Assisting HIVES in Developing a Continuous Quality Care Improvement Plan
HIV Care Services, Public Health Solutions
HIV Care Services, Public Health HIV Care Services (HIVCS) is a program of Solutions Public Health Solutions, whose mission is Assisting HIVCS in Developing a to manage federal and city funding for HIV Continuous Quality Care Improvement preventive, educational, and clinical services across NYC. HIVCS lacks a continuous quality improvement plan (CQI) to evaluate the different processes required to execute their contracts. The team's goal was to incorporate their current performance standards into a comprehensive CQI plan that suits the needs of the organization. The team identified an effective way to monitor HIVCS' performance indicators, and the major deliverable of this project was a quality improvement plan which includes an implementation strategy that establishes all the activities that HIVCS should undertake to manage and monitor the allocation and use of resources. This model will enhance the accuracy and timeliness of HIVCS' internal processes.
Development of a Pediatric Urgent Care Center
Maimonides Medical Center
The goal of this Capstone team's project was to assist Maimonides Medical Center in creating a pediatric urgent care center service model. By routing non-acute pediatric patients to a setting more appropriate for treatment of non-emergent problems, Maimonides can provide them, as well as acute emergency room patients, with higher quality medical care. In order to develop a business plan for the urgent care center, the group researched and evaluated existing pediatric urgent care models, both freestanding and hospital-affiliated, throughout the country to acquire best practice characteristics. Patient demographic and volume data was collected and analyzed to help identify an appropriate location and size for the center. The team also performed an urgent care needs assessment by interviewing and surveying key stakeholders within Maimonides and physicians in the community. Financial data was incorporated to project revenue for the center. Based on this information, the team presented Maimonides with recommendations for the creation of a successful pediatric urgent care center.
Drug Distribution and Medication Administration - Next Generation Planning
New York-Presbyterian Hospital
New York-Presbyterian Hospital's (NYPH) ultimate goal is to provide patients with high quality, safe and compassionate care. As one of the initiatives towards this goal, NYPH requested a Capstone team to evaluate the impact of a cart-less medication administration system on nurses' time spent in direct patient care. The team conducted observations and focus group interviews with nurses in both cart-less and carted units to study the respective medication administration processes. Based on this information, the team composed a list of barriers to the medication administration process in each of these units. In the final report, the team provided recommendations to overcome these barriers and improve the process in these units based on the data obtained and literature review. In addition, the team also provided NYPH with recommendations for the transition to and implementation of a cart-less system throughout the NYPH facilities.
Geriatric Consortium at New York Presbyterian Hospital
New York-Presbyterian Hospital, Columbia University
The Capstone team assisted the Department of Geriatrics at New York-Presbyterian Hospital to create a plan and make recommendations for a Consortium on Aging at the institution, encouraging greater collaboration and communication regarding geriatric work between departments at NYP and Columbia University. It is important that NYP/Columbia, located in an area with the highest density of nursing homes in the nation, be prepared to meet the needs of the community, particularly as the baby boom generation reaches retirement age. The team researched the best practices of geriatric centers and consortia across the United States through a series of phone interviews and a web based survey. The team then surveyed faculty and staff at New York-Presbyterian Hospital and Columbia University to assess the needs and strengths of the institution. With the knowledge gained from these studies, the team developed a business model and a set of recommendations to implement a consortium for geriatric studies at NYP and Columbia University.
Improving Equipment Procurement Processes for Nurses
New York-Presbyterian Hospital, Cornell Weill
The Capstone team worked with New York-Presbyterian Hospital to review the distribution of medical equipment throughout the Weill Cornell campus. The team was charged with finding an efficient process for nurses to procure the equipment they need for the right patient at the right time. Unfortunately, attempting to locate the needed equipment absorbs a significant amount of time. This equipment is currently distributed by the central distribution department once a nurse places an order. In order to identify barriers between ordering the equipment and delivering it to the nurses, team members interviewed several equipment and nurse managers, held focus groups with nurses, and compiled equipment utilization data through observational audits and database queries. Once the data was fully analyzed, the team was able to determine the optimal equipment par levels and designed efficient processes for delivering the equipment to the nurse staff in a timely manner, allowing them to spend more time by their patients' bedsides.
Evaluation of the Root Cause Analysis Process at the VANYHHS
VA New York Harbor Healthcare System
The VA New York Harbor Healthcare System (VANYHHS) charged the Capstone team with the review of Root Cause Analysis (RCA) output measurements, through the Office of Patient Safety. It is the goal of the Office of Patient Safety to effectively use RCA processes as tools to improve clinical operations and quality of care. The team provided the VANYHHS with recommendations on methods, measurement metrics, and potential technological platforms for a database of quality and operational RCA outcome measurements tracking. The recommendations will initially be implemented with the VANYHHS at both the Brooklyn and Manhattan campuses, before being potentially released as recommendations to the national system as a whole.