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Frances C Cunningham, Sue Ferguson-Hill, Veronica Matthews, Ross Bailie
BACKGROUND: Assessment of the quality of primary health care health delivery systems is a vital part of continuous quality improvement (CQI) processes. The Systems Assessment Tool (SAT) was designed to support Indigenous PHC services in assessing and improving their health care systems. It was based on the Assessment of Chronic Illness Care scale, and on practical experience with applying systems assessments in quality improvement in Indigenous primary health care. We describe the development and application of the SAT, report on a survey to assess the utility of the SAT and review the use of the SAT in other CQI research programs...
October 18, 2016: BMC Health Services Research
Andrew A M Ibey, Derek Andrews, Barb Ferreira
The authors present a case in which a physical anomaly with an infusion pump resulted in an unforeseen fault that the nurse's attempts to resolve unknowingly exacerbated. This case study presents the first report in the literature to detail the difficulty in recreating a patient safety event using smart pump logs, support server continuous quality improvement (CQI) data, and the drug order entry system to elucidate the clinical scenario. A 75-year-old male patient presented to a major teaching hospital and was admitted to the intensive care unit (ICU) with a massive gastrointestinal bleed and myocardial infarction, then stabilized...
December 2016: Drug Saf Case Rep
Bruce Ramshaw, Brandie Forman, Eric Heidel, Jonathan Dean, Andrew Gamenthaler, Michael Fabian
Patients who undergo laparoscopic ventral hernia repair can have significant post-operative pain and discomfort from both somatic pain due to mesh fixation and visceral pain due to CO2 insufflation pressure. In an attempt to improve outcomes, a Clinical Quality Improvement (CQI) project was implemented by a multi-disciplinary hernia team. CQI tools were applied for consecutive patients who underwent laparoscopic ventral hernia repair from June 2012 through September 2015 (39 months). Initiatives for improved patient outcomes during this period included the administration of a transversus abdominis plane (TAP) block and/or an intra-operative block with long-acting local anesthetic first, and then a low pressure pneumoperitoneum (LPP) system was implemented later in the project...
October 6, 2016: Surgical Technology International
Gill Schierhout, Veronica Matthews, Christine Connors, Sandra Thompson, Ru Kwedza, Catherine Kennedy, Ross Bailie
BACKGROUND: Addressing evidence-practice gaps in primary care remains a significant public health challenge and is likely to require action at different levels of the health system. Whilst Continuous Quality Improvement (CQI) is associated with improvements in overall delivery, little is known about delivery of different types of care processes, and their relative improvement during CQI. METHODS: We used data from over 15,000 clinical audit records of clients with Type 2 diabetes collected as part of a wide-scale CQI program implemented between 2005 and 2014 in 162 Aboriginal and Torres Strait Islander health centres...
October 7, 2016: BMC Health Services Research
Sandra C Buttigieg, Dorothy Gauci, Prasanta Dey
Purpose The purpose of this paper is to present the application of logical framework analysis (LFA) for implementing continuous quality improvement (CQI) across multiple settings in a tertiary care hospital. Design/methodology/approach This study adopts a multiple case study approach. LFA is implemented within three diverse settings, namely, intensive care unit, surgical ward, and acute in-patient psychiatric ward. First, problem trees are developed in order to determine the root causes of quality issues, specific to the three settings...
October 10, 2016: Journal of Health Organization and Management
Michelle Hendriks, Judith Dahlhaus-Booij, Anne Marie Plass
OBJECTIVE: Clients' perspective on the quality of audiology care has not been investigated thoroughly. Research has focused primarily on satisfaction with, and limitations of hearing aids. We developed a Consumer Quality Index (CQI) questionnaire 'Audiology Care' to systematically assess client experiences with audiology care. DESIGN: The CQI Audiology Care was developed in three steps: (1) posing open-ended questions through e-mail (n = 14), (2) two small-scale surveys assessing psychometric properties of the questionnaire (n = 188) and importance of quality aspects (n = 118), and (3) a large-scale survey (n = 1793) assessing psychometric properties and discriminatory power of the questionnaire...
