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Joint Commission Journal on Quality and Patient Safety

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https://www.readbyqxmd.com/read/28325208/a-systematic-review-of-team-training-in-health-care-ten-questions
#1
Shannon L Marlow, Ashley M Hughes, Shirley C Sonesh, Megan E Gregory, Christina N Lacerenza, Lauren E Benishek, Amanda L Woods, Claudia Hernandez, Eduardo Salas
BACKGROUND: As a result of the recent proliferation of health care team training (HTT), there was a need to update previous systematic reviews examining the underlying structure driving team training initiatives. METHODS: This investigation was guided by 10 research questions. A literature search identified 197 empirical samples detailing the evaluation of team training programs within the health care context; 1,764 measures of HTT effectiveness were identified within these samples...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28325207/using-a-systematic-framework-of-interventions-to-improve-early-discharges
#2
Hemali Patel, Sasha Morduchowicz, Michelle Mourad
BACKGROUND: Late-afternoon hospital discharges can lead to admission bottlenecks and negatively affect the flow of patients needing hospital admission. Delays in discharge are a prevalent health care problem and have been linked to increased length of stay, lower patient satisfaction scores, and adverse outcomes. As a result, hospitals are placing a renewed emphasis on early discharge as a way to reduce admission delays and achieve optimal patient flow. This study shows that the Model for Improvement (MFI) is an effective approach for complex improvement efforts...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28325206/improving-glycemic-control-safely-in-non-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#3
Gregory A Maynard, Diana Childers, Janet Holdych, Heather Kendall, Tom Hoag, Karen Harrison
BACKGROUND: Practice variations in insulin management and glycemic adverse events led nine Dignity Health hospitals to initiate a collaborative effort to improve hypoglycemia, uncontrolled hyperglycemia, and glycemic control. METHODS: Non-critical care adult inpatients with ≥4 point-of-care blood glucose (BG) readings in a ≥2-day period were included. Balanced glucometric goals for each hospital were individualized to improve performance by 10%-20% from baseline or achieve top performance derived from Society of Hospital Medicine (SHM) benchmarking studies...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28325205/a-blueprint-for-improving-systemwide-inpatient-glucose-management
#4
EDITORIAL
Pedro Ramos, John MacIndoe
No abstract text is available yet for this article.
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28325204/from-board-to-bedside-how-the-application-of-financial-structures-to-safety-and-quality-can-drive-accountability-in-a-large-health-care-system
#5
J Matthew Austin, Renee Demski, Tiffany Callender, K H Ken Lee, Ann Hoffman, Lisa Allen, Deborah A Radke, Yungjin Kim, Ronald J Werthman, Ronald R Peterson, Peter J Pronovost
BACKGROUND: As the health care system in the United States places greater emphasis on the public reporting of quality and safety data and its use to determine payment, provider organizations must implement structures that ensure discipline and rigor regarding these data. An academic health system, as part of a performance management system, applied four key components of a financial reporting structure to support the goal of top-to-bottom accountability for improving quality and safety...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28325203/developing-and-evaluating-an-automated-all-cause-harm-trigger-system
#6
Christine Sammer, Susanne Miller, Cason Jones, Antoinette Nelson, Paul Garrett, David Classen, David Stockwell
BACKGROUND: From 2009 through 2012, the Adventist Health System Patient Safety Organization (AHS PSO) used the Global Trigger Tool method for harm identification and demonstrated harm reduction. Although the awareness of harm demonstrated opportunities for improvement across the system, leaders determined that the human and fiscal resources required to continue with a retrospective manual harm identification process were unsustainable. In addition, there was growing concern that the identification of harm after the patient's discharge did not allow for intervention during the hospital stay...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28325202/casting-a-wider-safety-net-the-promise-of-electronic-safety-event-detection-systems
#7
EDITORIAL
Eric S Kirkendall
No abstract text is available yet for this article.
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334594/using-the-chronic-care-model-to-improve-pediatric-chronic-illness-care
#8
EDITORIAL
John S Adams, Lauren E Wisk
No abstract text is available yet for this article.
