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https://www.readbyqxmd.com/read/27919250/the-impact-of-health-information-technologies-on-quality-improvement-methodologies-efficiency-throughput-and-financial-outcomes-a-retrospective-observational-study
#1
Raed H AlHazme, Syed S Haque, Hal Wiggin, Arif M Rana
BACKGROUND: To evaluate whether or not the utilization of Health Information Technologies (HITs) in Quality Improvement Methodologies (QIMs) has impacts on QIMs' efficiency, throughput and financial outcomes at healthcare organizations and physician practices in the United States. METHODS: This is a retrospective observational study that was conducted between the years of 2014 and 2015 and relied on two data sources: the Dorenfest Institute dataset and the Healthcare Information and Management Systems Society (HIMSS) Analytics data source...
December 5, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27916419/comparative-transcriptomics-analyses-of-the-different-growth-states-of-multidrug-resistant-acinetobacter-baumannii
#2
Shuai Li, Haitao Li, Tianjie Qi, Xixin Yan, Boli Wang, Jitao Guan, Yu Li
Multidrug-resistant (MDR) Acinetobacter baumannii is an important bacterial pathogen commonly associated with hospital acquired infections. A. baumannii can remain viable and hence virulent in the environment for a long period of time due primarily to its ability to form biofilms. A total of 459 cases of MDR A. baumannii our hospital collected from March 2014 to March 2015 were examined in this study, and a representative isolate selected for high-throughput mRNA sequencing and comparison of gene expression profiles under the biofilm and exponential growth conditions...
December 1, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27867087/a-quantitative-immunoassay-for-lung-cancer-biomarker-ciz1b-in-patient-plasma
#3
Dawn Coverley, Gillian Higgins, Daniel West, Oliver T Jackson, Adam Dowle, Aidan Haslam, Eve Ainscough, Rebecca Chalkley, John White
OBJECTIVES: Non-invasive tests for early detection of lung cancer are an important unmet clinical need. CIZ1b plasma biomarker can discriminate stage 1 lung cancer from within high-risk groups with clinically useful accuracy, with ROC AUCs in excess of 0.9 for two independent retrospective cohorts, and could therefore meet this need. Our aim was to characterise the native state of the biomarker and develop a quantitative immunoassay. DESIGN AND METHODS: Selective denaturation, preparative electrophoresis and mass spectrometry of human plasma were used to characterise the biomarker and interaction partners...
November 17, 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27833464/urology-group-compensation-and-ancillary-service-models-in-an-era-of-value-based-care
#4
Neal D Shore, Dana Jacoby
Changes involving the health care economic landscape have affected physicians' workflow, productivity, compensation structures, and culture. Ongoing Federal legislation regarding regulatory documentation and imminent payment-changing methodologies have encouraged physician consolidation into larger practices, creating affiliations with hospitals, multidisciplinary medical specialties, and integrated delivery networks. As subspecialization and evolution of care models have accelerated, independent medical groups have broadened ancillary service lines by investing in enterprises that compete with hospital-based (academic and nonacademic) entities, as well as non-physician- owned multispecialty enterprises, for both outpatient and inpatient services...
2016: Reviews in Urology
https://www.readbyqxmd.com/read/27828987/analysis-of-taqman-array-cards-data-by-an-assumption-free-improvement-of-the-maxratio-algorithm-is-more-accurate-than-the-cycle-threshold-method
#5
Luigi Marongiu, Eric Shain, Lydia Drumright, Reidun Lillestøl, Donald Somasunderam, Martin D Curran
Quantitative PCR diagnostic platforms are moving towards increased sample throughput, with instruments capable of carrying out thousands of reactions at once already in use. The need for a computational tool to reliably assist in the validation of the results is therefore compelling. In the present study, 328 residual clinical samples provided by the Public Health England at Addenbrooke's Hospital (Cambridge, UK) were processed by TaqMan Array Card assay, generating 15 744 reactions from 54 targets. The amplification data were analysed by the conventional cycle-threshold (CT) method and an improvement of the maxRatio (MR) algorithm developed to filter out the reactions with irregular amplification profiles...
