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Quality improvement gastroenterology

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https://www.readbyqxmd.com/read/29470372/improving-veterans-access-to-gastroenterology-clinical-care
#1
Thomas H Hansen
At a VA hospital, wait times for gastroenterology care have been in the order of 60 to 90 days for new clinic consults. Through a quality improvement process, these times were reduced to less than 30 days. With a revised triage process, the number of consults needing to be scheduled into the clinic was reduced 34%. In addition to achieving rapid clinical access, the weekly half-day clinic became less congested and more efficient. We describe this process of achieving improved access.
March 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29470322/pediatric-gastroesophageal-reflux-clinical-practice-guidelines-joint-recommendations-of-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-and-the-european-society-for-pediatric-gastroenterology-hepatology-and-nutrition
#2
Rachel Rosen, Yvan Vandenplas, Maartje Singendonk, Michael Cabana, Carlo DiLorenzo, Frederic Gottrand, Sandeep Gupta, Miranda Langendam, Annamaria Staiano, Nikhil Thapar, Neelesh Tipnis, Merit Tabbers
This document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) 2009 clinical guidelines for the diagnosis and management of gastroesophageal reflux disease (GERD) in infants and children and is intended to be applied in daily practice and as a basis for clinical trials. Eight clinical questions addressing diagnostic, therapeutic and prognostic topics were formulated...
March 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29465251/managing-iron-deficiency-and-iron-deficiency-anemia-in-inflammatory-bowel-disease-the-results-of-the-gestiona-hierro-eii-survey
#3
Francesc Casellas Jordá, Isabel Vera Mendoza, Manuel Barreiro-de Acosta, Juan María Vázquez Morón, Javier López Román, Javier Júdez Gutiérrez
INTRODUCTION: iron deficiency anemia is a common and very relevant manifestation of inflammatory bowel disease (IBD). Although clinical practice guidelines have been published and updated on this subject, the management in the daily practice of this complication is far from optimal. OBJECTIVE: to determine the actual management, needs and limitations of anemia in IBD by means of a survey of gastroenterology specialists. MATERIAL AND METHODS: a self-administered telematic survey was carried out between April and May 2017 and was sent to SEPD members...
February 21, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29421953/using-community-engagement-and-navigators-to-increase-colon-cancer-screening-and-patient-outcomes
#4
Paul G Devereux, John Gray, Susan Robinson, Janie Galvin, Jesse Gutierrez
A theory-driven tailored intervention developed in partnership with the community used evidence-based practices to (a) increase knowledge about colon cancer and screening and (b) assist patients in completing screenings. During the 16 months of delivery screening, patient navigators integrated into gastroenterology clinics met all goals, which included (a) enrolling an ethnically diverse group of participants ( N = 415) through inreach (clinic-referred patients who did not schedule appointments) and community outreach, (b) facilitating screening completions for 217 of the 358 (61%) patients identified as needing screening, and (c) obtaining satisfaction ratings from 89% of participants...
February 1, 2018: Health Promotion Practice
https://www.readbyqxmd.com/read/29373438/pediatric-gastroesophageal-reflux-clinical-practice-guidelines-joint-recommendations-of-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-naspghan-and-the-european-society-for-pediatric-gastroenterology-hepatology-and-nutrition
#5
Rachel Rosen, Yvan Vandenplas, Maartje Singendonk, Michael Cabana, Carlo Di Lorenzo, Frederic Gottrand, Sandeep Gupta, Miranda Langendam, Annamaria Staiano, Nikhil Thapar, Neelesh Tipnis, Merit Tabbers
This document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) 2009 clinical guidelines for the diagnosis and management of gastroesophageal reflux disease (GERD) in infants and children and is intended to be applied in daily practice and as a basis for clinical trials. Eight clinical questions addressing diagnostic, therapeutic and prognostic topics were formulated...
January 25, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29344100/surgical-site-infection-prevention-an-analysis-of-compliance-with-good-practice-in-a-teaching-hospital
#6
Adriana Cristina de Oliveira, Camila Sarmento Gama
Background: Surgical teams play a critical role in reducing surgery-related risks during preoperative and intraoperative phases. Aim: To analyse the preoperative and intraoperative practices adopted by surgical teams in surgical site infections prevention. Methods: This was a cross-sectional study conducted during April-September 2013 in a large university hospital in Belo Horizonte, Minas Gerais, Brazil. It was conducted through observation of the surgical practice during preoperative and intraoperative phases of procedures used by a gastroenterological, cardiovascular and paediatric surgical team...
