Award Projects Showcase

Radial artery hemostasis can be achieved through various methods after sheath removal, but the risk of radial artery occlusion (RAO) remains a concern. A patented hemostasis technique preserves radial artery patency, reducing RAO risk. This study compared three TR band deflation protocols early initiation with long intervals, delayed initiation with short intervals, and routine protocol to identify the optimal approach after transradial coronary procedures. In a randomized controlled trial at King Abdullah Medical City, 207 patients were assigned 1:1:1 to the three protocols. Using the patented technique, 2 ml of air was reinjected after detecting the radial pulse following complete occlusion with 16 ml. Outcomes included total TR band removal time, bleeding, and RAO. Results showed significant differences in mean total TR band removal time among protocols A, B, and C (194.1 ±38.2, 200.1 ±27.2, 152.9 ±59.4 min; p=0.000). Bleeding rates were similar (11.8%, 15.9%, 22.9%; p=0.2), but first-hour bleeding differed significantly (10.3%, 7.2%, 22.9%; p=0.01). Only 1.4% of protocol B patients had small hematomas in the second hour. No RAO was observed. Early initiation appears most effective in minimizing bleeding complications.

This project focuses on enhancing pediatric medication safety by implementing a structured system to identify, monitor, and reduce the use of potentially inappropriate medications in children using the Key Potentially Inappropriate Drugs (KIDs) List. Pediatric patients are highly vulnerable to medication-related harm, and the absence of standardized safeguards increases the likelihood of preventable adverse drug reactions (ADRs). The project introduced a comprehensive pediatric medication safety initiative that applied the KIDs List as a screening and decision-support tool. Through systematic review of medication use, identification of high-risk prescribing patterns, and assessment of associated ADRs, the project uncovered opportunities to improve prescribing behavior and reduce harm. Based on the findings, multiple interventions were designed, including safer-prescribing recommendations, pharmacist-led verification processes, and targeted educational activities. The project provides a scalable framework that strengthens pediatric medication safety across diverse healthcare settings.

Hospital-acquired pressure injuries (HAPI) are a major yet preventable patient-safety concern in intensive care units, where critically ill patients are exposed to immobility, hemodynamic instability, impaired perfusion, and nutritional compromise. Patients admitted with community-acquired pressure injuries (CAPI) represent an especially vulnerable subgroup, as pre-existing tissue damage combined with critical illness significantly increases the risk of deterioration and new injury development. Despite this heightened risk, evidence focusing specifically on ICU patients with CAPI—particularly in the Middle East—remains limited. This project was undertaken to address this gap and to evaluate whether strong, standardized prevention systems can effectively protect even the highest-risk patients from additional harm. A retrospective observational study was conducted in a tertiary Medical-Surgical ICU, reviewing 136 admissions between July and December 2022, including 36 patients (26%) admitted with CAPI. Clinical data encompassing demographics, Braden Scale scores, Glasgow Coma Scale, comorbidities, laboratory markers, CAPI characteristics, ICU length of stay, and development of new Stage 2 or higher HAPI were analyzed using internationally recognized NPIAP staging guidelines. Despite significant baseline risk, the incidence of new HAPI among CAPI patients was only 5.6%, substantially lower than national and international benchmarks. Patients who developed HAPI shared consistent risk factors such as very low Braden scores, declining neurological status, prolonged ICU stay, hypoalbuminemia, and multiple comorbidities, with heels identified as the most common injury site. These findings demonstrate that consistent adherence to evidence-based prevention bundles, early risk identification, and multidisciplinary collaboration can successfully prevent avoidable harm, reinforcing Zero Harm principles and providing valuable regional patient-safety evidence.

