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"Audit and feedback"

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https://www.readbyqxmd.com/read/28719425/organizational-contributors-to-the-variation-in-red-blood-cell-transfusion-practices-in-cardiac-surgery-survey-results-from-the-state-of-michigan
#1
Anton Camaj, Darin B Zahuranec, Gaetano Paone, Barbara R Benedetti, Warren D Behr, Marc A Zimmerman, Min Zhang, Robert S Kramer, Jason Penn, Patricia F Theurer, Theron A Paugh, Milo Engoren, Alphonse DeLucia, Richard L Prager, Donald S Likosky
BACKGROUND: While large volumes of red blood cell transfusions are given to preserve life for cardiac surgical patients, indications for lower volume transfusions (1-2 units) are less well understood. We evaluated the relationship between center-level organizational blood management practices and center-level variability in low volume transfusion rates. METHODS: All 33 nonfederal, Michigan cardiac surgical programs were surveyed about their blood management practices for isolated, nonemergent coronary bypass procedures, including: (1) presence and structure of a patient blood management program, (2) policies and procedures, and (3) audit and feedback practices...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28708755/computed-tomography-coronary-angiography-with-heart-rate-control-premedication-a-best-practice-implementation-project
#2
Gordon Thomas Waterland Mander
BACKGROUND: Computed tomography coronary angiography patient preparation with heart rate control premedication is employed in departments across Australia. However, the methods of administration vary widely between institutions and do not always follow best practice. OBJECTIVES: This aim of the study was to identify and promote best practice in the administration of heart rate premedication in computed tomography coronary angiography at a regional hospital in Australia...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28705208/testing-feedback-message-framing-and-comparators-to-address-prescribing-of-high-risk-medications-in-nursing-homes-protocol-for-a-pragmatic-factorial-cluster-randomized-trial
#3
Noah M Ivers, Laura Desveaux, Justin Presseau, Catherine Reis, Holly O Witteman, Monica K Taljaard, Nicola McCleary, Kednapa Thavorn, Jeremy M Grimshaw
BACKGROUND: Audit and feedback (AF) interventions that leverage routine administrative data offer a scalable and relatively low-cost method to improve processes of care. AF interventions are usually designed to highlight discrepancies between desired and actual performance and to encourage recipients to act to address such discrepancies. Comparing to a regional average is a common approach, but more recipients would have a discrepancy if compared to a higher-than-average level of performance...
July 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28703927/reducing-the-primary-cesarean-birth-rate-a-quality-improvement-project
#4
Julie A Javernick, Amy Dempsey
INTRODUCTION: Research continues to support vaginal birth as the safest mode of childbirth, but despite this, cesarean birth has become the most common surgical procedure performed on women. The rate has increased 500% since the 1970s without a corresponding improvement in maternal or neonatal outcomes. A Colorado community hospital recognized that its primary cesarean birth rate was higher than national and state benchmark levels. To reduce this rate, the hospital collaborated with its largest maternity care provider group to implement a select number of physiologic birth practices and measure improvement in outcomes...
July 13, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28699944/improving-the-readability-of-pediatric-hospital-medicine-discharge-instructions
#5
Ndidi Unaka, Angela Statile, Karen Jerardi, Devesh Dahale, Joan Morris, Brianna Liberio, Ashley Jenkins, Blair Simpson, Randi Mullaney, Jodi Kelley, Michelle Durling, Jennifer Shafer, Patrick Brady
BACKGROUND: Readable discharge instructions may help caregivers understand and implement care plans following hospitalization. Many caregivers of hospitalized children, however, have limited literacy. We aimed to increase the percentage of discharge instructions written at 7th grade level or lower for hospital medicine patients from 13% to 80% in 6 months. METHODS: Quality improvement efforts targeted a 42-bed unit at the community satellite of our large, urban academic hospital...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28693330/reducing-unnecessary-blood-chemistry-testing-in-the-emergency-department-implementation-of-choosing-wisely
#6
Arjun K Venkatesh, David Hajdasz, Craig Rothenberg, Meir Dashevsky, Vivek Parwani, Mark Sevilla, Marc Shapiro, Ian Schwartz
Point of care (POC) laboratory testing is used to improve emergency department (ED) throughput but often overuses resources by duplicating formal laboratory testing. This study sought to evaluate the effect of a multimodal intervention on duplicate chemistry testing. This pre-post analysis included all visits to 2 urban EDs between June 2014 and June 2016. The multimodal intervention including provider education, signage, electronic health record redesign, and audit and feedback focused on reducing duplicate chemistry testing...
