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Feature on QI: Standardization and Variability of Care

Thu, 09/19/2013

TICU FacultyThe Department of Critical Care Medicine (CCM) is constantly striving to improve the quality of clinical practice. Quality patient care is optimized through a multidisciplinary team approach. This team approach, coordinated under the direction of a CCM physician, provides patients with the highest level of care based on the latest scientific evidence. 

A variety of quality improvement (QI) projects are currently taking place in various intensive care units.  Featured this week is “Standardization and Variability of Care” championed by Ali Al-Khafaji, MD, MPH.  The key drivers of this project are patient safety and comfort, nursing staff time and satisfaction, and potentially cost containment.

Transporting a critically ill patient for a scan is not a trivial task, carrying risks to the patient and consuming significant staff time. The QI team believes that there is an overuse of CT and MRI scans, where imaging studies are unhelpful to patient
management and outcomes. In an e-survey conducted prior to the start of the project, 65% of UPP faculty indicated that there was an overuse of CT scans. 

At a ½ day QI brainstorming session, run by CCM and the Donald D. Wolff Jr. Center for Quality, Safety & Innovation at UPMC, this project was chosen by a multidisciplinary group as one of four key CCM QI projects.

On August 5th 2013, the Transplant Intensive Care Unit (TICU), faculty featuerd in the photograph, launched the QI project with the goal of reducing the number of CT and MRI scans by 20% in the following 90 days.

The overall concept is for everyone to ask themselves two simple questions:  1) Is this scan really necessary?, and 2) How will it change patient management?  If the answer is ‘no’ to both questions, the scan is not necessary and, perhaps, should not be ordered.

Multidisciplinary care is the foundation of best intensive care unit with everyone striving for one common goal – the best outcomes for the patients.

For any questions, please contact Ali Al-Khafaji by email or phone at 412.418.9474.