In this two-part series, we will take a deeper dive into several QI conceptual frameworks, or ways to approach QI projects. In our previous posts, we discussed preparation strategies for QI projects; but when it comes to implementing a change, how would a team go about choosing an approach? We will start with a discussion of the variable effectiveness of different change interventions, then we will delve into an overview of some common …
FLOW Hacks 8 – In & out of the ED for the ‘Treat & Release’ patient.
To continue our FLOW Hacks series, Victoria Woolner (NP, MN, MSc QIPS) writes about her team’s project tackling the ‘Treat and Release‘ patient. Setting This intervention was carried out at Toronto General and Toronto Western Hospital (UHN) in Toronto, Ontario. Between the two sites, there are approximately 117, 000 visits per year. Description of the innovation Treat & release (T&R) patients are patients that have been seen in the ED and asked to return …
CAEP FEI | The Nursing Shift: Inter-Professional Education for Medical Students
Amy is a fourth year emergency medicine resident, who has recently started supervising medical students while on shift. She meets Jim, a third year medical student, who will be working with her for the shift. Over the course of the shift, it becomes apparent that Jim is struggling with understanding a charge nurse’s role in the emergency department. Amy wishes there was a way for medical students like Jim to gain more insight …
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 …
FLOW Hacks 7 – Doc in the Box: Improving Physician Initial Assessment Time in the Emergency Department
To continue our FLOW Hacks series, Dr. Joanna Bostwick writes about her team’s innovation aimed at improving physician initial assessment time in the ED. Setting This intervention was carried out at Hôpital Montfort, Ottawa, Ontario, an academic francophone community hospital with 56, 000 ED visits per year. Description of the innovation Our ED has applied an adapted version of Physician in Triage (PIT) termed “Doc in the Box” with the goal of decreasing physician …
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 …