Reducing hospital acquired pressure injury in a learning health center: Making the case for quality

Polancich, Shea; Patrician, Patricia A.; Miltner, Rebecca S.; Meese, Katherine A.; Armstrong, Amy; Layton, Shannon; Noot, Ross Vander; Poe, Terri; Hall, Allyson G.

doi:10.1002/lrh2.10355

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…There was a 70% reduction in total, all-stage HAPIs from the initial month of this study to the most recent month. A 6-year effort to improve HAPIs began in 2016, including a 16-member wound, ostomy, and continence team (Polancich, Coiner, et al, 2017;Polancich et al, 2019Polancich et al, , 2022. Continuous improvement efforts have been sustained despite fluctuations in RN staffing, particularly with lower numbers of permanent RN staff.…”

Section: Frommentioning

confidence: 99%

Quality Matters: Examining the Impact of Nurse Staffing Challenges on Clinical Outcomes

Polancich¹,

Miltner²,

Montgomery³

et al. 2023

Journal of Healthcare Management

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Goal: The purpose of this study was to examine nurse staffing while describing the relationships that exist in staffing and quality associated with nursing care during the COVID-19 pandemic, a significantly challenging time for nurse staffing. We examined the relationship between permanent registered nurse (RN) and travel RN staffing during the pandemic and the nursing-sensitive outcomes of catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), falls, and hospital-acquired pressure injuries (HAPIs) and length of stay and compared the cost of CAUTIs, CLABSIs, falls, and HAPIs in fiscal years 2021 and 2022. Methods: We used a descriptive, observational design to retrospectively examine permanent nurse staffing volume and CAUTI, CLABSI, HAPI, and fall counts from October 1, 2019, to February 28, 2022, and travel nurse volume for the most current 12 months, April 1, 2021, to March 31, 2022. Descriptive statistics, Pearson correlation, and statistical process control analyses were completed. Principal Findings: Pearson correlation showed a statistically significant, moderately strong negative correlation (r = −0.568, p = .001) between the active registered nurse full-time equivalents (RN FTEs) and average length of stay (ALOS), and a moderately strong positive correlation (r = 0.688, p = .013) between the travel RN FTEs and ALOS. Pearson correlations were not statistically significant, with low to moderate negative correlations for CAUTIs (r = −0.052, p = .786), CLABSIs (r = −0.207, p = .273), and falls (r = −0.056, p = .769). Pearson correlation for active RN and HAPI showed a moderately strong, statistically significant positive correlation (r = 0.499, p = .003). We observed common cause variation in CAUTIs and CLABSIs, with HAPIs and falls showing special cause variation via statistical process control. Practical Applications: Despite the challenges associated with the lack of available nurse staffing accompanied by increasing responsibilities including unlicensed tasks, positive clinical outcomes can be maintained by staff adherence to evidence-based quality improvement.

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Section: Frommentioning

confidence: 99%

Quality Matters: Examining the Impact of Nurse Staffing Challenges on Clinical Outcomes

Polancich¹,

Miltner²,

Montgomery³

et al. 2023

Journal of Healthcare Management

Self Cite

View full text Add to dashboard Cite

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Using a participatory approach to identify priorities to advance LHS implementation at an academic medical center

Eagleson,

Gibson,

Dobbins

et al. 2024

Learning Health Systems

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IntroductionLike many other academic medical centers, the University of Alabama at Birmingham (UAB) aspires to adopt learning health system (LHS) principles and practices more fully. Applying LHS principles establishes a culture where clinical and operational practices constantly generate questions and leverage information technology (IT) and methodological expertise to facilitate systematic evaluation of care delivery, health outcomes, and the effects of improvement initiatives. Despite the potential benefits, differences in priorities, timelines, and expectations spanning an academic medical center's clinical care, administrative operations, and research arms create barriers to adopting and implementing an LHS.MethodsUAB's Center for Outcomes and Effectiveness Research and Education, in partnership with UAB Medicine's Department of Clinical Practice Transformation, applied part of the Precision Problem Solving methodology to advance the implementation of LHS principles at UAB.ResultsSixty‐two stakeholders across the UAB health system and academic schools noted 131 concerns regarding the development of an LHS at UAB. From the 131 items, eight major themes were identified, named, and prioritized through a series of focus groups. Of the eight major themes, “Creating a Structure for Aligned and Informed Prioritization” and “Right Data, Right Time, Improved Performance” ranked in the top three most important themes across all focus groups and became the critical priorities as UAB enhances its LHS. A task force comprised of diverse constituents from across UAB's academic medical center is taking first steps toward addressing these priority areas. Initial funding supports a prototype for enhanced health system data access and pilot projects conducted by researchers embedded in health system teams.ConclusionWe suggest that our experience conducting a deliberate process with broad engagement across both the health system and academic arms of the university may be informative to others seeking to advance LHS principles at academic health centers across a myriad of settings.

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Reducing hospital acquired pressure injury in a learning health center: Making the case for quality

Cited by 2 publications

References 22 publications

Quality Matters: Examining the Impact of Nurse Staffing Challenges on Clinical Outcomes

Quality Matters: Examining the Impact of Nurse Staffing Challenges on Clinical Outcomes

Using a participatory approach to identify priorities to advance LHS implementation at an academic medical center

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