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QI Projects

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 core faculty with expertise in QI, and graduate with a unique set of skills including a deep understanding of systems of care delivery. Every project includes a disparities index to ensure we are meeting the diverse needs of our community.

Recent Projects


Clinic

HIV Screening: Collaborating with our clinic Quality Nurse, Dr. Garrett Spencer designed a workflow to prompt primary care physicians to order routine CDC-recommended HIV screening. Next steps will include efforts to reach out to members of our community who would be ideal candidates for pre-exposure prophylaxis (PrEP).

Social Determinants of Health: Dr. Larissa Sharma developed a pathway for easy referral from our primary care clinic to the Providence Community Resource Desk to provide real solutions for patients with food insecurity, need for childcare, need for dental care, or other social needs. An electronic referral generates not only a phone call to the patient, but also a follow-up after 30 days to make sure needs are truly met. Dr. Sharma’s poster won 2nd place at ACP 2019.

Inpatient

COPD Pathway: Collaborating with a hospitalist mentor, Dr. Nathan Zvejnieks and Dr. Gabe Hocum have designed a care pathway for patients with COPD. Process measures include percent of patients who get a blood gas and early non-invasive positive pressure ventilation per GOLD guidelines and percent of patients who are referred to pulmonary rehabilitation at discharge.

Early Mobility and Delirium Prevention: After securing a grant from the Providence Medical Foundation, resident Drs. Michael Silvas, Joe Miller, Tatyana Aleksandrova, and Lizzy Severson collaborated to hire 3 CNAs whom they trained as mobility aids to take all patients over age 65 on daily walks around our Accountable Care Unit as well as implement a package for delirium prevention including reorientation, water within arm’s reach, eyeglasses on, hearing aids in, and blinds open in the morning. Winner: 1st Place at ACP 2019

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.

Intensive Care Unit

Goals of Care: Our intensivists are committed to early and frequent family meetings. Resident Drs. Garrett Spencer, Heidi Reich, and Joanna Bove are collaborating with our system Institute for Human Caring to make sure those conversations are recorded in our “Good Green Goals of Care” tile within the electronic health record, all within 24 hours of ICU admission. Dr. Daphne Sy is bringing the conversation full circle by building a clinic workflow so that patients seen within 14 days of hospital stay for a transitional care management visit have an opportunity to revisit their goals of care with their primary care physician.