Best Practices Library

These resources aim help health care leaders expand their knowledge and enhance their performance in achieving their community health goals.

The library’s information is constantly changing as documents are continuously posted. Topics go across all health care issues and cut across all health care settings.

If you have questions e-mail us at hpoe@aha.org.


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Case Studies
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Curbing Readmissions at the Forefront: Experiences from Successful Reduction of COPD Readmissions

Sep 16, 2016
This academic medical center developed and implemented a program to improve outcomes and reduce readmissions for patients with chronic obstructive pulmonary disease (COPD).
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Transitional Care Nursing (TCN) Services

Sep 16, 2016
Hospital readmissions for patients with chronic obstructive pulmonary disease (COPD), heart failure (HF) and pneumonia have negative repercussions for the patient, the health care facility and the
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Expansion of an Oncology Rehabilitation Service Line

Sep 16, 2016
This project explains how a multisite, outpatient breast cancer and lymphedema rehabilitation program expanded into a certified, multidisciplinary oncology rehabilitation service line to meet the n
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Improving Compliance with the Core Measure VTE-1 (Venous Thromboembolism) Prophylaxis

Sep 16, 2016
This project was based on a multidisciplinary approach that focused on the admission process for every patient more than 18 years old admitted to acute care to ensure that the correct measures were
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Standardized Total Knee Replacement Analgesia Protocol Reduces Pain by 20% in Patients in an Academic Medical Center

Sep 16, 2016
The goal of this project was to standardize protocols for controlling patient pain following total knee replacement procedures.
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Reducing Immunohistochemistry Laboratory Turnaround Time by 20% Using Lean Six Sigma Methodology

Sep 16, 2016
Turnaround time for immunohistochemistry (IHC) stains in the laboratory of a 500 bed tertiary care, Level I trauma center was 6.4 hours for morning orders and 19.3 hours for afternoon orders, resul
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Baylor Scott & White Health – Diabetes Health and Wellness Institute at the Juanita J. Craft Recreation Center

Sep 16, 2016
What is it? The Diabetes Health and Wellness Institute (DHWI) seeks to improve the management of diabetes and other chronic diseases and improve overall health and wellness outcomes in a
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Pelham Medical Center – Impact Diabetes

Sep 16, 2016
What is it? Impact Diabetes is a program implemented at Senior Action, a senior center in Greenville, S.C., that is funded by Pelham Medical Center.
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Appropriate Use of Indwelling Urinary Catheters Reduces Risk of CAUTI

Sep 16, 2016
The best way to prevent catheter-associated urinary tract infections (CAUTI) is to limit the use of indwelling urinary catheters.
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Early Identification and Treatment of Sepsis through Initiation of Response Team in the Emergency Department (ED CODE SEPSIS)

Sep 16, 2016
According to the 2008 Centers for Disease Control and Prevention/National Center for Health Statistics National Hospital Discharge Survey, patients hospitalized for septicemia or sepsis had a 17 pe
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Increase Penetration of Appropriate Palliative Care Consultation in a Health System

Sep 16, 2016
This project addresses the health care system's strategic initiative to ensure interdisciplinary palliative care teams deliver sustainable, high-quality services within their health ministries
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A 22% Decrease in Foley Catheter Utilization Rates Improves Patient Care in an Intensive Coronary Care Unit

Sep 16, 2016
The organization initiated a project identified by the Infection Control Committee to reduce Foley catheter days or prevent catheter use entirely in order to eliminate urinary tract infections.
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Reduction of Surgical Site Infections Following Spinal Fusion Procedures Through Implementation of Bundled Interventions

Sep 16, 2016
The neurosurgery service at this Level I trauma center had experienced high rates of surgical site infections (SSIs) for several years.
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Using Culture of Safety Survey as a Roadmap to High Reliability

Sep 16, 2016
As identified in its 2014 Culture of Safety survey, the hospital's overall mean score for the standard questions was 64.0, which was 0.4 points higher than the prior year.
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Reduction of the Inappropriate Use of Stress Ulcer Prophylaxis Across the Health Care System