November 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29325112/autologous-haematopoietic-stem-cell-transplantation-ahsct-in-severe-crohn-s-disease-a-review-on-behalf-of-ecco-and-ebmt
#7
John A Snowden, Julián Panés, Tobias Alexander, Matthieu Allez, Sandro Ardizzone, Daan Dierickx, Jürgen Finke, Peter Hasselblatt, Chris Hawkey, Majid Kazmi, James O Lindsay, Francesco Onida, Azucena Salas, Riccardo Saccardi, Severine Vermeire, Montserrat Rovira, Elena Ricart
Despite the major recent progress in the treatment of Crohn's disease (CD), there is a subset of patients in whom the disease runs an aggressive course with progressive tissue damage requiring early and repeated surgical management. Increasing evidence supports sustained and profound improvement in gastrointestinal parameters and quality of life following high dose immunosuppressive therapy and autologous haematopoietic stem cell transplantation (AHSCT) compared to standard therapy in this context. In addition, international transplant registry data reflects the use of AHSCT in CD outside of trials in selected patients...
January 8, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29174953/signature-celebration-of-gastroenterology-colorectal-cancer
#8
Andrew T Chan, Paul Moayyedi
Gastroenterology has published many seminal articles that have transformed our understanding of colorectal cancer (CRC) as well as being influential in promoting colorectal cancer screening which has saved many people from developing the disease. CRC has a hereditary component most notably highlighted in Lynch syndrome. A key paper reported that the majority of mutations in patients with hereditary nonpolyposis colorectal cancer harbored mutations in the MLH1 or MSH2 mismatch repair proteins. Continuing on the gene mutation theme, another paper...
November 23, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29173893/a-novel-in-hospital-meal-service-improves-protein-and-energy-intake
#9
Dorian N Dijxhoorn, Manon G A van den Berg, Wietske Kievit, Julia Korzilius, Joost P H Drenth, Geert J A Wanten
BACKGROUND & AIMS: Improvement of hospital meal services is a strategy to optimize protein and energy intake and prevent or treat malnutrition during hospitalization. FoodforCare (FfC) is a new concept comprising 6-protein-rich meals per day, provided directly at the bedside following proactive advice from a nutritional assistant. Our aim is to investigate whether this new concept, FfC, improves dietary intake and patient satisfaction, compared to the traditional 3-meals a day service (TMS)...
November 9, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29165636/reducing-redundant-anaerobic-therapy-through-spaced-education-and-antimicrobial-stewardship-interventions
#10
Kelly B Flett, Athos Bousvaros, Jane Carpenter, Carly E Millrinen, Patricia Martin, Thomas J Sandora
Background: Decreasing the use of redundant anaerobic therapy is a key target for antimicrobial stewardship. Education techniques that optimize knowledge retention could be an important component of reducing these regimens. Methods: We implemented a quality improvement project that incorporated spaced education to reduce the use of redundant anaerobic therapy. The initial interventions (November through December 2015) included education in a hospital-wide newsletter and review of redundant anaerobic regimens by the antimicrobial stewardship program...
November 20, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#11
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
November 3, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29093622/adalimumab-efficacy-in-enteropathic-spondyloarthritis-a-12-mo-observational-multidisciplinary-study
#12
Michele Maria Luchetti, Devis Benfaremo, Francesco Ciccia, Laura Bolognini, Monia Ciferri, Alessia Farinelli, Matteo Rossini, Piergiorgio Mosca, Giovanni Triolo, Armando Gabrielli
AIM: To report adalimumab (Ada) efficacy on articular-gastrointestinal disease and health-related quality of life (HRQoL) in patients with enteropathic spondyloarthritis (ES). METHODS: A cohort of 52 patients with ES was evaluated in the departments of gastroenterology and internal medicine. At baseline, all patients underwent assessment by an integrated gastro-rheumatologic evaluation of articular and gastrointestinal activity, as well patient reported outcomes (PROs) of the HRQoL questionnaires...
October 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29093596/-continuing-medical-education-in-gastroenterology-and-recertification-in-peru
#13
Ofelia Castillo Contreras, César Soriano Álvarez
The field of action of gastroenterology has been expanded due to technological development and the advent of new sub-specialties, such as gastroenterology oncology. Currently, there is no standardization of medical training programs in gastroenterology in our country. The health system and education are changing, so medical practice and competency assessment for medical certification and recertification should reflect these changes. On the other hand, the quality of a specialized unit, service or medical department is directly related to the quality of human resources...
July 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28984638/the-future-of-nonoperating-room-anesthesia-in-the-21st-century-emphasis-on-quality-and-safety
#14
Steven D Boggs, Sheila R Barnett, Richard D Urman
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) has grown from an insignificant percentage of total anesthesia cases into a major percentage of anesthesia workload over the past 30 years. This trend evidences no signs of abating. RECENT FINDINGS: With the rapid development of novel interventional techniques in cardiology, radiology, gastroenterology and pulmonary medicine and other areas, the core responsibilities of the anesthesia provider will no longer be confined to delivering care in traditional operating rooms...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28961577/predictors-of-no-show-rate-in-the-gi-endoscopy-suite-at-a-safety-net-academic-medical-center
#15
Asim Shuja, Ciel Harris, Petra Aldridge, Miguel Malespin, Silvio W de Melo
BACKGROUND/OBJECTIVES: Noncompliance with physician and procedure appointments is associated with poor disease control and worse disease outcomes. This also impacts the quality of care, decreases efficiency, and affects revenue. Studies have shown that no-show rates are higher in clinics caring for underserved populations and may contribute to poorer health outcomes in this group. METHODS: We performed a 17-month retrospective observational cohort study of patients scheduled for outpatient procedures in the Gastroenterology endoscopy suite at the University of Florida Health, Jacksonville...
