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Institute for Healthcare Improvement · ihi.org 1

EquityStoryboard Numbers: 1–5

1: Addressing Disparities in Patient Engagement Using a Design Thinking ApproachDefense Health Agency — National Capital Region — WRNMMCDowning Lu, MD, MPHdowning.lu@gmail.com

2: Building Trust: a Prescription for Improving Health Disparities in the African American CommunityBe There San DiegoKatherine Bailey, MSWk3bailey@ucsd.edu

3: Challenge Detroit Health Disparities ProjectWilliam Beaumont HospitalAsha Shajahan, MDasha.shajahan@beaumont.org

4: Improving Spanish Interpreting Efficiency and Service ReliabilityAnn & Robert H. Lurie Children’s Hospital of ChicagoSteve Laislai@luriechildrens.org

5: Partnerships to Improve Global HealthGundersen Health SystemLiz Arnold, MPHejarnold@gundersenhealth.org

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress BallroomDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 1

Health Plans & Insurers Advancing ImprovementStoryboard Numbers: 603–605

603: An Innovative Approach Improving the Development of Evidence Based Payer Medical PolicyJohns Hopkins HealthCare LLCMark R. Fracassomfracasso@whealthcare.com

604: Legal Design for Healthcare InnovationCareOregonMonica Martinezmartinezm@careoregon.org

605: Pediatric Asthma Quality Improvement CollaborativeDepartment of Health Care FinanceDerdire Coleman, RNderdire.coleman@dc.gov

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress BallroomDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 1

Improvement CapabilityStoryboard Numbers: 449–515

449: 6S Success: Improving Critical Care Stabilisation Facilities with Lean MethodologyAneurin Bevan University Health BoardMiriam Johnmiriam.john@doctors.org.uk

450: A Health System’s Transformational Approach: Laying the Foundation for Patient Reported Outcomes Usage in ClinicsUniversity of Texas Southwestern Medical CenterSherene Philipkarla.strange@utsouthwestern.edu

451: A Little Help From My Friends: Supporting Providers through Collaborative Tool Development New York University McSilver Institute for Poverty Policy and ResearchDaniel Ferrisdan.ferris@nyu.edu

452: Adding Housing Goals & Measures to DPH’s Quality Management SystemLos Angeles County Department of Public HealthQuan Truong, MPHqtruong@ph.lacounty.gov

453: Addressing Obstacles and Building Trust to Safely Implement and Evaluate Jet Ventilators in Electrophysiology proceduresJohns Hopkins University School of MedicineWailin Lauwlau5@jhmi.edu

454: Admission, Transfer & Discharge (ADT) in a Secondary Care Hospital The Aga Khan University HospitalIrfan Vallianiirfan.valliani@aku.edu

455: Ambulatory Infusion Center: An Improved Experience, A More Efficient TeamAnn & Robert H. Lurie Children’s Hospital of ChicagoLaurie Fusilerolfusiler@luriechildrens.org

456: Analyse, Understand and Reduce Hospital Readmissions National University HospitalBhuvaneshwari Mohankumar, MPHbhuvaneshwari@nuhs.edu.sg

457: Annual Wellness Visits by Clinical Pharmacists and LPNs Help Practice Reach More Older AdultsMountain Area Health Education CenterCaryn Hugginscaryn.huggins@mahec.net

458: Appropriate Use of Antipsychotics — a Provincial Long-Term Care Quality Improvement Initiative Alberta Health ServicesMollie Colemollie.cole@ahs.ca

459: Bedside Shift Report: Purposeful CommunicationNCH Healthcare SystemElizabeth Gutierrez, RNelizabeth.gutierrez@nchmd.org

460: Bridging Healthcare and Health ITCommunity Family Medicine, P.A.Christina Perezchristinaperezmha@gmail.com

461: Building a Culture of Situational Awareness and Safety across Hospital Clinical Operations through High Reliability The Children’s Hospital of PhiladelphiaEdward Hopkinshopkinse1@email.chop.edu

462: Building Improvement Capacity in State Early Hearing Detection and Intervention (EHDI) ProgramsNational Center for Hearing Assessment and MeasurementAlyson Wardalyson.ward@usu.edu

463: Cardiovascular Thoracic Surgery Multidisciplinary Team Collaboration for the Fast track Open Heart PatientGeisinger Health SystemMichael Richardsonmjrichardson@geisinger.edu

464: CareOregon’s CCO Metric Dashboard JourneyCareOregonChristine Castlecastlec@careoregon.org

465: Causes for Delay in Planned Discharge: Results from a Tertiary CentreUniversity of Western OntarioJack Li, MDlizhe17@gmail.com

466: Changing Patient Experience Perceptions NCH Healthcare SystemMarcia Swaseymarcia.swasey@nchmd.org

467: Class is Now in Session: Formalizing Performance Improvement EducationMethodist Health SystemsKatie Garmskatiegarms@mhd.com

468: Clinical Dashboard Utilization: A Novel Approach To Reducing Time To Antibiotics In The EDUTShivtej Kaushal, MDShivtej.Kaushal@uth.tmc.edu

469: Code Unicorn: Alerts Staff of Workplace Violence NCH Healthcare SystemKevin Smith, RNkevin.smith@nchmd.org

470: Collaborative Vascular Access Care,a Successful Strategy to Reduce Hospitalizations in Hemodialysis Patients Hamad Medical CorporationHicham Bouanane, RNhbouanane@hamad.qa

471: Continuous Improvement — Strategies for Physician Engagement in Fraser HealthFraser Health AuthorityCurt Smecher, MDcurt@smecher.bc.ca

472: Creating a Quality Improvement Curriculum: Aligning System Change with Resident EducationContra Costa Health ServicesBrea Bondi-Boyd, MDbondiboyd@yahoo.com

473: Data Driving Improvement: Testing a Coordinated Cardiovascular-Diabetes Model of Integrated Complex Chronic Disease ManagementSt. Joseph’s Health Care LondonKaren Unsworthkaren.unsworth@sjhc.london.on.ca

474: Delivering on the Promise: Optimizing Military Medical Transition from Service Member to VeteranHerren Associates, Inc.Michael Schutta, PhDmichael.schutta@jlha.com

475: Designing for Improvement at Stanford Children’s HealthLucile Packard Children’s HospitalL. Krisa Hoyle Elgin, MPHkelgin@stanfordchildrens.org

476: Developing a Culture of Quality Improvement: The Prince George Coaching ModelPrince George Division of Family PracticeMegan Hunter, RNteamlead@bluepineclinic.ca

477: Developing Practice Transformation Measures That Encourage Engagement Of PCPSGYMRBryan Fisherbfisher@grmy.com

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress BallroomDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 2

28TH ANNUAL NATIONAL FORUM STORYBOARDS: Improvement Capability

478: Development of a Province-Wide Audit Program for Return Visits to the Emergency DepartmentUniversity Health NetworkLucas Chartier, MDlucas.chartier@uhn.ca

479: Driver Diagram as a Tool for Evaluating the Mechanism of Action for Transitional Care ProjectsLondon Health Sciences CentreAlan Gob, MD alan.gob@lhsc.on.ca

480: Driving Quality Improvement Initiatives through the Analysis of Emergency Department Return VisitsUniversity Health NetworkLucas Chartier, MDlucas.chartier@uhn.ca

481: Dysphagia Screening Tool Compliance & ProficiencyNCH Healthcare SystemKristen Miller, RNkristen.miller@nchmd.org

482: Effectively Building Improvement Capacity with Improvement ChampionsUW HealthGregg Heatley, MDgheatley@wisc.edu

483: Effectiveness of a Co-Learning Model to Teach Quality Improvement at an Academic CentreAlan GobAlan Gob, MDalan.gob@me.com

484: Employee Safety In Healthcare: Raising Awareness and Building Infrastructure to Create a Safer WorkplaceNorthwestern Memorial HospitalBarbara Buckley, RNbbuckley@nm.org

485: Engaging hearts & minds: The Case for Human-Centered QI Data DesignVancouver Coastal Health AuthorityJanet Joy, PhDjanet.joy@vch.ca

486: Expanding Central Line Bundle to Address Line ManipulationsUniversity of PittsburghHeena Sheth, MDhss2@pitt.edu

487: Fast Track Transfer to St Luke’s Hospital for Stroke Patients in National University Hospital SingaporeNational University HospitalSutrisno Widjajalouis_widjaja@nuhs.edu.sg

488: FIM Change Improvement During Rehab NCH Healthcare SystemMaria Feola, RNmaria.feola@nchmd.org

489: Foundational Improvement Science Curriculum: An Interprofessional Faculty Development ProgramOHSU & PSU School of Public HealthSherril Gelmongelmons@pdx.edu

490: Geographic Patient Aggregation onto Teaching Team Home Units to Elevate the Patient Care ExperienceDanbury HospitalAparna Oltikar, MDaparna.oltikar@wchn.org

491: Golden Hours of Sepsis for Long Term Patients in Enaya Specialized Care CenterHamad Medical CorporationSusan Osman, MDsusan_mohi@hotmail.com

492: Healthcare 2.0: A New Paradigm for a Secure and Streamlined Healthcare IndustryXTec IncorporatedMorgan Richardmrichard@xtec.com

493: Healthy Competition: Leveraging Team Based Care to Improve Colorectal Cancer Screening RatesAlameda Health SystemPalav Babaria, MDpbabaria@alamedahealthsystem.org

494: Hospital Acquired Orthotic- Related Pressure Injuries: Using Continuous Improvement to Prevent Patient HarmThe Children’s Hospital of PhiladelphiaChristina Halloroszc@email.chop.edu

495: Hospital Management, Union Leaders, and Frontline Workers Build Capacity to Sustain Change InitiativesBronx-Lebanon Hospital Center, Poe Medical, Pediatric Sub-Specialty and Dental CenterLillian Negronlnegron1@bronxleb.org

496: How Does Your Garden Grow? Growing Your QI Department while Improving Cervical Cancer ScreeningIndian Health Center of Santa Clara ValleyMarie Piazzampiazza@ihcscv.org

497: How to Use Evidence to Inform Quality ImprovementTheEvidenceDocBelinda Ireland, MDbelindaireland@theevidencedoc.com

498: Impact of Early Mobility and Exercise on Mechanically Ventilated PatientsGeisinger Wyoming Valley Medical CenterAlvin Sharmaaksharma@geisinger.edu

499: Implementation of a Data Driven Colorectal Enhanced Recovery Program at a Community HospitalHartford HealthcareSharon Weintraub, MDsharon.weintraub@hhchealth.org

500: Implementation of Plastic Sheath Protector to Maintain Optimal Drainage Function of the Skater Draining CatheterSingapore General HospitalKwee Leng Chooandrea.choh.c.l@sgh.com.sg

501: Implementing Split Flow Strategy for Emergency Department (ED) Vertical Patients By Utilizing Lean Manufacturing PrinciplesStanford Health CareSam Shen, MDsshen01@stanford.edu

502: Improvement of laboratory Turn Around Time for STAT Potassium in Hospital Lab, QatarMinistry of Public HealthSafia Almarrisma20061@hotmail.com

503: Improving Access to care for Subsidised Renal patientsSingapore General HospitalYvonne Chan Ee Wen yvonne.chan.e.w@sgh.com.sg

504: Improving Consent-Taking Process — A Journey Worth the TravelNational University HospitalHeidi Mahheidi_mah@nuhs.edu.sg

505: Improving Emergency Department Stroke Outcomes Using an Interdisciplinary ApproachMonmouth Medical CenterErin Winkels, RNErin.Winkels@RWJBH.org

506: Improving Flow & Wait Time in Outpatient Infusion NCH Healthcare SystemErica Szczepkowski, RNerica.szczepkowski@nchmd.org

507: Improving Inpatient Pediatric Penumonia ManagementChildren’s National Medical CenterKavita Parikhkparikh@childrensnational.org

508: Improving Neurosurgical Care in Ontario: Development of an Integrated Comprehensive Provincial Neurosurgical SystemCritical Care Services OntarioJoyce Chanchanjoy9@gmail.com

509: Improving Patient/Provider Communication: Maximizing the Availability of Patient Reported Outcomes (PRO) during Clinic VisitUniversity of Texas Southwestern Medical CenterKarla Strangekarla.strange@utsouthwestern.edu

510: Improving Severe Sepsis Mortality Rates through Improving Sepsis Bundle ComplianceNew Jersey Hospital AssociationMonica Feinberg, RNmfeinberg@barnabashealth.org

511: “Improvement Through Measurement” — Pediatric Transplant IndexNationwide Children’s HospitalBob Feeneybob.feeney@nationwidechildrens.org

512: Improving the Accuracy of Front End Revenue CycleQuorum Health ResourcesJudy Krempinletterstojudy@gmail.com

513: Improving Utilization of Respiratory Care Services: Reducing Missed TherapiesNCH Healthcare SystemScott Wileyscott.wiley@nchmd.org

514: Increasing Use of Transdermal Lidocaine with Venipuncture: A Successful Change in Pediatric Urgent CareChildrens Mercy Hospital SouthMechelle House, RNmmhouse@cmh.edu

515: Infection Prevention Reporting Solutions at Florida HospitalFlorida HospitalSuzanne Denzasuzanne.denza@flhosp.org

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28TH ANNUAL NATIONAL FORUM STORYBOARDS: Improvement Capability

516: Initial Results of Integration of Applied Healthcare Improvement Methods in a Graduate Nurse Practitioner ProgramThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at DartmouthBrant Oliver, PhD, MPHbrant.j.oliver@dartmouth.edu

517: Inspiring minds, empowering change: The Quality Improvement (QI) journey of Singapore General HospitalSingapore General HospitalLin Hui Lee lee.lin.hui@sgh.com.sg