August 17, 2016: International Journal of Audiology
Dilip U Makhija, Surrey Walton, Juan P Mora, Mauricio Sanabria
♦ Background: There is little information regarding the financial burden of peritonitis and the economic impact of continuous quality improvement (CQI) programs in peritoneal dialysis (PD) patients. The objectives of this study were to measure the costs of peritonitis, and determine the net savings of a PD CQI program in Colombia. ♦ Methods: The Renal Therapy Services (RTS) network in Colombia, along with Coomeva EPS, provided healthcare resource utilization data for PD patients with and without peritonitis between January 2012 and December 2013...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Nelson Fijamo Mesquita, Renata Maculan, Luciana França Smith Maciel, Nathalia Alves, Rodirgues Rafaela DE Carvalho, Gabriel Miranda Moreira, José Camisão DE Souza
The aim of this study was to investigate possible relationships between morphometric characteristics of the bovine reproductive tract and measures of fertility, such as antral follicle counts (AFCs) and the number and quality of recovered cumulus oophorus complexes (COCs). First, the genital tracts of 360 abattoir Zebu/Holstein crossbred cows were studied. Rima vulvae length (RL), vulvar width (VW), ovarian size, pelvic fat, number of aspirated COCs, and AFCs were recorded. An index of COC quality (CQI) was established, which weighed overall gamete quality based on the IETS classification...
August 19, 2016: Journal of Reproduction and Development
I Zazpe, S Santiago, A Gea, M Ruiz-Canela, S Carlos, M Bes-Rastrollo, M A Martínez-González
BACKGROUND AND AIMS: Beyond the quantity of carbohydrate intake, further research is needed to know the relevance of carbohydrate quality following operational indices. No previous longitudinal study has assessed the association between an index for quality of dietary carbohydrate intake and the risk of cardiovascular disease (CVD). Here, we examined the association between a carbohydrate quality index (CQI) and the risk of CVD. METHODS AND RESULTS: We used a validated semi-quantitative 136-item food-frequency questionnaire (FFQ) in a prospective follow-up study of 17,424 middle-aged adults from Spain...
July 12, 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Simona Vecchi, Nera Agabiti, Susanna Mitrova, Laura Cacciani, Laura Amato, Marina Davoli, Anna Maria Bargagli
OBJECTIVES: we analysed evidence on effective interventions to improve the quality of care and management in patients with diabetes type 2. This review focuses particularly on audit and feedback intervention, targeted to healthcare providers, and continuous quality improvement (CQI) involving health professionals and health care systems, respectively. METHODS: we searched The Cochrane Library, PubMed, and EMBASE (search period: January 2005-December 2015) to identify systematic reviews (SR) and randomized controlled trials (RCTs) considering patients' outcomes and process measures as quality indicators in diabetes care...
March 2016: Epidemiologia e Prevenzione
Oroma B Nwanodi
Globally, preeclampsia-eclampsia (PE-E) is a major cause of puerperal intensive care unit admission, accounting for up to 10% of maternal deaths. PE-E primary prevention is possible. Antepartum low-dose aspirin prophylaxis, costing USD $10-24 can cut the incidence of PE-E in half. Antepartum low molecular weight heparin combined with low-dose aspirin prophylaxis can cut the incidence of early onset PE-E and fetuses that are small for their gestational age in half. Despite predictive antepartum models for PE-E prophylaxis, said prophylaxis is not routinely provided...
2016: Healthcare (Basel, Switzerland)
N Hubner, J C Langer, S Kives, L M Allen
STUDY OBJECTIVE: The aim of this study is to document the change in ovarian conservation rate after ovarian torsion (OT) as a result of continuous quality improvement (CQI) measures, and to determine factors contributing to this outcome. DESIGN: A retrospective, uncontrolled before-and-after study. SETTING: An academic children's hospital. PARTICIPANTS: Females <18 years with surgically confirmed OT from April 1, 1988 to October 15, 2013; excluding cases from 2003 (intervention period)...
