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: End-of-Life Care and How Communities Can Become "Conversation Ready"
WIHI: 10 Things Every Hospital Needs to Know to Be Safe
WIHI: The Road to Team-Based Primary Care and Behavioral Health
WIHI: 100 Million Healthier Lives by 2020
WIHI: Optimizing Safety with the Electronic Health Record: The Latest on Glitches and Fixes from the Frontlines
WIHI: Better Care and Better Value for Hip and Knee Replacement
WIHI: Mental Health Care in the Hospital: Preventing Harm, Promoting Safety
WIHI: From Here to CLER: Graduate Medical Education and the Clinical Learning Environment Review (CLER)
WIHI: Tread Water No More! Making Sense of Patient Experience Data
WIHI: Preventing Financial Harm to Patients: The Costs of Care Initiative
WIHI: From Prehospital to In-Hospital: The Continuum for Time-Sensitive Care
WIHI: New Roles, New Routes for Managing Populations
WIHI: Making the Work of QI Less Draining and More Sustaining
WIHI: The Patient-Centered Medical Home: Early Results, Tough Scrutiny
WIHI: Partnering with Patients for Safety: The Next Phase of Work and Commitment
WIHI: Transforming Tensions and Tempers on Health Care Teams
WIHI: Reclaiming Empathy — Best Practices for Engaging with Patients
WIHI: Bright Spots for Patients with Complex Needs
WIHI: How High? How Low? Shared Decision Making Amidst Shifting (Hypertension) Guidelines
WIHI: Mobilizing Skilled Nursing Facilities to Reduce Avoidable Rehospitalizations
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