518: Interprofessional Education: Assessing Teamwork and Communication Skills During SimulationYork HospitalDawn Becker, RNdbecker@wellspan.org

519: Interprofessional Mortality ReviewsBon Secours Health SystemLiana Orsolini, PhD, RNliana_orsolini@bshsi.org

520: Investing in Continuous Improvement to Ensure Continuous GrowthRadiology AssociatesJill Speecejspeece@ra-slo.com

521: Lab Redesign to Meet Customer Requirements with a Lean ApproachQuorum Health Resources and RiverView HealthJudy Krempinletterstojudy@gmail.com

522: Lactates: Not Just One and DoneSaint Luke’s Health SystemSamir Doshi, MDsdoshi@saint-lukes.org

523: Let’s Debrief: Pressure Injury Prevention and Education program Using the Debrief ToolThe Stephen and Alexandra Cohen Children’s Medical Center of New YorkVita Boyar, MDvboyar@gmail.com

524: Leveraging Resources to Enhance Health System Emergency Response CapabilitiesNorthwell HealthMary Mahoney, RNmmahone1@northwell.edu

525: Leveraging the Electronic Medical Record to Reduce the Rate of Hospital Acquired Clostridium Difficile Infections Boston Medical CenterDeborah Gregsondeborah.gregson@bmc.org

526: Managing Emergency Department Behavioral Health — Insuring Safety and Promoting ThroughputNorthwell HealthMichael Guttenberg, DOMGuttenberg@northwell.edu

527: MCA Improving Flow: Building Capability to Coach Pathway RedesignSheffield Teaching HospitalsTom Downes, MPHtom.downes@sth.nhs.uk

528: Measuring Post-Acute Impact on Overall System Improvement. Leveraging Advanced Analytics to Drive Operational ChangesCarolinas HealthCare SystemAndrea Maslow, PhDandrea.maslow@carolinashealthcare.org

529: Medical Staff Hits A Grand Slam With Credentialing, Improving Compliance NCH Healthcare SystemLisa Velascolisa.velasco@nchmd.org

530: Monitoring the Nutrition Care Process in U.S. Hospitals to Drive Quality Improvement Protocols for MalnutritionAbbott LaboratoriesChristina Sherry, PhDchristina.sherry@abbott.com

531: Mount Sinai Queens / 1199SEIU Healthcare Workers East: Building Capacity for an Inclusive LeadershipMount Sinai QueensGeorge Lowegeorge.lowe@mountsinai.org

532: MRSA Bacteremia Reduction InitiativeSingapore General HospitalMoi Lin Lingling.moi.lin@singhealth.com.sg

533: Neonatal Abstinence Syndrome — The Power of EducationHartford HealthCareKate Simskate.sims@hhchealth.org

534: Nurse-Managed Transitional Beds as a Method of Increasing Geographic Placement of an Academic Inpatient ServiceUniversity of South CarolinaChris Goodmanchristopher.goodman@uscmed.sc.edu

535: Nursing Role in Enhanced Recovery in NSQIP (ERIN)Stanford Health CareRoxanne Hyke, RNrhyke@stanfordhealthcare.org

536: On-Boarding in the Digital AgeNCH Healthcare SystemSuzi Burgersuzi.burger@nchmd.org

537: Operational Improvement Across a Health SystemNorthwell HealthJohn D’Angelo, MDjdangelo@northwell.edu

538: Optimizing Emergency Operation Theatre (EOT): Developing Prioritization Guidelines and Performance IndicatorsSingHealthXin Yu Adeline Leongadelineleong@gmail.com

539: Optimizing the Management of Chronic Obstructive Pulmonary Disease in Patients with Lung CancerQueen’s UniversityGenevieve Digby, MDgenevieve.digby@gmail.com

540: Optimizing the Nutrition Care Process: The Advocate Nutrition Care ModelAbbott LaboratoriesSuela Sulo, PhDsuela.sulo@abbott.com

541: Osteoporosis in Male Veterans: A Trainee-Led Quality Improvement InitiativeLouis Stokes VA Medical CenterTiffany Chua, MDtiffany.y.chua@gmail.com

542: Panel Management in a Resident Primary Care Clinic: A Platform for Population HealthHighland Hospital/Alameda Health SystemJenny Cohenbgregory@alamedahealthsystem.org

543: Patient Compliance & Education: How to Improve Healing Rates in Venous UlcersNCH Healthcare SystemRob Leydenrobert.leydon@nchmd.org

544: Patient Reported Outcomes: Is It Sustainable?Stanford Health CareZarrina Bobokalonova, RNZbobokalonova@stanfordhealthcare.org

545: Perioperative Respiratory Bundle: A Standardized Approach to Reducing Post-Op Cardiothoracic Pulmonary ComplicationsUF HealthSean Kiley, MDskiley@anest.ufl.edu

546: Pharmacist Participation in Team Rounds and its Impact on Patient CareBurke Rehabilitation HospitalThomas Grandville, PharmDtgrandvi@burke.org

547: Pharmacist-lead Multidisciplinary Team Significantly Improves Outcomes for Patients with Poorly Controlled DiabetesNovant HealthAnne Pratheraprather@novanthealth.org

548: Physician Shadowing Program to Improve Clinic Patient SatisfactionOklahoma Heart HospitalAngel Williamsangel_williams@okheart.com

549: Practice Facilitation in Community Practices: Increasing Fluride Varnish ApplicationNationwide Children’s HospitalChristina Toth, MPHChristina.Davey@nationwidechildrens.org

550: Preventing the spread of Clostridium Difficile Infections by Non-verbal Communication Strategies Boston Medical CenterDeborah Gregsondeborah.gregson@bmc.org

551: Promoting Sleep and Rest Through Noise ReductionHartford HospitalChristine Waszynski, RNChristine.waszynski@hhchealth.org

552: Quality Improvement Through Better Estimation and Appropriateness of Resources to Intensive Care Units: The Ontario Algorithm Critical Care Services OntarioNasim Haque, MDnasim.haque@uhn.ca

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28TH ANNUAL NATIONAL FORUM STORYBOARDS: Improvement Capability

553: Raising the Clinical Bar with Sustained ResultsBanner HealthMikaela Mackeymikaela.mackey@bannerhealth.com

554: Redesigning the Quarterly Medication Review Process in Long Term Care Facilities in OntarioMedical Pharmacies Group LimitedDenis O’Donnell, PharmDdodonnell@medicalpharmacies.com

555: Reduce Wait Time for Transplant Patients in the Outpatient LaboratoryFlorida Hospital Medical CenterMary A WomackMaryAnn.Womack@flhosp.org

556: Reducing our Rate of Catheter Associated Urinary Tract Infections through Effective Rounding and Education The Children’s Hospital of PhiladelphiaKelly O’Sheaosheaka@email.chop.edu

557: Reducing Overrides from Automated Medication Dispensing MachinesChildren’s Hospital of AlabamaJeremy Jordanjeremy.jordan@childrensal.org

558: Reducing Pain, Agitation and Delirium to Optimize Outcomes in Mechanically Ventilated Critically Ill Oncology Patients Eastern Cancer Treatment Centers of AmericaGerry Finkelston, RNGerry.Finkelston@ctca-hope.com

559: Reducing Patient No-Call/No-ShowsCompDrugGretchen Conturogconturo@compdrug.org

560: Reducing PSI-90 through Case Analysis, Clinical Intervention and Clinical Documentation New Jersey Hospital AssociationMonica Feinberg, RNmfeinberg@barnabashealth.org

561: Reducing the Amount of Medicaid Denials NCH Healthcare SystemHeather Cintronheather.cintron@nchmd.org

562: Reducing the Laboratory Cost of False Positive Blood Cultures in the Adult Emergency Department Medical University of South CarolinaLisa L Steed, PhDsteedll@musc.edu

563: Reducing Wait Times for Diagnostic Imaging Tests in the Urgent Medicine Clinic (UMC) Department of Medicine, Western University, Canada, london Health Sciences CentreSaira Zafar, MDszafar9@uwo.ca

564: Refining a Change Package That Is Adaptive Yet Grounded in EvidenceGYMRBryan Fisherbfisher@grmy.com

565: Reinventing the Wheel: Standardized Serious Event AnalysisHospital Corporation of AmericaRuth Westcott, RNRuth.Westcott@HCAHealthcare.com

566: Rethinking Anticoagulation Clinic in a Virtual World: Metric Development and Implementation of Innovative Practice ModelNovant HealthRebecca Bean, PharmDrabean@novanthealth.org

567: Rising Tide: Nurse to Patient CommunicationNCH Healthcare SystemElisabeth Novakovich, RNelisabeth.novakovich@nchmd.org

568: Say “NO” to InterruptionSpecialist Outpatient Clinic (SOC), Centre for Digestive & Liver Disease, Singapore General HospitalSankittha Kunasegaramandrea.choh.c.l@sgh.com.sg

569: Scale Up Patientsafety Work in the Community SettingDanish Society for Patient SafetyTina Lynge Lyngbye, RNtina.lynge@patientsikkerhed.dk

570: Sepsis Care Improvement Through an Automated Clinical Decision Support Solution at East Jefferson General HospitalEast Jefferson General HospitalJohn DePaula, MDjmdepaula@ejgh.org

571: Sepsis Superheroes: MARVEL-ous Staff Engagement Decreases MortalityMethodist West Houston HospitalSherry Nelsonslnelson@tmhs.org

572: Standardize the BayCare Wide Sepsis EducationBaycare Health SystemChhavi Gupta, PhDchhavi.gupta@baycare.org

573: STEMI: Improving Door to Cath Lab Times through High ReliabilityCleveland Clinic Health SystemElizabeth Smithsmithe11@ccf.org

574: Stepping Towards Data Informed Quality ImprovementPrince George Division of Family PracticeKaren Gillkaren.gill@northernhealth.ca

575: Strengthening a Culture of Quality Improvement: The Development Implementation of a CGH Improvement InfrastructureChangi General HospitalGarry Semenianogarry_semeniano@cgh.com.sg

576: Sustaining Severe Sepsis Survival SuccessSaint Luke’s Health SystemSamir Doshi, MDsdoshi@saint-lukes.org

577: Tailoring Quality Improvement Educational Intervention Projects for Community Healthcare FacilitiesUniversity of Arkansas for Medical Sciences (UAMS)Muhammad Jaffar, MDjaffarmuhammad@uams.edu

578: Take a Stand to Prevent FallsKing Abdulaziz Medical City — National Guard Health AffairsRohana Yahyar_ann76@yahoo.com

579: Taking a Fresh Aim at Improving Blood Pressure ControlAmerican Medical AssociationLaken Barkowski, RNlaken.barkowski@ama-assn.org

580: The Collaborative Model Optimizes Clinic LaborGundersen Health SystemMatthew Schumachermrschuma@gundersenhealth.org

581: The Impact of a Multidisciplinary Quality Transformation Team on Patient Safety and Quality OutcomesTexas Children’s HospitalSheranda Feslersmfesler@txch.org

582: The Lung Center — An Interdisciplinary Quality Improvement Initiative Eastern Cancer Treatment Centers of AmericaGerry Finkelston, RNGerry.Finkelston@ctca-hope.com

583: The Sheffield Microsystem Coaching Academy — Improving a City’s Healthcare from WithinSheffield Teaching HospitalsTom Downes, MD, MPHtom.downes@sth.nhs.uk

584: The Spread of Better Coordinated Cross-Sectoral Medication Reconciliation (BOOMR) Medical Pharmacies Group LimitedCarla Beatoncbeaton@medicalpharmacies.com

585: The Spread of Quality Singapore General Hospital Kok Yong Fongfong.kok.yong@singhealth.com.sg

586: Time is Brain | Redesigning Stroke Care at Kaiser Permanente Northern CaliforniaKaiser PermanenteVivian Reyesvivian.m.reyes@kp.org

587: To Eliminate Nasal Trauma Amongst Neonates on Non-Invasive Respiratory Support in Neonatal Intensive Care UnitSingapore General HospitalMary Grace S. Tanmary.grace.tan@sgh.com.sg

588: To Reduce the Incidence of Incorrectly Perfected Electronic Medication Orders by 75% in 9 MonthsSingapore General Hospital Jun Jie Benjamin Sengbenjamin.seng.j.j@sgh.com.sg

589: Tracking and Profiling Health Human Resources in the Critical Care System — A Provincial ViewCritical Care Services OntarioCatherine LundyCatherine.lundy@uhn.ca

590: Transforming Shoulder Care Through Innovative Hospital and Primary Care CollaborationRouge Valley Health SystemFarah NabiFarah.nabi@gmail.com

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28TH ANNUAL NATIONAL FORUM STORYBOARDS: Improvement Capability

591: Transforming Workforce for SingHealth’s Academic Medicine JourneySingapore Health ServicesSalina Ongsalina.ong.y.l@singhealth.com.sg

592: Transitioning to a New Era of Critical Care: Improving Outcomes with a Closed Model ICUMonmouth Medical CenterSharon Holden, RNSharon.Holden@RWJBH.org

593: Two-year Pilot Results of Healthcare Improvement Integration Into the Interprofessinal IMPACT Health Professions Education ProgramThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at DartmouthBrant Oliver, PhD, MPHbrant.j.oliver@dartmouth.edu

594: Universal Tdap in PregnancySt. Luke’s Boise Medical CenterCathy Archibald-Seifferarchibac@slhs.org

595: Urine Collection in Urgent Care: Striving to Decrease Contamination RatesChildren’s Mercy HospitalKelsey Williamskmwilliams@cmh.edu

