International journal of health care quality assurance
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Int J Health Care Qual Assur · Jan 2013
Clinical quality improvement: eliminating unplanned extubation in the CCU.
This article aims to explore coronary care unit (CCU) extubation structures, processes and outcomes. There were 13 unplanned-extubation cases (UE) among 251 intubated patients (5.2 per cent) in a cardiologist-led CCU in 2008. Seven did not require re-intubation, implying possible earlier extubation. A quality improvement project was undertaken with a goal to eliminate CCU UE within 12 months. ⋯ There is little published data on improving intubated patient care in cardiologist-led CCUs. Previous studies centered on intensive care units managed by critical care specialists.
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Int J Health Care Qual Assur · Jan 2013
Simulation team training for improved teamwork in an intensive care unit.
This study aims to describe implementation of simulator-based medical team training and the effect of this programme on inter-professional working in an intensive care unit (ICU). ⋯ The present results broaden our understanding of how to create and sustain an organizational system that supports medical team training.
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The purpose of this paper is to present findings relating to how Lean is implemented in English hospitals. ⋯ This research is the first to examine more closely "how" Lean is implemented in English hospitals. The emergent typology could prove relevant to other public sector organizations and service organisations more generally. The research also presents a first step to understanding Lean thinking in the English NHS. This article empirically analyses Lean implementation in English hospitals. It identifies divergent approaches that allow inferences about how far Lean is implemented in an organisation. Data represent a baseline for further analysis so that Lean implementation can be tracked.
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The paper aims to provide a simulation optimization solution to improve patient scheduling that accounts for varying ancillary service time such as x-ray to minimize patient wait time. ⋯ This article presents a unique approach to considering the required ancillary services in outpatient scheduling system that minimizes patient wait times. The approach will strengthen the existing scheduling methods to allow the time for ancillary services.
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The Uganda Makerere University provides clinical laboratory support to over 70 clients in Uganda. With increased volume, manual data entry errors have steadily increased, prompting laboratory managers to employ the Six Sigma method to evaluate and reduce their problems. The purpose of this paper is to describe how laboratory data entry quality was improved by using Six Sigma. ⋯ This innovative QI method of reducing data entry errors in medical laboratories may improve the clinical workflow processes and make cost savings across the health care continuum.