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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/28166114/examining-emergency-department-treatment-processes-in-severe-pediatric-traumatic-brain-injury
#1
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...
February 3, 2017: 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
#2
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...
February 1, 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
#3
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...
January 31, 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
#4
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...
January 11, 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
#5
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...
December 9, 2016: 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
#6
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...
December 9, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28045765/developing-an-organizational-model-for-improvement-from-translation-to-practice
#7
Shea Polancich
This department column highlights translation of research into healthcare quality practice. Achieving the highest quality in healthcare is a goal that requires focused attention and accountability. Standardization in practice through translation and application of evidence-informed practice promotes excellence in outcomes. To meet the goal of achieving the highest quality of care through evidence-informed translation and application in practice, organizations should outline a plan for developing, organizing, implementing, and evaluating evidence-informed improvement interventions...
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28045764/implementation-and-quality-improvement-of-a-screening-and-counseling-program-for-unhealthy-alcohol-use-in-an-academic-general-internal-medicine-practice
#8
Daniel E Jonas, Thomas Miller, Shana Ratner, Brooke McGuirt, Carol E Golin, Catherine Grodensky, Emily Sturkie, Jennifer Kinley, Maureen Dale, Michael Pignone
Unhealthy alcohol use is the third leading cause of preventable death in the United States. The U.S. Preventive Services Task Force (USPSTF) recommends screening for unhealthy alcohol use but little is known about how best to do so. We used quality improvement techniques to implement a systematic approach to screening and counseling primary care patients for unhealthy alcohol use. Components included use of validated screening and assessment instruments; an evidence-based two-visit counseling intervention using motivational interviewing techniques for those with risky drinking behaviors who did not have an alcohol use disorder (AUD); shared decision making about treatment options for those with an AUD; support materials for providers and patients; and training in motivational interviewing for faculty and residents...
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28045763/editorial-onward-and-upward
#9
Maria R Shirey
No abstract text is available yet for this article.
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28045762/nahq-leads-in-defining-the-competencies-for-the-healthcare-quality-profession
#10
Nancy Curdy, Andrew Kopolow, Stephanie E Mercado, Karen Schrimmer
No abstract text is available yet for this article.
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27820712/improved-resident-adherence-to-aaa-screening-guidelines-via-an-electronic-reminder
#11
David Sypert, Kenneth Van Dyke, Namrata Dhillon, John O Elliott, Kim Jordan
The 2014 United States Preventive Services Task Force systematic review found abdominal aortic aneurysm (AAA) screening decreased related mortality by close to half. Despite the simplicity of screening, research suggests poor adherence to the recommended AAA screening guidelines. Using the quality improvement plan-study-do-act cycle, we retrospectively established poor adherence to AAA screening and poor documentation of smoking history in our resident clinic. An electronic reminder was prospectively implemented into our electronic medical record (EMR) with the goal of improving screening rates...
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27579603/improving-employees-safety-awareness-in-healthcare-organizations-using-the-dmaic-quality-improvement-approach
#12
Amer Momani, Muʼath Hirzallah, Ahmad Mumani
Occupational injuries and illnesses in healthcare can cause great human suffering, incur high cost, and have an adverse impact on the quality of patient care. One of the most effective solutions for addressing health and safety issues and improving decisions at the point of care rests in raising employees' safety awareness to recognize, avoid, or respond to potential problems before they arise. In this article, the DMAIC Six Sigma model (Define, Measure, Analyze, Improve, Control) is used as a systematic program to measure, improve, and sustain employees' safety awareness in healthcare organizations...
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27183173/nationwide-30-day-readmissions-after-elective-orthopedic-surgery-reasons-and-implications
#13
Shobhit V Minhas, Benjamin S Kester, Francis C Lovecchio, Joseph A Bosco
INTRODUCTION: Reducing readmissions after orthopedic surgery is important for decreasing hospital costs and patient morbidity. Our goals were to establish national rates and reasons for 30-day readmissions after common elective orthopedic procedures. METHODS: Patients undergoing total knee arthroplasty, total hip arthroplasty, posterior lumbar fusion, anterior cervical discectomy and fusion, or total shoulder arthroplasty were identified from the American College of Surgeons National Surgical Quality Improvement Program database...