596: Using an Electronic Board to Improve Oncology Patient OutcomesCancer Treatment Centers of America — ERMCDana McNeil, RNdana.mcneil@ctca-hope.com

597: Using Patient Input and Lean to Redesign the UNC Family Medicine Center UNC Department of Family MedicineSam Weir, MDDonna_Parker@med.unc.edu

598: Using the Atlas Rate Generator to Inform Disciplined QI Projects in Evidenced Based MedicineDartmouth CollegeStephanie Tomlinstephanie.tomlin@dartmouth.edu

599: Utilizing an Interactive Performance Dashboard to Improve Patient CareRouge Valley Health SystemFarah Nabifarah.nabi@gmail.com

600: Utilizing Beta-Hydroxybutyrate Testing to Improve Time to Diabetic Ketoacidosis Therapy IntitiationChildren’s Mercy Kansas CityAmy Scott, RNalscott@cmh.edu

601: What is a Service Line?Northwell HealthJohn D’Angelo, MDjdangelo@northwell.edu

602: Where Do I Find That Policy? A System QuestionNovant HealthKathy Hayeskchayes@novanthealth.org

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Joy in WorkStoryboard Numbers: 445–448

445: Emergency Department Inpatient Rounding: The Patient Experience and Service RecoveryCEP AmericaEdward Pillar, MDbrennaharrington@bellsouth.net

446: Helping Hospital Staff in Dealing with Abusive PatientsNational University HospitalSandhya Mujumdarsandhya_mujumdar@nuhs.edu.sg

447: Improving Staff Satisfaction Through A Self-Scheduling ProcessGeisinger Health SystemCheryl Daviscfdavis@geisinger.edu

448: Strengthening Copassion, Decreasing Burnout in Clinic Based Healthcare: A Randomized TrialProvidence Health & ServicesRebecca Hawkinsrebecca.hawkins@providence.org

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress BallroomDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 1

LeadershipStoryboard Numbers: 436–444

436: A Transformational Leadership Program: A Necessity in Today’s Healthcare EnvironmentNorton HealthcareKristin Pickerellkristin.pickerell@nortonhealthcare.org

437: Creating Workplaces Where Staff Can FlourishNHS ImprovementSuzie Baileysuzie.bailey@nhs.net

438: Enhancing Patient Safety/Experience through Team Diversity: Capitalizing on Internationally Educated Nurses’s Cultural and Linguistic AbilitiesHamilton Health SciencesDaniela Beckford, RNbeckfordd@hhsc.ca

439: How do Health Care Leaders Think About Change? Dartmouth CollegeAdrienne Faerber, PhDadrienne.e.faerber@dartmouth.edu

440: Making Quality Work Count: Meeting Multiple Institutional Priorities Through Combining QI Reporting and CredentialingUniversity of Arkansas for Medical SciencesChris Cargile, MDmmorris2@uams.edu

441: One Health System’s Success Story in Developing a System Wide Respiratory DepartmentGeisinger Health SystemKelly Crescikjcresci@geisinger.edu

442: Pay-for-Performance Incentive to Drive Safety and Quality in an Academic Medical CentreNational University HospitalSandhya Mujumdarsandhya_mujumdar@nuhs.edu.sg

443: Safety Huddle Improves Safety CultureMethodist Mansfield Medical CenterDonna Crimmins-Bonnell, RNdonnacrimmins-bonnell@mhd.com

444: What Makes a Project Successful? Measuring Success of Local Quality Improvement ProjectsPartners HealthCareOrinta Kalibatasokalibatas1@partners.org

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress BallroomDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 1

Patient SafetyStoryboard Numbers: 301–435

301: A Comprehensive Opioid Safety Program in the Military’s National Capital Region Medical DirectorateDefense Health Agency — National Capital Region — WRNMMCDowning Lu, MD, MPHdowning.lu@gmail.com

302: A Comprehensive Quality Improvement Initiative to Prevent Falls in the Emergency DepartmentUniversity Health NetworkLucas Chartier, MDlucas.chartier@uhn.ca

303: A QI Initiative to Decrease the Rate of Solitary Blood Cultures Sent from the EDUniversity Health NetworkJoseph Choi, MDjoseph.m.choi@gmail.com

304: A Quality Improvement Initiative to Reduce the Use of Physical Restraints in the PICUCohen Children’s Medical Center of New York, Hofstra Northwell School of MedicineGlater-Welt Lily, MDlglater@nshs.edu

305: Acetaminophen: Making a Deadly Medication SafeNovant HealthBridget Bridgman, PharmD, RNbmbridgman@novanthealth.org

306: An Accident Waiting to Happen — Effective Handover is Key to Inter-hospital TransferBelfast Health and Social Care TrustSOPHIE DAVIDSONsophnash_davidson@hotmail.co.uk

307: Antimicrobial Stewardship in the Ambulatory Setting: Success in PediatricsNovant HealthHerbert Clegg, MDhwclegg@novanthealth.org

308: Bah Hum Bug! HAI Best Practice to the BedsideNovant HealthSue DeCampFreeze, RNsldecamp-freeze@novanthealth.org

309: Beyond the Feelings: Linking Patient Stories to the Quality Improvement ProcessLAM Professional Services, LLCLisa Morriselisa.morrise@gmail.com

310: Breaking the Code: Using Plain Language Emergency Communication to Improve Safety in Healthcare Hartford HealthCarePatrick Turekpatrick.turek@hhchealth.org

311: Building a Culture of Situational Awareness and Safety across Hospital Clinical Operations through High Reliability The Children’s Hospital of PhiladelphiaEric Branningbranninge@email.chop.edu

312: Changing Culture in the Intensive Care Unit to Reduce Catheter Associated Urinary Tract Infections (CAUTI)Exempla Good Samaritan Medical CenterMarcia Maxwell, RNmarcia.maxwell@sclhs.net

313: Changing Culture to Eliminate CAUTI Events in the Surgical Intensive Care UnitYNHHAlison Venditti, RNAlison.Venditti@ynhh.org

314: Changing Culture, One Conversation At A TimeRoyal Melbourne HospitalFiona Watsonfiona.watson@mh.org.au

315: Changing the Conversation: Harm Prevention Data Infrastructure at CHOPThe Children’s Hospital of PhiladelphiaSichao LiLiS4@email.chop.edu

316: CLABSI Reduction “Back to Basics”Shands Jacksonville Medical CenterChristopher Wilson, RNchristopher.wilson2@jax.ufl.edu

317: Clot Busters: Promoting Implementation of the CHEST 2016 Guidelines to Optimize Patient Care and SafetyBoston Medical Center GME ProgramPooja Phull, MDpphull06@gmail.com

318: Code Resus: Using a Quality Improvement Approach to Improve Health-Care Provider Response During ResuscitationsUniversity Health NetworkLucas Chartier, MDlucas.chartier@uhn.ca

319: Collaboration to Reduce Unplanned Extubations in NICU and PICUThe Stephen and Alexandra Cohen Children’s Medical Center of New YorkKathy Albertkalbert@northwell.edu

320: Collaborative Approach to Improve the Identification and Delivery of Sepsis 6 Bundle NHS LanarkshireJohn Hardenjohn.harden@nhs.net

321: Communication in Overlapping Procedures: Best Practices to Support Safety and Compliance Emory University School of MedicineAaron Finkafink01@comcast.net

322: Concerns About Falling Autopsy Rates Have Given Rise to New Autopsy Legislation in NorwayAkershus University HospitalGlenny Cecilie Alfsen, MD, PhDcecilie.alfsen@medisin.uio.no

323: Creating a Safe and Healthy Work EnvironmentBoston Medical CenterCharlotte Cuneo, RNCharlotte.Cuneo@bmc.org

324: Critical Care Multidisciplinary Rounds NCH Healthcare SystemCheryl Holderfield, RNlisa.leonard@nchmd.org

325: Daily Safety Check In Call — Eliminating Silos for the Safety of the Patient!New Hanover Regional Medical CenterSandy Andrews, RNsandy.andrews@nhrmc.org

326: Decreasing falls through a culture of peer accountabilityMeridian HealthChris Sicilianochristopher.siciliano@hackensackmeridian.org

327: Decreasing Time from Patient Arrival via Emergency Medical Services to CT Imaging and Alteplase Regions HospitalHilary Radtkehilary.f.radtke@healthpartners.com

328: Designing an Evidence-Based Patient Centered Acuity MeasureVeterans Health AdministrationDouglas Howarddouglas.howard@va.gov

329: Developing a Two-Way Exchange of Inpatient Information Between Tertiary-care and Primary-care PhysiciansWestern UniversityErin Spicer, MDSpicer.erin@gmail.com

330: Developing Situation Awareness on Inpatient Units: Lessons from the Frontline, Including Barriers and Facilitators RCPCH and ISQuaPeter Lachman, MD, MPHplachman@isqua.org and mily.stapley@annafreud.org

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress BallroomDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 2

28TH ANNUAL NATIONAL FORUM STORYBOARDS: Patient Safety

331: Blood Pressure SafetyNo OrganizationMohamed Abdulkawidr_markis@yahoo.com

332: Door to CT: EMS Collaboration Improves tPA Administration TimesWesley Medical CenterBrett Hartkoppbrett.hartkopp@ghhwesleymc.com

333: Driven Distraction: Individual and Organizational Differences Modulate Alarm Fatigue in NursesProvidence Park HospitalAdam Savine, RNadam.savine@stjohn.org

334: Evidence-driven Fall Prevention in Post-acute CareCarolinas Healthcare SystemMichael Malamentmichael.malament@carolinashealthcare.org

335: Evolving Towards High Reliability in the OR: Implementation of a New Surgical Safety ProcessNYC Health + Hospitals/ElmhurstBenjamin Malkin, MDmalkinb@nychhc.org

336: Expansion of Pharmacy Technician Histories for Reconciliation Over Three Years: Continued Efficiency and Quality ImprovementJohns Hopkins All Children’s HospitalKathy Haydu-Tinyeskhaydu1@jhmi.edu

337: Fall prevention: A continuous Plan-do-study-act ProcessNew York University Langone Medical CenterMeliza Weir doctorella@msn.com

338: Falling Through the Cracks: Malpractice Risks Associated with MiscommunicationCRICODana Siegal, RNdsiegal@rmf.harvard.edu

339: Falls Awareness Safety Team: An Innovative Approach to Fall ReductionCancer Treatment Centers of AmericaNicollette Anzideo, RNNicollette.Anzideo@ctca-hope.com

340: Finding Value in Incident Learning SystemInternational Atomic Energy AgencyDebbie Gilleyd.gilley@iaea.org

341: First 15: Successful Hospital-wide Daily Safety CallRegions HospitalMichele Island, RNmichele.a.island@healthpartners.com

342: Getting Ahead — From Field to ScannerNovant HealthShellie Voncannon, RNsvoncannon@novanthealth.org

343: Handheld Metal Detector Protocol to Reduce Radiation Exposure in Pediatric Patients with Esophageal Coins Nationwide Children’s HospitalKris Jatana, MDKris.Jatana@nationwidechildrens.org

344: Hospital Fall Management: Results of Six Years of Follow-UpHospital Estadual de DiademaMarco Vitorino Cunha, MDmarcoavcunha@yahoo.com.br

345: How An OSCE Station on Speaking the Patient’s Language Reduced Healthcare Disparities & Increased SafetyUF HealthCarolyn Stalvey, MDcasscm@shands.ufl.edu

346: How Product Changes Can Lead to Improvement and Effect Patient Outcomes: New PICCs and DVTsHenry Ford Health SystemHeather Faraone, RNHFARAON1@hfhs.org

347: I Can Classify that Safety Event in Three Notes!Novant HealthMarcia Bakermcbaker@novanthealth.org

348: Impact of Office-Based Surgical Skill and Safety Orientation for Clinical TraineesUniversity of IowaHillary Johnson-Jahangir, MD, PhDhillary-johnson@uiowa.edu

349: Implementation of an Early Warning System at Boston Medical CenterBoston Medical CenterAbhinav Vemula, MDabhinav.vemula@bmc.org

350: Implementation of Quality Improvement Curriculum for an Anesthesia ResidencyUniversity of Colorado Anschutz Medical CenterMelanie Donnelly, MDmelanie.donnelly@ucdenver.edu

351: Improved Patient Safety and Efficiency of Care with Nighttime Nurse Practitioners Methodist West Houston HospitalLaura Espinosalaespinosa@houstonmethodist.org

352: Improvement and Sustainability in Communicating Outpatient Critical Laboratory ValuesKing Abdulaziz Medical City — National Guard Health AffairsAbdulmohsen Alsaawi, MDdrsaawi@gmail.com

352: Improving Antipsychotic Medication Safety in Children and AdolescentsNationwide Children’s HospitalJahnavi Vallerujahnavi.valleru@nationwidechildrens.org

354: Improving Communication Delay of Outpatient Sleep Study Results Back to ENT Patients/FamiliesNationwide Children’s HospitalJames Ruda, MDJames.ruda@nationwidechildrens.org

355: Improving Endoscope Cleaning With ATP TestingNCH Healthcare SystemMichael Miller, RNmichael.miller@nchmd.org

356: Improving Morbidity & Mortality Rounds: Hospital-wide Implementation of a Structured ModelOttawa HospitalEdmund Kwok, MDeddeestyle@gmail.com

357: Improving patient safety culture in Norwegian nursing homes: Validating the NHSOPSC instrumentUniversity College of Southeast NorwayKathrine Cappelen, RNkathrine.cappelen@hit.no

358: Improving Skin to Skin Rate in the Birth PlaceNCH Healthcare SystemCathy Brockman, RNcathy.brockman@nchmd.org

