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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/28193103/is-telemetry-monitoring-useful-in-patients-admitted-with-suspected-acute-coronary-syndrome
#1
Jack Perkins, Naveen K Voore, Jaideep Patel, Sathish Sanna, Edana Mann, Sammy Zakaria, Aysegul Gozu
Patients with a chief complaint of chest pain are frequently monitored by telemetry for evaluation of acute coronary syndrome (ACS). However, there is insufficient evidence to support this practice in younger patients without coronary artery disease (CAD). The objective is to assess outcomes of patients younger than 50 years of age and monitored by telemetry. Consecutive medical records of patients admitted for chest pain between January 1, 2009, and June 30, 2010, were reviewed. Patients were excluded who had a CAD history, an abnormal initial troponin, or an abnormal initial electrocardiogram...
February 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28134559/social-media-as-a-tool-to-reduce-sexual-misconduct-in-medical-facilities
#2
David Bychkov, Sean Young
No abstract text is available yet for this article.
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28118727/commentary-on-the-link-between-clinically-validated-patient-safety-indicators-and-clinical-outcomes
#3
John R Griffith
No abstract text is available yet for this article.
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28107785/blood-management-strategies-to-reduce-transfusions-after-elective-lower-extremity-joint-arthroplasty-surgeries
#4
Ankit Kansagra, Chester Andrzejewski, Robert Krushell, Andrew Lehman, Jordan Greenbaum, Paul Visintainer, Joan McGirr, Kathleen Mahoney, Darlene Cloutier, Alice Ehresman, Mihaela S Stefan
Blood loss associated with lower-extremity total joint arthroplasty (TJA) often results in anemia and the need for red blood cell transfusions (RBCTs). This article reports on a quality improvement initiative aimed at improving blood management strategies in patients undergoing TJA. A multifaceted intervention (preoperative anemia assessment, use of tranexamic acid, discouragement of autologous preoperative blood collection, restrictive RBCT protocols) was implemented. The results were stratified into 3 intervention periods: 1, pre; 2, peri; and 3, post...
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28064518/if-health-care-teams-had-to-win-championships
#5
Ravi Dhurjati, Eduardo Salas, Jochen Profit
No abstract text is available yet for this article.
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28277751/poster-presentations
#6
(no author information available yet)
No abstract text is available yet for this article.
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28277749/book-review-inspired-physician-leadership-stoner-cr-stoner-js-inspired-physician-leadership-tampa-fl-american-association-of-physician-leadership-2015
#7
Mitul Kanzaria
No abstract text is available yet for this article.
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28166642/improving-timeliness-of-discharge-summaries-at-an-academic-affiliated-veterans-administration-hospital
#8
Blake John Anderson, Krysta Johnson-Martinez, Benjamin Flink, Jonathan Gandhi, Anne Tomolo
No abstract text is available yet for this article.
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27940884/the-cultivation-of-chinese-health-care-professionals
#9
Pingping Yang, Gaosi Xu
No abstract text is available yet for this article.
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27565816/technology-development-in-health-care-is-broken
#10
Peter J Pronovost, Joe Powers, Walter Jin
No abstract text is available yet for this article.
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27565815/computerized-provider-order-entry-using-two-prescription-writing-software-in-oncology
#11
Amaury Guédon, Angélique Rome, Jean-Laurent Deville, Michael Besse, Ludivine Blanchet, Amandine Savry, Laurence Gauthier-Villano, Pierre Bertault-Peres, Bertrand Pourroy
No abstract text is available yet for this article.
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27037267/incorporating-patient-acuity-rating-score-into-patient-handoffs-and-the-correlation-with-rapid-responses-and-unexpected-icu-transfers
#12
Christopher O'Donnell, Samantha Thomas, Crystal Johnson, Lalit Verma, Jonathan Bae, David Gallagher
Handoffs and rapid response team (RRT) activations have been a focus for quality improvement in hospital medicine. This study aimed to incorporate a previously used scoring system (1-7) for severity of illness on initial encounter as a handoff adjunct and to determine its impact on the number of RRTs and intensive care unit transfers. The Patient Acuity Rating (PAR) scale correlates with subsequent RRTs and transfers to a higher level of care, with higher scores leading to increased rates of RRTs and transfers...
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27030689/heart-failure-readmission-reduction
#13
Joseph P Drozda, Donna A Smith, Paul C Freiman, Janet Pursley, Jeffrey A VanSlette, Timothy R Smith
Little is known regarding effectiveness of readmission reduction programs over time. The Heart Failure Management Program (HFMP) of St. John's Physician Group Practice (PGP) Demonstration provided an opportunity to assess outcomes over an extended period. Data from an electronic health record, an inpatient database, a disease registry, and the Social Security Death Master File were analyzed for patients admitted with heart failure (HF) for 5 years before (Period 1) and 5 years after (Period 2) inception of PGP...
