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Tags : Antibiotic timing   pneumonia   appointment non-adherence  more

Tags : Antibiotic timing   pneumonia   appointment non-adherence   tracking abnormal lab results  less

Reference : Schmitt, BP, Hoffstadter,LK et al: Using patient traffic control to reduce treatment delays for hig    more

Reference : Schmitt, BP, Hoffstadter,LK et al: Using patient traffic control to reduce treatment delays for high risk patients at a VA hospital. Jt Comm J Qual Patient Saf. 2008; 34:147-153 Schmitt, BP, Hoffstadter,LK et al: "Sustainability and Generalizability of Patient Traffic Control to Time-Sensitive Performance Problems." Implementing and Sustaining Improvement in Health Care. Joint Commission Resources; 2009; 203-17    less

Abstract : Background: For patients at high risk of function-limiting or life-limiting disease the time elapse    more

Abstract : Background: For patients at high risk of function-limiting or life-limiting disease the time elapsed between first clinical presentation, diagnosis, and treatment can influence the likelihood of treatment success. Methods: A systematic change in the management of high-risk patients was developed similar to the approach used in air traffic control. Outpatients identified with a high risk concern were actively monitored daily (nurse or PI specialist) for successful progression through the health care system. Those failing to make appointments or complete tests were identified and contacted. Apppointments were promptly re-scheduled and their monitoring continued until the high risk diagnosis was excluded or treatment was initiated. Subsequently, the approach was applied to the inpatient setting to a different time sensitive issue: time to first dose of antibiotic in patients admitted with community acquired pneumonia. Results: In the outpatient setting most patients identified as being high risk had xray or lab abnormalities that raised the posibility of a malignancy. In this group of patients > 60% had the high risk diagnosis excluded or treatment initiated within 60 days of presentation. No patient was passively lost to follow-up. In the inpatient setting all patients with community acquired pneumonia were tracked from the time of hospital admission. The % of patients receiving the first dose of antibiotic increased from 64% to 82% from before to after implmentation (p < 0.05). Conclusion: Patient traffic control enabled the management of the majority of high risk patients within 60 days of presentation and reduced the delay in receipt of antibiotics in patients admitted with pneumonia- Slides    less