Improvement Practices and Resources

Tools and help to make change happen.

There are a lot of resources available to help you undertake change to improve brain health management for older patients around the time of surgery. Here are some useful links and tips from anesthesiologists experienced in improvement.

Frailty Toolkit

This resource includes an introduction to frailty, frailty assessment and instruments with infographic, four case studies, and collected key papers in perioperative frailty. Curated by the Committee on Geriatric Anesthesia and updated June 2021.

PBHI Delirium Infographic

Keeping Your Brain Healthy When You Have Surgery
What You Need to Know

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Institute for Healthcare Improvement (IHI)

The Institute for Healthcare Improvement (IHI) website IHI is a not-for-profit organization based in Cambridge, Massachusetts, that is a resource for innovation and improvement in healthcare in the U.S. and world-wide. There are a multitude of resources on this website including resources for change. Also explore their Open School which has online courses on improvement, and is free to any member of staff enrolled in a training program such as Residents or Fellows.

IHI has recently published a Quality Improvement Essentials toolkit, a very useful downloadable resource which includes templates for project planning forms, driver diagrams and a lot more quality improvement (QI) aids.

ASA Monitor article by Drs. Kaur and Spanakis

Initial steps to set up a quality improvement program and how to get started on the journey are described in this excellent article by Drs. Kaur and Spanakis, published in the ASA Monitor.

Harvard edX

Harvard edX has a practical improvement science online course that is free if you are not seeking certification and offers new quality and safety courses on a regular basis.

The Royal College of Anaesthetists

The Royal College of Anaesthetists in the U.K. has many resources on quality improvement that are free to access. The Perioperative Improvement Science and Management (PRISM) section has an introductory QI course at . There is also a downloadable QI book and includes a background to QI and details on tools such as driver diagrams.

AHRQ and their Team STEPPS program

Managing change in projects such as the Brain Health Initiative can be challenging.  AHRQ has some resources on change management within their Team STEPPS program.

There are also resources within the links mentioned above, and many books on change management.

Top Tips by Carol Peden, M.B. Ch.B., M.D., M.P.H.

Please see the top tips section for more practical QI tips.

Hospital Elder Life Program (HELP) for Prevention of Delirium

HELP is a comprehensive patient-care program that ensures optimal care for older adults in the hospital. HELP prevents delirium (a sudden state of confusion or change in mental state) and loss of functioning. Visit their site to learn more.