Safe Passage: Improving the Transition of Care Between Triage and Labor and Delivery.


OBJECTIVE:The multifaceted nature of the transition of care from the triage unit to labor and delivery has historically led to confusion, delays, and errors in care. This study evaluated the effect of standardization of roles and communication on improving this transition. METHODS:A multidisciplinary team was assembled to define and standardize roles of team members. A huddle safety board was created as a visual aid to promote closed-loop communication during an admission bedside huddle. The primary metrics collected were duration of time from the admission decision in the triage unit to when the admission huddle was completed on labor and delivery, duration of time from the admission decision in the triage unit to initiation of the plan of care and documented completion of the admission huddle. RESULTS:There was a 66-minute reduction in time from the admission decision to the huddle completion between the preintervention and postintervention periods. There was a 93-minute reduction in the time from the admission decision to when the plan of care was initiated between the preintervention and post-intervention periods. The weekly huddle compliance rate improved from 48% to 84% by the postintervention period. CONCLUSIONS:The implementation of standardized roles and processes facilitating closed-loop communication decreases delays in communication and initiation of care in pregnant women transferred from the triage unit to labor and delivery.


Qual Manag Health Care


Lee DD,Colwill AC,Teel J,Srinivas SK




Has Abstract


2018-10-01 00:00:00














  • Patient-Centered Handovers: Ethnographic Observations of Attending and Resident Physicians: Ethnographic Observations of Attending and Resident Physicians.

    abstract::Handover communication improvement initiatives typically employ a "one size fits all" approach. A human factors perspective has the potential to guide how to tailor interventions to roles, levels of experience, settings, and types of patients. We conducted ethnographic observations of sign-outs by attending and reside...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Mount-Campbell AF,Rayo MF,OʼBrien JJ Jr,Allen TT,Patterson ES

    更新日期:2016-10-01 00:00:00

  • A patient-centered decision rule for referral of patients to weight-loss programs.

    abstract:BACKGROUND:The obesity epidemic threatens to shorten life expectancy and reduce the quality of life for large segments of the population. The purpose of this study was to develop a decision rule for referral to a weight-loss program on the basis of the relationship between body mass index (BMI) and self-rated overall h...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Rohrer JE,Merry SP,Lopez-Jimenez F,Adamson SC,Wilshusen L

    更新日期:2007-07-01 00:00:00

  • Appropriateness of care: the case for changing the focus of "quality" measurement.

    abstract::"Quality" of care has become one of the main foci of the American health care system during the last 20 years. As costs escalated in all areas of health care, the purchasers and consumers of health care have begun to demand accountability for the products they purchase. The initial focus of the system was "quality of ...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Rowell PA

    更新日期:2004-07-01 00:00:00

  • Why we love quality but hate to measure it.

    abstract::As a group, physicians strive for quality but often resist quality measurement. Cost, inconvenience, lack of time, mistrust of quality measures, and a fear of what assessment may find are all factors contributing to this resistance. However, quality, in both rich and poor counties, continues to be poor at worse and va...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Peabody J

    更新日期:2006-04-01 00:00:00

  • Perioperative nurses' ability to think critically.

    abstract:AIMS:The purpose of this quantitative descriptive correlational study was to assess for presence and degree of critical thinking skills among perioperative (OR) nurses. BACKGROUND:Critical thinking has become a multidisciplinary "buzz phrase"; however, critical thinking, reflective thinking, or mental discipline was d...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Fesler-Birch DM

    更新日期:2010-04-01 00:00:00

  • Interventions to Improve Hospital Admission and Discharge Management: An Umbrella Review of Systematic Reviews.

    abstract:BACKGROUND:The aim of this umbrella review was to summarize the research evidence on programs to improve the transition between ambulatory and hospital care. METHODS:The MEDLINE database and the Cochrane library were searched. Systematic reviews of randomized controlled trials published between January 2000 and Septem...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Straßner C,Hoffmann M,Forstner J,Roth C,Szecsenyi J,Wensing M

    更新日期:2020-04-01 00:00:00

  • Extending the application of critical path methods.

    abstract::Most health care organizations are using critical pathways in an attempt to reduce the variation in patient care, improve quality, enhance communication, and reduce costs. Virtually all of the critical path efforts to date have developed tables of treatments, medications, and so forth by day and have displayed them in...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Coffey RJ,Othman JE,Walters JI

    更新日期:1995-01-01 00:00:00

  • Transactional versus transformational style of leadership--employee perception of leadership efficacy in public and private hospitals in Kuwait.

    abstract:OBJECTIVES:To determine whether employees working for a transformational leader perceive their leader as more effective than do those working for a transactional leader. To assess whether employees in private hospitals are more likely to perceive their leaders as transformational than are employees in public hospitals....

