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Quality Management in Health Care

Andrew J Knighton, Colin K Grissom, Kirk U Knowlton, M Sean Esplin, Tom Graydon, Raj Srivastava
No abstract text is available yet for this article.
July 2018: Quality Management in Health Care
Farhan I Merali, Oliver D Schein, Sean M Berenholtz
No abstract text is available yet for this article.
July 2018: Quality Management in Health Care
Ann-Christine Andersson, Anna Melke, Boel Andersson Gäre, Marie Golsäter
The purpose of this study was to elucidate conditions at all system levels in a specific health care service to develop practices for identification of children as relatives. An interactive research approach with the intention to create mutual learning between practice and research was used. The participating health care service cared for both clinic in- and outpatients with psychiatric disorders. Health care professionals from different system levels (micro, meso, macro) participated, representing different professions...
July 2018: Quality Management in Health Care
Jamison V Kovach, Shrutika Borikar
Health systems typically lose approximately 3% to 5% of net revenues annually due to insurance claim denials. While most denials can be appealed, the administrative burden of sorting through and appealing them can be time consuming and delays the revenue collection process. This article describes how the Lean Six Sigma methodology was used to improve the revenue cycle by reducing insurance claim denials for a leading pediatric hospital in the United States. The use of this approach is demonstrated through a case example focused on reducing denials by improving the hospital's Emergency Center registration process...
July 2018: Quality Management in Health Care
Laura F Garabedian, Anna D Sinaiko, Dennis Ross-Degnan, Tariq Abu-Jaber, Martha Hoefer, Stephanie Oddleifson, Anita K Wagner
BACKGROUND: Providers need timely, clinically meaningful, and actionable information to improve quality of care. Payers may play an important role in providing such information in ambulatory care settings. We sought to learn about providers' use and perceptions of quality reports from insurers. METHODS: We employed a mixed-methods study design. We analyzed the performance of 118 provider groups on 21 HEDIS measures included in one New England insurer's quality reporting program and evaluated how a subset of provider groups (n = 55) accessed the reports...
July 2018: Quality Management in Health Care
Constantin Shuster, Andrew Hurlburt, Terence Yung, Tony Wan, John A Staples, Penny Tam
BACKGROUND: Unplanned hospital readmissions are associated with increased patient mortality and health care costs, yet only a fraction are likely to be preventable. This study's objective was to identify preventable hospital readmissions of general internal medicine patients, and their common causes. METHODS: Patients who were discharged from the general internal medicine teaching service and readmitted to hospital within 28 days for 24 hours or more were recruited to the study; they were identified via the hospital electronic medical record system...
July 2018: Quality Management in Health Care
Sky Graybill, Joseph Kluesner, Mark True, Irene Folaron, Joshua Tate, Jeffrey Colburn, Darrick Beckman, Jana Wardian
: New diagnostic results are constantly arriving to outpatient practices. It is imperative to effectively communicate these results and their implications to patients. METHODS: We surveyed 100 patients and our clinic personnel to assess opinions regarding methods of communication in common scenarios. RESULTS: Response rate was 79% from patients and 75% from clinic personnel. Most patients thought letters were an appropriate way to receive normal test results (83%)...
July 2018: Quality Management in Health Care
Hillary J Mull, Kamal M F Itani, Martin P Charns, Steven D Pizer, Peter E Rivard, Mary T Hawn, Amy K Rosen
BACKGROUND: Research on adverse events (AEs) in outpatient surgery has been limited. As part of a Veterans Health Administration (VA) project on AE surveillance, we chart-reviewed selected outpatient surgical cases to characterize the nature and severity of AEs. METHODS: We abstracted financial year 2012-2015 VA outpatient surgery cases selected with high (n = 1185) and low (n = 1072) likelihood of an AE based on postoperative health care utilization. The abstraction tool included established AE definitions and validated harm and severity scales...
July 2018: Quality Management in Health Care
Rachel E Ganaden, Lori Mitchell
OBJECTIVE: To determine whether a Comprehensive Unit-based Safety Program could be used to enhance a culture of patient safety and improve medication safety at 1 pilot site. METHODS: The Canadian Patient Safety Culture Survey tool was used to assess the culture of patient safety and drill down on the key factors contributing to medication errors. Based on staff input and site improvement team investigations, solutions were developed to address medication safety issues...
July 2018: Quality Management in Health Care
Jenna Howard, William L Miller, Rachel Willard-Grace, Elizabeth Stewart Burger, Kelly J Kelleher, Paul A Nutting, Karissa A Hahn, Benjamin F Crabtree
OBJECTIVE: To learn from the experiences of innovative primary care practices that have successfully developed care teams. RESEARCH DESIGN: A 2½-day working conference was convened with representatives from 10 innovative primary care practices, content experts, and researchers to discuss experiences of developing care teams. Qualitative data included observation notes, transcripts of conference sessions and interviews, and narrative summaries of innovations. Case summaries of practices and an analysis matrix were created to identify common themes...
