Improvements in healthcare quality increase patient safety and satisfaction, positively impacting the reputation of a facility. However, these may also require resources: more budget, effort, or time – either to employ and train new staff or to invest in equipment and hospital infrastructure. But what is the impact on the bottom line?
There is little evidence publicly on how quality influences the financial health of institutions. As a result, hospitals often lack the resources they need to make data-based decisions about quality programs. In order to provide additional evidence, IFC launched the “Business Case for Healthcare Quality” contest. The goal: to present real-life cases from hospitals around the world that successfully used quality to improve their business.
Participating institutions that displayed a strong understanding of the business case for healthcare quality and provided a measurable impact collaborated with the IFC IQ-Health program to produce the 2023 Business Case for Healthcare Quality Highlights. IFC gleaned further insights by conducting interviews with top leadership, as well as the quality practitioners who implemented new programs.
About IFC IQ-Healthcare
Responding to global gaps in healthcare competence, IFC IQ-Healthcare —with the IQ standing for Improving Quality—helps health providers improve patient safety, align practices with global quality standards, and build safe health infrastructure. To date, the IFC IQ-Healthcare program has helped more than 130 hospitals and clinics in nearly 20 countries. Over 6,000 healthcare professionals benefited from IFC open resources: a webinar series and self-paced training on healthcare quality and patient safety.
Learn More at https://www.ifc.org/iqhealth
· What is the NDNQIThe National Database of Nursing Quality Ind.docxodiliagilby
· What is the NDNQI?
The National Database of Nursing Quality Indicators (NDNQI®) is the only national nursing database that provides quarterly and annual reporting of structure, process, and outcome indicators to evaluate nursing care at the unit level. Linkages between nurse staffing levels and patient outcomes have already been demonstrated through the use of this database. Currently over 1100 facilities in the United States contribute to this growing database which can now be used to show the economic implications of various levels of nurse staffing.
NDNQI data allows staff nurses and nursing leadership to review and evaluate nursing performance in relation to patient outcomes. Hospitals can use the information to establish organizational goals for improvement at the unit level, and mark progress in improving patient care and the work environment. It can also help your facility avoid costly complications.
· What are nursing-sensitive quality indicators?
Nursing-sensitive indicators identify structures of care and care processes, both of which in turn influence care outcomes. Nursing-sensitive indicators are distinct and specific to nursing, and differ from medical indicators of care quality. For example, one structural nursing indicator is nursing care hours provided per patient day. Nursing outcome indicators are those outcomes most influenced by nursing care.
· Which particular quality indicator did you select to address in your tutorial?
Medication error
· Why is this quality indicator important to monitor?
· Be sure to address the impact of this indicator on quality of care and patient safety.
Medication safety is an important topic because medication errors (MEs) are a common, serious and expensive type of medical error
may cause or lead to inappropriate medication use or patient harm
· Why do new nurses need to be familiar with this particular quality indicator when providing patient care?
The nurse’s role in and ability to change patient safety and quality improvement within health care has implications for both safety and quality processes and nursing, patient, and organizational outcomes. The relationships between organizational systems factors, clinical processes, and patient safety and quality outcomes. It is important to focus on improving and widening the assessment of the impact of patient safety and quality improvements on the incidence of the broad array of errors that can and do occur in nurses’ work environments. For example, leaders and clinicians need to understand the association between an organization’s culture of safety and patient outcomes as well as how nurses can influence executives to lead working environment improvements.
Hello and welcome to the University Hospital Health Care System. My name is Diane Tate. We are so excited to have you on our nursing team. I am here today to help you better understand how our healthcare system uses Nursing Sensitive Quality Indicators – also known as the NDNQI - to en ...
· What is the NDNQIThe National Database of Nursing Quality Ind.docxalinainglis
· What is the NDNQI?
The National Database of Nursing Quality Indicators (NDNQI®) is the only national nursing database that provides quarterly and annual reporting of structure, process, and outcome indicators to evaluate nursing care at the unit level. Linkages between nurse staffing levels and patient outcomes have already been demonstrated through the use of this database. Currently over 1100 facilities in the United States contribute to this growing database which can now be used to show the economic implications of various levels of nurse staffing.
NDNQI data allows staff nurses and nursing leadership to review and evaluate nursing performance in relation to patient outcomes. Hospitals can use the information to establish organizational goals for improvement at the unit level, and mark progress in improving patient care and the work environment. It can also help your facility avoid costly complications.
· What are nursing-sensitive quality indicators?
Nursing-sensitive indicators identify structures of care and care processes, both of which in turn influence care outcomes. Nursing-sensitive indicators are distinct and specific to nursing, and differ from medical indicators of care quality. For example, one structural nursing indicator is nursing care hours provided per patient day. Nursing outcome indicators are those outcomes most influenced by nursing care.
· Which particular quality indicator did you select to address in your tutorial?
Medication error
· Why is this quality indicator important to monitor?
· Be sure to address the impact of this indicator on quality of care and patient safety.
Medication safety is an important topic because medication errors (MEs) are a common, serious and expensive type of medical error
may cause or lead to inappropriate medication use or patient harm
· Why do new nurses need to be familiar with this particular quality indicator when providing patient care?
The nurse’s role in and ability to change patient safety and quality improvement within health care has implications for both safety and quality processes and nursing, patient, and organizational outcomes. The relationships between organizational systems factors, clinical processes, and patient safety and quality outcomes. It is important to focus on improving and widening the assessment of the impact of patient safety and quality improvements on the incidence of the broad array of errors that can and do occur in nurses’ work environments. For example, leaders and clinicians need to understand the association between an organization’s culture of safety and patient outcomes as well as how nurses can influence executives to lead working environment improvements.
Hello and welcome to the University Hospital Health Care System. My name is Diane Tate. We are so excited to have you on our nursing team. I am here today to help you better understand how our healthcare system uses Nursing Sensitive Quality Indicators – also known as the NDNQI - to en.
Engage Front-line Care Team Using Clinical Audit Checklists iCareQuality.us
The culture of patient safety, quality, and transparency is central to improving care delivery at the organization and industry level. Implementing a sustainable frontline solution like quality checklists will require new leadership, innovative thinking, applications of human factor engineering, and patient voices who demand better. We need to reward staff engagement and quality patient safety efforts which can translate into better patient outcomes. CCG, PSO developed a Clinical Audit Checklist program that can support a culture of transparency and accountability, thereby reducing healthcare costs and delivering positive patient outcomes. Together, we can make continuous daily improvement a standard practice at the hospital and system level. Patients are counting on us to make care delivery safer today for a better patient experience tomorrow.
Presenting Statistical Results for Decision MakingAt any enterpr.docxstilliegeorgiana
Presenting Statistical Results for Decision Making
At any enterprise, statistical results can point the way to better decisions. This is especially true in health care, where trends or changes in patient care or results can have powerful effects on health care organizations — clinical effects, and financial effects. Knowing the facts about trends and changes is crucial to navigating them, which means that in many ways, statistical results are powerful tools.
But they’re less powerful if nobody understands them. More often than not, stakeholders in health care organizations are not well versed in statistics or data analysis. Especially for these stakeholders, it’s critical to make careful choices about which numbers to include — and how to talk about those numbers. Doing so helps you to present statistical results in a way that’s understandable and actionable even for those with less data literacy.
In this activity, you’ll have an opportunity to analyze a health trend at a large urban hospital, and to decide which results of the analysis are most important to communicate to the stakeholders concerned with it.St. Anthony Medical CenterYour Office
You are an analyst in the Quality Assurance department at St. Anthony Medical Center, a large hospital in Minneapolis, Minnesota. You have an email from David Brooks, the manager of Quality Assurance, in which he explains your next assignment.
EMAIL FROM DAVID BOOKS- QA MANAGER
Hello! So I’m aware that you’re relatively new around here, but I’ve got to pull you in on an important project. Here’s the short version, and I can answer questions later if this isn’t enough background.
