1. 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%

2. 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

3. 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

4. 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

5. 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

6. 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