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"Audit and feedback"

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https://www.readbyqxmd.com/read/29152678/first-year-results-of-an-antibiotic-stewardship-program-in-a-greek-tertiary-care-hospital
#1
K Chrysou, O Zarkotou, S Kalofolia, P Papagiannakopoulou, G Chrysos, K Themeli-Digalaki, A Tsakris, S Pournaras
The aim of this study was to investigate the effect of the implementation of an antibiotic stewardship program (ASP) on antibiotic consumption in our 428-bed hospital. The Infection Control Committee implemented an ASP beginning in January 2016, aiming to reduce inappropriate antibiotic use through improved prescribing practices. The ASP included both pre-authorization and prospective audit and feedback strategies. We collected pharmacy and hospital data for the years 2015 (pre-intervention) and 2016 (post-intervention)...
November 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29146562/multi-method-laboratory-user-evaluation-of-an-actionable-clinical-performance-information-system-implications-for-usability-and-patient-safety
#2
Benjamin Brown, Panos Balatsoukas, Richard Williams, Matthew Sperrin, Iain Buchan
INTRODUCTION: Electronic audit and feedback (e-A&F) systems are used worldwide for care quality improvement. They measure health professionals' performance against clinical guidelines, and some systems suggest improvement actions. However, little is known about optimal interface designs for e-A&F, in particular how to present suggested actions for improvement. We developed a novel theory-informed system for primary care (the Performance Improvement plaN GeneratoR; PINGR) that covers the four principal interface components: clinical performance summaries; patient lists; detailed patient-level information; and suggested actions...
November 13, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29134582/long-term-efficacy-of-comprehensive-multidisciplinary-antibiotic-stewardship-programs-centered-on-weekly-prospective-audit-and-feedback
#3
Takeshi Kimura, Atsushi Uda, Tomoyuki Sakaue, Kazuhiko Yamashita, Tatsuya Nishioka, Sho Nishimura, Kei Ebisawa, Manabu Nagata, Goh Ohji, Tatsuya Nakamura, Chihiro Koike, Mari Kusuki, Takeshi Ioroi, Akira Mukai, Yasuhisa Abe, Hiroyuki Yoshida, Midori Hirai, Soichi Arakawa, Ikuko Yano, Kentaro Iwata, Issei Tokimatsu
OBJECTIVE: To evaluate the long-term effects of comprehensive antibiotic stewardship programs (ASPs) on antibiotic use, antimicrobial-resistant bacteria, and clinical outcomes. DESIGN: Before-after study. SETTING: National university hospital with 934 beds. INTERVENTION: Implementation in March 2010 of a comprehensive ASPs including, among other strategies, weekly prospective audit and feedback with multidisciplinary collaboration...
November 13, 2017: Infection
https://www.readbyqxmd.com/read/29128686/when-is-audit-and-feedback-effective-in-dementia-care-a-systematic-review
#4
REVIEW
Michael J Sykes, Jennifer McAnuff, Niina Kolehmainen
BACKGROUND: Evidence-based care for people with dementia is a priority for patients, carers and clinicians and a policy priority. There is evidence that people with dementia do not always receive such care. Audit and feedback, also known as clinical audit, is an extensively-used intervention to improve care. However, there is uncertainty about the best way to use it. OBJECTIVES: To investigate whether audit and feedback is effective for improving health professionals' care of people with dementia...
November 9, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29120292/survival-and-negotiation-narratives-of-severe-near-miss-neonatal-complications-of-syrian-women-in-lebanon
#5
Livia Wick
The World Health Organization has elaborated a maternal and neonatal near-miss reporting, audit and feedback system designed to improve the quality of care during and after childbirth. As part of a four-hospital comparative study in the Middle East, this article discusses the experiences of mothers whose newborns suffered from severe complications at birth in the Rafik Hariri University Hospital, the only public hospital in Beirut. Based on in-depth home interviews several weeks after childbirth, it aims to explore the experience of neonatal near-miss events through the mothers' birth narratives...
