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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/29315153/overall-emergency-department-rating-identifying-the-factors-that-matter-most-to-patient-experience
#1
Emily L Aaronson, Elizabeth Mort, Jonathan D Sonis, Yuchiao Chang, Benjamin A White
BACKGROUND: Patient experience is becoming an area of interest in Emergency Medicine as more is understood about its impact on outcomes and the expectation that it will soon be tied to reimbursement. No study has investigated the predictors of emergency department (ED) patient satisfaction in over a decade. As the care environment, access to information, and consumer interests change, determinants of satisfaction have likely evolved. Our objective was to examine the factors that were most predictive of ED satisfaction...
January 8, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29315152/impact-of-surgeon-self-evaluation-and-positive-deviance-on-postoperative-adverse-events-after-non-cardiac-thoracic-surgery
#2
Jelena Ivanovic, Fargol Mostofian, Caitlin Anstee, Sebastien Gilbert, Donna E Maziak, Farid M Shamji, Ramanadhan Sudhir Sundaresan, Patrick James Villeneuve, Andrew J E Seely
As an innovative approach to improve quality of surgical care, we combined surgeon self-assessment and anonymized peer comparison with continuous quality improvement seminars using positive deviance (CQI/PD) to identify surgeon(s) with the lowest rates of adverse events (AEs) to guide group practice recommendations. Our objective was to quantify the impact these interventions on postoperative AEs rates after major non-cardiac chest operations. All postoperative AEs after all thoracic operations (n = 1,084, March, 2013 to February, 2016, single-center) were prospectively collected using the thoracic morbidity and mortality system, based on Clavien-Dindo schema...
January 8, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29315151/factors-associated-with-delayed-discharge-on-general-medicine-service-at-an-academic-medical-center
#3
Nidhi Rohatgi, Marlena Kane, Marcy Winget, Farnoosh Haji-Sheikhi, Neera Ahuja
Lack of collaboration between care teams and patients/families has been associated with delayed discharge from the hospital. In this study, we determine whether patients' awareness of the estimated date of discharge (EDD) was associated with a decrease in delayed discharge, and determine the factors associated with a delayed discharge. A total of 221 patients admitted to the General Medicine service between July and September 2014 were included in the study. Estimated date of discharge was identified within 36 hours of admission...
January 8, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29315150/meeting-management-standards-and-improvement-in-clinical-outcomes-among-patients-with-hip-fractures
#4
Lieu Thi Thuy Trinh, Helen Achat, Sze Ming Loh, Robert Pascoe, Hassan Asarreh, Joanne Stubbs
OBJECTIVES: To determine the association between management standards and clinical outcomes among patients with hip fracture (HF). METHODS: Data from a prospective cohort study were linked with hospital administration data. RESULTS: In 2014 and 2015, 493 patients had surgery for HF. The proportion of patients meeting care standards ranged from 69% for surgery within 48 hours to 96% for being seen by a geriatrician. Thirty-nine per cent of patients received all the standards...
January 8, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29280779/breast-cancer-does-type-of-hospital-where-you-get-surgery-affect-survival
#5
Jenny J Lin, Natalia Egorova, Rebeca Franco, Nina A Bickell
Under the Affordable Care Act (ACA), more women are insured with Medicaid, which should improve healthcare access. We sought to determine whether there are survival differences among patients with breast cancer undergoing surgery at facilities with varying proportions of Medicaid patients. We used New York State (NYS) Vital Statistics death records data linked with NYS discharge inpatient and ambulatory surgery databases to examine 90-day survival after surgery from 2008 to 2013. We used all Medicaid discharges to calculate and create quintiles of facilities based on Medicaid volume...
December 22, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29280778/perceptions-of-integration-of-the-clinical-pharmacist-into-the-pcmh-model-by-the-pcmh-team
#6
M Shawn McFarland, Kristen Lamb, Jonathan Hughes, Ashley Thomas, Justin Gatwood, Jacob Hathaway
INTRODUCTION: The patient-centered medical home (PCMH) model is a multidisciplinary, team-based approach to healthcare that focuses on actively involving the patient in clinical decision making. The Veterans Health Administration (VA), while desiring to be a national leader in the delivery of primary care services, used the principles of the PCMH model to design the patient-aligned care team (PACT). The purpose of this study, was to explore the perception of the PACT members after integration of a clinical pharmacist to the PACT...
December 22, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29280777/promoting-secure-provider-to-provider-communication-with-electronic-health-record-messaging-an-educational-outreach-study
#7
Kathleen E Walsh, Jessica L Secor, Jon S Matsumura, Margaret L Schwarze, Beth E Potter, Peter Newcomer, Michael K Kim, Christie M Bartels
INTRODUCTION: With increasing electronic health record (EHR) use, providers are talking less with one another. Now, many rely on EHRs, informal emails, or texts, introducing fragmentation and new data security challenges with new communication strategies. We aimed to examine the impact of a physician champion educational outreach intervention to promote electronic provider-to-provider communication in a large academic multispecialty group. METHODS: Physician champions provided educational outreach to 16 academic departments, using 10-minute case-based presentations...
