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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/29779398/handoff-tool-enabling-standardized-transitions-between-the-emergency-department-and-the-hospitalist-inpatient-service-at-a-major-cancer-center
#1
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...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29756457/descriptive-analysis-of-associated-factors-for-urgent-versus-nonurgent-inpatient-spine-transfers-to-a-tertiary-care-hospital
#2
Gregory D Schroeder, James C McKenzie, David S Casper, Seth Stake, Joseph Buchholz, Chris Kepler, Jeffery A Rihn, Barret I Woods, Kris E Radcliff, I David Kaye, Kristen Nicholson, D Greg Anderson, Alan S Hilibrand, Alexander R Vaccaro, Safdar Khan, Mark F Kurd
Patients with spine-associated symptoms are transferred regularly to higher levels of care for operative intervention. It is unclear what factors lead to the transfer of patients with spine pathology to level I care facilities, and which transfers are indicated. All patients with isolated spinal pathology who were transferred from 2011 to 2015 were reviewed. Patients were divided into urgent transfers, defined as anyone who required operative intervention, and nonurgent transfers. Two hundred twenty-seven patients were transferred for isolated spinal pathology over 51 months; 109 (48...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29745236/effect-of-ambulatory-transitional-care-management-on-30-day-readmission-rates
#3
Jonathan Ballard, Wade Rankin, Karen L Roper, Sarah Weatherford, Roberto Cardarelli
A process improvement initiative for transitional care management (TCM) was evaluated for effectiveness in reducing 30-day readmission rates in a retrospective cohort study. Regression models analyzed the association between level of TCM component implementation and readmission rates among patients discharged from a university medical center hospital. Of the 1884 patients meeting inclusion criteria, only 3.7% (70) experienced a 30-day readmission. Patients receiving the full complement of TCM had 86.6% decreased odds of readmission compared with patients who did not receive TCM ( P < ...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29739233/hcahps-scores-and-community-factors
#4
Jeph Herrin, Kathleen G Mockaitis, Stephen Hines
The objective was to examine associations between patient experience, as measured by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, and the sociodemographic, cultural, and access-to-care factors of the surrounding community. Using an empty model, this study found that 27% of the variation in HCAHPS scores was at the level of the county in which the hospital was located. The county factors examined explained about half of this county-level variation. Among community factors most strongly associated with increased HCAHPS scores were higher numbers of primary care physicians per capita, fewer specialists per capita, and smaller percentages of African Americans and Hispanics in the county...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29717882/gratitude-and-recognition-in-a-hospital-setting-addressing-provider-well-being-and-patient-outcomes
#5
Caitlin Hamilton, Helge Osterhold, Jessica Chao, Kristin Chu, Arup Roy-Burman
No abstract text is available yet for this article.
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29707957/a-health-plan-s-journey-to-identifying-meaningful-quality-measures
#6
Misty Roberts, Faith Green, Worthe Holt
The number of quality measures in health care is overwhelming, and reporting requirements are inconsistent. Value-based payments emphasize the need to prioritize quality measures and align across organizations. This article describes the process Humana undertook to reduce the quality measurement burden, refine measure consistency across the organization, ensure alignment with national standards, and relate quality measures to improved health outcomes within the health plan. Of the 1100 measures identified in use at Humana, 699 were duplicative or inconsistent...
April 1, 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
#7
Umbereen S Nehal, Jack Maypole, Matthew Sadof
No abstract text is available yet for this article.
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29681163/patterns-of-narcotic-prescribing-by-orthopedic-surgeons-for-medicare-patients
#8
Matthew R Boylan, Kelly I Suchman, James D Slover, Joseph A Bosco
In recent years, narcotics have been subject to increased regulation and monitoring because of their side effects and potential for misuse. Currently, variation in prescribing patterns of narcotics among orthopedic surgeons is unknown. The Medicare Part D claims database was used to identify orthopedic surgeons who prescribed at least one schedule II or III narcotic during 2014. The median duration of a narcotic prescription was 8.2 days. The median prescription duration was shortest for hand surgeons (5.6 days) and longest for spine surgeons (12...
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29676174/are-we-confident-of-across-hospital-mortality-comparisons
#9
Richard L Fuller, John S Hughes, Norbert I Goldfield, Graham Atkinson
No abstract text is available yet for this article.
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29667895/delivery-of-standardized-patient-instructions-in-the-after-visit-summary-reduces-telephone-calls-between-clinic-visits
#10
Stefanie Deeds, Stephanie Carr, Michelle Garrison, Tyra Fainstad
Telephone calls from patients can be a large source of between-visit work in outpatient clinics. A baseline audit at the study clinic identified medication refills and test results as the most common preventable calls. The authors created a dot phrase with standardized text detailing methods for refilling medications and reviewing test results and instructed providers to use it in the after-visit summary (AVS). After implementation of the AVS dot phrase, telephone calls for medications and results had an adjusted absolute decrease of 23...
