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Introduction of checklists at daily progress notes improves patient care among the gynecological oncology service
Teresa P Diaz-Montes1, Lauren Cobb, Okechukwu A Ibeanu
1The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. tdiazmo@jhmi.edu
Objectives:
To evaluate the impact of the introduction of checklists at the daily progress note to improve patient care among gynecologic oncology patients.
Methods:
A progress note incorporating checklists that were pertinent for our patient population was developed with input obtained from all staff involved on patients care. The form was approved by the hospital. The average length of stay, compliance with prophylactic guidelines (anticoagulation, peptic ulcer disease), reason for admission, and readmission rate were compared among the preimplementation and postimplementation periods.
Results:
A total of 492 discharge summaries were evaluated through the study period (267 for the preimplementation period and 225 for the postimplementation period). The mean length of stay was of 4.46 days for the preimplementation and 3.46 days for the postimplementation period (P = 0.007). TEDs/SCDs were not used in 9.3% of the patients in the pre group versus 0.6% in the post group (P < 0.001). DVT prophylaxis was given to 30.1% of the pre group versus 34.8% of the post group (P = 0.0013). The administration of PUD prophylaxis also increased from 28.3% in the pre group to 40.2% of the post group (P < 0.001). There was a decrease in the nonsurgical admissions from 22.2% in the pre group versus 14.6% in the post group (P = 0.049).
Conclusions:
The use of checklists in daily progress notes enhances patient care by improving the delivery of routine care that is often overlooked in the light of major medical issues.
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