September 28, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28919797/quality-of-care-in-inflammatory-bowel-disease-results-of-a-prospective-controlled-cohort-study-in-germany-netibd
#16
Jana Langbrandtner, Angelika Hüppe, Petra Jessen, Jürgen Büning, Susanna Nikolaus, Heiner Raspe, Bernd Bokemeyer
BACKGROUND/AIMS: Patients with inflammatory bowel disease (IBD) need comprehensive, interdisciplinary and cross-sectoral health care. In Germany, evidence-based care pathways have been developed to improve the quality of care of IBD patients. We aimed to evaluate the effects of the implementation of some of these recommendations on patient-related outcomes. METHODS: In a region of North Germany, outpatients with IBD were recruited by gastroenterologists (intervention group)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28906293/frequency-and-variables-associated-with-fasting-orders-in-inpatients-with-ulcerative-colitis-the-audit-of-diet-orders-ulcerative-colitis-adore-uc-study
#17
Zane R Gallinger, Amir Rumman, Kevin Pivovarov, Kyle J Fortinsky, A Hillary Steinhart, Adam V Weizman
INTRODUCTION: Current clinical practice guidelines suggest that patients with ulcerative colitis (UC) hospitalized because of a disease flare should be offered a normal diet, unless such a diet is not tolerated. Studies of hospitalized patients have demonstrated iatrogenic malnutrition from unjustified or inappropriate nil per os (NPO) or clear liquid diet (CLD) orders. In this study, we aim to characterize the burden of this problem in hospitalized patients with UC. METHODS: We conducted a retrospective cohort study of all patients with UC admitted to the gastroenterology service or the general internal medicine service at a tertiary, academic hospital between January 2009 and December 2014, with a length of stay between 2 and 30 days...
October 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28905800/analysis-of-factors-affecting-the-quality-of-life-of-those-suffering-from-crohn-s-disease
#18
Joanna Chrobak-Bień, Anna Gawor, Małgorzata Paplaczyk, Ewa Małecka-Panas, Anita Gąsiorowska
INTRODUCTION: Crohn's disease is an inflammatory bowel disease of unknown etiology. Its chronic nature, as well as symptoms of intestinal and overall significantly impedes the daily functioning of patients. Alternately occurring periods of exacerbation and remission are the cause of reduced quality of life of patients. Understanding the factors that caused the decrease in the quality of life, it allows us to understand the behavior and the situation of the patient and the ability to cope with stress caused by the disease...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28877841/cognitive-behaviour-therapy-for-health-anxiety-in-medical-patients-champ-a-randomised-controlled-trial-with-outcomes-to-5-years
#19
Peter Tyrer, Paul Salkovskis, Helen Tyrer, Duolao Wang, Michael J Crawford, Simon Dupont, Sylvia Cooper, John Green, David Murphy, Georgina Smith, Sharandeep Bhogal, Shaeda Nourmand, Valentina Lazarevic, Gemma Loebenberg, Rachel Evered, Stephanie Kings, Antoinette McNulty, Yvonne Lisseman-Stones, Sharon McAllister, Kofi Kramo, Jessica Nagar, Steven Reid, Rahil Sanatinia, Katherine Whittamore, Gemma Walker, Aaron Philip, Hilary Warwick, Sarah Byford, Barbara Barrett
BACKGROUND: Health anxiety is an under-recognised but frequent cause of distress that is potentially treatable, but there are few studies in secondary care. OBJECTIVE: To determine the clinical effectiveness and cost-effectiveness of a modified form of cognitive-behaviour therapy (CBT) for health anxiety (CBT-HA) compared with standard care in medical outpatients. DESIGN: Randomised controlled trial. SETTING: Five general hospitals in London, Middlesex and Nottinghamshire...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28839877/colonic-lesion-characterisation-skills-among-uk-endoscopists-and-the-impact-of-a-brief-training-intervention
#20
P Basford, G Longcroft-Wheaton, Reiji Higashi, Toshio Uraoka, P Bhandari
OBJECTIVE: To assess UK gastroenterology registrars' and consultants' competence in in vivo characterisation of polyps, plus the impact of a dedicated colonic lesion characterisation training intervention. DESIGN: Prospective evaluation of a computer-based colonic lesion training module. SETTING: Three UK general hospitals. PATIENTS: High-quality endoscopic images obtained during colonoscopy in a previous study. INTERVENTIONS: 30 min computer-based training module covering in vivo characterisation of colonic lesions viewed under white light, chromoendoscopy and magnification chromoendoscopy...
January 2017: Frontline Gastroenterology
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