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Review
. 2020 Jul-Sep;16(3):192-198.
doi: 10.14797/mdcj-16-3-192.

Advancing the Culture of Patient Safety and Quality Improvement

Affiliations
Review

Advancing the Culture of Patient Safety and Quality Improvement

Thomas E MacGillivray. Methodist Debakey Cardiovasc J. 2020 Jul-Sep.

Abstract

The American health care system has many great successes, but there continue to be opportunities for improving quality, access, and cost. The fee-for-service health care paradigm is shifting toward value-based care and will require accountability around quality assurance and cost reduction. As a result, many health care entities are rallying health care providers, administrators, regulators, and patients around a national imperative to create a culture of safety and develop systems of care to improve health care quality. However, the culture of patient safety and quality requires rigorous assessment of outcomes, and while numerous data collection and decision support tools are available to assist in quality assessment and performance improvement, the public reporting of this data can be confusing to patients and physicians alike and result in unintended negative consequences. This review explores the aims of health care reform, the national efforts to create a culture of quality and safety, the principles of quality improvement, and how these principles can be applied to patient care and medical practice.

Keywords: evidence-based medicine; outcomes; patient safety; practice-based learning; value-based care.

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Conflict of interest statement

Conflict of Interest Disclosure: The author has completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.

Figures

Figure 1.
Figure 1.
The Deming Cycle: Plan-Do-Check-Act.
Figure 2.
Figure 2.
The Methodist DeBakey Heart & Vascular Center preoperative prolonged ventilation prevention algorithm. BMI: body mass index; Hx: history; FEV1: forced expiratory volume in one second; FVC: forced vital capacity
Figure 3.
Figure 3.
Suggested fast-track weaning and extubation from the ventilator. Adapted from Chan et al. RN: registered nurse; RR: respiratory rate; SpO2: blood oxygen saturation level; FIO2: fraction of inspired oxygen; CPAP: continuous positive airway pressure

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