|
West Virginia
Success
Stories: WEST VIRGINIA
|
- The West Virginia
Medical Institute (WVMI), West Virginia ’s QIO, received
a $1.8 million matching implementation grant from the Agency for Healthcare Research
and Quality (AHRQ) to expand the West Virginia Patient Safety Project. The project
allows rural West Virginia hospitals to input medical errors and “near
misses” using a Web-based tool. WVMI’s “Partnering To Improve
Patient Safety” project is a collaboration with Quantros, Verizon, the
West Virginia State Office of Rural Health, the West Virginia State Hospital
Association, and about 75% of West Virginia ’s hospitals. More than 17,000
events have been logged; improvement has been reported in all participating hospitals.
- After working
in 2003 with West Virginia Medical Institute, the state’s
QIO, Cameron Continuous Care Center, a 60-bed rural facility in
West Virginia, reduced the percentage of residents with chronic
pain from 14% in the third quarter of 2003 to 7% in the first quarter
of 2005.
- Through
in-services and consultation with the state QIO, West Virginia Medical
Institute, Elkins Regional Convalescent Center in 2003 developed
a pain-management committee that established new systems to address
pain among patients. The center lowered the percentage of residents
with chronic pain to 1%, a figure that is below both the state and
national average.
- West Virginia
Medical Institute, the state QIO, provided support in 2003 and
2004 to the Charleston Area Medical Center to help reduce surgical
infection rates. The hospital increased from 62% to 85% the proportion
of patients with prophylactic antibiotics discontinued 24 hours after
surgery, and increased from 91% to 97% the proportion of patients receiving
prophylactic antibiotics one hour before surgical incision.
- Home health
agency improves patient self-medication skills: Working with the West
Virginia Medical Institute (WVMI), the state’s QIO, Nicholas-Webster
Home Health in Summersville, WV improved the percentage of patients
who get better at taking their medicines correctly from 22 to 35 percent
in one quarter. After training and onsite consultation from WVMI, the
agency’s administration began offering weekly in-service sessions
to update staff clinical skills; developed flow sheets; and studied
data in detail to ensure proper coding for medication administration.
The nurse director at Nicholas-Webster serves as a project champion
and ensures that the entire staff can continue to attend WVMI’s
statewide learning seminars. “WVMI’s seminars are excellent,” Cheryl
Amick, the agency’s nurse director said. “My goal is not
only for our county to improve but also our entire state.”
- Good Shepherd
Nursing Home L.C., a 192-bed facility in Wheeling, reduced the percentage
of residents who suffer from chronic pain to less than 2%--compared
to the state average of 8% and the national average of 7%--by implementing
procedures to assess and track residents’ pain throughout their
stay. The approach looked at pain as the fifth vital sign, along with
blood pressure, pulse, respiration and temperature. Staff now checks
daily for pain when vital signs are taken and also perform a weekly
assessment of residents on a pain management program. A more comprehensive
care-planning assessment is performed at least quarterly.
- Elkins Regional
Convalescent Centerreduced the percentage of residents who have chronic
pain to 2%. Through in-services and consultation with WVMI, Elkins
Regional developed a pain-management committee that put new assessment
and documentation tools into place. The new tools helped to decrease
the percentage of residents experiencing chronic pain from 10% to 2%.
At Elkins Regional, the percentage of residents who have moderate to
severe pain is 1%, compared to the state and national average of 6%.
- Cameron Continuous
Care Center, a 60-bed rural facility, reduced the percentage of residents
who have chronic pain from 14% in the third quarter of 2003 to 8% mid-2004.
With WVMI providing resources and guidance, the center’s interdisciplinary
team took a fresh look at how it assesses residents’ pain: reviewing
patient charts to make sure the appropriate pain-management medications
were being used; exploring approaches other than medication to relieve
pain, such as repositioning the patient; working with residents to
determine if behaviors, such as combativeness, were the result of pain;
and learning to identify the signs and symptoms of pain such as restlessness,
grimacing and crying. Staff learned to accept residents’ perception
of pain and to treat it appropriately. The facility’s physician
helped to improve treatment of breakthrough pain, pain experienced
despite taking around-the-clock medication to alleviate it. In addition,
Cameron Continuous Care began using a patient-controlled analgesic
pump with morphine to improve comfort at the end of life after trying
other options, such as alternative pain medications and approaches
other than medication.
- West Virginia
NH reduces use of physical restraints by 44%: Working with the West
Virginia Medical Institute (WVMI), the state QIO, a 105-bed skilled
nursing home reduced by almost half the percentage of residents who
were physically restrained. Worthington Manor in Parkersburg, WV, attended
educational seminars sponsored by WVMI, which addressed how the use
of physical restraints can lead to problems such as pressure ulcers,
emotional distress and loss of ability to walk. Worthington Manor subsequently
developed a restraint committee to discuss the use of physical restraints
and to check newly admitted residents to make sure the least restrictive
devices, such as alarms, are being used. As a result, Worthington Manor
is exploring alternative methods to keep patients safe. Since December
2003, Worthington Manor has reduced the percent of residents who were
physically restrained by 44 % and is 90% free of restraints.
|
|
