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American Journal of Medical Quality: the Official Journal of the American College of Medical Quality

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https://www.readbyqxmd.com/read/30569734/incorporating-continuity-in-a-7-on-7-off-hospitalist-model-and-the-correlation-with-patient-handoffs-and-length-of-stay
#1
Christopher M O'Donnell, Marsha Stern, Traci Leong, Ethan Molitch-Hou, Bruce Mitchell
Little research in hospital medicine examines the effects of hospitalist continuity on patient outcomes. This study implemented a novel staffing model with approximately half of rounding teams starting their 7-day workweek on Monday and the others on Friday. Teams admitted their own patients on their first 4 days with additional nighttime admissions handed off to those teams. No admissions were given to teams on their last 3 days. Length of stay was significantly reduced from 6.34 days in 2015 to 5.7 days in 2016 ( P < ...
December 20, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30525894/myva-access-an-evaluation-of-changes-in-access-for-a-system-wide-program-implemented-in-the-veterans-health-administration
#2
Janice L Pringle, Aleksandra S Milićević, Jaime A Fawcett, Jerrold H May, Shannon M Kearney, Youxu C Tjader, Dominic L Vargas, Luis G Vargas, John P Radack, Poonam L Alaigh
The current study evaluates changes in access as a result of the MyVA Access program-a system-wide effort to improve patient access in the Veterans Health Administration. Data on 20 different measures were collected, and changes were analyzed using t tests and Chow tests. Additionally, organizational health-how able a system is to create health care practice change-was evaluated for a sample of medical centers (n = 36) via phone interviews and surveys conducted with facility staff and technical assistance providers...
December 10, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30525892/preoperative-evaluation-clinic-redesign-an-initiative-to-improve-access-efficiency-and-staff-satisfaction
#3
Joan M Irizarry-Alvarado, Matthew Lundy, Barbara McKinney, Frank A Ray, Virginia E Reynolds, Sher-Lu Pai
In 2008, Mayo Clinic in Jacksonville, Florida, developed the preoperative evaluation (POE) clinic under the department of anesthesiology to provide preoperative history and physical examination, and medical optimization. Over time, the POE clinic expanded to accommodate more than 90% of surgical patients, outgrowing the initial practice model. The increased patient volume with shortened turnaround times bottlenecked patient access. A multidisciplinary quality improvement team used Define, Measure, Analyze, Improve, and Control methodology to understand the issues, test potential solutions, and develop sustainable processes...
December 7, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30516067/the-domino-effect-of-medical-errors
#4
Samer Ellahham
No abstract text is available yet for this article.
December 5, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30501498/patient-and-family-centered-care-as-a-dimension-of-quality
#5
Ravi Dhurjati, Krista Sigurdson, Jochen Profit
No abstract text is available yet for this article.
December 2, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30442026/a-quality-improvement-intervention-to-improve-the-efficiency-of-arteriovenous-access-placement-for-pre-dialysis-inpatients
#6
Yasmin Brahmbhatt, Peter Burke, Brianna Shinn, Brandon Menachem, Babak Abai, Dawn Salvatore, Rachel Sorokin
The authors aimed to improve the rate of pre-dialysis arteriovenous (AV) access placement for hospitalized patients with advanced chronic kidney disease. The authors developed and implemented a protocol for hospitalized adult patients with an estimated glomerular filtration rate <20 mL/min to streamline the workflow for obtaining AV access. The protocol was piloted on 5 inpatient medical services over 3 months at 1 institution. Specific-Measurable-Achievable-Realistic-Timely (SMART) aims, Fishbone diagrams, Plan-Do-Study-Act cycles, and run charts were used to assess the process and outcomes of the intervention...
November 16, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30409021/primary-care-2-0-design-of-a-transformational-team-based-practice-model-to-meet-the-quadruple-aim
#7
Cati G Brown-Johnson, Garrett K Chan, Marcy Winget, Jonathan G Shaw, Kendra Patton, Rumana Hussain, J Nwando Olayiwola, Sang-Ick Chang, Megan Mahoney
A new transformational model of primary care is needed to address patient care complexity and provider burnout. An 18-month design effort (2015-2016) included the following: (1) Needs Finding, (2) Integrated Facility Design, (3) Design Process Assessment, and (4) Development of Evaluation. Initial outcome metrics were assessed. The design team successfully applied Integrated Facility Design to primary care transformation design; qualitative survey results suggest that design consensus was facilitated by team-building activities...
