Improving pneumococcal immunization rates in an ambulatory setting.

The purpose of this quality improvement project was to improve the immunization rates of an at-risk adult population seen in a presurgical testing center through staff training and patient education. Over 24 months, there were 2257 patients preintervention and 2505 patients postintervention. There was a statistically significant difference between preintervention rate of 24% and postintervention rate of 47% (χ2 [1, N = 4736] = 173.

Use of the national surgical quality improvement program to reduce surgical mortality: implementation of intensive preoperative screening and intervention.

The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) data at our institution indicated that surgical mortality was significantly higher than expected. This study examines the effect of implementation of a strict, intensive preoperative screening and intervention process on postoperative mortality at our institution, as measured by the NSQIP. Carilion Roanoke Memorial Hospital (CRMH) is a 763-bed tertiary care hospital serving a population of one million people in southwest Virginia.