February 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28691323/knowledge-translation-interventions-to-sustain-direct-care-provider-behaviour-change-in-long-term-care-a-process-evaluation
#7
Susan E Slaughter, Erin Bampton, Daniel F Erin, Carla Ickert, Adrian S Wagg, C Allyson Jones, Corinne Schalm, Carole A Estabrooks
RATIONALE, AIMS, AND OBJECTIVES: Process evaluation can be used to understand the factors influencing the impact of knowledge translation (KT) interventions. The aim of this mixed methods process evaluation was to evaluate the processes and perceived outcomes of eight KT interventions that were used with healthcare aides (HCAs) to introduce a mobility innovation into their daily care practices. The study examined the perceived effectiveness of various KT interventions in sustaining daily performance of the sit-to-stand mobility innovation by HCAs with residents in long-term care...
July 10, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28673310/the-evaluation-of-enhanced-feedback-interventions-to-reduce-unnecessary-blood-transfusions-affinitie-protocol-for-two-linked-cluster-randomised-factorial-controlled-trials
#8
Suzanne Hartley, Robbie Foy, Rebecca E A Walwyn, Robert Cicero, Amanda J Farrin, Jill J Francis, Fabiana Lorencatto, Natalie J Gould, John Grant-Casey, Jeremy M Grimshaw, Liz Glidewell, Susan Michie, Stephen Morris, Simon J Stanworth
BACKGROUND: Blood for transfusion is a frequently used clinical intervention, and is also a costly and limited resource with risks. Many transfusions are given to stable and non-bleeding patients despite no clear evidence of benefit from clinical studies. Audit and feedback (A&F) is widely used to improve the quality of healthcare, including appropriate use of blood. However, its effects are often inconsistent, indicating the need for coordinated research including more head-to-head trials comparing different ways of delivering feedback...
July 3, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28652480/influences-on-the-start-selection-and-duration-of-treatment-with-antibiotics-in-long-term-care-facilities
#9
Nick Daneman, Michael A Campitelli, Vasily Giannakeas, Andrew M Morris, Chaim M Bell, Colleen J Maxwell, Lianne Jeffs, Peter C Austin, Susan E Bronskill
BACKGROUND: Understanding the extent to which current antibiotic prescribing behaviour is influenced by clinicians' historical patterns of practice will help target interventions to optimize antibiotic use in long-term care. Our objective was to evaluate whether clinicians' historical prescribing behaviours influence the start, prolongation and class selection for treatment with antibiotics in residents of long-term care facilities. METHODS: We conducted a retrospective cohort study of all physicians who prescribed to residents in long-term care facilities in Ontario between Jan...
June 26, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28618147/feedback-preferences-of-patients-professionals-and-health-insurers-in-integrated-head-and-neck-cancer-care
#10
Lydia F J van Overveld, Robert P Takes, Thomas W Vijn, Jozé C C Braspenning, Jan P de Boer, John J A Brouns, Rolf J Bun, Boukje A C van Dijk, Judith A W F Dortmans, Emilie A C Dronkers, Robert J J van Es, Frank J P Hoebers, Arvid Kropveld, Johannes A Langendijk, Ton P M Langeveld, Sjoukje F Oosting, Hendrik P Verschuur, Jan G A M de Visscher, Stijn van Weert, Matthias A W Merkx, Ludi E Smeele, Rosella P M G Hermens
BACKGROUND: Audit and feedback on professional practice and health care outcomes are the most often used interventions to change behaviour of professionals and improve quality of health care. However, limited information is available regarding preferred feedback for patients, professionals and health insurers. OBJECTIVE: Investigate the (differences in) preferences of receiving feedback between stakeholders, using the Dutch Head and Neck Audit as an example. METHODS: A total of 37 patients, medical specialists, allied health professionals and health insurers were interviewed using semi-structured interviews...