November 9, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30360638/adherence-to-inpatient-venous-thromboembolism-prophylaxis-a-single-institution-s-concurrent-review
#8
Tyler M Bauer, Adam P Johnson, Katerina Dukleska, Johanna Beck, Myles S Dworkin, Kamini Patel, Scott W Cowan, Geno J Merli
Hospital-acquired venous thromboembolism (VTE) affects morbidity and mortality and increases health care costs. Poor adherence to recommended prophylaxis may be a potential cause of ongoing events. This study aims to identify institutional adherence rates and barriers to optimal VTE prophylaxis. The authors performed patient and nurse interviews and a concurrent review of clinical documentation, utilizing a cloud-based, HIPAA-compliant tool, on a convenience sample of hospitalized patients. Adherence and agreement between different assessment modalities were calculated...
October 26, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30360634/creating-a-culture-of-continuous-improvement-in-outpatient-laboratories-effects-on-wait-times-employee-engagement-and-efficiency
#9
Joseph Featherall, Alexander Chaitoff, Anthony Simonetti, James Bena, Daniel Kubiak, Michael Rothberg, Kavous Roumina, Nathan Hurle, Walter Henricks, Lisa Yerian
Transforming health care remains a challenge as many continuous improvement (CI) initiatives fail or are not sustained. Although the literature suggests the importance of culture, few studies provide evidence of cultural change creating sustained CI. This improvement initiative focused on creating cultural change through goal alignment, visual management, and empowering frontline employees. Data included 113 133 encounters. Cochran-Armitage tests and X-bar charting compared wait times during the CI initiative...
October 26, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30345785/a-discharge-time-out-a-case-study-on-physician-nurse-discharge-communication-and-the-challenge-of-sustainability-in-resident-led-quality-improvement
#10
Katie E Raffel, Neha Gupta, Christopher Vercammen-Grandjean, Jessica Hohman, Sumant Ranji, Edgar Pierluissi, Michelle Mourad
Resident-led quality improvement (QI) is an important component of resident education yet sustainability of improvement and impact on resident education have rarely been explored. This study describes a resident-led intervention to improve nursing (RN)-provider (MD) communication at discharge-the Discharge Time-Out (DTO)- and explores its uptake and sustainability. One year later, residents were surveyed regarding QI self-efficacy and planned QI involvement. Baseline verbal RN-MD communication at discharge was rare...
October 22, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30345804/characterization-of-the-recommendations-in-the-choosing-wisely-initiative
#11
Kelsey Corrigan, Leonid Aksenov, Alexandra Paul, Banafsheh Sharif-Askary, Sarvesh Agarwal, Arif Kamal
Choosing Wisely is a comprehensive set of recommendations that guides clinicians and patients away from low-value services. The recommendations were reviewed to investigate their breadth and limitations. The authors performed an abstraction of all Choosing Wisely recommendations between March 1 and May 27, 2016. Descriptive statistics were used to characterize various topics found in the recommendations. Of the 461 Choosing Wisely recommendations, 48% targeted workup studies, 26% non-medication management, 20% medication management, and 6% disease prevention...
October 20, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30345783/leveraging-structural-changes-in-an-electronic-health-record-tool-to-standardize-written-handoff
#12
Jillian Zavodnick, Rebecca Jaffe, Marc Altshuler, Scott Cowan, Alexis Wickersham, Gretchen Diemer
Miscommunications during patient handoff can lead to harm. The I-PASS bundle has been shown to improve safety outcomes. Although effective training reliably improves verbal handoffs, research has demonstrated a lack of effect on written handoffs. The objective was to compare written handoff before and after integration of a standardized electronic health record (EHR) tool. Interns at a large urban academic medical center underwent I-PASS handoff training. The EHR handoff tool was then revised to prompt the I-PASS components...