October 2017: Reproductive Health Matters
https://www.readbyqxmd.com/read/29117959/barriers-and-facilitators-to-provide-quality-tia-care-in-the-veterans-healthcare-administration
#6
Teresa M Damush, Edward J Miech, Jason J Sico, Michael S Phipps, Greg Arling, Jared Ferguson, Charles Austin, Laura Myers, Fitsum Baye, Cherie Luckhurst, Ava B Keating, Eileen Moran, Dawn M Bravata
OBJECTIVE: To identify key barriers and facilitators to the delivery of guideline-based care of patients with TIA in the national Veterans Health Administration (VHA). METHODS: We conducted a cross-sectional, observational study of 70 audiotaped interviews of multidisciplinary clinical staff involved in TIA care at 14 VHA hospitals. We de-identified and analyzed all transcribed interviews. We identified emergent themes and patterns of barriers to providing TIA care and of facilitators applied to overcome these barriers...
November 8, 2017: Neurology
https://www.readbyqxmd.com/read/29111416/evidence-that-a-regional-surgical-collaborative-can-transform-care-surgical-site-infection-prevention-practices-for-colectomy-in-michigan
#7
Joceline V Vu, Stacey D Collins, Elizabeth Seese, Samantha Hendren, Michael J Englesbe, Darrell A Campbell, Greta L Krapohl
BACKGROUND: Surgical site infections (SSI) after colectomy are associated with increased morbidity and health care use. Since 2012, the Michigan Surgical Quality Collaborative (MSQC) has promoted a "bundle" of care processes associated with lower SSI risk, using an audit-and-feedback system for adherence, face-to-face meetings, and support for quality improvement projects at participating hospitals. The purpose of this study was to determine whether practices changed over time. STUDY DESIGN: We previously found 6 processes of care independently associated with SSI in colectomy...
October 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29110667/a-complex-intervention-to-improve-implementation-of-world-health-organization-guidelines-for-diagnosis-of-severe-illness-in-low-income-settings-a-quasi-experimental-study-from-uganda
#8
Matthew J Cummings, Elijah Goldberg, Savio Mwaka, Olive Kabajaasi, Eric Vittinghoff, Adithya Cattamanchi, Achilles Katamba, Nathan Kenya-Mugisha, Shevin T Jacob, J Lucian Davis
BACKGROUND: To improve management of severely ill hospitalized patients in low-income settings, the World Health Organization (WHO) established a triage tool called "Quick Check" to provide clinicians with a rapid, standardized approach to identify patients with severe illness based on recognition of abnormal vital signs. Despite the availability of these guidelines, recognition of severe illness remains challenged in low-income settings, largely as a result of infrequent vital sign monitoring...
November 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29104769/does-audit-and-feedback-improve-the-adoption-of-recommended-practices-evidence-from-a-longitudinal-observational-study-of-an-emerging-clinical-network-in-kenya
#9
Susan Gachau, Philip Ayieko, David Gathara, Paul Mwaniki, Morris Ogero, Samuel Akech, Michuki Maina, Ambrose Agweyu, Jacqiue Oliwa, Thomas Julius, Lucas Malla, James Wafula, George Mbevi, Grace Irimu, Mike English
Background: Audit and feedback (A&F) is widely used in healthcare but there are few examples of how to deploy it at scale in low-income countries. Establishing the Clinical Information Network (CIN) in Kenya provided an opportunity to examine the effect of A&F delivered as part of a wider set of activities to promote paediatric guideline adherence. Methods: We analysed data collected from medical records on discharge for children aged 2-59 months from 14 Kenyan hospitals in the CIN...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29103637/deployment-of-a-touchless-ultraviolet-light-robot-for-terminal-room-disinfection-the-importance-of-audit-and-feedback
#10
Michele Fleming, Amie Patrick, Mark Gryskevicz, Nadia Masroor, Lisa Hassmer, Kevin Shimp, Kaila Cooper, Michelle Doll, Michael Stevens, Gonzalo Bearman
Touchless ultraviolet disinfection (UVD) devices effectively reduce the bioburden of epidemiologically relevant pathogens, including Clostridium difficile. During a 25-month implementation period, UVD devices were deployed facilitywide for the terminal disinfection of rooms that housed a patient who tested positive for C difficile. The deployment was performed with structured education, audit and feedback, and resulted in a multidisciplinary practice change that maximized the UVD capture rate from 20% to 100%...