    journal_title:Quality management in health care

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Al-Mailam FF

    更新日期:2004-10-01 00:00:00

  • Ambulatory care in the new millennium: the role of consumer information.

    abstract::The past decade has been marked by extensive change in the organization of health care delivery systems (the "supply side" of health care). There has been relatively less change in the nature of the health care consumer (the "demand side" of health care). The emergence of the Internet as a consumer health care technol...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Sennett C

    更新日期:2000-01-01 00:00:00

  • Through the eye of the beholder: multiple perspectives on quality in women's health care.

    abstract::Quality is an illusive concept with different meanings to different people. Providers often define quality in terms of patient outcomes, professional standards of practice, predetermined criteria used to measure quality, and even subjective opinion. Patients describe quality in terms of the interpersonal aspects of ca...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Stichler JF,Weiss ME

    更新日期:2000-07-01 00:00:00

  • Medical home interventions and quality outcomes for older adults: a systematic review.

    abstract:PURPOSE:Medical home care has been identified as a model for improving primary care delivery and population-specific quality and safety outcomes. Questions remain how this model affects older adult quality. This systematic review addresses 2 important questions: Are quality and safety outcomes associated with medical h...

    journal_title:Quality management in health care

    pub_type: 杂志文章,评审


    authors: DePuccio MJ,Hoff TJ

    更新日期:2014-10-01 00:00:00

  • Providing public health services through an integrated delivery system.

    abstract::This article examines a recently implemented strategy to transfer responsibility for local public health service delivery from a county health department to a hospital-based integrated delivery system. Innovative quality management efforts at both local and state levels offer opportunities for sustained improvement in...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Keener SR,Baker JW,Mays GP

    更新日期:1997-01-01 00:00:00

  • Patient safety and the integration of graduate nurses into effective organizational clinical risk management systems and processes: an Australian study.

    abstract:OBJECTIVES:This article explores and describes key processes facilitating the integration of neophyte graduate nurses into safe and effective organizational systems and processes as part of a hospital's overall local clinical governance and clinical risk management (CRM) program. METHODS:This study was undertaken usin...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Johnstone MJ,Kanitsaki O

    更新日期:2008-04-01 00:00:00

  • An Assessment of Organizational Health Literacy Practices at an Academic Health Center.

    abstract:BACKGROUND:Organizational health literacy is the degree to which an organization considers and promotes the health literacy of patients. Addressing health literacy at an organizational level has the potential to have a greater impact on more health consumers in a health system than individual-level approaches. OBJECTI...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Prince LY,Schmidtke C,Beck JK,Hadden KB

    更新日期:2018-04-01 00:00:00

  • Advancing Payment Reform at the Community Level.

    abstract:BACKGROUND:Multistakeholder alliances-groups of payers, purchasers, providers, and consumers that voluntarily work together to address local health goals-have increasingly been used to improve health care quality within their communities. Under the Robert Wood Johnson Foundation's Aligning Forces for Quality (AF4Q) ini...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: McHugh M,Shaw B,Wolf L,Bleser W,Duckett P

    更新日期:2016-04-01 00:00:00

  • Seven propositions of the science of improvement: exploring foundations.

    abstract:CONTEXT:The phrase "Science of Improvement" or "Improvement Science" is commonly used today by a range of people and professions to mean different things, creating confusion to those trying to learn about improvement. In this article, we briefly define the concepts of improvement and science, and review the history of ...

    journal_title:Quality management in health care

    pub_type: 历史文章,杂志文章


    authors: Perla RJ,Provost LP,Parry GJ

    更新日期:2013-07-01 00:00:00

  • Use of computer alerts to prevent the inappropriate use of metformin in an inpatient setting.

    abstract:BACKGROUND:Metformin is recommended as initial therapy for most patients with type 2 diabetes mellitus. Its most serious adverse effect, lactic acidosis, is a rare entity with a high mortality rate. Despite well-publicized contraindications, metformin is inappropriately prescribed to many hospitalized patients. OBJECT...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Rossi AP,Wellins CA,Savic M,Devlin JT

    更新日期:2012-10-01 00:00:00

  • Changing physician behavior: the Maine Medical Assessment Foundation.

    abstract::Methods to produce change in physician practice patterns are of increasing importance to payers and regulators as well as to physicians themselves. Because some of the strategies being adopted occur without physician input and participation, they have aroused concern in the medical community. We describe the methods u...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Keller RB,Wennberg DE,Soule DN

    更新日期:1997-07-01 00:00:00

  • Reengineering the organization: an approach for discontinuous change.

    abstract::Improvement will be constrained by the function-based organizational model found in most health care organizations. Most components of the typical organization are driven by the concept of division of labor. The organization needs to challenge the underlying assumptions and reengineer from top to bottom. Reengineering...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Coan T