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/26566238/chaos-in-the-clinic-characteristics-and-consequences-of-practices-perceived-as-chaotic
#14
Hector R Perez, Matthew Beyrouty, Katelyn Bennett, Linda Baier Manwell, Roger L Brown, Mark Linzer, Mark D Schwartz
The Minimizing Error, Maximizing Outcome (MEMO) study of clinics in New York City, Chicago, and Wisconsin linked primary care work experiences to physician stress. We analyzed MEMO data to determine how chaos in the clinic was associated with work conditions and quality of care measures. Surveys and medical record audits determined practice characteristics and medical errors, respectively. Physicians rated clinic atmosphere on a scale of 1 (calm) to 5 (chaotic). Chaotic clinics were defined as practices rated either 4 or 5 by greater than 50% of clinic physicians...
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/26042751/is-access-to-and-use-of-primary-care-practices-that-patients-perceive-as-having-essential-qualities-of-a-patient-centered-medical-home-associated-with-positive-patient-experience-empirical-evidence-from-a-u-s-nationally-representative-sample
#15
Haichang Xin, Meredith L Kilgore, Bisakha Pia Sen
OBJECTIVE: The patient-centered medical home (PCMH) has emerged as an innovative healthcare delivery model that holds the conceptual promise to improve healthcare quality and patient experience. This study examined how patient perceived PCMH is related to patient satisfaction and experience nationwide. This study advances academic discussion in that it is among the first to examine empirical evidence using a U.S. nationally representative sample. METHODS: This retrospective cohort study used data from the 2010 to 2011 Medical Expenditure Panel Survey...
January 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27902532/lean-six-sigma-to-reduce-intensive-care-unit-length-of-stay-and-costs-in-prolonged-mechanical-ventilation
#16
Stephen Trzeciak, Michael Mercincavage, Cory Angelini, William Cogliano, Emily Damuth, Brian W Roberts, Sergio Zanotti, Anthony J Mazzarelli
OBJECTIVE: Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. DESIGN: Before-and-after cohort study. SETTING: Multidisciplinary intensive care unit (ICU) in an academic medical center...
November 29, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27811579/a-comprehensive-approach-to-pediatric-pneumonia-relationship-between-standardization-antimicrobial-stewardship-clinical-testing-and-cost
#17
Lori Rutman, Davene R Wright, James OʼCallaghan, Suzanne Spencer, K Casey Lion, Matthew P Kronman, Chuan Zhou, Rita Mangione-Smith
OBJECTIVE: In September 2012, our institution implemented an emergency department (ED) and inpatient pathway for community-acquired pneumonia (CAP) based on national guideline recommendations. The objective of this study was to determine the relationship between standardizing ED and inpatient care for CAP and antimicrobial stewardship, clinical testing, and cost. METHODS: We used descriptive statistics, statistical process control, and interrupted time series analysis to analyze measures 12 months before and after implementation...
November 1, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27811578/process-mapping-and-time-study-to-improve-efficiency-of-new-procedure-implementation-for-high-dose-rate-prostate-brachytherapy
#18
Laura A Doyle, Menachem Yondorf, Cheng Peng, Amy S Harrison, Robert B Den
New technologies and procedures have the potential to improve outcomes; however, initial implementation is often associated with a steep learning curve, decreased efficiency, and patient safety implications. Implementation of a real-time, ultrasound-based prostate high-dose rate brachytherapy procedure involved a multidisciplinary team composed of approximately 6-8 team members and numerous complex tasks. To characterize time spent on various aspects of the procedure and improve efficiency, the team developed a detailed process map, time study, and team debriefings...
November 1, 2016: 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
#19
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...
November 1, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27631713/meta-analysis-of-clinical-trials-that-evaluate-the-effectiveness-of-hospital-initiated-postdischarge-interventions-on-hospital-readmission
#20
Patricia M Branowicki, Judith A Vessey, Dionne A Graham, Margaret A McCabe, Alison L Clapp, Kevin Blaine, Margaret R OʼNeill, Julie A Gouthro, Colleen K Snydeman, Nancy E Kline, Vincent W Chiang, Courtney Cannon, Jay G Berry
Under pressure to avoid readmissions, hospitals are increasingly employing hospital-initiated postdischarge interventions (HiPDI), such as home visits and follow-up phone calls, to help patients after discharge. This study was conducted to assess the effectiveness of HiPDI on reducing hospital readmissions using a systematic review of clinical trials published between 1990 and 2014. We analyzed twenty articles on HiPDI (from 503 reviewed abstracts) containing 7,952 index hospitalizations followed for a median 3 months (range 1-24) after discharge for readmission...
September 13, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
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