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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/30409021/primary-care-2-0-design-of-a-transformational-team-based-practice-model-to-meet-the-quadruple-aim
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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/30303029/improving-pediatric-sepsis-treatment-using-a-novel-guideline-based-pro-forma
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/30235933/training-to-improve-communication-quality-an-efficient-interdisciplinary-experience-for-emergency-department-clinicians
#12
Emily L Aaronson, Benjamin A White, Lauren Black, David F Brown, Theodore Benzer, Allison Castagna, Ali S Raja, Jonathan Sonis, Elizabeth Mort
Patient-provider communication has been recognized as a critical area of focus for improved health care quality, with a mounting body of evidence tying patient satisfaction and provider communication to important health care outcomes. Despite this, few programs have been studied in the emergency department (ED) setting. The authors designed a communication curriculum and conducted trainings for all ED clinical staff. Although only 72% of clinicians believed the course would be a valuable use of their time before taking it, 97% reported that it was a valuable use of their time after ( P < ...
September 21, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30229680/making-triage-decisions-for-the-acute-community-care-program-paramedics-caring-for-urgent-health-problems-in-patients-homes
#13
Lisa I Iezzoni, Dhruva Kothari, Carlos A Camargo, Amy J Wint, W Scott Cluett, Yorghos Tripodis, Joseph Palmisano
The Acute Community Care Program (ACCP) initiative sends specially trained paramedics to evaluate and treat patients with urgent care problems in their residences during evening hours. ACCP safety depends on making appropriate triage decisions from patients' reports during phone calls about whether paramedics could care for patients' urgent needs or whether they require emergency department (ED) services. Furthermore, after ACCP paramedics are on scene, patients may nonetheless need ED care if their urgent health problems are not adequately treated by the paramedic's interventions...
September 19, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30223675/patient-satisfaction-is-associated-with-dialysis-facility-quality-and-star-ratings
#14
Abhijit V Kshirsagar, Amir Alishahi Tabriz, Heejung Bang, Shoou-Yih D Lee
The Dialysis Facility Compare Star Rating and the Quality Incentive Program (QIP) generate separate performance scores from clinical measures, and the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS) survey evaluates patient satisfaction across 6 separate domains related to nephrologists, dialysis facility, and information transmission. This study examined the relationship of the 3 measures for US clinics, modeling the 6 ICH-CAHPS domains as independent variables and QIP and star ratings as dependent variables...
September 18, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30205697/effect-of-audit-and-feedback-on-physician-adherence-to-clinical-practice-guidelines-for-pneumonia-and-sepsis
#15
Stacy A Trent, Edward P Havranek, Adit A Ginde, Jason S Haukoos
The objective was to estimate the effect of feedback with blinded peer comparison on emergency physician adherence to guidelines for appropriate antibiotic administration for inpatient pneumonia and completion of the 3-hour Surviving Sepsis Bundle for severe sepsis. The authors performed a quasi-experiment using a stepped wedge design at a single urban safety net hospital. Attending emergency physicians were randomized into 6 clusters. Once a cluster crossed into the intervention group, physicians in that cluster began receiving detailed feedback with blinded peer comparison on their adherence to guidelines for pneumonia and sepsis...
September 12, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30198304/innovative-implementation-studies-conducted-in-us-safety-net-health-care-settings-a-systematic-review
#16
Courtney R Lyles, Margaret A Handley, Sara L Ackerman, Dean Schillinger, Pamela Williams, Marisa Westbrook, Gato Gourley, Urmimala Sarkar
Little is known about dissemination and implementation in safety net settings. The authors conducted a literature review of innovation/implementation studies in US safety net health care settings between 2008 and 2017. Each article was coded for (1) intervention characteristics, (2) implementation stage, (3) internal versus external ownership, and (4) prespecified implementation outcomes (eg, acceptability and fidelity). Twenty studies were identified; the majority were implemented within community clinics or integrated safety net systems (15 articles), most involved care process improvements (13 articles), and most were internally developed (13 articles)...
September 10, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30198303/promoting-high-value-change-by-addressing-the-structure-of-order-sets-lessons-from-the-cardiac-catheterization-lab
#17
Nagendra Pokala, Shruti Singh, Gene Hu, Timothy J Brown, Ambarish Pandey, Sandeep R Das, Arjun Gupta
No abstract text is available yet for this article.
September 10, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30196712/impact-of-hearing-loss-on-patient-provider-communication-among-hospitalized-patients-a-systematic-review
#18
Aishwarya Shukla, Carrie L Nieman, Carrie Price, Michael Harper, Frank R Lin, Nicholas S Reed
Age-related hearing loss is a highly prevalent chronic condition in older adults, but hearing loss is rarely accounted for in patient-provider communication studies. This systematic review synthesizes current evidence on the impact of age-related hearing loss on patient-provider communication in hospitalized older adults. Five databases were queried to identify original research that examined patient-provider communication in older adults with hearing loss in an inpatient setting. Of 1053 studies, 13 were included in the final review...
September 9, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30196709/taking-the-patient-out-of-patient-centered-care
#19
Harjot Uppal
No abstract text is available yet for this article.
September 9, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/30196708/changes-in-care-after-implementing-a-multifaceted-intervention-to-improve-preventive-cardiology-practice-in-rheumatoid-arthritis
#20
Darcy S Majka, Ji Young Lee, Yaw A Peprah, Dawid Lipiszko, Elisha Friesema, Eric M Ruderman, Stephen D Persell
Rheumatoid arthritis (RA) increases cardiovascular disease (CVD) risk. However, CVD risk factor identification and treatment is often inadequate. The authors implemented a multifaceted rheumatology practice intervention to improve CVD risk factor measurement, assessment, and management. The intervention included clinician education, point-of-care decision support, feedback, and care management. The authors measured quality indicators from electronic health records and assessed impact with interrupted time series...
September 9, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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