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Clinical audit tool

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https://www.readbyqxmd.com/read/28424055/how-participation-in-surgical-mortality-audit-impacts-surgical-practice
#1
Chi-Wai Lui, Frances M Boyle, Arkadiusz Peter Wysocki, Peter Baker, Alisha D'Souza, Sonya Faint, Therese Rey-Conde, John B North
BACKGROUND: Surgical mortality audit is an important tool for quality assurance and professional development but little is known about the impact of such activity on professional practice at the individual surgeon level. This paper reports the findings of a survey conducted with a self-selected cohort of surgeons in Queensland, Australia, on their experience of participating in the audit and its impact on their professional practice, as well as implications for hospital systems. METHODS: The study used a descriptive cross-sectional survey design...
April 19, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28423747/establishment-of-requirements-and-methodology-for-the-development-and-implementation-of-greymatters-a-memory-clinic-information-system
#2
Archana Tapuria, Matt Evans, Vasa Curcin, Tony Austin, Nathan Lea, Dipak Kalra
INTRODUCTION: The aim of the paper is to establish the requirements and methodology for the development process of GreyMatters, a memory clinic system, outlining the conceptual, practical, technical and ethical challenges, and the experiences of capturing clinical and research oriented data along with the implementation of the system. METHODS: The methodology for development of the information system involved phases of requirements gathering, modeling and prototype creation, and 'bench testing' the prototype with experts...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28412135/moving-beyond-quality-control-in-diagnostic-radiology-and-the-role-of-the-clinically-qualified-medical-physicist
#3
REVIEW
H Delis, K Christaki, B Healy, G Loreti, G L Poli, P Toroi, A Meghzifene
Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality...
April 12, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28402908/current-treatment-trends-and-the-need-for-better-predictive-tools-in-the-management-of-ductal-carcinoma-in-situ-of-the-breast
#4
REVIEW
Carlos Martínez-Pérez, Arran K Turnbull, Gregory E Ekatah, Laura M Arthur, Andrew H Sims, Jeremy S Thomas, J Michael Dixon
Ductal carcinoma in situ (DCIS) of the breast represents a group of heterogeneous non-invasive lesions the incidence of which has risen dramatically since the advent of mammography screening. In this review we summarise current treatment trends and up-to-date results from clinical trials studying surgery and adjuvant therapy alternatives, including the recent consensus on excision margin width and its role in decision-making for post-excision radiotherapy. The main challenge in the clinical management of DCIS continues to be the tailoring of treatment to individual risk, in order to avoid the over-treatment of low-risk lesions or under-treatment of DCIS with higher risk of recurring or progressing into invasion...
March 31, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28398988/protected-mealtimes-for-adults-with-cancer-in-a-hematology-oncology-setting-an-evidence-based-implementation-project
#5
Benazir Naseer, Solano S G Tan, Seri S Ramli, Emily Ang
BACKGROUND: Patients with cancer are often at risk or suffer from some form of malnutrition, which could be attributed to their disease progression or the adverse effects of cancer treatment. Protected mealtime and offering assistance during mealtime may not improve their nutritional status but would allow them to enjoy their meal and improve patient satisfaction. OBJECTIVES: The aim of this project was to promote best practice in protecting mealtimes in hematology-oncology patients...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28395369/antibiotics-prescriptions-in-the-neonatal-intensive-care-unit-how-to-overcome-everyday-challenges
#6
D Donà, E Mozzo, V Mardegan, U Trafojer, P Lago, S Salvadori, E Baraldi, C Giaquinto
Antimicrobial prescriptions in neonatal intensive care units (NICUs) represent a point of concern for the emergence of MDROs and for morbidity associated with prolonged antibiotic exposure (e.g., invasive candidiasis, necrotizing enterocolitis, and late-onset sepsis). Antimicrobial stewardship programs (ASPs) have shown to be a valuable tool for the prevention of resistance with the goals of optimizing clinical outcomes while decreasing unnecessary prescribing. The most frequent ASP strategies include the correct collection and interpretation of microbiological specimens, prescription of the narrowest-spectrum antibiotic appropriate for a particular case, and de-escalation or discontinuation of therapy in defined situations...
