Goals of the Clinical Committee
- Addressing day-to-day operational concerns
- Developing systematic solutions to inter-service difficulties
- David Bozaan, MD
- Robert Chang, MD
- Alexis Lopez, MD
- Anu Goyal, MD
- Julieann Grant, MD
- Mark Kolbe, MD
- Megan Mack, MD
- Jeffrey Rohde, MD
- Staci Valley, MD
- Denege Ward, MD
Examples of Recent Projects
I. Evaluating the paging culture, frequency, and content of high-frustration pages – and engaging nursing leadership to improve interdisciplinary communication through education and IT interventions.
- This work began with the evaluation of ~3000 pages and characterizing the content (clinical information, call-back, sender of page).
- This was followed by an intervention on specific nursing units without successful change to the quality of paging, rated by independent investigators.
- This is currently being evaluated, engaging the highest level nursing leadership to lead the change in a collaborative attempt to improve communication.
II. Investigating and improving MRI order-to-completion time.
- This work delineated that clinical indication (cord compression vs. foot osteomyelitis) and urgency (STAT vs. urgent vs. routine) did not impact completion of MR time (average and median of 55 hours), despite the existence of specific institutional priorities around specific conditions and MR urgencies.
- On the flip side, 25% of MRI’s were ultimately canceled, ½ of which were followed by an alternative test, and ½ by discharge.
- This work contributed to the addition of MRI questionnaire to the electronic medical record to reduce delay times and better include nursing workflow in MRI.
- MR is investigating their completion times after recently implementing the MR questionnaire.
III. Expanding our high-census algorithm to formally incorporate an inpatient family practice service into our process for high census.
- Our hospitalist group has a fully established algorithm to manage high census spikes.
- Despite this algorithm, at times, even our existing measures to manage high census was overwhelmed using internal resources, therefore we reached out to other services to form collaborative, mutually beneficial operational plans.