Engaging the Front Line: Tapping into Hospital-Wide Quality and Safety Initiatives

Introduction:Most children undergoing anesthesia experience significant preoperative anxiety. We developed a bedside entertainment and relaxation theater (BERT) as an alternative to midazolam for appropriate patients undergoing anesthesia. The primary aim of this study was to determine if BERT was as effective as midazolam in producing cooperative patients at anesthesia induction. Secondary aims reviewed patient emotion and timeliness of BERT utilization.Methods:We conducted a retrospective cohort study of pediatric patients undergoing anesthesia at Lucile Packard Children’s Hospital Stanford between February 1, 2016, and October 1, 2016. Logistic regression compared induction cooperation between groups. Multinomial logistic regression compared patients’ emotion at induction. Ordinary least squares regression compared preoperative time.Results:Of the 686 eligible patients, 163 were in the BERT group and 150 in the midazolam. Ninety-three percentage of study patients (290/313) were cooperative at induction, and the BERT group were less likely to be cooperative (P = 0.04). The BERT group was more likely to be “playful” compared with “sedated” (P < 0.001). There was a reduction of 14.7 minutes in preoperative patient readiness associated with BERT (P = 0.001).Conclusions:Although most patients were cooperative for induction in both groups, the midazolam group was more cooperative. The BERT reduced the preinduction time and was associated with an increase in patients feeling “playful.”

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“…By incorporating the frontline staff into the development of the process, we were able to ensure buy-in. 24 …”

Section: Discussionmentioning

confidence: 99%

A Retrospective Review of a Bed-mounted Projection System for Managing Pediatric Preoperative Anxiety

Caruso

Tsui

Wang

et al. 2018

Pediatric Quality &Amp; Safety

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“…Individualized action plans developed by the SATs for each clinical microsystem were a more recent initiative and have been showed to be effective in another large health care system. 26 Education and engagement of house staff has been shown to be of value in other large-scale patient experience improvement initiatives 26,27 and proved to be of importance in our pediatric environment as well. Residents and other trainees are often the first point of clinical contact with the patient and could have significant influence over the patient's perception of the medical team.…”

Section: Primary Aimmentioning

confidence: 99%

Improving Patient Experience of Care Providers in a Multispecialty Ambulatory Pediatrics Practice

Fustino

Moore

Viers

et al. 2018

Clin Pediatr (Phila)

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Patient experience is positively associated with superior medical outcomes, clinical quality, patient safety measures, physician job satisfaction, doctor-patient communication, and patient compliance with treatment recommendations. A concrete pediatrics-focused methodology for improving patient experience in a multispecialty ambulatory setting has not been described, nor has the impact on practice outcomes been assessed. The primary aim of this study was to improve patient experience care provider scores at a single multiclinic children’s hospital in the Midwest to the 70th percentile in a 5-year period. The secondary aim sought to determine the impact of quality improvement efforts on practice growth, patient complaint rate, and provider/staff engagement. Patient experience was measured by returned Press-Ganey surveys. Interventions involved establishing infrastructure, promoting feedback and transparency, providing education, and transforming culture. Provider scores improved from the 19th to the 70th percentile within 5 years. Practice volume increased by 17.1%; patient complaint/grievance frequency decreased 33-fold; and provider/staff engagement did not appreciably change.

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Mentoring Fellows in Adult Cardiothoracic Anesthesiology for Academic Practice in the Contemporary Era—Perspectives From Mentors Around the United States

Neelankavil

Goeddel

Dwarakanath

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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Engaging the Front Line: Tapping into Hospital-Wide Quality and Safety Initiatives

Cited by 4 publications

References 26 publications

A Retrospective Review of a Bed-mounted Projection System for Managing Pediatric Preoperative Anxiety

A Retrospective Review of a Bed-mounted Projection System for Managing Pediatric Preoperative Anxiety

Improving Patient Experience of Care Providers in a Multispecialty Ambulatory Pediatrics Practice

Mentoring Fellows in Adult Cardiothoracic Anesthesiology for Academic Practice in the Contemporary Era—Perspectives From Mentors Around the United States

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