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
We will discuss the various dimensions of preventing fatal central line air emboli
- Policy: What laws, policies, rules, regulations, etc. improve or worsen the quality and safety of Central Line placement, maintenance, or removal?
- 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.
- 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?
- 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.
- 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?
- 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
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.
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.