Since you’re in health care, you must know that hospital-acquired conditions (HACs) are a big deal. Hospitals are designed from the ground up to minimize them, but the fact is that hospitals always have a lot of bugs floating around and that means they’re a constant danger. And while we try to minimize mistakes, health care professionals are human, and sometimes mistakes cause real problems.
The hospital’s board is getting worked up about them again, because we’ve had some high-profile cases where a patient went home and had to be readmitted because of a mistake or an infection they picked up while they were here. They’re worried about PR, of course, but they’re worried about patient outcomes, and — of course — financial reimbursement and penalties, too.
What I need you to do is start working on a presentation about HACs here, specifically as they relate to staffing levels and skill mix. That presentation should explain our recommendations to the board. You’ll want to include some statistics to bolster our case, so take a look at the AHRQ National Scorecard on Hospital-Acquired Conditions and the CMS Hospital-Acquired Conditions Reduction Program. Look at published research about the relationship between HACs and staffing levels, too.
Let’s get this right; this is our chance to get the board to understand that HACs will go dow ...
· What is the NDNQIThe National Database of Nursing Quality Ind.docxodiliagilby
· What is the NDNQI?
The National Database of Nursing Quality Indicators (NDNQI®) is the only national nursing database that provides quarterly and annual reporting of structure, process, and outcome indicators to evaluate nursing care at the unit level. Linkages between nurse staffing levels and patient outcomes have already been demonstrated through the use of this database. Currently over 1100 facilities in the United States contribute to this growing database which can now be used to show the economic implications of various levels of nurse staffing.
NDNQI data allows staff nurses and nursing leadership to review and evaluate nursing performance in relation to patient outcomes. Hospitals can use the information to establish organizational goals for improvement at the unit level, and mark progress in improving patient care and the work environment. It can also help your facility avoid costly complications.
· What are nursing-sensitive quality indicators?
Nursing-sensitive indicators identify structures of care and care processes, both of which in turn influence care outcomes. Nursing-sensitive indicators are distinct and specific to nursing, and differ from medical indicators of care quality. For example, one structural nursing indicator is nursing care hours provided per patient day. Nursing outcome indicators are those outcomes most influenced by nursing care.
· Which particular quality indicator did you select to address in your tutorial?
Medication error
· Why is this quality indicator important to monitor?
· Be sure to address the impact of this indicator on quality of care and patient safety.
Medication safety is an important topic because medication errors (MEs) are a common, serious and expensive type of medical error
may cause or lead to inappropriate medication use or patient harm
· Why do new nurses need to be familiar with this particular quality indicator when providing patient care?
The nurse’s role in and ability to change patient safety and quality improvement within health care has implications for both safety and quality processes and nursing, patient, and organizational outcomes. The relationships between organizational systems factors, clinical processes, and patient safety and quality outcomes. It is important to focus on improving and widening the assessment of the impact of patient safety and quality improvements on the incidence of the broad array of errors that can and do occur in nurses’ work environments. For example, leaders and clinicians need to understand the association between an organization’s culture of safety and patient outcomes as well as how nurses can influence executives to lead working environment improvements.
Hello and welcome to the University Hospital Health Care System. My name is Diane Tate. We are so excited to have you on our nursing team. I am here today to help you better understand how our healthcare system uses Nursing Sensitive Quality Indicators – also known as the NDNQI - to en ...
· What is the NDNQIThe National Database of Nursing Quality Ind.docxalinainglis
· What is the NDNQI?
The National Database of Nursing Quality Indicators (NDNQI®) is the only national nursing database that provides quarterly and annual reporting of structure, process, and outcome indicators to evaluate nursing care at the unit level. Linkages between nurse staffing levels and patient outcomes have already been demonstrated through the use of this database. Currently over 1100 facilities in the United States contribute to this growing database which can now be used to show the economic implications of various levels of nurse staffing.
NDNQI data allows staff nurses and nursing leadership to review and evaluate nursing performance in relation to patient outcomes. Hospitals can use the information to establish organizational goals for improvement at the unit level, and mark progress in improving patient care and the work environment. It can also help your facility avoid costly complications.
· What are nursing-sensitive quality indicators?
Nursing-sensitive indicators identify structures of care and care processes, both of which in turn influence care outcomes. Nursing-sensitive indicators are distinct and specific to nursing, and differ from medical indicators of care quality. For example, one structural nursing indicator is nursing care hours provided per patient day. Nursing outcome indicators are those outcomes most influenced by nursing care.
· Which particular quality indicator did you select to address in your tutorial?
Medication error
· Why is this quality indicator important to monitor?
· Be sure to address the impact of this indicator on quality of care and patient safety.
Medication safety is an important topic because medication errors (MEs) are a common, serious and expensive type of medical error
may cause or lead to inappropriate medication use or patient harm
· Why do new nurses need to be familiar with this particular quality indicator when providing patient care?
The nurse’s role in and ability to change patient safety and quality improvement within health care has implications for both safety and quality processes and nursing, patient, and organizational outcomes. The relationships between organizational systems factors, clinical processes, and patient safety and quality outcomes. It is important to focus on improving and widening the assessment of the impact of patient safety and quality improvements on the incidence of the broad array of errors that can and do occur in nurses’ work environments. For example, leaders and clinicians need to understand the association between an organization’s culture of safety and patient outcomes as well as how nurses can influence executives to lead working environment improvements.
Hello and welcome to the University Hospital Health Care System. My name is Diane Tate. We are so excited to have you on our nursing team. I am here today to help you better understand how our healthcare system uses Nursing Sensitive Quality Indicators – also known as the NDNQI - to en.
Engage Front-line Care Team Using Clinical Audit Checklists iCareQuality.us
The culture of patient safety, quality, and transparency is central to improving care delivery at the organization and industry level. Implementing a sustainable frontline solution like quality checklists will require new leadership, innovative thinking, applications of human factor engineering, and patient voices who demand better. We need to reward staff engagement and quality patient safety efforts which can translate into better patient outcomes. CCG, PSO developed a Clinical Audit Checklist program that can support a culture of transparency and accountability, thereby reducing healthcare costs and delivering positive patient outcomes. Together, we can make continuous daily improvement a standard practice at the hospital and system level. Patients are counting on us to make care delivery safer today for a better patient experience tomorrow.
Presenting Statistical Results for Decision MakingAt any enterpr.docxstilliegeorgiana
Presenting Statistical Results for Decision Making
At any enterprise, statistical results can point the way to better decisions. This is especially true in health care, where trends or changes in patient care or results can have powerful effects on health care organizations — clinical effects, and financial effects. Knowing the facts about trends and changes is crucial to navigating them, which means that in many ways, statistical results are powerful tools.
But they’re less powerful if nobody understands them. More often than not, stakeholders in health care organizations are not well versed in statistics or data analysis. Especially for these stakeholders, it’s critical to make careful choices about which numbers to include — and how to talk about those numbers. Doing so helps you to present statistical results in a way that’s understandable and actionable even for those with less data literacy.
In this activity, you’ll have an opportunity to analyze a health trend at a large urban hospital, and to decide which results of the analysis are most important to communicate to the stakeholders concerned with it.St. Anthony Medical CenterYour Office
You are an analyst in the Quality Assurance department at St. Anthony Medical Center, a large hospital in Minneapolis, Minnesota. You have an email from David Brooks, the manager of Quality Assurance, in which he explains your next assignment.
EMAIL FROM DAVID BOOKS- QA MANAGER
Hello! So I’m aware that you’re relatively new around here, but I’ve got to pull you in on an important project. Here’s the short version, and I can answer questions later if this isn’t enough background.
Since you’re in health care, you must know that hospital-acquired conditions (HACs) are a big deal. Hospitals are designed from the ground up to minimize them, but the fact is that hospitals always have a lot of bugs floating around and that means they’re a constant danger. And while we try to minimize mistakes, health care professionals are human, and sometimes mistakes cause real problems.
