Intrathecal baclofen (ITB) pump complications may result in poor therapeutic effect, withdrawal, hospitalization, or reoperation. Consider this project if you have concerns about ITB pump management in your practice.

Catheter associated urinary tract infections (CAUTIs) are one of the most common complications associated with hospital admission. CAUTIs can result in patient morbidity and mortality, extended hospital stays, and increased health care costs. Consider this project if your facility’s CAUTI rate is higher than expected or desired.

Children with cerebral palsy (CP) are at increased risk for developmental hip dysplasia (DDH) requiring hip surveillance at periodic intervals for optimal medical care. The American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) has developed a care pathway to address this medical concern in patients with CP during their developmental years (CPHS). Consider this project to integrate this pathway into your care.

Create your own IHHC (QI) project based on minor annoyances, inefficiencies, or persistent issues in your practice, your education work, your administrative role, or your research that you could improve by completing a QI project.

Physician burnout is a national problem amongst practitioners due to the ever-changing face of health care, including EMR burdens, decreased reimbursements, increased requirements and policing of documentation, insurance denials, loss of autonomy, and more. Consider this project if you’re concerned about burnout and physician wellness in your department or practice.

Participation and contributions from diverse individuals is critical to the future of medicine and our civil society. Consider this project if there are improvements to be made in areas such as staff and resident diversity, unconscious bias in payer and insurance considerations, holiday considerations, patient satisfaction measures, or if you have your own idea for making a small improvement in this vital area.

Exercise has been shown to improve cardiovascular and respiratory function, cognition, mood, sleep, and physical function. Exercise can reduce morbidity and mortality, pain, and fall risk in older adults. This project could help integrate physical activity into your daily practice. You can see an action guide for this project here.

Literature suggests that tracking the functional status of patients with spine-related pain improves outcomes. Consider this project if you could begin consistently obtaining a functional status measure in this patient group and utilizing this effectively amongst your team.

Effective communication is important in almost every area of a physician’s professional work. Consider this project if trainees describe your communication as too abrupt/directive/distant, patients have requested diagnosis-specific education, or you see opportunities to improve communication about next appointments or other care aspects.

Proper use of personal protective equipment (PPE) in health care settings has always been important for patient and provider safety, but PPE has gained increased attention in the era of COVID-19. Consider this project if there is concern in your work that PPE is not being used optimally.

Longer-than-optimal patient wait times lower patient satisfaction scores; implementing simple changes to decrease wait times could make a major difference to your patients. Consider this project if long patient wait times are a persistent problem in your practice.

Research has demonstrated that pre-procedure timeouts decrease procedure-related errors. Consider this project if your practice needs consistency in performing pre-procedure timeouts.

Literature indicates safety gaps exist when patients are discharged from the hospital. Consider this project if there are potential safety issues to address with the current method of discharging patients at your facility.

Physicians prescribing or renewing prescriptions for opioids may not be aware that patients are obtaining opioids from multiple providers or being prescribed other substances. The Centers for Disease Control recommends that physicians consider checking their state’s Physician Drug Monitoring Program (PDMP) to monitor their patients’ prescriptions. Consider this project to help assess how often you’re checking the PDMP when prescribing and renewing opioid prescriptions.

Current guidelines suggest that to promote a healthy lifestyle, children ages 3-5 should get three hours of activity daily and adolescents 6-17 should be active for at least 60 minutes a day. Consider this project if you need to address physical activity and obesity with your patients.

Patient falls during an admission to an inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF) can cause significant morbidity and possibly even mortality. Consider this project if your facility’s fall rate is higher than desired.

Acute care transfers (ACT) from inpatient rehabilitation facilities (IRF) cause interruptions of functional progress, are related to negative overall outcomes, and are increasingly viewed by external parties as an indicator of IRF quality. Consider this project if your facility’s acute care transfer rate could be decreased.

Multiple factors (e.g. impaired cognition and/or sensation, decreased strength and mobility, poor nutritional status, incontinence, etc) that are commonly present in patients admitted to an inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF) can greatly increase the risk that those patients will develop pressure injuries. Consider this project if your facility’s pressure injury rate is higher than desired.

Literature suggests that early identification of opioid abuse potential improves the outcome of patients with painful medical conditions. Identify whether your practice uses the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) or a similar tool. Consider this project if the SOAPP-R tool is not administered consistently or the results of the screener are not used effectively to manage a patient’s risk of opioid misuse.

Research demonstrates that standard management protocols for anticoagulation therapy reduce errors and improve outcomes, including diet and drug interaction education. Consider this project if there is room for improvement in your practice’s current protocols and implementation for anticoagulation diet and drug interaction education.

Some practice areas were already starting to embrace it, but the COVID-19 pandemic substantially accelerated the widespread development and use of telemedicine. Consider this project if the infrastructure, quality of care, and patient satisfaction in your telemedicine processes and procedures need improvement.

Medical errors are a common and serious problem in health care; the FDA receives more than 100,000 reports per year of medication errors. A medical error is a single event that should prompt a root cause analysis to prevent a recurrence. Consider this project if you experienced a medical error and want to use a IHHC (QI) project to measure its impact and implement a change to prevent future errors.