Welcome to THE QUALITY SOURCE
– a Web site hosted by the North Carolina AHEC Program in partnership with the NC Center for Hospital Quality and Patient Safety. This Web site will keep you up to date on significant education offerings and information about Quality and Patient Safety. There is lots of activity in the state and this site can be your ONE PRIMARY SOURCE to identify the many valuable resources. It is also a way for you to communicate what interests you may have so that the AHEC can work with you and our community partners to target your specific needs. Please contact us with any questions or suggestions.
Educational Offerings
Charlotte AHEC Quality Initiative Programs (link)
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The NC Lean Healthcare Alliance between NC State University and The NC Quality Center presents: Lean Healthcare 200: Applying the Fundamentals (pdf) -- February 11 & 12, 2009 in Wilmington, NC. Why Lean Healthcare? Lean healthcare is a systematic approach to aligning work at each level and step of the healthcare organization or patient experience. Whether building a car or providing health care for a patient, employees must rely on multiple, complex processes to accomplish their tasks and provide value to the customer or patient. Waste of money, time, supplies, or good will decreases value. Adopting and applying lean thinking in health care, when applied rigorously and throughout an entire organization, can have a positiveproductivity, cost, quality, and timely delivery of services.
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The NC Center for Hospital Quality and Patient Safety is now accepting registration for the 2009 North Carolina Quality and Patient Safety conference (pdf) on March 12-13, 2009 at The Friday Center in Chapel Hill. The conference will focus around several themes; present on admission, hospital acquired conditions, creating a culture of safety and physician engagement.
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If you missed it before, QI 101: A Toolbox for Improvement is back for 2009! Charlotte AHEC in collaboration with the NC AHEC Program and the North Carolina Center for Hospital Quality and Patient Safety is partnering to offer this course to help develop and improve your skills in quality improvement. Quality Improvement 101 (QI 101) is an interactive learning opportunity for teams and organizations leading initiatives to improve health care quality. This program includes an action-oriented curriculum in which participants learn about systems improvement principles and immediately apply what they are learning to specific local projects. For more information see brochure (pdf) or contact Eddie Curran. Additional information can also be found on the Charlotte AHEC website.
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North Carolina TeamSTEPPS Fundamentals (pdf): Health care organizations depend on the coordinated interactions of multiple teams operating in a complex and high-risk environment. Patient safety experts agree that communication and other teamwork skills are essential for the provision of quality healthcare and the prevention of medical errors and patient harm. Communication failure is the leading root cause of sentinel events reported to the Joint Commission. Despite the importance of teamwork and communication skills, most healthcare professionals are not trained in teamwork principles. Teamwork skills are not innate - they must be learned and practiced.
TeamSTEPPS is an evidence-based system aimed at optimizing patient outcomes by improving communication and other teamwork skills among healthcare professionals. It was developed by the Department of Defense Patient Safety Program in collaboration with the Agency for Healthcare Quality and Research (AHRQ) and is based in over 20 years of research and lessons learned from the application of teamwork principles in high reliability organizations.
The NC Center for Hospital Quality and Patient Safety is now accepting registration for TeamSTEPPS Fundamentals, an interactive workshop that focuses on improving core team functioning through lecture, role-playing, exercises and mini-case studies. To register for the program, visit http://www.ncqualitycenter.org/.
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North Carolina Safe ICUs: Eliminating CLABSI Collaborative (pdf): North Carolina has been selected as one of ten states by the Health Research and Educational Trust (HRET) of the American Hospital Association to participate in a national initiative to reduce central-line associated blood stream infections (CLABSI) in intensive care units (ICUs). The project is funded by the Agency for Healthcare Research and Quality (AHRQ) and is in partnership with the Michigan Health & Hospital Association’s (MHA) Keystone Center for Patient Safety & Quality and the Johns Hopkins University Quality & Safety Research Group (JHU).
In October 2003, the Keystone Center worked with Dr. Peter Pronovost of JHU on a two-year project to reduce CLABSI rates in Michigan ICUs. A total of 108 ICUs participated in this collaborative which focused on the implementation of evidence-based interventions aimed at reducing the incidence of CLABSI and ventilator associated pneumonia (VAP); improving teamwork and communication between clinicians; and enhancing the culture of safety and improving staff satisfaction. The project resulted in a decrease in the median infection rate from 2.7 per 1000 catheter days at baseline to zero at 3 months after implementation of the intervention. The benefit from the interventions was sustained resulting in a 66% reduction in CLABSI at the end of the study period.
AHRQ seeks to replicate the success of the Michigan ICUs in dramatically reducing CLABSI throughout the nation. Michigan used the Comprehensive Unit Based Safety Program (CUSP) and CLABSI reduction protocols developed by JHU to significantly save lives and reduce costs. The North Carolina Center for Hospital Quality and Patient Safety will lead the initiative in North Carolina.
REGISTER TODAY to participate in this opportunity to improve quality and safety for your ICU patients. Collaborative activities begin in MARCH 2009. To register, visit http://www.ncqualitycenter.org/ .
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CDC/DHHS/EAHEC Perinatal HIV and other STIs Quality Initiative: Eastern North Carolina has been selected by the Center of Disease Control (CDC) to participate in an initiative to promote health care professional education and awareness regarding the prevention and testing of HIV and other STIs during pregnancy. Collaborating partners include Eastern AHEC, NC Department of Health and Human Services Women's Health Branch and the HIV/STD Prevention and Care Branch. This project uses a quality improvement model to implement a best practices approach in private practices who provide prenatal care in eastern NC. This approach is designed to focus on the application of best practice guidelines to enhance screening/testing of HIV and other STIs during pregnancy in accordance with CDC guidelines and NC law.
