The culture of patient safety, quality, and transparency is central to improving care delivery at the organization and industry level. Implementing a sustainable frontline solution like quality checklists will require new leadership, innovative thinking, applications of human factor engineering, and patient voices who demand better. We need to reward staff engagement and quality patient safety efforts which can translate into better patient outcomes. CCG, PSO developed a Clinical Audit Checklist program that can support a culture of transparency and accountability, thereby reducing healthcare costs and delivering positive patient outcomes. Together, we can make continuous daily improvement a standard practice at the hospital and system level. Patients are counting on us to make care delivery safer today for a better patient experience tomorrow.

1. Engage Frontline
Staff using Clinical
Audit Checklists to
Improve Patient
Background and Context of the Problem
Standardized
Work is:
"The current
one BEST way
to safely
complete an
activity with
the proper
outcome, and
the highest
quality, using
the fewest
possible
resources".
Graban M (2012)
Lean Hospitals
Dr. Atul Gawande, in his recent TED talk, "How do we Heal Medicine", described
talk,
how the science of medicine, has made great discoveries in the last 60 year The
years.
future challenge for the healthcare industry is this how do we deliver "new
advances in medicine" to the general public, with the right technology, price,
quality, and sim
simplicity that we can all afford?
"Better care" means - engaged patients, providers and organizations that support
the quality mission in a learning organization. Overcoming this challenge will
require new skills, new technology, and novel ways of care delivery that
ca
incorporates real time information from routine patient care, disseminates this
real-time
critical patient data using electronic methods and e tools to help analyze and
e-tools
trend key metrics to improve care at the micro and macro levels.
The continuous pursuit of quality improvement (QI), in many industries, has
us
proven to lower costs, customizable product offerings, better customer service
and improved satisfaction. Succes
Successful companies have achieved improved
outcomes and lowered costs by engaging their staff, leading by example, being
their
example
transparent in actions, with a priority focus on quality and safety.
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2. Obstacles to Quality Improvement in Healthcare
Patient safety, rising costs, healthcare outcomes, targeted mea
measures, and
improvement efforts, are often "talked" about and "debated" in government,
If we always
DO what we’ve
academia, and senior leadership circles.
Even healthcare workers on the
re
frontline agree T
THEY NEED quality improvement . However, many times
these efforts fall short and don't operate as planned due to conflicting needs
always DONE,
and expectations. Common obstacles to the QI process are often derived by
We will GET,
the hospital's own Staff and Management - making the QI system almost
what we’ve
impossible to work properly to improve pa
ble
patient care. Typical thinking often
thinki
always GOT.
includes....
~ Adam
 Staff can do QI in their spare time
Urbanski
 It's not my job, it's someone else's
s
 Lean Six Sigma are good strategies, but take too long
 We don't have time. We're too busy with patient care
 We have so many metrics, it's hard to track them all
What Would Happen if we don’t Invest in QI?
Medical errors and unintentional deaths would continue to rise and plague our burdened health
system. New patient safety data just released refutes the legendary IOM report (To Err is Human)
a
that revealed startling news how medical errors caused over 100 thousand patient deaths each year.
The new report in the Journal of Patient Safety (Sept 2013), new estimates that medical harm is three
hat
times higher than previously thought, and estimated are closer to 400 thousand deaths per year. It's
han
over 10 years now since the regulatory and organizational focus on quality, however, two key
e
questions remain: Have we made a difference in front
front-line care delivery? And, have we improved the
ave
quality and safety of care for our patients and families? And the unfortunate answer is NO..not
enough.
Clinical Checklist Solution
Our current healthcare system is undergoing unprecedented change. It feels more like a "Super
ealthcare
Storm Sandy" or massive hurricane on a daily basis Patients, providers and policy leaders are
basis.
attempting to re-design care delivery, expand services, improve patient safety, and reduce errors. At
design
the same time, healthcare costs are escala
escalating, regulatory mandates
are expanding with little
improvement in patient safety at the bedside. So, the million dollar question remains.. how DOES a
hospital reduce costs, improve quality that produces positive patient outcomes, and saves lives?
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© Copyright iCareQuality Inc. 2013 www.iCareQuality.org

