Collaborating to improve health-care quality

Posted Aug. 3, 2011

Dr. Ulfat Shaik © UC Regents
Pediatrician Ulfat Shaikh is leading a systemwide effort to expand the use of hospital quality-improvement measures, beginning with processes for reducing readmissions.

UC Davis researcher Ulfat Shaikh is leading an effort to create a network among all five UC medical centers that will engage trainees and faculty in addressing several of today's most challenging health-care problems.

The UC Health Quality Improvement Network will increase teamwork among health-care providers and facilitate training in quality-improvement methods designed to assure the delivery of safe, high-quality care.

"Now is not the time to move slowly as far as health-care quality is concerned," said Shaikh, an associate professor of pediatrics. She noted that communication about efficiency and effectiveness is key. "If one medical center has tried an approach that has not worked well, knowing that may save the other medical centers time, money and effort."

More quality-improvement collaborations

UC Davis Health System faculty will be instrumental on three additional projects funded by the University of California Office of the President's Healthcare Innovation Center Awards.

Stop the clot: Patrick Romano and Richard White will work on a team to reduce the threat of deadly blood clots that plague hospitalized patients.

Reducing CT dose: John BooneRamit Lamba and James Anthony Seibert are part of a team that will standardize CT doses across UC medical centers so that patients receive the lowest possible dose to produce the necessary medical benefit.

CT use in the ER: Daniel Nishijima will help create guidelines for safely reducing unnecessary chest CT scans for blunt force trauma victims in the ER.

The network is being created through a three-year, $750,000 grant from the University of California Office of the President's Center for Health Quality and Innovation.

As its first challenge, the network will take on the problem of hospital readmissions — one that results in poor patient outcomes and increased costs. Almost 20 percent of patients with Medicare are readmitted to the hospital, at a cost of $12 billion a year.

"It is difficult enough for a patient to be admitted to the hospital, without adding the burden of an unplanned readmission due to breakdowns in the discharge process," said Shaikh.

Dr. Ulfat Shaik © UC Regents"We anticipate that our trainees will take these skills with them when they graduate and become leaders in quality improvement wherever they practice."
— Ulfat Shaikh

The network will begin by assessing what each UC medical center has done in this area. Health-care providers will then be trained in teamwork, communication skills and BOOST, or Better Outcomes for Older Adults through Safe Transitions. This discharge-planning kit aims to improve the transition from hospital to home. The research team will adapt it for use with pediatric patients and their families.

This first project will allow trainees unprecedented input into solving a systemwide problem.

"Residents and other trainees are on the frontlines of health-care delivery. They bear the brunt of inefficiencies and can offer valuable insights," Shaikh said.

Trainees will join other providers in learning about quality-improvement methods — tools relatively new to the health-care industry but long used by the automotive and airline sectors.

"We anticipate that our trainees will take these skills with them when they graduate and become leaders in quality improvement wherever they practice," Shaikh said.