Children often experience anxiety, confusion, and limited involvement during medication counseling, placing them at risk of misuse, poor adherence, and preventable harm. Baseline findings showed that only 42% of children aged 7 years and older could explain their medication purpose and dosing, and pediatric medication-related near-misses reached 6.5 per 1,000 visits. Traditional parent-centered counseling did not adequately support children’s active role in their own safety. This project implemented the first structured, co-designed pediatric medication safety model in the country. Guided by child-participation principles aligned with the UN Convention on the Rights of the Child, children and families co-developed pictorial medication cards, color-coded dosing aids, a child-friendly counseling script, and the “My Med Story” booklet. Children also helped create new pediatric PROM and PREM tools to assess understanding, communication, and perceived safety. Over ten months, the model achieved significant gains in safety, understanding, and experience. Children correctly explaining their medicines increased from 42% to 81%. Pediatric near-misses decreased from 6.5 to 2.1 per 1,000 visits. Child-reported feelings of being “safe and heard” rose from 48% to 86%, and parent satisfaction with child involvement improved from 59% to 90%. All pharmacists were trained in child-centered communication, and tool adoption reached 88%. Dispensing time rose only +1.4 minutes, remaining within workflow targets. Estimated annual cost avoidance was ~102,200 SAR due to fewer adverse events and reduced complaint investigations, compared with implementation costs of ~60,000 SAR (ROI 1.7:1). The intervention is low-cost, scalable, and adaptable for national use. Empowering children as partners in their medication journey led to measurable improvements in outcomes, experience, and system performance.

Pediatric peritoneal dialysis (PD) patients often face significant challenges in home-based care, including inconsistent follow-up, unverified dialysis sessions, and difficulty responding to machine alarms. Families—particularly mothers—frequently experience anxiety and confusion when troubleshooting PD issues, leading to unnecessary emergency visits. Recognizing this gap, the hospital introduced an innovative remote monitoring system designed to strengthen communication between patients’ homes and hospital-based caregivers. This initiative actively engages patients and families in co-designing safety strategies, empowering them to participate in care while enhancing patient safety. Through remote monitoring, clinicians can track ultrafiltration, fill volume, and treatment hours in real time, enabling early detection of problems and timely interventions. Structured education for nurses and families, clear follow-up protocols, and integrated dashboards further support safe and efficient care delivery. The impact has been remarkable: PD readmission rates dropped from 26% in December 2023 to 0% by June 2024, sustained thereafter. This achievement eliminated PD-related complications, reduced nurse workload, optimized physician coordination, and improved hospital resource utilization. Families reported satisfaction levels above 90%, citing reduced stress, fewer hospital visits, and a stronger sense of partnership in care. Beyond immediate outcomes, the project positions the hospital as a national leader in technology-assisted pediatric care. It sets a new benchmark for remote patient monitoring, aligning with the national goals of patient safety, digital transformation, and innovation. Building on this success, replication plans are underway to expand remote monitoring to other chronic pediatric conditions, including diabetes and epilepsy, further advancing the hospital’s broader telehealth vision.

The SAFE Mothers Initiative: Stopping VTE through Accurate Scoring (SAFE) addresses one of the leading preventable causes of maternal mortality—Venous Thromboembolism (VTE)—by transforming the maternal safety landscape at our facility. Triggered by a sentinel maternal death in October 2024, the project tackled critical gaps in compliance, scoring accuracy, prophylaxis duration, and fragmented postpartum follow-up. Using the FOCUS-PDCA methodology, a multidisciplinary team developed a culturally-adapted, first-in-Kingdom VTE risk scoring system—the "SAFE Score"—integrated directly into the Electronic Health Record (EHR) with automated alerts, hard stops, and dual-signoff verification. Complementary measures included structured telehealth follow-up, PHC integration, intensive staff training, and a patient education mobile app. Within months, the initiative achieved zero VTE-related maternal deaths, zero readmissions, zero hospital-acquired VTE events, a rise in protocol compliance from 58% to 96%, and a significant increase in patient satisfaction. The program also demonstrates strong financial stewardship, projecting annual savings of 910,000 SAR by preventing costly complications. SAFE Mothers exemplifies a scalable, sustainable model that embeds safety into clinical workflows, strengthens community links, and empowers patients, providing a replicable blueprint for national adoption in alignment with Saudi Vision 2030.