The focus of the grant is on the eight counties with greater than 20 reported cases of HIV in 2007. These counties include: Pitt, Wayne, Edgecombe, Craven, Hertford, Lenoir, Wilson, and Nash. Consultation, technical assistance and education based on a self- assessment of testing rates for HIV and other STIs is offered to practices who self-select to participate.
Participating physicians, nurses, and advanced practice providers will receive tool kits with current CDC guidelines, NC laws and articles to enhance prenatal screening and testing of HIV and other STIs during pregnancy. Continuing Medical Education and health professional credits will be awarded for participation in this quality improvement project.
Anyone interested in learning more about this project using a quality improvement model can contact the Eastern AHEC Perinatal Outreach Office, Mildred Carraway, at 252-744-3089.
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ABC-123: Applying Best Practice in Child Developmental Services: Charlotte AHEC has been awarded a grant from Smart Start of Mecklenburg County in support of this pediatric developmental screening initiative. This quality improvement and outreach initiative aims to advance the concept of the medical home by integrating a standardized screening tool into well child visits and enhancing the communication between primary care practitioners, parents, referral sources, and other community service agencies in the early identification and management of children with special needs/chronic conditions and other at-risk populations. Collaborating partners include Community Care Partners of Greater Mecklenburg, Mecklenburg County Health Department, Carolinas HealthCare System, Carlton G. Watkins Center, Charlotte-Mecklenburg Schools , and Reach Out and Read Charlotte. Participating physicians will receive developmental screening office guides, tools, and assistance to redesign office workflow to promote early intervention, surveillance, and follow-up. Continuing Medical Education credit will also be awarded for participation and practice-based quality improvement efforts. For more information contact Mary Webster, assistant director for quality initiatives at Charlotte AHEC.
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The Quality and Patient Safety Special Collection is now available on the AHEC Digital Library (ADL). You can access the collection clicking on the link, "Quality and Patient Safety," under the "Special Collections" heading on the home page of the ADL. The ADL is very excited about providing this collection and hope that health professionals across the state will benefit from it. Please send any feedback or comments to Jill Mayer.
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A1R/1000
A1R/1000 is a partnership for Asthma Improvement and Resources (A1R) that seeks to reduce pediatric, asthma-related hospitalizations and emergency room visits. Specifically, the aim of A1R/1000 is to reduce asthma-related hospitalizations among children to less than one hospitalization per 1000 children per year. To achieve this, Southern Regional and Charlotte AHECs are working in partnership with individual practices and practice networks, as well as other state and local agencies, to implement 20 high-leverage strategies for improving asthma care. A secondary aim of A1R/1000 is to support the NC AHEC Program in integrating practice-based, outcome oriented approaches to continuing medical education as part of the AHEC infrastructure. NC AHEC intends to spread this innovative approach throughout its system to position itself to play a key role in ongoing health care improvement efforts throughout North Carolina . The Center for Health Care Quality will train and support AHEC staff in the implementation and management of the program activities.
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Improving Performance in Practice (IPIP)
IPIP is designed as a state-based approach that can support efforts by primary care physicians, including internists, family physicians and pediatricians and their care teams, to improve the way chronic illness and preventive care is provided to patients. The program is a national effort supported by the Robert Wood Johnson Foundation, and is a collaborative effort among the boards of the three specialties as well as their professional societies. North Carolina and Colorado have been chosen as the two pilot states and the project is in its design phase. There will be three major components to the project, including:1) the creation of collaborative improvement networks of practices; 2) Web-based improvement modules; and 3) collection reporting of data at the practice and physician level.
Major partners in North Carolina include the NC Academy of Family Physicians, the NC Pediatric Society, Community Care of North Carolina, The Carolina Center for Medical Excellence, and NC AHEC. Warren Newton, MD, MPH, chair of the Department of Family Medicine at the UNC School of Medicine, chairs the NC Steering Committee.
In the first year of the IPIP project, 24 practices will be recruited to participate. In years two and three, 50 more practices will be recruited in each year. NC AHEC is seen as playing a key role through the use of the statewide AHEC network to educate physicians about the project, provide support to physicians and practices implementing quality improvement methods, and serving as an information resource through the AHEC Digital Library and other means for the content that will form the basis for the project. A key part of the project involves staff called “field agents” who will support physician practices in their work in performance improvement. In the first year, two field agents will be placed to work jointly with NC AHEC and CCNC networks. Two regions of the state will be selected to serve as pilot sites in the first year.
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Other Internet Resources
www.ihi.org is the Web site for the Institute of Healthcare Improvement, founded by Dr. Don Berwick. It includes many downloadable resources including "How-to Guides" for areas such as Rapid Response Teams. In addition, IHI is a current resource on national Quality and Patient Safety information and resources.
Chronic Disease Management information on the NC Community Health Center Association Web site.
Improve First is the centerpiece of the Alliance for Pediatric Quality’s strategy to improve the quality of care for children. Spreading what works is the single most important first step the pediatric community can take to measurably improve children’s health outcomes and transform how care is delivered.
Community Care of North Carolina