Quality improvement (QI) principles are increasingly important in every area of today’s healthcare, encompassing efforts to make healthcare delivery safer, more effective, patient-centered, timely, equitable, and efficient. Perioperative Quality Improvement provides up-to-date, easy-to-read guidance for perioperative clinicians on this critical topic. Each chapter covers a pertinent area of QI in the perioperative setting, focusing on both concepts and implementation. Written and edited by key international opinion leaders in the field, this text is a relevant, concise resource for anesthesiologists, surgeons, nurse anesthetists, and hospitalists—anyone involved in perioperative medicine regardless of specialty area.
Key Features
Explains concepts related to understanding the tools and techniques used in improving the quality of care, establishing a culture of quality, prioritizing areas of improvement, collecting and analyzing data, communicating, motivating people to change, and performing ongoing evaluations. Covers key topics such as patient-centered care, equity, shared decision making, process mapping, and sustainability. Addresses the critical areas of structure, process and outcome with a focus on perioperative care and relevant case studies. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Author Information
Edited by Carol Peden, MD; Lee A. Fleisher, MD, Robert Dunning Dripps Professor and Chair of Anesthesiology and Critical Care Medicine, Professor of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania and Michael Englesbe, MD, Cyrenus G. Darling Sr. & Cyrenus G. Darling Jr. Professor of Surgery, University of Michigan, Ann Arbor, Michigan, USA
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Section 1 Background
1. What is quality in medicine and why do we need to work on it? 2. Where does safety fit in? 3. What is perioperative medicine and why do we need it? 4. The case for improvement in perioperative medicine 5. The Promise and Pitfalls of Big Data Studies in Perioperative Medicine 6. Clinical trials in perioperative medicine 7. Large scale audits: using citizen science to gather high quality “big data 8. Education in perioperative medicine 9. System thinking in perioperative medicine 10. Patient- Centered Care in Perioperative Outcomes 11. Shared decision making 12. Clinical Outcomes and Measures in Perioperative Care 13. Equity and Perioperative Care 14. Qualitative research in perioperative medicine 15. Publication in Perioperative Medicine 16.The SQUIRE 2.0 (Standards for Quality Improvement Reporting Excellence) guidelines: a framework for designing and reporting quality improvement studies; applications in Perioperative Care 17. Leveraging the Perioperative Period to Address Population Health 18. Building for sustainability 19. Risk Management and Perioperative Quality 20. Using innovative payment models to drive improvement in perioperative care
Section 2 Improvement Science Tools for Change
21. What is programme theory and why is it important to perioperative quality improvement? 22. An Overview of Common Improvement Methodologies and their Background 23. The Model for Improvement: A tool to drive perioperative improvement 24. Lean in Healthcare 25. Other Performance Improvement Tools: From Compliance to Excellence 26. Building a Measurement System that Works: Milestones, Measure Development and Sampling. 27. Analyzing Variation with Run Charts 28. Statistical Process Control Charts for Clinical Users 29. Process mapping 30. Driver diagrams 31. Care bundles for Perioperative Improvement 32. Human Factors in Peri-Operative Care: General Principles 33. Human Factors and Perioperative Improvement: Handover checklists and protocols for safe and reliable care transitions 34. Checklists for Safer Perioperative Care 35. Social aspects of change in perioperative care and the importance of context 36. Stakeholder engagement 37. Techniques for Creating Urgency 38. Leadership in Perioperative Quality 39. Establishing and running quality collaboratives: the Michigan experience 40. Excellent Perioperative Patient Experience 41. An International Perspective on Training and Setting?Standards in Perioperative Medicine
Section 3 Putting It All Together – Clinical Quality Improvement Examples
42. Implementation of enhanced recovery for colorectal surgery: a real world example of quality improvement 43. Quality Improvement through the lens of the Multicenter Perioperative Outcomes Group 44. The Michigan Urological Surgery Improvement Collaborative (MUSIC) Reducing Operative Complications from Kidney Stones (ROCKS) quality initiative 45. ERAS protocols 46. Pain Care Pathways and Patient Reported Outcomes 47. Health Services Research 48. The Perioperative Brain Health Initiative 49. Quality Improvement in Emergency Surgery: learning from two large scale programmes to reduce mortality after emergency laparotomy 50. Perioperative Quality Improvement Programme (PQIP) 51. Using Real-World Data for Improvement – The Seattle Children’s Example 52. Optimizing Perioperative Medicine Value, and the High Value Practice Academic Alliance: A Case Based Study on Preoperative Assessment 53. Perioperative Medicine for Older People: translating a geriatrician-led perioperative care model from an inner-London teaching hospital to a district general hospital 54. Clinical Quality Improvement Examples: Agency for Healthcare Research and Quality Improving Surgical Care and Recovery 55. Cardiovascular Disease: Preoperative Testing and Evaluation for Non-Cardiac Surgery 56. Orthopedics and regional anesthesia: an outpatient total shoulder replacement pathway 57. A Case Study: National Emergency Laparotomy Audit 58. Provider resilience and care for the carer 59. Nursing and perioperative quality improvement 60. Certified Registered Nurse Anesthetists and Perioperative Medicine 61. Environmental Sustainability and Perioperative Quality Improvement 62. Gaining and Keeping C-Suite Support for Perioperative Quality Improvement Initiatives
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