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 …
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 …
HiQuiPs: Quality of Care and the ED
You have just finished a busy ED shift on a warm summer evening and feel that you have been able to help a lot of people today. You plan to visit a patio and relax as you have earned it! On your way out you overhear a patient and their family members saying that they came to this ED because they heard it was “the best”, and they would never go back to …