#MEQAPI – Tweetchat Aug 23-2018 3:00ET Central Line Embolism

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

Central lines are a valuable tool in medical care where rapid access to the bloodstream is required. Central lines allow clinicians to administer infusions with less risk, monitor blood flow, etc. However, central lines run the risk of introducing infection, or, perhaps worse, allow air to enter the bloodstream, potentially resulting in death. Air emboli can be due to removal of central lines with the patient seated upright instead of lying down.

Some quality improvement efforts have tried to reduce this risk. For example Dr. Rob Hackett has proposed something as simple as a warning label that might alert the clinician at the critical moment

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We will discuss the various dimensions of preventing fatal central line air emboli

Central Line

Topics

  1. Policy: What laws, policies, rules, regulations, etc. improve or worsen the quality and safety of Central Line placement, maintenance, or removal?
  2. Equipment: How do equipment and devices improve or worsen the quality and safety of Central Line placement, maintenance, or removal? Everything from transport, to gurneys, beds, scanners, infusion sets, etc.
  3. Measurement: How do quality, safety, and performance metrics improve or worsen the quality and safety of Central Line placement, maintenance, or removal? Are we measuring the right things?
  4. Environment: What environmental factors improve or worsen the quality and safety of Central Line placement, maintenance, or removal? Everything from the room where it is carried out, facility location, transport, etc.
  5. People: How do the people in healthcare – the staff, cleaners, technicians, clinicians, researchers, public, media, friends, family, etc improve or worsen the quality and safety of Central Line placement, maintenance, or removal?
  6. Materials: What affect does the “medical stuff” patients need improve or worsen the quality and safety of Central Line placement, maintenance, or removal? – the medications, contrast media, instruction sheets, information, medications, test results, etc

Background

MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

http://www.meqapi.org

The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.

 

 

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#MEQAPI – Tweetchat Aug 9-2018 3:00ET Radiology

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

Radiology is one of the essential healthcare services that are usually invisible, but critical when needed. Although miniaturized equipment is making radiology more mobile, most radiology is done at central locations where there is room, firm foundations, and adequate three-phase industrial power for the gargantuan machines it often uses. An MRI machine can generate a 7 Tesla magnetic field, and needs liquid helium to cool the superconducting magnets. An MRI can use 20KW of electricity when operating.

The intense magnetic fields can result in injury or death for the unwary, for example, a case in 2001 in which a child was killed by a flying oxygen cylinder, or a man in 2008 who was fatally injured when  the oxygen bottle he was carrying was pulled into an MRI machine.  Radiology also has risks of x-ray exposure, and sensitivity to contrast dyes, but patient injuries are very rare due to the high level of care in quality and safety.

However, for patients, the journey through radiology can be confusing, alarming, or exhausting, and can start with the travel and parking associated with getting to a facility that offers the required radiological services, to the claustrophobia of an MRI, to the hot flushes from an injectable contrast material, to the ignominy of a Barium enema.

Since many patients only venture into the radiology department on rare occasions, the unfamiliarity can be daunting.

We will chat about the clinician and patient perspectives of the radiology journey.

 

Radiology

Topics

  1. Policy: What laws, policies, rules, regulations, etc. improve or worsen the quality and safety of radiology?
  2. Equipment: How do equipment and devices improve or worsen the quality and safety of radiology? Everything from transport, to gurneys, beds, scanners, infusion sets, etc.
  3. Measurement: How do quality, safety, and performance metrics improve or worsen the quality and safety of radiology? Are we measuring the right things?
  4. Environment: What environmental factors improve or worsen the quality and safety of radiology?
  5. People: How do the people in healthcare – the staff, cleaners, technicians, clinicians, researchers, public, media, friends, family, etc improve or worsen the quality and safety of radiology?
  6. Materials: What affect does the “medical stuff” patients need improve or worsen the quality and safety of radiology? – the medications, contrast media, instruction sheets, information, medications, test results, etc

Background

MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

http://www.meqapi.org

The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.