Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements

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• 作者：Meghan R. Flanagan ; M.D. ; M.P.H.^a ; ¹ ; ^{mrf22@uw.edu" class="auth_mail" title="E-mail the corresponding author} ; Carolyn C. Foster ; M.D.^b ; ¹ ; Anneliese Schleyer ; M.D. ; M.H.A.^c ; ^d ; Gene N. Peterson ; M.D. ; Ph.D.^e ; Samuel P. Mandell ; M.D. ; M.P.H.^a ; Kristina E. Rudd ; M.D.^c ; Byron D. Joyner ; M.D. ; M.P.A.^f ; ^g ; Thomas H. Payne ; M.D.^c ; ^h ; ⁱ
• 关键词：Inpatient problem list ; Electronic medical record ; Quality improvement ; Meaningful Use ; Clinical Learning Environment Review ; House staff
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：211
• 期：2
• 页码：390-397
• 全文大小：882 K

文摘

House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program.

Methods

House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention.

Results

The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P = .002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P < .001).

Conclusions

This innovative project serves as a model for successful engagement of house staff in institutional quality and safety initiatives with tangible institutional benefits.