2016: PloS One
https://www.readbyqxmd.com/read/27817131/reliable-collection-of-real-time-patient-physiologic-data-from-less-reliable-networks-a-monitor-of-monitors-system-moms
#6
Peter F Hu, Shiming Yang, Hsiao-Chi Li, Lynn G Stansbury, Fan Yang, George Hagegeorge, Catriona Miller, Peter Rock, Deborah M Stein, Colin F Mackenzie
Research and practice based on automated electronic patient monitoring and data collection systems is significantly limited by system down time. We asked whether a triple-redundant Monitor of Monitors System (MoMs) to collect and summarize key information from system-wide data sources could achieve high fault tolerance, early diagnosis of system failure, and improve data collection rates. In our Level I trauma center, patient vital signs(VS) monitors were networked to collect real time patient physiologic data streams from 94 bed units in our various resuscitation, operating, and critical care units...
January 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/27810850/how-empowering-is-hospital-care-for-older-people-with-advanced-disease-barriers-and-facilitators-from-a-cross-national-ethnography-in-england-ireland-and-the-usa
#7
Lucy Ellen Selman, Barbara A Daveson, Melinda Smith, Bridget Johnston, Karen Ryan, R Sean Morrison, Caty Pannell, Regina McQuillan, Suzanne de Wolf-Linder, Steven Z Pantilat, Lara Klass, Diane Meier, Charles Normand, Irene J Higginson
BACKGROUND: patient empowerment, through which patients become self-determining agents with some control over their health and healthcare, is a common theme across health policies globally. Most care for older people is in the acute setting, but there is little evidence to inform the delivery of empowering hospital care. OBJECTIVE: we aimed to explore challenges to and facilitators of empowerment among older people with advanced disease in hospital, and the impact of palliative care...
November 3, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27791449/lean-intervention-improves-patient-discharge-times-improves-emergency-department-throughput-and-reduces-congestion
#8
Michael J Beck, Davin Okerblom, Anika Kumar, Subhankar Bandyopadhyay, Lisabeth V Scalzi
OBJECTIVE: To determine if a lean intervention improved emergency department (ED) throughput and reduced ED boarding by improving patient discharge efficiency from a tertiary care children's hospital. METHODS: The study was conducted at a tertiary care children's hospital to study the impact lean that changes made to an inpatient pediatric service line had on ED efficiency. Discharge times from the general pediatrics' service were compared to patients discharged from all other pediatric subspecialty services...
November 15, 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27769228/quantifying-the-effect-of-complications-on-patient-flow-costs-and-surgical-throughputs
#9
Ahmed Almashrafi, Laura Vanderbloemen
BACKGROUND: Postoperative adverse events are known to increase length of stay and cost. However, research on how adverse events affect patient flow and operational performance has been relatively limited to date. Moreover, there is paucity of studies on the use of simulation in understanding the effect of complications on care processes and resources. In hospitals with scarcity of resources, postoperative complications can exert a substantial influence on hospital throughputs. METHODS: This paper describes an evaluation method for assessing the effect of complications on patient flow within a cardiac surgical department...
October 21, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27766960/spontaneous-preterm-birth-and-single-nucleotide-gene-polymorphisms-a-recent-update
#10
Ishfaq A Sheikh, Ejaz Ahmad, Mohammad S Jamal, Mohd Rehan, Mourad Assidi, Iftikhar A Tayubi, Samera F AlBasri, Osama S Bajouh, Rola F Turki, Adel M Abuzenadah, Ghazi A Damanhouri, Mohd A Beg, Mohammed Al-Qahtani
BACKGROUND: Preterm birth (PTB), birth at <37 weeks of gestation, is a significant global public health problem. World-wide, about 15 million babies are born preterm each year resulting in more than a million deaths of children. Preterm neonates are more prone to problems and need intensive care hospitalization. Health issues may persist through early adulthood and even be carried on to the next generation. Majority (70 %) of PTBs are spontaneous with about a half without any apparent cause and the other half associated with a number of risk factors...
