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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/29463092/super-utilization-of-health-care-resources-among-gynecologic-oncology-patients
#1
Casey M Hay, Joseph L Kelley, Robert P Edwards, Kathleen M Pombier, John T Comerci
Super-utilizers account for many emergency department visits (EDV) and hospitalizations. Among Medicare/Medicaid patients, 5% to 10% account for >50% of spending. Little is known about super-utilization in gynecologic oncology. Charts of 64 gynecologic oncology patients with ≥3 EDV and/or admissions over 12 months were reviewed retrospectively. Cancer type distribution was 47% ovarian, 23% cervical, 23% endometrial, and 6% vulvar. Treatment at index visit was 61% chemotherapy, 16% no treatment, 8% recent surgery, and 6% radiation...
February 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29463091/urinary-tract-infections-pilot-study-to-improve-guideline-adherence
#2
Maroun M Sfeir, Alexandria G Beranger
No abstract text is available yet for this article.
February 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29411621/hospice-care-needs-study
#3
Temple D West, Marissa C Galicia-Castillo, Cynthia P Cadieux, Agatha Parks-Savage
No abstract text is available yet for this article.
February 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29392958/using-written-instructions-to-improve-the-quality-of-emergency-department-discharge-communication-an-interdisciplinary-patient-centered-approach
#4
Justin N Hall, Jeffrey P Graham, Melissa McGowan, Amy H Y Cheng
No abstract text is available yet for this article.
February 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29374965/the-impact-of-a-transition-of-care-program-on-acute-myocardial-infarction-readmission-rates
#5
Jeffrey A Marbach, Drew Johnson, Juergen Kloo, Amit Vira, Scott Keith, Walter K Kraft, Natalie Margules, David Whellan
Hospital discharge is a high-risk time period, and acute myocardial infarction (AMI) patients often have early readmissions. The authors hypothesized that a multifaceted AMI care coordination program would reduce early hospital readmission rates. The outcomes of patients receiving care coordination (n = 304) were compared to patients receiving standard care (n = 192). Multivariable analyses of the outcomes were conducted by conditional logistic regression of propensity score matched sets. The primary outcome-hospital readmission within 30 days of discharge-occurred in 18% of standard care patients and 11...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29374964/identifying-what-is-known-about-improving-operating-room-to-intensive-care-handovers-a-scoping-review
#6
Karolina Zjadewicz, Kirsten S Deemer, Jennifer Coulthard, Christopher J Doig, Paul J Boiteau
The purpose is to provide a descriptive overview of relevant material exploring improvement of handovers from the operating room (OR) to intensive care unit (ICU). An online search (MEDLINE, Cochrane, EMBASE, CINAHL, and Joanna Briggs), including gray literature and relevant reference lists, was completed. In all, 4574 unique citations were screened and 155 full-text reviews performed; 65 articles were included in the final analysis. The majority of articles discuss an ideal structure for handover (n = 63; 97%); 43 (66%) articles mentioned strategies for implementing such an approach...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29366331/does-having-open-access-to-care-improve-patient-experience-a-case-control-study
#7
Lauren M Duhigg, Rebecca A Baranowski, Gerald K Arnold
This study investigated whether primary and specialist care practices utilizing open access to care (OA) receive better patient experience scores than propensity-matched control practices without OA. From March 2010 to December 2014, 711 physicians classified as having OA in their practice, indicated by scoring 15 or higher on the OA checklist, were propensity matched to practices without OA. Patient experience was measured with 5 composites: timely care, communication, staff quality, care coordination, and overall physician rating...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29366330/practical-implementation-of-failure-mode-and-effects-analysis-for-extracorporeal-membrane-oxygenation-activation
#8
Faria Nasim, Joseph T Poterucha, Lisa M Daniels, John G Park, Troy G Seelhammer, John K Bohman, Tammy P Friedrich, Caitlin L Blau, Jennifer L Elmer, Gregory J Schears
