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: Reports from the Frontlines of Effective Crisis Management
WIHI: Primary Care's (New) Pressures and Possibilities
WIHI: Health Care’s Newest Improvers: Patient and Family Advisors
WIHI: The Newest Innovator on the Block: Center for Medicare and Medicaid Innovation
WIHI: A Legible Prescription for Health Care
WIHI: Alert to Change: New Models for Residency Work Hours
WIHI: The Power of Specialty Care – and the Necessity to Use It Wisely
WIHI: The Patient Activist
WIHI: Finding the Will to Bend the Cost Curve
WIHI: Nursing’s New Roadmap: Education, the Workforce, and Health Care Quality
WIHI: The Leaders Needed for the Changes Health Care Needs
WIHI: The Power to Detect and Reduce Harm: IHI’s Global Trigger Tool and Adverse Events in the US
WIHI: Reducing Readmissions, Restoring Revenues: Making Good Care Count
WIHI: The Buzz about Medical Training: It’s (Slowly) Changing
WIHI: Leaders Never Stop Learning
WIHI: Against All Odds: Maternal Survival in Ghana and the US
WIHI: Unprofessional Behavior Not Permitted Here
WIHI: The Image of Better (Radiation) Imaging Practices
WIHI: Learning by Data and by Doing: Low-Cost, High-Quality Health Care in America
WIHI: Coaching’s the Thing for Primary Care Practice
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