WIHI - A Podcast from the Institute for Healthcare Improvement
Health & Fitness:Medicine
Date: November 7, 2013
We don’t typically associate the ambulatory care setting with serious lapses in quality that threaten patient safety. Much of the improvement in recent years targeting outpatient care has focused on access, waiting times, communication, and coordination of care. But these areas ripe for change have often obscured others that, if not handled well, can have even more dire consequences: the ordering of tests, the timely handling and communication of results, and the overall process of making a diagnosis in response to a patient’s symptoms or complaints, including making referrals to specialists.
This WIHI explores what’s been learned from a three-year initiative known as PROMISES, charged with reducing malpractice risk in the ambulatory setting by making care safer, more efficient, and more reliable.
The WIHI panel will be headed up by the lead researcher for PROMISES, Dr. Gordon Schiff, who’s also the lead author of a recently published article in JAMA Internal Medicine ("Primary Care Closed Claims Experience of Massachusetts Malpractice Insurers") that found that the lion’s share of malpractice claims in Massachusetts primary care practices relate to allegations of misdiagnosis stemming, in part, from dropped balls with test results. This finding matches national trends, which is why the work of PROMISES, centered on making improvements at 16 sites, should resonate with many.
Dr. Damian Folch worked on improvements at his practice in Chelmsford, MA, and he and other sites were coached by Improvement Advisors, including Nicholas Leydon. Because it’s rarely a matter of one thing that’s been missed or that can go wrong, IHI’s Frank Federico will help us understand why a systems approach is critical to managing the many things that transpire in the ambulatory setting, including careful tracking of prescribed medications.
This WIHI promises to be rich with results and real-world experience, and it will offer you ways to get involved to help shape and spread further change. Could your team use a PROMISES Patient Safety Curriculum? Would you like to explore becoming a Primary Care Patient Safety Innovator? Listen to the discussion on this WIHI.
WIHI: Innovation and Improvement in Times of Crisis
WIHI: How to Navigate Power and Enhance Psychological Safety
WIHI: Which Way is North? Setting Your Compass for Population Health
WIHI: Workload, Stress, and Patient Safety: How Human Factors Can Help
WIHI: Special Edition Podcast: Creating a Culture of Continuous Improvement that Outlasts Your Leaders
WIHI: The Benefits of Behavioral Health in the ED
WIHI: Increasing Joy in Work: Notes from a Cardiac ICU Team
WIHI: Let’s Get to Work on Waste in Health Care
WIHI: NO LET UP ON SAFETY
WIHI: Black Women and and Maternal Care: Redesigning for Safety, Dignity, and Respect
WIHI: Aim High For Equity in the Health Care Workforce
WIHI: Assessing the Value of Age-Friendly Health Care
WIHI: Taking Acute Pain Seriously, Treating it Safely
WIHI: What’s an Apology Worth? The Case for Communication and Resolution
WIHI: How to Make Patient Safety Easier to Explain and to Champion
WIHI: How to Speak So Leaders Will Listen
WIHI: New Guidance for Governance of Health System Quality - What Trustees Should Know and Do
Special Edition WIHI - Women in Action: Paving the Way for Better Care
WIHI: BUILDING THE WILL AND SKILL TO BE A CLINICAL IMPROVER
WIHI: Lowering Readmissions, Reducing Disparities
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