The hospital’s board is getting worked up about them again, because we’ve had some high-profile cases where a patient went home and had to be readmitted because of a mistake or an infection they picked up while they were here. They’re worried about PR, of course, but they’re worried about patient outcomes, and — of course — financial reimbursement and penalties, too.
What I need you to do is start working on a presentation about HACs here, specifically as they relate to staffing levels and skill mix. That presentation should explain our recommendations to the board. You’ll want to include some statistics to bolster our case, so take a look at the AHRQ National Scorecard on Hospital-Acquired Conditions and the CMS Hospital-Acquired Conditions Reduction Program. Look at published research about the relationship between HACs and staffing levels, too.
Let’s get this right; this is our chance to get the board to understand that HACs will go dow ...
In October 2014, INTEGRATED's Bill Jessee presented "Where Is Healthcare Going? And How Will We Get There?" at Iowa Hospital Association's annual meeting. The presentation focuses on the forces shaping healthcare today, the delivery system changing in response to the environment, and what this all means for hospitals and physicians.
A Case Study forBecky Skinner, RRT, BSSpecialized Care Coo.docxevonnehoggarth79783
A Case Study for
Becky Skinner, RRT, BS
Specialized Care Coordinator
University of Iowa Hospitals and Clinics
May 30, 2013
UIHC Human Capital Strategies to Comply and Thrive Under The Patient Protection Affordable Care Act Regulations
Table of Contents
Mission & Vision 3
History of the University of Iowa Hospitals & Clinics 4
Fiscal Year 2012 Facts 4
Statement of Problem or Challenge 5
Research and Background Data 7
Implications PPACA Has on UIHC Human Capital Management 11
Resolution Proposal 14
Summary and Conclusion 17
Appendix A: SWOT Analysis 19
Appendix B: Corporate Parenting Strategy 27
Appendix C: Portfolio Analysis 35
References 45
History of the University of Iowa Hospitals & ClinicsVision:
World Class People.
· Building on our greatest strength.
World Class Medicine.
· Creating a new standard of excellence in integrated patient care, research and education.
For Iowa and the World.
· Making a difference in quality of life and health for generations.Mission:
Simply stated, our mission is: Changing Medicine. Changing Lives.®
University of Iowa Health Care is changing medicine through Pioneering discovery
· Innovative inter-professional education
· Delivery of superb clinical care
· An extraordinary patient experience in a multi-disciplinary, collaborative, team-based environment
University of Iowa Health Care is changing lives by
· Preventing and curing disease
· Improving health and well-being
· Assuring access to care for people in Iowa and throughout the world
In 1873 The University of Iowa began providing medical services when it reached an agreement with Sisters of Mercy to operate a small hospital in the area. It began with two wards, one for women and the other for men containing four private rooms and a surgical amphitheater. In 1865 this agreement was terminated when the Sisters of Mercy moved across town and opened up Mercy Hospital. Today, the University of Iowa Hospitals and Clinics is a public -teaching hospital affiliated with the University of Iowa and a Level 1 trauma center. It has 711 beds including a 190-bed UI Children’s Hospital (About Us, n.d.). On an average day, there are close to 9,000 individuals providing care to patients, including employees, students and volunteers (About Us, n.d.). Fiscal Year 2012 Facts
There were 32,000 patients admitted to the hospital for in-patient care with 59,000 emergency room visits. In the 200 outpatient clinics of the UIHC, 977,337 clinic visits were counted. In addition to the 1,300 volunteers of UIHC, it employed during FY2012:
· 1,548 physicians, residents, and fellows
· 8,221 non-physician employees of whom 1,845 are professional nurses (About Us, n.d.)
Since U.S. News & World Report began to rank hospitals in 1990, UIHC has made the list as one of the best and has over 271 physicians ranked as “Best Doctors in America”.
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Delete text and place photo here.
June
Place logo
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Patient Engagement: The Next Wave of Change in Healthcare ITCascadia Capital
Patient Engagement is one of the fastest growing sub verticals in Healthcare. Is it really going to solve some of the big issues plaguing the Healthcare system? We think so.
Patient leakage - What to know and how to avoid itChiron Health
Patient leakage to urgent care centers is a well known and costly issue for many practices. However, with the rise of telemedicine, there is a new aspect of patient leakage that practices need to be aware of: leakage to on-demand telemedicine companies.
Value-Based Purchasing in healthcare is here to stay. Though the industry has come to terms with this reality, there are still more updates and changes than most of us can keep up with. In a world of accountable care, quality measures, shared savings, and bundled payments, everyone seems to have more questions than answers.
Bobbi Brown, Vice President, Financial Engagements outlines the latest announcements on Value-Based and how to prepare your organization for success in this new reality. Having previously worked in healthcare administration and finance for Kaiser, Sutter, and Intermountain, Bobbi is no stranger to translating complex legislative requirements for complex health systems.
Bobbi discusses the various programs offered by CMS, in particular:
What the programs are
How these programs are measured
What the current incentives are
Results of the programs to date
Organizational changes needed for the shift in programs
In this edition....Summaries of innovation projects
Resident transfers from aged care facilities to emergency departments: Can they be avoided?
NSW Trauma App
Queensland’s Digital Hospital
Investigating the relationship between emotional intelligence and transformation leadership in Nurse Managers
Embedding Consumer Engagement in Organisational Governance — Moving Consumers on Committees from Tokenistic to Having an Impact
UK Report Alcohol’s Impact on Emergency Services
The Sustainable Health Care Facility of the FutureTextbooks H.docxchristalgrieg
The Sustainable Health Care Facility of the Future
Textbooks:
Hayward, C. (2006). Healthcare Facility Planning: Thinking Strategically. Chicago, IL: Health Administration Press.
Vickery, C.G., Nyberg, G., & Whiteaker, D. (2015). Modern Clinic Design: Strategies for an Era of Change. Hoboken, NJ: Wiley.
Instructions: Please ensure to substantiate your response with scholarly sources and/or also a personal account of your own experience in the work place or personal life. Cite and reference work! Must be 150 -200 word count.
What reactions do you have to the ideas they presented? Include examples from the course readings or your own experience to support your perspective, and raise questions to continue the dialogue. 100 to 150 words for questions 1, 2, 6, 9, 10 & 11.
1. I agree that the changes made with CMS (center for Medicare and Medicaid Services) how changed the guidelines for how providers can bill for services. One of the biggest changes was the upgrade of ICD codes which has expanded enormously to be more specific with diagnosis and services to bill for. I work for a program of hospice, called palliative care, and the change over from using ICD9 codes to ICD10 was a very large task that took time to switch over to but I have come to realize that changes in health care are inevitable and to be prepared for things to change constantly. With being a palliative care program I don't think the change was as big of an impact on us like I'm sure it was for a hospital. Our program provides education on disease progress for chronic illnesses such a chronic kidney disease, hypertension, diabetes, cancer, heart disease and so on. The amount of ICD 10 codes we use are minimal compared to what a hospital would see. Nonetheless the codes are way more specific now which can be challenging when trying to narrow down for accuracy.
2. I think training and feedback are two important aspects of implementing electronic medical records. The users are the most important stakeholders and they should be trained properly. Their feedback should be taken seriously as this helps with post implementation changes to the system. No one likes changes but change in any organization is essential. Technology has completely transformed the health care industry and from my experience resistance typically comes from the older generation who doesn't really understand the importance. Most are used to doing things manually. Most organizations are turning to the technology to transform their environment by cutting costs and ensuring that their revenues are coming in timely.
3. Open your web browser and search for videos, articles and other resources discussing the health care system in the United States. Look for new trends, current issues affecting the health care system, etc.
4. Discuss your findings with the class
5. As a healthcare leader, you will need to have a strong base with understanding healthcare systems. Where will health care be delivered in the future? ...
Still struggling to find the monetary value of a strong patient communications program? This white paper maps the advantages and provides evidence about the ROI of using sustained electronic communications to improve patient satisfaction and outcomes.
