BOOK
Quality Improvement and Implementation Science, An Issue of Anesthesiology Clinics, E-Book
Meghan B. Lane-Fall | Lee A Fleisher
(2018)
Additional Information
Book Details
Abstract
This issue of Anesthesiology Clinics focuses on Quality Improvement and Implementation Science, with topics including: Applying implementation science principles to perioperative care; Emergency checklists in perioperative care; Human factors applied to perioperative process improvement; Handoffs in perioperative care; Use of simulation in performance improvement; Developing capacity to do improvement science work; Developing multicenter registries to advance quality science; Rethinking clinical workflow; data-driven quality improvement; and Scaling quality improvement at the health system level.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Quality Improvementand ImplementationScience\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword: Improving Perioperative Care: What Are the Tools That Lead to Sustainable Change? | vii | ||
| Preface: Quality Improvement and Implementation Science: Different Fields with Aligned Goals | vii | ||
| Implementation Science in Perioperative Care | vii | ||
| Human Factors Applied to Perioperative Process Improvement | vii | ||
| Quality Improvement in Anesthesiology—Leveraging Data and Analytics to Optimize Outcomes | vii | ||
| Emergency Manuals: How Quality Improvement and Implementation Science Can Enable Better Perioperative Management During Crises | viii | ||
| Use of Simulation in Performance Improvement | viii | ||
| Developing Multicenter Registries to Advance Quality Science | viii | ||
| Handovers in Perioperative Care | viii | ||
| Rethinking Clinical Workflow | ix | ||
| Developing Capacity to Do Improvement Science Work | ix | ||
| Diffusing Innovation and Best Practice in Health Care | ix | ||
| ANESTHESIOLOGY CLINICS\r | x | ||
| FORTHCOMING ISSUES | x | ||
| June 2018 | x | ||
| September 2018 | x | ||
| December 2018 | x | ||
| RECENT ISSUES | x | ||
| December 2017 | x | ||
| September 2017 | x | ||
| June 2017 | x | ||
| Foreword:\rImproving Perioperative Care: What Are the Tools That Lead to Sustainable Change? | xi | ||
| Preface:\rQuality Improvement and Implementation Science: Different Fields with Aligned Goals | xiii | ||
| REFERENCES | xv | ||
| Implementation Science in Perioperative Care | 1 | ||
| Key points | 1 | ||
| INTRODUCTION | 1 | ||
| WHAT IS IMPLEMENTATION SCIENCE? | 2 | ||
| HOW MIGHT IMPLEMENTATION SCIENCE ADVANCE OUR UNDERSTANDING OF PERIOPERATIVE CARE? | 2 | ||
| Potential for Implementation Research to Improve Perioperative Care | 3 | ||
| Perioperative Studies in Implementation Science | 4 | ||
| WHAT THEORIES, MODELS, OR FRAMEWORKS ARE PARTICULARLY SUITED TO PERIOPERATIVE IMPLEMENTATION SCIENCE? | 4 | ||
| WHAT ARE EXAMPLES OF IMPLEMENTATION OUTCOMES? | 4 | ||
| WHAT ARE THE CHALLENGES TO IMPLEMENTATION SCIENCE IN PERIOPERATIVE CARE? | 6 | ||
| Implementation Science Rests on the Assumption That There Are Evidence-Based Practices to Spread and Scale | 6 | ||
| Implementation Science Is a Young Field | 7 | ||
| Implementation Outcomes Include Qualitative and Quantitative Measures | 7 | ||
| WHAT TRAINING OPPORTUNITIES EXIST IN IMPLEMENTATION SCIENCE? | 8 | ||
| Implementation Science Training Institutes | 8 | ||
| Implementation Science Certificates | 8 | ||
| WHAT STRATEGIES MAY BE USED TO FUND IMPLEMENTATION SCIENCE RESEARCH? | 9 | ||
| WHAT ARE OPTIONS FOR DISSEMINATING AND PUBLISHING IMPLEMENTATION RESEARCH? | 9 | ||
| Specialty-Specific Audiences | 9 | ||
| Implementation Science–Specific Audiences | 10 | ||
| SUMMARY | 10 | ||
| REFERENCES | 10 | ||
| Human Factors Applied to Perioperative Process Improvement | 17 | ||
| Key points | 17 | ||
