TOOLBOX


Collection of educational projects and tools - link here


A repository of resources to help jump-start high-value care projects at your institution.

 Reducing Inappropriate
Acid Suppression Therapy

(proton-pump inhibitors, H2-blockers)

 A pilot project where rounding pharmacists are given tools to help review patients' medication lists and evaluate for appropriateness of acid suppression therapy (AST). Understanding that a large number of patients are on AST with no active indications, the goal is to reduce unnecessary long-term AST.
 
Acid Suppression Therapy Pocket Card for Indications

Literature Review

Sample smart phrases for use in EPIC (EMR)

Reducing Cardiac Enzyme Testing


An intervention to improve evidence-based ordering of cardiac biomarkers to diagnose acute coronary syndrome

*No more than three troponins for ACS

*Only check total CK or CK-MB if troponin testing unavailable 

This project led to 66% reduction in ordering and $1.25 million decrease in charges at Johns Hopkins Bayview Medical Center

 Optimizing Telemetry Utilization (Non-ICU)

An ongoing project to order telemetry per American Heart Association guidelines 

*Order for the appropriate indication and duration

Why discontinue telemetry?
  • Low incidence of clinically significant arrhythmias for non-guideline indications
  • High burden of alarm fatigue
  • Resource intensive for nursing
  • Delays hospital throughput
  • Patient risks (delirium and falls)
Telemetry Pocket Card

Literature Review

Teaching Scenarios Resource

American Heart Association Guidelines

Choosing Wisely recommendations (Society of Hospital Medicine)
 Decreasing Chest X-Rays in the ICU


 An ongoing project to decrease routine morning chest x-rays in the intensive care unit

*Order chest x-rays based on symptoms to answer a clinical question
ICU Chest X-Ray Pocket Card

Literature Review

Teaching Scenarios Resource

American College of Radiology Guidelines

ICU Chest X-Rays Meta-analysis in Radiology 

ICU Chest X-Rays Meta-analysis in Critical Care

Choosing Wisely recommendations (Critical Care Societies Collaborative)


Ordering Wisely

https://sites.google.com/site/prophysicians/project-toolbox/Ordering%20Wisely%20-%20One%20Pager.jpg?attredirects=0



 
A project from University of Chicago, combining three high-value care guidelines into one initiative. 

- Appropriate Folate Testing
- Appropriate Thyroid Function Testing 
- ANA First, a Judicious approach to Rheumatic work-up

Ordering Wisely One Page Guidelines
 - Literature review included
 One Minute Guide to High Value Care One Minute Guides to High Value Care, written by contributors from Johns Hopkins Hospital, and archived on the Medicine Matters blog.

Topics: 
Folate, Hepatitis C Inpatient testing, Nebulizer vs. MDI, Appropriate Urine Cultures, Telemetry and more.
 One Minute Guides

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  199k v. 1 Apr 11, 2017, 12:34 PM Sonali Palchaudhuri