359: Improving the Management of Fever and Suspected Chemotherapy Induced Neutropenia: A Tertiary Care Center ExperienceNational Guard HospitalMona Alshamishamimo@ngha.med.sa

360: Improving the Process of Reporting Critical Lab Results in Pediatric units-HGH: Patient SafetyHamad Medical CorporationManasik Hassanmhassan17@hamad.qa

361: Inclusion of Pathologists in Monitoring Inpatient Deaths Improves Notification Procedures in Cases of Unnatural DeathsAkershus University HospitalGlenny Cecilie Alfsen, MD, PhDcecilie.alfsen@medisin.uio.no

362: Interdisciplinary Communication Solutions from the Front-line Boston Medical CenterNicole Lincoln, RN Nicole.Lincoln@bmc.org

363: Interprofessional Patient Safety Education: Start EarlyNational University HospitalBhuvaneshwari Mohankumar, MPHbhuvaneshwari@nuhs.edu.sg

364: IV Labetalol Protocol Adherence for Treatment of Hypertensive Crises on the Labor and Delivery UnitThe University of Kansas School of Medicine — WichitaLauren O’Brien, MDlaobrien21@gmail.com

365: Keeping Falls Out of Our AutumnNCH Healthcare SystemAngela Devaney, RNangela.devaney@nchmd.org

366: Learning from Hospital Mortality; Moving Beyond the NumbersRoyal College of PhysiciansKevin Stewart, MPHkevin.stewart@rcplondon.ac.uk

367: Learning from Preoperative and Postoperative Diagnoses’ Discrepancy to Improve Surgical SafetyNational University HospitalBhuvaneshwari Mohankumar, MPHbhuvaneshwari@nuhs.edu.sg

368: Learning Portal for Safer Care — Reforming Patient Safety CultureQreform LtdMilla Lindqvist, PhDmilla.lindqvist@qreform.com

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28TH ANNUAL NATIONAL FORUM STORYBOARDS: Patient Safety

369: “Let’s get on same page”: Improving Interdisciplinary Communication and Teamwork through TeamSTEPPSUniversity of Minnesota School of NursingRazaq Adedayo, RNaded0014@umn.edu

370: Leveraging Simulation To Achieve High Reliability in HealthcareUniversity of Texas Southwestern Medical CenterOren Guttman, MDoren.guttman@utsouthwestern.edu

371: Longitudinal Identity Taskforce Intended for NewX Mayo ClinicMatthew Salernosalerno.matthew@mayo.edu

372: Maternal Code Blue Improvements Resulting from OB In Situ SimulationsBoston Medical CenterPamela Corey, RNpamela.corey@bmc.org

373: Medication Safety in the Interventional Radioloyg SuiteWestside Regional Medical CenterPatty Stover, RN, MSWPatricia.Stover@hcahealthcare.com

374: MMMC Falls Reduction ProjectMethodist Mansfield Medical CenterDonna Crimmons-Bonnell Nolen, RNDonnaCrimmins-Bonnell@mhd.com

375: Morse Fall Risk Score: Change of ThresholdNCH Healthcare SystemJeannie Kellogg, RNjeannie.kellogg@nchmd.org

376: National Patient Safety Consortium and Integrated Patient Safety Action PlanCanadian Patient Safety InstituteJennifer Rodgers, MSWjrodgers@cpsi-icsp.ca

377: Never Give Up, Never Surrender! Layering Interventions to Lower Clostridium difficile (C-diff) IncidenceMary Immaculate HospitalSusan Moeslein, RNsusan_moeslein@bshsi.org

378: Never Learn How to Deal with an Emergency at an Actual EmergencyLondon Health Sciences CentreLucy Vermeulen, RNlucia.vermeulen@lhsc.on.ca

379: Nicotine Cessation Program Participation for Bariatric Surgery PatientsSt. Luke’s Boise Medical CenterCathy Archibald-Seifferarchibac@slhs.org

380: Non-ventilator Hospital Acquired Pneumonia in U.S. Hospitals: Incidence and CostHallmark HealthKaren Giuliano, PhD, RNkkgiuliano96@gmail.com

381: Northwestern Medicine Medical Group — Pain ProtocolsNorthwestern Memorial HospitalJon Hughes jon.hughes@nm.org

382: Novel method to involve nursing staff in targeted medication-effect-observation and reportingThe Norwegian Medical AssociationStephan Orestephan.ore@gmail.com

383: Nursing “Need-to-knows” An interdisciplinary, innovative educational series on common diagnoses in acute careLong Island Jewish Medical CenterJordana Kozupsky, RNjordana.kozupsky79@myhunter.cuny.edu

384: One Patient is One Too may: Preventing Hopsital-Acquired Venous Thromboembolism Royal Melbourne HospitalFiona Watsonfiona.watson@mh.org.au

385: Optimizing Failure-Free Use of Medical DevicesMemorial Hermann Health SystemPatricia Hercules, RNpatricia.hercules@memorialhermann.org

386: Optimizing Postoperative Survival for Patients Operated for Hip FractureAalborg University HospitalRikke Beckermannr.beckermann@rn.dk

387: Patient Identification: Reducing Precursor Safety Events The Stephen and Alexandra Cohen Children’s Medical Center of New YorkHelen Scott, MDhmaliagros@northwell.edu

388: PATIENT SAFETY CULTURE — Systems Failure Focus/ Nonpunitive Response to ErrorsFawcett Memorial HospitalMary McKinleymary.mckinley@hcahealthcare.com

389: Patient Safety in Opiod Prescribing QuadMedMary Ellen Benzik, MDmebenzik@gmail.com

390: Patient Safety is PersonalNo OrganizationDavid MorrillWolfalien1476@gmail.com

391: Peripherally Inserted Central Catheters (PICC) Alteplase Usage and Venous Access Nurse Consults NCH Healthcare SystemLiz Barley, RNLiz.Barley@nchmd.org

392: Pharmacist Participation on Adult Code Blue Teams: A Quality Improvement InitiativeBoston Medical CenterMichael Rio, PharmDjennifer.empfield@bmc.org

393: Pre-cleaning and Transportation of Endoscopes: Ensuring Best Practices UC Irvine HealthLynn Willismwillis@uci.edu

394: Prevention of Sacral and Heel Pressure InjuriesNCH Healthcare SystemValerie LaRiche, RNvalerie.lariche@nchmd.org

395: Promotion of an Organizational Culture of Safety, Reducing Patient Harm through a Collaborative Team EffortNew Jersey Hospital AssociationMonica Feinberg, RNmfeinberg@barnabashealth.org

396: Purposeful Patient Safety Rounds — Building Trust and Making it Count!New Hanover Regional Medical CenterGrace Ferraro, RNGrace.Ferraro@nhrmc.org

397: Quality Improvement in Emergency Department Chaos NHS LanarkshireJohn Hardenjohn.harden@nhs.net

398: Redefining ER Process Flow to Reduce Wait Times & Prevent Patients Leaving Without Being SeenFlagler HospitalMatthew Rill, MDmatthew.rill@flaglerhospital.org

399: Reducing Colon SSI by Hardwiring Colon Bundle Practices: Pre op Bathing and Skin PreparationSamaritan HospitalJessica Hayashijessica.hayashi@sphp.com

400: Reducing Exposure to Second Hand Smoke in ChildrenStony Brook University HospitalGrace Propper, RNgrace.propper@stonybrook.edu

401: Reducing Hospital Acquired Central Line Associated Bloodstream Infections (CLABSI) at Florida HospitalFlorida HospitalKyle Carterkyle.carter@flhosp.org

402: Reducing Hospital Acquired Clostridium Difficile Infections at Florida HospitalFlorida HospitalKyle Carterkyle.carter@flhosp.org

403: Reducing Hospital Acquired Catheter-Associated Urinary Tract Infections (CAUTI) at Florida HospitalFlorida HospitalKyle Carterkyle.carter@flhosp.org

404: Reducing Radiation Hazards In Neonatal Unit - Quality Improvement in Radiation Safety PracticesSingapore General HospitalPriyantha Edisonedison.priyantha.samuel@sgh.com.sg

405: Reducing Restraint Use With Medical PatientsNew Hanover Regional Medical CenterBillie T. Robinson, RNbillie.robinson@nhrmc.org

406: Reducing Sepsis Mortality: Sepsis AlertsThe University of Kansas School of Medicine — WichitaGina Berg, PhDgberg@kumc.edu

407: Reducing Sepsis Mortality: Educating Sepsis ChampionsWesley Medical CenterSuzanne Fletcher, RNsuzanne.fletcher@wesleymc.com

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28TH ANNUAL NATIONAL FORUM STORYBOARDS: Patient Safety

408: Reduction of Advanced Stage Post-Operative Pediatric Tracheostomy WoundsNationwide Children’s HospitalKris Jatana, MDKris.Jatana@nationwidechildrens.org

409: Reduction of Hypoglycemic Events in a Community Hospital SettingNCH Healthcare SystemKim Thorpkimberly.thorp@nchmd.org

410: Reduction of Inpatient Falls Through Engineering Upgrades, Policy Changes, and Improved Staff AwarenessRaulerson HospitalLance Richards, RNlr967015@ohio.edu

411: Reduction of Radiation through Physician Education NCH Healthcare SystemJim Batesjim.bates@nchmd.org

412: Right patient, Right Catheter, Right TimeMayo ClinicMary Seversonseverson.mary@mayo.edu

413: Root Cause Analysis as a Potential Communication Improvement Tool Japan Association for Development of Community MedicineMasahiko Ishikawa, MD, PhDmasahikois@jadecom.jp

414: Safe VTE Prophylaxis on the Observation UnitNew York University Langone Medical CenterJason Wylanddoctorella@msn.com

415: Safety in Numbers: Increasing Adverse Event ReportingChildren’s National Medical CenterSonal Kalburgi, DOskalburg@cnmc.org

416: Safety Marketing Communication Strategy and Initiatives: Helping to Change a CultureSignature Healthcare Brockton HospitalLorraine McGrathlmcgrath@signature-healthcare.org

417: Saving Sacrums: Reducing Pressure InjuriesNCH Healthcare SystemErin Raney, RNerin.raney@nchmd.org

418: Sepsis Checklist decreases Sepsis MortalityMethodist Mansfield Medical CenterDonna Crimmins-Bonnell, RNdonnacrimmins-bonnell@mhd.com

419: Sharing Notes is Good Medicine: The Patient Safety Benefits of OpenNotesBeth Israel Deaconess Medical CenterSigall Bell, MDsbell1@bidmc.harvard.edu

420: Simulation Education to Ensure Safe Care After a Fall London Health Sciences CentreLucy Vermeulen, RNLucia.vermeulen@lhsc.on.ca

421: Standardization of Aseptic Technique in Regional Anesthesia BlocksHamad General HospitalSami AbdelmaksoudSibrahim4@hamad.qa

422: Strategies for Fall Injury ReductionLawnwood Regional Medical Center and Heart InstituteNoreen Spano, RNnoreentj@comcast.net

423: Systemic Error Proofing to Prevent Hypoglycaemia in the Management of Hyperkalaemia PatientsNational University HospitalBhuvaneshwari Mohankumar, MPHbhuvaneshwari@nuhs.edu.sg

424: Teaming Up Against Venous Thromboembolism (VTE) Following Total Knee Arthroplasty (TKA)Hartford HospitalRobert Magaldirjm443@cornell.edu

425: The Academy for Emerging Leaders in Patient Safety: The Telluride Experience MedStar Health Quality and Safety InstituteSarveshwari Singhss3456@georgetown.edu

426: The Fastest Way to Catch a Killer NCH Healthcare SystemMaritza Lemesmaritza.lemes@nchmd.org

427: The Secret in the Steam: How does Steam Quality Impact the Risk of Infection? Community Medical CenterMary Ann Wellsmary.ann.wells@rwjbh.org

428: To Reduce Chemotherapy Spillage Singapore General HospitalLi Ying andrea.choh.c.l@sgh.com.sg

429: Treat Before TransferWesley Medical CenterBrett Hartkoppbrett.hartkopp@ghhwesleymc.com

430: Use of a Fluorescent Gel Monitoring System to Improve Compliance with Cleaning of Clinical EquipmentTexas Health Harris Methodist Hospital Southwest Fort WorthKatherine Rhodes, RNKatherineRhodes@texashealth.org

431: Using a Bundle-Element Approach in Pediatric Central Line-Associated Bloodstream InfectionsThe Children’s Hospital of PhiladelphiaStephanie PowellPowellS@email.chop.edu

432: Validity and Reliability of the Cognitive PyramidOregon Health and Science University (OHSU)Mariah Hayes, RNhayesma@ohsu.edu

433: Vulerability in Canadian Mental Health Settings: In-Patient SuicidesHIROCPolly Stevensjnoble@hiroc.com

434: When Hospitals Unite — The Focus is Patient SafetyJFK Medical CenterJudy Westhouse, RNwestthousej@bellsouth.net

435: When One Fall Becomes Another: Stop the Cycle in Ambulatory CareNovant HealthAaron Westawest@novanthealth.org

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Person- and Family-Centered CareStoryboard Numbers: 250–300

250: Advancing the Patient Experience through MindfulnessSaint Barnabas Health Care SystemPatrick Swift, PhDpatrick.swift@rwjbh.org

251: CCO’s Advisor Connect: A virtual community bringing together patient, family and public advisorsCancer Care OntarioSuman Dhanjusuman.dhanju@cancercare.on.ca

252: Cervical Cancer Screening: An Innovative Approach for HIV+ WomenUNM Truman Health ServicesTamra Williamstjwilliams@unmmg.org

253: Coaching Primary Care Practices in Patient-Centered Care: Engagement Measurement and ImprovementIntegrated Physician NetworkLauren OKipneyLOKipney@ipn.org