June 15, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28607686/improving-care-for-patients-with-or-at-risk-for-chronic-kidney-disease-using-electronic-medical-record-interventions-a-pragmatic-cluster-randomized-trial-protocol
#11
Danielle M Nash, Noah M Ivers, Jacqueline Young, R Liisa Jaakkimainen, Amit X Garg, Karen Tu
BACKGROUND: Many patients with or at risk for chronic kidney disease (CKD) in the primary care setting are not receiving recommended care. OBJECTIVE: The objective of this study is to determine whether a multifaceted, low-cost intervention compared with usual care improves the care of patients with or at risk for CKD in the primary care setting. DESIGN: A pragmatic cluster-randomized trial, with an embedded qualitative process evaluation, will be conducted...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28605452/optimizing-preoperative-prophylaxis-in-patients-with-reported-%C3%AE-lactam-allergy-a-novel-extension-of-antimicrobial-stewardship
#12
Alon Vaisman, Janine McCready, Sandy Hicks, Jeff Powis
Background: Use of alternative second-line antibiotics is associated with adverse events in patients reporting β-lactam allergy. In the perioperative setting, we hypothesized that structured allergy histories, without the use of skin testing, can reduce alternative prophylactic antibiotic use. Objectives: Assess the impact of structured allergy histories on patients with self-reported β-lactam allergy (SRBA) undergoing elective surgical procedures. Methods: Structured allergy histories were performed by a pharmacist and reviewed with an infectious diseases physician...
June 10, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28602031/audit-and-feedback-using-the-robson-classification-to-reduce-caesarean-section-rates-a-systematic-review
#13
Adeline Adwoa Boatin, Fiona Cullinane, Maria Regina Torloni, Ana Pilar Betrán
BACKGROUND: In most regions worldwide caesarean section (CS) rates are increasing. In these settings, new strategies are needed to reduce CS rates. OBJECTIVES: To identify, critically appraise and synthesize studies using the Robson classification as a system to categorise and analyse data in clinical audit cycles to reduce CS rates. SEARCH STRATEGY: Medline, Embase, CINAHL and LILACS were searched from 2001-2016. SELECTION CRITERIA: Studies reporting use of the Robson classification to categorise and analyse data in clinical audit cycles to reduce CS rates...
June 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28583301/the-toronto-thromboprophylaxis-patient-safety-initiative-topps-a-cluster-randomised-trial
#14
Artemis Diamantouros, Alex Kiss, Tina Papastavros, David U, Merrick Zwarenstein, William H Geerts
BACKGROUND: Although venous thromboembolism (VTE) is one of the most common and most preventable complications of hospital stay, review of the literature demonstrates large evidence-care gaps for VTE prevention. OBJECTIVES: This study aimed to determine if a multi-component quality improvement (QI) strategy, including the support of hospital leadership, use of order sets, audit and feedback, and active pharmacy involvement, could increase the use of appropriate thromboprophylaxis in patients hospitalized for hip fracture surgery (HFS), major general surgery (MGS) and acute medical illness (MED)...
May 27, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28581341/improving-cardiometabolic-monitoring-of-children-on-antipsychotics
#15
Robert O Cotes, Nisha K Fernandes, Jennifer L McLaren, Gregory J McHugo, Stephen J Bartels, Mary F Brunette
OBJECTIVES: This study evaluated changes in cardiometabolic monitoring for children and adolescents who were prescribed an antipsychotic medication in a state mental health system before and after a quality improvement intervention. METHODS: The intervention included education for prescribers, auditing on metabolic monitoring, and feedback to mental health center leaders regarding their monitoring. Research staff extracted yearly data on cardiometabolic monitoring from randomly selected community mental health center records before and after the intervention...
