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: Highly Reliable Hospitals: The Work Ahead
WIHI: The Patient Will See You Now: New Technology for New Collaborations
WIHI: The Social Imperative to Demonstrate That Better Care = Lower Costs
WIHI: Have You Had "The Conversation"? Helping Loved Ones Discuss End-of-Life Preferences
WIHI: Removing Barriers to Care with Medical-Legal Partnerships
WIHI: Heard at the Forum: New Ideas and Learning from IHI's 23rd Annual National Forum
WIHI: Night Talks and Nocturnists: New Interventions for the Hospital at Night
WIHI: Health Literacy: New Skills for Health Professionals
WIHI: Organizing for Health: A Story from South Carolina
WIHI: Safety Net Hospitals: Untold Stories of Quality Transformation
WIHI: Family Caregiving, Caregivers, and Compassion
WIHI: Managing Medication Shortage: Best Practices for a Crisis
WIHI: Always Events: Raising Expectations for Patient Experience
WIHI: Payment Reform As We Speak
WIHI: Improving Health Care: The Global View
WIHI: New Models for Patients with Multiple Health and Social Needs
WIHI: Integrity On and Off the Page: A Discussion with JAMA’s (Departing) Editor-in-Chief
WIHI: Leading Across the Continuum
WIHI: Palliative Care = Quality Care
WIHI: The Power to Detect and Improve: Revisiting the IHI Global Trigger Tool and Adverse Events
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