Teachers of Quality Academy 1.0

January 2014 – May 2015 – REACH Project Team: Dr. Libby Baxley – Principal Investigator, Jenna Garris – Project Director, Dr. Herb Garrison – Co-Investigator, Dr. Jason Higginson – TQA Leader, Dr. Donna Lake – LINC Scholars Leader, Dr. Luan Lawson – Co-Principal Investigator, Dr. Suzanne Lazorick – Co-Investigator and Evaluator, and Dr. Danielle Walsh – TQA Leader

TQA 1.0 Clinical Improvement Projects

TQA FellowDepartmentProject Topic
Gail AllenEmergency MedicineBy December 2014, reduce radiation exposure among pediatric patients at the Emergency Department with appendicitis by changing the radiographic order practice.
Niti ArmisteadInternal MedicineBy December 2014, decrease incidence of hypoglycemia (blood sugar <50) in patients admitted to 2South ECU General Internal Medicine service by 10% through improvements in order sets.
Toni JohnsonPsychiatryBy December 2014, increase rates of communication by 50% within first 72-hours between the discharging resident on the inpatient psychiatric unit, the receiving provider at the ECU Psychiatric Medicine clinic and the patient at-risk for suicide.
Bryan KitchEmergency MedicineWithin 3 months of implementation, achieve an adoption rate of 80% or higher for a new medication reconciliation system for boarding ED patients.
Erwin ManaloPhysical Medicine and RehabBy December 2014, decrease patient days in restraints each month by 20% in confused traumatic brain injury survivors through a time toileting protocol.
By October 2014, decrease monthly frequency/incidence of falls in agitated TBI patients by 25% through use of “hands-on” sitters.
Hellen RansomBioethicsBy August 2014, increase the presence of Bioethics at VMC by defining what constitutes rounding and how often they should occur, with the goal to begin rounding in three new areas of VMC.
Pam ReisNursingBy December 2014, increase the number of pregnant women age 18-24 who choose LARC as a method of birth control by 36-38 weeks gestation by 50% over baseline measures.
Megan SippeySurgeryDecrease the number of diagnostics tests in the Surgical Oncology inpatient population by 10% within six months without compromising clinical outcomes.
Coral SteffeyPediatricsBy December 2014, increase satisfaction with clinical services provided by ECU Pediatric Outpatient Clinic among Spanish-speaking patients and families by 20% as measured by survey.
Beatrice ZepedaPediatricsBy December 2014, improve patient handoff procedure among OR and PICU staff using a rolling call in the patient’s room to decrease delays in administration of medications.

Efficiency Projects

TQA FellowDepartmentProject Topic for
William DossPhysical Medicine & RehabComplete the Sleep Apnea Screening on 50% of GR1 patients and 100% of stroke patients by August 2014.
Improve the competence of day staff in administration of APNEIC screening tools and STOP BANG questionnaires by 50% by August 2014.
David EldridgePediatricsIncrease the monthly reporting rate of patient safety events in the electronic reporting system (Safety Intelligence) by 50% within one year.
Tim FitzgeraldSurgeryBy December 2014, reduce cost of care by 10% and length of stay by two days by implementing ERAs for patients with pancreatic resection.
Jason FoltzFamily MedicineBy December 2014, reduce the no show rate on the ECU Family Medicine Buccaneer module from 26% to 10%.
Libby HarrisRadiation OncologyImplement breast cancer radiation order sets in 100% of treated patients for one month at LJCC and in one community based practice.
Caroline HoustonInternal Medicine/ EndocrinologyBy December 2014, reduce the no show rate in the ECU Endo Clinic by 5% by switching to a person-to-person reminder call one week prior to appointment.
Nadyah JohnPsychiatryDecrease no show rates for follow up visits in the ECU Psychiatry CAP Outpatient clinic to less than 20% by December 2014.
Ari MwachofiPublic HealthBy September 2014, increase the number of Medicaid and self-pay infant and postpartum referrals using the LEAN improvement model to facilitate necessary home visits for infant post-partum assessments for those at risk.
Raj NekkantiCardiologyBy December 2014, decrease inappropriate use of transesophageal echo as part of the work up for infectious endocarditis at ECHI and VMC by developing a revised protocol for referrals.
Keith NelsonOB-GYNBy January 2015, decrease the number of patients who consent to sterilization but do not have the procedure don
Balaji PabbuFamily MedicineDecrease preventable readmission among geriatric patients by 50% over one year by improving the efficiency of transition of care by 50% in the next six months.
Tim Reeder/ Vontrelle RoundtreeEmergency MedicineImprove the use of standing extremity x-rays in the Children’s ED by 50% in two months (August 2014?).
Tom RossHealth Services/ Info ManagementIncrease use of EPIC’s Health Maintenance features among Family Medicine physicians to 90% within one year.
Coral SteffeyPediatricsBy December 2014, decrease the average time between patient check in and initial provider contact at the ECU Pediatric Outpatient Clinic for Spanish-speaking patients so that it is equal to the average time for non-Spanish speaking patients.

Educational Projects

TQA FellowDepartmentProject Topic
Harry AdamsInternal Medicine/ Infectious DiseaseBy December 2014, conduct a pilot study to integrate Pathologic and Pharmacologic learning materials into one small group discussion in the Intro to Medicine course for M2 students.
Lou Ann BaldreeCollege of NursingIncrease the knowledge of first semester nursing students about premedical education requirements, curriculum and medical student life as measured by pre and post medical school exposure questionnaires.
Increase the knowledge of M1 students about pre-nursing education requirements, curriculum and nursing student life as measured by pre and post nursing school exposure questionnaires.
Linda BolinCollege of NursingTo improve medical and nursing student collaboration and communication by 50% through use of a simulated clinical experience and a pre and post-questionnaire survey over a 14 week period (ECU Academic Calendar - Fall Semester 2014), beginning in August and ending in December 2014.
Michael KennedyHealth Services/ Info ManagementBy August 2014, achieve recruitment targets for graduating seniors and past program graduates to participate in LinkedIn.
By December 2014, improve response rate to departmental alumni surveys to 40%.
Gina WoodyCollege of NursingImprove communication and demonstrate an understanding of professional role/scope of practice among nursing and medical students through a shared learning environment using SBAR.