Sep 16, 2016
Inappropriate stress ulcer prophylaxis is a serious problem across the health care continuum.
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A Collaborative Approach for the Reduction of CAUTI in a Long-Term Acute Care Facility

Sep 16, 2016
A review of the hospital's quality indicators revealed an unacceptable rate of catheter-associated urinary tract infection (CAUTI).
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Breakthrough Improvement on Sepsis

Sep 16, 2016
The project focused on managing sepsis in the emergency department and in admitted patients, with an emphasis on early identification and treatment.
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Decreasing VTE Rate and Length of Stay for Total Joint Patients Through an Interdisciplinary Orthopedic Co-Management Collaborative

Sep 16, 2016
The hospital's venous thromboembolism (VTE) rate for total joint patients was 36.2 in 2011 and 37.70 in 2012.
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Implementing the Richmond Agitation Sedation Scale and Wake Up and Breath Protocol to Reduce Ventilator Days

Sep 16, 2016
The ultimate goal for patients who are mechanically ventilated is to promptly and safely discontinue their dependence on mechanical ventilation to promote recovery from illness.
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Medicare Inpatient Length of Stay: A Relevant Value Metric

Sep 16, 2016
Reducing inpatient length of stay has a strong impact on value and organizational performance, and is linked with improving quality and access.
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Helping Adults Breathe and Thrive: A Healthy Homes Approach to Improving Respiratory Health of Adults with Asthma

Sep 16, 2016
As a health organization that serves communities disproportionately affected by asthma, Sinai Health System adopted an innovative community health worker (CHW) home-based intervention model to deli
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Improving Throughput in Children's Surgical Services While Increasing the Use of Standard Best Practices

Sep 16, 2016
The clinic throughput time was viewed as excessive and lacked standardized best practices.
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Palliative Care and the Patient: Pain and Symptom Management, Patient and Family Satisfaction, and Stay Length and Government Burden

Sep 16, 2016
This project involves raising awareness and expanding the palliative care program at HSHS St. John's Hospital and other hospitals within Hospital Sisters Health System.
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Implementation of New Surgery Patient Advocate Role Improves Patient and Family Satisfaction

Sep 16, 2016
Undergoing surgery of any kind can be a stressful experience for patients and their families. The surgical center at HSHS St.
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Achieving Perfect Patient Care for Two Years: It Is Possible

Sep 16, 2016
By using evidence-based medicine and hardwiring concurrent review, HSHS St.
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Implementing Evidence-Based Research and Standardized Quality Measures in the Management and Prevention of Chronic Ulcers

Sep 16, 2016
Chronic wounds are a growing problem in the United States.
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Decreasing Evidence-Based Medicine Order Set Review and Approval Cycle Time through Lean-Six Sigma Methodology

Sep 16, 2016
The problem faced by the health system was the lack of a coordinated approach for the review and approval of order sets, including standing orders and protocols, across the division's four com
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Leveraging Real-Time Clinical Decision Support with Mobile Devices to Impact Medication Safety

Sep 16, 2016
The hospital identified two process improvement opportunities related to medication safety efforts: heparin protocols and capturing correct patient weights.
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Taming the Violence: An Interdisciplinary Approach

Sep 16, 2016
Staff at this community-based rural hospital in northwest Illinois that treats more than 18,000 emergency department (ED) patients annually and has a 13 bed inpatient psychiatric unit voiced safety
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Collaboration for Healthy Schools and Healthy Students

Sep 16, 2016
Today, about one out of three children and adolescents ages 2-19 in the United States is overweight.
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Reducing Readmissions: Making Data Real

Sep 16, 2016
The Reducing Readmissions: Making Data Real project decreased acute rehospitalization rates by almost half.
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Lean Six Sigma Reduces Admission Delays in a Critical Access Hospital Emergency Department by 40%

Sep 16, 2016
Managing the flow of patient throughput is essential to preventing overcrowding in the emergency department (ED)—reducing the number of patients who leave without treatment and improving the
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Lean Six Sigma Reduces Implementation Time of Venous Thromboembolism Mechanical Prophylaxis by 78%

