Nursing Role

Comprehensive Program Featuring Registry, Self-Management Education, Action Plans, and Home Visits Reduces Asthma-Related Admissions and Emergency Department Visits

CHS Teal The University of Michigan Health System implemented a comprehensive asthma management program that includes the following elements:

  • a registry of all patients with asthma,
  • standardized patient education and self-management asthma action plans,
  • periodic home visits from nurses, and
  • specialized programs for children with asthma who are at high risk for emergency department visits or hospitalizations.

Overseen by a multidisciplinary committee, this program allows the health system to develop innovative interventions tailored to the unique needs of individual patients with asthma. The initiative has led to more patients having self-management plans, fewer asthma-related hospitalizations (both overall and among children), and fewer emergency department visits among children with asthma.

Read the full innovation profile at the AHRQ Health Care Innovations Exchange...

in Chronic Care, Compliance and Self Management, Healthcare Guidelines, Leading Change, Nursing Role, Patient Centered Medical Home, Quality Improvement |

AHRQ Report Looks at Medical Teamwork and Patient Safety

This 2005 report, commissioned by the Agency for Healthcare Research and Quality (AHRQ), assesses the status of relevant team training research from aviation and other domains and applies this research to the field of medicine. It additionally provides a comprehensive review and evaluation of current medical team training initiatives and their effectiveness.

Key Conclusions

1. The science of team performance and training can help the medical community improve patient safety. A general science of team performance and training has evolved and matured over the last 20 years. This science has produced a number of principles, lessons learned, tools, and guidelines that will serve the patient safety movement.

2. Research has already identified many of the competencies that are necessary for effective teamwork in medical environments. The science of team performance and training has identified the competencies that are required for effective team functioning in a number of complex settings. Many, if not most, of these competencies apply to the medical community.

3. A number of proven instructional strategies are available for promoting effective teamwork. The science of team performance and training has also developed and validated numerous training strategies that can provide requisite competencies to teams who perform in complex environments. These strategies extend beyond CRM training and could easily be adapted to health care.

4. The medical community has made considerable progress in designing and implementing team training across a number of settings. Our review of existing medical team training programs clearly shows that the health care community is striving to implement CRM training across a number of medical domains. We recommend that this trend be continued. However, the extent to which these programs are being implemented with the help of what we know from the science of learning, of team performance and of training is less clear. Thus, we recommend strengthening the link between scientific knowledge and medical-team training.

5. The institutionalization of medical-team training across different medical settings has not been addressed. To make teamwork a common, effective practice throughout the delivery of health care, there is an imperative need to embed team training in professional development. By "embedding" we mean implementing and regulating team training throughout a health care provider's career.

 

To learn more click on any of the links below to go to AHRQ.gov:

Medical Teamwork and Patient Safety: The Evidence based Relation (full report) 

Abstract and Summary

Primary teamwork competencies (Table)

Individual and Team-level Training Strategies (Table)

in Leading Change, Nursing Role, Quality Improvement |

Physician Insights on Barriers to Care for Diabetes Patients

A new study by J.C.Crosson, et.al. and published in the Journal of the American Board of Family Medicine reports on physicians' perspectives of barriers to care for diabetic patients with CVD risks.  The barriers range from health system obstacles to socioeconomic obstacles to lack of patient motivation.  While physicians have a role in addressing some of these barriers, many barriers are beyond the ability of the physician to address.  There is clearly a need for more comprehensive approaches involving a range of professionals collaborating for quality improvement. 

Read the full study online here...

 

 

in Chronic Care, Compliance and Self Management, Health Information Technology, Healthcare Guidelines, Nursing Role, Patient Centered Medical Home, Quality Improvement, Safety Net Health Care |

Video Series Describes Evidence-Based Health Coaching and Motivational Interviewing

Produced by Health Sciences Institute (HSI), this series of videos offers an introduction to Motivational Interviewing and evidence-based health coaching. In the videos Susan Butterworth, Ph.D. Associate Professor, Schools of Nursing & Medicine,Oregon Health Sciences University and HSI Advisory Board Member defines and describes Motivational Interviewing techniques and their application in the clinical setting.

This series may be of benefit to organizations considering using  'health coaches' on their PCMH, disease management, or chronic care improvement inter-disciplinary teams.

Video topics include:

  • Applying Motivational Interviewing in Health Care (4.5 min)
  • What is Motivational Interviewing (4.0 min)
  • Patient Centered Care or 'Worst Case Scenario' (7.0 min)
  • How can organizations Build  Evidence-Based Health Coaching Teams? (3.5 min)
  • What are the Guiding Principle of Motivational Interviewing? (5.0 min)
  • What is the 'Best Case Scenario' for Patient Centered Care? (5.0 min)

Click here to go to the HSI website to view these videos

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in Chronic Care, Compliance and Self Management, Healthcare Guidelines, Nursing Role, Patient Centered Medical Home, Safety Net Health Care, Video Library |

Nurse practitioner-led multidisciplinary teams to improve chronic illness care

J Am Acad Nurse Pract.2009 Mar;21(3):167-72. Watts SA, Gee J, O'Day ME, Schaub K, Lawrence R, Aron D, Kirsh S. Diabetes Clinic, Department of Endocrinology, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio 44106, USA. sharon.watts@va.gov

 

This article shines light on the distinctive role of nurse practitioners as leaders of team approaches to chronic care improvement. The authors conclude that with the increasing numbers of patients with chronic illnesses, healthcare systems are increasingly challenged to provide necessary care and empower patients to participate in that care. NPs can play a key role in helping to meet these challenges.

Click here to read the PubMed Abstract

in Chronic Care, Leading Change, Nursing Role |

Team effectiveness and organizational context in the implementation of a clinical innovation.

Qual Manag Health Care.2009 Jan-Mar;18(1):25-39.Lukas CV, Mohr DC, Meterko M.Department of Veterans Affairs, Boston University School of Public Health, Boston, Massachusetts, USA. carol.vandeusenlukas@va.gov

 

This article explores the critical role of teamwork in implementing successful quality improvement initiatives. Findings support the underlying theory that implementation of clinical innovations depends on both individual staff and a more complex dynamic of individuals operating within work units in the larger organization.

Click here to read the PubMed Abstract

in Chronic Care, Leading Change, Nursing Role, Quality Improvement |

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