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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/29870426/trends-in-avoidable-hospitalizations-for-diabetes-experience-of-a-large-clinically-integrated-health-care-system
#1
Maidah Yaqoob, Jihan Wang, Ann T Sweeney, Cynthia Wells, Virginia Rego, Bertrand L Jaber
Prevention quality indicators (PQIs) are used in hospital discharge data sets to identify quality of care for ambulatory care-sensitive conditions, such as diabetes. We examined the impact of clinical integration efforts on diabetes-related PQIs in a large community-based health care organization. Inpatient and observation hospitalizations from nine acute care hospitals were trended over 5 years (2012-2016). Using established technical specifications, annual hospitalizations rates were calculated for four diabetes-related PQIs: uncontrolled diabetes, short-term complications, long-term complications, and lower extremity amputations...
June 4, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29794813/improving-geriatric-care-processes-on-two-medical-surgical-acute-care-units-a-pilot-study
#2
Katrina A Booth, Emily E Simmons, Andres F Viles, Whitney A Gray, Kelsey R Kennedy, Shari H Biswal, Jason A Lowe, Anisa Xhaja, Richard E Kennedy, Cynthia J Brown, Kellie L Flood
The Acute Care for Elders (ACE) Unit model improves cognitive and functional outcomes for hospitalized elders but reaches a small proportion of patients. To disseminate ACE Unit principles, we piloted the "Virtual ACE Intervention" that standardizes care processes for cognition and function without daily geriatrician oversight on two non-ACE units. The Virtual ACE Intervention includes staff training on geriatric assessments for cognition and function and on nurse-driven care algorithms. Completion of the geriatric assessments by nursing staff in patients aged 65 years and older and measures of patient mobility and prevalence of an abnormal delirium screening score were compared preintervention and postintervention...
May 23, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29787406/effect-of-patient-and-provider-education-on-antibiotic-overuse-for-respiratory-tract-infections
#3
Erin Chiswell, Debra Hampton, Chizimuzo T C Okoli
Antibiotic overuse for respiratory tract infections (RTIs) in primary care (PC) is a known important contributor to the serious health threat of antibiotic resistance, yet remains a difficult problem to improve. The purpose of the study was to assess the effects of a combination patient and provider education program on antibiotic prescribing in RTIs in a rural primary care clinic. Utilizing a quasi-experimental pretest-posttest design, a retrospective electronic medical record review was conducted to determine if a patient and provider education program changed the rates of antibiotics being prescribed (immediate or delayed) during a visit for RTI for 207 randomly selected patients during the established evaluation time periods...
May 18, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29787405/introducing-a-clinical-documentation-specialist-to-improve-coding-and-collectability-on-a-surgical-service
#4
Maria Castaldi, John McNelis
INTRODUCTION: Inadequate electronic medical record (EMR) documentation remains a significant source of revenue loss. The Department of Surgery in a trauma and tertiary care teaching hospital developed a revenue optimization initiative for inpatients on general, vascular, and trauma surgery and surgical intensive care unit services to enhance clinical documentation and increase revenue capture. METHODS: Clinical documentation management program included six trained clinical documentation specialists (CDSs), five physician assistants (PAs), directors of health information management (HIM), and two surgical champions...
May 18, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29787404/hospital-value-based-purchasing-and-trauma-certified-hospitals-performance
#5
Aaron Spaulding, Hanadi Hamadi, Luis Martinez, Timothy Martin, Justin M Purnell, Mei Zhao
INTRODUCTION: Hospital Value-Based Purchasing (HVBP) is an initiative that rewards acute-care hospitals with incentive payments for the quality of care they provide. A hospital's trauma certification has the potential to influence HVBP scores as attaining the certification provides indication of the service quality offered by the hospital. As such, this study focuses on hospitals' level of trauma certification attainment through the American College of Surgeons and whether this certification is associated with greater HVBP...
May 18, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29975672/-hot-seat-simulation-model-for-conflict-resolution-a-pilot-study
#6
Sara Kim, Elise Frans, Isaac Bohannon, Karen Barr, Elizabeth Buttrick, Ryan Fehr, Sarah E Shannon
BACKGROUND: Unresolved conflicts in health care threaten both clinician morale and quality of patient care. We piloted a training model that targeted clinicians' conflict resolution skills. METHODS: Sixty clinicians from local hospitals were randomized into an intervention group (n = 30), completing a 3-hour conflict resolution training session, and a control group (n = 30) without training. The training included facilitated practice with actors, coaching, and feedback...
