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Chartier LB, Masood S, Choi J, McGovern B, Casey S, Friedman SM, Porplycia D, Tosoni S, Sabbah S. A blueprint for building an emergency department quality improvement and patient safety committee. CAN J EMERG MED 2022; 24:195-205. [PMID: 35107806 PMCID: PMC8808466 DOI: 10.1007/s43678-021-00252-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022]
Abstract
The field of quality improvement and patient safety (QIPS) has matured significantly in emergency medicine over the past decade. From standalone, strategically misaligned, and incoherently designed QIPS projects years ago, emergency department (ED) leaders have now recognized that developing a more robust QIPS infrastructure helps prioritize and organize projects for a greater likelihood of success and impact for patients and the system. This process includes the development of a well-defined, accountable, and supported departmental QIPS committee. This can be achieved effectively using a deliberate and structured approach, such as the one described by Harvard Business School Professor John Kotter in his seminal work, “Leading Change.” Herein, we present a blueprint using this framework and include practical examples from our experience developing a robust and successful ED QIPS committee and infrastructure. The steps include how to develop a “burning platform,” select a guiding coalition of leaders, develop a strategic vision and initiatives, recruit a volunteer army of members, enable actions for the committee, generate short-term successes, sustain the pace of change, and, finally, enable the infrastructure to support ongoing improvements. This road map can be replicated by ED teams of variable sizes and settings to structure, prioritize, and operationalize their QIPS activities and ultimately improve the outcomes of their patients.
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Affiliation(s)
- Lucas B Chartier
- Department of Emergency Medicine, University Health Network, 200 Elizabeth St., RFE-GS-480, Toronto, ON, M5G 2C4, Canada. .,Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada.
| | - Sameer Masood
- Department of Emergency Medicine, University Health Network, 200 Elizabeth St., RFE-GS-480, Toronto, ON, M5G 2C4, Canada.,Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - Joseph Choi
- Department of Emergency Medicine, University Health Network, 200 Elizabeth St., RFE-GS-480, Toronto, ON, M5G 2C4, Canada.,Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - Barb McGovern
- Ryerson University, Daphne Cockwell School of Nursing, Toronto, ON, Canada.,Emergency Department, Trillium Health Partners, Mississauga, ON, Canada
| | - Stephen Casey
- Department of Emergency Medicine, University Health Network, 200 Elizabeth St., RFE-GS-480, Toronto, ON, M5G 2C4, Canada
| | - Steven Marc Friedman
- Department of Emergency Medicine, University Health Network, 200 Elizabeth St., RFE-GS-480, Toronto, ON, M5G 2C4, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Danielle Porplycia
- Department of Emergency Medicine, University Health Network, 200 Elizabeth St., RFE-GS-480, Toronto, ON, M5G 2C4, Canada
| | - Sarah Tosoni
- University Health Network, Quality, Safety & Clinical Adoption, Toronto, ON, Canada
| | - Sam Sabbah
- Department of Emergency Medicine, University Health Network, 200 Elizabeth St., RFE-GS-480, Toronto, ON, M5G 2C4, Canada.,Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada
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de Steenwinkel M, Haagsma JA, van Berkel ECM, Rozema L, Rood PPM, Bouwhuis MG. Patient satisfaction, needs, and preferences concerning information dispensation at the emergency department: a cross-sectional observational study. Int J Emerg Med 2022; 15:5. [PMID: 35073836 PMCID: PMC8903487 DOI: 10.1186/s12245-022-00407-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background Patient satisfaction is an important indicator of emergency care quality and has been associated with information dispensation at the emergency department (ED). Optimal information dispensation could improve patient experience and expectations. Knowing what kind of information patients want to receive and the preferred way of information dispensation are essential to optimize information delivery at the ED. The purpose of this cross-sectional observational study was to evaluate patient satisfaction concerning information dispensation (including general, medical, and practical information), the need for additional information, and preferences with regard to the way of information dispensation at the ED of a teaching hospital in the Netherlands. Results Four hundred twenty-three patients (patients ≥ 18 years with Glasgow Coma Scale 15) were enrolled (response rate 79%). The median patient satisfaction score concerning the overall information dispensation at the ED was 7.5 on a rating scale 0–10. Shorter length of ED stay was associated with higher patient satisfaction in multivariate analysis (P < 0.001). The majority of respondents were satisfied regarding medical (n = 328; 78%) and general information (n = 233; 55%). Patients were less satisfied regarding practical information (n = 180; 43%). Respondents who indicated that they received general, medical and practical information were significantly more often satisfied compared to patients who did not receive this information (P < 0.001). Two thirds (n = 260; 62%) requested more general information. Half of the respondents (n = 202; 48%) requested more practical information and a third (n = 152; 36%) requested more medical information. The preferred way for receiving information was orally (n = 189; 44.7%) or by leaflets (n = 108; 25.5%). Conclusion The majority of respondents were satisfied concerning information dispensation at the ED, especially regarding medical information. Respondents requested more general and practical information and preferred to receive the information orally or by leaflets.
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Affiliation(s)
- Marank de Steenwinkel
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Juanita A Haagsma
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Esther C M van Berkel
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Lotte Rozema
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Pleunie P M Rood
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Marna G Bouwhuis
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
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