The “Digital Transformation of the Newborn Registration Logbook” project was launched in January 2024 to replace a fully manual, paper-based newborn registration process with a secure, efficient, and accurate digital system. Manual logbooks had caused recurring issues—including illegible entries, delayed reporting, data duplication, and risk of information loss—affecting accuracy, workflow efficiency, and timely submission of newborn data. Using the PDSA quality-improvement framework, a multidisciplinary team redesigned workflows, developed an electronic registration platform, trained staff, upgraded infrastructure, and integrated the system with existing hospital information services. By September 2024, digital registration reached 100%—four months ahead of target—and this performance was sustained throughout 2025, resulting in real-time documentation, zero missed or duplicate entries, faster data retrieval, enhanced data integrity, and streamlined reporting.

This Quality Improvement (QI) initiative addressed the critical newborn safety topic of Intraventricular Hemorrhage (IVH) prevention, a leading cause of severe neurodevelopmental impairment in premature infants. The target population was very preterm infants ≤ 32 weeks gestation. The project was initiated in response to a baseline IVH incidence (Grade 1-4) of 24% (20/84), recorded over a 24-month time frame prior to intervention, a rate deemed suboptimal compared to peer institutions. The elevated rate was systematically traced to the inconsistent and unreliable application of evidence-based neuro-protective protocols during the critical 72-hour transition period. The overall goal was ambitious: to reduce the IVH incidence to a sustained operational target of below 20% by the end of 2025. The systematic approach employed the QI methodology (Plan-Do-Study-Act cycles) focusing on standardizing care via a 5-element IVH Neuro-Protective Care Bundle (IVHNPB). This bundle focused on critical elements like maintaining hemodynamic stability, minimal handling, and strict PCO2 control. Key stakeholders, including the multidisciplinary clinical team (neonatologists, nurses, respiratory therapists) and unit leadership were robustly engaged through mandatory high-fidelity simulation-based training, the use of visual cue cards, and continuous data feedback to ensure behavioral change and accountability. The project delivered exceptional results: the IVH incidence was reduced to 12%, representing a substantial 50% relative reduction that significantly surpassed the target. This successful outcome resulted in profound value by improving newborn safety, optimizing early neonatal care through a structured, multidisciplinary neuroprotective bundle aligned with best international evidence and achieving an estimated 8,000,000 SAR cost avoidance associated with the management of complex IVH cases and long-term disability, demonstrating a high return on investment and clinical excellence.

This quality improvement project aimed to strengthen patient safety and clinical outcomes in treating large, non-infected Wagner grade 2 diabetic foot ulcers by introducing Acellular Dermal Membrane (ADM) therapy as an innovative alternative to split-thickness skin grafting (STSG). Large DFUs carry high risks of delayed healing, infection, donor-site morbidity, repeated interventions, and prolonged hospitalization, making them a priority for therapeutic safety improvement. STSG remains common but is associated with significant procedural risk and inconsistent outcomes. ADM provides a biologically active extracellular matrix that supports regeneration, modulates inflammation, and removes the need for donor-site harvesting. A structured PDSA cycle evaluated ADM within a standardized multidisciplinary pathway, including debridement, vascular assessment, off-loading, and glycemic optimization. Ten eligible patients received ADM and were compared with ten treated using STSG. ADM demonstrated clear patient-safety advantages: higher 30-day healing (80% vs 20%), markedly lower infection (10% vs 70%), elimination of donor-site complications, shorter hospital stay, and better patient experience. These results directly addressed baseline safety gaps and aligned with international evidence supporting regenerative matrices. Overall, ADM proved to be a safe, feasible, and cost-effective therapeutic innovation capable of reducing harm and improving outcomes. The findings support broader adoption, additional PDSA cycles, and long-term integration into clinical pathways to sustain patient-safety gains.

Sickle Cell Disease (SCD) causes recurrent vaso-occlusive crises that lead to severe pain and frequent Emergency Department (ED) visits. Traditionally, opioids were the primary treatment, but repeated exposure resulted in tolerance, dependence, recidivism, prolonged ED stays, and significant safety risks. Data demonstrated a high number of SCD-related ED visits, increased opioid dependency, elevated unscheduled return (USR) rates within 72 hours, and frequent admissions—reflecting variability in clinical practice and the absence of a standardized pain-management protocol. In late 2024, a revised VOC pain-management protocol was implemented, prioritizing ketamine while reserving opioids strictly for inpatient escalation. The initiative aimed to improve pain control, reduce avoidable admissions, enhance patient safety and experience, and decrease dependency-related ED visits. Growing evidence supports sub-dissociative ketamine as an effective, opioid-sparing alternative that provides strong analgesia without respiratory compromise and significantly reduces reliance on narcotics. This standardized protocol introduced a safer, faster, and more reliable approach to managing acute SCD pain crises, supporting early stabilization, reducing unnecessary hospitalizations, and improving overall patient outcomes.

