Improving Patient Safety through Research and Implementation
“Improving the quality, safety, and efficiency of patient care is a passion that I gladly share with AHRQ. Our commitment to rigorous, innovative research is the only way to provide the best possible patient-safety resources to healthcare teams across the country.”
As a hospitalist and Chief Quality Officer at the University of California Davis Medical Center, Gregory Maynard, M.D., has not only served countless patients, but also helped to make their stay in the hospital safer. With funding from AHRQ, he has applied quality improvement (QI) principles to two important safety risks in hospital patients: blood clots and the proper management of blood sugar levels.
Patients who are hospitalized are often at higher risk of developing blood clots or venous thromboembolism (VTE), which are a leading cause of preventable deaths in hospitals nationwide. With AHRQ funding, Dr. Maynard and his team tackled this problem by developing and implementing a VTE prophylaxis protocol that simplifies the steps that clinicians need to take to prevent blood clots in at-risk patients. He then created a customizable toolkit on this proven practice to help other hospitals and clinicians tackle this problem and make care safer.
The VTE protocol and toolkit have been used in a number of hospitals nationwide. For instance, in 2012 seven New York hospitals integrated the toolkit recommendations into their hospital’s protocol. One hospital saw appropriate VTE prophylaxis increase to 100 percent. Even more than a decade later, the results of Dr. Maynard's AHRQ-funded study are used in hospitals and taught to clinicians.
Dr. Maynard followed up his work on VTE by using AHRQ funding to focus on managing blood sugar in hospital patients with and without diabetes. Hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar) are largely preventable, but can result in much lengthier hospital stays, increases in infection rates, dehydration, and other harmful conditions. Managing blood sugar levels properly leads to better patient outcomes.
A study published in Endocrine Practice details how Dr. Maynard’s team identified a benchmark for safe blood sugar levels for hospital patients with non-life-threatening issues and then introduced real-time monitoring of blood sugar levels so they could determine best practices for maintaining this standard.
Using his AHRQ research as a springboard, he then worked with the Society of Hospital Medicine, where he was then the Senior Vice President of the Center for Hospital Innovation and Improvement, to develop a QI toolkit that other clinicians and hospitals could use to apply this knowledge.
Dr. Maynard has successfully used AHRQ funding to combine QI principles with safe practices to develop protocols that reduce patient harm and create tools that bring this knowledge to the front lines of care, making care safer. Across large hospital networks, Dr. Maynard’s work has decreased hospital-acquired VTE more than 20 percent. Thanks to these and other efforts, he was named a Healthcare-Associated VTE Prevention Challenge Champion in 2016 and the resulting QI toolkits helped earn the Society of Hospital Medicine the John M. Eisenberg Award in 2011 for Innovation in Patient Safety and Quality on the national level.
Principal Investigator: Gregory Maynard, Chief Quality Officer
Institution: University of California Davis Medical Center
Grantee Since: 2005
Type of Grant: Various
Consistent with its mission, AHRQ provides a broad range of extramural research grants and contracts, research training, conference grants, and intramural research activities. AHRQ is committed to fostering the next generation of health services researchers who can focus on some of the most important challenges facing our Nation's health care system.
To learn more about AHRQ's Research Education and Training Programs, please visit http://www.ahrq.gov/training.