Issue link: https://viewer.e-digitaledition.com/i/1170700
A Systematic Approach to Practice Improvement BY STEVE BARRETT GRE ATER EFFICIENCY AND EFFECTIVENESS IN A MEDICAL PR ACTICE COME FROM SYSTEMATIC EFFORT, ACCORDING TO THE AMERICAN ACADEMY OF FAMILY PHYSICIANS (A AFP). IN AN ARTICLE on its website, A AFP outlines concepts that should undergird practice improvement initiatives: + A culture of quality. All facets of a practice's processes and procedures should be included in quality improvement efforts. This may require a dedicated improvement team, among other measures. + A list of priorities. Identifying areas for improvement — low employee morale or long patient wait times, for example — is vital. The National Quality Forum (qualityforum.org) and other agencies offer quality measures that can help with this. + Good data. Practices should gather baseline data before implementing an improvement project. They should then regularly collect additional data, analyze it and act on the basis of what they learn. This aids understanding of practices' systems and evaluation of how changes in processes are working. + Communication. Clinicians, other staff and patients should all be part of planning and implementing efforts to boost quality, and the results of that pursuit should be communicated transparently to all those stakeholders. + Continual evaluation. Assessment of quality improvement measures should be ongoing and should include routine feedback from staff and patients. n 059990055_PM1.indd 1 5/9/19 12:34 PM DROPS DROPS DROPS Rate of Healthcare-Associated Infections in Hospitals DROPS BY STEVE BARRETT AMONG PATIENTS IN U.S. HOSPITALS, ABOUT ONE IN 30 HA S ONE OR MORE HE ALTHCARE-A SSOCIATED INFECTIONS (HAIs) ON A GIVEN DAY, ACCORDING TO THE CDC. HOWEVER, RECENT RESEARCH published in The New England Journal of Medicine shows the risk of patients acquiring HAIs in nearly 200 hospitals surveyed fell 16 percent from 2011 to 2015. Surgical site and urinary tract infections saw the largest drops. While the study did not gather data about practices hospitals had used to reduce surgical site infections, researchers noted that fewer patients had urinary catheters in 2015 and that hospitals prioritized the earliest possible removal of catheters to ward off infections. All told, slightly more than 3 percent of patients in U.S. hospitals had HAIs in 2015, down from 4 percent in 2011. Not all the news was good. Pneumonia and digestive infec- tions — particularly Clostridioides difficile (C. diff ) — are the most common infections, according to the study, which calls them out as targets for enhanced prevention efforts. C. diff infections did not decline, the authors note in a United Press International (UPI) article, and pneumonia infection rates remain troubling. "The findings are encouraging," the study's lead author, Shelley Magill, MD, a medical officer with the CDC, tells UPI. "Progress is being made in infections affecting hospitals in the United States. But more work needs to be done." n M D N E W S . C O M /// M D N E W S M i D H u D S O N ■ 2 019 P R A C T i C E M A N A G E M E N T ❰❰❰❰❰ 0 5