Extracorporeal membrane oxygenation (ECMO) is used to treat severe hypoxemic respiratory failure and as a rescue therapy for patients with cardiopulmonary arrest within a narrow window of time. A failure modes and effects analysis (FMEA) was conducted to analyze the clinical and operational processes leading to delays in initiating ECMO. FMEA determined these highest-risk failure modes that were contributing to process failure: (1) ECMO candidacy not determined in time, (2) no or incomplete evaluation for ECMO prior to consult or arrest, (3) ECMO team not immediately available, and (4) cannulation not completed in time...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29357679/area-deprivation-index-predicts-readmission-risk-at-an-urban-teaching-hospital
#9
Jianhui Hu, Amy J H Kind, David Nerenz
A growing body of evidence has shown that neighborhood characteristics have significant effects on quality metrics that evaluate health plans or health care providers. Using a data set of an urban teaching hospital patient discharges, this study aimed to determine whether a significant effect of neighborhood characteristics, measured by the Area Deprivation Index, could be observed on patients' readmission risk, independent of patient-level clinical and demographic factors. This study found that patients residing in more disadvantaged neighborhoods had significantly higher 30-day readmission risks compared to those living in less disadvantaged neighborhoods, even after accounting for individual-level factors...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29345150/an-initial-assessment-of-the-utility-of-validated-alcohol-and-drug-screening-tools-in-predicting-30-day-readmission-to-adult-general-medicine-wards
#10
Steven P Gerke, Jon D Agley, Cynthia Wilson, Ruth A Gassman, Philip Forys, David W Crabb
Previous studies have identified drug and alcohol use as risk factors for readmission using claims data, but not by using substance use screening scores. This preliminary study tested the hypothesis that prevalence of 30-day readmission would be higher among patients screening positive on the 10-item Alcohol Use Disorders Identification Test (AUDIT-10) or the 10-item Drug Abuse Screening Test (DAST-10) tools at intake than among the general patient population. Social workers screened 4708 adult inpatients using prescreening questions followed by the AUDIT-10 and/or DAST-10...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29345143/readability-of-online-health-information-a-meta-narrative-systematic-review
#11
Lubna Daraz, Allison S Morrow, Oscar J Ponce, Wigdan Farah, Abdulrahman Katabi, Abdul Majzoub, Mohamed O Seisa, Raed Benkhadra, Mouaz Alsawas, Prokop Larry, M Hassan Murad
Online health information should meet the reading level for the general public (set at sixth-grade level). Readability is a key requirement for information to be helpful and improve quality of care. The authors conducted a systematic review to evaluate the readability of online health information in the United States and Canada. Out of 3743 references, the authors included 157 cross-sectional studies evaluating 7891 websites using 13 readability scales. The mean readability grade level across websites ranged from grade 10 to 15 based on the different scales...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29310442/idea4ps-the-development-of-a-research-oriented-learning-healthcare-system
#12
Susan Moffatt-Bruce, Timothy Huerta, Alice Gaughan, Ann Scheck McAlearney
Leveraging opportunities to learn and then improve the delivery of care using experiences throughout the health care system is essential in efforts to transform health care delivery. The authors present the approach of one academic medical center in becoming a research-oriented Learning Healthcare System (ro-LHS). By reframing the role of research in improving outcomes, the organization was able to move beyond its focus on quality improvement to foster a culture in which feedback informs practice and research drives improvement...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29301403/improving-mandatory-vaccination-against-influenza-minimizing-anxiety-of-employees-to-maximize-health-of-patients
#13
Andrea L Benin, Gina Lockwood, Tracy Creatore, Donna Donovan, Maggi Predmore, Susan MacArthur
The objective was to describe qualitatively the attitudes among employees toward mandatory vaccination against influenza to ultimately improve such programs and prevent hospital-acquired influenza. Qualitative interviews were conducted with 21 employees at a freestanding children's hospital. Analysis of interview transcripts used grounded theory and the constant comparative method; codes were iteratively revised and refined as themes emerged. Themes emerged elucidating promoters and concerns. Promoters included a desire to protect self, family, and patients; perception of vaccination as part of professional responsibility; and free vaccination as a benefit from the organization...
