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Medical-Surgical Care: General

The content in this section includes tools that the Institute for Healthcare Improvement has developed and adapted to help organizations accelerate their work to improve medical-surgical care. In addition, many organizations have developed tools in the course of their improvement efforts — successful protocols, order sets and forms, instructions and guidelines for implementing key changes — and are making them available on IHI.org for others to use or adapt in their own organizations. We invite you to submit tools you have found useful!

Congestive Heart Failure
General Tools
Information Gathering Tools
Pressure Ulcers
Vitality and Teamwork

Tools Icon Key
PDF PDF (Downloadable) Power Point Powerpoint (Downloadable)
Word Doc Word (Downloadable) Access Access (Downloadable)
Excel Excel (Downloadable) Tool Interactive Tool (Online)

Congestive Heart Failure

This How-to Guide highlights four key components of an ideal transition home; specifies practical step-by-step changes that can be tested; and provides tips, tools, resources, and case studies of hospitals that have implemented many of the changes. Developed by the Institute for Healthcare Improvement (Cambridge, Massachusetts, USA) in collaboration with the Robert Wood Johnson Foundation.

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A form used to indicate physician admission orders for patients with congestive heart failure; developed by Cleveland Regional Medical Center (Shelby, North Carolina, USA).

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A form used to indicate physician discharge orders for patients with congestive heart failure; devolped by Cleveland Regional Medical Center (Shelby, North Carolina, USA).

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A tool for documenting education provided to patients with congestive heart failure and their families about care after discharge; developed by Cleveland Regional Medical Center (Shelby, North Carolina, USA).

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A documentation sheet for discharge instructions provided to patients with congestive heart failure; developed by Cleveland Regional Medical Center (Shelby, North Carolina, USA).

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General Tools

This How-to Guide provides an overview of the key components needed to sustain and spread improvements; specifies practical step-by-step activities to lay the foundation for spread, including how to create a plan for spread; and provides tips, tools, resources, and case studies. Developed by the Institute for Healthcare Improvement (Cambridge, Massachusetts, USA) in collaboration with the Robert Wood Johnson Foundation.

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A tool used to rate nursing assistants on their performance of critical elements of care for patients with ostomies; developed by Morristown Memorial Hospital (Morristown, New Jersey, USA).

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A generic discharge instructions tool which includes all important elements for patients with congestive heart failure; developed by Baystate Medical Center (Springfield, Massachusetts, USA).

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Information Gathering Tools

This tool helps hospitals assess how nurses spend time on the unit during a shift and identify obvious inefficiencies and waste in processes; developed by the Institute for Healthcare Improvement (Cambridge, Massachusetts, USA).

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Pressure Ulcers

This brochure provides information for patients and families on what a pressure ulcer is, who is at risk, how to keep skin healthy, what to do at home and in the hospital to prevent pressure ulcers, and what caregivers in the hospital will do to prevent them; developed by Yuma Regional Medical Center (Yuma, Arizona, USA).

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This tool is used by nurses to help identify the interventions needed for those patients with an identified deficit in any or all of the Braden sub-scales; developed by Yuma Regional Medical Center (Yuma, Arizona, USA).

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This tool is used to document the presence of a wound and condition of surrounding skin on admission and at regular intervals thereafter to document wound progression, in addition to photographic images of treatment outcomes; developed by Yuma Regional Medical Center (Yuma, Arizona, USA).

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A flowchart indicating the steps taken to assess a patient’s risk of developing pressure ulcers and steps to identify and treat pressure ulcers that have formed; developed by Morristown Memorial Hospital (Morristown, New Jersey, USA).

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A grid identifying various elements of care for patients with pressure ulcers; developed by Morristown Memorial Hospital (Morristown, New Jersey, USA).

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This tool is used to educate nursing staff on the prevention and management of wounds by listing critical elements for identifying pressure ulcers, determining their severity (stage), and differentiating them from other types of wounds; developed by Morristown Memorial Hospital (Morristown, New Jersey, USA).

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Use this poster to display important facts about skin care necessary to avoid pressure ulcers; developed by Iowa Health Des Moines (Des Moines, Iowa, USA).

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The turn clock tool is posted to alert staff that this patient has been identified as being at risk for pressure ulcers and serves as a reminder to reposition the patient every two hours; developed by Owensboro Medical Health System (Owensboro, Kentucky, USA)

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Vitality and Teamwork

This How-to Guide describes three improvement strategies for building improvement capability and engaging front-line staff in innovation on medical and surgical units; specifies practical changes that can be tested; and provides tips, tools, resources, and case studies of hospitals that have implemented many of the changes. Developed by the Institute for Healthcare Improvement (Cambridge, Massachusetts, USA) in collaboration with the Robert Wood Johnson Foundation.

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