�㽶��Ƶֱ��

Oct 4, 2023, 09:48 by Sarah Moore

A 24-year-old male presents to the emergency room with a chief complaint of “I can’t swallow.” He states that while eating dinner, chicken suddenly “got stuck, and I could not swallow.” He can swallow saliva; however, he cannot swallow liquids. He has associated mid-chest discomfort. He denies GI bleeding, heartburn, weight loss or any additional symptoms. Over the last two to three years, he has experienced intermittent solid food dysphagia, which has caused him to eat slowly and chew food repeatedly. There are no prior episodes of food impaction. He has a history of seasonal allergies for which he takes an over-the-counter antihistamine. He denies other medical problems.

Sep 29, 2023, 11:45 by Sarah Moore

No incorrectly labeled specimen containers, no specimens placed in wrong containers, no missing specimens, 100% real-time timeout charting compliance

Sep 29, 2023, 11:44 by Sarah Moore

The health system has a strategic goal of increasing the ratings on the NRC “What Matters Most” question in patient satisfaction surveys to 66.9% for all departments. Prior to this goal being established, no specific efforts were made to make sure the patient’s most pressing concern was addressed in the appointment.

Sep 29, 2023, 11:42 by Sarah Moore

On November 16, 2021, a quality improvement study was conducted to determine that all endoscopes are going from end of procedure to high-level disinfection (HLD) within the national guideline of one hour. Data was gathered from EMR platforms measuring the end of procedure time and the time reprocessing began as proven by the (automated endoscope reprocessor) data. A formula was followed to calculate this time, and each staff member had 14 cases analyzed for the data collection. It was proven that each staff member was well under the one-hour time frame from end of procedure to start of HLD. The average time between all staff members was 17 minutes. All staff was 100% compliant with this national standard. No improvement is needed, and we achieved our project goals to prove our excellence.

Sep 29, 2023, 11:40 by Sarah Moore

It is suspected that patients are perceiving excessive wait times in relation to their experience at [the facility] and delays in discharge which is increasing the time the patient is in the facility. The target for performance for patient wait time scores was 4.6 or higher (patient satisfaction surveys) and the patient’s average time in the facility of 150 minutes or less.

Sep 29, 2023, 11:14 by Sarah Moore

Over the past three years, [the unit] has used several different bowel preps in order to achieve the best possible colonoscopy for our patients. The cleansing quality is a critical factor in determining the quality, ease, speed, and completeness the colonoscopy. Our facility has used [Prep A], [Prep B], and [Prep C] over the past two years with varying results.

Sep 29, 2023, 11:11 by Sarah Moore

To determine if the use of Carbon Dioxide for GI insufflation will decrease the patient complaints of abdominal pain and cramping can be discharged to home after his or her procedure sooner.

Sep 29, 2023, 11:04 by Sarah Moore

The organization reviewed the adequacy of the use of Brand A wipes in the contact cleaning of stretchers and procedure room surfaces between cases. The gap in quality of care that was discovered was that Clostridium difficile is not decontaminated by the chemical components in Brand A. The project goal is to find and use a product for wiping down stretchers and room surfaces that will adequately kill all the microorganisms that Brand A wipes handles and in addition covers Clostridium difficile which is a microorganism that is found in endoscopy patients.

Sep 29, 2023, 11:01 by Sarah Moore

The gap in quality of care that we studied is the lack of a standard recommended time for repeating a colonoscopy in patients who present for colon cancer screening but have inadequate bowel prep. We aimed to determine the incidence of adenomas detected in that population on the next colonoscopy and we attempted to define the optimum interval that should be recommended for a repeat colonoscopy in patient with inadequate bowel prep on their first examination.