In a new report, SVB Analytics examines the challenges facing stakeholders in the U.S. healthcare system, the solutions made possible by technology advancements and opportunities for entrepreneurs and investors.
Learn more here: http://www.svb.com/Blogs/Alex_Lee/Digital_Health__Mapping_Digital_Health_Solutions/
Emergency Department Quality Improvement Transforming the Delivery of CareHealth Catalyst
Overcrowding in the emergency department has been associated with increased inpatient mortality, increased length of stay, and increased costs for admitted patients. ED wait times and patients who leave without seeing a qualified medical provider are indicators of overcrowding. A data-driven system approach is needed to address these problems and redesign the delivery of emergency care.
This article explores common problems in emergency care and insights into embarking on a successful quality improvement journey to transform care delivery in the ED, including an exploration of the following topics:
A four-step approach to redesigning the delivery of emergency care.
Understanding ED performance.
Revising High-Impact Workflows.
Revising Staffing Patterns.
Setting Leadership Expectations.
Improving the Patient Experience.
La mayoría de las universidades tienen un conjunto de atributos de posgrado y cada vez más incluyen habilidades digitales y alfabetización. Teniendo en cuenta tanto las habilidades digitales basadas en la disciplina para cumplir con las expectativas cambiantes de la industria, como la alfabetización digital independiente de la disciplina que contribuye a la identidad digital de los graduados, se alienta a las universidades a articular su estrategia de aprendizaje digital. La clave de una estrategia de aprendizaje digital es mantenerla ágil confiando en procesos y estructuras en curso para respaldar el entorno cambiante en el espacio de aprendizaje digital. Esta presentación revisa los elementos básicos de dicha estrategia.
Most universities have a set of graduate attributes and increasingly those include digital skills and literacy. In consideration of both – discipline-based digital skills to meet ever changing industry expectations AND discipline-neutral digital literacy that contributes to graduates’ digital identity, universities are encouraged to articulate their Digital Learning Strategy. The key to a digital learning strategy is to keep it agile by relying on ongoing processes and structures to support the changing environment in the digital learning space. This presentation reviews the sasic elements of such a strategy.
Más contenido relacionado
Similar a Finalists of the 2023 Business Case for Healthcare Quality
In October 2014, INTEGRATED's Bill Jessee presented "Where Is Healthcare Going? And How Will We Get There?" at Iowa Hospital Association's annual meeting. The presentation focuses on the forces shaping healthcare today, the delivery system changing in response to the environment, and what this all means for hospitals and physicians.
A Case Study forBecky Skinner, RRT, BSSpecialized Care Coo.docxevonnehoggarth79783
A Case Study for
Becky Skinner, RRT, BS
Specialized Care Coordinator
University of Iowa Hospitals and Clinics
May 30, 2013
UIHC Human Capital Strategies to Comply and Thrive Under The Patient Protection Affordable Care Act Regulations
Table of Contents
Mission & Vision 3
History of the University of Iowa Hospitals & Clinics 4
Fiscal Year 2012 Facts 4
Statement of Problem or Challenge 5
Research and Background Data 7
Implications PPACA Has on UIHC Human Capital Management 11
Resolution Proposal 14
Summary and Conclusion 17
Appendix A: SWOT Analysis 19
Appendix B: Corporate Parenting Strategy 27
Appendix C: Portfolio Analysis 35
References 45
History of the University of Iowa Hospitals & ClinicsVision:
World Class People.
· Building on our greatest strength.
World Class Medicine.
· Creating a new standard of excellence in integrated patient care, research and education.
For Iowa and the World.
· Making a difference in quality of life and health for generations.Mission:
Simply stated, our mission is: Changing Medicine. Changing Lives.®
University of Iowa Health Care is changing medicine through Pioneering discovery
· Innovative inter-professional education
· Delivery of superb clinical care
· An extraordinary patient experience in a multi-disciplinary, collaborative, team-based environment
University of Iowa Health Care is changing lives by
· Preventing and curing disease
· Improving health and well-being
· Assuring access to care for people in Iowa and throughout the world
In 1873 The University of Iowa began providing medical services when it reached an agreement with Sisters of Mercy to operate a small hospital in the area. It began with two wards, one for women and the other for men containing four private rooms and a surgical amphitheater. In 1865 this agreement was terminated when the Sisters of Mercy moved across town and opened up Mercy Hospital. Today, the University of Iowa Hospitals and Clinics is a public -teaching hospital affiliated with the University of Iowa and a Level 1 trauma center. It has 711 beds including a 190-bed UI Children’s Hospital (About Us, n.d.). On an average day, there are close to 9,000 individuals providing care to patients, including employees, students and volunteers (About Us, n.d.). Fiscal Year 2012 Facts
There were 32,000 patients admitted to the hospital for in-patient care with 59,000 emergency room visits. In the 200 outpatient clinics of the UIHC, 977,337 clinic visits were counted. In addition to the 1,300 volunteers of UIHC, it employed during FY2012:
· 1,548 physicians, residents, and fellows
· 8,221 non-physician employees of whom 1,845 are professional nurses (About Us, n.d.)
Since U.S. News & World Report began to rank hospitals in 1990, UIHC has made the list as one of the best and has over 271 physicians ranked as “Best Doctors in America”.
Place logo
or logotype here,
otherwise
delete this.
Delete text and place photo here.
June
Place logo
or logotype here,.
Patient Engagement: The Next Wave of Change in Healthcare ITCascadia Capital
Patient Engagement is one of the fastest growing sub verticals in Healthcare. Is it really going to solve some of the big issues plaguing the Healthcare system? We think so.
Patient leakage - What to know and how to avoid itChiron Health
Patient leakage to urgent care centers is a well known and costly issue for many practices. However, with the rise of telemedicine, there is a new aspect of patient leakage that practices need to be aware of: leakage to on-demand telemedicine companies.
Value-Based Purchasing in healthcare is here to stay. Though the industry has come to terms with this reality, there are still more updates and changes than most of us can keep up with. In a world of accountable care, quality measures, shared savings, and bundled payments, everyone seems to have more questions than answers.
Bobbi Brown, Vice President, Financial Engagements outlines the latest announcements on Value-Based and how to prepare your organization for success in this new reality. Having previously worked in healthcare administration and finance for Kaiser, Sutter, and Intermountain, Bobbi is no stranger to translating complex legislative requirements for complex health systems.
Bobbi discusses the various programs offered by CMS, in particular:
What the programs are
How these programs are measured
What the current incentives are
Results of the programs to date
Organizational changes needed for the shift in programs
In this edition....Summaries of innovation projects
Resident transfers from aged care facilities to emergency departments: Can they be avoided?
NSW Trauma App
Queensland’s Digital Hospital
Investigating the relationship between emotional intelligence and transformation leadership in Nurse Managers
Embedding Consumer Engagement in Organisational Governance — Moving Consumers on Committees from Tokenistic to Having an Impact
UK Report Alcohol’s Impact on Emergency Services
The Sustainable Health Care Facility of the FutureTextbooks H.docxchristalgrieg
The Sustainable Health Care Facility of the Future
Textbooks:
Hayward, C. (2006). Healthcare Facility Planning: Thinking Strategically. Chicago, IL: Health Administration Press.
Vickery, C.G., Nyberg, G., & Whiteaker, D. (2015). Modern Clinic Design: Strategies for an Era of Change. Hoboken, NJ: Wiley.
Instructions: Please ensure to substantiate your response with scholarly sources and/or also a personal account of your own experience in the work place or personal life. Cite and reference work! Must be 150 -200 word count.
What reactions do you have to the ideas they presented? Include examples from the course readings or your own experience to support your perspective, and raise questions to continue the dialogue. 100 to 150 words for questions 1, 2, 6, 9, 10 & 11.
