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: The How and Why of Deprescribing
WIHI: Connecting Patient Experience to Strategic Aims
WIHI: How to Build Better Behavioral Health in the Emergency Department
WIHI: Addiction Treatment Demystified: Proven, Practical Steps for Complex Care.
WIHI: Strategic Pathways to Population Health
WIHI: Giving Patients and Families the Tools to be Health Care Improvers
WIHI: How to Make Change Happen: An Introduction to IHI's Psychology of Change Framework
WIHI: Pursuing Health Equity in North Carolina
WIHI: Sustaining and Strengthening Safety Huddles
WIHI: Mobility Matters for Age-Friendly Care
WIHI: Mindfulness and Patient Safety
WIHI - Aging in Place with a Disability and Dignity
WIHI: Practicing More Careful and Thoughtful Diagnosis
WIHI: What's in a Name? Health Care's Chief Quality Officer.
WIHI: Opioid Crisis: Changing Habits and Improving Pain Management
WIHI: Discovering Your Way to Greatness
WIHI: The Careful and Kind Patient Revolution
WIHI: Health Care Innovation and R&D - Taking Stock at Ten Years
WIHI: A New Emergency Checklist for Office-Based Surgery
WIHI: QI Takes on Veteran and Chronic Homelessness
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