| OVERVIEW OF HUMAN FACTORS AND ERGONOMICS | 17 | ||
| HUMAN COGNITION AND PERFORMANCE | 18 | ||
| Selective Attention | 19 | ||
| Prospective Memory | 19 | ||
| Decision Making and Bias | 19 | ||
| STRESS AND WORKLOAD | 20 | ||
| Stress | 20 | ||
| Workload | 23 | ||
| PERFORMANCE ASSESSMENT | 23 | ||
| SAFETY AND ACCIDENTS | 24 | ||
| SUMMARY | 25 | ||
| Adopt Cognitive Aids and Checklists for Complex Tasks | 25 | ||
| Use Error Reporting Systems | 26 | ||
| Enhance the Root Cause Analysis Process | 27 | ||
| Summary of Recommendations | 27 | ||
| REFERENCES | 27 | ||
| Quality Improvement in Anesthesiology — Leveraging Data and Analytics to Optimize Outcomes | 31 | ||
| Key points | 31 | ||
| MEASURING DATA IN QUALITY IMPROVEMENT: DEFINING METRICS | 32 | ||
| Outcome Measures | 32 | ||
| Process Measures | 33 | ||
| Balancing Measures | 33 | ||
| APPROACHING QUALITY IMPROVEMENT: DIFFERENT FRAMEWORKS FOR SUCCESS | 33 | ||
| The Model for Improvement | 33 | ||
| Six Sigma | 35 | ||
| Lean Methodology | 35 | ||
| Blended Methodologies | 38 | ||
| MONITORING QUALITY: USING DATA FOR ONGOING QUALITY IMPROVEMENT EFFORTS | 38 | ||
| Run Charts | 38 | ||
| Control Charts | 39 | ||
| Dashboards | 39 | ||
| Big Data in Anesthesia: Registries and Databases for Quality Management | 40 | ||
| AUDIT AND FEEDBACK: USING DATA TO DRIVE POSITIVE CHANGE | 41 | ||
| SUMMARY | 41 | ||
| REFERENCES | 42 | ||
| Emergency Manuals | 45 | ||
| Key points | 45 | ||
| DEFINING THE PROBLEM\r | 45 | ||
| TERMINOLOGY\r | 46 | ||
| ENABLING TOOLS\r | 46 | ||
| EMERGENCY MANUALS IMPLEMENTATION COLLABORATIVE: RESOURCES AND REACH\r | 47 | ||
| LEARNING FROM OTHER INDUSTRIES\r | 47 | ||
| EMERGENCY MANUALS: A HISTORY AND A FRAMEWORK\r | 47 | ||
| SIMULATION-BASED STUDIES OF EMERGENCY MANUALS\r | 49 | ||
| EARLY CLINICAL IMPLEMENTATIONS AND TRAININGS: DATA AND FURTHER\rRESOURCES\r | 50 | ||
| MAKING MANUALS WORK: IMPLEMENTATION AND IMPROVEMENT\r | 51 | ||
| Establishing a Problem | 52 | ||
| Local Ownership | 52 | ||
| Organizational Systems | 53 | ||
| Customization and Improvement | 53 | ||
| EMERGENCY MANUAL FUTURES: DISCUSSION AND IMPLICATIONS\r | 54 | ||
| ACKNOWLEDGMENTS\r | 54 | ||
| REFERENCES\r | 59 | ||
| Use of Simulation in Performance Improvement | 63 | ||
| Key points | 63 | ||
| A BRIEF HISTORY OF PERFORMANCE IMPROVEMENT | 63 | ||
| SIMULATION DEFINED | 64 | ||
| SIMULATION EDUCATION: ANESTHESIOLOGISTS AT THE FOREFRONT | 65 | ||
| PRINCIPLES OF SIMULATION EDUCATION | 66 | ||
| Encouraging Deliberate Practice | 66 | ||
| Teaching and Assessing Nontechnical Skills | 67 | ||
| Replicating Reality | 67 | ||
| SIMULATION AND CONTINUING EDUCATION FOR PHYSICIAN ANESTHESIOLOGISTS | 67 | ||
| SIMULATION AND THE AMERICAN BOARD OF ANESTHESIOLOGY | 68 | ||
| SIMULATION AND MEDICAL MALPRACTICE | 70 | ||
| SIMULATION AND FUTURE RESEARCH | 70 | ||
| SUMMARY | 70 | ||
| REFERENCES | 70 | ||
| Developing Multicenter Registries to Advance Quality Science | 75 | ||
| Key points | 75 | ||
| WHY REGISTRIES? | 75 | ||
| Definition and Design | 76 | ||
| Why form a registry | 76 | ||
| Who should be involved | 76 | ||
| What is needed | 76 | ||
| How will it be maintained | 76 | ||
| Difference between clinical trial and clinical registry | 78 | ||
| Implementation | 78 | ||
| Different types of databases within the registries | 78 | ||
| Sharing information from each type of database | 78 | ||
| Protection of sensitive information | 78 | ||
| Innovative ways to obtain complete data | 79 | ||
| Standardization and using the data | 80 | ||
| Interpretation and Outcomes | 81 | ||
| Defining and assessing quality | 81 | ||
| A FEW EXAMPLES OF USING REGISTRY DATA | 82 | ||
| Adjunct in Quality Improvement Science | 82 | ||
| Adjunct in Randomized Controlled Trials | 82 | ||
