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https://www.readbyqxmd.com/read/28550706/st-michael-s-improvement-program-a-collaborative-approach-to-sustainable-cost-savings
#1
Anne Trafford, Danielle Jane
In response to a challenging financial environment and increasing patient demand, St. Michael's Hospital needed to find long-term sustainable solutions to continue to provide high-quality patient care and invest in key priorities. By conducting Operational Reviews in focused areas, the hospital achieved $7.4 million of in-year savings in the first year, found standardizations, process efficiencies and direct cost savings that positioned itself for success in future funding models. Initiatives were grounded in evidence and relied heavily on the effective execution by the leadership, front-line staff and physicians...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550700/optimizing-transitions-of-care-hospital-to-community
#2
Emily Sheridan, Christine Thompson, Tania Pinheiro, Nicole Robinson, Karen Davies, Nancy Whitmore
Discharging patients from the hospital is a complex process, and preventing avoidable readmissions has the potential to improve both the quality of life for patients and the financial sustainability of the healthcare system (Alper et al. 2016). Improving the discharge process is one method to mitigate readmission to the hospital. Historically, St. Thomas Elgin General Hospital (STEGH) consistently experienced higher-than-expected readmission rates, and only 41% of discharge summaries were sent from the hospital to the community primary care within 48 hours...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550696/the-case-for-quality-improvement
#3
Christina Krause
Healthcare systems around the world are facing increasing public and government scrutiny, financial pressures and challenges from growing complexity. There is a need to accelerate the pace of change, and improve the quality of care while reducing cost. These changes must centre on improving care and increasing accountability for quality in the system. But how do we achieve this goal?
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550380/barriers-motivators-and-facilitators-to-engagement-in-hiv-care-among-hiv-infected-ghanaian-men-who-have-sex-with-men-msm
#4
Adedotun Ogunbajo, Trace Kershaw, Sameer Kushwaha, Francis Boakye, Nii-Dromo Wallace-Atiapah, LaRon E Nelson
In Ghana, men who have sex with men (MSM) bear a high burden of HIV. Identifying factors that influence engagement in HIV care among HIV-infected Ghanaian MSM is critical to devising novel interventions and strengthening existing programs aimed at improving outcomes across the HIV care continuum. Consequently, we conducted an exploratory qualitative research study with 30 HIV-infected Ghanaian MSM between May 2015 and July 2015. Common barriers were fear of being seen in HIV-related health facility, financial difficulties, and health system challenges...
May 26, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28549867/integrated-testing-strategies-can-be-optimal-for-chemical-risk-classification
#5
Marko Raseta, Jon Pitchford, James Cussens, John Doe
There is an urgent need to refine strategies for testing the safety of chemical compounds. This need arises both from the financial and ethical costs of animal tests, but also from the opportunities presented by new in-vitro and in-silico alternatives. Here we explore the mathematical theory underpinning the formulation of optimal testing strategies in toxicology. We show how the costs and imprecisions of the various tests, and the variability in exposures and responses of individuals, can be assembled rationally to form a Markov Decision Problem...
May 23, 2017: Mathematical Biosciences
https://www.readbyqxmd.com/read/28549788/implementation-of-a-multicenter-shoulder-dystocia-injury-prevention-program
#6
Linda Szymanski, Christine Arnold, Arthur J Vaught, Susan LaMantia, Theresa Harris, Andrew J Satin
Although the evidence for supporting the effectiveness of many patient safety practices has increased in recent years, the ability to implement programs to positively impact clinical outcomes across multiple institutions is lagging. Shoulder dystocia simulation has been shown to reduce avoidable patient harm. Neonatal injury from shoulder dystocia contributes to a significant percentage of liability claims. We describe the development and the process of implementation of a shoulder dystocia simulation program across five academic medical centers and their affiliated hospitals united by a common insurance carrier...
May 23, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28549706/long-term-effectiveness-of-a-multifactorial-fall-and-fracture-prevention-program-in-bavarian-nursing-homes-an-analysis-based-on-health-insurance-claims-data
#7
Claudia Schulz, Ivonne Lindlbauer, Kilian Rapp, Clemens Becker, Hans-Helmut König
OBJECTIVE: Femoral fractures are frequently consequences of falls in nursing homes and are associated with considerable costs and unfavorable outcomes such as immobility and mortality. The purpose of this study was to examine the long-term effectiveness of a multifactorial fall and fracture prevention program in nursing homes in terms of reducing femoral fractures. DESIGN: Retrospective cohort study. SETTING: Nursing homes. PARTICIPANTS: Health insurance claims data for 2005-2013 including 85,148 insurants of a sickness fund (Allgemeine Ortskrankenkasse Bayern), aged 65 years or older and living in 802 nursing homes in Bavaria, Germany...
