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"order set" or "order sets" or "carepath" or "care path"

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https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#1
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27932381/improving-the-efficiency-of-care-for-pediatric-patients-hospitalized-with-asthma
#2
Kathleen W Bartlett, Victoria M Parente, Vanessa Morales, Jillian Hauser, Heather S McLean
BACKGROUND: Asthma exacerbations are a leading cause of hospitalization among children. Despite the existence of national pediatric asthma guidelines, significant variation in care persists. At Duke Children's Hospital, we determined that our average length of stay (ALOS) and cost for pediatric asthma admissions exceeded that of our peers. Our aim was to reduce the ALOS of pediatric patients hospitalized with asthma from 2.9 days to 2.6 days within 12 months by implementing an asthma pathway within our new electronic health record...
December 8, 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27925424/evaluation-of-an-institutional-project-to-improve-venous-thromboembolism-prevention
#3
REVIEW
Christina A Minami, Anthony D Yang, Mila Ju, Eckford Culver, Kathryn Seifert, Lindsey Kreutzer, Terri Halverson, Kevin J O'Leary, Karl Y Bilimoria
BACKGROUND: Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. OBJECTIVE: To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27925423/the-johns-hopkins-venous-thromboembolism-collaborative-multidisciplinary-team-approach-to-achieve-perfect-prophylaxis
#4
REVIEW
Michael B Streiff, Brandyn D Lau, Deborah B Hobson, Peggy S Kraus, Kenneth M Shermock, Dauryne L Shaffer, Victor O Popoola, Jonathan K Aboagye, Norma A Farrow, Paula J Horn, Hasan M Shihab, Peter J Pronovost, Elliott R Haut
Venous thromboembolism (VTE) is an important cause of preventable harm in hospitalized patients. The critical steps in delivery of optimal VTE prevention care include (1) assessment of VTE and bleeding risk for each patient, (2) prescription of risk-appropriate VTE prophylaxis, (3) administration of risk-appropriate VTE prophylaxis in a patient-centered manner, and (4) continuously monitoring outcomes to identify new opportunities for learning and performance improvement. To ensure that every hospitalized patient receives VTE prophylaxis consistent with their individual risk level and personal care preferences, we organized a multidisciplinary task force, the Johns Hopkins VTE Collaborative...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27925421/reducing-the-incidence-of-hospital-associated-venous-thromboembolism-within-a-network-of-academic-hospitals-findings-from-five-university-of-california-medical-centers
#5
REVIEW
Ian H Jenkins, Richard H White, Alpesh N Amin, Nasim Afsarmanesh, Andrew D Auerbach, Raman Khanna, Gregory A Maynard
BACKGROUND: Almost 700 patients suffered from hospital-associated venous thromboembolism (HA-VTE) across 5 University of California hospitals in calendar year 2011. OBJECTIVE: Optimize venous thromboembolism (VTE) prophylaxis (VTEP) in adult medical/surgical inpatients and reduce HA-VTE by at least 20% within 3 years. DESIGN: Prospective, unblinded, open-intervention study with historical controls. SETTING: Five independent but cooperating academic hospitals...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27919372/does-extended-cpoe-use-reduce-patient-length-of-stay
#6
Darryl Romanow, Arun Rai, Mark Keil, Steven Luxenberg
OBJECTIVE: This study compares use of Computerized Provider Order Entry (CPOE) and related clinical systems (i.e., extended CPOE) across 796 clinical teams caring for five distinct patient conditions. Our focus is the relationship between clinical teams' extended CPOE use and extent of prolonged stay (EPS), defined as the deviation in patients' observed length of stay from expected risk-adjusted length of stay. MATERIALS AND METHODS: Using archival data from two affiliated hospitals in the Southeastern United States, we focused on five different patient conditions of varying mortality risk (vaginal birth, knee/hip replacement, cardiovascular surgery, organ transplant and pneumonia)...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27893884/effect-of-the-goals-of-care-intervention-for-advanced-dementia-a-randomized-clinical-trial
#7
Laura C Hanson, Sheryl Zimmerman, Mi-Kyung Song, Feng-Chang Lin, Cherie Rosemond, Timothy S Carey, Susan L Mitchell
Importance: In advanced dementia, goals of care decisions are challenging and medical care is often more intensive than desired. Objective: To test a goals of care (GOC) decision aid intervention to improve quality of communication and palliative care for nursing home residents with advanced dementia. Design, Setting, and Participants: A single-blind cluster randomized clinical trial, including 302 residents with advanced dementia and their family decision makers in 22 nursing homes...
