ดาวน์โหลดงานนำเสนอ
งานนำเสนอกำลังจะดาวน์โหลด โปรดรอ
1
Clinical tracer Breast cancer
Head Neck & Breast Surgery
2
No planed coordination
Breast cancer tracer Good reputation Over crowded Hi tech No planed coordination All around
3
Breast cancer tracer
4
Breast cancer tracer Strategy to fix problems
Center Breast Research Center Administration of admission and day surgery
5
Breast cancer tracer Strategy to fix problems
6
Breast cancer tracer Strategy to fix problems
7
Breast cancer tracer Strategy to fix problems
Circle of Tracer Circle of Coordination Circle of KPI Circle of CQI
8
Breast cancer tracer Process Risk identification
Project for risk correction Tools or instruments Identify Providers & Evaluators KPI Meeting & Feed back (CQI)
9
Breast cancer tracer กิจกรรม
10
Breast cancer tracer 101 OPD Ward 101 OR OPD Ward 101 OR Ward Ward
Explain variety of treatment 100% ความสมบูรณ์และถูกต้อง consent pre op. evaluation Delay surgery cause by medical condition Psycho-social-patient anxiety improvement pre-op advise >10% Pts. Identification 100% correct side, site Sentinel node identification rate Identified > 90% Operative wound infection Wound infection < 1% D/C planning 1% นัดผิดวัน OPD Ward 101 OR OPD Ward 101 OR Ward Ward Ward OR OR OR OR IC Ward 101 Ward 101 OPD
11
Breast cancer tracer Advice treatment
Risk Miscommunication to pts Activities Explain variety of treatment Consent form Instructions Instruction for patients Action response unit KPI Questionnaire at ward 100% complete consent at waiting room, reported / 6 months Evaluation unit OPD 101 Ward OR
13
Breast cancer tracer Advice treatment
100 % มี consent form 100% (7/7) 90% complete consent form Data Sep 2007
14
Breast cancer tracer Pre-operative preparation
Risk Delayed surgery due to medical condition & drug Activities pre op. evaluation & consult med. CPG Instructions pre op check list patients information for pre-op preparing Action response unit KPI Delay surgery cause by medical condition Evaluation unit OPD 101 Ward OR
15
อัตราการงด/เลื่อนผ่าตัด ผู้ป่วย CA. Breast
ร้อยละ 13.2 11.4 10.1 4.8 4.2 ไตรมาส
16
Breast cancer tracer Patients identification
Risk Pts. Identification: person, drug, site Miscommunication Activities advice & inform time out Instructions time out form Action response unit KPI 100% correct side, site 100% correct operation 100% complete time out form Evaluation unit OPD Ward OR OR
17
Breast cancer tracer Patients identification
100% correct side, site, 100% correct operation 100 % Completeness of time out form Incomplete ~ 60% Data Sep 2007
18
ร้อยละของความสมบูรณ์ในการบันทึกแบบระบุตัวผู้ป่วยในช่วง time out ของสาขาศีรษะ คอและเต้านม
เดือน
19
ร้อยละความสมบูรณ์ของการบันทึกการตรวจสอบการระบุตัวผู้ป่วย ของสาขาศีรษะ คอและเต้านม ( สค.50 )
ไตรมาส
20
Breast cancer tracer Psycho-social-patient anxiety
Risk Psycho-social-patient anxiety Activities โครงการลดความวิตกกังวลและส่งเสริมภาพลักษณ์ Instructions Action response unit KPI improvement pre-op advise >60% of cases Evaluation unit Ward Ward
21
Breast cancer tracer Psycho-social-patient anxiety
Anxiety score at ward at admission and pre discharge decrease > 60% of all breast cancer patients decrease 66% Data Sep 2007
22
Breast cancer tracer Sentinel node
Risk Miss sentinel node (disease specific) Activities Sentinel lymph node biopsy Instructions Sentinel lymph node form Action response unit KPI > 90% sln indentified Evaluation unit OR OR
23
อุบัติการณ์ไม่พบ Sentinel node
ร้อยละ ไตรมาส
24
Breast cancer tracer operative complication
Risk Operative complication: infection, bleeding, re-op Activities Standard OR precaution Instructions IC form Action response unit KPI 0% within 24 hr. re-op < 5% wound infection Evaluation unit OR IC OR
25
Breast cancer tracer operative complication
Rate of surgical site infection (q 1 month) <5% 5.9% (1*/17) *skin flap necrosis Data Sep 2007
26
Breast cancer tracer Inappropriate D/C planning
Risk Inappropriate D/C planning Activities Education, appointment system Instructions Documentation of discharge planning (date of D/C, condition on D/C, activity at home, diet, exercise, wound care, limitation etc. Action response unit KPI < 10% Loss of post-op F/U 1st visit < 10% of shoulder stiffness at 1st visit (เทียบ 2 ข้าง) 0% readmission within a week after discharge Evaluation unit Ward 101 OPD
27
Breast cancer tracer operative complication
< 10% Loss of post-op F/U 1st visit 0% < 10% of shoulder stiffness at 1st visit (เทียบ 2 ข้าง) Data collected at สยม 101 < 2% readmission in 28 days after discharge due to surgical site infection Data Sep 2007
28
Breast cancer tracer General excellent
KPI % of breast conserve % of reconstruction % of non-palpable % of DCIS % of preserve axilla by SLN % of arm morbidity
งานนำเสนอที่คล้ายกัน