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27030687/enhancing-the-safe-and-effective-management-of-chronic-pain-in-accountable-care-organization-primary-care-practices-in-kentucky
#14
Selam Wubu, Laura Lee Hall, Paula Straub, Matthew J Bair, Jill A Marsteller, Yea-Jen Hsu, Doron Schneider, Gregory A Hood
Chronic pain is a prevalent chronic condition with significant burden and economic impact in the United States. Chronic pain is particularly abundant in primary care, with an estimated 52% of chronic pain patients obtaining care from primary care physicians (PCPs). However, PCPs often lack adequate training and have limited time and resources to effectively manage chronic pain. Chronic pain management is complex in nature because of high co-occurrence of psychiatric disorders and other medical comorbidities in patients...
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27016948/rapid-process-optimization
#15
Jennifer L Wiler, Kelly Bookman, Derek B Birznieks, Robert Leeret, April Koehler, Shauna Planck, Richard Zane
Health care systems have utilized various process redesign methodologies to improve care delivery. This article describes the creation of a novel process improvement methodology, Rapid Process Optimization (RPO). This system was used to redesign emergency care delivery within a large academic health care system, which resulted in a decrease: (1) door-to-physician time (Department A: 54 minutes pre vs 12 minutes 1 year post; Department B: 20 minutes pre vs 8 minutes 3 months post), (2) overall length of stay (Department A: 228 vs 184; Department B: 202 vs 192), (3) discharge length of stay (Department A: 216 vs 140; Department B: 179 vs 169), and (4) left without being seen rates (Department A: 5...
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/26917809/adding-laboratory-data-to-hospital-claims-data-to-improve-risk-adjustment-of-inpatient-30-day-postdischarge-outcomes
#16
Michael Pine, Donald E Fry, Edward L Hannan, James M Naessens, Kay Whitman, Agnes Reband, Feng Qian, Joseph Schindler, Mark Sonneborn, Jaclyn Roland, Linda Hyde, Barbara A Dennison
Numerical laboratory data at admission have been proposed for enhancement of inpatient predictive modeling from administrative claims. In this study, predictive models for inpatient/30-day postdischarge mortality and for risk-adjusted prolonged length of stay, as a surrogate for severe inpatient complications of care, were designed with administrative data only and with administrative data plus numerical laboratory variables. A comparison of resulting inpatient models for acute myocardial infarction, congestive heart failure, coronary artery bypass grafting, and percutaneous cardiac interventions demonstrated improved discrimination and calibration with administrative data plus laboratory values compared to administrative data only for both mortality and prolonged length of stay...
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/26917808/a-plan-do-study-act-approach-to-improving-bowel-preparation-quality
#17
Audrey H Calderwood, Elaine M Mahoney, Brian C Jacobson
Up to 20% of patients presenting for colonoscopy have inadequate bowel cleanliness. In this study, the Plan-Do-Study-Act quality improvement process was used to improve bowel cleanliness among outpatients undergoing screening colonoscopy at Boston Medical Center. Rates of inadequate bowel cleanliness were assessed at baseline (April 2010 to September 2012), during several rapid-cycle experiments (October 2012 to September 2013), and through an observation phase (October 2013 to September 2015). The baseline rate of inadequate cleanliness was 9% with a target of 5%...
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/26917807/the-burden-of-burnout
#18
Hany Elmariah, Samantha Thomas, Joel C Boggan, Aimee Zaas, Jonathan Bae
This study sought to determine burnout prevalence and factors associated with burnout in internal medicine residents after introduction of the 2011 ACGME duty hour rules. Burnout was evaluated using an anonymized, abbreviated version of the Maslach Burnout Inventory. Surveys were collected biweekly for 48 weeks during the 2013-2014 academic year. Burnout severity was compared across subgroups and time. A score of 3 or higher signified burnout. Overall, 944 of 3936 (24%) surveys were completed. The mean burnout score across all surveys was 2...
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/26917805/an-organizational-learning-framework-for-patient-safety
#19
Marc T Edwards
Despite concerted effort to improve quality and safety, high reliability remains a distant goal. Although this likely reflects the challenge of organizational change, persistent controversy over basic issues suggests that weaknesses in conceptual models may contribute. The essence of operational improvement is organizational learning. This article presents a framework for identifying leverage points for improvement based on organizational learning theory and applies it to an analysis of current practice and controversy...
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/26911665/admission-laboratory-results-to-enhance-prediction-models-of-postdischarge-outcomes-in-cardiac-care
#20
Michael Pine, Donald E Fry, Edward L Hannan, James M Naessens, Kay Whitman, Agnes Reband, Feng Qian, Joseph Schindler, Mark Sonneborn, Jaclyn Roland, Linda Hyde, Barbara A Dennison
Predictive modeling for postdischarge outcomes of inpatient care has been suboptimal. This study evaluated whether admission numerical laboratory data added to administrative models from New York and Minnesota hospitals would enhance the prediction accuracy for 90-day postdischarge deaths without readmission (PD-90) and 90-day readmissions (RA-90) following inpatient care for cardiac patients. Risk-adjustment models for the prediction of PD-90 and RA-90 were designed for acute myocardial infarction, percutaneous cardiac intervention, coronary artery bypass grafting, and congestive heart failure...
March 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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