    更新日期:1994-04-01 00:00:00

  • Using Lean Six Sigma to Reduce Patient Cycle Time in a Nonprofit Community Clinic.

    abstract:BACKGROUND AND OBJECTIVES:The mission of nonprofit health care clinics is particularly challenging to fulfill given the large number of uninsured and underinsured people they serve. In addition, these clinics feel pressure to provide services in an efficient manner to prevent patient no-shows and encourage the continua...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Kovach JV,Ingle D

    更新日期:2019-07-01 00:00:00

  • Role of communication content and frequency in enabling evidence-based practices.

    abstract::Many hospitals are unable to successfully implement evidence-based practices. For example, implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs), is often challenging. This problem is broadly characterized as a "change implementation failure." A prospective...

    journal_title:Quality management in health care

    pub_type: 杂志文章,多中心研究


    authors: Rangachari P,Madaio M,Rethemeyer RK,Wagner P,Hall L,Roy S,Rissing P

    更新日期:2014-01-01 00:00:00

  • Tutorial: planning for data collection. Part II: Designing the study.

    abstract::Part II of this three-part tutorial focuses on the logistics of data collection. The author presents a checklist of things to consider when planning the details of a data collection effort; touches on the topics of bias and stratification; discusses examples of popular data collection methods; and points out some comm...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Plsek PE

    更新日期:1994-07-01 00:00:00

  • A note regarding the projections of some major health indicators.

    abstract::There are various methods to get some projections of health indicators that do not always produce satisfactory results. Our aim is to establish the rules for obtaining reliable projections, using simple models. In the procedure proposed here, there is no need, as in many other techniques, to directly connect the level...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Mouza AM

    更新日期:2006-07-01 00:00:00

  • Strategic planning for hotel operations: The Ritz-Carlton Hotel Company (Part I).

    abstract::The Ritz-Carlton Hotel Company won the Malcolm Baldridge National Quality Award in 1992. One key to its success is its strategic planning process. This two-part article reviews the Ritz-Carlton's approach to strategic planning. In particular, it describes (1) the role of senior leadership in the planning process and (...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Shriver SJ

    更新日期:1993-07-01 00:00:00

  • Association Between Hospital Accreditation and Outcomes: The Analysis of Inhospital Mortality From the National Claims Data of the Universal Coverage Scheme in Thailand.

    abstract:BACKGROUND:In Thailand, hospital accreditation (HA) is widely recognized as one of the system tools to promote effective operation of universal health coverage. This nationwide study aims to examine the relationship between accredited statuses of the provincial hospitals and their mortality outcomes. METHOD:A 5-year r...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Sriratanaban J,Ngamkiatpaisarn S,Charoenmukayananta S

    更新日期:2020-07-01 00:00:00

  • Proving the effectiveness of community programs in jeopardy: the role of formative evaluation.

    abstract::Today's health care programs are being scrutinized like never before and yet few clinicians and managers know how to show the value of programs without time-consuming outcomes research. This is especially true for new and innovative programs that are dependent on outside funding and may not have enough time to show an...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Quinn DC

    更新日期:2001-07-01 00:00:00

  • A Fellowship in Quality Management.

    abstract::The U.S. Healthcare Fellowship in Quality Management at Hahnemann University was developed by a managed health care organization and health science university in order to train physicians in the theory and practice of quality management and clinical outcomes measurement. This article describes in detail the program co...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Paz HL,Paradis J,Zatz S

    更新日期:1996-10-01 00:00:00

  • Application of attribute control charts to risk-adjusted data for monitoring and improving health care performance.

    abstract::This article proposes a new class of control charts that may be used for monitoring and improving the quality of care. Unlike conventional control charts that rely on observed performance data, these charts use risk-adjusted data in addition to the observed data. The resulting time-ordered charts are capable of reduci...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Hart MK,Lee KY,Hart RF,Robertson JW

    更新日期:2003-01-01 00:00:00

  • Adapting to the context and learning from earlier experience: the implementation of a national breakthrough collaborative in the context of social services in Sweden.

    abstract:BACKGROUND:Although often used in health care settings as a method for continuous quality improvement, experience with the breakthrough collaborative in nonclinical health care settings is limited. In this article, we report pilot data from a social services collaborative conducted in 2007 to 2009 in Sweden, with speci...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Lindgren J

    更新日期:2009-10-01 00:00:00

  • Control charts 101: a guide to health care applications.

    abstract::A control chart can be an effective way to display process data over time. It can differentiate common cause variation from special cause variation through the application of several probability-based interpretation rules. In addition, a control chart can be helpful in evaluating the effectiveness of a change. There a...

    journal_title:Quality management in health care

    pub_type: 杂志文章


    authors: Amin SG

    更新日期:2001-04-01 00:00:00