November 28, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27858570/multidisciplinary-optimization-of-oral-chemotherapy-delivery-at-the-university-of-wisconsin-carbone-cancer-center
#8
Daniel L Mulkerin, Jason J Bergsbaken, Jessica A Fischer, Mary J Mulkerin, Aaron M Bohler, Mary S Mably
PURPOSE: Use of oral chemotherapy is expanding and offers advantages while posing unique safety challenges. ASCO and the Oncology Nursing Society jointly published safety standards for administering chemotherapy that offer a framework for improving oral chemotherapy practice at the University of Wisconsin Carbone Cancer Center. METHODS: With the goal of improving safety, quality, and uniformity within our oral chemotherapy practice, we conducted a gap analysis comparing our practice against ASCO/Oncology Nursing Society guidelines...
October 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27852639/improving-geriatric-prescribing-in-the-ed-a-qualitative-study-of-facilitators-and-barriers-to-clinical-decision-support-tool-use
#9
Ann E Vandenberg, Camille P Vaughan, Melissa Stevens, Susan N Hastings, James Powers, Alayne Markland, Ula Hwang, William Hung, Katharina V Echt
QUALITY PROBLEM OR ISSUE: Clinical decision support (CDS) may improve prescribing for older adults in the Emergency Department (ED) if adopted by providers. INITIAL ASSESSMENT: Existing prescribing order entry processes were mapped at an initial Veterans Administration Medical Center site, demonstrating cognitive burden, effort and safety concerns. CHOICE OF SOLUTION: Geriatric order sets incorporating 2012 Beers guidelines and including geriatric prescribing advice and prepopulated order options were developed...
November 16, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27851054/1418-utility-of-a-severe-sepsis-order-set-in-a-medical-intensive-care-unit
#10
Francisco Ibarra, Annette Rowden, Kate Dzintars, John Lindsley
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850841/1205-evaluation-of-a-neuromuscular-blocking-agent-order-set-in-the-intensive-care-unit
#11
Chelsea Tasaka, Kendall Gross, Ashley Thompson, Deanna Horner, Cindy Burg, John Turnbull, Matthew Aldrich, Fanny Li
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850600/962-use-of-order-sets-to-improve-sedation-and-analgesia-practices-in-an-oncology-intensive-care-unit
#12
Mary Lou Warren, Sam Yerramsetti, Nick Holton, Jeffrey Bruno, Neetha Jawe, April Finnigan, Nisha Rathi, Lei Feng
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27826853/methods-of-synchronization-of-yeast-cells-for-the-analysis-of-cell-cycle-progression
#13
M Angeles Juanes
Cell division is a fascinating and fundamental process that sustains life. By this process, unicellular organisms reproduce and multicellular organisms sustain development, growth, and tissue repair. Division of a mother cell gives rise to two daughter cells according to an ordered set of events within four successive phases called G1 (gap1), S (DNA Synthesis), G2 (gap2), and M (Mitosis) phase. How these different phases are orchestrated to ensure the physical separation of the two daughter cells is a tightly regulated process...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27824514/30-day-readmission-rates-in-patients-admitted-for-heart-failure-exacerbation-with-and-without-palliative-care-consultation-a-retrospective-cohort-study
#14
Elizabeth Chuang, Gina Kim, Arthur E Blank, William Southern, James Fausto
BACKGROUND: Palliative care consultation improves quality of care through symptom management, communication, care coordination, and earlier hospice referral, and it may decrease burdensome hospital readmissions at the end of life. OBJECTIVES: To compare 30-day readmission rates for patients admitted with exacerbation of congestive heart failure (CHF) receiving palliative care consultation services compared with controls. DESIGN: Retrospective cohort study using propensity score matching...
