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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/28406843/analyzing-patient-safety-culture-from-viewpoints-of-physicians-and-nurses-a-case-of-a-regional-teaching-hospital-in-taiwan
#1
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...
April 12, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28481845/did-we-have-an-impact-changes-in-racial-and-ethnic-composition-of-patient-populations-following-implementation-of-a-pilot-program
#2
Pamela S Webster, Swathi Sampangi
High-quality data are necessary to eliminate health disparities, and are necessary in cancer prevention and control. A pilot project to improve the collection of race and ethnicity data was undertaken. The approach included train-the-trainer and staff training, and racial and ethnic categories were expanded to include "granular ethnicity" or ancestry terms in the patient registration system at five acute care hospitals in Rhode Island. The self-reported racial and ethnic distribution of the patient population was examined for each pilot hospital...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28481844/transformational-leadership-the-chief-nursing-officer-role-in-leading-quality-and-patient-safety
#3
Pam Jones, Shea Polancich, Robin Steaban, Nancye Feistritzer, Terri Poe
This department column highlights leadership perspectives of quality and patient safety practice. The purpose of this article is to provide strategic direction for transformational quality and safety leadership as the chief nursing officer (CNO) within the academic medical center environment.
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28481843/vha-patient-centered-medical-home-associated-with-lower-rate-of-hospitalizations-and-specialty-care-among-veterans-with-posttraumatic-stress-disorder
#4
Ian Randall, David C Mohr, Charles Maynard
OBJECTIVE: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). METHODS: VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28481842/electronic-health-record-adoption-among-obstetrician-gynecologists-in-the-united-states-physician-practices-and-satisfaction
#5
Greta B Raglan, Benyamin Margolis, Ronald A Paulus, Jay Schulkin
Implementation of electronic health records (EHRs) has historically been lower among obstetrician-gynecologists (ob-gyns) than many physician groups. This study described ob-gyns' adoption and use of EHR systems in practice, as well as barriers and benefits to implementation. Surveys asking about the physicians' use of EHR, satisfaction with systems, and what features they found most or least helpful were mailed to 1,200 ob-gyns. An overall response rate of 57.4% was achieved, with 559 returning completed surveys...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28481841/a-system-wide-enhanced-recovery-program-focusing-on-two-key-process-steps-reduces-complications-and-readmissions-in-patients-undergoing-bowel-surgery
#6
Terrence J Loftus, Susan Stelton, Brett W Efaw, Joshua Bloomstone
Enhanced recovery programs (ERPs) can improve outcomes following bowel surgery, but implementing an ERP across a large healthcare system remains challenging. In this study, a simplified ERP that focused on two process steps, early and frequent ambulation and early alimentation, was evaluated to determine its impact on outcomes. Data were collected on 5,000 adult patients undergoing elective small and large bowel operations over a 3-year period. Complication, readmission, and mortality rates were evaluated before and after ERP implementation...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28166113/using-a-mixed-methods-approach-to-examine-practice-characteristics-associated-with-implementation-of-an-adult-immunization-intervention-using-the-4-pillars-practice-transformation-program
#7
Mary Hawk, Mary Patricia Nowalk, Krissy K Moehling, Valory Pavlik, Jonathan M Raviotta, Anthony E Brown, Richard K Zimmerman, Edmund M Ricci
Adult immunization rates are consistently suboptimal, exacting significant human and financial burden of preventable disease. Practice-level interventions to improve immunization rates have produced mixed results. The context of change critically affects implementation of evidence-based interventions. We conducted a randomized controlled cluster trial of the 4 Pillars Practice Transformation Program to increase adult vaccination rates in primary care practices and used qualitative methods to test intervention effects and understand practice characteristics associated with implementation success...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/26087024/an-interdisciplinary-education-initiative-to-promote-blood-conservation-in-cardiac-surgery
#8
Tamara S Goda, Brad Sherrod, Linda Kindell
