A quality improvement tool - driver diagram: a model of driver diagram to reduce primary caesarean section rates

Fathima, Naima

doi:10.18203/2320-6012.ijrms20160979

Cited by 3 publications

(8 citation statements)

References 5 publications

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“…This is a quality improvement tool to highlight priority areas for change, by mapping the relationships between a project aim and key areas in a system for intervention. 28,29 We conducted focussed literature searches to identify existing initiatives for promoting patient safety in each priority area. Where available, the strength of each intervention was graded using the US Department of Veterans Affairs classification, where the strongest designs are permanent and physical (e.g.…”

Section: Methodsmentioning

confidence: 99%

Quality improvement priorities for safer out-of-hours palliative care: Lessons from a mixed-methods analysis of a national incident-reporting database

et al. 2018

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Background: Patients receiving palliative care are often at increased risk of unsafe care with the out-of-hours setting presenting particular challenges. The identification of improved ways of delivering palliative care outside working hours is a priority area for policymakers. Aim: To explore the nature and causes of unsafe care delivered to patients receiving palliative care from primary-care services outside normal working hours. Design: A mixed-methods cross-sectional analysis of patient safety incident reports from the National Reporting and Learning System. We characterised reports, identified by keyword searches, using codes to describe what happened, underlying causes, harm outcome, and severity. Exploratory descriptive and thematic analyses identified factors underpinning unsafe care. Setting/participants: A total of 1072 patient safety incident reports involving patients receiving sub-optimal palliative care via the out-of-hours primary-care services. Results: Incidents included issues with: medications (n = 613); access to timely care (n = 123); information transfer (n = 102), and/or non-medication-related treatment such as pressure ulcer relief or catheter care (n = 102). Almost two-thirds of reports (n = 695) described harm with outcomes such as increased pain, emotional, and psychological distress featuring highly. Commonly identified contributory factors to these incidents were a failure to follow protocol (n = 282), lack of skills/confidence of staff (n = 156), and patients requiring medication delivered via a syringe driver (n = 80). Conclusion: Healthcare systems with primary-care-led models of delivery must examine their practices to determine the prevalence of such safety issues (communication between providers; knowledge of commonly used, and access to, medications and equipment) and utilise improvement methods to achieve improvements in care.

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Section: Methodsmentioning

confidence: 99%

Quality improvement priorities for safer out-of-hours palliative care: Lessons from a mixed-methods analysis of a national incident-reporting database

et al. 2018

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“…Examples include the FOCUS-PDCA model, 5 FADE and six sigma DMAIC, 6 and all these models have a shared theme of, 'goal definition, data acquisition and analysis followed by the implementation of process change and results review'. 7 A reported effective quality improvement framework for health care 8 is the framework, 'Model the aim and 'secondary for Improvement' (MFI), 7 which involves asking three questions:…”

Section: Quality Improvement Frameworkmentioning

confidence: 99%

“…CYCLES WITH DATA COLLECTION This framework 'Model for Improvement' allows for incremental tests of change to be implemented followed by 'results analysis' and learning with the use of 'Plan-Do-Study-Act' (PDSA) cycles. 8 PDSA methodology (see Figure 2) is the most commonly used tool in QI. 12 They have been criticised as 'quick and dirty' tests of change 13 when not used appropriately, and this highlights the importance of planning each step and so each cycle is effective.…”

Section: Improvementmentioning

confidence: 99%

Quality improvement projects in paediatric dentistry

2021

Int J Paed Dentistry

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“…A few healthcare-specific frameworks have also been developed and these aim to improve care. The examples include FOCUS-PDCA, MUSIQ, or FADE (Fathima, 2016). These however were not extensively researched, and their usefulness remains unclear (Fathima, 2016).…”

Section: Figure 31mentioning

confidence: 99%

“…The examples include FOCUS-PDCA, MUSIQ, or FADE (Fathima, 2016). These however were not extensively researched, and their usefulness remains unclear (Fathima, 2016).…”

Section: Figure 31mentioning

confidence: 99%

Improving hydration of care home residents by addressing institutional barriers to fluid consumption – an improvement project.

Bak

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Background: Older people are at risk of dehydration due to a wide range of age related physiological changes. Additional conditions such as dementia or physical frailty may contribute to low fluid intakes and further predispose the older people to dehydration. Care home residents are more likely to be admitted to hospital with dehydration, but there are few recent studies that evaluated the amount of fluids that residents consume or the barriers to hydration that they experience. Little is also known about the care they receive and how this may influence their fluid intakes. Objectives: To assess current hydration care in care homes, identify barriers to drinking adequate amounts and develop strategies to optimise fluid intakes in the older care home residents. Method: This study was conducted in one care home in London, which provides care to a multi-ethnic population of residents. The exploratory phase used observations, focus groups and questionnaires to determine how drinks were provided and to explore attitudes of staff and residents towards hydration care. The intervention phase used Model for Improvement framework to identify and test strategies to improve hydration for the residents. Results: Observations revealed that most residents consumed less than the recommended minimum of 1500ml of fluids. Hydration was not seen as a priority, and this resulted in several barriers that prevented staff to provide sufficient fluids, and the residents to consume them. Interventions were designed to overcome these issues and included: increasing the number of drink opportunities, improving preference compliance and introducing a new drinking equipment. During the testing, most interventions resulted in the residents consuming more fluids, but sustaining these interventions was difficult. Barriers to sustainability included poor leadership and task-oriented work culture. Conclusions: This study demonstrated that fluid intakes in care home residents are suboptimal. This is mostly due to insufficient number of opportunities for the residents to obtain drinks as well as not receiving adequate assistance and preferred drinks. Interventions which target these barriers have a potential to increase fluid intakes. Care homes need to implement appropriate strategies, but this requires organisational commitment with support from senior managers and strong leadership at operational level.

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A quality improvement tool - driver diagram: a model of driver diagram to reduce primary caesarean section rates

Cited by 3 publications

References 5 publications

Quality improvement priorities for safer out-of-hours palliative care: Lessons from a mixed-methods analysis of a national incident-reporting database

Quality improvement priorities for safer out-of-hours palliative care: Lessons from a mixed-methods analysis of a national incident-reporting database

Quality improvement projects in paediatric dentistry

Improving hydration of care home residents by addressing institutional barriers to fluid consumption – an improvement project.

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