Quality & Safety Grand Rounds |
The Department of Quality and Patient Safety has initiated a monthly Quality and Safety Grand Rounds series, to enhance faculty knowledge and skills in Quality-Safety issues.
Last week, Dr. Danielle Scheurer spoke about the 10 Commandments of Quality. View the presentation.
Upcoming Grand Rounds
October 1st from 4-5pm
Guest speaker: Dr. Elizabeth Mack, Medical Director for Quality at Palmetto Health
Dr. Mack will speak about the prevention of central venous line blood stream infections. Please join us! |
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Let us know what you think about Clinical Connections! |
Ordering Blood in CPOE
The interface for ordering blood in CPOE will change effective September 16th. This new interface is easier to read and also includes weight based dosing for pediatrics.
Read more. |
Meet the Medical Director
Dr. Kevin Gray |
Chair, MUSC Credentials Committee
Read Dr. Gray's full interview. |
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Our Value Proposition
(What we are really good at & different in a way that's meaningful)
We transform expertise, learning and discovery into unrivaled patient-centered care in every setting.
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If you have questions or comments, let us know!
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CAUTI - Opportunity for Improvement! |
Dear MUSC Medical Staff,
Last week at the Medical Center Quality Operations Committee (this group oversees and reviews our quality performance), we continue to see an opportunity for improvement in catheter associated urinary tract infections (CAUTI). I have reviewed this in previous issues of Clinical Connections: "Time to Remove Unnecessary Catheters" and "Quality Updates: Infection Prevention and Culture of Safety".
There is a lot of positive energy and activity to improve these rates. We are seeing some improvements, but we are not yet seeing dramatic gains.
Quality Operations Presentation
Recall the reason we need to address this issue:
- Urinary tract infections are the most common nosocomial infection (up to 40% of infections reported by acute care hospitals)
- Overwhelming majority are associated with the presence of an indwelling urinary catheter
- A catheter-associated urinary tract infection (CAUTI) increases hospital cost and is associated with increased morbidity and mortality.
What do you need to do:
Medical Staff (physicians, fellows, residents, medical students, advance practice providers):
- Reexamine the need for an indwelling catheter placed prior to procedures. We are discovering that many catheters are being placed due to habit, rather than clear evidence.
- For patients with indwelling catheters, reevaluate the need daily and remove as soon as possible.
- Do not blindly agree to place a catheter when recommended by the patient's nurse. Rather, clearly discuss the need and alternatives with the patient's nurse before making a final decision.
Nurses:
- Know and follow the MUSC Early Catheter Discontinuation Protocol.
- Know and follow the MUSC Adult Bladder Management Bundle.
- Know and follow the MUSC Catheter Insertion Protocol (COMING SOON).
- Maintain availability of devices, supplies, and techniques that allow alternatives to indwelling catheters (eg, condom catheters, bladder scanners, incontinence products).
Tackling this issue truly requires a dedicated team effort. Let's continue to aggressively work on this together.
Thank you for the great care you provide every day!
Sincerely,
Patrick J. Cawley, MD
Executive Director/CEO, Medical Center
Vice President for Clinical Operations, University
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"Critical Bed Shortage..." Physician Understanding of Patient Discharge Process
Patient flow through MUSC is impacted by numerous factors, and in turn, affects many upstream processes, such as ED and PACU waiting times (boarding times), initiation of therapies, quality metrics, and even patient satisfaction scores. There are some factors outside a physician's direct control; however, physicians have direct influence over many processes.
The Bed Flow Management Committee is charged with identifying barriers to efficient discharges, and setting standard metrics and goals for performance of discharge activities. There is also a committee looking at barriers to timely discharges on the weekends. Information will be presented from these groups in coming months.
Some simple suggestions to facilitate flow through the hospital and hopefully expedite turnaround times for appropriate discharges:
1. Discharge planning should begin on admission.
2. Discharge planning is a multidisciplinary process, involving clinical teams, nursing and ancillary staff, as well as case management; interdisciplinary meetings should serve as the time for the entire care team to share and learn new information pertaining to the discharge plan.
3. Communicate daily with the patient/family and care team the projected length of stay. Let the patient know a range of possible discharge times in order to have a ride ready.
4. Prepare as much of the discharge paperwork, prescriptions, and teaching ahead of time. |
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