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No‐show patient visits should be considered risk events. No‐shows impact the quality and continuity of patient care. Missed visits increase health care risks by deferred or missed diagnosis and treatment, and increases costs of care. This performance improvement project proactively implemented a telemedicine system of care during a public health emergency (PHE). The goal was to improve health care access and decrease health care disparities despite emergency management changes in organizational staffing and federal stay‐at‐home orders. Telemedicine visits also addressed known causes of historically high in‐person no‐show office rates—lack of transportation, childcare issues, mobility issues, and adverse weather conditions. Despite location in a Hospital Census Tract where 50% of our population is below the Federal Poverty Level, with less access to technology, telemedicine proved to be successful. The Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) guidelines were the planning framework. The Model for Healthcare Improvement including Part 1 (AIM) and Part 2 (Plan‐Do‐Study‐Act) was used to develop interventions, outcomes, and rationale for use. Data was collected from January 2020 thru March 2022, with 22,831 total scheduled visits (15,837 in‐person, 6994 telemedicine). The average monthly no‐show rate for in‐person visits was 35% compared to 9% for telemedicine visits. [ABSTRACT FROM AUTHOR]

This article is the second of a 4-part quality improvement resource series for critical care nurses interested in implementing system process or performance improvement projects. The article is a brainstorming session on paper, written to assist nurses and managers in identifying possible quality improvement projects that are meaningful to them and will make a real difference in their critical care units. Every unit and institution has its own unique mix of resources, culture, physical environment, patient population, technology, documentation processes, health care providers, and multiple other factors. Thus specific patient care and safety challenges must be identified and prioritized individually for quality improvement by each unit. Projects also must be manageable and within the scope of time, effort, and expertise available--no quality improvement project is "too small" if it is applicable to your critical care area and will improve outcomes. [ABSTRACT FROM AUTHOR]