July 2, 2016: Journal of Pediatric and Adolescent Gynecology
Lynne M Connelly
No abstract text is available yet for this article.
March 2016: Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses
Melanie E Gibson-Helm, Alice R Rumbold, Helena J Teede, Sanjeeva Ranasinha, Ross S Bailie, Jacqueline A Boyle
BACKGROUND: Australian Aboriginal and Torres Strait Islander (Indigenous) women are at greater risk of adverse pregnancy outcomes than non-Indigenous women. Pregnancy care has a key role in identifying and addressing modifiable risk factors that contribute to adverse outcomes. We investigated whether participation in a continuous quality improvement (CQI) initiative was associated with increases in provision of recommended pregnancy care by primary health care centers (PHCs) in predominantly Indigenous communities, and whether provision of care was associated with organizational systems or characteristics...
2016: BMC Pregnancy and Childbirth
Travis R Denton, Lisa B E Shields, Michael Hahl, Casey Maudlin, Mark Bassett, Aaron C Spalding
Safety concerns may arise from a lack of standardization and ambiguity during the treatment planning and delivery process in radiation therapy. A standardized target and organ-at-risk naming convention in radiation therapy was developed by a task force comprised of several Radiation Oncology Societies. We present a nested-survey approach in a community setting to determine the methodology for radiation oncology departments to standardize their practice. Our Institution's continuous quality improvement (CQI) committee recognized that, due to growth from one to three centers, significant variability existed within plan parameters specific to patients' treatment...
2016: Journal of Applied Clinical Medical Physics
Nikki Percival, Lynette O'Donoghue, Vivian Lin, Komla Tsey, Ross Stewart Bailie
Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years...
2016: Frontiers in Public Health
Nidhi M Bhatnagar, Shital Soni, Maitrey Gajjar, Mamta Shah, Sangita Shah, Vaidehi Patel
BACKGROUND: Performance monitoring is an important tool which can be used for setting priorities for process improvement. At our centre, we have been monitoring every step in the processes, right from inventory of consumables (both critical and routine) to number of donors reactive for TTI. We conducted a study to measure the impact of monitoring Performance Indicators and how it could be used as a tool for Continuous Quality Improvement (CQI). MATERIALS AND METHODS: The present study was a retrospective study where the performance indicator (PI) data of blood bank was analyzed for over four years...
January 2016: Asian Journal of Transfusion Science
Zainab Samad, Stephanie Minter, Alicia Armour, Amanda Tinnemore, Joseph A Sivak, Brenda Sedberry, Karen Strub, Seanna M Horan, J Kevin Harrison, Joseph Kisslo, Pamela S Douglas, Eric J Velazquez
BACKGROUND: The management of aortic stenosis rests on accurate echocardiographic diagnosis. Hence, it was chosen as a test case to examine the utility of continuous quality improvement (CQI) approaches to increase echocardiographic data accuracy and reliability. A novel, multistep CQI program was designed and prospectively used to investigate whether it could minimize the difference in aortic valve mean gradients reported by echocardiography when compared with cardiac catheterization...
March 2016: Circulation. Cardiovascular Imaging
B K Poulose, S Roll, J W Murphy, B D Matthews, B Todd Heniford, G Voeller, W W Hope, M I Goldblatt, G L Adrales, M J Rosen
PURPOSE: Wide variation in care and costs exists regarding the management of abdominal wall hernias, with unproven benefit for many therapies. This work establishes a specialty society-based solution to improve the quality and value of care delivered to hernia patients during routine clinical management on a national scale. METHODS: The Americas Hernia Society Quality Task Force was charged by the Americas Hernia Society leadership to develop an initiative that utilizes the concepts of continuous quality improvement (CQI)...
April 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Bernard Candas, Gilles Jobin, Catherine Dubé, Mario Tousignant, Anis Ben Abdeljelil, Sonya Grenier, Marie-Pierre Gagnon
BACKGROUND AND AIM: Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. METHODS: We developed a search strategy adapted to 15 databases...
February 2016: Endoscopy International Open
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