December 22, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29271801/simulation-of-the-emergency-department-care-process-for-pediatric-traumatic-brain-injury
#8
Ali Ajdari, Linda Ng Boyle, Nithya Kannan, Jin Wang, Frederick P Rivara, Monica S Vavilala
The treatment of patients in the emergency department (ED) with severe pediatric traumatic brain injury (TBI) is challenging, and treatment process strategies that facilitate good outcomes are not well documented. The overall objective of this study was to identify factors that can affect the care process associated with pediatric TBI. This objective was achieved using a discrete-event simulation model of patients with TBI as they progress through the ED treatment process of a Level I trauma center. This model was used to identify areas where the ED length of stay can be reduced...
December 21, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29271800/pediatric-adverse-event-rates-associated-with-inexperience-in-teaching-hospitals-a-multilevel-analysis
#9
Linda Dynan, Anthony Goudie, Patrick W Brady
High adverse event rates are a signal of potentially low-quality care that imposes burdens on patients, families, and hospitals. In this article, we examine the relationship between the distinct characteristics of teaching hospitals with adverse event rates among pediatric patients, controlling for patient complexity and severity using 2009-2011 Nationwide Inpatient Sample data from the Agency for Healthcare Research and Quality. We hypothesize that adverse event rates increase with the availability of more complex services and technologies (transplantation and pediatric open-heart surgery); increase as experience of providers decreases (July effect); and increase with residents per bed, a measure of both average provider inexperience and congestion...
December 21, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29252871/differences-in-patient-experience-between-hispanic-and-non-hispanic-white-patients-across-u-s-hospitals
#10
Jose F Figueroa, Kimberly E Reimold, Jie Zheng, Endel John Orav
INTRODUCTION: Despite the increased emphasis on patient experience, little is known about whether there are meaningful differences in hospital satisfaction between Hispanic and non-Hispanic whites. METHODS: To determine if satisfaction differs, we used Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data (2009-2010) reported by hospitals to compare responses between Hispanic and non-Hispanic white patients. Clustered logistic regression models identified within-hospital and between-hospital differences in satisfaction...
December 15, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29252870/breaking-the-barriers-in-resident-education-a-quality-improvement-initiative
#11
Larissa H Cabarga, Luigi X Cubeddu, Jiny Olickal, Samira Habibnejad, Elizabeth Kury-Perez, Pooja Pundhir, Daniela Pirela, Robert C Goldszer
INTRODUCTION: In 2013, the American College of Cardiology and American Heart Association updated the cholesterol guideline. Despite strong evidence supporting the recommendations, a discernible gap exists in the number of residents who practice them. Our study aimed to identify barriers hindering residents from guideline implementation. METHODS: Twenty eight residents were administered a preintervention and postintervention questionnaire to identify barriers in guideline application...
December 15, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29189436/offering-econsult-to-family-physicians-with-patients-on-a-pain-clinic-wait-list-an-outreach-exercise
#12
Patricia A Poulin, Heather C Romanow, Jeannette Cheng, Clare Liddy, Erin J Keely, Catherine E Smyth
Wait times for many chronic pain programs in Canada range from 6 months to 2 years. This project sought to determine the interest of primary care providers (PCPs) in using an electronic consult system for patient(s) waiting for a pain consultation. This cross-sectional study was conducted at the pain clinic of a Canadian tertiary academic health sciences center. Participants were PCPs who had submitted a referral to this clinic. Referrals received between April 1, 2012, and March 31, 2014, were reviewed to determine their appropriateness for eConsult, and a letter providing information about eConsult and encouraging its use was sent to the referring PCP...
November 14, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29189435/investigating-physicians-views-on-soft-signals-in-the-context-of-their-peers-performance
#13
Myra van den Goor, Milou Silkens, Maas Jan Heineman, Kiki Lombarts
BACKGROUND: Physicians are responsible for delivering high quality of care. In cases of underperformance, hindsight knowledge indicates forewarning being potentially available in terms of concerns, signs, or signals. It is not known how the physicians involved perceive such signals. PURPOSE: To openly explore how physicians perceive soft signals and react on them. METHODS: In-depth interviews with 12 hospital-based physicians from various specialties and institutions following the interpretative phenomenological analysis approach...
November 14, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29166290/implementation-of-a-routine-health-literacy-assessment-at-an-academic-medical-center
#14
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
#15
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
#16
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/29300276/optimizing-surgical-capacity-for-a-rural-hospital-through-monte-carlo-simulation
#17
Rachel Ozer, Gregory Richards
This article describes the application of Monte Carlo simulation to evaluate operating room (OR) utilization at a small rural hospital in the province of Ontario, Canada. Using input factors that include the duration of procedures, the number of days of operation, and the shift duration, the simulation identifies ways of improving the capacity of the hospital's OR. The analysis was used to implement changes that led to a 38% increase in the number of procedures completed. The hospital also has created capacity for further growth and is adding both new service types and additional revenue-generating contract services...
January 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29300275/proactive-risk-mitigation-using-failure-modes-and-effects-analysis-for-evaluating-vascular-access
#18
Shea Polancich, Loring Rue, Terri Poe, Rebecca Miltner
This department column highlights translation of research into healthcare quality practice. Achieving the highest quality in healthcare requires organizations to understand care delivery and to proactively mitigate risks in care delivery processes. The purpose of this article was to describe the process for using the failure modes and effects analysis process to provide evidentiary support and proactive risk mitigation for the establishment of a comprehensive vascular access team within an academic medical center...
January 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29300274/shape-of-things-to-come
#19
Maria Shirey
No abstract text is available yet for this article.
January 2018: 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
#20
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
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