July 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29864070/reducing-readmissions-post-tonsillectomy-a-quality-improvement-study-on-intravenous-hydration
#7
Eileen Hession-Laband, Patrice Melvin, Herminia Shermont, Jane M Murphy, Bola Bukoye, Manali Amin
INTRODUCTION: Dehydration is a potentially preventable complication post-tonsillectomy and can result in an Emergency Department visit and/or readmission. Our objectives were to identify risk factors for dehydration readmissions and develop interventions to prevent them. METHODS: We used retrospective chart reviews to determine if increased intravenous (IV) hydration post-tonsillectomy prevented hospital readmissions for dehydration. All children aged 1-18 years who underwent tonsillectomy between July 1, 2007 and September 30, 2015 were included in this quality improvement study...
July 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29734270/managing-what-is-measured-a-rural-hospital-s-experience-in-reducing-patient-harm
#8
Lucretia F Stargell, Stephen L Heatherly
Effecting improvement in the small, rural hospital setting is often challenging. Harris Regional Hospital (HRH) is a small, acute care hospital in rural western North Carolina acquired by Duke LifePoint Healthcare in August, 2014. Since that time, HRH has been on a quality journey characterized by a data-driven approach to reducing patient harm events. Using a framework that comprised leadership, performance improvement, and cultural development to cultivate an environment of mutual respect and trust, HRH has demonstrated sustained improvement in patient harm events over a 29-month period from January 2015 to June 2017...
May 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29734269/improving-patient-compliance-with-mechanical-venous-thromboembolism-prophylaxis
#9
Deepti Nahar, Aaron Nizam, Monique Farrow, Andrea Restifo, Michael Nimaroff
Venous thromboembolic events (VTE) occurring in the postoperative period are serious yet preventable conditions. Multiple studies have demonstrated that the risk of postoperative VTE can be successfully reduced with mechanical prophylaxis and/or chemoprophylaxis. Patients are often noncompliant with mechanical prophylaxis in the postoperative period. We performed a prospective nonrandomized controlled study to determine if providing an educational pamphlet would increase knowledge and compliance with mechanical VTE prophylaxis...
May 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29734268/nahq-is-on-the-move
#10
Stephanie Mercado
No abstract text is available yet for this article.
May 2018: 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
#11
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...
May 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28857931/comparison-of-machine-learning-algorithms-for-the-prediction-of-preventable-hospital-readmissions
#12
Andres Garcia-Arce, Florentino Rico, José L Zayas-Castro
A diverse universe of statistical models in the literature aim to help hospitals understand the risk factors of their preventable readmissions. However, these models are usually not necessarily applicable in other contexts, fail to achieve good discriminatory power, or cannot be compared with other models. We built and compared predictive models based on machine learning algorithms for 30-day preventable hospital readmissions of Medicare patients. This work used the same inclusion/exclusion criteria for diseases used by the Centers for Medicare and Medicaid Services...
May 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28837451/within-hospital-variation-in-30-day-adverse-events-implications-for-measuring-quality
#13
Robert E Burke, Thomas Glorioso, Anna K Barón, Peter J Kaboli, P Michael Ho
Novel measures of hospital quality are needed. Because quality improvement efforts seek to reduce variability in processes and outcomes, hospitals with higher variability in adverse events may be delivering poorer quality care. We sought to evaluate whether within-hospital variability in adverse events after a procedure might function as a quality metric that is correlated with facility-level mortality rates. We analyzed all percutaneous coronary interventions (PCIs) performed in the Veterans Health Administration (VHA) system from 2007 to 2013 to evaluate the correlation between within-hospital variability in 30-day postdischarge adverse events (readmission, emergency department visit, and repeat revascularization), and facility-level mortality rates, after adjustment for patient demographics, comorbidities, PCI indication, and PCI urgency...
May 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28786845/measuring-consumer-engagement-a-review-of-tools-and-findings
#14
Laurie M Jacobs, Claire D Brindis, Dana Hughes, Caitlin E Kennedy, Laura A Schmidt
Consumer engagement is increasingly emphasized in healthcare initiatives and has been a priority in healthcare reforms. Consumer engagement takes multiple forms, including increased involvement of consumers in their own care, in organizational design, and in broader policy decision-making processes. Determining the effectiveness of such involvement requires both effective measurement and empirical study, both of which have yet to be standardized or fully explored. In this review, we examine both existing measurement tools for consumer engagement and current empirical knowledge regarding the outcomes associated with each of three levels of consumer engagement...
