Quality Improvement

A multidisciplinary team of physicians, case managers, pharmacists, and cardiac educators that follows all Medicare COPD, CHF, and pneumonia admissions for 30 days to reduce the risk of readmission.

Silvia Loica-Mersa

An EPIC AI model that predicts the chance of a deteriorating event (ICU transfer, RRT, or Code Blue) for medical-surgical patients. A workflow around the CDI score is currently in the pilot phase at Stanford Tri-Valley.

Silvia Loica-Mersa

Hospital Medicine participated in designing the workflows and launching the new service line to improve access to psychiatry and mental health service.

Alex Chu & David Svec

Updated hospital based and physician service referral orders to improve access.

Alex Chu & David Svec

A team of nurses and physicians that collaborate to create monthly educational sessions for nurses, as well as workshops related to improving communication between physicians and nurses.

Silvia Loica-Mersa

Dr. Minjoung Go led improvements to enhance the process and access to SHC Tri-Valley services – focusing on transfers from Stanford Palo Alto to Pleasanton and outside hospitals to Stanford Health Care Tri-Valley

Minjoung Go

This project aimed to improve the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores on patient experience related to Quiet at Night on the 3W unit. While ultimately there was still significant variability in noise ratings on the unit partly due to uncontrollable factors (i.e. yelling patients), the team was able to facilitate a significant shift in the attitude of the staff surrounding the role of a quiet environment in the healing process. This was accomplished through the creation of “quiet kits”, having staff reaffirm a commitment to quiet via one-point lessons, and working with the pharmacy to minimize nonessential medication passes at night.

Ginger Yang

1 in 5 Medicare beneficiaries is readmitted within 30 days of hospital discharge, incurring a cost of over $26 billion each year. Readmissions remain a significant factor in impacting patient outcomes and increasing costs for hospitals. Readmissions is a key variable for rising per member per month costs of Stanford managed care populations (Primary Care First (PCF), SHC Advantage, SHC Alliance). The goal is to reduce the 30-day all-cause readmission for high+mediium risk admitted SHC PCF from 21.4% to 18%.

Charles Liao

This team worked on decreasing delays in patient placement from the PACU (Post-Anesthesia Care Unit) to the 1W unit, which typically cares for post-operative patients. The team utilized an interdisciplinary approach with a discharge checklist involving the ADN, RNs, CM, PT/OTs as well as set up realistic expectations for patients to decrease median discharge time by 47 min on the unit as well as improve PACU board times to only 25 min.

Ginger Yang

Because there was a recent trend in the increase of the O:E ratio (observed deaths to expected deaths) of sepsis mortality at SHC-VC, this project focused on decreasing the observed mortality in POA (present on admission) cases of sepsis. Key drivers identified through the project included the timing of lactate draws as well as antibiotic administration. Through improvements made in early rooming of patients that screen positive for sepsis, the sepsis triage and order set process, and the number of antibiotics that were available to the ED (Emergency Department) MedSelect, both time to lactate results as well as time to antibiotic administration improved dramatically. This ultimately translates to 5 lives saved and $2.5 million dollars in cost savings realized per year.

Linda Wang, Ginger Yang, & Silvia Loica-Mersa