title: Expanding Continuous Quality Improvement Capacity in the Medical Intensive Care Unit: Prehealth Volunteers as a Solution.
abstract: Health care delivery systems are challenged to support the increasing demands for improving patient safety, satisfaction, and outcomes. Limited resources and staffing are common barriers for making significant and sustained improvements. At Oregon Health & Science University, the medical intensive care unit (MICU) leadership team faced internal capacity limitations for conducting continuous quality improvement, specifically for the implementation and evaluation of the mobility portion of an evidence-based care bundle. The MICU team successfully addressed this capacity challenge using the person power of prehealth volunteers. In the first year of the project, 52 trained volunteers executed an evidence-based mobility intervention for 305 critically ill patients, conducting more than 200 000 exercise repetitions. The volunteers contributed to real-time evaluation of the project, with the collection of approximately 26 950 process measure data points. Prehealth volunteers are an untapped resource for effectively expanding internal continuous quality improvement capacity in the MICU and beyond.
authors.affiliation: Division of Public Administration, School of Medicine and Portland State University, Oregon Health & Science University Oregon (Ms Priest); Division of Pulmonary and Critical Care Medicine, Department of Medicine (Ms Lobingier and Dr Hagg), Nursing Administration (Ms McCully), and Department of Acute Care Rehabilitation Services, Division of Rehabilitative Services (Dr Lombard), Oregon Health & Science University, Portland, Oregon; Pulmonary Department, Joint Base Elmendorf-Richardson Hospital, Anchorage, Alaska (Dr Hansen); Providence Alaska Medical Center, Alaska Regional Medical Center, Mat-Su Regional Medical Center, and Anchorage Veteran Affairs Regional Clinic, Anchorage, Alaska (Dr Hansen); and Legacy Health, Portland, Oregon (Dr Uchiyama).
authors.forename: Kelsey C
authors.initials: KC
authors.lastname: Priest
authors.forename: Hannah
authors.initials: H
authors.lastname: Lobingier
authors.forename: Nancy
authors.initials: N
authors.lastname: McCully
authors.forename: Jackie
authors.initials: J
authors.lastname: Lombard
authors.forename: Mark
authors.initials: M
authors.lastname: Hansen
authors.forename: Makoto
authors.initials: M
authors.lastname: Uchiyama
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Hagg
mesh_terms: D057191:Capacity Building / Q000458:organization & administration* / Q000592:standards; D003142:Communication; D016638:Critical Illness; D019317:Evidence-Based Medicine / Q000458:organization & administration; D000068156:Formative Feedback; D006801:Humans; D007318:Inservice Training; D007362:Intensive Care Units / Q000458:organization & administration* / Q000592:standards; D007857:Leadership; D064872:Patient Care Bundles / Q000592:standards*; D015397:Program Evaluation; D017749:Total Quality Management / Q000458:organization & administration* / Q000592:standards; D014838:Volunteers