Performance improvement boot camp

Various regulatory agencies require some form of quality improvement program. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) encourages hospital-wide continuous quality improvement (CQI) and performance improvement (PI) to be implemented by all departments.     

Baby boot camp: facilitating maternal role adaptation among military wives

BACKGROUND: Current research suggests that women married to military service members may experience difficulty during the transition to motherhood attributable to the additional stressors of military life and inability to access traditional support systems. OBJECTIVE: To test the effects of a nursing intervention on prenatal and postpartum maternal role adaptation among military wives. METHODS: Primigravid military wives were assigned randomly to either a traditional childbirth education program (n = 47) or Baby Boot Camp (n = 44). The Baby Boot Camp is a 4-week childbirth-parenting preparation program based on a resilience paradigm. The strategies of Baby Boot Camp include identification of nontraditional external resources and development of internal resources to facilitate maternal role adaptation. The Prenatal Self-Evaluation Questionnaire, Personal Resource Questionnaire, and Resilience Scale were administered at baseline (32 to 37 weeks gestation), immediately after the intervention, and at 6 weeks postpartum. RESULTS: The outcomes suggest that Baby Boot Camp strategies to enhance external and internal resources may have been successful in facilitating maternal role adaptation. An independent t-test showed that, as compared with the military wives who attended traditional childbirth education courses, the Baby Boot Camp participants experienced significantly greater prenatal and postpartum adaptation. As demonstrated by repeated measure analysis of variance, the Baby Boot Camp participants experienced an increase in external and internal resources immediately after the intervention. However, these differences in resources were not sustained at 6 weeks postpartum. CONCLUSIONS: The findings may lead to wider development and use of childbirth-parenting programs designed to meet the unique strengths and needs of the childbearing military wife.     

Performance improvement in the management of sepsis

Sepsis guidelines, although creating a base to allow change in health care practitioner behavior, do not, in and of themselves, effect change. Change only comes with institution of a PI program, converting a core of key goals of guideline recommendations to quality indicators, and giving feedback on performance. These quality indicators are tracked before or during (recommended approach) initiation of hospital-wide education to evaluate baseline performance. When combining multispecialty and multidisciplinary champions in the ED, hospital wards, ICU, and hospital administrative leadership with timely performance feedback, case failure analysis, and re-education, an opportunity to succeed in decreasing mortality in severe sepsis can be achieved. Sepsis bundle indicators require updating as new evidence emerges and new guidelines are published.(30,31)