October 17, 2016: BMC Genomics
https://www.readbyqxmd.com/read/27687425/using-an-at-risk-salary-model-to-improve-throughput-in-academic-medical-center-operating-rooms
#11
Rachel M Kacmar, Brian M Davidson, Matthew Victor, Ken Bullard, Jose Melendez
STUDY OBJECTIVE: The objective was to analyze if an at-risk salary model for faculty anesthesiologists could improve on-time first case starts (FCSs) and case turnovers (TOs) in an academic hospital inpatient operating room (IOR) and ambulatory surgery center (ASC). Organizational goals were 65% and 70% on-time FCS and case TO times for IOR and ASC, respectively. DESIGN: This was a retrospective study. SETTING: Surgical cases performed at both the IORs and the ASCs at a large academic medical center were included...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27681381/day-case-transobturator-tapes-a-cut-and-dried-solution
#12
T Ramhendar, D Keane
BACKGROUND: The transobturator tape (TOT) has been utilized in the surgical management of SUI since 2001 when it was first described and is associated with minimal risk of trauma as its purely perineal insertion avoids entry to the retropubic space. Given its high success rate, low associated peri-operative morbidity and relative ease of insertion, it has been increasingly used as a day case procedure worldwide. AIM: This study aims to demonstrate the suitability of the transobturator tape (TOT) as a day surgery procedure in the Republic of Ireland...
September 28, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27658897/systematic-identification-and-management-of-barriers-to-vascular-surgery-patient-discharge-time-of-day
#13
Gaurav Sharma, Danny Wong, Dean J Arnaoutakis, Samir K Shah, Alice O'Brien, Stanley W Ashley, C Keith Ozaki
OBJECTIVE: Length of stay fails to completely capture the clinical and economic effects of patient progression through the phases of inpatient care, such as admission, room placement, procedures, and discharge. Delayed hospital throughput has been linked to increased time spent in the emergency department and postanesthesia care unit, delayed time to treatment, increased in-hospital mortality, decreased patient satisfaction, and lost hospital revenue. We identified barriers to vascular surgery inpatient care progression and instituted defined measures to positively impact standardized metrics...
September 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27658706/primary-triage-nurses-do-not-divert-patients-away-from-the-emergency-department-at-times-of-high-in-hospital-bed-occupancy-a-retrospective-cohort-study
#14
Mathias C Blom, Karin Erwander, Lars Gustafsson, Mona Landin-Olsson, Fredrik Jonsson, Kjell Ivarsson
BACKGROUND: Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced in several Swedish EDs. In short, primary triage means that a nurse separately evaluates patients who present in the Emergency Department (ED) and either refers them to primary care or discharges them home, if their complaints are perceived as being of low acuity. The aim of the present study is to elucidate whether high levels of in-hospital bed occupancy are associated with decreased permeability in primary triage...
September 22, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27648947/diversity-of-sccmec-elements-in-staphylococcus-aureus-as-observed-in-south-eastern-germany
#15
Stefan Monecke, Lutz Jatzwauk, Elke Müller, Hedda Nitschke, Katharina Pfohl, Peter Slickers, Annett Reissig, Antje Ruppelt-Lorz, Ralf Ehricht
SCCmec elements are very important mobile genetic elements in Staphylococci that carry beta-lactam resistance genes mecA/mecC, recombinase genes and a variety of accessory genes. Twelve main types and a couple of variants have yet been described. In addition, there are also other SCC elements harbouring other markers. In order to subtype strains of methicillin-resistant S. aureus (MRSA) based on variations within their SCCmec elements, 86 markers were selected from published SCC sequences for an assay based on multiplexed primer extension reactions followed by hybridisation to the specific probes...
2016: PloS One
https://www.readbyqxmd.com/read/27639803/cell-culture-system-for-analysis-of-genetic-heterogeneity-within%C3%A2-hepatocellular-carcinomas-and-response-to-pharmacologic-agents
#16
Qiang Gao, Zhi-Chao Wang, Meng Duan, Yi-Hui Lin, Xue-Ya Zhou, Daniel L Worthley, Xiao-Ying Wang, Gang Niu, Yuchao Xia, Minghua Deng, Long-Zi Liu, Jie-Yi Shi, Liu-Xiao Yang, Shu Zhang, Zhen-Bin Ding, Jian Zhou, Chun-Min Liang, Ya Cao, Lei Xiong, Ruibin Xi, Yong-Yong Shi, Jia Fan
BACKGROUND & AIMS: No targeted therapies have been found to be effective against hepatocellular carcinoma (HCC), possibly due to the large degree of intratumor heterogeneity. We performed genetic analyses of different regions of HCCs to evaluate levels of intratumor heterogeneity and associate alterations with responses to different pharmacologic agents. METHODS: We obtained samples of HCCs (associated with hepatitis B virus infection) from 10 patients undergoing curative resection, before adjuvant therapy, at hospitals in China...