| Guiding Therapy | 82 | ||
| Describing Rare Diseases | 83 | ||
| Practice Patterns and Adverse Events | 83 | ||
| SUMMARY | 84 | ||
| REFERENCES | 84 | ||
| Handovers in Perioperative Care | 87 | ||
| Key points | 87 | ||
| INTRODUCTION | 87 | ||
| Why Are Handovers Important? | 88 | ||
| TYPES OF PERIOPERATIVE HANDOVERS | 88 | ||
| Preoperative Handovers | 89 | ||
| Holding room to operating room handovers | 89 | ||
| Intensive care unit to operating room handovers | 89 | ||
| Interventions to Improve Preoperative Handovers | 90 | ||
| Intraoperative Handovers | 90 | ||
| Handovers for short breaks | 90 | ||
| End-of-shift handovers | 90 | ||
| Why Might Intraoperative Handovers Lead to Poorer Outcomes? | 91 | ||
| Interventions to Improve Intraoperative Handovers | 91 | ||
| Postoperative Handovers | 92 | ||
| Operating room to post anesthesia care unit handovers | 92 | ||
| Operating room to intensive care unit handovers | 93 | ||
| Interventions to Improve Postoperative Handovers | 93 | ||
| PRACTICAL RECOMMENDATIONS FOR IMPLEMENTING A STRUCTURED HANDOVER PROCESS IN THE PERIOPERATIVE PERIOD | 94 | ||
| SUMMARY | 95 | ||
| REFERENCES | 96 | ||
| Rethinking Clinical Workflow | 99 | ||
| Key points | 99 | ||
| WORKFLOW, TEAM DYNAMICS, AND CLINICAL ENVIRONMENTS | 99 | ||
| HEALTH CARE–SPECIFIC WORKFLOW MODELS | 101 | ||
| HUMAN FACTORS AND THE DONABEDIAN STRUCTURE-PROCESS-OUTCOME FRAMEWORK | 101 | ||
| THE SYSTEMS ENGINEERING INITIATIVE FOR PATIENT SAFETY MODEL | 101 | ||
| URGENCY AND ATTENTION: IMPACTING CLINICAL WORKFLOW | 103 | ||
| Conveying Urgency in a Clinical Setting | 103 | ||
| Culture–Societal Customs and Hierarchy in Medicine | 103 | ||
| Taking Lessons from Music Perception and Cognition | 103 | ||
| A New Interdisciplinary Approach | 104 | ||
| Attention and Space | 105 | ||
| Auditory Scene Analysis | 105 | ||
| INTRAOPERATIVE DISTRACTIONS: IMPACT ON WORKFLOW AND PRODUCTIVITY | 105 | ||
| External Distractions | 106 | ||
| Performance Impact | 106 | ||
| Internal Distractions | 106 | ||
| Prevention/Mitigation | 107 | ||
| HOW THE ACOUSTIC SPACE AFFECTS CONCENTRATION, PATIENT CARE, AND WORKFLOW | 107 | ||
| Acoustic Space | 107 | ||
| Noise | 108 | ||
| Intraoperative Music: Effects on Clinical Workflow | 108 | ||
| CLINICAL WORKFLOW: TECHNIQUES FOR THE INTENSIVE CARE UNIT | 109 | ||
| Multidisciplinary Rounds | 109 | ||
| Attention Attrition During Rounds and the Handover Process | 110 | ||
| Telemedicine Intensive Care Unit | 110 | ||
| SUMMARY | 111 | ||
| REFERENCES | 111 | ||
| Developing Capacity to Do Improvement Science Work | 117 | ||
| Key points | 117 | ||
| INTRODUCTION | 117 | ||
| DEFINITION | 118 | ||
| LEADERSHIP: LEADING CHANGE | 118 | ||
| TRAINING AND CREATING COMMON PURPOSE | 119 | ||
| UNDERSTANDING BEHAVIORAL CHANGE | 120 | ||
| APPLYING QUALITY IMPROVEMENT KNOWLEDGE: PRACTICAL STRATEGIES | 122 | ||
| PERIOPERATIVE QUALITY IMPROVEMENT OPPORTUNITIES | 123 | ||
| INCLUDING PATIENTS AND FAMILIES IN QUALITY IMPROVEMENT | 123 | ||
| SUMMARY | 124 | ||
| REFERENCES | 124 | ||
| Diffusing Innovation and Best Practice in Health Care | 127 | ||
| Key points | 127 | ||
| INTRODUCTION | 127 | ||
| ASSESSMENT OF READINESS FOR DIFFUSION | 129 | ||
| DIFFUSION BEST PRACTICE CASE STUDY | 130 | ||
| Case Study: Leadership | 132 | ||
| Organizational Set-Up | 133 | ||
| Communication | 133 | ||
| Nurturing Social Systems | 133 | ||
| Measurement, Feedback, and Knowledge Management | 133 | ||
| Debriefing: Getting Ready | 134 | ||
| Developing Spread Plan | 134 | ||
| Debriefing: Executing and Refining the Spread Plan | 135 | ||
| DEVELOPING CAPACITY FOR DIFFUSION (SPREAD) | 135 | ||
| LIMITATIONS AND FUTURE RESEARCH | 138 | ||
| SUMMARY | 138 | ||
| ACKNOWLEDGMENTS | 138 | ||
| REFERENCES | 139 |