Format

Send to:

Choose Destination
See comment in PubMed Commons below
Proc (Bayl Univ Med Cent). 2014 Apr;27(2):100-2.

Factors affecting adherence to a quality improvement checklist on an inpatient hepatology service.

Author information

  • 1Division of Gastroenterology (Tapper, Lai) and Department of Medicine (Tapper), Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Abstract

Given the increasing emphasis on measuring quality indicators such as adherence to practice guidelines, we sought to determine the factors and address the barriers affecting guideline adherence on an academic inpatient hepatology service. We performed a single-center, prospective observational study. Physicians were given a handheld checklist to complete daily. We first measured the adherence rate and studied factors affecting adherence by performing surveys. We then modified the program to address the factors affecting adherence and reassessed the adherence rate. There was a baseline 46% checklist adherence rate. Reasons given for nonadherence fell into two categories: ease of task and physician commitment from both attending physicians and housestaff. Specific reasons given were that the attending did not prompt (39%), the adherence sheet was not in the chart (35%), the individual forgot (12%), as well as lack of time, unclear protocol, "too difficult," and "didn-t pay attention" (4% each). Each of these factors was addressed with a multimodal approach. Thereafter, the adherence rate rose from 46% to 83% (P < 0.001). Maintaining checklist adherence is time intensive and requires commitment from the whole medical team.

PMID:
24688186
[PubMed]
PMCID:
PMC3954656
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for PubMed Central
    Loading ...
    Write to the Help Desk