Background: Carotid endarterectomy [CEA) is one of the top-five surgical diagnosis-related groups at Keesler Medical Center. The geometric mean length of stay for CEA during fiscal year (FY) 1996 was 5.84 days (N = 41...
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Background: Carotid endarterectomy [CEA) is one of the top-five surgical diagnosis-related groups at Keesler Medical Center. The geometric mean length of stay for CEA during fiscal year (FY) 1996 was 5.84 days (N = 41), compared with 1.79 for a benchmark facility. Objective: Create a critical pathway to standardize care, maintain/improve patient outcomes, reduce lengths of stay, and decrease costs. Methods: A multidisciplinary team was formed to evaluate four patient-flow options. The team decided to discharge patients directly from the intensive care unit to meet both patient and staff needs. Results: The geometric mean length of stay decreased to 1.70 days (N = 54) in FY 1998, compared with 2.42 days (N = 40) in FY 1997. The cost savings was $5,841 per case, compared with $1,684 before creation of the pathway. This represents an annual savings of more than $224,000 and a 30% reduction in length of stay. Conclusions: The CEA pathway has standardized the care received by this group of patients. By decreasing variation, processes have become routine and more efficient.
Persons residing in long-term care facilities are especially vulnerable to potentially preventable morbidity and mortality caused by influenza S. pneumoniae, and tuberculosis. This project's objective was to incre...
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Persons residing in long-term care facilities are especially vulnerable to potentially preventable morbidity and mortality caused by influenza S. pneumoniae, and tuberculosis. This project's objective was to increase the rates of pneumococcal vaccination, tuberculosis screening, and annual influenza vaccination. intervention consisted of staff training videos, sample policies, and educational materials for residents and their families. At baseline during the 1995-1996 flu season, 84% of Colorado long-term care residents were vaccinated for influenza;16% of residents had ever received pneumococcal vaccination;and 59% had been screened for tuberculosis. At remeasurement during 1997 to 1998, influenza vaccination rates were up to 89%, p = 0.006. The percentage of residents who had ever received pneumococcal vaccination increased to 48% at remeasurement, p < 0.001. Tuberculosis screening rates increased to 83%, p < 0.001. Following an educational intervention targeting both residents and staff residents were significantly more likely to receive all three preventive services.
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