At Providence St. Vincent, we train doctors to own the system of care so
that we do the right thing, every time, for every patient.
Each resident designs and implements a quality improvement project during protected QI curriculum time over their three year residency. Our residents select a project that dovetails with future career interests, work directly with our own dedicated analyst to design process and outcome measures, "learn by doing" with guidance from faculty experts, and graduate with a unique set of skills including a deep understanding of systems of care delivery. Every project checks for disparities to ensure we are meeting the diverse needs of our community.
Green Inhalers: Dr. Abby Lindseth is improving the health of our community and the planet by sharing a preferred list of Dry Powder Inhalers (DPIs) to replace Metered Dose Inhalers (MDIs) which contain greenhouse gases. At Providence we recognize our underserved populations suffer disproportionately from heat waves, poor air quality and other consequence of greenhouse emissions and WE ACT to achieve our goal of carbon negative by 2030.
Priming Patients for Goals of Care: Dr. Allison Schue won first place at Oregon ACP in 2023 for her High Value Cost Conscious Care workflow, providing a short, plain language priming letter to patients at check-in for their Annual Wellness Exam so that they are prepared to discuss Goals of Care during the visit.
Vaccine Hesitancy: Dr. Divya Nimmatoori created an outreach program for Spanish-speaking clinic patients who are under-vaccinated against COVID-19.
Support for Sobriety: Dr. Michael Knapp is leading work to support alcohol cessation with Medication Assisted Therapy (MAT) and coordinated behavioral health integrated in our residency clinic.
Neurocognitive Screening Pathway: Drs. Lisa Stampke and Matthew Moritz are building a clinic workflow to ensure patients with abnormal cognitive screening receive appropriate testing, counseling and follow-up.
Inpatient
Sepsis Patient and Family Education: Drs. Beth Koschel and Brit Cook worked with the system Sepsis Focus Group and our Patient Family Advisory Council to create patient education integrated into our Sepsis Order Set. Her work was translated into Arabic, simplified Chinese, Russian, Spanish and Vietnamese to meet the needs of our diverse patient population across the entire 50+ hospital Providence Health System. Dr. Koschel won 3rd Place at Oregon ACP and is an invited speaker at the September Sepsis Alliance Symposium 2024.
SGLT2i for CHF: Dr. Omar Pandhair worked with hospitalists, cardiologists and pharmacists to solidify workflows so that every patient admitted for heart failure is offered an SGLT2i.
Community Acquired Pneumonia Pathway: Dr. Kemin Fena is working with pharmacists to transition patients to oral antibiotics, while Dr. Christinia Patel streamlines interdisciplinary communication by championing the Estimated Date of Discharge Field in Epic – together forming a pathway to help our pneumonia patients get home sooner. They are continuing award-winning work prior to COVID QI Winner: 2nd Place at ACP 2020.
Early Mobility and Delirium Prevention: Initially grant-funded, award-winning work (Winner: 1st Place at ACP 2019) on our Accountable Care Unit continues, with Dr. Dalton Vanderpol collaborating with our Providence Senior Health leaders to revise and simplify nurse screening for delirium. Our CNAs are trained to provide a package for delirium prevention including reorientation, water within arm’s reach, eyeglasses on, hearing aids in, blinds open in the morning, and daily walks.
Sepsis Equity: Dr. Linh Taylor designed and implemented a care pathway to reach out by phone to Black and Spanish-speaking sepsis patients within 1 week of discharge to ensure access to follow-up care and reduce the chances of readmission. The work builds on Dr. Shelley Sanders’ Providence Health Equity Fellowship 2023.
Heart Failure Patient Education: Dr. Andrew Elton embedded QR code and hyperlinks to our Providence heart education in standardized discharge instructions and is counting how many times patients visit the website to determine uptake. Dr. Julia Townsend is optimizing palliative care referral for patients with advanced heart failure in accordance with AHA/ACC guidelines.
Improving Wellness by Streamlining Epic: Dr. Calder Dorn is using Epic Signal to identify ways to reduce time at the computer and support physicians to spend more time at the bedside.
Trusted Decision-Maker: Dr. Lexi Amatisto is making sure every admitted patient has their trusted decision-maker accurately recorded in Epic by embedding a hyperlink to the correct section of the chart right in our admission template.
COPD Pathway: Collaborating with a hospitalist mentor, Drs Nathan Zvejnieks, Gabe Hocum, Adrianna Morse, and Hannah Giger have designed a care pathway for patients with COPD. Process measures include percent of patients who get a blood gas early non-invasive positive pressure ventilation per GOLD guidelines and percent of patients who are referred to pulmonary rehabilitation at discharge. Dr. Morse presented results at both Oregon and National ACP 2024.
Reduction of Unnecessary Labs: Dr. Khoi Nguyen used feedback and friendly competition to safely reduce lab tests, saving patients money as well as red cells. Value Winner: 1st Place at ACP 2020.
Under Pressure: In collaboration with a hospitalist, Dr. Jakob Feeney led a project to safely reduce unnecessary treatment of inpatient hypertension. QI Winner: 2nd Place ACP 2022
Community Acquired Pneumonia (CAP) Pathway: In collaboration with our pharmacists and nurses on the Accountable Care Unit, resident Drs. Leah Grant and Jillian Catral designed and implemented an evidence-based CAP Pathway including 3 elements which were shown in a clinical trial to reduce both length of stay and time on antibiotics by 2 days: 1) Early transition from IV to oral antibiotics when patient meets pre-specified clinical criteria, 2) Early mobility; 3) Shared patient , family, nurse, and physician understanding of criteria for discharge. QI Winner: 2nd Place at ACP 2020. The project was on hold during COVID but Drs. Christinia Patel and Kemin Fena are relaunching our CAP Pathway in September 2023.
Reduction of Unnecessary Labs: Dr. Khoi Nguyen used feedback and friendly competition to safely reduce lab tests, saving patients money as well as red cells. Value Winner: 1st Place at ACP 2020.
Under Pressure: In collaboration with a hospitalist, Dr. Jakob Feeney led a project to safely reduce unnecessary treatment of inpatient hypertension. QI Winner: 2nd Place ACP 2022
Intensive Care Unit
Extubation to Heated High Flow Oxygen: Dr. Jobe Ashby is working with intensivist Dr. Lianne Lin to ensure most patients are extubated to Heated High Flow Oxygen, a practice that has been shown to reduce reintubation.
