Backround : At Aurora Health Care, an integrated delivery system based in Milwaukee, a system-level clinical quality improvement department was established in 1995 to facilitate collaboration on clinical quality improvement (QI) initiatives.
The collaborative model : A model was developed to use expertise within the system and avoid unnecessary duplication of efforts, while maintaining buy-in for the project's interventions as the point of service delivery.
It was believed that a single team could design the improvement efforts or guidelines, and then work at a more local level with a different group of people to implement the processes.
Applying the model to the heparin QI project : Anticoagulation with heparin is considered the mainstay of treatment for pulmonary embolism and deep venous thrombosis.
However, a large gap was found between present anticoagulation practices and published best practice in regards to achieving a key process measure.
To reduce the overall time to achieving effective anti-coagulation, a system-level team created an intervention primarily consisting of a preprinted order sheet, including the weight-based heparin dosing nomogram, and an education plan for physicians and other health care professionals.
Significant improvement was observed at all pilot sites with overall rates of adequate anticoagulation within the first 24 hours improving from 73% to 95%. (...)
Mots-clés Pascal : Amélioration, Processus, Méthodologie, Qualité, Nursing, Soin, Médicament, Chimiothérapie, Traitement, Recommandation, Efficacité, Evaluation, Poids corporel, Indicateur nutritionnel, Information, Santé, Aide décision, Anticoagulant, Indicateur, Mesure
Mots-clés Pascal anglais : Improvement, Process, Methodology, Quality, Nursing, Care, Drug, Chemotherapy, Treatment, Recommendation, Efficiency, Evaluation, Body weight, Nutritional indicator, Information, Health, Decision aid, Anticoagulant, Indicator, Measurement
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 19/02/1999.