April 10, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28393064/exploring-systems-that-support-good-clinical-care-in-indigenous-primary-health-care-services-a-retrospective-analysis-of-longitudinal-systems-assessment-tool-data-from-high-improving-services
#7
Cindy Woods, Karen Carlisle, Sarah Larkins, Sandra Claire Thompson, Komla Tsey, Veronica Matthews, Ross Bailie
BACKGROUND: Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28371469/improving-emergency-department-medical-clinical-handover-barriers-at-the-bedside
#8
Gerrard Oren Marmor, Michael Yonghong Li
OBJECTIVE: The present paper describes our experience of developing and piloting a best practice model of medical clinical handover. Secondary aims were to improve reliability of communication, identify negative effects on patient care and assess staff adherence and acceptance of the process. METHODS: We described existing handover practice. We designed and implemented a process incorporating bedside handover, the Identification, Situation, Background, Assessment, Requirements and Requests (ISBAR) tool and handover documentation...
March 29, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28370624/developing-a-risk-stratification-tool-for-audit-of-outcome-after-surgery-for-head-and-neck-squamous-cell-carcinoma
#9
David F Tighe, Alan J Thomas, Isabel Sassoon, Robin Kinsman, Mark McGurk
BACKGROUND: Patients treated surgically for head and neck squamous cell carcinoma (HNSCC) represent a heterogeneous group. Adjusting for patient case mix and complexity of surgery is essential if reporting outcomes represent surgical performance and quality of care. METHODS: A case note audit totaling 1075 patients receiving 1218 operations done for HNSCC in 4 cancer networks was completed. Logistic regression, decision tree analysis, an artificial neural network, and Naïve Bayes Classifier were used to adjust for patient case-mix using pertinent preoperative variables...
March 29, 2017: Head & Neck
https://www.readbyqxmd.com/read/28365234/chart-stimulated-recall-as-a-learning-tool-for-improving-radiology-residents-reports
#10
Naila Nadeem, Abdul Mueed Zafar, Sonia Haider, Rukhsana W Zuberi, Muhammad Nadeem Ahmad, Vijayanadh Ojili
RATIONALE AND OBJECTIVES: Workplace-based assessments gauge the highest tier of clinical competence. Chart-stimulated recall (CSR) is a workplace-based assessment method that complements chart audit with an interview based on the residents' notes. It allows evaluation of the residents' knowledge and heuristics while providing opportunities for feedback and self-reflection. We evaluated the utility of CSR for improving the radiology residents' reporting skills. MATERIALS AND METHODS: Residents in each year of training were randomly assigned to an intervention group (n = 12) or a control group (n = 13)...
March 29, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28355621/use-of-pre-travel-vaccine-preventable-disease-serology-as-a-screening-tool-to-identify-patients-in-need-of-pre-travel-vaccination-a-retrospective-audit
#11
David P Turner, Sarah L McGuinness, Jonathan Cohen, Lynette J Waring, Karin Leder
Background: Vaccination is a safe and effective public health intervention that not only protects individual travellers from vaccine-preventable diseases (VPDs), but prevents them from becoming a source of disease in their destination and on their return. Obtaining an accurate vaccination history from travellers during a pre-travel review can be difficult; serology may be used to identify patients who are non-immune to specific diseases in order to guide vaccination requirements. Clinically relevant data about the usefulness of serology in this setting are lacking...
May 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28306586/voice-outcomes-post-total-laryngectomy
#12
Anne Hurren, Nick Miller
PURPOSE OF REVIEW: A consensus and body of robust evidence has developed regarding optimal laryngeal voice outcome measures. This contrasts with a lack of clarity for equivalent assessments in alaryngeal voice. Addressing this situation would enable clinicians to select the best tools currently available to facilitate research, audit and clinical practice. This is important because of the limited knowledge regarding the optimal surgical or reconstruction techniques and rehabilitation regimes for the laryngectomy population...
March 16, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28306417/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#13
Paul M Brennan, Angelos G Kolias, Alexis J Joannides, Jonathan Shapey, Hani J Marcus, Barbara A Gregson, Patrick J Grover, Peter J Hutchinson, Ian C Coulter
OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28292267/assignment-of-adverse-event-indexing-terms-in-randomized-clinical-trials-involving-spinal-manipulative-therapy-an-audit-of-records-in-medline-and-embase-databases
#14
Lindsay M Gorrell, Roger M Engel, Reidar P Lystad, Benjamin T Brown
BACKGROUND: Reporting of adverse events in randomized clinical trials (RCTs) is encouraged by the authors of The Consolidated Standards of Reporting Trials (CONSORT) statement. With robust methodological design and adequate reporting, RCTs have the potential to provide useful evidence on the incidence of adverse events associated with spinal manipulative therapy (SMT). During a previous investigation, it became apparent that comprehensive search strategies combining text words with indexing terms was not sufficiently sensitive for retrieving records that were known to contain reports on adverse events...
