Challenges in conducting quality improvement projects: reflections of a junior doctor

Madu, Alpha

doi:10.7861/fhj.2022-0076

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…Moreover, potential biases in observational data collection via the checklist could influence the interpretation of results. Factors such as resistance to change, staff project engagement, technology, or policies may also impact project outcomes [ 25 ]. Addressing these limitations is crucial for a comprehensive understanding of the project's outcomes and implications for future initiatives in hospital pharmacy operations.…”

Section: Discussionmentioning

confidence: 99%

Improving Efficiency in Hospital Pharmacy Services: An Integrated Strategy Using the OCTAGON-P Framework and Lean 5S Management Practices

Sallam,

Allam,

Kassem

2024

Cureus

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Background Hospital pharmacy departments have a critical role in the healthcare system, as they aim to provide excellent patient services while also ensuring cost-effectiveness. Lean methodologies are well-known for improving efficiency and quality in various industries, but their impact on healthcare, particularly in hospital pharmacy settings, has not been thoroughly investigated. Aim This quality improvement (QI) study aimed to assess the impact of implementing the sort, set in order, shine, standardize, and sustain (5S) methodology using the innovative orientation, coordination, training, awareness, governance, observation, normalization, and promotion (OCTAGON-P) framework on the operations of Mediclinic Parkview Hospital (MPAR) Pharmacy in Dubai, UAE. Methods The QI project spanned a period of six weeks, from December 18th , 2023 , to January 28th , 2024. Throughout this period, a new novel OCTAGON-P framework's eight crucial elements were methodically integrated. Simultaneously, an extensive preparation process encompassing the five stages of the 5S method was carried out. Results The findings indicated a notable enhancement in organization, orderliness, cleanliness, medication storage, and workspace standardization. The significant improvement of 217% in terms of organization highlighted the effectiveness of resource arrangement. The orderliness of the workspace saw an increase of 800%, indicating a transformation in the systematic organization. Additionally, cleanliness improved by 138%, demonstrating a significant advancement in maintaining a spotless environment. The standardization of processes experienced a boost of 300%, reflecting a solidified approach to consistent operational methods. These refinements resulted in an overall improvement of 90% from the initial baseline of 20% on the 5S checklist scores. Efficiency gains were observed, with outpatient medication retrieval times reduced by 50%, inpatient times by 40%, emergency prescription serving by 16.7%, and pediatric prescription serving by 11%. The inpatient medication return process saw a 67% improvement. Patient counseling time increased by 23.3%, indicating a more patient-centered approach. Prescription verification and medication expiry checks increased by 50% and 200%, respectively, enhancing the quality of care. Inventory management efficiency improved by 36%, and medication label printing time decreased by 70% with the additional label printers. Installing extra medication label printers was done through the OCTAGON-P framework, specifically in the "orientation" and "coordination" phases. These two initial phases focused on leadership's 5S orientation, management support, and securing additional resources. Therefore, the OCTAGON-P framework provided a structured approach that promoted continuous improvement and sustained lean practices. Conclusion This research stu...

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Section: Discussionmentioning

confidence: 99%

Improving Efficiency in Hospital Pharmacy Services: An Integrated Strategy Using the OCTAGON-P Framework and Lean 5S Management Practices

Sallam,

Allam,

Kassem

2024

Cureus

View full text Add to dashboard Cite

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“…Key challenges to implementing HQI projects of multidisciplinary nature are clinician availability, adequate center capacity and resourcing, coordination of team efforts across multiple areas of expertise and need for strong team leadership. [38][39][40][41][42][43] Limited resourcing and capacity resulted in premature cancellation of the project in one center (Kelowna) and failure to implement the main HQI initiative in another (Vancouver). Merge of MDTs from two centers (Surrey and Abbottsford) was an adaptation mechanism used that is associated with increased capacity and reductions in overall and individual participant burden.…”

Section: Discussionmentioning

confidence: 99%

BeTTer Outcomes Workgroup Health Quality Initiative to optimize bone health for prostate cancer patients in the British Columbia Cancer System

Noonan,

Ko,

Black

et al. 2023

CUAJ

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Introduction: Bone-targeted therapies (BTTs) are integral to the management of bone metastases in metastatic castration-resistant prostate cancer (mCRPC). BTTs vary considerably in referral and drug access pathways and optimal BTT use requires multi-specialty consultation and supervision. Health quality improvement (HQI) has become the predominant framework to improve patient care in multidisciplinary settings. Methods: HQI initiatives on use of BTT in mCRPC were developed and evaluated in five centers of a provincial cancer center network using Plan-Do-Study-Act (PDSA) methodology. Multidisciplinary teams (MDTs) completed a common quality assessment form and an HQI template and then implemented an HQI initiative. Feedback and findings were shared and discussed at regional events. It was subsequently determined whether to adopt, adapt, or abandon initiatives. Results: Patterns of unmet needs varied across type of BTT. Gaps in use of radium-223 were mostly referral and education issues that could be directly addressed at the local level by participating clinician teams. Conversely, most supportive BTT gaps were related to coverage and resourcing support. HQI initiatives selected by each site consisted of implementation or expansion of local MDT meetings, referral documents, databases, and improvement charters. The main HQI initiative was completed in four sites and was adapted or adopted in three. Improvements in BTT use were observed in two of three centers with data on HQI process measures. Conclusions: Despite the overall heterogenous structure of the groups and metrics used, this study demonstrated that the PDSA framework provides the needed structure for improvements in BTT use in mCRPC across multiple sites.

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A retrospective analysis of a clinician-initiated high-intensity locomotor training implementation project in an inpatient rehabilitation facility

Tapp,

Dray,

Griswold

et al. 2024

Physiotherapy Theory and Practice

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Challenges in conducting quality improvement projects: reflections of a junior doctor

Cited by 4 publications

References 4 publications

Improving Efficiency in Hospital Pharmacy Services: An Integrated Strategy Using the OCTAGON-P Framework and Lean 5S Management Practices

Improving Efficiency in Hospital Pharmacy Services: An Integrated Strategy Using the OCTAGON-P Framework and Lean 5S Management Practices

BeTTer Outcomes Workgroup Health Quality Initiative to optimize bone health for prostate cancer patients in the British Columbia Cancer System

A retrospective analysis of a clinician-initiated high-intensity locomotor training implementation project in an inpatient rehabilitation facility

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