This project aims to strengthen patient safety in Emergency Departments by implementing a structured training program for Emergency Navigators using the Golden Hour framework. The program was developed to address critical challenges that affect patient outcomes, including prolonged waiting times, inconsistent triage practices, and delays in diagnostics and clinical decision-making. Through a unified training curriculum, simulation-based learning, and standardized operational policies, the program improved the readiness and competency of Emergency Navigators across multiple facilities. The enhancements resulted in measurable improvements in key emergency performance indicators and contributed to a safer and more reliable patient experience. One participating facility also recorded a positive trend in emergency-related mortality following the implementation of the model, reflecting the strengthened emergency responsiveness achieved through the training program.

The Performance Improvement (PI) Consultation Clinic was established in January 2024 as part of the organization’s commitment to strengthening patient safety and building a culture of continuous improvement. Under the Robust Process Improvement (RPI) Framework, the clinic operates during two structured windows each year, ensuring that projects are prioritized, supported, and followed through in a consistent way. The clinic serves as a central resource for staff across all disciplines, providing them with clear guidance on how to design, implement, and sustain improvement projects. Through coaching, training, and access to standardized tools, staff learn how to develop project charters, analyze data, apply driver diagrams, identify root causes, test changes, and create sustainability plans. Before the clinic existed, many teams struggled to access timely guidance, which led to variation in project quality and difficulty maintaining improvements over time. The clinic addressed these issues by offering tailored consultations, structured coaching, and regular follow-up. This created a more reliable pathway for staff to carry out improvement work in a systematic and measurable way. Since its launch, the clinic has shown significant impact. Utilization increased from 50% to 80% in the first year, reflecting greater staff engagement and confidence in using improvement methods. Projects supported through the clinic consistently achieved their aims and showed sustained results. The clinic has strengthened performance across the organization, supported staff-led innovation, and contributed to a stronger culture of safety.

Polypharmacy and prolonged use of medications without clear ongoing indication contribute significantly to avoidable harm, reduced quality of life, and unnecessary healthcare costs. Although Choosing Wisely initiatives encourage reducing low-value treatments, patients rarely feel empowered to question long-term medications, and deprescribing often depends solely on clinician initiative. This gap results in missed opportunities to discontinue unnecessary therapy and improve safety. This project introduced patient-activated deprescribing model designed to shift the conversation from clinician-driven to patient-initiated, increasing engagement, safety, and shared decision-making. Simple yet powerful Choosing Wisely tool- question prompt card titled “Why Am I Taking This?”-was implemented to help patients ask essential questions about necessity, risks and alternatives. Pharmacists were trained in structured medication review, behavioral-science communication strategies, and practical deprescribing workflows Project used COM-B behavior change model to address patient capability (knowledge), opportunity (workflow prompts), and motivation (confidence to ask). Standardized deprescribing checklist, shared decision-making script and follow-up safety plan were embedded into routine pharmacy encounters, creating consistent, reproducible practice Over 10 months, intervention produced substantial improvements: patient-initiated deprescribing conversations rose sharply, potentially inappropriate medications decreased and overall medication burden declined. Symptom recurrence remained low, and no safety events occurred. Patients reported increased confidence discussing medications, while pharmacists reported improved satisfaction and clearer pathways for safe deprescribing By integrating behavioral design, Choosing Wisely principles and patient partnership, this initiative demonstrates scalable, low-cost model for improving medication safety and reducing low-value care

This project focuses on optimizing laboratory test utilization by reducing unnecessary or repetitive blood tests. Overutilization was identified as a source of increased operational costs, patient discomfort, clinical inefficiencies, and avoidable workload. Baseline data showed a significant rise in test volume despite stable patient numbers, indicating inappropriate laboratory ordering. The project aims to enhance clinical efficiency, improve resource utilization, and reduce costs through a structured quality improvement approach conducted from 2023 to 2025.