Sep 29, 2023, 10:46 by Sarah Moore

This study will identify all procedures performed at the unit during a sample time period to calculate the average total patient wait time from the arrival/check in process at the front desk to the the performance of the procedure “Time Out” verification done in the procedure room prior to the start of anesthesia. The goal is to achieve a reasonable average total patient wait time of 60 minutes or less. This study will also identify areas in the patient’s procedure process where improvement can be made if the 60-minute goal is not met.

Sep 29, 2023, 10:36 by Sarah Moore

In the United States, it is estimated that more than 52,000 people will die of colorectal cancer in 2022, and roughly 151,000 new cases will be diagnosed; this makes colorectal cancer the second leading cause of cancer-related death and the fourth most diagnosed cancer site.

Sep 29, 2023, 10:32 by Sarah Moore

There is not a clearly defined process for follow-up in patients with a positive FIT ordered by primary care. Among patients with an abnormal FIT result, between 1 in 10 and 1 in 30 have colorectal cancer (CRC), and failure to complete a colonoscopy is associated with a higher risk of colorectal cancer death.

Sep 29, 2023, 10:28 by Sarah Moore

The surgery center's management and Quality Assurance (QA) Committee noticed a significant disparity in requests for pre-procedure blood thinner clearances (BTCs) for patients receiving anticoagulation therapy and responses (if any) from prescribing physicians. This gap would lead to frequent cancellation of procedures, as patients would not be able to be off anticoagulants for an appropriate amount of time or, in some instances, patients would take the initiative and “self-discontinue” critical medications without the recommendation of their physician. The center relied upon its sister medical practice and scheduling service up to this point to send BTCs to a patient’s prescribing physician with a generous lead time (at least 10 days) to receive a response. Our goal was to test-drive improvements in BTC tracking and follow-up and patient and physician communication in both the surgery center and scheduling department to reduce the amount of associated procedure cancellations due to not having received a response and the potential risk of delayed care.

Sep 29, 2023, 10:25 by Sarah Moore

Our newest improvement project was to eliminate the use of hot biopsy forceps for diminutive polyps. Over the years, the number of providers using this method has decreased; however, there were still a few using it. We had discussions with these physicians and showed them "Endoscopic Removal of �㽶��Ƶֱ�� Lesions: Recommendations by the US Multi-Society Task Force on �㽶��Ƶֱ�� Cancer." We encouraged them to switch from hot biopsy forceps to cold snare. From the beginning of 2022 to now, there has been no use of hot biopsy forceps polypectomies.

Sep 29, 2023, 10:22 by Sarah Moore

A gap was identified in quality of care around a safe exit from the building. The focus of our study surrounded optimal patient safety and satisfaction in relation to the discharge exit. The goal was that by the end of September there would be no more than one negative patient comment regarding unsafe exits from the building.

Sep 29, 2023, 10:13 by Sarah Moore

The practice has seen an increased percentage of “no-shows” across all physicians over the past several months. “No-show” means any patient who fails to arrive for a scheduled procedure appointment. No-shows create gaps and inefficiency in quality care, schedules and finances.

Sep 29, 2023, 10:07 by Sarah Moore

Appropriate scheduling of endoscopy patients in an ASC is critical in providing safe quality care. Rescheduling due to patient complexity is costly to the patients, families and ASC. Patients performed colon preparations, found transportation and took time off work. With limited resources that an ASC can offer, it is essential that the most appropriate care is provided to the most appropriate population.

Sep 29, 2023, 10:03 by Sarah Moore

To increase ADR while integrating AI-assisted colonoscopy into patient care.

Sep 29, 2023, 10:00 by Sarah Moore

During physician peer review meetings in January 2021, physicians reported a significant increase in incomplete and aborted colonoscopies due to suboptimal bowel cleanses in the past three months. Colonoscopy remains the standard in colon cancer screening and prevention. Inadequate colon preparation could result in poor mucosal visibility, leading to low adenoma detection rates, which could result in an increase in adenocarcinomas. The purpose of this study was to increase the quality of bowel preparation.

Sep 29, 2023, 09:57 by Sarah Moore