You are working on a local quality improvement (QI) project aimed at improving emergency department (ED) lab test turnaround time. You started with a period of stakeholder engagement including the nursing staff, physicians, porters, administrators, clinical biochemists, lab technologists, and patients. Your team completed a root cause analysis and several potential interventions were highlighted. Your team decided to utilize a Plan-Do-Study-Act (PDSA) cycle approach to carry out several interventions including implementing a new …
HiQuiPs: Implementation Part 2 – Which Strategy to Choose: PDSA, Lean, or Six Sigma?
PDSA, Lean, and Six Sigma are three different frameworks that can be part of your quality improvement armamentarium. Each of them can often be applied to the same quality issue. Deciding on which one to use requires an understanding of their inherent strengths and weaknesses. In our last post, we briefly introduced the theory behind Lean, Six Sigma, and PDSA cycles. Here, we will practically apply each methodology to one quality problem to …
HiQuiPs: Preparation Part 3 – Root Cause Analysis
You have just finished a monthly business meeting with your emergency department (ED) team. One of your colleagues highlighted a recurring issue of the length of time it takes from ordering blood products to administering them in your ED. There is often a long delay in administration for patients who are in acute need. You have gathered a team to start working on this quality improvement project. The team has put a …
HiQuiPs: Preparation Part 2 – Stakeholder Engagement and Behavior Change
You have recently finished a review of incidents that have been flagged in your ED. You have chosen a pertinent issue to tackle, formed a core group to work on the project, and formulated a SMART aim statement after reading our last HiQuiPs post. The median time for obtaining 12-lead ECGs is 13 minutes, while guidelines recommend less than 10 minutes.1 Your aim is to decrease the initial 12-lead ECG acquisition time by …
HiQuiPs: Preparation Part 1 – General Considerations for ED Quality Improvement Projects
You are in the middle of a busy night shift and you see a 73-year-old female with diffuse abdominal pain who is hemodynamically stable. You have a wide differential and order a CT scan to aid in the diagnosis as you begin empiric management. Three hours pass by and the CT has not been performed. This is the third time this week that this has happened. In light of this, you feel strongly …