254: Community Based Clinical Research — It Takes a VillageNovant HealthWendy Hobbswlhobbs@novanthealth.org

255 Comprehensive Diabetic Care In Chronic Hemodialysis Patients : A Holistic Team EffortNo OrganizationFadumo Yasinfyasin@hamad.qa

256: Courageous Communication: Impact of Inter-professional Collaboration and Communication at the Bedside Practice University HospitalSean Mooresean.moore2@uhs-sa.com

257: Developing Patient Centered Care in the Yukon Delta Region of AlaskaHealthcare Performance PartnersThomas Wallenrbaldwin@hpp.bz

258: Early Structured Communication Improves End-of-Life Care in the ICU? SSM Health CareAlbert Musa, MDalbert.musa@deancare.com

259: Empowering Meaningful Discussion and Documentation of Code StatusNew York University Langone Medical CenterJordan Dourmashkindoctorella@msn.com

260: Engaging Families to Improve Communication: The Patient and Family Centered I-PASS BundleCohen Children’s Medical CenterAnu Subramony, MDasubramony@northwell.edu

261: Enhancing the Patient/Provider Conversation through the use of Patient Reported Outcome Questionnaire (PRO-Q) responsesUniversity of Texas Southwestern Medical CenterSherene Philipsherene.philip@utsouthwestern.edu

262: Enhancing Ways To Improve The Care For Bariatric PatientsSingapore General HospitalAngelina Fooandrea.choh.c.l@sgh.com.sg

263: Failing Forwards as an Essential Component of Improving Predictive Discharge Alan GobAlan Gob, MDalan.gob@me.com

264: Families Influencing Safety Initiatives: Partnering to Prevent Patient Falls The Children’s Hospital of PhiladelphiaKimberly DiGerolamo, RNdigerolamk@email.chop.edu

265: Gateways to Patient Family EngagementPatient & Family Centered Care PartnersLindsey Bournelindsey@pfccpartners.com

266: Get Ready to MOON Your Patients! New Notification Requirements for Patients Receiving Outpatient Observation ServicesTaylor HealthcareTimothy Kellytimothy.kelly@taylorcommunications.com

267: Hearing the Voice of the Patient — Adding Self-Coaching to a Patient Follow-Up ToolEdward-Elmhurst HealthcareTom Scaletta, MDtscaletta@edward.org

268: How do you improve care? Ask kids and youth to share their ideasHolland Bloorview Kids Rehabilitation HospitalLaura Oxenham-Murphyloxenham-murphy@hollandbloorview.ca

269: Improving End of Life Care: A Patient-Centered ApproachNorthwestern Memorial HospitalBarbara Buckley, RNbbuckley@nm.org

270: Improving Medication Review for Older Patients in Acute CareChelsea AND Westminster NHS Foundation TrustEmily Wardemily.ward@chelwest.nhs.uk

271: Improving Patient Understanding of Medications Through MedMatcher Application York HospitalDawn Becker, RNdbecker@wellspan.org

272: Informational Needs of Patients and Families in the Hospital SettingAlbany Medical Center/Somml HealthMichael WaxmanWaxmanm@mail.amc.edu

273: Integrating Patients in Patient-Centered Communication Training for Surgical Residents: A Simulation-Based CurriculumInova Health SystemAnna Newcombanna.newcomb@inova.org

274: Motivational Interviewing: Successful IntegrationQ-consult, LLCSusan Butterworth, PhDbutterwo@qconsulthealthcare.com

275: Novel Tool as A Trigger for Advanced care Planning (ACP) in Hospitalized Oncology PatientsBoston Medical CenterNicole Lincoln, RNNicole.Lincoln@bmc.org

276: Optimizing The After Visit for MaineHealth Outpatient ClinicsUniversity of New England and MaineHealthTahlia Wolfgangahess@maine.rr.com

277: Partnering With Families to Design an Inclusive Ambulatory Building The Children’s Hospital of PhiladelphiaAmy Kratchman, MSWrichardsam@email.chop.edu

278: Partnering with Patients and Families in the CommunityHouston Methodist West HospitalTere Jacksontjackson2@houstonmethodist.org

279: Partnering with Providers in Process ImprovementPatient & Family Centered Care PartnersLindsey Bournelindsey@pfccpartners.com

280: Partners Pediatric iCMP Program Caring for Children with Complex Care Needs in Primary CarePartners HealthcareBarbara Chambers, RNbchambers@partners.org

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress BallroomDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 2

28TH ANNUAL NATIONAL FORUM STORYBOARDS: Person- and Family-Centered Care

281: Patient and Family Advisory Councils Clinic StyleGundersen Health SystemGinny Moorevamoore@gundersenhealth.org

282: Patient Feedback Improves Mental Health Outcomes: An Evidence Based PracticeKaiser PermanenteCosette Taillaccosette.taillac@kp.org

283: Patient Portal 2.0: Innovation Drives EngagementHealthEast Care SystemTodd Smith, MDinfo@ubicare.com

284: Patients and Families First: Meeting the Needs of Autistic and Special Needs Perioperative PatientsThe Stephen and Alexandra Cohen Children’s Medical Center of New YorkKathy Albertkalbert@northwell.edu

285: Patients and Families First: Meeting the Needs of Pediatric Autistic and Special Needs Perioperative PatientsThe Stephen and Alexandra Cohen Children’s Medical Center of New YorkKathy Albertkalbert@northwell.edu

286: Poke Plan: Communicating Patient Needs and Preferences for Pain and Anxiety ManagementAnn & Robert H. Lurie Children’s Hospital of ChicagoSteve Laislai@luriechildrens.org

287: Preserving Kidney Function in Spina Bifida PatientsNationwide Children’s HospitalStephen Salesstephen.sales@nationwidechildrens.org

288: QI Meets Patient Stories: Are You Making the Most of Your Patient Stories?Scottish GovernmentShaun Maher, RN54maher@gmail.com

289: Right Care, Right Place, Right Time: Simplifying Care for Complex Care NeedsChangi General HospitalChristopher ChangChristopher_Chang@cgh.com.sg

290: Setting the Stage for Patient Involvement in the Research Agenda: The PerioPatient ProjectPeriodontal Patient ProjectVictoria Henson-Apolloniovha2014pa@gmail.com

291: South West Hospice Palliaitve Care in the South West LHINSouth West Local Health Integration NetworkLisa Penner, RNlisa.penner@sw.ccac-ont.ca

292: State of Person and Family Centered Care — Organizations and SupportsLAM Professional Services, LLCLisa Morriselisa.morrise@gmail.com

293: Sutter Health Patient and Family Advisory Councils Sutter HealthRoberta Mori, RN morir@sutterhealth.org

294: Sutter Health Patient Experience (SHPX) Advisory Council Sutter HealthRoberta Mori, RN morir@sutterhealth.org

295: The Advisor Experience Survey: Improving the Engagement Experience of Patient, Family and Public AdvisorsCancer Care OntarioSuman Dhanjusuman.dhanju@cancercare.on.ca

296: The Bortezomib @Home ProgramNational University Cancer Institute of Singapore (NCIS)Yee Mei Lee, PhDyee_mei_lee@nuhs.edu.sg

297: The Family Will See You Now: A Prototype for Family Health and Well-BeingBusiness Innovation FactoryElizabeth MacLareneli@businessinnovationfactory.com

298: Three Sides to Every Story: Preparing Patient and Family Storytellers, Facilitators and Audience ParticipantsLondon Health Sciences CentreLisa Hawthornthwaiterobin.magri@lhsc.on.ca

299: Use of Patient-Oriented Discharge Summaries (PODS) to Improve Patient Education and Access to Timely Follow-upWestern UniversityErin Spicer, MDespicer4@uwo.ca

300: What matters to you? Day 2016, #wmty16Scottish GovernmentShaun Maher, RN54maher@gmail.com

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Quality, Cost, and ValueStoryboard Numbers: 164–249

164: A Blood Management Paradigm for Patients Undergoing Elective Orthopedic SurgeryNew Hanover Regional Medical CenterCharmaine Lewis, MDCharmaine.lewis@nhrmc.org

165: A Lean Approach to the Spread of Innovations: The Sharing of Good IdeasUniversity of North Carolina (UNC) at Chapel HillErica Wolak, RNerica.wolak@unchealth.unc.edu

166: A Systemic Approach to Decreasing VariabilityHartford HealthCareKate Simskate.sims@hhchealth.org

167: A Test of Change, A New Model for Chronic Disease Management North York General HospitalSusan Woollard, RN heather.brien@nygh.on.ca

168: Adherence Impact for New Hepatitis C Treatment on Cost Effectiveness in a Managed Care OrganizationVNSNY CHOICE SelectHealthLauren Benyolalauren.benyola@vnsny.org

169: Anemia Clinic and the effects on elective total hip and knee replacementNew Hanover Regional Medical CenterCharmaine Lewis, MD Charmaine.lewis@nhrmc.org

170: Breaking Barriers: Lean-Designed Discharge Command Center Improves Patient Flow St. Luke’s-Roosvelt Hospital/Mount Sinai Health SystemLucy Xenophon, MD lxenophon@chpnet.org

171: Breaking the Barriers to 11am Discharge on East Pavilion 9-5 at Yale New Haven HospitalYale New Haven HospitalJessica Cruz, RNJessica.cruz@ynhh.org

172: Community Based Care:Mobile Health ParamedicsGeisinger Wyoming Valley Medical CenterDavid Schoenwetter, DOklsharp1@geisinger.edu

173: Continuing Quality Improvement in Motion: Portering DepartmentLondon Health Sciences CentreEamonn Cullenrobin.magri@lhsc.on.ca

174: Decrease ED Blood Culture Contamination RatesSamaritan HospitalJudith QuinnJudithR.Quinn@SPHP.com

175: Department of Medicine (DOM) — Outpatient Practice “Doc of the Day” (DOD)Mayo ClinicTroy Thulthul.troy@mayo.edu

176: Developing and Sustaining a Comprehensive and Collaborative Approach to Breathing Easier All Children’s Hospital John’s Hopkins MedicineSherry Belchersherry.belcher@jhmi.edu

177: Development of a Clinical Program: Piloting Our Approach Using a Pathway for Evaluating CautiUniversity of PennsylvaniaCraig Umscheid, MDCraig.Umscheid@uphs.upenn.edu

178: Development of an Interactive Dashboard: An Innovative Approach to Presenting Hospital Acquired Infection Data Partners HealthcareSarah Doughertysdougherty@partners.org

179: Early Mobility in Critical Care Patients “ICU-Move It”: Movement is MedicineRegions HospitalSean Schullerhilary.f.radtke@healthpartners.com

180: Effectively Managing the Workforce for Success in Value-Based HealthcareKronos IncJocelyn Strong, RNJocelyn.strong@kronos.com

181: Failing Forward as a Case for Moral MeasurementMethodist Health SystemsBenjamin Jacobbenjaminjacob@mhd.com

182: Fast, Accurate, Systematic & Transitional: (FAST) Care Model for Patients to Receive Early Rehabilitation ReviewSingapore General HospitalSu Fee Limlim.su.fee@sgh.com.sg

183: Financial Counselling, Reinvented!Singapore Health ServicesChen Ee Leelee.chen.ee@singhealth.com.sg

184: Fixing Free-Floating Forms: Creating a Standard Process for Handling Patients’ FMLA and Disability FormsMayo ClinicChristopher Laulau.christopher@mayo.edu

185: Gastrointestinal Endoscopy (GI)Realignment and Best Practice Implementation ProjectLondon Health Sciences CentreSara Foliasrobin.magri@lhsc.on.ca

186: Heart Failure to Healthy Lives — A 6 Year Journey at Monmouth Medical CenterMonmouth Medical CenterSharon Holden, RNsholden@barnabashealth.org

187: Hospital Consumer Assessment of Healthcare Providers & Systems: A Deep Dive into Institutional DataMayo ClinicElizabeth Habermann, PhDhabermann.elizabeth@mayo.edu

188: Impact of Standardizing Transitional Care Management Services in the Ambulatory Care SettingNortheast Medical GroupJohn Palumbojohn.palumbo@ynhh.org

189: Improve Early Access of High Risk Patients to Primary Care Podiatry for Acute ManagementNational healthcare Group PolyclinicsDonna Tan, MDdonna_tan@nhgp.com.sg

190: Improving Access and Convenience of Patient Master ListSingapore General HospitalDerek Leederek.lee.z.n@sgh.com.sg

191: Improving Appropriate Utilization of Cardiac Telemetry at Bridgeport Hospital Bridgeport HospitalLinda Epsteinlinda.epstein@bpthosp.org

192: Improving Efficiency of Care for Complex Tracheostomy PatientsCarolinas Healthcare SystemMeridith Gombarlaura.foxx@carolinashealthcare.org

193: Improving Patient Accessibility By Reducing Re-Scheduling Rate: An Essential Healthcare Quality DimensionKing Faisal Specialist Hospital & Research CenterMustafa Khanmustafakhansaheb@gmail.com

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress BallroomDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 4

28TH ANNUAL NATIONAL FORUM STORYBOARDS: Quality, Cost, and Value

194: Improving Quality of Palliative Care: Developing and implementing National Guidelines for Palliative CareNational Cancer Centre SingaporeTong Jen Lo, MDlo.tong.jen@nccs.com.sg

195: Improving Rapid Streptococcal Testing in the Pediatric Emergency Department Saint Barnabas HospitalAna Landaverde-Carpioanalandaverde@hotmail.com

196: Improving Sepsis Outcomes through Continuous Improvement in a Community Hospital SettingMission HospitalsLiz Lafitteelizabeth.lafitte@msj.org

