Establishing a Culture of Patient Safety, Quality, and Service in Plastic Surgery: Integrating the Fractal Model
| Autor: | Ricardo J. Bello, Michele A. Manahan, Carisa M. Cooney, Peter J. Pronovost, Renee Demski, Charalampos Siotos, Gedge D. Rosson, Jeffrey W. Aston |
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| Rok vydání: | 2018 |
| Předmět: |
Quality management
Leadership and Management Computer science media_common.quotation_subject Specialty 030230 surgery 03 medical and health sciences Patient safety 0302 clinical medicine Patient satisfaction Patient experience Humans Operations management Quality (business) Surgery Plastic media_common business.industry Public Health Environmental and Occupational Health Plastic Surgery Procedures Quality Improvement Fractals Analytics 030220 oncology & carcinogenesis Service (economics) Patient Safety business |
| Zdroj: | Journal of patient safety. 17(8) |
| ISSN: | 1549-8425 |
| Popis: | Problem There are obstacles to effective nationwide implementation of a culture of patient safety. Plastic surgery faces unique challenges in this area because quality measures are not as well-established as in other fields. Plastic surgery may also require emphasis on patient-reported outcomes as a quality-of-life specialty with distinct concomitant analytical methods. Approach We devised a dynamic framework, based on our 3-year experience using a Comprehensive Unit-Based Safety Program-a formal quality improvement committee structure, literature review, and work from The Johns Hopkins Armstrong Institute for Patient Safety and Quality. This framework is specific and exportable to the field of plastic surgery. Monthly patient safety, quality, and service committee meetings encourage multilevel participation in a bottom-up fashion, while connecting with other departments and entities in Johns Hopkins Medicine. Our model focuses our work in the following four domains: (1) safety, (2) external measures, (3) patient experience, and (4) value. Our framework identifies and communicates clear goals, creates necessary infrastructure, identifies opportunities and needs, uses robust performance to develop and implement interventions, and includes analytics to track improvement plans and results. Outcomes We have gradually implemented this quality improvement structure into the Johns Hopkins Department of Plastic and Reconstructive Surgery successfully since 2012. Outcomes have improved in externally reported measures of patient safety, quality, and service. We have demonstrated exemplary National Surgical Quality Improvement Program performance for morbidity, return to operating room, and readmission rates. Patient satisfaction surveys show improvement related to the high-level patient experience. |
| Databáze: | OpenAIRE |
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