1. I agree that the changes made with CMS (center for Medicare and Medicaid Services) how changed the guidelines for how providers can bill for services. One of the biggest changes was the upgrade of ICD codes which has expanded enormously to be more specific with diagnosis and services to bill for. I work for a program of hospice, called palliative care, and the change over from using ICD9 codes to ICD10 was a very large task that took time to switch over to but I have come to realize that changes in health care are inevitable and to be prepared for things to change constantly. With being a palliative care program I don't think the change was as big of an impact on us like I'm sure it was for a hospital. Our program provides education on disease progress for chronic illnesses such a chronic kidney disease, hypertension, diabetes, cancer, heart disease and so on. The amount of ICD 10 codes we use are minimal compared to what a hospital would see. Nonetheless the codes are way more specific now which can be challenging when trying to narrow down for accuracy.
2. I think training and feedback are two important aspects of implementing electronic medical records. The users are the most important stakeholders and they should be trained properly. Their feedback should be taken seriously as this helps with post implementation changes to the system. No one likes changes but change in any organization is essential. Technology has completely transformed the health care industry and from my experience resistance typically comes from the older generation who doesn't really understand the importance. Most are used to doing things manually. Most organizations are turning to the technology to transform their environment by cutting costs and ensuring that their revenues are coming in timely.
3. Open your web browser and search for videos, articles and other resources discussing the health care system in the United States. Look for new trends, current issues affecting the health care system, etc.
4. Discuss your findings with the class
5. As a healthcare leader, you will need to have a strong base with understanding healthcare systems. Where will health care be delivered in the future? ...
Still struggling to find the monetary value of a strong patient communications program? This white paper maps the advantages and provides evidence about the ROI of using sustained electronic communications to improve patient satisfaction and outcomes.
In a new report, SVB Analytics examines the challenges facing stakeholders in the U.S. healthcare system, the solutions made possible by technology advancements and opportunities for entrepreneurs and investors.
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Emergency Department Quality Improvement Transforming the Delivery of CareHealth Catalyst
Overcrowding in the emergency department has been associated with increased inpatient mortality, increased length of stay, and increased costs for admitted patients. ED wait times and patients who leave without seeing a qualified medical provider are indicators of overcrowding. A data-driven system approach is needed to address these problems and redesign the delivery of emergency care.
This article explores common problems in emergency care and insights into embarking on a successful quality improvement journey to transform care delivery in the ED, including an exploration of the following topics:
A four-step approach to redesigning the delivery of emergency care.
Understanding ED performance.
Revising High-Impact Workflows.
Revising Staffing Patterns.
Setting Leadership Expectations.
Improving the Patient Experience.
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La mayoría de las universidades tienen un conjunto de atributos de posgrado y cada vez más incluyen habilidades digitales y alfabetización. Teniendo en cuenta tanto las habilidades digitales basadas en la disciplina para cumplir con las expectativas cambiantes de la industria, como la alfabetización digital independiente de la disciplina que contribuye a la identidad digital de los graduados, se alienta a las universidades a articular su estrategia de aprendizaje digital. La clave de una estrategia de aprendizaje digital es mantenerla ágil confiando en procesos y estructuras en curso para respaldar el entorno cambiante en el espacio de aprendizaje digital. Esta presentación revisa los elementos básicos de dicha estrategia.
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In the most recent UNAIDS Press Statement, UNAIDS Executive Director, Michel Sidiblé, explains recent goals for stopping new HIV infections and how we can end AIDS by 2030. With combined efforts and the Sustainable Development Goals, our generation has the potential to end a global epidemic that has claimed millions of lives for over 30 years.
This week, we went around the office and asked the Vedics for some great holiday gift ideas for technology lovers. We got a variety of responses, from the truly technical to the highly dorkish. Find more content like this at: ivedix.com/blog
In his recent Forbes article, "The Internet Of Things Is About Data, Not Things", John Fruehe stated: "All of the strategy and shiny objects in the world won’t help if the data isn’t accurate, secure, and actionable." That's why, at iVEDiX, we believe in taking a well rounded approach to our thought leadership and the technologies we produce. Here's a look at some twitterers who have joined us in this belief and been great ambassadors of IoT, data, and analytics.
Through our mobile product, miVEDiX, iVEDiX Inc. has been able to create solutions for challenges like: Physician Rounding, Staff Optimization, and Population Analytics. Check out this presentation to learn what specifications are required for these different use-cases, and how they ultimately impact patient care.
This week, we went around the office and asked the Vedics for some great holiday gift ideas for technology lovers. We got a variety of responses, from the truly technical to the highly dorkish. Check some of them out at ivedix.com/blog
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As active as we are in contributing content and sharing articles on Twitter, there are a select few twitter handles we recognize by name. These people are industry pros who have caught our attention and earned our recognition. Above, you'll see a brief snapshot of their respective pages. See what we like so much about them at ivedix.com/blog
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PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
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This document is designed as an introductory to medical students,nursing students,midwives or other healthcare trainees to improve their understanding about how health system in Sri Lanka cares children health.
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Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
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Finalists of the 2023 Business Case for Healthcare Quality
1. 2.7%
5.7%
11%
7.8%
4.8%
4.6%
0.0%
0.0%
1.9% 2.5%
0.0%
J F M A M J J A S O N D
MONTHLY PATIENT FALL RATE (2020)
PER 1,000 INPATIENT DAYS
30%
45%
50% 48%
53%
70%
78%
72% 75%
68%
78% 75% 78%
84%
73%
81%
90%
80% 80% 78% 80% 80% 82%
86% 84%
90% 91%
100%
95%
84% 84%
91%
98%
45%
75%
86%
January
February
March
April
May
June
July
August
September
October
November
December
January
February
March
April
May
June
July
August
September
October
November
December
January
February
March
April
May
June
July
August
September
October
November
December
Avenue Hospital's baseline review showed the rate of patient falls in
their facilities had increased sharply from January to March 2020.
There was an increase in the average number of falls per 1,000
inpatient days. The average number of falls rose from 2.7% to 11%.
THE BUSINESS CASE:
FALL PREVENTION
FALL RISK ASSESSMENT COMPLIANCE (%)
INTERNATIONAL PATIENT SAFETY SCORE #6 (%)
REDUCE RISK OF PATIENT HARM RESULTING FROM FALLS
AV E N U E H O S P I TA L PA R K L A N D S , K E N YA
From January to March 2020, Avenue Parklands Hospital observed an uptick in
patient falls. The hospital quickly mobilized a multidisciplinary team to conduct a
thorough root-case analysis. After identifying several problem areas, they designed
and implemented a three-year program of quality improvements. The data below
illustrates the financial benefit of these changes.
2020 2021 2022
To prevent further incidents, Avenue invested in equipment,
services, and repairs. They examined HR, recruitment, training,
and orientation. Over two years, the improvements cost
Avenue less than the cost of falls in 2020 alone.
Between 2020 and 2022, the cost of injury-related care decreased
97%. After interventions, incidents fell, resulting in a total annual cost
of $7K in injury management and $0 in legal fees. These savings
covered Avenue’s investment cost and resulted in long-term returns.
98%
COMPLIANCE
BY 2022 97%
REDUCED
ANNUAL PATIENT FALL COST
AFTER INTERVENTION, IN US DOLLARS
$243K
TOTAL COST
(2020)
$7K
TOTAL COST
(2022)
BEDS: 130
STAFF: 1,700 SIZE: 7,229 m2
COST OF FALLS IN 2020 INTERVENTION COST 2020-2022
INCIDENT VS. INTERVENTION COST
IN US DOLLARS
$188K
LEGAL FEES
$55K
INJURY MANAGEMENT
$141K
STRUCTURAL ADJUSTMENTS
$94K
RECRUITMENT
ORIENTATION AND TRAINING
$65K
SERVICES AND REPAIRS
March 2024 Disclaimer: The figures and information depicted in this document were self-reported by the hospital named above and submitted during the “IFC Business Case for Healthcare Quality 2023” contest.