November 3, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29101616/a-multifaceted-intervention-to-reduce-guideline-non-adherence-among-prescribing-physicians-in-dutch-hospitals
#11
Jacqueline M Bos, Stephanie Natsch, Patricia M L A van den Bemt, Johan L W Pot, J Elsbeth Nagtegaal, Andre Wieringa, Gert Jan van der Wilt, Peter A G M De Smet, Cornelis Kramers
Background Despite the potential of clinical practice guidelines to improve patient outcomes, adherence to guidelines by prescribers is inconsistent. Objective The aim of the study was to determine whether an approach of introducing an educational programme for prescribers in the hospital combined with audit and feedback by the hospital pharmacist reduces non-adherence of prescribing physicians to key pharmacotherapeutic guidelines. Setting This prospective intervention study with a before-after design evaluated patients at surgical, urological and orthopaedic wards...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29092694/reducing-antibiotic-prescribing-in-australian-general-practice-time-for-a-national-strategy
#12
REVIEW
Christopher B Del Mar, Anna Mae Scott, Paul P Glasziou, Tammy Hoffmann, Mieke L van Driel, Elaine Beller, Susan M Phillips, Jonathan Dartnell
In Australia, the antibiotic resistance crisis may be partly alleviated by reducing antibiotic use in general practice, which has relatively high prescribing rates - antibiotics are mostly prescribed for acute respiratory infections, for which they provide only minor benefits. Current surveillance is inadequate for monitoring community antibiotic resistance rates, prescribing rates by indication, and serious complications of acute respiratory infections (which antibiotic use earlier in the infection may have averted), making target setting difficult...
November 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29081997/implementation-of-effective-practices-in-health-facilities-a-systematic-review-of-cluster-randomised-trials
#13
Emma R Allanson, Özge Tunçalp, Joshua P Vogel, Dina N Khan, Olufemi T Oladapo, Qian Long, Ahmet Metin Gülmezoglu
BACKGROUND: The capacity for health systems to support the translation of research in to clinical practice may be limited. The cluster randomised controlled trial (cluster RCT) design is often employed in evaluating the effectiveness of implementation of evidence-based practices. We aimed to systematically review available evidence to identify and evaluate the components in the implementation process at the facility level using cluster RCT designs. METHODS: All cluster RCTs where the healthcare facility was the unit of randomisation, published or written from 1990 to 2014, were assessed...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29058640/implementation-and-dissemination-of-a-transition-of-care-program-for-rural-veterans-a-controlled-before-and-after-study
#14
Chelsea Leonard, Emily Lawrence, Marina McCreight, Brandi Lippmann, Lynette Kelley, Ashlea Mayberry, Amy Ladebue, Heather Gilmartin, Murray J Côté, Jacqueline Jones, Borsika A Rabin, P Michael Ho, Robert Burke
BACKGROUND: Adapting promising health care interventions to local settings is a critical component in the dissemination and implementation process. The Veterans Health Administration (VHA) rural transitions nurse program (TNP) is a nurse-led, Veteran-centered intervention designed to improve transitional care for rural Veterans funded by VA national offices for dissemination to other VA sites serving a predominantly rural Veteran population. Here, we describe our novel approach to the implementation and evaluation = the TNP...
October 23, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28975305/effect-of-a-community-health-worker-led-multicomponent-intervention-on-blood-pressure-control-in-low-income-patients-in-argentina-a-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Jiang He, Vilma Irazola, Katherine T Mills, Rosana Poggio, Andrea Beratarrechea, Jacquelyn Dolan, Chung-Shiuan Chen, Luz Gibbons, Marie Krousel-Wood, Lydia A Bazzano, Analia Nejamis, Pablo Gulayin, Marilina Santero, Federico Augustovski, Jing Chen, Adolfo Rubinstein
Importance: Despite extensive knowledge of hypertension treatment, the prevalence of uncontrolled hypertension is high and increasing in low- and middle-income countries. Objective: To test whether a community health worker-led multicomponent intervention would improve blood pressure (BP) control among low-income patients with hypertension. Design, Setting, and Participants: A cluster randomized trial was conducted in 18 centers for primary health care within a national public system providing free medications and health care to uninsured patients in Argentina...
