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Cited by 7Healthcare Quality and ManagementPatient Safety and Medication ErrorsTrauma and Emergency Care Studies

The DOI matches its Crossref record.

Using Lean Six Sigma to Improve Delayed Intracranial Hemorrhage Screening in a Geriatric Trauma Population

Birmingham, Lauren E., Sedorovich, Ashley, Mann, Nolan, George, Richard L.·2018·Quality Management in Health Care
DOI 10.1097/qmh.0000000000000186
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Abstract

PURPOSE: Geriatric trauma patients taking preinjury anticoagulant or antiplatelet (ACAP) medications are at greater risk for delayed intracranial hemorrhage (DICH), a rare but potentially life-threatening condition. Routine repeat head computed tomography (RRHCT) scans can identify DICH. Our objective was to decrease the rate of missed RRHCT in a level 1 Midwest trauma center geriatric minor trauma population on preinjury ACAP medications. OBJECTIVE: The objective of the quality improvement project was to identify the root cause of the missed RRHCTs and to implement a comprehensive solution to reduce rates of missed RRHCTs. METHODS: Medical records from before and after the intervention were evaluated. Frequencies and percentages were calculated. In addition, χ and logistic regression were utilized. The Lean Six Sigma (LSS) DMAIC (Define, Measure, Analyze, Improve, and Control) process was used to drive process improvement. RESULTS: At baseline, 15% (41 of 267) of RRHCTs were missed. After solution implementation, missed RRHCTs dropped to 4% (2 of 50). Of the 2 that were missed, zero were clinically inappropriate misses, making the postimplementation rate effectively 0%. CONCLUSION: The LSS DMAIC process helped health care professional to facilitate improved adherence to the department's practice guideline with respect to RRHCT. Adherence with this guideline can help providers identify patients with DICH, a potentially life-threatening condition.

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Metadata

Authors
Birmingham, L. E., Sedorovich, A., Mann, N., & George, R. L.
Affiliations
Summa Health System (US)
Corresponding author
Birmingham, Lauren E.
ORCID
Venue
Quality Management in Health Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-10
Volume
27
Issue
4
Pages
199-203
ISSN
1063-8628 (ISSN-L)
DOI
10.1097/qmh.0000000000000186
OpenAlex
W2893388641
Cited by
7
References
0
Citations by year
2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2
FWCI
1.27
Type
journal article
Language
en
Open access
closed
Locations
  • Quality Management in Health Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
  • Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
Keywords
delayed intracranial hemorrhage, geriatric trauma, quality improvement, practice guideline adherence, trauma care
MeSH terms
Accidental Falls, Aged, Aged, 80 and over, Anticoagulants, Female, Humans, Male, Wounds and Injuries, Geriatric Assessment, Logistic Models, Total Quality Management, Intracranial Hemorrhages, Quality Improvement

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