2. What problem did the hospital face?
In early 2020, our hospital recorded a significant
increase in falls. During a three-month period, the
fall rate increased from 2.7% to 11% per 1,000
patient days. Three of these cases were sentinel
events, resulting in serious injuries. Apart from the
human tragedy, they cost the organization
$190,000 in compensation payments.
Why were patients falling?
After a root cause analysis, we identified several
factors related to falls, specifically with
infrastructure. Our floors were slippery, especially
the bathrooms. There were no guardrails in the
hallways, no alarms at the bedside or in the
bathrooms. Our policies and procedures needed
attention. Another problem included staffing. We
had to work on nursing hours per patient day. The
number of nurses was inadequate given the kind
of attention patients needed.
What was done to alleviate the situation?
There were many mitigation measures, but a few
important ones included improving the hospital’s
infrastructure. Also, we made it easy for staff to
identify high-risk patients with a yellow wristband
so that when they appeared at any point of care
delivery, staff would see it and pay more attention
to fall prevention measures. We also instituted
new policies and procedures and educated
families on risks.
What role did staff ratio play in falls?
We compared the number of falls when we had
very low nursing hours per patient days from 4.5
hours previously to 9.5 hours today. We tallied
statistics every day and reviewed them monthly to
make decision data. Figures do not lie. Things
improved and we reduced the falls to almost zero.
Should we aim for zero falls or is it normal
for patients to fall anyway?
Falls still happen even when measures have
been put in place. For us, if there was a fall
despite our best efforts, it was much less
severe. After every incident, it is very
important to identify where things went
wrong. In our case, most of the recent falls
happened when we relaxed a little bit. For
example, when we hired part-time workers to
substitute staff taking vacation.
What challenges did you face?
Introducing and implementing change was
not easy, especially as the program spanned
three years. I was a new staff member
determined to change the culture and
behavior of staff who worked there for many
years. They were used to doing things in a
particular way. I knew that I needed to be
strategic.
What advice can you give to quality teams
to obtain financial support from top
leadership?
In my experience, the only way to effectively
communicate with leadership is through data.
It must be demonstrated and linked. It must
also be continuously tracked and monitored
to show the costs that will rise if there is
nonconformity.
Who were the important key stakeholders
needed to achieve success?
When it comes to healthcare quality, the
nursing team is the driving force. They are
crucial to pushing policy agendas because
they are the majority in any healthcare
facility, and they are the ones who spend
most of their time with patients.
“Figures do not lie.
Things improved and
we reduced the falls
to almost zero.”
___________________
Do patients appreciate these efforts and
that the hospital is safer?
Yes. In fact, we see clear evidence of this
on social media. From a quality
perspective, our Net Promoter Score
(NPS) is public. We embrace transparency.
We have a live screen where patients can
air their concerns, and we address them
positively as they happen. This is further
demonstrated by the fact that we discuss
incidents with patients.
What is next for Avenue Parklands?
We have many ongoing projects. We are
consistently collecting data to identify
areas that need improvement. One of our
current focus areas is the turnaround time
for admission and discharge. Patients have
highlighted this as a significant pain point.
We are also passionate about reducing
maternal mortality rates and have made
significant progress in this area.
Any last words of wisdom?
Maintaining quality in a hospital is not a
one-time task. It requires continuous effort
and improvement. Quality is never
delegated. It is everyone’s responsibility.
HER LIFELONG MISSION:
TO IMPACT HEALTHCARE QUALITY
Penina Kirea of Avenue Parklands describes how her mother’s passing in childbirth fueled her
commitment to improve healthcare quality for all.
Penina Kirea
Group Chief Nursing
Officer and Head of Quality
Avenue Healthcare
The IFC Business Case for
Healthcare Quality contest is
sponsored by IFC’s IQ-Healthcare
program in partnership with the
governments of Japan, Norway,
and the Netherlands.
Contact Us
www.ifc.org/iqhealth
ifc_healthcare@ifc.org
Scan code below to join our
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How implementing a fall prevention
program directly impacted Avenue
Hospital’s operations.
3. MONTH 1 MONTH 2 MONTH 3 MONTH 4
Patients began canceling their annual diabetes care memberships,
which adversely impacted patient access in addition to business
results. Implementing software that used clinical guidelines for
medication, significantly decreased cancellations.
C L I N I C A S D E L A Z U C A R , M E X I C O
The software intervention was implemented when Azucar had just
15 clinics. Since then, it has continued to be an important quality
control tool as new service areas have opened. Today, the EHR is
used in Azucar’s 37 clinics across Mexico.
GROWTH IN NUMBER OF CLINICS
AFTER INTERVENTION
2x
SERVICE
AREAS
STAFF: 600 SIZE: 250 m2
CLINICS: 37
Clinicas del Azucar, Mexico's largest diabetes and hypertension clinic network, identified
numerous medication errors causing patient dissatisfaction, appointment cancellations,
and treatment discontinuation. To address this, the hospital implemented medication
guidelines and electronic health record (EHR) improvements, empowering doctors to
improve patient care. The following data highlights the financial benefits of these changes.
BEFORE INTERVENTION AFTER INTERVENTION
THE BUSINESS CASE:
TREATMENT GUIDELINES
COST OF PATIENT CANCELLATIONS
IN # OF CANCELLATIONS
ENHANCED COMPLIANCE
% PRESCRIBED MEDICATIONS OUTSIDE GUIDELINES
In the initial week of measurement, 13% of medication was outside
the guidelines. After four months, this percentage was significantly
reduced to 2%. This reduction in medication errors contributed to a
noteworthy decrease in patient cancellations and complaints.
13%
MONTH 1
2%
MONTH 4
TREATMENT
GUIDELINES
INTRODUCED
EHR SYSTEM
DEPLOYED
BETTER PATIENT
SAFETY
COST OF CARE
DECREASES
ENHANCED DOCTOR
ENGAGEMENT
HIGHER PATIENT
SATISFACTION
BETTER PATIENT
RETENTION
MORE DEMAND
FOR SERVICES
BUSINESS
EXPANSION
FEWER ERRORS
COMPLIANCE
INCREASES
REDUCED
ERRORS
PAID BACK IN
1 MONTH
$360K
SAVINGS PER
YEAR
$20K
INVESTMENT
100
CANCELATIONS
AVOIDED PER
MONTH
March 2024 Disclaimer: The figures and information depicted in this document were self-reported by the hospital named above and submitted during the “IFC Business Case for Healthcare Quality 2023” contest.
4. What problems did the clinics face?
We were losing patients; they were canceling
their diabetes care memberships.
Why were they canceling?
Patients were having side effects. Others
couldn’t afford the care. The diabetes
medication was also not tailored to their needs.
We found that doctors would recommend the
same prescription for everyone, especially for
low-income patients.
We discovered a hiccup in the way diabetes
patients are treated everywhere. Although
doctors follow treatment guidelines, they
prescribe based on averages. But people vary
greatly. If you look at the ADA and global
guidelines, they are generic and almost the
same for every patient, whether married,
single, divorced, male, female, 40, or 60 years
old.
What was done to alleviate the situation?
We built an electronic system that used
algorithms to open or close medications. Using
a software platform provided protection and
standardization. Following a standard is always
safer because it excludes the human factor. We
had concerns about the type of medication and
the costs and whether doctors were being
pressured by the industry to push a specific
medication. Of course, the doctor had the
flexibility to override recommendations and
prescribe whatever they needed to.
Did doctors still have the final say?
We needed to continue to give the doctor the
flexibility to choose what to prescribe. However,
the system would say to this patient, “Only
consider this list.” So, when the doctor
prescribes something outside that list, the
system automatically first says, "You are
prescribing something outside the
recommendation," and then asks why. The
doctor needed to justify a different medication.
As you implemented the new medication
guideline software, what happened?
It was very interesting. We could see what was
happening in all the clinics at the same time.
