Each approved NC MOC Project is integrated into the work physicians do every day in their office or in their clinical practice in an effort to improve the process of care and produce better patient outcomes.

 

Approved QI ProjectDescriptionQuality Improvement Project Manager
Improving Transitions of Care and Preventing ReadmissionsReducing readmissions is an ongoing organizational goal and strategic priority for UNC Medical Center.

Key elements of readmission prevention are: risk stratification & patient identification; comprehensive assessment by care manager; medication management; self-care training; timely, accurate discharge summary; post-hospitalization phone call; structured, patient-coordinated appointment with follow-up provider within 7 days; and ongoing care management.

The project’s goal is for the transitional care model to be standard practice for all high and moderate risk adult medicine and surgery inpatients admitted to UNC Hospitals.
Fabienne McClellan,
Quality and Organizational Excellence Leader, UNC HCS
Clean In, Clean Out: Hand Hygiene at UNCHospital Acquired Infections remain a priority of prevention in healthcare delivery especially in higher risk times of care such as during admission to an inpatient unit. Appropriate hand hygiene practices have been shown to decrease healthcare acquired infections and mortality as well as shorten length of stay in inpatient settings and decrease healthcare costs.

The program’s goal is that the UNC Hospitals inpatient care areas will have achieved a specific mean regarding hand hygiene compliance as detected on audits completed at the individual unit level.
Emily Sickbert-Bennett,
PhD, MS, CIC| Director
Hospital Epidemiology and Occupational Health Services
UNC Hospitals
Primary Care Improvement Collaborative (PCIC)UNC Health Care provides comprehensive primary care to a large population of North Carolinians through a variety of locations, both academic and community-based.

Primary care practice representatives from across the UNC Health Care System have joined together as a
Primary Care Improvement Collaborative (PCIC) to facilitate shared learning and accountability.

Our goal is to improve the health and outcomes of the patients we treat. The collaborative will target measures that balance the needs of our providers, priorities of the organization, and the impact to our patients.
Crystal Hoffman,
MHA
HealthCare System Program Manager, Improvement Collaboratives
Practice Quality, Innovation and Population Health Services
Code SepsisPrompt recognition and treatment of sepsis have been identified as a means of improving sepsis survivorship. Many of the interventions aimed at early recognition of sepsis also increase the likelihood of earlier recognition of complications included in the definition of Failure to Rescue. The main indicators of survival from sepsis are timely administration of initial antibiotics and fluids, making recognition a key component of treating patients with sepsis. Code Sepsis aims to implement a standardized pathway for adult and pediatric sepsis patients including recognition, activation, and treatment in UNC Hospitals. Karen Gupton,
Quality Organizational Excellence Leader,
UNC Hospitals
Integrating Palliative and Oncology CareCancer patients who receive palliative care have better advanced care planning, reduced ICU admissions, and earlier Hospice referral providing a better quality of life for the patient and reduced cost savings for everyone.

This project will review the census on a daily basis to identify patients with metastatic cancer who could benefit from a Palliative Care consultation. In addition, the project will provide monthly feedback of palliative care metrics and provide training in Palliative Care skills to the Hematology/Oncology fellows, residents, and NP/PA staff.
Laura C. Hanson,
MD, MPH
Professor, Geriatric Medicine
Director, UNC Palliative Care Program
Falls Screening and Follow-up CareFalls is the leading cause of fatal and non-fatal injuries among people over 65 years of age. They occur frequently – more than one out of three people in this age group fall each year. The human impact is significant and includes death, loss of independence, reduced quality of life, and lost time to work.

The American Geriatrics Society (AGS) developed clinical practice guidelines for identifying individuals most at risk of falling and performing a comprehensive falls-risk assessment.

The project’s goal is to implement evidence-based falls screening and follow-up for patients over 65 in primary care practices and improve performance in the related Accountable Care Organizations (ACO) measure.
R. Evan Richardson,
MSN, CNM, Quality Improvement Consultant
Mountain Area Health Education Center (MAHEC)
Antibiotic Stewardship in the Pediatric Emergency Department: Standardizing Diagnostic TestingUrinary Tract Infections (UTIs) is one of the most common pediatric infections and effective management requires appropriate diagnostic methods and treatment. Antibiotic resistance is an increasing threat in healthcare, which is principally driven by the misuse of antibiotics. Therefore, it is critical to follow clinical practice guidelines and provide the most appropriate antibiotics, only to patients who truly have a bacterial infection. The Pediatric Antimicrobial Stewardship Program at UNC is tasked with implementing programs that enhance the appropriate use of antibiotics in both inpatient and outpatient areas. Elizabeth Walters,
Doctor of Nursing Practice Student, School of Nursing, UNC-Chapel Hill
Pediatric Asthma Improvement ModuleAsthma affects 6.3 million children nationally. It exacts a huge toll on children, families, communities and the health care system and disproportionately impacts black, Hispanic, multi-race, Native American, and poor children and families.

Although the rate of pediatric hospital stays for asthma has declined nationally, pediatric asthma continues to be a leading cause of hospital admissions.

This project aims to engage pediatric and family medicine practices in implementing evidence based Asthma care processes and improve performance on key asthma outcome measures.
R. Evan Richardson,
MSN, CNM, Quality Improvement Consultant
Mountain Area Health Education Center (MAHEC)
Clinical pathway for the outpatient education of pediatric patients with newly diagnosed Type 1 Diabetes MellitusType 1 Diabetes Mellitus (T1DM) is one of the most common chronic illnesses in childhood. At the time of diagnosis, a significant amount of education is needed to equip children and their parents with the knowledge and skills necessary for managing diabetes. Historically pediatric patients with newly diagnosed T1DM have been hospitalized to receive this education, and prior to discharge, the family was required to demonstrate the ability to check blood sugars, give insulin, and know what to do in the case of hypoglycemia or hyperglycemia.

Our goal is to develop, implement, and refine an effective and safe outpatient diabetes management pathway
Elizabeth Sandberg,
MD, Fellow,
Division of Pediatric Endocrinology, School of Medicine at UNC-Chapel Hill