Healthcare quarterly (Toronto, Ont.)
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This article discusses the background and process for developing a multi-year corporate quality plan. The Ottawa Hospital's goal is to be a top 10% performer in quality and patient safety in North America. In order to create long-term measurable and sustainable changes in the quality of patient care, The Ottawa Hospital embarked on the development of a three-year strategic corporate quality plan. ⋯ The three-year quality plan was approved by senior management and the board in April 2009. This process has supported The Ottawa Hospital's journey of excellence through the creation of a quality plan that will enable long-term measurable and sustainable changes in the quality of patient care. It also engaged healthcare providers who aim to achieve more measured quality patient care, engaged practitioners through collaboration resulting in both alignment of goals and outcomes and allowed for greater commitment by those responsible for achieving quality goals.
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This study implemented and evaluated the adapted Situation-Background-Assessment-Recommendation (SBAR) tool for use on two inter-professional rehabilitation teams for the specific priority issue of falls prevention and management. SBAR has been widely studied in the literature, but rarely in the context of rehabilitation and beyond nurse-physician communication. In phase one, the adapted SBAR tool was implemented on two teams with a high falls incidence over a six-month period. ⋯ While SBAR was used in the context of falls prevention and management, it was also utilized it in a variety of other clinical and non-clinical situations such as transitions in care, as a debriefing tool and for conflict resolution. Staff found the tool useful in helping to communicate relevant and succinct information, and to "close the loop" by providing recommendations and accountabilities for action. Suggestions are provided to other organizations considering adopting the SBAR tool within their clinical settings, including the use of an implementation tool kit and video simulation for enhanced uptake.
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The objective of this study was to evaluate whether Ontario's End-of-Life Care Strategy, which aimed to shift care from acute settings to the home, improved performance on quality indicators for end-of-life home care patients in use of more home care services and fewer acute care services. The study cohort included patients at the end of life admitted into home care between April 1, 2005, and September 30, 2006, and who died before April 1, 2007. Based on their admission date, patients were divided into three six-month periods corresponding to the six months prior to the strategy's implementation compared with the 12 months after. ⋯ In conclusion, one year after the strategy's implementation, individual patients' use of end-of-life home care and acute care services remained unchanged. The strategy may require more time for its impact to be fully achieved. Measuring these quality indicators across regions may help to monitor and evaluate interventions.
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Hospitals are faced with increasing challenges of antibiotic-resistant organisms and rising antimicrobial costs despite widespread attention to infection prevention and control measures. Government, professional organizations and accreditation bodies are all signalling an urgent need for the establishment of programs in hospitals to address antibiotic misuse. Although variations of such "antimicrobial stewardship programs" have been functioning in Canada for some time, a formal approach using change management and quality improvement principles has largely been lacking. We describe how we have established such a program in a teaching hospital, modelled on John Kotter's eight steps of leading change.