June 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28549421/comparison-of-vividtrac%C3%A2-airtraq%C3%A2-king-vision%C3%A2-macintosh-laryngoscope-and-a-custom-made-videolaryngoscope-for-difficult-and-normal-airways-in-mannequins-by-novices
#8
Szilárd Rendeki, Dóra Keresztes, Gábor Woth, Ákos Mérei, Martin Rozanovic, Mátyás Rendeki, József Farkas, Diána Mühl, Bálint Nagy
BACKGROUND: Direct laryngoscopy remains the gold standard for endotracheal intubation and is preferred by experienced operators. However, an increasing number of reports currently support videolaryngoscopy, particularly for novice users. The widespread use of videolaryngoscopy may be limited due to financial limitations, especially in low-income countries. Therefore, affordable single-use scopes are now becoming increasingly popular. We sought to compare these new scopes with direct laryngoscopes and the previously tested videolaryngoscopes in mannequins by novices...
May 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28549409/a-qualitative-study-of-immigrant-women-on-long-term-sick-leave-and-their-experience-of-dignity
#9
Line Nortvedt, Bernadette Nirmal Kumar, Vibeke Lohne
PURPOSE: The purpose of this study was to explore if and how immigrant women suffering from chronic pain experience and maintain their dignity, during rehabilitation. METHODS: The study was designed as a field study, with participant observation and in-depth interviews. Participant observations were carried out during a rehabilitation course for 14 immigrant women on an outpatient clinic at a rehabilitation hospital in southern Norway. In-depth interviews were performed after the rehabilitation period...
May 26, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28549304/landowner-preferences-for-wetlands-conservation-programs-in-two-southern-ontario-watersheds
#10
Ryan Trenholm, Wolfgang Haider, Van Lantz, Duncan Knowler, Pascal Haegeli
Wetlands in the region of Southern Ontario, Canada have declined substantially from their historic area. Existing regulations and programs have not abated this decline. However, reversing this trend by protecting or restoring wetlands will increase the supply of important ecosystem services. In particular, these actions will contribute to moderating the impacts of extreme weather predicted to result from climate change as well as reducing phosphorous loads in Lake Erie and ensuing eutrophication. Since the majority of land in the region is privately owned, landowners can play an important role...
May 23, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28549019/ocular-genetics-in-taiwan
#11
Yu-Hung Lai, Kwou-Yeung Wu
PURPOSE OF REVIEW: Ocular genetics is an emerging specialty which has accompanied the advancement of modern genetic technology. This review is to understand the current status of practice in ocular genetics in Taiwan. RECENT FINDINGS: There is only one ocular genetics clinic in Taiwan. Certified clinical laboratories provide few gene tests in ocular genetics. Most ocular genetic study is focused on myopia. Financial obstacles are a major problem for patients to seek gene tests...
April 25, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28549007/surgeon-experience-and-medicare-expenditures-for-laparoscopic-compared-to-open-colectomy
#12
Kyle H Sheetz, Andrew M Ibrahim, Scott E Regenbogen, Justin B Dimick
OBJECTIVE: To quantify the extent to which payments for laparoscopic and open colectomy are influenced by a surgeon's experience with laparoscopy. BACKGROUND: Numerous studies suggest that healthcare costs for laparoscopic colectomy are lower than open surgery. None have assessed the importance of surgeon experience on the relative financial benefits of laparoscopy. METHODS: We conducted a study of 182,852 national Medicare beneficiaries undergoing laparoscopic or open colectomy between 2010 and 2012...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548997/anterior-inferior-plating-results-in-fewer-secondary-interventions-compared-to-superior-plating-for-acute-displaced-mid-shaft-clavicle-fracture
#13
Rafael Serrano, Amrut Borade, Hassan Mir, Anjan Shah, David Watson, Anthony Infante, Mark A Frankle, Mark A Mighell, H Claude Sagi, Daniel S Horwitz, Roy W Sanders
OBJECTIVES: To determine if a difference in plate position for fixation of acute, displaced, mid-shaft clavicle fractures would affect the rate of secondary intervention. DESIGN: Retrospective Comparative Study SETTING:: two academic Level 1 Regional Trauma Centers PATIENTS:: 510 patients treated surgically for an acutely displaced mid-shaft clavicle fracture between 2000-2013 were identified and reviewed retrospectively at a minimum of 24 months' follow-up (F/U)...
