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Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality

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https://www.readbyqxmd.com/read/29166290/implementation-of-a-routine-health-literacy-assessment-at-an-academic-medical-center
#1
Carrie D Warring, Jacqueline R Pinkney, Elaine D Delvo-Favre, Michelle Robinson Rener, Jennifer A Lyon, Betty Jax, Irene Alexaitis, Kari Cassel, Kacy Ealy, Melanie Gross Hagen, Erin M Wright, Myron Chang, Nila S Radhakrishnan, Robert R Leverence
Limited health literacy is a common but often unrecognized problem associated with poor health outcomes. Well-validated screening tools are available to identify and provide the opportunity to intervene for at-risk patients in a resource-efficient manner. This is a multimethod study describing the implementation of a hospital-wide routine health literacy assessment at an academic medical center initiated by nurses in April 2014 and applied to all adult inpatients. Results were documented in the electronic health record, which then generated care plans and alerts for patients who screened positive...
November 14, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29095745/improving-quality-of-care-in-federally-qualified-health-centers-through-ambulatory-care-accreditation
#2
Suma Nair, Jie Chen
HRSA supported health centers have a long history of participating in ambulatory care accreditation; however, there is a dearth of information on the relationship between accreditation and quality of care. We conducted a cross-sectional study of 1,202 health centers, using multivariate regression to estimate the association between accreditation and 14 clinical quality measures, controlling for patient and organizational characteristics. We also predicted national estimates of accreditation-related improvement in quality...
October 26, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29095744/quality-improvement-foley-project-to-reduce-catheter-related-trauma-in-a-large-community-hospital
#3
Chirag Dave, Kassem Faraj, Paras Vakharia, Judy Boura, Jay Hollander
Indwelling catheter placement is a modifiable risk factor for urethral trauma. We implemented a multidisciplinary Foley Project protocol in June 2015, which consisted of a system-wide catheter education program, difficult urinary catheterization (DUC) algorithm, and skilled catheter nursing team to improve patient outcomes. A retrospective review of male DUC consults between June 2014 and September 2015 was performed. The preprotocol group includes consults received from June 2014 to May 2015. The postprotocol group includes consults received from June 2015 to September 2015...
October 26, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29045284/increasing-colorectal-cancer-screening-using-a-quality-improvement-approach-in-a-nurse-managed-primary-care-clinic
#4
Diane Hountz, Jennifer Coddington, Karen J Foli, Janet Thorlton
According to the American Cancer Society, 1 in 23 Americans will be diagnosed with colorectal cancer (CRC) in their lifetime. Screening for CRC is an effective, yet underused preventive approach. This is especially true in rural areas, where only 35% of patients were found to be up to date on their screenings in 2014. Increasing CRC screening can produce positive patient outcomes by early recognition and removal of precancerous polyps. The purpose of this project was to use quality improvement (QI) interventions to increase CRC screening rates at a nurse-managed clinic in rural Indiana...
October 17, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29016408/family-initiated-pediatric-rapid-response-characteristics-impetus-and-outcomes
#5
Aarti C Bavare, Jenilea K Thomas, Elizabeth P Elliott, Angela C Morgan, Jeanine M Graf
BRIEF DESCRIPTION: Family-initiated rapid response (FIRR) empowers families to express concern and seek care from specialized response teams. We studied FIRRs that occurred in a pediatric tertiary hospital over a 3-year period. The main aims were to describe the characteristics and outcomes of FIRRs and compare them with clinician-activated RRs (C-RRs). Of the 1,906 RRs events reviewed, 49 (2.6%) were FIRRs. All FIRRs had appropriate clinical triggers with the most common being uncontrolled pain...
October 6, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28933709/evidence-for-misspecification-of-a-nationally-used-quality-measure-for-substance-use-treatment
#6
Soeren Mattke, Zachary Predmore, Elizabeth Sloss, Asa Wilks, Katherine E Watkins
OBJECTIVES: The National Committee for Quality Assurance's (NCQA) measure "Initiation and Engagement of Alcohol and Other Drug Dependence Treatment" captures the proportion of substance use patients with (1) treatment initiation within 14 days and (2) treatment engagement within 30 days thereafter. The definition of treatment considers only counseling but not medication-assisted treatment (MAT), although MAT is supported by current guidelines. Our research question is whether this omission results in meaningful measurement error...
September 4, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28933708/statewide-longitudinal-progression-of-the-whole-patient-measure-of-safety-in-south-carolina
#7
Christine B Turley, Jordan Brittingham, Aunyika Moonan, Dianne Davis, Hrishikesh Chakraborty
Meaningful improvement in patient safety encompasses a vast number of quality metrics, but a single measure to represent the overall level of safety is challenging to produce. Recently, Perla et al. established the Whole-Person Measure of Safety (WPMoS) to reflect the concept of global risk assessment at the patient level. We evaluated the WPMoS across an entire state to understand the impact of urban/rural setting, academic status, and hospital size on patient safety outcomes. The population included all South Carolina (SC) inpatient discharges from January 1, 2008, through to December 31, 2013, and was evaluated using established definitions of highly undesirable events (HUEs)...