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29667894/changing-the-narrative-refocusing-the-efforts-of-emergency-departments-in-the-opioid-epidemic
#11
Jennifer Voelker, Vittorio Maio, Priya Mammen
No abstract text is available yet for this article.
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29665700/organizational-response-to-known-medical-errors-does-peer-review-protection-impede-improvement
#12
William J Wenner, Sung W Choi
No abstract text is available yet for this article.
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29660993/a-multi-targeted-quality-improvement-project-of-ct-guided-procedure-start-times
#13
Michael Collard, Jason Wachsmann, Sheryl Thrash, Sheila Herring, Margie Caramucci, Linda Hrebec, James Collins, Jeannie Kwon
No abstract text is available yet for this article.
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29658295/an-assessment-of-the-impact-of-just-culture-on-quality-and-safety-in-us-hospitals
#14
Marc T Edwards
In pursuit of high reliability, numerous organizations have promoted Just Culture, but its impact has never been assessed. This report combines data from a longitudinal survey-based study of clinical peer review practices in a cohort of 457 acute care hospitals with 43 measures from the Hospital Compare database and interprets them in relation to the long-term trends of Agency for Healthcare Research and Quality (AHRQ) data on the Hospital Survey of Patient Safety Culture. In all, 211 of 270 respondents (79%) indicated that their hospital has adopted Just Culture...
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29658291/teaching-the-concepts-of-quality-improvement-for-challenging-patient-populations
#15
Juniper J Lee-Park, Richard D Ha, Anita Kablinger
No abstract text is available yet for this article.
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29644872/harnessing-the-power-of-peer-influence-to-improve-quality
#16
Christina T Yuan, Peter J Pronovost, Jill A Marsteller
No abstract text is available yet for this article.
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29644871/interprofessional-rounds-improve-timing-of-appropriate-palliative-care-consultation-on-a-hospitalist-service
#17
Rafina Khateeb, Margaret R Puelle, Janice Firn, D'Anna Saul, Robert Chang, Lillian Min
Despite known benefits, palliative care (PC) consultation for hospitalized patients remains underutilized. The objective was to improve frequency and timeliness of appropriate inpatient PC consultation. On 2 of 11 hospitalist teams, a PC representative attended discharge rounds twice a week. Control teams' discharge rounds were unenhanced. Subjects were all patients admitted to a hospitalist service in a quaternary academic medical center. The primary outcome was change in provision of PC consultation over time; the secondary outcome was change in time-to-consult (days)...
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29637791/measuring-value-in-internal-medicine-residency-training-hospitals-using-publicly-reported-measures
#18
Adam Schickedanz, Reshma Gupta, Vineet M Arora, Clarence H Braddock
Graduate medical education (GME) lacks measures of resident preparation for high-quality, cost-conscious practice. The authors used publicly reported teaching hospital value measures to compare internal medicine residency programs on high-value care training and to validate these measures against program director perceptions of value. Program-level value training scores were constructed using Centers for Medicare & Medicaid Services Value-Based Purchasing (VBP) Program hospital quality and cost-efficiency data...
March 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29606010/use-of-a-surgical-debriefing-checklist-to-achieve-higher-value-health-care
#19
Michael R Rose, Katherine M Rose
Efforts to improve surgical care by using checklists have been inconsistent in results and not reproducible at scale. The ideal manner for using checklists, along with the time horizon for achieving meaningful and measurable benefits, has been unclear. This article describes a novel process for utilizing debriefing checklists to improve value in surgical care. Debriefings of 54 003 consecutive surgical cases and subsequent analysis of 4523 defects in care by multidisciplinary teams led to rapid-cycle iterative changes in care design and processes...
March 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29590756/improved-outcomes-with-integrated-intensivist-consultation-for-cardiac-surgery-patients
#20
Omer W Sultan, Lori L Boland, Tyler G Kinzy, Roman R Melamed, Susan C Seatter, Robert S Farivar, Lisa L Kirkland, Maximilian Mulder
This study examined the impact of integrated intensivist consultation in the immediate postoperative period on outcomes for cardiac surgery patients. A retrospective cohort study was conducted in 1711 adult cardiac surgery patients from a single quaternary care center in Minnesota. Outcomes were compared across 2 consecutive 2-year time periods reflecting an elective intensivist model (n = 801) and an integrated intensivist model (n = 910). Patients under the 2 models were comparable with respect to demographics, comorbidities, procedure types, and Society for Thoracic Surgery predicted risk of mortality score; however, patients in the earlier cohort were slightly older and more likely to have chronic kidney disease ( P = ...
March 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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