Teams need to find patients to include in quality improvement efforts. One way to do this is to establish a patient registry from which to cull data about patients whose care is affected by quality improvement efforts. The easiest place to start is with a list of patients. For example, groups with computerized patient databases, for example, might search for diagnoses, severity, or some other factor. Many teams find that the best way to assemble a registry is to talk to health care providers on a unit or in a specific discipline. For instance, groups involved in improving care for heart failure patients have asked cardiologists to review their patient panel and note whether it would be a surprise if a patient were to die within the year.
Teams can begin to make improvements to the system of care while a registry is being set up. Changes can be developed and tried with the patients identified. Refinements to the changes can be made based on discussions with caregivers, patients, and families. The learning can be expanded as additional patients are added to the registry. Over time, teams can gather evidence about whether a change is an improvement to the system.
This text is derived from the book Improving Care for the End of Life : A Sourcebook for Health Care Managers and Clinicians.