197: Improving the Health of a CommunityNew Hanover Regional Medical CenterSue Ballato, RNsue.ballato@nhrmc.org

198: Increase the Rate of Ankle Brachial Index Assessment for Newly Diagnosed Diabetic Foot UlcersNational healthcare Group PolyclinicsLye Yoong Tan, MDrachel_r_li@nhgp.com.sg

199: Is Dry Indoor Air a Driver for Patient Infections?Harvard Medical SchoolStephanie Taylor, MDstaylorvt@gmail.com

200: It’s a Miracle: Clinical Variation Reduction... A Supply Chain / Physician Collaboration Novant HealthLawerence “Lars” Nycum, MDlrnycum@novanthealth.org

201: Keep Calm and Document On: Documentation ExcellenceNovant HealthAbby Steelhammer, RNabsteelhammer@novanthealth.org

202: Lets BEE Mindful An Individualized Program for Children with Special NeedsThe Stephen and Alexandra Cohen Children’s Medical Center of New YorkSharon Goodman, RNsgoodman3@northwell.edu

203: Leveraging Medicare Spend Per Beneficiary Claims Data to Imrove Post-acute UtilizationVizient IncColleen Oldham, RNcolleen.oldham@vizientinc.com

204: Management of HypoglycemiaMethodist Health SystemsLorenzo Manquero, RNLorenzoManquero@mhd.com

205: Massive Transfusion Protocol in a Community Non-Trauma Setting: Is Blood Product Wastage Avoidable?The Hospital of Central ConnecticutNoubar Kevorkiannoubar.kevorkian@hhchealth.org

206: Navigating ICU Expenses in the ACO EnvironmentBellin HealthJason Mattson, RNjason.mattson@bellin.org

207: New Hanover Hospitalists Choosing Wisely: TelemetryNew Hanover Regional Medical CenterCharmaine LewisCharmaine.lewis@nhrmc.org

208: Nurse-led Virtual Monitoring of Chronic Hepatitis B Patients as a Cost-Effective Alternative to Standard CareSingapore General HospitalEdmund Pek Siang Teoedmund.teo.p.s@sgh.com.sg

209: Optimizing Transitions of Care for Medical Patients from Hospital to Community St. Thomas Elgin General HospitalKaren Davies, RNkdavies@stegh.on.ca

210: Optimizing Value: A Time-Driven Activity-Based Costing and Workflow Study in Primary CareDepartment of Family Medicine, University of Virginia School of MedicineM. Norman Oliver, MDmno3p@virginia.edu

211: Our Journey in Reducing Readmissions at Nemours Children’s Hospital (NCH)Nemours Children’s HospitalJan Genke, RNjan.genke@nemours.org

212: Our Journey to Zero Harm: Reducing CAUTI in the Children’s HospitalYale New Haven Health SystemLauren Edwards, RNlauren.edwards@ynhh.org

213: Pathways to Population Health: A Case StudyOhioHealth GroupKyrsten Chamberskchambers@ohiohealthgroup.com

214: Payer/Provider Collaborative Reduces Utilization and Cost, Improves Quality for 60K Medicare Advantage PatientsEvolution HealthLanty O’Connorlanty.oconnor@evolution.net

215: Pediatric Echocardiography Payment InnovationMedical College of WisconsinJulie Slickerjslicker@chw.org

216: People — Preparation — Process; The Lean Approach to Facility Design at Carolinas HealthCare SystemCarolinas Healthcare SystemNathan Berghlaura.foxx@carolinashealthcare.org

217: Quality Improvement Study of Discharge SummaryDetroit Receiving HospitalFaisal Kanbar Aghafsl_zm@yahoo.com

218: Rapid Response Liaisons — Just a Heartbeat AwayKaiser PermanenteLaura Reeselaura.m.reese@kp.org

219: Redefining Fracture Care: A multifaceted program of osteoporosis detection, fracture prevention and evidence-based treatmentto Alberta Health Services, Bone & Joint Strategic Clinical NetworkLiz Evenslevens@abjhi.com

220: Redesigning Care to Lower Episode Costs in Bone Marrow TransplantationStanford Health CareDiana PattersonDPatterson@stanfordhealthcare.org

221: Redesigning the Care of the Patient with Sickle Cell Disease: A Partnership with Patients Bridgeport HospitalSheran Simosheran.simo@bpthosp.org

222: Reducing Cancellations on the Day of Scheduled Surgery at a Public General HospitalHospital Estadual de DiademaMarco Vitorino Cunha, MDmarcoavcunha@yahoo.com.br

223: Reducing Incidence of Peripheral Intravenous Therapy Infiltrations and Extravasations (PIVIEs) at an Academic Medical Center Dartmouth Hitchcock Medical CenterNicole Batulisnicole.s.batulis@hitchcock.org

224: Reducing the Intraoperative Use of Human Albumin at a University and a Community HospitalUniversity Of Cincinnati Medical CenterSean Josephs, MDsjosephsmd@gmail.com

225: Reducing Unnecessary Testing in the Care of Children with BronchiolitisChildren’s Hospital ColoradoPaige Krackpaige.krack@childrenscolorado.org

226: Reducing Waste in the PICU Through a Standardized Lab Reduction StrategyUniversity of Alabama at BirminghamWilliam Sasserwsasser@peds.uab.edu

227: Sitter Validation Tools Reduces Cost without Negative Impact on Quality Care Brigham and Women’s HospitalEscel Stanghellini, RNestanghellini@partners.org

228: Small People in a Big World: It’s a “SPECIAL-T”The Stephen and Alexandra Cohen Children’s Medical Center of New YorkSharon Goodman, RNsgoodman3@northwell.edu

229: Telepsychiatry and Patient Placement: Using Lean Methods to Improve Patient Care and Reduce ED LOSCarolinas Healthcare SystemBruce Silbermanlaura.foxx@carolinashealthcare.org

Institute for Healthcare Improvement · ihi.org 5

28TH ANNUAL NATIONAL FORUM STORYBOARDS: Quality, Cost, and Value

230: The Added Value of a Daily Check-In Safety Call at a Pediatric Health System Children’s National Health SystemAhmed Almuhannaaalmuhan@ChildrensNational.org

231: The Development of the Observation Unit and the Triple AimNew York University Langone Medical CenterChristopher Caspersdoctorella@msn.com

232: The Inception of a Combined Enhanced Recovery After Surgery & Surgical Site Infection Prevention ProtocolPartners HealthcareSadiqa Mahmood, MPHsmahmood4@partners.org

233: The Lean Leadership Development Program at Carolinas HealthCare SystemCarolinas Healthcare SysteChicana Moorelaura.foxx@carolinashealthcare.org

234: The Malnutrition Quality Improvement Initiative: A Dual-Pronged Approach to Advancing Malnutrition Care in Older Adults Avalere HealthEleanor Fitallefitall@avalere.com

235: The Shift to Electronic Clinical Quality Measures (eCQMs)Encore Health ResourcesSophia Batallas, RNsophia.batallas@quintiles.com

236: The SPIN Team: Supporting Premature Infant NutritionUniversity of PennsylvaniaLori Christ, MDlori.christ@uphs.upenn.edu

237: The Transplant Online Exercise (TONE) Program: Bringing Specialized Physiotherapy Care to Patients across Ontario, CanadaLondon Health Sciences CentreNancy Howesrobin.magri@lhsc.on.ca

238: Transforming Clinical Practice Guidelines into Action Society of Critical Care MedicineVishakha Kumar, MDkhanolkarv@gmail.com

239: Transforming Post-Operative Care through the Creation of the Surgical Extended Care UnitAll Children’s Hospital John’s Hopkins MedicineTracy West-Grubbtwestgr1@jhmi.edu

240: Transforming Specialty Care. Hub and Community Shared-Care Satellite ModelRouge Valley Health SystemStephen Gallaystephengallay@gmail.com

241: Triple Aim as a Conceptual Framework for Conducting Comparative Effectiveness Research in Postoperative PainMallinckrodt PharmaceuticalsGeorge WanGeorge.Wan@mallinckrodt.com

242: Turnaround Time Reduction of Radiology Results for Emergency Department PatientsCarolinas Healthcare SystemMelissa Hospelhornlaura.foxx@carolinashealthcare.org

243: Unanticipated Benefits of a Collaborative Approach to Reducing Preventable Readmissions in Bariatric SurgeryPartners HealthcareSadiqa Mahmood, MPHsmahmood4@partners.org

244: Understanding Your Peritoneal Dialysis Bloodwork ValuesLondon Health Sciences CentreNancy Woodcockrobin.magri@lhsc.on.ca

245: Using Transparency to Decrease Emergency Department Computed Tomography UtilizationCornell Scott-Hill Health CorporationMark Silvestri, MDmark.silvestri@gmail.com

246: Utilizing a Multidisciplinary Team Approach to Reduce Hospital Acquired C. difficile Infections.Memorial Hospital Of TampaStephanie Green, RNStephanie.green@hcahealthcare.com

247: Working Together in a Multispecialty Organization: Decreasing Patient Wait Time for Lab Services OU Physicians-TulsaJennifer FoughtJennifer-Fought@ouhsc.edu

248: Zero Diversion Across Multiple Emergency Departments: Open Access for the Acute PatientAurora Health CareMimi Kokoska, MDMimi.kokoska@aurora.org

249: Reducing Hip Fracture Surgery Delays in Edmonton, AlbertaUniversity of AlbertaLiz Evenslevens@albertaboneandjoint.com

Institute for Healthcare Improvement · ihi.org 1

Triple Aim for PopulationsStoryboard Numbers: 6–34

6: A System-Level Implementation of a High-Risk Pathway for Heart Failure PatientsIntermountain HealthcareJose Benuzillojose.benuzillo@imail.org

7: A Triple Aim Improvement Story: How to Reduce and Report Cumulative Radiation ExposureIntermountain HealthcareColleen Roberts, RNcolleen.roberts@imail.org

8: ACO’s and the Seriously IllCare New England Health SystemAna Tuya Fulton, MD, FACPafulton@carene.org

9: Adaptations to International Collaboratives That Work!Institute for Healthcare ImprovementMaureen Tshabalala, MPHmtshabalala@ihi.org

10: Advanced Medical Home —Transforming Primary Health to Meet the Needs of People Spectrum Health Medical GroupEdward Millermaier, MDedward.millermaier@spectrumhealth.org

11: An Innovative Partnership to Serve Vulnerable PatientsProvidence St. Vincent Medical CenterMichelle Matsonmichelle.matson@providence.org

12: Assessment of a Pharmacist-Managed Outpatient Transition Clinic in a Community Hospital Florida Hospital CelebrationKristin Morsekristin.morse@flhosp.org

13: Building Sustainability into Reduced Heart Failure Patient Readmissions and Improved OutcomesStanford Hospital and Clinics Christine Thompson, RNchrthompson@stanfordhealthcare.org

14: Concussion: Regional Collaboration Takes Triple AimCentraCareScott Picklerscott.pickler@centracare.com

15: Disease Registries as a Tool for Improving Patient OutcomesThe University of Texas Medical Branch at GalvestonCraig Kovacevichcskovace@utmb.edu

16: Down to zero — Reducing SSI in Heart Surgerycarmel medical centerSharon Alroy-Preis, MD, MPHsharon.alroy.preis@gmail.com

17: Dry Indoor Air Drives Patient InfectionsTaylor Healthcare Consulting, IncStephanie Taylor, MDmd@taylorcx.com

18: Enacting Family Centered Care in Situations of Required Social SeparationThe Children’s Hospital of PhiladelphiaRachel Biblow, MSWrichardsam@email.chop.edu

19: Evaluating Long Term Care Homes’ IntraVenous Therapy Experiences (LIVE Study)Medical Pharmacies Group LimitedHrishikesh Navarehnavare@medicalpharmacies.com

20: Exemplary Practices in Primary Care Home ImplementationOHSU & PSU School of Public HealthSherril Gelmon, DrPHgelmons@pdx.edu

21: Formulating a provincial strategy for Regional Trauma Network developmentCritical Care Services OntarioCherryl Koylasscherryl.koylass@ccso.ca

22: Implementation and Outcomes of Comprehensive Epilepsy Model in OntarioCritical Care Services OntarioAnastasia VogtAnastasia.Vogt@uhn.ca

23: Improving Chronic Kidney Disease Care: EMR Tools Help Providers Accurately Stage and Close Care Gaps University of Texas Southwestern Medical CenterYolanda Normanyolanda.norman@utsouthwestern.edu

24: Improving Population Health: Hepatitis C screening for Baby Boomers (Adults Born 1945-1965) University of Kansas Medical CenterEyad Al-Hihi, MDeal-hihi@kumc.edu

25: Improving Transitions Near End of LifeCare New EnglandKelly Baxterkbaxter@kentri.org

26: Integrating a Systems-Based Practice Curriculum into Graduate Medical EducationArizona State UniversityKristen Willkkwill@asu.edu

27: Medicare Annual Wellness Visit: Unique Opportunities to Meet the Triple Aim MerckLisa Wrightlisa_wright2@merck.com

28: Overcoming Initiative Fatigue — A Roadmap for Health Systems Transformation National Association of Community Health Centers (NACHC)Cheryl Modica, PhD, MPHcmodica@nachc.com

29: Pediatric Asthma ED Visit Reduction in Dallas Childrens Health System of TexasChad Brands, MDRobert.Shaum@childrens.com

30: Promoting Colorectal Cancer Screening: Fine-tuning an iFOBT Mailing CampaignAustin Regional ClinicElena Chow, RNemschow@austinregionalclinic.com