There was a lot of variation in treatment
recommendations because doctors were often
overriding the software’s suggested
prescriptions. Some doctors said the patient
requested a medication they thought was
better, but a few weeks later the patient would
come back. Having not taken the medication,
they were afraid to tell the doctor this happened
because they couldn't afford it. The doctors
complied with most of the guidelines but
reducing this trend took a different approach.
Doctors with high compliance scores were
named mentors for other doctors. We
implemented this a few years ago, and it has
allowed us to quickly scale the number of
clinics.
What other supports did you put in place?
We have a patient support center, which is a
call center that reaches out to the patients on
certain days to ask how they are feeling,
whether the amount and cost of the medication
are okay, and whether they understand the
medication change correctly.
As a leader, do you have any tips for those
implementing similar technology?
Build a culture of technology process
improvement from the beginning. That is the
only way to enable delivery at low cost to
“Build a culture of
technology process
improvement from the
beginning.”
__________________
millions. Because we started from scratch,
we were able to set the tone from early on.
It is very important for the CEO to
consistently convey the message. It is
critical to define the strategy and the type
of company you are creating, and have
executive leadership agree on that.
Switching gears, on a personal note,
what compelled you to disrupt the
system?
I had spent years applying process
improvements to chronic care around the
world. The issue became very personal
when it came to researching diabetes, a
disease my mother battled for ten years.
She was exhausted from going from doctor
to doctor, multiple doctors who gave
conflicting advice. She didn’t want
treatment anymore, even if she died. I was
shocked. That was my aha moment.
I realized diabetes care was broken
everywhere. I launched Clinicas del Azúcar
to create highly efficient diabetes clinics so
patients could receive seamless treatment.
I applied all my years of experience with a
mission: to transform care by creating
standardized one-stop shops around the
country.
DISRUPTING DIABETES CARE:
AN ENTREPRENEUR’S ULTIMATE GOAL
In an interview with IFC, Javier Lozano, CEO of Clinicas del Azúcar, describes how gaps in his
mother’s diabetes treatment propelled him to disrupt the entire industry.
Javier Lozano
CEO
CLINICAS DEL AZÚCAR
How implementing new
medication protocols dramatically
improved patient retention and
created a reliable system for
quality and patient safety.
The IFC Business Case for
Healthcare Quality contest is
sponsored by IFC’s IQ-Healthcare
program in partnership with the
governments of Japan, Norway,
and the Netherlands.
Contact Us
www.ifc.org/iqhealth
ifc_healthcare@ifc.org
Scan code below to join our
community of practice, or visit
http://bit.ly/3ZYt1PO
5. 72%
OVERALL
-5%
OVERALL
Facilities Growth Patient Growth
Before Intervention After Intervention
2017 2018 2019 2020 2021 2022
The Ministry of Health estimates only 40% of care delivered in
Kenya meets national recommendations. Penda Health was at
a similar level before addressing quality improvements. Now,
they are one of the highest-performing facilities in the country.
P E N DA H E A LT H , K E N YA
The plan, implemented over four years, quadrupled Penda’s
physical footprint. More importantly, its patient volume increased
tenfold while it continued to improve customer satisfaction and
affordability for low-income patients.
GROWTH IN NUMBER OF CLINICS
BEFORE AND AFTER INTERVENTION
10X
PATIENT
GROWTH
Penda Health leads in offering high-quality
primary care. They primarily serve lower-
income markets in Kenya. Standardizing IT and
clinical support mechanisms allowed for the
quicker rollout of new clinics. It also positively
impacted workflow, as staff quickly aligned to
the new systems.
THE BUSINESS CASE:
STANDARDIZING
PRIMARY CARE
BEST IN CLASS PERFORMANCE
COMPARED TO MINISTRY OF HEALTH AVERAGES
IMPROVED EFFICIENCY
AFTER LAUNCHING EHR
Clinical decision support allowed Penda to quickly and easily scale its
quality systems across new clinics – allowing new medical staff to be
quickly trained and onboarded. Clinicians used the EHR in 90% of
visits and adhered to its recommendations more than 75% of the time.
STAFF: 350 FACILITIES: 19
BEDS: 130
EHR FULLY IMPLEMENTED
($250,000)
CDSS LAUNCH & TRAINING ($30,000)
IMPROVEMENTS & ADDITION OF 300+ CONDITIONS
90% UTILIZE CLINICAL
DECISION SUPPORT
75%
ADHERE TO
RECOMMENDATIONS
CDSS FRAMEWORK DEVELOPED
EFFICIENCY
GROWTH
EHR UTILIZATION
90%
COMPLIANCE
40%
COMPLIANCE
NATIONAL GUIDELINE
COMPLIANCE
NET PROMOTER
SCORE
4X
CLINICS
March 2024 Disclaimer: The figures and information depicted in this document were self-reported by the hospital named above and submitted during the “IFC Business Case for Healthcare Quality 2023” contest.
IMPROVED
REFERRAL
SYSTEM
6. What problem did the company face?
Standardization was lacking which
complicated operations in several areas. For
instance, healthcare providers were
recommending treatments outside of the
national treatment guidelines. This led to
inconsistencies in care and complicated our
pharmaceutical supply chain. At the time, our
pharmacy had 1,400 SKUs.
Using an EHR with clinical decision support
allowed us to standardize clinic operations
and patient flow, so we could frontload
processes in very busy clinics. Ultimately,
reducing costs, which allowed us to expand
services to even more patients.
How does the setting impact the amount
of standardization required?
In the US, doctors typically treat about 20
conditions over and over, because we have
a high degree of specialization. In that
setting, clinical decision support for those
experts is not needed. At Penda, in a week
they are vaccinating children, treating
motorcycle accidents, seeing chronic
illnesses, delivering babies, and taking care
of pregnant moms. The spectrum is truly
massive and the multitasking that each
clinician does requires this support.
Standardization actually makes everyone
much safer.
What were a few important things that
you got right?
Changing culture is incredibly important,
especially when implementing clinical
decision support. A lot of people think
technology is the most important thing, but
it's not.
Operationally, we said, let’s not go straight to
standardizing treatment protocols for 300
conditions, let's start with 20. We did that for
about six months.
We also launched a big change management
effort and made infographics and shared them
on WhatsApp. We put posters up, conducted
Zoom town halls, and explained why we were
standardizing. We bought cakes and celebrated.
It is critical to have champions. Who helped
you through this process?
The group that led the roll out consisted of a
clinical quality team. They would visit different
facilities and involve staff and managers. If I
could do it over again, I would involve frontline
staff even more initially.
How did you help the finance department to
see the value of approving these expenses?
Penda is investor-backed, so we have unlocked
support for scalable growth. Investments in
technology make sense. The good thing is,
electronic health records are becoming
affordable and there are free options.
Did success depend on technology
solutions, such as EHRs?
Yes. My advice is to invest fully in EHR first,
then build in digital support. This is the hardest
part but if you want scalable quality, you must
have it.
Once you installed the new clinical system,
did you notice any reduction in the number
of incidents or other improvements?
Yes. We now have a really robust system that
compiles a patient safety report every other day
or so. We're very much on top of the safety
“EHRs are becoming
vastly more affordable
and there are lots of
free options”
____________________
issues. The wrong treatment of a diagnosis
has gone way down. The beauty of clinical
decision support is that it is a cloud-based
record. No matter which facility of Penda
you're at, it's the same record, notes and
clinical decision support tools. This has
improved consistency. The system allows for
communication through the medical record
that all doctors can access.
Has the outside world noticed?
Yes. There has been a lot of interest in what
Penda has done with clinical decision
support from other Chief Medical Officers.
They are our competitors, but they're also our
friends and colleagues within the ecosystem
and we've been talking very openly about
what we've done. Everyone is interested in
doing it. So basically, with this initiative, we
were the first, so we actually impacted the
market as well. The rest of the market will
follow after us.