September 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28973402/2017-update-on-medical-overuse-a-systematic-review
#16
Daniel J Morgan, Sanket S Dhruva, Eric R Coon, Scott M Wright, Deborah Korenstein
Importance: Overuse of medical care is a well-recognized problem. Objective: To identify and highlight original research articles published in 2016 that are most relevant to understanding medical overuse or strategies to reduce it. Evidence Review: A structured review of English-language articles on PubMed published in 2016 coupled with examination of tables of contents of high-impact journals to identify articles related to medical overuse in adults...
October 2, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28963171/implementing-maternal-death-surveillance-and-response-in-kenya-incremental-progress-and-lessons-learned
#17
Helen Smith, Charles Ameh, Pamela Godia, Judith Maua, Kigen Bartilol, Patrick Amoth, Matthews Mathai, Nynke van den Broek
Maternal death surveillance and response (MDSR) constitutes a quality improvement approach to identify how many maternal deaths occur, what the underlying causes of death and associated factors are, and how to implement actions to reduce the number of preventable stillbirths and maternal and neonatal deaths. This requires a coordinated approach, ensuring both national- and district-level stakeholders are enabled and supported and can implement MDSR in a "no name, no blame" environment. This field action report from Kenya provides an example of how MDSR can be implemented in a "real-life" setting by summarizing the experiences and challenges faced thus far by maternal death assessors and Ministry of Health representatives in implementing MDSR...
September 27, 2017: Global Health, Science and Practice
https://www.readbyqxmd.com/read/28962632/advancing-the-literature-on-designing-audit-and-feedback-interventions-identifying-theory-informed-hypotheses
#18
Heather L Colquhoun, Kelly Carroll, Kevin W Eva, Jeremy M Grimshaw, Noah Ivers, Susan Michie, Anne Sales, Jamie C Brehaut
BACKGROUND: Audit and feedback (A&F) is a common strategy for helping health providers to implement evidence into practice. Despite being extensively studied, health care A&F interventions remain variably effective, with overall effect sizes that have not improved since 2003. Contributing to this stagnation is the fact that most health care A&F interventions have largely been designed without being informed by theoretical understanding from the behavioral and social sciences. To determine if the trend can be improved, the objective of this study was to develop a list of testable, theory-informed hypotheses about how to design more effective A&F interventions...
September 29, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28927439/barriers-and-facilitators-towards-implementing-the-sepsis-six-care-bundle-bliss-1-a-mixed-methods-investigation-using-the-theoretical-domains-framework
#19
Neil Roberts, Guy Hooper, Fabiana Lorencatto, Wendell Storr, Michael Spivey
BACKGROUND: The 'Sepsis 6', a care bundle of basic, but vital, measures (e.g. intravenous fluid, antibiotics) has been implemented to improve sepsis treatment. However, uptake has been variable. Tools from behavioral sciences, such as the Theoretical Domains Framework (TDF) may be used to understand and address such implementation issues. This study used a behavioral science approach to identify barriers and facilitators towards Sepsis Six implementation at a case study hospital. METHODS: Semi-structured interviews based on the TDF were conducted with a sample group of consultants, junior doctors and nurses from Emergency Department, Medical and Surgical Admissions, to explore barriers/facilitators to Sepsis Six performance...
September 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28918994/meaningful-methods-for-increasing-human-papillomavirus-vaccination-rates-an%C3%A2-integrative-literature-review
#20
Kristin Vollrath, Susan Thul, Jenny Holcombe
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is a well-known cause of oropharyngeal, cervical, vaginal, vulvar, penile, and anal cancers. Despite the proven efficacy of the HPV vaccine, vaccination rates remain persistently low. Much literature has focused on attitudes toward the HPV vaccine; however, researchers have also investigated strategies clinicians can use to improve vaccination attitudes and acceptance. Such strategies include provider education, vaccine reminder/recall, and chart audit and feedback...
September 14, 2017: Journal of Pediatric Health Care
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