3. Clinical Audit Checklists can be the answer! It's that simple. Checklists are a quick and easy tool to
conduct quality improvement projects on the frontlin Checklists are visual, practical, and concise.
ment
frontline.
Checklists standardized our actions and help us cook a meal or land a plane. According to AHRQ, "a
tions
checklist is an algorithmic listing of actions to be performed in a given clinical setting, the goal being
to ensure that no step will be forgotten. Although a seemingly simple intervention, checklists have a
intervention,
sound theoretical basis in principles of human factors engineering and have played a major role in
some of the most significant successes achieved in patient safety."
ficant
Best Practice checklists are a simple, cost
cost-effective solution that can be used by front-line providers to
front
measure staff compliance to best practice standards in the industry In other words.. use clinical
iance
industry.
us
checklists to MEASURE ONGOING QUALITY IMPROVEMENT EFFORTS.
MENT
It's great method to
implement a quality safety program. But the challenge is... how to sustain it!! Now that's the real
challenge! Clinical Audit Checklists are the answer to Continuous Daily Improvement (CDI) where
Daily
quality and patient centeredness become the norm.
CloseCareGap, Patient Safety Organization
tient
For the past five years, our iCareQuality team has worked on a process improvement and quality
patient safety for front-line clinicians. Our goal is to collaborate with our quality partners on key
line
healthcare
initiatives
to
improve
improve
patient
safety
at
the
regional
and
national
level.
CloseCareGap(CCG) is a new Patient Safety Organization (PSO) in Springfield, PA. In 2013, CCG, PSO
was officially listed by the U.S. Department of Health and Human Services as a federal designated
federally
Patient Safety Organization under the Patient Safety and Quality Improvement Act of 2005.
CCG,PSO has developed a sustainable, automated Clinical Checklist program based on the 2013
National Quality Strategies. We've adopted the Triple Aim and HRET - Partnership for Patients
campaign to help improve quality, safety and affordability of health care. Our ePlatform gives
frontline providers automated checklists and smart tools to help measure best practice, standardize
care processes, reduce variations, and ultimately improve care delivery and patient outcomes. The
ations,
basic quality toolkit is FREE and can be used in any healthcare care setting to improve high risk
conditions such as Falls, Hand-off, CLABSI, CAUTI, Pressure Ulcers, VAP, Surgical Site Infections,
off,
and much more.
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© Copyright iCareQuality Inc. 2013 www.iCareQuality.org

4. Conclusion
The culture of patient safety, quality, and transparency is central to improving care delivery at the
organization and industry level. Implemen
Implementing a sustainable frontline solution like quality checklists
will require new leadership, innovative thinking, applications of human factor engineering, and
patient voices who demand better. We need to reward staff engagement and quality patient safety
efforts which can translate into better patient outcomes. Our PSO, Clinical Audit Checklist program
inical
C
can support a culture of transparency and accountability thereby reducing healthcare costs and
ulture
accountability,
delivering positive patient outcomes. Together, we can make continuous daily improvement a
standard practice at the hospital and system level. Patients are counting on us to make care delivery
ounting
safer today for a better patient experience tomorrow.
If you would like to learn more about how your organization can join our team, or becoming a beta
,
site please contact CloseCareGap, PSO to discuss how we can support your quality improvement
program.
Visit our website at: http://www.iCareQuality
iCareQuality.org/
Kate ONeill, MSN, RN
VP of Quality and Safety
kate.oneill@iCareQuality.org
www.iCareQuality.org
610.732.8500
Sathya Elumalai B. Tech, MS
Director of Research and Development
Sathya.Elumalai@iCareQuality.org
www.iCareQuality.org
610.732.8500
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© Copyright iCareQuality Inc. 2013 www.iCareQuality.org