The barrier is that so few healthcare
organizations that provide outpatient services
in Kenya have electronic records. If you're
not actually paperless then you can't
implement clinical decision support even if
you want to. Making a commitment to
become fully digital is key.
A DOCTOR’S DREAM:
TO STANDARDIZE OPERATIONS
Robert spoke with the IFC from his office in Nairobi about his journey standardizing operations
and how using electronic health records (EHRs) has unlocked growth at scale.
Dr. Robert Korom
Chief Medical Officer at
Penda Health
How technology solutions
standardized clinical decisions, led
to better quality outcomes, and
reduced costs. The greatest
outcome of this? The ability to
reach more patients.
The IFC Business Case for
Healthcare Quality contest is
sponsored by IFC’s IQ-Healthcare
program in partnership with the
governments of Japan, Norway,
and the Netherlands.
Contact Us
www.ifc.org/iqhealth
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7. January
February
March
April
May
June
July
August
September
October
November
December
January
February
March
April
May
June
July
August
19.2%
7.5%
10.2%
13%
8.9% 8.9%
7.9%
3.1% 3.4%
13.1%
4.9%
3.3%
1.4% 4.4%
6.4%
4.1% 0.7% 1.2%
0.4% 0.7%
IMPLEMENTED FAST-TRACK CLINIC
The number of emergency department cancellations in January 2022
resulted in a financial loss of about $5,000 per month. After
implementing fast-track clinic operations, the losses prevented
amounted to over $60,000 annually.
In June 2022, the fast-track clinic served 634 patients.
This number grew to 1,577 patients by October 2022. As
of August 2023, 16% of emergency department patients
were being served in fast-track clinics.
DA R A L S H I FA H O S P I TA L , K U W A I T
Dar Al Shifa Hospital (DASH) was established in 1963; it was the
first private hospital built in Kuwait. The hospital provides inpatient
facilities and emergency medical services across the region. In
2022, staff observed that patients left the emergency room without
receiving care. What followed was an intensive quality improvement
project focused on enhancing Emergency Department (ED)
practices and patient flow.
THE BUSINESS CASE:
FAST-TRACKING
EMERGENCY TRIAGE
INCREASED PATIENTS SERVED
THROUGH FAST-TRACK CLINIC
BETTER EMERGENCY ROOM ACCESS
BY INDEXING EMERGENCY SEVERITY
DASH emergency department observed that 16% of patients triaged
were Emergency Severity Index Levels 4 and 5, meaning the cases were
less urgent and non-urgent. Fast-tracking these less-urgent and non-
urgent cases led to shorter wait times and increased patient satisfaction.
STAFF: 2,700+ BEDS: 249
PATIENT CANCELLATIONS DUE TO “CANNOT WAIT” FROM TOTAL CANCELLATIONS IN ADULT EMERGENCY DEPARTMENT
COMPARED TO 5% DASH TARGET
FINANCIAL RESULTS
IMPACT OF INTERVENTION, IN US DOLLARS
2022 2023
16% CAN WAIT
Redirected to fast-track clinic
Level 5: Non-Urgent Condition
Level 4: Less Urgent Condition
84% CAN NOT WAIT
Level 3: Urgent Condition
Level 2: Emergent Condition
Level 1: Life-Threatening Condition
-$5K
MONTHLY LOSS OF
REVENUE
$60K
LOSS OF REVENUE
PREVENTED PER YEAR
AFTER INTERVENTION
BEFORE INTERVENTION
634
JUNE 2022
1,577
OCTOBER 2022
85%
SATISFACTION
ACHIEVED
2X
SERVICE CAPACITY
5 MONTHS
March 2024 Disclaimer: The figures and information depicted in this document were self-reported by the hospital named above and submitted during the “IFC Business Case for Healthcare Quality 2023” contest.
SIZE: 34,972 m2
IMPROVED
REFERRAL
SYSTEM
8. What problem did the hospital face?
In January 2022, we noticed a 19% increase
in canceled invoices in the Emergency
Department (ED). This resulted in an
estimated financial loss of 5,000 USD per
month. Because we are a private facility,
anybody can walk in at any time. Patients
come to the ED, check in, and receive an
invoice followed by an appointment to be
seen by a doctor. At some point in that
process, patients began to leave the hospital.
We discovered that our 20-minute wait to see
a doctor was too long for most patients.
How did the hospital alleviate the
situation?
We brought together the ED doctors, nurses,
customer service, and IT staff from the
Health Information department to hear from
patients. Many of the ideas generated were
simple but highly effective. For example, our
patient’s top concern was having their
feedback heard. So, we monitor it via an
online platform called Press Ganey. When
there were comments that required follow-up,
our ED head called the patients directly to
ask about their experiences and how we
could improve. This had the greatest impact
on return visits.
We noticed that 20% of our patients were
level 4 or 5 on the Emergency Severity Index
(ESI), which meant they were less severe
and did not need hospital resources. The
question was how non-serious patients could
bypass occupying an emergency bed, which
added to wait time. Some of those patients
needed sick leave notes. Others needed to
be seen by a doctor because insurance
demanded it, even
if it was just a medication refill, lab, or routine
checkup. Patients would even walk in for a copy of
their medical report. So, we realized if we targeted
this group differently, it could improve patient
satisfaction and revenue. We decided to implement
a fast-track clinic and educated patients and staff
on the importance of using these services to
reduce wait times.
Can you talk more specifically about the steps
taken to improve the situation?
We assigned four additional nurses in the female
section and three in the male section of the hospital
during evening shifts. We installed screens in the
waiting area to show each patient’s turn based on
the queue number and triage level. We began
using a color-coded process on ID bands that
displayed the expected wait time. We changed the
priority of lab tests to urgent if needed. We
implemented a bedside payment process across
the ED. Our ED charge nurse closely monitored
patient discharge records via electronic medical
records. Ultimately, we reduced the number of
patients leaving without treatment within a month or
two.
Why does data make a difference?
Data always provides insight into larger situations.
For us, it was critical to identify patterns. In the
case of the ED, we correlated the data to see
which interventions would have the greatest impact
on positive patient feedback, patient volume, and
ED revenue.
What challenges did the hospital face?
We had a huge manpower shortage at this time,
which made it difficult to effectively distribute staff
across the hospital. One of the biggest obstacles
was finding doctors who could be dedicated to
staffing the fast-track clinic. These physicians do
“We correlated the
data to see which
interventions would
have the greatest
impact on positive
patient feedback”
__________________
not see very critical cases, so for multiple
reasons, there was less interest in staffing
this function. So, we started with
dedicated fast-track nurses. They were
trained on patient intake, collecting and
recording basic information, and were
responsible for calling the doctor so that
no time was wasted.
Are there plans for the future?
Yes. We have recently expanded our
overall hospital with the addition of three
new wings. This allows us to offer
additional inpatient services. One of the
closest areas to the emergency
department was the laboratory. Due to the
success of our fast-track clinic, the lab will
be shifted out to create a full-fledged
expansion of the Emergency Department.
This expansion will actually double the
emergency department capacity. We plan
to have dedicated fast-track areas, areas
for the Adult Emergency Department,
Pediatrics, and Obstetrics.
RESHAPING EMERGENCY CARE
AMONG KUWAIT’S LARGEST HOSPITALS
In an interview with IFC, Dar Al Shifa Hospital describes sweeping changes implemented after it
observed almost 20 percent of patients leaving the Emergency Department without being treated.
Jessy Jacob
Quality Director
Dar Al Shifa Hospital
How Dar Al Shifa Hospital used
data as its first line of defense in
improving satisfaction, reputation,
patient volume, and revenue.
The IFC Business Case for
Healthcare Quality contest is
sponsored by IFC’s IQ-Healthcare
program in partnership with the
governments of Japan, Norway,
and the Netherlands.
Contact Us
www.ifc.org/iqhealth
ifc_healthcare@ifc.org
Scan code below to join our
community of practice, or visit
http://bit.ly/3ZYt1PO