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334593/pediatric-postoperative-pulse-oximetry-monitoring-during-transport-to-the-postanesthesia-care-unit-reduces-frequency-of-hypoxemia
#9
Thomas J Caruso, Tara E Mokhtari, Monica J Coughlan, Diane S Wu, Juan L Marquez, Melissa Duan, Heather Freeman, Andrew Giustini, Mary Tweedy, Paul J Sharek
BACKGROUND: The standard use of pulse oximetry during the transport of postoperative patients from the operating room (OR) to the postanesthesia care unit (PACU) is not routinely practiced. A study was conducted to determine if the frequency of hypoxemia on admission to the PACU decreased after implementation of routine use of transport pulse oximeters for postoperative patients being transferred to the PACU. METHODS: In this prospective cohort study, which was conducted at an academic pediatric hospital, the primary outcome measure was the frequency of hypoxemic events on arrival to the PACU...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334592/using-an-electronic-perioperative-documentation-tool-to-identify-returns-to-operating-room-ror-in-a-tertiary-care-academic-medical-center
#10
Robert R Cima, Sarah R Dhanorker, Christopher L Ostendorf, Mfonabasi Ntekpe, Raghu V Mudundi, Elizabeth B Habermann, Claude Deschamps
BACKGROUND: The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers. METHOD: A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#11
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334590/a-prospective-emergency-department-quality-improvement-project-to-improve-the-treatment-of-vaso-occlusive-crisis-in-sickle-cell-disease-lessons-learned
#12
Paula Tanabe, Caroline E Freiermuth, David M Cline, Susan Silva
BACKGROUND: Guidelines recommend rapid, aggressive management of vaso-occlusive crisis (VOC) for patients with sickle cell disease (SCD). A large prospective research and quality improvement (QI) project was conducted to measure changes in clinical outcomes in two EDs-academic medical centers with emergency medicine residency programs and Level 1 trauma centers-during a 2.5-year time period (October 2011-March 2014). METHODS: A QI team used a Plan-Do-Study-Act approach to modify and implement changes to opioid analgesic protocols for the emergency department (ED) treatment of VOC...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334589/timely-care-for-sickle-cell
#13
EDITORIAL
Joseph S Colla, Pavitra Kotini-Shah, Stephen B Brown, Lewis L Hsu
No abstract text is available yet for this article.
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334588/applying-the-chronic-care-model-to-improve-care-and-outcomes-at-a-pediatric-medical-center
#14
Jennifer Lail, Pamela J Schoettker, Denise L White, Bhavna Mehta, Uma R Kotagal
BACKGROUND: Cincinnati Children's Hospital Medical Center launched the Condition Outcomes Improvement Initiative in 2012 to help disease-based teams use the principles of improvement science to implement components of the Chronic Care Model and improve outpatient care delivery for populations of children with chronic and complex conditions. The goal was to improve outcomes by 20% from baseline. METHODS: Initiative activities included review of the evidence to choose and measure outcomes, development of condition-specific patient registries and tools for data collection, patient stratification, planning and coordinating care before and after visits, and self-management support...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334567/review-of-nonformulary-medication-approvals-in-an-academic-medical-center
#15
Qoua L Her, Mary G Amato, Diane L Seger, James F Gilmore, John Fanikos, Julie M Fiskio, David W Bates
BACKGROUND: The Joint Commission requires hospitals to formally review formulary medications at least annually based on new clinical information. Although review of nonformulary medication (NFM) use is not required, frequent and inappropriate use of NFMs has the potential to increase hospital costs, negatively affect quality of care, and increase medication errors. Limited resources may restrict an institution's ability to review NFM use in addition to the required annual formulary review...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#16
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334565/year-end-resident-clinic-handoffs-narrative-review-and-recommendations-for-improvement
#17
Amber T Pincavage, Michael J Donnelly, John Q Young, Vineet M Arora
BACKGROUND: Year-end clinic handoffs in resident continuity clinics are an important patient safety issue. METHODS: Intervention articles addressing the year-end resident clinic handoff were identified in a targeted literature search. These articles were reviewed and abstracted to summarize the current literature. On the basis of these reviews and consensus expert opinion, recommendations to improve year-end clinic handoffs were developed. RESULTS: Of 23 identified articles, 10 intervention articles in the fields of internal medicine, internal medicine-pediatrics, psychiatry, and family medicine were ultimately included...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334564/data-driven-implementation-of-alarm-reduction-interventions-in-a-cardiovascular-surgical-icu
#18
Sharon H Allan, Peter A Doyle, Adam Sapirstein, Maria Cvach
BACKGROUND: Alarm fatigue in the ICU setting has been well documented in the literature. The ICU's high-intensity environment requires staff's vigilant attention, and distraction from false and non-actionable alarms pulls staff away from important tasks, creates dissatisfaction, and is a potential patient safety risk if alarms are missed or ignored. This project was intended to improve patient safety by optimizing alarm systems in a cardiovascular surgical intensive care unit (CVSICU)...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334563/quality-improvement-initiatives-lead-to-reduction-in-nulliparous-term-singleton-vertex-cesarean-delivery-rate
#19
Mary A Vadnais, Michele R Hacker, Neel T Shah, JoAnn Jordan, Anna M Modest, Molly Siegel, Toni H Golen
BACKGROUND: The nulliparous term singleton vertex (NTSV) cesarean delivery rate has been recognized as a meaningful benchmark. Variation in the NTSV cesarean delivery rate among hospitals and providers suggests many hospitals may be able to safely improve their rates. The NTSV cesarean delivery rate at the authors' institution was higher than state and national averages. This study was conducted to determine the influence of a set of quality improvement interventions on the NTSV cesarean delivery rate...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334562/leading-change-on-labor-and-delivery-reducing-nulliparous-term-singleton-vertex-ntsv-cesarean-rates
#20
EDITORIAL
Elliott K Main
No abstract text is available yet for this article.
February 2017: Joint Commission Journal on Quality and Patient Safety
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