November 8, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27822373/using-lean-methodology-to-improve-efficiency-of-electronic-order-set-maintenance-in-the-hospital
#15
Lori Idemoto, Barbara Williams, Craig Blackmore
Order sets, a series of orders focused around a diagnosis, condition, or treatment, can reinforce best practice, help eliminate outdated practice, and provide clinical guidance. However, order sets require regular updates as evidence and care processes change. We undertook a quality improvement intervention applying lean methodology to create a systematic process for order set review and maintenance. Root cause analysis revealed challenges with unclear prioritization of requests, lack of coordination between teams, and lack of communication between producers and requestors of order sets...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27818602/effects-of-extreme-prematurity-on-numerical-skills-and-executive-function-in-kindergarten-children-an-application-of-partially-ordered-classification-modeling
#16
Curtis Tatsuoka, Bridget McGowan, Tomoko Yamada, Kimberly Andrews Espy, Nori Minich, H Gerry Taylor
Although mathematics disabilities (MD) are common in extremely preterm/extremely low birth weight (EPT/ELBW) children, little is known about the nature of these problems. In this study partially ordered set (POSET) models were applied to classify 140 EPT/ELBW kindergarten children (gestational age <28 weeks and/or birth weight <1000 g) and 110 normal birth weight (NBW) controls into profiles of numerical and cognitive skills. Models based on five numerical skills and five executive function and processing speed skills provided a good fit to performance data...
July 2016: Learning and Individual Differences
https://www.readbyqxmd.com/read/27818228/computerized-insulin-order-sets-and-glycemic-control-in-hospitalized-patients
#17
Bertha Wong, Muhammad M Mamdani, Catherine H Y Yu
OBJECTIVE: To evaluate the impact of computerized provider order entry subcutaneous insulin order sets on inpatient glycemic control and ordering behavior. METHODS: This was an interrupted time series study of non-intensive care patients at an urban teaching hospital. The primary outcome was proportion of capillary blood glucose in optimal range (4.0-10.0 mmol/L [72 -180 mg/dL]) during the six months before and after a change to a computerized provider order entry-integrated insulin order set...
November 3, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27811162/pediatric-medication-safety-in-adult-community-hospital-settings-a-glimpse-into-nationwide-practice
#18
Francisco Alvarez, Lana Ismail, Allison Markowsky
BACKGROUND AND OBJECTIVES: Most children in the United States are treated in adult settings. Studies show that the pediatric population is vulnerable to medication errors. It can be extrapolated that children cared for in adult settings are at equal or higher risk for errors. The goal of this study was to assess the existing pediatric medication safety infrastructure within adult hospitals. METHODS: Questionnaire developed through Research Electronic Data Capture (REDCap) and distributed to pediatric hospitalist programs listed on the American Academy of Pediatrics, Section on Hospital Medicine web site and members of the American Academy of Pediatrics Quality Improvement Innovation Networks listserv...
December 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27805455/decreased-rates-of-hypoglycemia-following-implementation-of-a-comprehensive-computerized-insulin-order-set-and-titration-algorithm-in-the-inpatient-setting
#19
Naina Sinha Gregory, Jane Jeffrie Seley, Linda M Gerber, Chin Tang, David Brillon
OBJECTIVES: More than one-third of hospitalized patients have hyperglycemia. Despite evidence that improving glycemic control leads to better outcomes, achieving recognized targets remains a challenge. The objective of this study was to evaluate the implementation of a computerized insulin order set and titration algorithm on rates of hypoglycemia and overall inpatient glycemic control. METHODS: A prospective observational study evaluating the impact of a glycemic order set and titration algorithm in an academic medical center in non-critical care medical and surgical inpatients...
November 2, 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27802861/financial-impact-of-a-targeted-reduction-in-cardiac-enzyme-testing-at-a-community-hospital
#20
Li Zhang, Anne M Sill, Ilene Young, Sabreen Ahmed, Maria Morales, Sapna Kuehl
OBJECTIVES: Nearly one-third of healthcare costs are potentially avoidable and would not compromise medical care if eliminated. Therefore, we sought to evaluate the financial impact of reduction in use of creatinine kinase (CK)-MB and myoglobin tests after removing them from the cardiac enzyme order set at a community hospital. METHODS: Grand rounds were held, and an email notification was sent to de-emphasize the use of CK, CK-MB, myoglobin, SGOT (glutamic-oxaloacetic transaminase), and SGPT (serum glutamic-pyruvic transaminase) in acute coronary syndrome (ACS) work up...
2016: Journal of Community Hospital Internal Medicine Perspectives
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