June 5, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28580878/optimizing-adherence-to-advice-from-antimicrobial-stewardship-audit-and-feedback-rounds
#16
Matthew D M Rawlins, Frank M Sanfilippo, Paul R Ingram, Duncan G J McLellan, Colin Crawford, Luca D'Orsogna, John Dyer
We examined adherence to antimicrobial stewardship prospective audit and feedback rounds in a rehabilitation service compared with the remainder of the acute hospital, and explored the reasons for this. Between October 2014 and December 2015, we retrospectively assessed the rate of non-adherence to advice from antimicrobial stewardship prospective audit and feedback rounds between the rehabilitation service and the acute hospital, along with the source of the patient referral. Compared with the rehabilitation service, acute hospital medical staff were almost twice as likely to not adhere to advice provided on antimicrobial stewardship prospective audit and feedback rounds (13...
June 5, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28571589/computer-assisted-antimicrobial-recommendations-for-optimal-therapy-analysis-of-prescribing-errors-in-an-antimicrobial-stewardship-trial
#17
David N Schwartz, Kevin W McConeghy, Rosie D Lyles, Ulysses Wu, Robert C Glowacki, Gail S Itokazu, Piotr Kieszkowski, Yingxu Xiang, Bala Hota, Robert A Weinstein
Clinician education and prospective audit and feedback interventions, deployed separately and concurrently, did not reduce antimicrobial use errors or rates compared to a control group of general medicine inpatients at our public hospital. Additional research is needed to define the optimal scope and intensity of hospital antimicrobial stewardship interventions. Infect Control Hosp Epidemiol 2017;38:857-859.
July 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28566070/reducing-cardiovascular-disease-risk-in-diabetes-a-randomised-controlled-trial-of-a-quality-improvement-initiative
#18
Santhi Chalasani, David P Peiris, Tim Usherwood, Julie Redfern, Bruce C Neal, David R Sullivan, Stephen Colagiuri, Nicholas A Zwar, Qiang Li, Anushka Patel
OBJECTIVES: To describe the management of cardiovascular disease (CVD) risk in Australian patients with diabetes; to compare the effectiveness of a quality improvement initiative for people with and without diabetes. RESEARCH DESIGN AND METHODS: Subgroup analyses of patients with and without diabetes participating in a cluster randomised trial. SETTING AND PARTICIPANTS: Indigenous people (≥ 35 years old) and non-Indigenous people (≥ 45 years old) who had attended one of 60 Australian primary health care services at least three times during the preceding 24 months and at least once during the past 6 months...
June 5, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28562638/every-antibiotic-every-day-maximizing-the-impact-of-prospective-audit-and-feedback-on-total-antibiotic-use
#19
Tonya J Campbell, Melissa Decloe, Suzanne Gill, Grace Ho, Janine McCready, Jeff Powis
BACKGROUND: The success of antimicrobial stewardship is dependent on how often it is completed and which antimicrobials are targeted. We evaluated the impact of an antimicrobial stewardship program (ASP) in three non-ICU settings where all systemic antibiotics, regardless of spectrum, were targeted on the first weekday after initiation. METHODS: Prospective audit and feedback (PAAF) was initiated on the surgical, respiratory, and medical wards of a community hospital on July 1, 2010, October 1, 2010, and April 1, 2012, respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28545535/electronic-audit-and-feedback-intervention-with-action-implementation-toolbox-to-improve-pain-management-in-intensive-care-protocol-for-a-laboratory-experiment-and-cluster-randomised-trial
#20
Wouter T Gude, Marie-José Roos-Blom, Sabine N van der Veer, Evert de Jonge, Niels Peek, Dave A Dongelmans, Nicolette F de Keizer
BACKGROUND: Audit and feedback is often used as a strategy to improve quality of care, however, its effects are variable and often marginal. In order to learn how to design and deliver effective feedback, we need to understand their mechanisms of action. This theory-informed study will investigate how electronic audit and feedback affects improvement intentions (i.e. information-intention gap), and whether an action implementation toolbox with suggested actions and materials helps translating those intentions into action (i...
May 25, 2017: Implementation Science: IS
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