May 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28346244/a-six-sigma-approach-to-analyze-time-to-assembly-variance-of-surgical-trays-in-a-sterile-services-department
#15
Flavio S Fogliatto, Michel J Anzanello, Guilherme L Tortorella, Daniela S S Schneider, Cintia G R Pereira, Beatriz D Schaan
INTRODUCTION: We analyze the assembly of surgical trays in a hospital's sterile services department. The department assembles 520 different tray setups. However, tray assembly times are unknown, imposing a challenge to production planners. To respond to demand, workers from other departments are often called, leading to higher operational costs and more frequent quality problems due to workers' poor training and inconsistency. METHODS: Conducting traditional time-motion studies is infeasible in such a high variety production setting...
May 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28151775/continuity-of-care-in-older-adults-with-multiple-chronic-conditions-how-well-do-administrative-measures-correspond-with-patient-experiences
#16
Eva H DuGoff
Continuity of care (COC) is a fundamental component of primary care and particularly important to older adults who are managing multiple chronic conditions. Administrative measures of continuity are often used to evaluate care coordination interventions, but it is not known whether administrative continuity are correlated with patient reports of continuity among older adults with multiple chronic conditions (MCCs). The objective of this study is to assess the concordance of administrative continuity indices and patient reports of continuity among older adults with MCCs...
May 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27579602/medication-knowledge-among-older-adults-admitted-to-home-care-in-ontario-during-2012-2013
#17
Kim Sears, Kevin Y Woo, Joan Almost, Rosemary Wilson, Eliot Frymire, Marlo Whitehead, Elizabeth VanDenKerkhof
BACKGROUND: Medication use among Canadian seniors is widespread and increases with the number of comorbidities. Limited evidence exists on medication knowledge among seniors, especially in home care. PURPOSE: The purpose of this retrospective cohort study was to describe medication knowledge and ability to take medication among seniors admitted to home care in Ontario. RESULTS: Ten percent had little or no knowledge of what medication to take (n = 1,389/14,004) or an understanding of the purpose of their medications (n = 1,396/14,004)...
May 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29634594/pilot-teledermatology-service-for-assessing-solitary-skin-lesions-in-a-tertiary-london-dermatology-center
#18
Chung-Mei Maggie Cheung, Kayria Muttardi, Suchitra Chinthapalli, Ferina Ismail
BACKGROUND: Efficient clinical pathways are needed to meet the growing pressures in dermatology due to the significant rise in the number of suspected skin cancer referrals. Our hospital serves a wide geographical area and receives a large number of 2-week-wait (2WW) suspected skin cancer referrals. In the United Kingdom, approximately 10-12% of 2WW referrals are diagnosed as skin cancers fulfilling the 2WW criteria. PURPOSE: We sought to assess the role of teledermatology in reducing hospital consultations for patients referred via the dermatology 2WW pathway...
April 9, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29634593/oral-care-clinical-trial-to-reduce-non-intensive-care-unit-hospital-acquired-pneumonia-lessons-for-future-research
#19
Edel McNally, Gintas P Krisciunas, Susan E Langmore, Janet T Crimlisk, Jessica M Pisegna, Joseph Massaro
Hospital-acquired pneumonia (HAP) contributes greatly to patient mortality and healthcare costs. Studies have shown that aggressive oral care in intensive care units (ICUs) can significantly reduce pneumonia rates, and hospitals have implemented stringent protocols in this setting. However, little is known about the effectiveness of aggressive oral care in reducing HAP in non-intensive care wards, prompting us to conduct a nonrandomized controlled clinical trial. A structured toothbrushing program was provided to an experimental cohort of patients...
April 9, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29553966/subsequent-fracture-prevention-in-patients-50-years-and-older-with-fragility-fractures-a-quality-improvement-initiative
#20
Patricia A Mackey, Laura D Rosenthal, Lanyu Mi, Michael D Whitaker
Because of osteoporosis, patients older than 50 years with fragility fractures are at risk of further fractures. We developed a quality improvement initiative based on an evidence-based Fracture Liaison Service (FLS) model of care to help prevent subsequent fractures. Previous to the implemented FLS model, less than 13% of patients with fragility fractures were assessed for osteoporosis at our institution. We created a registry tool to identify patients with fractures who were older than 50 years. Our interventions focused on identifying, contacting, and educating patients; and coordinating screening tests and an outpatient follow-up visit with an endocrinologist...
March 16, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
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