31: Quality is not Incidental! Optimizing outcomes for patients with pulmonary nodulesChristiana Care Health SystemHeather Powell, RNhpowell@christianacare.org

32: Reducing Door to Needle in Stroke patientscarmel medical centerSharon Alroy-Preis, MD, MPHsharon.alroy.preis@gmail.com

33: Simple Interventions Can Break the Cycle of Pediatric Emergency Department Utilization for Low Acuity ConditionsChildrens Health System of TexasPenny Wiliams, RNpenny.williams@childrens.com

34: Transitions of Care Efforts to Improve Care Coordination and Appropriate Resource UtilizationThe University of Texas Medical Branch at GalvestonCraig Kovacevichcskovace@utmb.edu

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress BallroomDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 2

Student and Resident StoryboardsStoryboard Numbers: 35–161

35: Mr. and Mrs. No Show: An Analysis Characterizing Patients with High Rates of NonattendanceAlbany Medical CollegeCara Zimmermanzimmerc1@mail.amc.edu

36: Glycemic Control Transformation at Phoenix VAHCS: A QI InitiativeBanner HealthRustan Sharer, MDrustan.sharer@bannerhealth.com

37: Factors Associated with Reporting of Professionalism Violations by Medical StudentsBaylor College Of MedicineJaden Kohnjaden.schupp@bcm.edu

38: Improving Chapter Activities to Increase Student Engagement in QI/PSBaylor College Of MedicineKevin ShahKevin.Shah@bcm.edu

39: Planning a Quality Improvement & Patient Safety Conference in the Texas Medical CenterBaylor College Of MedicineKevin ShahKevin.Shah@bcm.edu

40: Accurate Body Weight Recording in a Trauma and Orthopaedic WardBelfast Health and Social Care TrustJonathan Rooneyroonbop@gmail.com

41: Exploring Access to Healthcare for the Homeless Population in Green Bay, WIBellin CollegeKortney Marshallkortney.marshall@bellincollege.edu

42: Critical Care Resource RN Communication Improvements for Patient SafetyBoston Medical CenterKatherine Scanlon, RNkatherine.scanlon@bmc.org

43: Improving Inpatient Care of COPD Exacerbations: Targeting Appropriate Oxygen SupplementationBoston Medical CenterRadha Govindraj, Marianne Bauer, and David Yuh, MDradha.govindraj@bmc.org

44: Improving transitions of care through implementation of IPASS handoff bundle — Multidisciplinary BMC experienceBoston Medical Center GME ProgramAravind Ajakumar Menon, MDaravind.ajakumarmenon@bmc.org

45: Reducing Radiation Exposure in Crohn’s Disease Patients by the Availability of Magnetic Resonance ImagingBoston Medical Center GME ProgramStephanie Le, MDStephanie.Le468@gmail.com

46: Ancillary Services Committee: Improving Resident Well-Being through Workflow RedesignBoston Medical Center Graduate Medical Education, CIRAmir Meiri, MDameiri@gmail.com

47: Developing a Quality Improvement Curriculum for the Family Medicine ClerkshipBoston UniversityAlicia Wongawong12@bu.edu

48: Using Data to Teach Medical Students Quality Improvement: a Pilot StudyBoston UniversityHelen Jinjin.s.helen@gmail.com

49: Implementing Patient Education to Combat Chronic Disease ExacerbationBoston University School of MedicineRauvynne Sangararsangara@bu.edu

50: Medical Student Initiative To Measure And Improve Low Back Pain Imaging Appropriateness Boston University School of MedicineMichael Von Platovonplato@bu.edu

51: Patient-Centered Discharge Education in a Neurology Clerkship Curriculum: Student-Owned Quality Improvement Initiative to Reduce RehospitalizationsBoston University School of MedicineRobert McInnisbobbymcinnis@gmail.com

52: Addressing HIV Post-Exposure Prophylaxis Delay in the Pediatric Emergency DepartmentBoston University School of Medicine / Boston Medical CenterNicole Penwillnpenwill@bu.edu

53: ATTEND: A Two-pronged Trial to Eliminate No Shows in Diagnostic ImagingBrock UniversityJohn Mikhaeiljmikhaeil96@gmail.com

54: Healthcare Through the Patient’s EyesBrody School of MedicineJustin Hesshessj15@students.ecu.edu

55: Improving COPD Care: A Resident-lead Continuous Quality Improvement Initiative in a Teaching Outpatient ClinicBuffalo General Hospital: UBMD Internal Medicine Residency ProgramEd Wilson, DOewilson1mph@gmail.com

56: Supporting Autonomy Through A Practice Improvement TeamCambridge Health AllianceSpencer Rittner, MDserittner@challiance.org

57: Don’t Waste the Medical Waste: Reducing Improperly Classified Hazardous Waste in a Medical FacilityCentennial High SchoolDanny Hemanidannyhemani@gmail.com

58: Development of a Septic Shock Algorithm in the Pediatric Intensive Care UnitChildren’s Hospital of Alabama and University of Alabama at BirminghamSteven Nye, MDstevennye@uabmc.edu

59: Quality Improvement to Reduce Procedural Delays and Improve Patient Satisfaction Using The DMAIC Data-Driven Strategy Columbia UniversityMaryLou Almanzorma3421@columbia.edu

60: Standardizing Protocols: Effects on Nurse Satisfaction and Diabetes EducationDuke University Health SystemYingna Liuyingna.liu@duke.edu

61: Standardizing Text Paging to Improve Physician-Nurse Communication: A Pilot InterventionDuke University Health SystemPatrick O’Sheapatrick.o.shea@duke.edu

62: Clarkston Community Health Center Quality Improvement Initiative: Optimizing Patient FlowEmory UniversityJoyce Kimjoyce.chung@emory.edu

StoryboardsThe 28th Annual National Forum on Quality Improvement in Health Care

December 4–7, 2016 · Orlando, FL

Storyboard ReceptionTuesday, December 6, 4:30 PM–6:30 PM, Cypress HallDuring this reception, presenters will be standing by their boards to answer questions.

Institute for Healthcare Improvement · ihi.org 3

28TH ANNUAL NATIONAL FORUM STORYBOARDS: Student and Resident Storyboards

63: Early Intervention and Standardization of Management of Postpartum Hemorrhage in the Birth Center Setting Frontier Nursing UniversityCindy McCulloughcynthia.mccullough@frontier.edu

64: Implementation of a Standardized Communication Transfer Tool: Improving Transfers from Birth Center to Hospital SettingFrontier Nursing UniversityShari Long Romeroshari.romero@frontier.edu

65: Improving Health Literacy and Patient Safety: A Quality Improvement Project to Reinforce Teach-BackFrontier Nursing UniversityJessica Blountjessica.blount@frontier.edu

66: Creating an Actionable, Visual Data Base for the Intensive Care Unit Geisinger Health SystemChristian Greco, DOcgreco1@geisinger.edu

67: Healthcare Leadership Track Students Post-Online Leadership Module AssessmentGeorgetown UniversityDavid Melnickdsm71@georgetown.edu

68: Re-Energizing the Georgetown University Open School ChapterGeorgetown UniversityConner McMainscjm275@georgetown.edu

69: Improving Patient Satisfaction Scores Implementing a Rapid Triage and Direct Bedding ProcessGreenwich HospitalAmanda Jagodzinskiamanda.jagodzinski@gmail.com

70: Electronic Tracking of Opioid Prescriptions Among Family Medicine PhysiciansHalifax HealthLeslie Williamsleslie.williams@halifax.org

71: Establishing the physical health needs of victims of domestic violence. Halifax Health Family Medicine Residency ProgramKyle Correllkyle.correll@halifax.org

72: Implementation of a Physician-Led Rapid Response Team to Decrease Mortality and Code Blue Calls. Halifax Health Family Medicine Residency ProgramBich Nguyenbich.nguyen@halifax.org

73: Perception of the multidisciplinary ICU team regarding the effectiveness of communicationHospital Israelita Albert EinsteinCarin Ferreira Lopescarin_lopes@hotmail.com

74: Sickle Cell Disease (SCD)-Related Pain: Perceptions of Medical ResidentsHoward University HospitalGbeminiyi Samuel, MDgbeminiyi.samuel@gmail.com

75: Implementation of a House Staff-Led Pneumonia Antibiotic Stewardship ProgramIcahn School of Medicine at Mount SinaiDavid Andersondavid.anderson@icahn.mssm.edu

76: Quality Improvement Handoff Template: A Methodological Approach to Standardizing and Simplifying Quality Improvement Project WorkJames A. Haley Veterans’ HospitalJustin Iannello, DOjiannell@health.usf.edu

77: Addressing No-Shows and Same-Day Cancellations in a Primary Care Clinic through Provider Slot UtilizationLouis Stokes Cleveland VAMCSharjeel Hooda, MDsharjeel.hooda@gmail.com

78: Decreasing Inappropriate Prescription of Proton Pump Inhibitors in a Resident-Run VA Primary Care Clinic Louis Stokes VA Medical CenterAshwinee Natu, MDashwinee.natu@gmail.com

79: #Transfuse-LESS — Reduction of Intraoperative Blood Product Usage during Coronary Artery Bypass Graft OperationsMassachusetts General HospitalJordan Bloom, MDjpbloom@partners.org

80: Assessing a Practice Change on Surgical OutcomesMayo ClinicBrittany Murphy, MDmurphy.brittany@mayo.edu

81: Reducing Alarms and Cost of Cardiac Telemetry BedsMayo ClinicAli Alsaad, MDalsaad.ali@mayo.edu

82: Improving Text Page Communication on Pediatric Wards in a Tertiary Medical CenterMedStar Georgetown University HospitalMarko Culjat, MD, PhDmarkoculjat@yahoo.com

83: Assessing a Clinical Pathway on Hypoglycemia and Quality OutcomesMercy Hospital St. LouisBecky Sidberryrebecca.sidberry@mercy.net

84: Good Old Snail Mail: Reducing No Shows in Primary CareMichigan State University College of Human MedicineSaya Yusasayayusa91@gmail.com

85: Prevalence of Depression in Heart Failure Patients in Outpatient SettingMonmouth Medical CenterIsha Verma, MDishaaaaa5@gmail.com

86: Screening for Malnutrition at the Tulane Head and Neck Cancer CenterNew Orleans Healthcare Improvement Group Jeremy Barrjbarr@tulane.edu

87: Reducing Avoidable Emergency Department Visits and Hospitalizations in a New York City Safety-Net HospitalNew York City Department of Health and Mental HygieneLinda Wong, MDLinda.Wong@alumni.mssm.edu

88: IHI Open School as an Academic Framework for Resident Education in Quality Improvement at OVMC-UCLAOlive View Medical CenterAra Rostomian, MD, MPHarostomian@dhs.lacounty.gov

89: News and Updates from the PSU & OHSU IHI Open School ChapterOregon Health and Science University (OHSU) Jeffrey Goldsethjrg@pdx.edu

90: Active Panel Management Implementation Orlando VA Medical Center/University of Central Florida Medical School Jose Lozano-Garciajoselozano@hotmail.com

91: Improving At Home Pain Control After Pediatric TonsillectomyPenn State Hershey Medical CenterMichele Carr, PhDmcarr@psu.edu

92: Pet Therapy for Children Post-TonsillectomyPenn State Hershey Medical CenterMichele Carr, PhDmcarr@psu.edu

93: A Population Health Framing of Deming’s 14 PointsPortland State University (PSU)-Oregon Health and Science University (OHSU) School of Public HealthAdam Hoverman, DOhoverman@ohsu.edu

94: IHI Open School Purdue University Chapter: An interdisciplinary Student Organization Devoted to Healthcare ImprovementPurdue UniversityMeghan Cowdenmcowden@purdue.edu

95: Summer Certification: Improving Chapter Education and Leadership Purdue UniversityMeghan Cowdenmcowden@purdue.edu

96: Resilient Wellness Healing NetworkResilient WellnessDaisy Ozimdozim91@gmail.com

97: Co-Creation: the West Coast Regional Improvement ProjectSchool of Public Health, Oregon Health and Science University-Portland State UniversityKelsey Priest, MPHkpriest22@gmail.com

98: The Value of Bedside Scheduling for the 7-day PCP Follow-up VisitSentara HealthcareAnthony Hardt, MDABHARDT@sentara.com

Institute for Healthcare Improvement · ihi.org 4

28TH ANNUAL NATIONAL FORUM STORYBOARDS: Student and Resident Storyboards

99: Designing Virtual Reality Paradigms for Chronic Pain Patients Self-Management: Pain Self-modulation and Pain DistractionSimon Fraser UniversityXin Tongtongxint@sfu.ca

100: Evaluating “AS IF”, a Interactive Game to Enhance Empathy for Chronic Pain PatientSimon Fraser UniversityXin Tongtongxint@sfu.ca

101: Improving Hand Hygiene Compliance Among Doctors Singapore General HospitalWeixian Alex Tantanweixian@hotmail.com

102: Decreasing Time to Antibiotics in the Neonatal Intensive Care UnitThe Children’s Hospital of PhiladelphiaKatherine Wu, MDkatherineywu@gmail.com

103: Implementing a Modified Comprehensive Elder Exam Model for High-Risk AdmissionsTsehootsooi Medical CenterCristina Stuefen, RNcrstuefen@email.arizona.edu

104: Effect of Intervention on Nurse Attendance and Incidence of Infection at ICU Daily Bedside Rounds Tulane UniversityEliza Lewineelewine@tulane.edu

105: Can We Improve Management of Organ Donors? A Comparison of Low-Dose and High-Dose Steroid ProtocolsTulane University School of MedicineAakash Aminaamin@tulane.edu