October 20, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30479157/new-acmq-management-to-help-make-vip%C3%A2-growth-a-reality
#13
Joseph M Jackson
No abstract text is available yet for this article.
November 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29779398/handoff-tool-enabling-standardized-transitions-between-the-emergency-department-and-the-hospitalist-inpatient-service-at-a-major-cancer-center
#14
Carmen E Gonzalez, Norman Brito-Dellan, Srinivas R Banala, David Rubio, Mohamed Ait Aiss, Terry W Rice, Karen Chen, Diane C Bodurka, Carmelita P Escalante
Communication failures during patient handoff can lead to serious errors. A quality improvement team created a standardized handoff tool/process (DE-PASS: Decisive problem requiring admission, Evaluation time, Patient summary, Acute issues/action list, Situation unfinished/awareness, Signed out to) for admitting patients from the emergency department (ED) to the hospitalist inpatient service of a tertiary cancer center. DE-PASS mirrors the institution's ED workflow, stratifies patients as stable/urgent/emergent, and establishes requirements for verbal and email communications between providers...
November 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29682974/a-patient-centered-measure-reduction-strategy-three-lenses-of-value
#15
Umbereen S Nehal, Jack Maypole, Matthew Sadof
No abstract text is available yet for this article.
November 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30303029/improving-pediatric-sepsis-treatment-using-a-novel-guideline-based-pro-forma
#16
Ahmed Hussain, Pratap Harbham, Mohamad Zeina
No abstract text is available yet for this article.
October 10, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30293436/reducing-telemetry-use-is-safe-a-retrospective-analysis-of-rapid-response-team-and-code-events-after-a-successful-intervention-to-reduce-telemetry-use
#17
Lijia Xie, Trit Garg, David Svec, Jason Hom, Rajani Kaimal, Neera Ahuja, James Barnes, Lisa Shieh
Interventions guiding appropriate telemetry utilization have successfully reduced use at many hospitals, but few studies have examined their possible adverse outcomes. The authors conducted a successful intervention to reduce telemetry use in 2013 on a hospitalist service using educational modules, routine review, and financial incentives. The association of reduced telemetry use with the incidence of rapid response team (RRT) and code activations was assessed in a retrospective cohort study of 210 patients who experienced a total of 233 RRT and code events on the inpatient internal medicine services from January 2012 through March 2015 at a tertiary care center...
October 6, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30288990/u-s-news-and-world-report-top-ranked-children-s-hospitals-and-academic-productivity
#18
Don Hayes
No abstract text is available yet for this article.
October 5, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30264579/developing-and-testing-a-chart-abstraction-tool-for-icu-quality-measurement
#19
Jarone Lee, J Matthew Austin, Jungyeon Kim, Paola D Miralles, Haytham M A Kaafarani, Peter J Pronovost, Vipra Ghimire, Sean M Berenholtz, Karen Donelan, Elizabeth Martinez
Quality measures are increasingly used to measure the performance of providers, hospitals, and health care systems. Intensive care units (ICUs) are an important clinical area in hospitals, given that they generate high costs and present high risks to patients. Yet, currently, few valid and clinically significant ICU-specific outcome measures are reported nationally. This study reports on the creation and evaluation of new abstraction tools that evaluate ICU patients for the following clinically important outcomes: central line-associated bloodstream infection, methicillin-resistant Staphylococcus aureus, gastrointestinal bleed, and pressure ulcer...
September 28, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30246541/a-comparative-analysis-of-academic-and-nonacademic-hospitals-on-outcome-measures-and-patient-satisfaction
#20
Alissa S Chen, Lee Revere, Alissa Ratanatawan, Christopher L Beck, Julio A Allo
Academic hospitals contribute to health care through patient care, research, and teaching; however, their outcomes may not be equivalent to nonacademic hospitals. Multivariate analysis of variance is used to compare publicly reported data on patient satisfaction, readmission rates, mortality rates, and hospital-acquired injury scores between 1906 academic and nonacademic hospitals, while controlling for hospital-level covariates. Results show that academic hospitals have higher levels of patient satisfaction on 7 of the 11 measures and are equivalent to nonacademic hospitals on the remaining 4 measures...
September 23, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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