This project addresses critical patient safety concerns in CT Angiography (CTA) by systematically optimizing radiation exposure and contrast media administration. Prior to the project, significant variation in dose levels and contrast usage was observed, creating avoidable patient risk and inconsistencies in diagnostic quality. In response, a structured, evidence-based quality improvement initiative was launched to enhance safety, clinical efficiency, and resource utilization. The project aimed to reduce radiation exposure by 40%, contrast volume by 30%, and associated costs by 30%, while maintaining high diagnostic accuracy and minimizing the incidence of Contrast-Induced Nephropathy (CIN). A multidisciplinary team including radiologists, technologists, quality improvement specialists, and financial analysts implemented a comprehensive approach based on the Institute for Healthcare Improvement (IHI) methodology, incorporating Plan-Do-Study-Act (PDSA) cycles, staff training, protocol standardization, and innovative contrast dilution techniques. The target population included all patients undergoing CTA, with emphasis on high-risk individuals such as those with chronic renal impairment or requiring repeated scans. Stakeholders involved in the project included imaging staff, patient safety teams, and finance departments, all engaged through regular workshops, iterative discussions, and structured feedback loops. Outcomes included measurable reductions in radiation doses and contrast volumes, improved consistency of imaging quality, enhanced renal safety, and significant cost savings. For example, 39 CTA cases resulted in 571 SAR savings, projecting an annual saving of 35,843 SAR based on 2,132 CTA scans in 2024. The initiative demonstrates how low-cost, data-driven interventions can produce sustainable improvements in patient safety, clinical performance, and operational efficiency, providing a scalable model for other imaging departments.

ii. Local problem: • The referral process for elective cardiac catheterization at our cardiac center has traditionally relied on paper-based systems. This method has been associated with frequent issues, including missing or incomplete referral data, poor communication between departments, and delayed scheduling. In 2024, our elective cardiac catheterization services faced many challenges, with a large waiting list, including 250 pending cases with an average of 3 months of cardiac clinic waiting time. This contributed to patient dissatisfaction and impacted patient safety. • A quality improvement project was initiated involving the development of a secure electronic referral form integrated with the hospital’s EMR. The system enforces mandatory data fields and triggers automated notifications to the catheterization lab and the pre-admission clinic. A new pre-admission cardiac clinic was also introduced to ensure standardized pre-procedure assessment, including clinical evaluation, laboratory tests, ECG, and consent. A root cause analysis and a Pareto chart were used to identify and prioritize key sources of error in the existing process. Process and outcome metrics were tracked to assess the impact of the interventions.

This project aimed to enhance patient safety in the management of diabetic foot ulcers (DFUs) by integrating Acellular Dermal Matrix (ADM) therapy within a standardized, multidisciplinary care pathway. DFUs are commonly associated with unsafe medication practices particularly the overuse of systemic antibiotics, inconsistent infection-control measures, and variability in wound-care treatments. These gaps contribute to preventable harm, including antimicrobial resistance, prolonged hospitalization, and increased risk of amputation. Using a structured PDSA approach, the project introduced safe-practice protocols for wound assessment, debridement, offloading, and infection management. ADM therapy was implemented as a biological alternative that reduces reliance on repeated topical agents and minimizes unnecessary systemic antibiotic exposure. Clinicians received unified guidance on appropriate antimicrobial selection, dosing, documentation, and duration, aligned with international wound-care safety standards. The initiative resulted in significant safety improvements: infection rates decreased by 67%, antibiotic-resistant organisms declined by 67%, and hospitalization for intravenous antibiotics dropped by 75%. Standardized practice eliminated major amputations and improved healing within 30 days from 32% to 64%. These outcomes demonstrate safer medication use, reduced exposure to high-risk treatments, and improved reliability of care processes.