Sep 16, 2016
Venous thromboembolism (VTE), defined as a deep vein thrombosis and/or pulmonary emboli, is linked to increased hospital length of stay, increased cost of care, readmissions, disability and death.
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Lean Six Sigma Reduces Non-Value-Added Lab Tests for Acute Coronary Syndrome by 77% and Mortality by 20%

Sep 16, 2016
The CK-MB Test is a traditional blood test of a cardiac marker used to assist in the diagnosis of life-threatening acute coronary syndrome.
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Lean Six Sigma Reduces Non-Value-Added Amylase Testing by 82% in a Tertiary Medical Center Emergency Department

Sep 16, 2016
Studies show lipase to be as sensitive as and more specific than amylase in diagnosing pancreatitis; performing amylase with lipase adds no value over lipase testing alone.
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Using Virtual Discrete Event Simulation and Lean Six Sigma to Reduce Door-to-Provider Time in a Tertiary Emergency Department

Sep 16, 2016
The emergency department (ED) was experiencing an increase in door-to-doctor times due to high patient volume.
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Improving Community Health Through a Concussion Impact Evaluation and Treatment Program at a Rural Critical Access Hospital

Sep 16, 2016
Concussions are a growing problem for young athletes.
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St. John's Medical Center – Prenatal Entry Program

Sep 16, 2016
What is it? The Prenatal Entry Program (PEP) exists to incentivize entry for low-income families to enroll in prenatal care.
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Texas Health Resources – Healthy Eating Initiative

Sep 16, 2016
What is it? The goal of the Healthy Eating Initiative is to improve the accessibility, affordability, and quality of fresh produce in Azle and the surrounding areas.
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A Multifactorial Falls Program to Reduce Injury from Falls

Sep 16, 2016
Reducing and eliminating patient harm are at the forefront of patient safety and continue to be a national focus.
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Care Coordination - New Model

Sep 16, 2016
The hospital identified an opportunity to improve its discharge planning process to allow more time to be spent with patients and reduce duplication of duties within the case management and social
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Readmission Reduction from Post-Acute Care Facilities

Sep 16, 2016
In response to high readmission rates coming from the health system's skilled nursing facility (SNFs) partners, it instituted a new comprehensive transition of care (TOC) model.
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Automated Wellbeing Checks by Text and Email Enhance the Care of Discharged Emergency Department and Immediate Care Patients

Sep 16, 2016
In 2008, the health system's program to contact discharged emergency department (ED) and immediate care (IC) patients by telephone was recognized as a best practice by the Robert Wood Johnson Found
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IV Injection and Infusion Documentation Improvement Project

Sep 16, 2016
Because the medical center's lost charge capture related to IV injection and infusions totaled $80,000 per month, it established a goal of improving the process of IV injection and infusion charge
Case Studies
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Concurrent Review Takes Care to a Whole New Level

Sep 16, 2016
Concurrent review of three core measure sets has ensured appropriate and timely patient care.
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Sepsis Power Hour: Saving Lives with a Multidisciplinary Approach

Sep 16, 2016
The hospital began working on its sepsis initiative in January 2014, after root cause analysis showed an opportunity for improving outcomes for septic patients.
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Critical Access Hospital Uses Lean Six Sigma to Improve Anesthesia's Postoperative Note Completion by 95%

Sep 16, 2016
The goal was to reduce anesthesia's postoperative evaluation errors to less than 10 percent of all cases using Lean Six Sigma methodologies.
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Breathalyzer Testing in Level I Trauma Center Emergency Department Improves Psychiatric Patient Length of Stay by 52 Minutes

Sep 16, 2016
The emergency department (ED) was experiencing extended lengths of stay for psychiatric patients, which was negatively impacting patient care, costs and throughput.
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Lean Six Sigma Reduces Troponin Turnaround Time by 94% for Cardiac Patients in Critical Access Hospital Emergency Department

Sep 16, 2016
Troponin is a cardiac marker for acute myocardial infarction, making this lab test a key part of emergency management of chest pain patients.
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Lean Six Sigma Reduces Risk of Medication Errors Due to Medical Dispense Overrides by 53% in a Critical Access Hospital

Sep 16, 2016
Medical dispense overrides allow nurses to dispense medications from the Pyxis machine without pharmacy review in emergency situations.