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July 2006 Volume 30 No. 7

Quality Corner

June Highlights of Performance Improvement at SHC
- Quality Improvement and Patient Safety Committee [QIPSC]
Joseph Hopkins, associate chief of staff, chair


DVT/P
-- Newly revised DVT/PE risk assessment form was implemented in the OR region effective June 5 - See article in June ’06 Medical Staff Update on page 6 or http://med.stanford.edu/shc/update/dvt.htm

• Daily monitoring and feedback to physicians and nurses has resulted in significant compliance improvement

• Quality specialist to continue with weekly reporting to leadership to ensure progress towards identified targets


Preoperative beta blockade
-- Implement standardized approach to prophylactic beta blockade in all patients at risk

National Patient Safety Goals
• Result audits reported monthly to medical staff and medical center leadership committees and focused action plans are required to ensure best practices

• Education continues - To improve house staff compliance with NPSG, a comprehensive quality orientation packet was included in new house staff orientation

Iatrogenic Pneumothorax
• Hospitalists and attendings to supervise residents performing invasive procedures

• Simulation Unit to open in fall to train housestaff and nursing staff

• Ultrasound required for IJ central line insertions

Point of Care Testing (POCT) Policy Changes
• Infection control policy applies to POCT

• Self-testing prohibited - physician order required for POCT

• Guideline added for utilization of iSTAT HCT parameter

• Policy added to address patient home glucose meter us

• New tests: lactate, GFR, troponin and creatinine

Medication Reconciliation
-- policy revised to include:

• SHC outpatient services - clinics

• Emergency Department

• 23-hour unit