Transfusion practices vary extensively for patients undergoing cardiac surgical procedures, leading to high utilization of blood products despite evidence that transfusions negatively impact outcomes. An important factor affecting transfusion practice is recognition of the importance of teams in cardiac surgery care delivery. This article reports an evidenced-based practice (EBP) initiative constructed using the Society of Thoracic Surgery (STS) 2011 Blood Conservation Clinical Practice Guidelines (CPGs) to standardize transfusion practice across the cardiac surgery team at a large academic medical center...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/26042755/quality-of-interhospital-transfer-communication-practices-and-association-with-adverse-events-on-an-internal-medicine-hospitalist-service
#9
Jennifer S Borofsky, Jason C Bartsch, Alan B Howard, Allen B Repp
Communication practices around interhospital transfer have not been rigorously assessed in adult medicine patients. Furthermore, the clinical implications of such practices have not been reported. This case-control study was designed to assess the quality of communication between clinicians during interhospital transfer and to determine if posttransfer adverse events (PTAEs) are associated with suboptimal communication. Cases included patients transferred to a Medicine Hospitalist Service from an outside hospital who subsequently experienced a PTAE, defined as unplanned transfer to an intensive care unit or death within 24 hours of transfer...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/25403268/the-patient-centered-discharge-an-electronic-discharge-process-is-associated-with-improvements-in-quality-and-patient-satisfaction
#10
Lacey T Buckler, Carla Teasdale, Matthew Turner, Aric Schadler, Tracy M Schwieterman, Charles L Campbell
In this retrospective cohort study, 100 records were randomly selected from the intervention period (April 2012) and the control period (April 2011). The hospital's institutional database was queried to compare mortality, length of stay, and patient satisfaction, in the year prior to and the year after the integration of the new process. A chart review was performed to determine if the reengineered process was associated with an improvement in documentation. A scoring system was developed to gauge the quality and timeliness of the process...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28346246/analysis-of-a-patient-intervention-to-reduce-patients-who-leave-without-being-seen-in-an-ophthalmology-dedicated-emergency-room
#11
Alice C Lorch, Maureen Martinez, Matthew Gardiner
Patients who leave without being seen (LWBS) by a medical provider in emergency care settings are a concern because their urgent complaints remain unaddressed. This study aims to characterize the LWBS population in an ophthalmology-dedicated emergency room and to evaluate an intervention designed to decrease the number of these patients. A program of rounding and patient contact in the waiting room of our emergency room was initiated to this end. A patient database was used retrospectively to review 13,124 charts and collect clinical and demographic data on 71 LWBS patients...
March 24, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28346245/hospitalist-versus-subspecialist-perspectives-on-reasons-timing-and-impact-of-consultation
#12
Kelly Pacitti, Anne Mathew, Amanda Royse, John O Elliott, Kim Jordan
BACKGROUND: Hospitalists frequently consult medical subspecialists in the management of inpatients. Given the potential impact on health resource utilization, it is important to understand the working relationship between these groups. METHODS: A cross-sectional survey of hospitalists, n = 655, and subspecialists across Ohio (nephrologists and endocrinologists), n = 293, was conducted to investigate perceptions and communication about reasons, timing, and impact of hospital consultations...
March 24, 2017: 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
#13
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...
March 24, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28257287/editorial-interprofessional-collaboration-and-care-coordination-models-strategies-and-instruments
#14
Maria R Shirey
No abstract text is available yet for this article.
March 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28146038/enhanced-transitions-of-care-centralizing-discharge-phone-calls-improves-ability-to-reach-patients-and-reduces-hospital-readmissions
#15
Kristin A Schuller, Bita A Kash, Larry D Gamm
BACKGROUND: The discharge phone call (DPC) is an important initiative aimed at improving transitions of care and reducing readmissions. It is of added importance as financial penalties will be imposed on hospitals with "excessive" Medicare readmissions. This study examines the impact of DPCs on percentages of patients reached through the DPCs and hospital readmission rates based on the centralized or noncentralized mode of DPCs. METHODS: The health system centralized the Studer Group Discharge Phone Call program into one central call center with the goals of reaching more discharged patients and to ultimately reduce hospital readmissions...
