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dc.contributor.advisorEstes, Krista
dc.contributor.authorHorne, Michael
dc.contributor.committeememberCampbell, Colleen
dc.contributor.committeememberThomas, Laura
dc.date.accessioned2020-04-09T22:33:08Z
dc.date.available2020-04-09T22:33:08Z
dc.date.submitted2019
dc.descriptionIncludes bibliographical references.
dc.description.abstractBackground: Patient-access delays due to excessive wait times for clinic consult appointments impair timely diagnosis/treatment, resulting in worse outcomes. Problem: Average days wait (ADW) for clinic consult appointments for the cardiology group of a regional managed care organization (MCO) was excessive. Methods and Intervention: Based on the IHI Model for Improvement, a quality improvement project (QIP) was implemented to reduce ADW while improving patient coverage. The QIP entailed a new cardiology hospital service with 11 cardiologists and 3 cardiology NPs who rotated between hospital and clinic service. Two cardiologists and one NP covered all cardiology inpatients, alleviating the need for clinic-assigned cardiologists to also see hospitalized patients and thereby improving capacity. The primary measure was ADW; secondary measures were patient satisfaction with access, hospital readmissions, clinic cancellations, and provider job satisfaction. Results: All measures were assessed on pre/post 6-month averages. ADW fell from 28 days to 14. Patient satisfaction improved from 39% to 52%. Readmissions dropped from 13.2% to 9.7%. Intervention-related provider job satisfaction was 91%. No significant changes arose in potential confounding factors, and no negative consequences were identified. Conclusions: Implementation of a cardiology hospital service with NPs was feasible, shortening ADW and improving patient access/associated outcomes.
dc.format.mediumBorn digital
dc.format.mediumDoctoral dissertations
dc.identifier.urihttps://hdl.handle.net/10968/5446
dc.languageEnglish
dc.publisherUniversity of Colorado Anschutz Medical Campus. Strauss Health Sciences Library
dc.relation.ispartofDoctor of Nursing Practice - College of Nursing
dc.rightsCopyright of the original work is retained by the author(s).
dc.subject.meshDelivery of Health Care
dc.subject.meshNurse Practitioners
dc.subject.meshNursing
dc.subject.meshCardiology
dc.subject.meshCardiology Service, Hospital
dc.subject.meshQuality Improvement
dc.subject.meshAppointments and Schedules
dc.titleImplementation of a new cardiology hospital service with Nurse Practitioners: a quality improvement project to improve patient access and outcomes
dc.title.alternativeQuality improvement project to improve patient access and outcomes
dc.typeText
thesis.degree.disciplineCollege of Nursing
thesis.degree.grantorUniversity of Colorado at Denver, Anschutz Medical Campus
thesis.degree.levelDoctoral
thesis.degree.nameDoctor of Nursing Practitioner (DNP)


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