Quality Improvement

Turning Insight into Measurable Change

Quality Improvement transforms departmental priorities, performance data, and safety insights into structured action. This domain focuses on designing, implementing, and sustaining initiatives that improve clinical outcomes, operational reliability, patient safety, and system performance across the Department. Quality Improvement is the mechanism through which strategic priorities become measurable progress. By applying structured methodology, interdisciplinary collaboration, and data-driven evaluation, QI initiatives create sustainable system-level improvement rather than temporary fixes.

Our Approach

The Department’s Quality Improvement work is guided by structured project design and strategic alignment. Each initiative is expected to:

  • Align with departmental quality priorities
  • Address clearly defined clinical or operational challenges
  • Include measurable aim statements and performance metrics
  • Apply evidence-based improvement methodology
  • Identify project leadership and sponsorship
  • Monitor progress through regular review and reporting

Current focus areas include:

  • Medication safety
  • Perioperative glycemic control
  • Environmental sustainability
  • Perioperative efficiency and length-of-stay reduction
  • Reduction of postoperative respiratory complications
  • Prevention of postoperative acute kidney injury
  • Blood product stewardship and safe administration
  • Quantitative neuromuscular monitoring

Active Quality Improvement Focus Areas

The Department’s Quality Improvement portfolio reflects active, division-led initiatives aligned with strategic departmental priorities.

Adult General & Ortho/Regional

  • Reducing postoperative respiratory failure and pneumonia
  • Evaluating epinephrine dosing and adherence to resuscitation guidelines
  • Streamlining sedation recommendations after STAT intubations
  • Creating trigger criteria for emergent NORA anesthesia coverage
  • Regional block first-case on-time starts
  • Improving communication for patients receiving regional blocks
  • Hypothermia prevention initiatives
  • Improving preoxygenation quality
  • Preventing endotracheal tube cuff overinflation
  • Risk mitigation for patients with body piercings

Cardiac Anesthesiology

  • Reducing postoperative acute kidney injury rates
  • Characterizing transfusion practices
  • Intraoperative extubation optimization
  • Atrial fibrillation reduction following mitral valve surgery
  • Evaluating methadone efficacy and safety
  • Improving TEE teaching aids and documentation methods
  • Developing ROTEM-directed transfusion protocols
  • Evaluating opioid utilization in cryoablation patients

Critical Care (ICU)

  • ICU consult process standardization

  • Amiodarone prophylaxis after cardiac surgery

  • A–F bundle implementation

  • Reducing inappropriate restraint use

  • I-COUGH bundle implementation

  • Updating case-based and problem-based guidance

Neuroanesthesiology

  • Improving post-thrombectomy vital sign documentation
  • Optimizing EPOC use for intracranial surgery with hyperventilation

Obstetric Anesthesiology

  • Hemorrhage protocol implementation
  • Standardization and automation of rotation orientation
  • Evaluation of blood product utilization

Pain Medicine

  • Chronic pain inpatient manual development
  • Intrathecal pump safety initiatives
  • Anticoagulation management dashboard and communication protocol
  • Preprocedural anxiety screening and intervention protocols

Pediatric Anesthesiology

  • Optimizing EPIC notable events for quality reporting
  • Improving NPO instruction communication
  • Double-verification of infusion medications
  • ERAS pathway development for liver transplantation
  • Functional coagulation assay implementation
  • Optimizing NPO timing and patient/family satisfaction
  • Early extubation protocols for pediatric liver transplantation
  • Updating perioperative antifibrinolytic recommendations
  • Reducing unnecessary type and screen testing

QI Project Workspace

The Department maintains a centralized Quality Improvement workspace that supports visibility, collaboration, and accountability across divisions. This platform provides:

  • Department-wide project tracking
  • Project milestone monitoring
  • Division-specific collaboration spaces
  • Standardized project documentation
  • Access to project charters and reports
  • Shared tools and improvement resources
CUIMC Anesthesiology Quality - QI Project List

Project Governance and Accountability

Each active Quality Improvement initiative includes:

  • Defined project ownership
  • Departmental sponsorship
  • Clear aims and success metrics
  • Regular progress updates
  • Identification of barriers and escalation needs
  • Ongoing evaluation of long-term sustainability

This governance model ensures projects maintain momentum and remain connected to departmental goals.

VITALS: Quality Dispatch

VITALS: Quality Dispatch is the Department’s quality newsletter that shares project updates, quality education, safety reminders, and departmental best practices. It helps keep improvement work visible across divisions, highlights active initiatives, promotes collaboration, and supports a strong culture of continuous learning across the Department.

Reach out for help getting started, if you have a project to add to the database, or to showcase your work in a future Quality Dispatch! 


Taylor Johnston, MD
Director of Quality Assurance, Chair QA Committee
taj2101@cumc.columbia.edu


Jonathan Paul, DO
Director of Quality Improvement
jap2179@cumc.columbia.edu


Mouaze Adam, RN
Interim QA Support during Shu’s leave
ma4611@cumc.columbia.edu


Prior issues of VITALS: Quality Dispatch are available in the Quality workspace on C8.

Back to top