Patient Safety Topic: Early recognition and rapid response. Prevention and rapid management of sepsis in adult and pediatric oncology patients, focusing on neutropenia and central line–associated risks. Overall Goal: To implement an Early Warning and Sepsis Prevention Model that reduces sepsis, speeds detection, and limits infection-related deterioration in high-risk oncology patients. Time Frame: November 2024 – December 2025. Approach / Methodology: Using PDCA, an EMR-linked Early Warning System combines vital signs, neutropenia status, and chemotherapy toxicity grade to trigger unified sepsis workflows across Oncology, Emergency, and ICU. Nurses apply a Sepsis Prevention Bundle (mucositis care, strict hygiene, daily CLABSI-prevention, central line maintenance). The model embeds fast-track ED triage (≤30 minutes), immediate diagnostics, and antibiotics within 60 minutes, with repeated PDCA cycles to refine thresholds and processes. Results: Sepsis incidence fell to <8%; triage met ≤30 minutes; bundle compliance reached 94%; antibiotics started ≤60 minutes; neutropenia days decreased 38%; CLABSI-associated bacteremia declined. Target Population: Adult and pediatric oncology patients receiving myeloablative chemotherapy at risk of neutropenic and central line–associated sepsis. Stakeholders: Multidisciplinary teams from Oncology, ED, ICU, Pharmacy, Laboratory, Infection Prevention, Quality and Patient Safety, and Health Informatics. Outcome: The model strengthened prevention, early warning, and rapid response, reducing sepsis and complications and demonstrating scalable oncology safety gains.

This project aims to reduce the incidence of Multidrug-Resistant Organisms (MDROs) in Adult Intensive Care Units across the Qassim Health Cluster, following a significant rise in 2024 (6.6 per 1,000 patient days). A pilot initiative was launched in Buraidah Central Hospital ICU, where 49 confirmed MDRO cases (5.6 per 1,000 patient days) were recorded, contributing to prolonged length of stay, increased mortality risk, higher operational burden, and a total financial impact of 4.19M SAR. Using the FOCUS–PDCA methodology, a multidisciplinary team analysed baseline performance, mapped care processes, and identified root causes by using the Fishbone tool and critical root causes by using Pareto—including weak Antimicrobial Stewardship Program (ASP) practices, low hand hygiene compliance, and gaps in environmental cleaning. Prioritized interventions included strengthening ASP governance (pre authorization, antibiotic time-out by improving time needed for culture results from three to one day and weekly stewardship rounds), enhancing hand hygiene compliance and monitoring with real-time auditing, and standardizing environmental cleaning protocols for MDRO rooms. Implementation began in January 2025, supported by strong executive leadership. Tailored training, continuous auditing, and rapid feedback mechanisms helped embed safe practices into daily ICU workflows. Advanced dashboards and HESN Plus reporting enabled transparent monitoring and timely corrective action. By September 2025, the project achieved >45% reduction in MDRO infections, >44% reduction in antimicrobial consumption, and substantial improvements in hand hygiene (>79%) and environmental cleaning compliance (>90%). ICU efficiency, staff engagement, and patient safety all improved, contributing to a projected annual cost reduction of ~52%. This initiative directly supports Saudi Vision 2030, national AMR priorities, and value-based healthcare principles by improving patient safety, and patient outcomes.

This project aims to significantly increase the rate of same-day admissions for eligible surgical patients by improving pre-operative preparation, optimizing workflow efficiency, and enhancing coordination among clinical teams. In 2023, only 16% of surgical patients were admitted on the same day of surgery, leading to prolonged hospital stays, higher bed occupancy, increased operational costs, and reduced flexibility in accommodating emergency cases. The project introduced a structured Pre-Operative Assessment Clinic, established clear eligibility criteria for same-day admission, and implemented daily coordination between the operating room team and bed management. The process was initially piloted with orthopedic surgeries and later expanded to additional specialties. As a result of these interventions, same-day admission rates increased to more than 80% by September 2024. Additionally, the project reduced the average length of stay per patient by 12 hours, creating a substantial positive impact on hospital capacity and operational efficiency. This reduction contributed to significant financial savings compared to previous practices, where unnecessary overnight stays consumed resources that could otherwise be allocated to higher-priority cases. Overall, the project improved bed utilization, enhanced patient flow, reduced cancellations due to unavailability, strengthened interdisciplinary collaboration, and elevated the overall patient experience. These improvements demonstrate a sustainable and scalable model for optimizing surgical care pathway