March 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27984357/perceptions-of-teamwork-in-the-interprofessional-bedside-rounding-process
#16
Genevieve Beaird, John M Dent, Jessica Keim-Malpass, Abigail Guo Jian Muller, Nicole Nelson, Valentina Brashers
Patient perceptions of teamwork have been a relatively undiscovered domain. Our study investigated the use of the Patients' Insights and Views of Teamwork (PIVOT) survey on an acute cardiology unit in an academic teaching hospital with patients receiving Rounding with Heart, an interprofessional bedside rounding initiative, and others receiving traditional rounding processes. Sixty-three subjects were surveyed during their hospital stay. We found a significant difference (p = .006) in PIVOT scores between those receiving interprofessional rounding and those not receiving this rounding structure...
March 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27811577/exploring-the-validity-of-developing-an-interdisciplinarity-score-of-a-patient-s-needs-care-coordination-patient-complexity-and-patient-safety-indicators
#17
Ashley Hodgson, Lacey Etzkorn, Alexander Everhart, Nicholas Nooney, Jessica Bestrashniy
Despite the Affordable Care Act's push to improve the coordination of care for patients with multiple chronic conditions, most measures of coordination quality focus on a specific moment in the care process (e.g., medication errors or transfer between facilities), rather than patient outcomes. One possible supplementary way of measuring the care coordination quality of a facility would be to identify the patients needing the most coordination, and to look at outcomes for that group. This paper lays the groundwork for a new measure of care coordination quality by outlining a conceptual framework that considers the interaction between a patient's interdisciplinarity, biological susceptibility, and procedural intensity...
March 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27427882/the-effect-of-an-interprofessional-heart-failure-education-program-on-hospital-readmissions
#18
Julia N Clarkson, Susan D Schaffer, Joshua J Clarkson
Heart failure (HF) is an increasing concern to public health, affecting approximately 5.1 million Americans and costing the United States over $32 billion annually. Compounding the concern, research has exposed the significant problem of hospital readmissions for the HF population, with an estimated 25% of HF patients are rehospitalized within 30 days of discharge. This project focuses on an education-based strategy designed to decrease hospital readmissions for this at-risk population. In particular, an interprofessional outpatient educational program (Heart Failure University [HFU]) was initiated to reduce healthcare costs and increase the quality of care for HF patients at a large private hospital in Florida...
March 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27310299/interprofessional-clinical-rounding-effects-on-processes-and-outcomes-of-care
#19
Susan Ashcraft, Curry Bordelon, Sheila Fells, Vera George, Karen Thombley, Maria R Shirey
BACKGROUND AND PURPOSE: Communication breakdown is viewed as a significant contributor to preventable patient harm. Interprofessional rounding (IPR) is one method of communication supporting the evidenced-based care delivery. The purpose of this paper is to explore the benefits of IPR for patients, clinicians, and the healthcare system. REVIEW OF THE LITERATURE: Interprofessional rounding supports collaboration, discussion, and timely intervention to prevent miscommunication leading to adverse patient events...
March 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27049625/an-analysis-of-the-daily-work-rounding-process-in-a-pediatric-intensive-care-unit
#20
Sandeep Gangadharan, Brian Belpanno, Peter Silver
OBJECTIVE: To complete an objective analysis of the activities that occur during the course of daily rounds in a high acuity academic tertiary care pediatric intensive care unit (PICU). DESIGN: Prospective observational work sampling design. SETTING: Tertiary care academic Children's Hospital Pediatric Intensive Care Unit. SUBJECTS: Multidisciplinary PICU teams. INTERVENTIONS: None. METHODS: Intensive care unit rounds were observed as part of an initiative to improve efficiency over a 2-month period...
March 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
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