September 4, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28885241/technology-solutions-to-support-care-continuity-in-home-care-a-focus-group-study
#8
Dawn W Dowding, David Russell, Nicole Onorato, Jacqueline A Merrill
BACKGROUND: Elevated hospital readmission rates from home care are an indicator of poor care quality, and rates are particularly high for patients with heart failure. Readmissions may be avoided by optimizing continuity of care. PURPOSE: To explore perceptions among home care clinicians of the barriers they face and the information they need to improve care continuity for patients with heart failure. METHODS: Focus groups were conducted with teams of home care clinicians at a large certified home healthcare agency in the Northeastern United states...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28885240/advancing-value-based-population-health-management-through-payer-provider-partnerships-improving-outcomes-for-children-with-complex-conditions
#9
Pamela Peele, Donna Keyser, John Lovelace, Deborah Moss
Population health management (PHM) approaches to improve cost and quality remain limited. To address this gap, stakeholders within an integrated delivery and financing system in Western Pennsylvania designed, implemented, and tested a value-based care model for children with medically complex conditions that could be scaled across the broader pediatric population. The model included: (1) a multilevel, interdisciplinary infrastructure; (2) actionable analytics reports to guide continuous quality improvement; (3) alternative provider payments; (4) consumer-directed spending accounts; and (5) shared savings with practices...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28885239/opioid-use-in-children-and-adolescents-after-anterior-cruciate-ligament-repair
#10
Nicole Taylor, Shannon Frick, Samantha Killilea, Teri Dugan-Frost, Jean Solodiuk
Opioid overdose is a leading cause of death from unintentional injury in the United States. When more opioids are prescribed than needed, leftover opioids may be misused if not properly disposed. The purpose of this study is to describe the opioid use of subjects (aged 13-21 years) after an anterior cruciate ligament (ACL) repair. After obtaining IRB approval, we obtained consent from 100 subjects (over an 8-month period) undergoing ACL reconstructions performed by five sports medicine surgeons. The mean age of enrolled subjects was 16 years, most were female (60%) and white (72%)...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28885238/improving-the-implementation-of-lung-cancer-screening-guidelines-at-an-academic-primary-care-practice
#11
Alison T Brenner, Laura Cubillos, Katherine Birchard, Caleb Doyle-Burr, John Eick, Louise Henderson, Laura Jones, Michael Massaro, Bailey Minish, Paul Molina, Michael Pignone, Shana Ratner, Maria Patricia Rivera, Daniel S Reuland
Expert groups recommend annual chest computed tomography for lung cancer screening (LCS) in high-risk patients. Lung cancer screening in primary care is a complex process that includes identification of the at-risk population, comorbidity assessment, and shared decision making. We identified three key processes required for high-quality screening implementation in our academic primary care practice: (1) systematic collection of lifetime cumulative smoking history to identify potentially eligible patients; (2) visit-based clinical reminders and order sets embedded in the electronic health record (EHR); and (3) tools to facilitate shared decision making and appropriate test ordering...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28885237/exploring-the-perceived-value-of-a-personalized-informatics-tool-to-anticipate-and-mitigate-patient-risk
#12
Michael D Kneeland, Catherine H Ivory, Phebe Bloomingburg, Neesha N Choma
Health care systems are implementing a myriad of strategies to improve patient outcomes and reduce both adverse events and unplanned readmissions. These approaches include interventions related to people, processes, and technology. This article describes the development of a technology-based model in the form of an actionable risk profile, which was used by one inpatient surgical unit (people) during a daily care team briefing (process). The risk profile was evaluated for its perceived value to the care team as a method of organizing care and anticipating patients' needs...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29112040/using-data-analytics-as-evidentiary-support-for-financial-outcome-success-in-nurse-led-population-based-clinics
#13
Shea Polancich, Jason Williamson, Cynthia S Selleck, Michele Talley, Jennifer Frank, Connie White-Williams, Maria R Shirey
Achieving the highest quality in health care requires organizations to develop clinical improvements that result in measurable outcomes for success. The purpose of this article is to demonstrate an example of clinical quality improvement through the use of data analytics to generate evidence for financial return on investment in two nurse-led, population-based clinics.
November 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28166114/examining-emergency-department-treatment-processes-in-severe-pediatric-traumatic-brain-injury
#14
Ali Ajdari, Linda Ng Boyle, Nithya Kannan, Ali Rowhani-Rahbar, Jin Wang, Richard Mink, Benjamin Ries, Mark Wainwright, Jonathan I Groner, Michael J Bell, Chris Giza, Douglas F Zatzick, Richard G Ellenbogen, Pamela H Mitchell, Frederick P Rivara, Monica S Vavilala
BACKGROUND: In the treatment of pediatric traumatic brain injury (TBI), timely treatment of patients can affect the outcome. Our objectives were to examine the treatment process of acute pediatric TBI and the impact of non-value-added time (NVAT) on patient outcomes. METHODS: Data for 136 pediatric trauma patients (age < 18 years) with severe TBI from 2 trauma centers in the United States were collected. A process flow and value stream map identified NVATs and their sources in the treatment process...