July 2018: Quality Management in Health Care
Caroline P Gray, Maayan Yakir, Dorothy Y Hung
OBJECTIVE: Data and metrics play important roles in quality and process improvement efforts. For one specific process improvement method, Lean or Lean health care, data and metrics are central components, allowing users to identify areas that need improvement and to assess the degree to which improvements have been realized. This article explores the role that metrics and measurement played in a wide-reaching "Lean"-based continuous quality improvement effort carried out in the primary care departments of a large, ambulatory care health care organization...
July 2018: Quality Management in Health Care
Timothy P Daaleman, Dawn Brock, Mark Gwynne, Sam Weir, Iris Dickinson, Beth Willis, Alfred Reid
BACKGROUND: Lean is emerging as a quality improvement (QI) strategy in health care, but there has been minimal adoption in primary care teaching practices. This study describes a strategy for implementing Lean in an academic family medicine center and provides a formative assessment of this approach. METHODS: A case study of the University of North Carolina Family Medicine Center that used the Consolidated Framework for Implementation Research to guide a formative evaluation...
July 2018: Quality Management in Health Care
Jordan A Albritton, Joseph Dalto, Brian Wayling
No abstract text is available yet for this article.
April 2018: Quality Management in Health Care
Lauren E Benishek, Jed Wolpaw, Sean Berenholtz, Peter J Pronovost
No abstract text is available yet for this article.
April 2018: Quality Management in Health Care
Kristie Hadden, Latrina Y Prince, C Lowry Barnes
BACKGROUND: In response to an assessment of organizational health literacy practices at a major academic health center, this case study evaluated the health literacy demands of patient-reported outcome measures commonly used in orthopedic surgery practices to identify areas for improvement. METHODS: A mixed-methods approach was used to analyze the readability and patient feedback of orthopedic patient-reported outcome materials. Qualitative results were derived from focus group notes, observations, recordings, and consensus documents...
April 2018: Quality Management in Health Care
Latrina Y Prince, Carsten Schmidtke, Jules K Beck, Kristie B Hadden
BACKGROUND: Organizational health literacy is the degree to which an organization considers and promotes the health literacy of patients. Addressing health literacy at an organizational level has the potential to have a greater impact on more health consumers in a health system than individual-level approaches. OBJECTIVE: The purpose of this study was to assess health care practices at an academic health center using the 10 attributes of a health-literate health care organization...
April 2018: Quality Management in Health Care
Danielle M Olds, Mary A Dolansky, Kari Gali, Carol Callaway-Lane
Despite the increase in quality improvement (QI) education both in practice and in health professions' education, gaps exist in the usefulness and success of QI projects. Barriers to successful QI are a result of delays in implementation, teamwork issues, and lack of QI knowledge. These barriers can be addressed using a QI Coach. A QI Coach is an expert in QI principles who has excellent communication and collaboration skills, and is experienced with organizational policies. The purpose of this article is to (a) describe the VA Quality Scholars (VAQS) QI Coach Model that includes the role of a coach and effective coaching strategies and (b) discuss lessons learned from the application of the VAQS QI Coach Model...
April 2018: Quality Management in Health Care
Katharine E Morley, Constance M Barysauskas, Victoria Carballo, Orinta Kalibatas, Sandhya K Rao, Joseph O Jacobson, Brian M Cummings
INTRODUCTION: The Partners Clinical Process Improvement Leadership Program provides quality improvement training for clinicians and administrators, utilizing graduates as volunteer peer coaches for mentorship. We sought to understand the factors associated with volunteer coach participation and gain insight into how to improve and sustain this program. METHODS: Review of coach characteristics from course database and survey of frequent coaches. RESULTS: Out of 516 Partners Clinical Process Improvement Leadership Program graduates from March 2010 to June 2015, 117 (23%) individuals volunteered as coaches...
April 2018: Quality Management in Health Care
Tanya Di Genova, Christina Sperling, Ashley Gionfriddo, Zelia Da Silva, Leanne Davidson, Jason Macartney, Michael Finelli, Robert P Jankov, Peter C Laussen
PURPOSE: Inhaled nitric oxide (iNO) is a pulmonary vasodilator that is approved for use in term and near-term neonates with hypoxic respiratory failure associated with evidence of pulmonary hypertension. However, it is commonly used in infants and children to treat a variety of other cardiopulmonary diseases associated with pulmonary hypertension and hypoxic respiratory failure. In critically ill children, iNO therapy may be continued for a prolonged period, and this increases the risk for adverse consequences including toxicity and unnecessary costs...
April 2018: Quality Management in Health Care
Yaron Niv, David Itskoviz, Michal Cohen, Hagit Hendel, Yonit Bar-Giora, Evgeny Berkov, Irit Weisbord, Yifat Leviron, Assaf Isasschar, Arian Ganor
BACKGROUND: Failure modes and effects analysis (FMEA) is a tool used to identify potential risks in health care processes. We used the FMEA tool for improving the process of consultation in an academic medical center. METHODS: A team of 10 staff members-5 physicians, 2 quality experts, 2 organizational consultants, and 1 nurse-was established. The consultation process steps, from ordering to delivering, were computed. Failure modes were assessed for likelihood of occurrence, detection, and severity...
April 2018: Quality Management in Health Care
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