledge and skills.

Results: The average pre-test score was 60%, which increased to 84% after the training (p = 0.0001). There was a significantly positive relationship between the quality indicators and the clinical audit results (p = 0.006).

Conclusion: The induction training program effectively improved the employees' knowledge regarding their rights and responsibilities as well as clinical knowledge (i.e., Infection control and prevention, quality, disaster management, biomedical waste management, and facility safety).

Introduction: Patient experience in the setting of the emergency department (ED) is an area of strategic priority forall healthcare facilities. Patient experience can be affected by several factors that encompass the cultural, behavioral, and psychological domains of the healthcare organization. Al Hada Armed Forces Hospital, in its efforts to achieve the strategic objectives of continuously improving the patient experience at scale, implemented an ED-basedbehavioral model of service behaviors that was adapted to match the local community needs and practiced by the frontline healthcare staff at the ED during Q2-2021.

Methods: A pre-experimental and postexperimental design was used for our patient experience quality improvement project. The Institute for Healthcare Improvement model for improvement plan-do-study-act was used to implement the quality improvement initiative. Our work is reported in accordance with the SQUIRE (Standards for Quality Improvement Reporting Excellence for Education) 2.0 guidelines from the EQUATOR network.

Results: The ED patient experience mean score improved during the postimplementation phase by 5.23 points (8% increase) in Q1-2022 and reached a sustainability level during Q3-2022.

Conclusion: This quality improvement project in patient experience at our ED provides strong evidence for adopting organizational values-aligned standardized service behaviors to improve the patient experience at scale across ED settings.

Introduction: Needlestick injury, which occurs when the skin is accidentally punctured, is linked to infection transmission of HIV, hepatitis B, and hepatitis C. Because of the associated risks, hospitals are keen to do everything necessary to prevent needlestick injuries to their staff. This is a quality improvement project aimed at reducing needlestick injuries among staff at Nyaho Medical Centre (NMC).

Methods: A facility-based assessment of the incidence of needlestick injury recorded and quality intervention employed was conducted between 2018 and 2021. Quality improvement tools such as the fishbone (cause and effect analysis) and the run chart were used to analyze and evaluate improvements made over time.

Results: NMC staff have greatly reduced the incidence of needlestick injuries from 2018 to 2021 (from 11 needlestick injuries in 2018 to 3 recorded needlestick injuries in 2021).

Conclusion: Using root cause analysis to investigate the possible cause of needlestick injury and use of the run chart to monitor the implemented improvement strategies (interventions) helped reduce the incidence of needlestick injuries among staff and thereby improved staff safety. The introduction of the incident reporting management systems saw an increase in the culture of incident reporting in general. Other incidents, such as medical errors and patient falls, were being reported using the incident reporting system. The inclusion of infection prevention and control training as part of NMC's onboarding for new employees helped in the knowledge and awareness creation of needlestick injuries and safety measures to prevent injury from needles and sharps. Policy changes and audit with feedback sharing key performance indicators with frontline team members were identified to have had the most effect.