Decreasing Time in ICU & Time to Mobility in Cardiothoracic Surgery (CTS) Patients by Adam Andruska

Cardiothoracic surgery (CTS) patients require highly coordinated care by numerous services in the intensive care unit (ICU) after surgery. Complications in this time period increase morbidity, are costly, and significantly increase time spent in the ICU. We set out to shorten the time between cardiothoracic surgery and the patient ambulating with physical therapy as a marker for appropriate patient progress. Delays in time to ambulation after surgery reflect both patient complications and systems issues preventing progression. Our goal was to improve the percentage of patients ambulating on postoperative day one from 60% to greater than 70%.

Reducing Unproductive Visits for Thyroid Cancer Patients – Kaniksha Desai

The Problem:Patients with thyroid cancer were often arriving for their follow up visits without necessary labs or imaging leading to an unproductive visit. This information would need to be reviewed at a later time asynchronously with the patient, leading to delays in treatment and inefficient workflow. As we sought to understand the different causes of this problem, we prioritized having a […]

The FMEA I Wish I Did – Hurley Smith

I failed again. This time it’s still too raw for me to embrace the learning quite yet. This will be my therapy: a thousand words or less to help me reflect, discern, and grow.
It was a “right care, right place, right time” project. The literature says that colon cancer screening with an at-home fecal immunochemical test (FIT) is just as effective as a colonoscopy. FITs are much less expensive and invasive for patients so, how do we influence patients to choose FIT? This was the scientific question at the heart of the project. To answer it, the team would mail out different forms of outreach in a randomized experiment to see which is most effective.

When A3 Problem Solving Fails – Hurley Smith

Are A3s overrated? Seasoned improvers learn that, while helpful, following the A3 method for problem solving does not guarantee success for an improvement project. In this article, Stanford Improvement Team leader Hurley Smith explores some of the most common reasons improvement projects fail and suggests practical advice for improvers hoping to avoid those pitfalls.