Publications

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Nov 13, 2024

Clinical pathways translate best evidence into the local context through a structured multidisciplinary care plan. However, little is known about clinical pathway programs especially in pediatric settings. This study sought to determine the prevalence of clinical pathway programs in pediatric hospitals and describe similarities and differences. The team, led by IHQSE graduate, Dr. Leigh Anne Bakel, surveyed 81 of 111 Pediatric Research in Inpatient Settings (PRIS) network hospitals regarding the existence of a clinical pathway program, number, type, creation or revision of clinical pathways as well as other pathway program characteristics. More than half of respondents confirmed that clinical pathways were in place; however, nearly half of those programs were hindered by limited funding and an inability to measure pathway outcomes or improvements in care.

Nov 7, 2024

After observing a low but consistent rate of incorrect surgical line placement for pediatric cancer patients, IHQSE graduate Dr. Jonathan Roach and team implemented a new multi-factorial process to schedule and place surgical central lines. The intervention reduced the rate of incorrect line placement and near miss events to zero! IHQSE Faculty Dr. Tyler Anstett and Dr. Michael Tchou are coauthors of this publication in the Journal of the American College of Surgeons.

Oct 31, 2024

One of the greatest challenges in acute care is the ability to hire and retain nurses. With high turnover and a limited candidate pool, how do you build a highly reliable organization with fewer nurses? This advanced care setting calls for Bachelor-level nurses, but those can be hard to come by, and contract labor is expensive and unsustainable in the long term. IHQSE graduate, Stephanie Elston, MSN, and her team have built a model that optimizes support to the front-line staff, helping to relieve the disproportionate reliance on RNs.

Oct 23, 2024

Using patient-reported outcome measures to guide clinical care is associated with improved outcomes and widely regarded as a best practice in mental health. However, many systems have struggled to routinely adopt the practice. In an article in Psychiatric Services, IHQSE faculty, alumni, and members of the University of Colorado Department of Psychiatry describe how they used technology to address major barriers to using this best practice in their design and implementation of the Measurement-Assisted Care (MAC) program. In MAC, patient-reported outcome measures are automatically attached to patient eCheck-in and clinician documentation templates nudge clinicians to view and discuss the responses during visits. MAC increased the availability of patient-reported outcome measures from 5% to 60%+ of patient visits with more than 90% of clinicians reporting the information was useful.

Oct 14, 2024

In-basket burden is frequently cited as a contributor to burnout. In a research letter published in JAMA Network Open, IHQSE graduate, Dr. Eden English, discusses her recent study of the use of large language models (LLMs) for drafting replies to patient messages within a large health system.

Oct 2, 2024

Secure messaging (SM) is becoming a common way for hospitalists to communicate, but most existing literature focuses on usage patterns and implementation science, without clear understanding of the benefits and challenges users may be encountering. IHQSE Faculty Michelle Knees, DO and team led a mixed methods study involving surveys and focus groups with hospitalists from 24 academic institutions, finding that, while SM enhances communication efficiency, it also increases multitasking, cognitive load, and alters interpersonal dynamics. The study underscores the need for clear institutional guidelines for SM use and emphasizes the importance of collaborating with frontline workers to improve communication practices.

Oct 1, 2024

IHQSE graduate Dr. Daniel Lam is lead author on this publication in Pediatric Quality & Safety which discusses the implementation and outcomes of a fast-track pathway called "Supertrack" in a pediatric emergency department. Fast-track models decrease patient crowding in emergency departments (EDs) by redirecting low-acuity patients to an expedited care pathway. This intervention resulted in improved flow of "Supertrack" patients in addition to decreased length of stays and increased timely discharges.

Aug 14, 2024

Electronic Health Records (EHR) have become integral to quality care delivery in many specialties. In spite of the usefulness of the these tools, surgeons have been reluctant to incorporate EHR into their toolbox. IHQSE Faculty, Sarah Tevis, MD, is corresponding author of a viewpoint article published by JAMA Surgery that calls for surgeons to engage in electronic health record innovation to improve patient and clinician experience.

Aug 1, 2024

A recent editorial penned by Madeline Higgins, MD and IHQSE director Jeff Glasheen, MD and IHQSE faculty member Sarah Tevis, MD explores the challenges with current patient safety data. Despite advances in medical care, patient safety remains a critical area of focus within healthcare given that many patients continue to experience harm. While patient safety has gradually improved over time, progress is limited by outdated data models that prevent measurement of the true burden of harm, and therefore reduces our ability to understand ongoing drivers and develop innovative solutions to improving patient safety. The authors call for a change in how we measure and track data related to patient safety.

Jun 27, 2024

IHQSE faculty member Dr. Sandra Spencer and a team quality improvement experts at Children’s Hospital Colorado developed a novel fast-track model, typically seen in emergency departments, and implemented it in urgent care. The initiative resulted in a 74% reduction in door-to-provider time and 36% reduction in urgent care length of stay. The fast-track process also continued to function and reduce door-to-provider and urgent care length of stay times during a large volume surge. Improvements in these metrics for higher acuity patients in the co-located emergency department were also observed. The results of this QI project suggest that a FT model can improve efficiency in an appropriately selected UC setting.