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Clin Colon Rectal Surg 2023; 36(04): 265-270
DOI: 10.1055/s-0043-1762926
Review Article

Quality Improvement Initiative Implementation at the Unit or Hospital Level

Alexis Colley
1   Department of Surgery, University of California San Francisco, San Francisco, California
,
Elizabeth Wick
1   Department of Surgery, University of California San Francisco, San Francisco, California
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Abstract

Quality improvement efforts take considerable commitment, including mentorship, training, and resources. Leveraging an established framework, such as that outlined by the American College of Surgeons, to design, implement, and analyze quality improvement projects offers the best chance for success. Herein, we illustrate the application of this framework to a gap in advance care planning for surgical patients. This article helps outline how to go from identifying and outlining a problem, to articulating a clearly defined project goal that is specific, measurable, attainable, relevant, and timebound, and later implementing and analyzing a gap in quality identified at the unit (e.g., service line, inpatient unit, clinic) or hospital level.

Keywords

advance care planning - informatics - resident education - quality improvement


Publication History

Article published online:
22 February 2023

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  • References

  • 1 Institute of Medicine. To Err Is Human: Building a Safer Health System. Washington, DC: The National Academies Press; 2000
    Google Scholar
  • 2 Ko CY, Shah T, Nathens A. et al; American College of Surgeons Quality Programs Advisory Improvement Committee. How well is surgical improvement being conducted? Evaluation of 50 local surgery-related improvement efforts. J Am Coll Surg 2022; 235 (04) 573-580
    CrossrefPubMedGoogle Scholar
  • 3 Ko CY, Shah T, Nelson H, Nathens AB. Developing the American College of Surgeons quality improvement framework to evaluate local surgical improvement efforts. JAMA Surg 2022; 157 (08) 737-739
    CrossrefPubMedGoogle Scholar
  • 4 Sudore RL, Lum HD, You JJ. et al. Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. J Pain Symptom Manage 2017; 53 (05) 821-832.e1
    CrossrefPubMedGoogle Scholar
  • 5 Fineberg HV. Retooling for an aging America. Medscape J Med 2008; 10 (08) 188
    PubMedGoogle Scholar
  • 6 Tang VL, Dillon EC, Yang Y. et al. Advance care planning in older adults with multiple chronic conditions undergoing high-risk surgery. JAMA Surg 2019; 154 (03) 261-264
    CrossrefPubMedGoogle Scholar
  • 7 Colley A, Lin JA, Pierce L, Finlayson E, Sudore RL, Wick E. Missed opportunities and health disparities for advance care planning before elective surgery in older adults. JAMA Surg 2022; 157 (10) e223687
    CrossrefPubMedGoogle Scholar
  • 8 Lin JA, Im CJ, O'Sullivan P, Kirkwood KS, Cook AC. The surgical resident experience in serious illness communication: a qualitative needs assessment with proposed solutions. Am J Surg 2021; 222 (06) 1126-1130
    CrossrefPubMedGoogle Scholar
  • 9 Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. BMJ Qual Saf 2016; 25 (12) 986-992
    CrossrefPubMedGoogle Scholar