At Duke University Health System, we constantly strive to improve the quality and safety of care we provide to patients. In the stories below, you'll learn about just a few of our quality and safety improvement initiatives.

Security Check: Improving Specimen Labeling
Kelly Nelson, MD, medical director of Clinic 3K, and the PDC Accreditation and Patient Safety group looked for opportunities to improve specimen labeling within the clinic.

Medication Reconciliation
Careful adherence to Duke Home Health’s medication reconciliation policy helped Duke physical therapist Bob Yane catch and correct a potentially harmful overdose of a patient’s anticoagulant medication.

New Recognition for Total Joint Replacement at Duke Raleigh Hospital
The Joint Commission awarded Disease-Specific Care Certification to Duke Raleigh Hospital's Total Joint Replacement Program, in recognition of the program’s commitment to excellence in providing care for total joint replacement patients.

Cardiac Monitoring: Waking Up to Alarm Fatigue
Alarm fatigue is the term for what happens when alarm sounds occur so frequently that caregivers may begin to tune them out. Duke is taking steps to ensure that the most important alarms are heard.

Access Revolution: Improving Appointment Wait Times
A six-month wait list to be seen at Duke Endocrinology sparked a targeted program to shorten wait times and get sick patients treated sooner.

Better, Together: Care Partners Program
The goal of the Care Partners program is to enhance the focus and care of patients with chronic diseases.

One Shared Goal: Successful Steps to Reduce Central-Line Bloodstream Infections
Duke Raleigh Hospital and Durham Regional Hospital have been working hard to reduce central-line bloodstream infections -- and the results have been promising.

It Takes a Team: Creating the Duke Experience
In June 2011, thousands of physicians, staff, and volunteers who work at Duke University Hospital came together for the 2011 All-Staff Event to recommit to caring for patients and their loved ones.

Architects of Quality Care and Patient Safety
Hundreds of Duke Medicine faculty and staff members have been involved in an interactive design process for the new Duke Medicine Pavilion. The team has worked through patient-care scenarios from mock intensive care unit (ICU) patient rooms housed in an old warehouse.

Advanced Imaging: Balancing Patient Safety and Image Quality
In the absence of national regulations regarding CT radiation doses, Duke researchers are investigating evidence-based ways to protect patients from excess radiation while maintaining the highest level of image quality.

Duke Residents and Fellows Aim to Improve Handoff Processes
In early 2010, house staff with special interests in patient safety and quality improvement coalesced to form the Duke GME Patient Safety and Quality Council (PSQC).

One Month, Lasting Impact: Duke's Employee Weight Loss Program
The Duke Diet & Fitness Center offers and employee weight loss program that improves quality of life for employees at Duke.

Student Ambassador Program: Improving the Patient Experience
Durham Regional Hospital's new Student Ambassador Program enlists the help of local university students to serve as patient experience ambassadors in the Emergency Department (ED) and Perioperative Services -- all in an effort to help improve the patient experience.

Teamwork in Stride: Using Teamwork to Improve Patient Safety
A system designed to help achieve best patient outcomes finds footing at Duke's Cardiothoracic OR.

Concurrent Therapy Nurse: Improving Communication and Patient Safety
After identifying specific issues related to communication, follow-up appointments, and parameters for treatment interventions, a new role of concurrent therapy nurse was established to improve communication and safety.

The Compassion Cart
Durham Regional Hospital has developed a new service to help the loved ones of patients who are receiving end-of-life care in the hospital -- the compassion cart.

The Virtual Patient: Simulating Care Delivery to Improve Patient Safety
Duke's Clinical Education & Professional Development (CEPD) uses a virtual patient for training purposes.

Right This Way: Patient Navigators Provide Guidance
Patient navigators at Duke Raleigh Hospital provide essential guidance during life-changing health events.

Heart Failure Readmissions: Tipping the Scales in a New Direction
Durham Regional Hospital seeks to curb heart failure readmissions through the Six Sigma process.

DigiChart: Patient Records at Doctors' Fingertips
Harris & Smith OB-GYN and Durham Obstetrics and Gynecology converted to DigiChart, an electronic medical records system that provides instant access to a patient’s chart.

Memory Measures: Improving Patient Handoffs
Duke's pediatric critical care team uses situation awareness and medical simulation to measure recall and improve patient handoffs.

Scoping It Out: Lessons from a Product Recall
Jane Pleasants, assistant vice president for procurement at Duke Medicine, discusses lessons learned from a very unusual recall.

New System Prevents Falls
A news system implemented by nurse Ann Brandley-Loner at Duke Raleigh Hospital prevents patient falls.

Enhancing Safety Reporting for Patient Falls
A computerized reporting system leads to unit-specific improvements and improves patient safety throughout Duke.

Moving in the Right Direction: Reducing Falls
Efforts at Duke Health Center at North Duke Street to reduce falls reflect system-wide efforts to decrease fall incidents in outpatient clinic settings.

Going Steady: Fall Prevention
Duke HomeCare and Hospice keeps falls prevention top-of-mind and develops tools to identify patients at greater risks for falls.

Putting the Patient First: ED Sets the Standard for Service
Learn how the Duke Emergency Department significantly improved patient satisfaction scores.

A NICHE for Geriatric Nursing Care
Duke's nurse-led initiatives aim to improve elder care on a national scale -- and bring immediate comfort to local patients.

In a Nutshell, Crisis Averted: Staying Ahead of Peanut Recall
Advance planning and swift action keep Duke ahead of national peanut recall.

Helping Uninsured Patients Access Care
See how Duke is aiding uninsured patients in Durham County receive the medical care they need.

Ensuring Equality in Patient Care
Learn the steps Duke is taking to ensure all patients are treated with equal standards of care.

Duke's RACE to Save Lives
Learn how the RACE project shortens the time for heart attack patients to receive lifesaving care.

SHHH! Keeps Noise Down, Promotes Healing
Research shows that people heal more quickly in a quiet, peaceful environment. At Duke Raleigh Hospital, Laura Tavares, RN, led an innovative effort to keep the noise down -- SHHH! or Silent Hospital Helps Healing.

A Pill for Every Ill: Managing the Pitfalls of Polypharmacy
An award-winning Duke affiliated program helps patients in need.