November 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28858966/using-technology-to-support-data-analytics-a-chief-nursing-officer-accountability-scorecard
#15
Shea Polancich, Terri Poe, Natalie Hackney, Jason Williamson
Accountability for health system improvement is a requirement for nursing leadership in practice. However, to be accountable for organizational goals, nurse leaders need the tools to identify gaps in their microsystems of care. The purpose of this article was to provide a case study example of chief nursing officer (CNO) leadership in using a technology solution to develop a CNO accountability scorecard. This project highlights the HQ Essential for data analytics using an innovative technological approach to drive improvement at the front line of clinical care...
September 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28858965/stepping-back-to-move-forward-evaluating-the-effectiveness-of-a-diabetes-prevention-program-within-a-large-integrated-healthcare-delivery-system
#16
Kimberly D Brunisholz, Elizabeth A Joy, Mia Hashibe, Lisa H Gren, Lucy A Savitz, Sharon Hamilton, Wayne Cannon, Kelly Huynh, Tonya A N Schafer, Laurel M Newman, Jodi Parker, Joilynne Musselman, Jaewhan Kim
OBJECTIVE: To evaluate the short-term effectiveness of the Intermountain Healthcare (IH) Diabetes Prevention Program (DPP) for patients with prediabetes (preDM) deployed within primary care clinics. STUDY DESIGN: A quasi-experimental study design was used to deploy the DPP within the IH system to identify patients with preDM and target a primary goal of a 5% weight loss within 6-12 months of enrollment. STUDY POPULATION: Adults (aged 18-75 years) who met the American Diabetes Association criteria for preDM were included for study...
September 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28858964/improvement-through-small-cycles-of-change-lessons-from-an-academic-medical-center-emergency-department
#17
Amit Arbune, Sarah Wackerbarth, Penne Allison, Joseph Conigliaro
This article describes the experiences of a quality improvement team that used small cycles of change to improve the emergency department (ED) of an academic medical center. The role of EDs in the provision of healthcare continues to increase in importance. ED bottlenecks contribute to long waits and diminished outcomes for ED patients as well as more system-wide issues, such as inefficiencies in inpatient admission processes. The purpose of this "ED Operational Efficiency Project" was to reduce lengths of stay (LOS) for low-acuity patients...
September 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28406843/analyzing-patient-safety-culture-from-viewpoints-of-physicians-and-nurses-a-case-of-a-regional-teaching-hospital-in-taiwan
#18
Yii-Ching Lee, Jiunn-I Shieh, Chih-Hsuan Huang, Chieh Yu Wang, Hsin-Hung Wu
The Chinese version of safety attitudes questionnaire is used to evaluate patient safety culture from the viewpoints of physicians and nurses of a regional teaching hospital in Taiwan in 2014. This study applies Mann-Whitney U test for two independent samples test and analysis of variance to observe if different demographic variables are perceived differently in patient safety culture in terms of eight dimensions. In addition, linear regression models are applied to take into account the confounding effects of demographic variables in eight dimensions...
September 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27984358/quality-improvement-changing-patterns-of-antibiotic-prophylaxis-for-surgical-abortion
#19
Olivia T Muramoto, Alexa L Calfee, Jade M Shorter, Mitchell D Creinin, Melody Y Hou
OBJECTIVE: Postprocedure infection complicates nearly 5% of abortions. Multiple organizations endorse prophylactic antibiotics to reduce infection risk with surgical abortion, but the adherence rate remains unknown for women who obtain antibiotics at a pharmacy and take them at home before their procedure. Our objective was to evaluate the effect of quality improvement interventions on antibiotic utilization and preoperative documentation for women undergoing surgical abortion at our academic institution...
September 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27631708/low-rate-of-adverse-events-associated-with-inpatient-parenteral-prostacyclins
#20
Rana L Awdish, Michael P Mendez, Nancy MacDonald, Lenar Yessayan, Jeffrey H Jennings, Kamelia Albujoq, Sara Hegab, Hector R Cajigas
Parenteral prostacyclin is the most-effective therapy for patients with pulmonary arterial hypertension. Administration is complex, and administration errors are potentially life threatening. Hospital policies to minimize the risk to patients are necessary, but their effectiveness has not been well studied. We quantified the adverse event incident rate per at-risk patient day in a tertiary care hospital with an established parenteral prostacyclin policy. Patients on parenteral prostacyclin including new initiations from January 2003 to January 2013 were identified, encompassing 386 discrete admissions...
September 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
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