March 14, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28283488/quality-of-clinical-practice-guidelines-in-delirium-a-systematic-appraisal
#15
Shirley H Bush, Katie L Marchington, Meera Agar, Daniel H J Davis, Lindsey Sikora, Tammy W Y Tsang
OBJECTIVE: To determine the accessibility and currency of delirium guidelines, guideline summary papers and evaluation studies, and critically appraise guideline quality. DESIGN: Systematic literature search for formal guidelines (in English or French) with focus on delirium assessment and/or management in adults (≥18 years), guideline summary papers and evaluation studies.Full appraisal of delirium guidelines published between 2008 and 2013 and obtaining a 'Rigour of Development' domain screening score cut-off of >40% using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument...
March 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28281044/using-patient-reported-outcome-measures-for-quality-improvement-in-clinical-genetics-an-exploratory-study
#16
A Costal Tirado, A M McDermott, C Thomas, D Ferrick, J Harris, A Edwards, Marion McAllister
International advocacy of patient-centred healthcare delivery has led to emphasis on the (re)design and evaluation of healthcare processes and outcomes from a patient perspective. Patient-reported outcome measures (PROMs) have significant potential to inform such attempts. However there is limited understanding of the processes by which this can be achieved. This exploratory study followed attempts to utilise two different PROMs measures to support service quality improvement in clinical genetics. PROMs used were the Genetic Counseling Outcome Scale (GCOS-24), a well-validated clinical genetics-specific PROM and Euroqol (EQ-5D), a generic PROM favoured by the UK National Institute for Health and Excellence (NICE)...
March 9, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28267948/a-clinical-audit-to-assess-the-efficacy-of-the-coolsense%C3%A2-pain-numbing-applicator-for-intravenous-cannulation-in-children
#17
P G Ragg, G Cahoon, A Yeo, G Chalkiadis
The Coolsense® device is a topical applicator that is used to anaesthetise the skin before a painful procedure. It is a handheld device with a temperature-controlled head that acts on application, without chemicals, to cool and anaesthetise the site of injection. This prospective observational audit of 100 children and adolescents aged six to 18 years studied the analgesic efficacy and patient and carer satisfaction rating of the device during intravenous cannulation and complications arising from its use...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28255139/effectiveness-of-selective-risk-based-screening-for-gestational-diabetes-gdm-in-malaysia-a-retrospective-cohort-study-based-on-the-national-obstetric-registry-nor-of-malaysia
#18
G Muniswaran, S A Soelar, S D Karalasingam, M A Bujang, R Jeganathan, H Suharjono
INTRODUCTION: Gestational diabetes (GDM) has significant maternal and foetal implications. screening allows active interventions which significantly improves pregnancy outcomes. Despite World Health Organization (WHO), FIGO and National Institute of clinical Excellence (NIcE) recommendations for universal screening especially among high risk population; Malaysia currently adopts a selective risk based screening for GDM. OBJECTIVE: the objective is to audit the effectiveness of the current practice of selective risk based screening in detection of GDM in Malaysia...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28241880/development-of-the-major-trauma-case-review-tool
#19
Kate Curtis, Rebecca Mitchell, Amy McCarthy, Kellie Wilson, Connie Van, Belinda Kennedy, Gary Tall, Andrew Holland, Kim Foster, Stuart Dickinson, Henry T Stelfox
BACKGROUND: As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-review process that includes trauma system safety and human factors. There is no published, evidence-informed standardised tool that considers these factors for use in adult or paediatric trauma case peer-review...
February 28, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28240996/impact-of-the-opioid-safety-initiative-on-opioid-related-prescribing-in-veterans
#20
Lewei A Lin, Amy S B Bohnert, Robert D Kerns, Michael A Clay, Dara Ganoczy, Mark A Ilgen
The Veterans Health Administration (VHA) designed the Opioid Safety Initiative (OSI) to help decrease opioid prescribing practices associated with adverse outcomes. Key components included disseminating a dashboard tool that aggregates electronic medical record data to audit real-time opioid-related prescribing and identifying a clinical leader at each facility to implement the tool and promote safer prescribing. This study examines changes associated with OSI implementation in October 2013 among all adult VHA patients who filled outpatient opioid prescriptions...
May 2017: Pain
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