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Clinical Redesign Projects

Overview of projects 2015-2018

clinical redesign projects FY2018



Delivery Network Project Goal Impact
System Rational Opioid Utilization Optimize the use of opioids Administered opioid MME per day down 17%
Lawrence + Memorial COPD/PNACare Reduce LOS and improve patient outcomes PNA ICU Patient ALOS down 43%
Bridgeport  Behavioral Intervention Team Optimize care of medicine patients requiring psych services. ALOS down 10% 
Greenwich  Multimodal Analgesia Deployed a multimodal pain management approach Administered opioid MME per day down 10%.
Yale New Haven  Outpatient Parenteral Antimicrobial Therapy Create OPAT program to free up inpatient beds; Patients receiving OPAT in outpatient setting

More clinical redesign projects


Delivery Network Department Title Description
YNHH Multiple Inpatient Consultations & Provider to Provider Communication  Develop standards for inpatient consultation (ordering, response time, documentation etc.)  
YNHHS Obstetrics System Cervidil Utilization  Develop guidelines for optimized use of cervidil for labor inducion


Delivery Network Department Title Description
YNHH Blood Bank Sickle Cell Patient Redesign - Adult Update Surgical Blood Ordering System and Type/Screen requirement lists to reduce unnecessary utilization.
YNHHS Digestive
Constipation & Impaction Treatment Protocol Develop system wide constipation / impaction care  protocol.  
YNHH Geriatrics YNHH Palliative Care Optimization 
Implement a predictive model to trigger palliative care consultations. 
YNHHS Gynecology  Abnormal Pap Smear Tracking  Create standards for abnormal Pap smear test follow-up and loop closure. 
YNHHS  Labor & Delivery  Surgical Pack Optimization  Optimize surgical packs for Women's surgical procedures 
BH Medicine  Reducing CHF Readmissions  Using Rothman Index to stratify CHF patients for risk of readmission & applying post-acute interventions to reduce the risk 
BH  Medicine   Reducing post-operative pneumonia  Reduce post-operative pneumonia 
BH  Medicine  Medication Reconciliation  Med Reconciliation: Planning deployment of Med Rec Techs at BH 
YNHH  Multiple  Outpatient Parenteral Antimicrobial Therapy Program  Develop an Outpatient Parenteral Antimicrobial Treatment (OPAT) program to track patients and provide more antimicrobial therapy options to patients. 
YNHH  Multiple  Non-OR Anesthesia  Optimize utilization & deployment of NORA resources.  
YNHH Oncology  Early Discharge of Acute Leukemia Patients  Apply evidence based methods to initiate the early discharge of patients with acute leukemia. 
BH Psychiatry  Behavioral Intervention Team  Plan deployment of Behavioral Intervention Team (BIT) to optimize care of patients requiring psych services. 
YNHH Respiratory  Nitric Oxide Utilization  Develop standards for optimized Nitric Oxide utilization. 
BH  Surgery  Podiatry Patient LOS  Optimize care of podiatry patients admitted to the hospital 
YNHHS  Urology  ERAS - Urology  System Deploy Enhanced Recovery After Surgery (ERAS) protocol in Urology Department 


Delivery Network Department Title Description
BH Critical Care Expand Intermediate Care Area Expand the capacity and utilization of the Intermediate Care Area (Step Down Unit) at Bridgeport Hospital
YNHH Digestive Diseases Endoscopy Operational Redesign Optimize the utilization of endoscopy services 
GH  Emergency Emergency Department Throughput   Improve flow to reduce ED Length of Stay 
BH  Gynecology  ERAS - Gynecology  Deploy Enhance Recover After Surgery (ERAS) protocol for GYN surgery patients 
YNHH  Gynecology  ERAS - Gynecology  Deploy ERAS protocol for patients undergoing gynecological surgery 
YNHH  Heart & Vascular  Interventional Radiology Turnaround   Optimization of IR scheduling  & throughput  
YNHHS  Medicine Palliative Care  System deployment of standardized palliative care approach 
YNHH  Medicine Medicine Long Stay Patients  Providing appropriate level of care for patients who medically do not require ongoing hospitalization, though do not have other safe disposition options 
BH  Medicine  Patient Mobilization  Improve patient outcomes by increasing inpatient mobilization 
YNHHS  Medicine  LTACH Utilization  Develop & implement criteria for identifying and referring Long Term Acute Care Hospital (LTACH) patients 
BH  Medicine  Improve Care of Sepsis Patients  Deploy evidence-based sepsis care at Bridgeport Hospital 
YNHH  Multiple Virtual Hospice Launch a Hospice within a hospital  
YNHH  Musculoskeletal  Musculoskeletal Bundled Payments  Restructuring of bundled payments 
YNHH Musculoskeletal  Musculoskeletal Hip Fractures  An integrated fragility fracture program to promote the best outcomes for patients  
YNHH  Neurology Neuro - CT Utilization for Head Trauma Patients  Avoiding unnecessary computed tomography (CT) scans of the head in ED patients 
YNHH  OB/GYN  LOS  Improve inpatient management of post-partum patients 
YNHH  Pediatrics  Pediatric Sepsis Patient Care  Deploy evidence-based sepsis care in the Children's Hospital 
YNHH  Radiology Diagnostic Radiology Turnaround  Improve turnaround time for select diagnostic radiology tests 
YNHH  Respiratory Therapy Spirometry Redesign  Determine if patients admitted for COPD exacerbation have airflow obstruction 
YNHH  Supply Chain Surgical Low-End Physician Preference Items  Engage surgeons to reduce/standardize the numbers and types of surgical low end items 
YNHH Surgery  ERAS - GI / Colon   Deploy ERAS protocol for GI surgery patients  
YNHH  Surgery   Surgical Cost per Case  Deliver procedure-specific cost per case to surgical providers  
YNHH  Surgery   Thoracic Surgery Blood Utilization   Optimize proper screening, typing, and utilization of blood products for patients undergoing thoracic surgery 
GH Surgery   ERAS - GI / Colon  Deploy ERAS protocol for GI\Colon Surgery patients