Unhealthy Alcohol Use Screening and Interventions Aim: Implement unhealthy alcohol use screening and interventions for 50% of patients (n = 12,603) in UNC General Internal Medicine Clinic by June 30, 2017. Interventions: Develop and implement screening and intervention protocols Nurse screens patients using AUDIT Alcohol Use Screener Provider scores AUDIT and counsels, sets goals with patient & makes referral Men Women Review AUDIT score <6 <4 Alcohol use disorder unlikely. Counseling for risky drinking. 6-14 4-12 Review questions 4-6: <2 counsel for risky drinking. ≥2 alcohol use disorder likely. Referral. ≥15 ≥13 Alcohol use disorder likely. Consider referral. Mean rate = 42% Mean rate = 80%

Tar Heel Trauma Care: The Golden Hour and Beyond Aim: Improve consistency, efficiency and reliability of trauma resuscitations. Interventions: Standardize care: bay prep, defined roles, huddle, structured patient assessment, debrief Simulation, observation, and feedback to improve fidelity to standard care Multidisciplinary continuum of care conference to review patient case from first responder through rehab

Metabolic Monitoring in Outpatient Psychiatry Aim: Monitor metabolic indicators of UNC Psychiatry patients prescribed antipsychotic drugs (APDs). Interventions: Develop and implement process for identifying patients prescribed APDs due for monitoring Identify and address barriers to laboratory monitoring Develop and implement process for educating and reminding providers when labs are due QI Interventions Improve Rates of Metabolic Monitoring Grand Rounds Notes APD Survey Monitoring Poster Consent Forms Initial Survey

Quiet Time: Reducing Noise to Improve Patient Care Aim: Implement Quiet Time on two Medicine units (6 Bed Tower and 3 West). Interventions: Dimmed lights, sleep menus, clustered care Lowered voices, quieter cart wheels, Quiet Time hours posted Continuous monitoring and feedback regarding quiet time

Falls Risk Management for Patients in Primary Care Aim: Decrease risk of falls in UNC primary care patients who are 65 years and older, ambulatory, and enrolled in Medicare. Interventions: Screen patients for falls risk at primary care visit Refer patients to UNC Physical Therapy based on results of Timed Up and Go (TUG) Patients learn Otago Exercise Program from physical therapists and practice at home

Cystic Fibrosis Transitions: From Pediatric to Adult Care Aim: Increase the number of patients with cystic fibrosis transitioned from pediatric to adult care at the appropriate time. Interventions: Transition Coordinator monitors and guides transition of patients Patients and families participate in structured activities to prepare for transition Patients complete CF RISE (Responsibility. Independence. Self Care. Education.) Program Patients and families meet with adult care team prior to transition