April 5, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28548873/students-with-asthma-and-its-impacts
#14
Elif Isik, Ismet S Isik
Asthma is a common chronic disease in children. Uncontrolled asthma is a significant contributor to school absenteeism, emergency room visits, and hospitalization, all of which can lead to low school performance, financial burdens, and emotional problems for children and their parents. Asthma in children restricts the activities of school-aged children, such as participating in before- and after-school activity and extracurricular activities such as sports. Uncontrolled asthma has the potential to impact a student's self-confidence and social interactions...
May 1, 2017: NASN School Nurse
https://www.readbyqxmd.com/read/28547775/acidic-electrolyzed-water-delays-browning-by-destroying-conformation-of-polyphenoloxidase
#15
Jiangping Sun, Meng Wang, Haiquan Liu, Jing Xie, Yingjie Pan, Changhua Xu, Yong Zhao
BACKGROUND: Browning frequently occurs at fruits, vegetables and aquatic products during storage, it drastically reduces the consumer's acceptability and considerable financial loss. The objective of this paper was to investigate the effects of acidic electrolyzed water (AEW) technology on polyphenoloxidase (PPO), which is an essential enzyme for browning. RESULTS: AEW ice exhibited a good ability in delaying browning in shrimp. Kinetic study revealed that AEW exhibited the mixed type inhibition of PPO with Ki value of 1...
May 26, 2017: Journal of the Science of Food and Agriculture
https://www.readbyqxmd.com/read/28547746/the-support-needs-of-parents-having-a-child-with-a-chronic-kidney-disease-a-focus-group-study
#16
W W Geense, B G I van Gaal, J L Knoll, E A M Cornelissen, T van Achterberg
BACKGROUND: Parents of children with a chronic kidney disease (CKD) have a crucial role in the management of their child's disease. The burden on parents is high: they are often exhausted, depressed and experience high levels of stress and a low quality of life, which could have a negative impact on their child's health outcomes. Support aiming at preventing and reducing parental stress is essential. Therefore, it is necessary to have insight in the problems and support needs among these parents...
May 25, 2017: Child: Care, Health and Development
https://www.readbyqxmd.com/read/28546093/best-practice-guidance-for-the-use-of-strategies-improved-retention-in-randomised-trials-developed-from-two-consensus-workshops
#17
V Brueton, S P Stenning, F Stevenson, J Tierney, G Rait
OBJECTIVE: To develop best practice guidance for the use of retention strategies in randomised clinical trials (RCTs). DESIGN: Consensus development workshops. SETTING: Two UK Clinical Trials Units. PARTICIPANTS: 66 statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs. METHODS: The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions...
May 22, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28545456/towards-an-equitable-healthcare-in-china-evaluating-the-productive-efficiency-of-community-health-centers-in-jiangsu-province
#18
Lulin Zhou, Xinglong Xu, Henry Asante Antwi, Linna Wang
BACKGROUND: While the demand for the health service keeps escalating at the grass root or rural areas of China, a substantial portion of healthcare resources remains stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, the Deepening Health Care Reform in 2012 China was intended to flush out these discrepancies and promote a more equitable and efficient distribution of health resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight...
May 25, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28545379/tissue-engineering-in-achilles-tendon-reconstruction-the-role-of-stem-cells-growth-factors-and-scaffolds
#19
D S Pillai, Bal S Dhinsa, Wasim Khan
Achilles tendon injuries are common, and present a challenge in the acute and chronic setting. There is significant morbidity associated with the injury and the numerous management strategies, as well as financial implications to the patient and the health service. To date, repair tissue from all methods of management fail to achieve the same functional and biomechanical properties as the native tendon. The use of tissue engineering technology may reduce morbidity, improve the biomechanical properties of repair tissue and reduce the financial burden...
May 23, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28545201/treatment-experiences-of-women-with-reproductive-cancers-in-odisha-india-a-qualitative-exploration-of-enablers-and-barriers
#20
Sanghamitra Pati, Abhimanyu Singh Chauhan, Sandeep Mahapatra, Sabita Nayak, Sukdev Nayak, David Weller
Introduction: Cancer continues to be a major menace to our Indian society notwithstanding significant progress in diagnosis and treatment. In India cancer mortality rates in women are high compared to other countries, despite efforts to improve survival through the development of effective detection techniques and increased numbers of viable treatment options. Indian women’s advanced stage of disease at diagnosis is largely attributable to delay in seeking treatment. The present qualitative inquiry was conducted with the aim of capturing the treatment experiences of patients with gynecology cancer at a tertiary care hospital and understanding the barriers, enablers, stress and apprehension they experience during the treatment phases...
April 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
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