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29262690/assessment-of-risk-factors-associated-with-hospital-acquired-pressure-injuries-and-impact-on-health-care-utilization-and-cost-outcomes-in-us-hospitals
#14
Jill Dreyfus, Julie Gayle, Paul Trueman, Gary Delhougne, Aamir Siddiqui
Hospital-acquired pressure injuries (HAPI) are a societal burden and considered potentially preventable. Data on risk factors and HAPI burden are important for effective prevention initiatives. This study of the 2009-2014 US Premier Healthcare Database identified HAPI risk factors and compared outcomes after matching HAPI to non-HAPI patients. The cumulative incidence of HAPI was 0.28% (47 365 HAPI among 16 967 687 total adult inpatients). Among the matched sample of 110 808 patients (27 702 HAPI), the strongest risk factors for HAPI were prior PI (odds ratio [OR] = 12...
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29258325/patient-centered-morning-blood-collections
#15
Alan M Hall, Romil Chadha, John Romond, Paula Bailey, Andrew Kelly, Mark V Williams
No abstract text is available yet for this article.
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29258324/evaluating-the-utility-of-facebook-reviews-as-a-hospital-quality-improvement-tool
#16
Severine Z Cao, Gideon P Smith
No abstract text is available yet for this article.
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29258323/barriers-and-benefits-to-the-use-of-patient-reported-outcome-measures-in-routine-clinical-care-a-qualitative-study
#17
Lindsey M Philpot, Sunni A Barnes, Rachel M Brown, Jessica A Austin, Cameron S James, Richard H Stanford, Jon O Ebbert
Patient-reported outcomes (PROs) provide information on how health care affects patient health and well-being and represent a patient-centered approach. Despite this potential, PROs are not widely used in clinical settings. Semi-structured focus groups were conducted with 3 stakeholder groups (patients, providers, and health care administrators) to determine the top 5 perceived barriers and benefits of PRO implementation. The Delphi technique was employed to obtain consensus and rank order responses. Patients perceived survey length to be important, whereas providers and administrators perceived time to collect data and patient health literacy, respectively, as the greatest barriers to PRO implementation...
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29258322/clinical-and-sociocultural-factors-associated-with-failure-to-escalate-care-of-deteriorating-patients
#18
Firas S Elmufdi, Susan L Burton, Nishant Sahni, Craig R Weinert
In-hospital medical emergencies occur frequently. Understanding how clinicians respond to deteriorating patients outside the intensive care unit (ICU) could improve "rescue" interventions and rapid response programs. This was a qualitative study with interviews with 40 clinicians caring for patients who had a "Code Blue" activation or an unplanned ICU admission at teaching hospitals over 7 months. Four study physicians independently analyzed interview transcripts; refined themes were linked to the transcript using text analysis software...
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29241347/hospital-based-clinicians-perceptions-of-geographic-cohorting-identifying-opportunities-for-improvement
#19
Areeba Kara, Cynthia S Johnson, Siu L Hui, Deanne Kashiwagi
Members of the Society of Hospital Medicine were surveyed about geographic cohorting (GCh); 369 responses were analyzed, two thirds of which were from GCh participants. Improved collaboration with the bedside nurse, increased nonclinical interactions, decreased paging interruptions, and improved efficiency were perceived by >50%. Narrowed clinical expertise, increased fragmentation, increased face-to-face interruptions, and an adverse impact on camaraderie within the hospitalist group were reported by 25% to 50%...
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29239197/maintaining-quality-in-lower-volume-cardiac-surgery-a-blueprint-from-a-military-program
#20
Jared L Antevil, Philip S Mullenix, Junewai L Reoma, Paul S Massimiano, Frederick C Lough, Eric A Elster
Although there is a clear volume-outcome relationship in the field of cardiac surgery, the existence of high-performing programs with relatively low case volumes is well established. This report describes the programmatic and institutional processes in place at a lower volume cardiac surgery center in a US military hospital, which have been executed to optimally leverage available resources in the delivery of exemplary patient care. By implementing a highly collaborative practice, rigorous outcomes review, evidence-based standardized care pathways, consistent attending surgeon oversight for care delivery, careful case selection, and a mechanism for support from highly experienced outside cardiac surgeons, the cardiac surgery program at the authors' institution delivers care on par with its higher volume counterparts...
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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