QUALITY IMPROVEMENT INITIATIVES  

Flu Vaccine

The 2009/2010 Flu season presented new challenges to our Healthcare resources. We were faced with two strains of flu (seasonal Flu and H1N1) that had potential of striking our community. Historically, the focus during flu season was the risk to our elderly and compromised population. This season the additional threat was to pregnant women; children 6 months through 4 years of age and children 5 through 18 years of age with chronic health conditions. Porter Hospital played an integral role in the assuring Addison County residents had over 6000 doses of H1N1 available to providers to administer to provide protection. All pregnant women in Addison County had the opportunity to be vaccinated for protection against H1N1.

Hospital staff, volunteers and other community Healthcare and childcare providers were encouraged to be vaccinated for both seasonal flu and H1N1. Porter Hospital administer 1130 vaccines to this group. This was effort helped to protect our patients at high risk for complications from the flu. Our success this season will be reviewed to provide a guide of enhancing our methods. Our goals are to increase the number of vaccinated persons to further prevent the spread of infection next flu season.

Diane Haughney, RN
Perform. Improvement/Risk Mgt Department
Porter Hospital
115 Porter Drive
Middlebury, VT 05753
802 388-5609

Medication Reconciliation

When a patient enters the hospital for care, often, they are on medication at home prescribed by their doctor. Medication Reconciliation is the process of comparing a patient's home medications to all of the medications ordered for the patient in the hospital. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions.

Porter Hospital has developed a process of gathering, organizing, and communicating medication information. Physicians, Nurses and Pharmacist work to verify the patient’s current list of medications and medications that are prescribed in the hospital.
This improved process helps to assure that during hospitalization and upon discharge, patients are receiving the intended course of therapy in a safe, consistent way.  When preparing our patient’s for discharge, the Medical team again re-evaluates and educates the patient on their medication to ensure safe home administration.

Diane Haughney, RN
Perform. Improvement/Risk Mgt Department
Porter Hospital
115 Porter Drive
Middlebury, VT 05753
802 388-5609

Myocardial Infarction (Heart Attack) Care

A type of heart attack, known as a STEMI (ST segment elevation myocardial infarction) in which a patient’s arteries are completely blocked, needs treatment within 90 minutes. The treatment of interventional cardiac catheterization increases the patient’s likihood of successful re-prefusion (re-opening of the blocked arterys) is optimum.

In order to provide this standard of care for the patient’s presenting at Porter Hospital Emergency Department, we work in conjunction with Fletcher Allen Healthcare to realize that goal. For the approximately 18 patients that came to Porter Hospital Emergency Department in 2009 with STEMI, over 90% were successful in having the procedure necessary within the 90 minutes timeframe which is necessary to increase the odds of a positive outcome.

With a goal of 90 minutes to catheterization lab, Porter was faced with a significant challenge. The average drive time to Fletcher Allen is 50 minutes. To decrease the time which include precious minutes to diagnosis, start treatment and set up transfer took much consideration all processes were examined. An in depth review of the process resulted in changes to necessary steps involved in caring for these patients prior to transfer.

Nursing and Medical Staff improved the process in order to carve off what may be critical minutes needed to get the patient to the tertiary level of care. These processes will continue to be reviewed as new stiuations present challenges to our Emergency Department team.

The flow of handling all patients that present with chest pain or like symptom is under constant review to find ways to enhance our care.

Diane Haughney, RN
Perform. Improvement/Risk Mgt Department
Porter Hospital
115 Porter Drive
Middlebury, VT 05753
802 388-5609

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