September 14, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27627881/the-ontology-of-biological-and-clinical-statistics-obcs-for-standardized-and-reproducible-statistical-analysis
#17
Jie Zheng, Marcelline R Harris, Anna Maria Masci, Yu Lin, Alfred Hero, Barry Smith, Yongqun He
BACKGROUND: Statistics play a critical role in biological and clinical research. However, most reports of scientific results in the published literature make it difficult for the reader to reproduce the statistical analyses performed in achieving those results because they provide inadequate documentation of the statistical tests and algorithms applied. The Ontology of Biological and Clinical Statistics (OBCS) is put forward here as a step towards solving this problem. RESULTS: The terms in OBCS including 'data collection', 'data transformation in statistics', 'data visualization', 'statistical data analysis', and 'drawing a conclusion based on data', cover the major types of statistical processes used in basic biological research and clinical outcome studies...
September 14, 2016: Journal of Biomedical Semantics
https://www.readbyqxmd.com/read/27605653/emergency-department-length-of-stay-for-psychiatric-visits-was-significantly-longer-than-for-nonpsychiatric-visits-2002-11
#18
Jane M Zhu, Astha Singhal, Renee Y Hsia
Despite increases in the use of emergency department (EDs) for mental health care, there are limited data on whether psychiatric patients disproportionately contribute to ED crowding. We conducted a retrospective analysis using a national database of ED visits in the period 2002-11 to describe trends in median and ninetieth-percentile length-of-stay for patients with psychiatric versus nonpsychiatric primary diagnoses. Psychiatric patients who visited the ED were transferred to another facility at six times the rate of nonpsychiatric patients...
September 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27603225/effect-of-lean-processes-on-surgical-wait-times-and-efficiency-in-a-tertiary-care-veterans-affairs-medical-center
#19
Nakul P Valsangkar, Andrew C Eppstein, Rick A Lawson, Amber N Taylor
Importance: There are an increasing number of veterans in the United States, and the current delay and wait times prevent Veterans Affairs institutions from fully meeting the needs of current and former service members. Concrete strategies to improve throughput at these facilities have been sparse. Objective: To identify whether lean processes can be used to improve wait times for surgical procedures in Veterans Affairs hospitals. Design, Setting, and Participants: Databases in the Veterans Integrated Service Network 11 Data Warehouse, Veterans Health Administration Support Service Center, and Veterans Information Systems and Technology Architecture/Dynamic Host Configuration Protocol were queried to assess changes in wait times for elective general surgical procedures and clinical volume before, during, and after implementation of lean processes over 3 fiscal years (FYs) at a tertiary care Veterans Affairs medical center...
September 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27601573/fluorescence-based-flow-sorting-in-parallel-with-transposon-insertion-site-sequencing-identifies-multidrug-efflux-systems-in-acinetobacter-baumannii
#20
Karl A Hassan, Amy K Cain, TaoTao Huang, Qi Liu, Liam D H Elbourne, Christine J Boinett, Anthony J Brzoska, Liping Li, Martin Ostrowski, Nguyen Thi Khanh Nhu, Tran Do Hoang Nhu, Stephen Baker, Julian Parkhill, Ian T Paulsen
UNLABELLED: Multidrug efflux pumps provide clinically significant levels of drug resistance in a number of Gram-negative hospital-acquired pathogens. These pathogens frequently carry dozens of genes encoding putative multidrug efflux pumps. However, it can be difficult to determine how many of these pumps actually mediate antimicrobial efflux, and it can be even more challenging to identify the regulatory proteins that control expression of these pumps. In this study, we developed an innovative high-throughput screening method, combining transposon insertion sequencing and cell sorting methods (TraDISort), to identify the genes encoding major multidrug efflux pumps, regulators, and other factors that may affect the permeation of antimicrobials, using the nosocomial pathogen Acinetobacter baumannii A dense library of more than 100,000 unique transposon insertion mutants was treated with ethidium bromide, a common substrate of multidrug efflux pumps that is differentially fluorescent inside and outside the bacterial cytoplasm...
2016: MBio
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