Becker's Hospital Review

64 CMO / CARE DELIVERY NYU Langone Health adopts tactic from Amazon, Google for quality improvement By Anuja Vaidya N YU Langone Health in New York City successfully used randomized quality improvement projects to evaluate the effectiveness of routine patient care processes. e team that implemented the projects re- ported their findings in e New England Journal of Medicine. Companies in the private sector, such as Google and Amazon, oen use randomized continuous quality improvement methods in their workflow; however, it is not yet com- mon in the healthcare sector. At NYU Langone, randomized quality improvement projects were implemented across inpatient units, outpatient offices and the emergency department, focus- ing on improving care after hospital stays and capturing patient-reported outcomes, among other aims. e randomized quality improvement proj- ects tested many processes, allowing NYU Langone to make tweaks as needed. For ex- ample, one of the projects tested the effective- ness of post-discharge phone calls to patients. It showed that the phone calls were ineffective because patients who received the calls came back to the hospital at the same rate as those who didn't get the calls. e findings allowed the team to explore oth- er options for more effective post-discharge follow-up, such as changing the call script or only calling high-risk patients. e randomized quality improvement proj- ects were designed to be easy to implement, said Leora Horwitz, MD, an associate profes- sor at NYU Langone's departments of pop- ulation health and medicine, director of the Center for Healthcare Innovation and Deliv- ery Science and leader of the projects. ey did not require specialized tools or databases. "I believe we have an ethical responsibility to rigorously assess whether our operational in- terventions are effective, even when they may seem trivial, such as scripts for calls or mail- ings that we send to people to get them to get their colonoscopy," Dr. Horwitz said. "If we don't, we can't be sure we are doing the best by our patients." n UNC Children's can resume complex heart surgeries, independent panel says By Mackenzie Bean A n independent advisory board has ruled that Chapel Hill, N.C.-based UNC Children's Hospital can resume complex heart surgeries after a three-month pause, re- ported The News & Observer. The hospital temporarily suspended complex surgeries June 17 amid an investigation into the safety of its heart surgery program, which The New York Times highlighted in a 7,000- word investigative report in late May. That same month, UNC's board of directors hired an inde- pendent advisory board to review the cardiac surgery pro- gram and suggest improvements as necessary. The board visited the hospital Aug. 22 and issued a five-page re- port Sept. 11. "Significant investment and progress have been made, in- cluding new leadership, as well as additional faculty and support staff within the pediatric heart surgical program, and surgical outcomes have improved over the last year," the ad- visory board wrote in the report. State health officials and The Joint Commission also reviewed the program and found it in compliance with all regulations in August. n 1 in 6 physicians make diagnostic errors everyday By Gabrielle Masson O ne in six physicians report making diagnostic errors daily, according to a Medscape poll. Medscape surveyed 633 physician and 118 nurse practitioners/physician assistant for the poll, which was posted June 26. Four survey findings: 1. Responses varied by specialty, with pediatricians less likely to say they made diagnostic errors (11 percent) than physicians in internal medicine (15 percent), fami- ly medicine (18 percent), general practice (22 percent) and emergency medicine (26 percent). 2. Seventeen percent of nurses, advanced practice registered nurses and PAs said they made diagnostic errors daily. 3. Compared to physicians, NPs/PAs were more likely to report daily diagnostic uncertainty, Medscape said. Sixty-four percent of NPs/PAs estimated feeling diag- nostically uncertain everyday, while only 52 percent of physicians reported the same. 4. Among all clinicians, the three most common rea- sons for making diagnostic errors were "lack of feed- back on diagnostic accuracy," followed by "time con- straints" and "a culture that discourages disclosure or errors," reported Medscape. n

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