The 2001 Institute of Medicine (IOM) Report Crossing the Quality
Chasm: A New Health System for the 21st Century highlighted the gap
that exists between the quality of health care patients actually receive
and what we know they should receive. The report noted a contributing
factor to this gap is the inefficient and uncoordinated delivery of care
and the need for a “fundamental, sweeping redesign of the entire
health system.” The care delivery redesign called for was centered on
a health care system in a supportive environment that encourages the
development of efficient and high-performing patient-centered teams in
place of individuals practicing in isolated silos.
Today, hospitals across the country are launching the Institute of
Healthcare Improvement-endorsed daily Transition of Care (ToC)
interprofessional team rounds. In FY2017, UAB joined this national
movement by initiating ToC rounds for 27 services throughout UAB
Hospital. These ToC rounds are in varied stages of development; the
primary goal is that every member of a health care team, including the
patient and family members, should understand the plan for that day
and the plan for that hospital stay, including the care transition. This
helps ensure that we are delivering the right care at the right time in the
right place. Early results include reduced length of stay, improved care
transition HCAHPS scores, and trained and empowered staff.
OPIOID CRISIS MANAGEMENT
Future Directions: Addressing Opioid Crisis by Standardizing Pain
Management in Elective Hip and Knee Replacement Patients
The nation’s opioid crisis is very present in Alabama, and the epidemic
is only rising as patients struggle with addiction to prescription pain
medications. UAB Medicine is committed to providing appropriate
pain management to patients during hospitalization and will continue
to seek opportunities to improve in this area in support of optimal
patient care and treatment. One of the UAB Care clinical effectiveness
team’s initiatives currently underway is focused on improving pain
management following elective hip and knee replacement surgery.
Patients undergoing orthopedic procedures often experience difficulty
with post-operative pain management and may suffer from chronic pain
problems before and after hospitalization. To address these challenges,
the UAB Care clinical effectiveness team has engaged with orthopaedic
physician and nursing leaders to implement a multimodal approach to
pain management and to standardize patient pain education across the
care continuum. Among the primary outputs from the project will be
standardized physician order sets, a plan for ambulation post-op day
zero, and a process to identify and uniquely manage higher risk patient
populations.
TRANSITION OF CARE FOR
REDUCTION IN LENGTH OF STAY (LOS)
OBSERVED-TO-EXPECTED MEAN LENGTH OF STAY (LOS)
www.uabmedicine.org
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