How do emergency departments and emergency leaders catalyze positive change through quality improvement collaborations?

Autor:	Chartier LB; University Health Network, Emergency Department, Toronto, ON.; University of Toronto, Department of Medicine, Division of Emergency Medicine, Toronto, ON., Mondoux SE; Hamilton Health Sciences, Emergency Department, Hamilton, ON.; McMaster University, Department of Medicine, Division of Emergency Medicine, Hamilton, ON., Stang AS; University of Calgary Departments of Pediatrics, Community Health Science, Emergency Medicine, Calgary, AB.; Alberta Children's Hospital Research Institute, Calgary, AB., Dukelow AM; London Health Sciences Centre, Department of Emergency Medicine, London, ON.; University of Western Ontario, Department of Medicine, Division of Emergency Medicine, London, ON., Dowling SK; Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB.; Department of Emergency Medicine, Alberta Health Services, Calgary, AB., Kwok ESH; Department of Emergency Medicine, University of Ottawa, Ottawa, ON., Trivedi SV; Department of Emergency Medicine, University of Saskatchewan, Saskatoon, SK., Tepper J; North York General Hospital, Toronto, ON.; Department of Family and Community Medicine, University of Toronto, Toronto, ON., Lang E; Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB.; Department of Emergency Medicine, Alberta Health Services, Calgary, AB.
Jazyk:	angličtina
Zdroj:	CJEM [CJEM] 2019 Jul; Vol. 21 (4), pp. 542-549.
DOI:	10.1017/cem.2019.25
Abstrakt:	Objectives: Quality Improvement and Patient Safety (QIPS) plays an important role in addressing shortcomings in optimal healthcare delivery. However, there is little published guidance available for emergency department (ED) teams with respect to developing their own QIPS programs. We sought to create recommendations for established and aspiring ED leaders to use as a pathway to better patient care through programmatic QIPS activities, starting internally and working towards interdepartmental collaboration. Methods: An expert panel comprised of ten ED clinicians with QIPS and leadership expertise was established. A scoping review was conducted to identify published literature on establishing QIPS programs and frameworks in healthcare. Stakeholder consultations were conducted among Canadian healthcare leaders, and recommendations were drafted by the expert panel based on all the accumulated information. These were reviewed and refined at the 2018 CAEP Academic Symposium in Calgary using in-person and technologically-supported feedback. Results: Recommendations include: creating a sense of urgency for improvement; engaging relevant stakeholders and leaders; creating a formal local QIPS Committee; securing funding and resources; obtaining local data to guide the work; supporting QIPS training for team members; encouraging interprofessional, cross-departmental, and patient collaborations; using an established QIPS framework to guide the work; developing reward mechanisms and incentive structures; and considering to start small by focusing on a project rather than a program. Conclusion: A list of 10 recommendations is presented as guiding principles for the establishment and sustainable deployment of QIPS activities in EDs throughout Canada and abroad. ED leaders are encouraged to implement our recommendations in an effort to improve patient care.
Databáze:	MEDLINE
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