Leaving Against Medical Advice: A Physician Quality Improvement Project
Dr. Trudy Nasmith, who works in Internal Medicine at St. Paul’s Hospital, first began her quality improvement efforts with understanding the characteristics of patients who leave against medical advice (AMA).
After collecting and reviewing data from more than 400 records to better understand the factors or conditions of patients who leave AMA, she chose to focus on improving communication with Primary Care Provider (PCP) and follow-up arranged.
Dr. Nasmith has been working with physicians and residents to improve and document communication with PCPs; she has also used surveys to collect feedback. Her work has allowed her to join a multi-disciplinary working group focused on addressing the issue of patients who leave AMA that includes members from diverse groups such as Infectious Diseases, Addictions, General Medicine and the Medicine Program.
Physician Led Quality Improvement (PLQI) is a quality improvement partnership among VCH, Providence and Specialist Services Committee (SSC) to strengthen the quality improvement capacity and culture within our physician community. Work is done collaboratively with Quality department colleagues and help physicians connect with operations and gain support from senior leadership.