106: Improving Time to Provider Assessment for Outside Hospital Transfer PatientsTulane University School of MedicineAya Angstadtaya.angstadt@ucdenver.edu

107: Increasing Patient Engagement in their Care through Use of the In-Room Whiteboard Tulane University School of MedicineJeremy Barrjbarr@tulane.edu

108: Outpatient Follow-Up and Its Relationship to Patient OutcomesTulane University School of MedicineIsaac Jabenijaben@tulane.edu

109: Student Attitudes Toward Contact Precautions: A Window into Non-Compliance in An Academic Medical CenterTulane University School of Medicine, New Orleans Healthcare Improvement GroupEliza Lewineelewine@tulane.edu

110: “I-CAN” to “We Did”: A Quality Management Class & Medical Student Run Clinic Co-opTulane University School of Public Health & Tropical MedicineCatherine Countsccounts@tulane.edu

111: Medical School Student Run Clinics: Managing a Hepatitis C Screening and Linkage to Care ProgramTulane University School of Public Health & Tropical MedicineCatherine Countsccounts@tulane.edu

112: Medical School Student Run Clinics: Scaling Up a Hepatitis C Screening Program Tulane University School of Public Health & Tropical MedicineCatherine Countsccounts@tulane.edu

113: Evaluation of the Crash Cart Performance, Physical Conditions and Maintenance in the Emergency RoomUniversidad del Valle de México, campus QuerétaroJuan Yair Rodríguez Torres man_utd.777@hotmail.com

114: Exploring Vaccination Compliance in Co-managed Primary Care Patients — A Trainee Led ProjectUniversity Hospital — CMCOlapeju Olasokanolapeju.olasokan@gmail.com

115: Gamification of Dementia Education in Acute CareUniversity of British ColumbiaLillian HungLillian.Hung@vch.ca

116: Implications of SPRINT Trial on Current Management of High Risk Patients in Outpatient Cardiology ClinicUniversity of British ColumbiaRen Jie Yaorobert.rj.yao@gmail.com

116: Lessons learned from Retrospective Quality Improvement Audit for High Risk Patients in Outpatient Cardiology Clinic University of British ColumbiaRen Jie Yaorobert.rj.yao@gmail.com

117: One Year of Experience & Student Reflections on IHI Resource Integration within UBC’s Medical CurriculumUniversity of British ColumbiaJenna Smith-Forresterjsf@alumni.ubc.ca

118: Quality Improvement Practicum Program: One Year LaterUniversity of British ColumbiaKan Cheungkancheung123@hotmail.com

119: Consistency to Consensus: Impact of Standardization on Postnatal Management of Antenally Diagnosed Urinary Tract DilationUniversity of Calgary Neonatology FellowshipSmita Roychoudhury, MDsnilguha@gmail.com

120: Appropriateness of Troponin Ordering at Academic Medical CenterUniversity of California San FranciscoKatie Raffel, MDKatie.raffel@ucsf.edu

121: Naloxone Distribution and Training for Outpatient Veterans with High Risk Opiate UseUniversity of California San Francisco Medical CenterKatie Raffel, MDKatie.raffel@ucsf.edu

122: Google Glass: Its Role in Medical Error Prevention, Near Misses, and Root Cause AnalysisUniversity of Central Florida College of MedicineSteven Kellysteven.kelly04@Knights.ucf.edu

123: Improving Residents’ Code Status DiscussionUniversity of Central Florida College of MedicineJose Lozano Garciajoselozano@hotmail.com

124: Improving the Performance of the Diabetic Foot Exam in a Primary Care ClinicUniversity of Central Florida College of MedicineFaraz Afridi, MDfaraz.afridi@ucf.edu

125: The New Asthma Care Guideline: A Multidisciplinary Approach to Inpatient ManagementUniversity of Chicago Medical CenterAjanta Patelajanta.patel@uchospitals.edu

126: Applying User-Centered Design to Co-Create Experience Improvement Strategies on a Medical-Surgical UnitUniversity of Colorado School of MedicineTheodora Trantheodora.tran@ucdenver.edu

127: Diabetes in Pregnancy: Enhanced Patient Satisfaction with Cellular-Enabled Glucose MonitoringUniversity of Iowa Carver College of MedicineAlyson Pierickalyson-pierick@uiowa.edu

128: University of Miami Miller School of Medicine IHI Open School ChapterUniversity of Miami Miller School of MedicineLauren Tholemeierlxt267@med.miami.edu

129: Improving Teamwork and Communication among Healthcare Workers Using the TeamSTEPPS ApproachUniversity of Minnesota School of NursingRazaq Adedayo, RNaded0014@umn.edu

130: Implementation of a Daily Goals Tool Improves Team Communication in the Neurosciences ICUUniversity of North Carolina (UNC) at Chapel HillEmelin Tanemelin@live.unc.edu

131: JPS Hand Hygiene InitiativeUniversity of North Texas Health Science CenterChelsea Kleenclk0160@my.unthsc.edu

132: How Can We Work Together, If We Don’t Learn Together?University of Oklahoma Health Sciences CenterColleen ParrishColleen-parrish@ouhsc.edu

133: Plan of Care Communication Intervention for Hospitalized PatientsUniversity of PennsylvaniaMichael Knight, MDknightmg@gmail.com

Institute for Healthcare Improvement · ihi.org 5

28TH ANNUAL NATIONAL FORUM STORYBOARDS: Student and Resident Storyboards

134: Creating a “Dream Team” Prioritizing Sleep in the Hospital Setting University of Pittsburgh Medical Center (UPMC)/Waynesburg UniversityIrma D’Antonio, RNdantonioi@upmc.edu

135: University of South Carolina, Columbia — IHI Open School ChapterUniversity of South Carolina Faten Ragabanfatenrag@aol.com

136: A Pilot to Improve the Pain Medication Experience in HospiceUniversity of South FloridaBrittany Haybhay@health.usf.edu

137: Assessing the Fluid Intake of Geriatric Psychiatry PatientsUniversity of South FloridaRyan Kaufmanrkaufman@health.usf.edu

138: Improving Resident QI Culture and Curriculum Using Didactic and Experiential LearningUniversity of South FloridaDavid Brombergdbromberg24@gmail.com

139: Techniques to Improve Patient Flow in a Pediatric Street Medicine ClinicUniversity of South FloridaRichelle Reinhartrichelle.reinhart@gmail.com

140: USF Healthcare Improvement Group 2016University of South FloridaEdward Ohedwardoh@health.usf.edu

141: Decreasing Perioperative Medication ErrorsUniversity of Texas Health Science Center School of NursingJulie Boytimjulieandedward@gmail.com

142: Decreasing Diarrhea and Dehydration in the Dominican RepublicUniversity of Texas SouthwesternAlice Jeanalice.jean@utsouthwestern.edu

143: Decreasing ED Utilization by Patients Seen at the UT Southwestern Simmons Comprehensive Cancer CenterUniversity of Texas SouthwesternShantan Cheemerlashantan.cheemerla@utsouthwestern.edu

144 Improving Clinic Flow at Parkland Memorial Hospital’s Surgical Oncology ClinicUniversity of Texas SouthwesternMatthew Tranmatthew.tran@utsouthwestern.edu

145: Optimizing Clinic Flow at the Parkland Memorial Hospital Surgical Breast Oncology ClinicsUniversity of Texas SouthwesternCharisma DeSaicharisma.desai@utsouthwestern.edu

146: Reducing CPAP Failure in Extremely Preterm Infants University of Texas SouthwesternHenry Hehenruihe@gmail.com

147: Reducing Preventable Readmissions for Patients with Diabetes on the Parkland Hospitalist Units University of Texas SouthwesternTim ChangHuanTing.Chang@UTSouthwestern.edu

148: Improving Conformance to a Redesigned OR-to-ICU Patient Handover ProcessUniversity of Texas Southwestern Medical CenterEleanor Phelps, RNEleanor.Phelps@utsouthwestern.edu

149: Investigation of the Effectiveness of Anal Cancer Screening in HIV PatientsUniversity of Texas Southwestern Medical CenterAndrew Bietermanandrew.bieterman@utsouthwestern.edu

150: Improving the Adherence of Providers to AASM Guidelines for Evaluation, Treatment, and Management of OSAUniversity Of The Incarnate WordHeather Mileshmiles@student.uiwtx.edu

151: Butting Out: Improving Nicotine-Withdrawal Management in a Psychiatric Emergency DepartmentUniversity of TorontoPaul Benassipaul.benassi@mail.utoronto.ca

152: Quality Outcomes, Enhancing the Patient Experience, & Reducing Cost per Case in an Anesthesia DepartmentUrsuline CollegeBarbara Douglasbarbara.douglas381@gmail.com

153: QI Programs Impact to Successful Clinical Practice ChangesUT Health Science Center at San AntonioErika BowenBoweneo@uthscsa.edu

154: Quality Improvement Programs’ IMPACT to Successful Clinical Practice ChangesUT Health Science Center at San Antonio (UTHSCSA)/UIWErika BowenBoweneo@uthscsa.edu

155: Improving Event Reporting in the 9th floor CVICU at Clements University Hospital UT Southwestern Institute for Healthcare Improvement Open SchoolPatrick RobertsPatrick.Roberts@UTSouthwestern.edu

156: Vanderbilt Healthcare Improvement GroupVanderbilt UniversityRohini Chakravarthyrohini.chakravarthy@vanderbilt.edu

157: A Resident-Led QI Initiative to Increase Cardiac Rehabilitation Utilization in the Primary Care SettingVeterans AdministrationTimica Campbelltimica.campbell@uhhospitals.org

158: Resident-Run Quality Improvement Project to Increase Lung Cancer Screening in the Primary Care SettingVeterans AdministrationPaul Lin, MD, PhDplin@case.edu

159: Fall Prevention Through SimulationVHARoschelle Manigold Geralyn Voboril, RNroschelle.manigold@va.gov

160: Patient Safety and Quality Improvement Attitudes and Knowledge between Medical Students, Residents, and FacultyWashington University in St Louis School of MedicineMichael Hendrixmhendrix@wustl.edu

161: Early Integration of Quality Improvement within a Professional Identity FrameworkWestern UniversityJason Leonard Elzinga jelzinga2019@meds.uwo.ca

Institute for Healthcare Improvement · ihi.org 6

28TH ANNUAL NATIONAL FORUM STORYBOARDS: Student and Resident Storyboards

Storyboard Walkaround SessionsStoryboard Walkaround 1; Addressing the Opioid Epidemic

SW1 CCO Pharmacy Interventions for Regional Opioid Systems ChangeMelissa Brewster, PharmD, Ambulatory Care Coordinator, CareOregon

SW1 Systems Approach to Address the Opioid EpidemicSafina Koreishi, MD, Medical Director, Columbia Pacific CCO

SW1 We Own This! A Response to the Opioid Crisis Brian Konowalchuk, MD, MPH, Occupational Medicine Physician, Essentia Health; Joe Bianco, MD, Primary Care Director, Essentia Health

Storyboard Walkaround 2; Global Efforts in Achieving Health Equity

SW2 Addressing Equity with Community Health WorkersCelia Higueras, Project Manager, Oregon Community Health Workers Association

SW2 Climbing down from your Ivory TowerLisa Altman, Integrated Care Manager, The Sydney Children’s Hospitals Network

SW2 Guidelines: One Size Does Not Fit AllJodie Dvorkin, MD, MPH, Health Consultant/Project Manager, Institute for Clinical Systems Improvement

SW2 Tackling the Equity ChallengeMataroria Lyndon, Clinical Lead, Ko Awatea

Storyboard Walkaround 3; Transforming the Patient Experience through Technology

SW3 Leap-frogging Improvement with Mobile HealthJime Tambala, Project Officer, Maikhanda Trust

SW3 Social Media Used to Reduce CLABSIDawn Knight, Executive Administrator Performance Improvement, Loma Linda University

SW3 Technology + Process Improvement = ValuePatricia Embree, Senior Director, PFCC Innovation Center, University of Pittsburgh Medical Center

SW3 Using Technology to Take Care to the PatientLisa Curatulo, Consultant Paramedic, NHS Scotland

Storyboard Walkaround 4;

Patient, Team, System, Payer: The Quality Pillars

SW4 Quality Pillar 1: The PatientMarie Brown, MD, Assistant Professor of Medicine, Rush University Medical Center

SW4 Quality Pillar 2: The TeamSelam Wubu, Senior Associate, Quality Improvement, American College of Physicians

SW4 Quality Pillar 3: The SystemJulia Andrieni, MD, Vice President, Population Health & Primary Care, Houston Methodist

SW4 Quality Pillar 4: The PayerSteve Peskin, MD, Executive Medical Director, Horizon Blue Cross Blue Shield

Storyboard Walkaround 5; High-Impact Student Projects

SW5 In-person Interpreter Participation during Morning Rounds Changes Patient Management in the Pediatric Inpatient WardVivian Wang, Student, Boston University School of Medicine

SW5 Sustainability of a Mental Health Prevention Initiative through Community EngagementNikos Karakashian, Student, University of South Florida Morsani College of Medicine

SW5 University of Cincinnati Open School ChapterCourtney Gleason, Student, University of Cincinnati College of Medicine

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ORLANDO WORLD CENTER MARRIOTT, ORLANDO, FLORIDA

CYPRESS BALLROOM

DECEMBER 5 - 7, 2016

IHI - NATL FORUM ON QUALITY IMPROVEMENT

ENTRANCE

30" COCKTAILS

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LEMONADE/ICE TEA

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14'W x 16'6"H

24'W x 16'6"H

24'W x 16'6"H

26'W x 24'-6"H

20'W x 12'H

20'W x 11'-7"H

24'W x 16'6"H

24'W x 16'6"H

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