This comprehensive quality improvement initiative at our hospital is strategically focused on leveraging the IHI Model for Improvement to achieve its Overall Goal of a 10% cost reduction in high-volume medical consumables by the end of 2024. This objective is applied to the Target Population of all high-volume/high-cost stock medical consumables used throughout the hospital, critically ensuring the preservation of patient safety and the prevention of stock-outs. The project's methodology involves a data-driven foundation of rigorous inventory, usage, and cost analysis, with key actions implemented via PDSA cycles, action plans including 1. Process Standardization: Developing and implementing standardized operating procedures for ordering, storage, and departmental distribution to reduce variability and inventory errors. 2. Usage and Waste Tracking: Implementing new systems to track consumable consumption at the point of use, enabling the project team to identify and reduce procedural waste, spoilage, and obsolescence. 3. Supply Chain Optimization: Actively negotiating with suppliers to secure cost-effective alternatives for consumables that have been clinically vetted for equivalence, ensuring no downgrade in quality. 4. Staff Engagement: Launching comprehensive training and educational programs to ensure clinical and non-clinical staff adherence to new protocols and foster a culture of resource stewardship. The Stakeholders include all clinical and non-clinical staff involved in ordering, using, and managing these supplies, specifically Supply Chain and Inventory Management staff, and the hospital administration. The ultimate Outcome is measured holistically: successful financial performance (10% cost reduction) validated by essential balancing measures (minimal stock-out rates and adverse event monitoring), guaranteeing that enhanced financial stewardship directly translates into sustained operational efficiency and improved clinical quality.

Psychoneuroimmunological Integration for Improving Clinical Outcomes (PNI CARE) is an advanced healthcare initiative addressing a critical gap in hospital care by focusing on the scientifically proven link between psychological state and immune response in inpatient populations. The program started in February 2025 with a baseline phase, followed by successive improvement cycles based on the PDSA model, leading to its wide implementation in the inpatient department. The project targets early detection of mild psychological stress (undetected and untreated anxiety, fear, and tension) as well as complex invisible psychological stressors. It aims to reduce psychological stress related to hospital admission, improve patient safety outcomes, and decrease length of stay and complications. This is achieved through four main interventions: 1. A standardized psychological assessment conducted at admission, on day three, and as needed, led by a psychologist or trained nurse to identify patients with high psychological stress levels early. 2. A bundle of five innovative short psychological interventions (SPI-5), including regulated breathing, therapeutic reassurance, sensory grounding techniques, rapid family support, and brief calming sessions—all based on psychoneuroimmunology evidence. 3. Enhanced family engagement through brief educational sessions explaining the impact of emotional support on immunity and healing, training on supportive phrases, and clarifying the family’s role in treatment adherence, supervised by a social worker and psychologist. 4. Comprehensive and accurate documentation by adding dedicated fields in the electronic medical record to record psychological stress scores, intervention types, and notes from patients and families, managed by the nursing team. The program delivered measurable results: a 35% improvement in psychological stress indicators, a reduction in average length of stay by 0.8 days, and patient satisfaction with

This hospital-wide program transforms how children experience pain and procedures by making emotional safety a core clinical priority. Across pediatric emergency, intensive care, medical, surgical, and neonatal units, we built a reliable system that prevents avoidable fear, panic, and distress while also reducing physical pain. The intervention combines standardized pain and distress assessment, a personalized “Pain Passport” for every child, comfort kits and choice-based coping menus, virtual reality and cartoon distraction, child-friendly environments, psychology and physiotherapy support, and a digital pain dashboard with escalation triggers. Children are supported before, during, and after procedures; parents are empowered as safety partners; and staff are trained in trauma-informed communication. The result is a new model of care where children feel informed, respected, and in control, and where unrelieved pain and psychological harm are no longer accepted as inevitable.