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Quality improvement gastroenterology

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https://www.readbyqxmd.com/read/28984638/the-future-of-nonoperating-room-anesthesia-in-the-21st-century-emphasis-on-quality-and-safety
#1
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...
October 3, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28837507/clinical-report-intestinal-rehabilitation-programs-in-the-management-of-pediatric-intestinal-failure-and-short-bowel-syndrome
#8
Russell J Merritt, Valeria Cohran, Bram P Raphael, Timothy Sentongo, Diana Volpert, Brad W Warner, Praveen S Goday
Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation (IR) programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation...
August 23, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28821598/quality-standards-in-upper-gastrointestinal-endoscopy-a-position-statement-of-the-british-society-of-gastroenterology-bsg-and-association-of-upper-gastrointestinal-surgeons-of-great-britain-and-ireland-augis
#9
Sabina Beg, Krish Ragunath, Andrew Wyman, Matthew Banks, Nigel Trudgill, Mark D Pritchard, Stuart Riley, John Anderson, Helen Griffiths, Pradeep Bhandari, Phillip Kaye, Andrew Veitch
This document represents the first position statement produced by the British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, setting out the minimum expected standards in diagnostic upper gastrointestinal endoscopy. The need for this statement has arisen from the recognition that while technical competence can be rapidly acquired, in practice the performance of a high-quality examination is variable, with an unacceptably high rate of failure to diagnose cancer at endoscopy...
November 2017: Gut
https://www.readbyqxmd.com/read/28817791/using-practice-facilitation-to-increase-rates-of-colorectal-cancer-screening-in-community-health-centers-north-carolina-2012-2013-feasibility-facilitators-and-barriers
#10
Bryan J Weiner, Catherine L Rohweder, Jennifer E Scott, Randall Teal, Alecia Slade, Allison M Deal, Naima Jihad, Marti Wolf
INTRODUCTION: Practice facilitation involves trained individuals working with practice staff to conduct quality improvement activities and support delivery of evidence-based clinical services. We examined the feasibility of using practice facilitation to assist federally qualified health centers (FQHCs) to increase colorectal cancer screening rates in North Carolina. METHODS: The intervention consisted of 12 months of facilitation in 3 FQHCs. We conducted chart audits to obtain data on changes in documented recommendation for colorectal cancer screening and completed screening...
August 17, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28816296/-complete-androgen-insensitivity-syndrome-associated-with-vesical-fistula-a-case-report-and-literature-review
#11
K H Hua, L Yang, X W Zhang, W J Bai, Q Li, T Xu
Androgen insensitivity syndrome (AIS) is a very uncommon genetic disorder that results from the resistance of androgen receptor (AR) to androgen, which influences the formation of the male genitalia and in turn presents with female phenotype. Surgical resection of undesceaded testicle and different kinds of genitoplasty are crucial methods to correct the deformity of reproductive system, as well as hormone replacement therapy, which is an essential therapy for postoperational rehabilitation in AIS patients...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28815353/perceptions-of-the-inpatient-training-experience-a-nationwide-survey-of-gastroenterology-program-directors-and-fellows
#12
EDITORIAL
Navin L Kumar, Molly L Perencevich, Jerry S Trier
BACKGROUND: Inpatient training is a key component of gastroenterology (GI) fellowship programs nationwide, yet little is known about perceptions of the inpatient training experience. AIM: To compare the content, objectives and quality of the inpatient training experience as perceived by program directors (PD) and fellows in US ACGME-accredited GI fellowship programs. METHODS: We conducted a nationwide, online-based survey of GI PDs and fellows at the conclusion of the 2016 academic year...
October 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28724036/clinical-pharmacology-profile-of-care-in-hepatology-clinic
#13
Talita Rocha Passos, Fabiana Silva Santos, Maria Cleusa Martins, Vanusa Barbosa Pinto, Flair José Carrilho, Suzane Kioko Ono
Since 2010, the Clinical Gastroenterology and Hepatology Division of the Central Institute of Hospital das Clínicas of the University of São Paulo Medical School (HC-FMUSP, in the Portuguese acronym) has been developing specialized electives assistance activities in the Outpatient Specialty Clinic, Secondary Level, in São Paulo NGA-63 Várzea do Carmo. The objective of this study was to analyze the pharmacotherapeutic profile of patients. This is a cross-sectional and retrospective study in which patients were seen at the Hepatology sector and the results were submitted to descriptive statistics...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28701025/epidemiology-of-hepatic-encephalopathy-in-german-hospitals-the-ephe-study
#14
Christian Labenz, Marcus-Alexander Wörns, Jörn M Schattenberg, Yvonne Huber, Peter Robert Galle, Joachim Labenz
Background Hepatic encephalopathy (HE) is a serious complication of liver cirrhosis. The proportion of patients with liver cirrhosis attending German hospitals suffering from HE is unknown. Methods In the first part of the study, data of 14 community hospitals and 5 university hospitals covering the years 2010 and 2011 were analyzed retrospectively for the DRG codes of liver cirrhosis and hepatic encephalopathy. In the second prospective part of the multicenter observational study, all patients with liver cirrhosis attending the departments of gastroenterology of 16 participating community hospitals within a study period of 3 months were included and screened for HE clinically according to the West Haven criteria (grades 1 - 4)...
July 12, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28689187/acupuncture-for-the-treatment-of-gastro-oesophageal-reflux-disease-a-systematic-review-and-meta-analysis
#15
Jiajie Zhu, Yu Guo, Shan Liu, Xiaolan Su, Yijie Li, Yang Yang, Liwei Hou, Guishu Wang, Jiaxin Zhang, Jiande Jd Chen, Qingguo Wang, Ruhan Wei, Wei Wei
BACKGROUND: Gastro-oesophageal reflux disease (GORD) is one of the most common diseases presenting to gastroenterology clinics. Acupuncture is widely used as a complementary and alternative treatment for patients with GORD. OBJECTIVE: To explore the effectiveness of acupuncture for the treatment of GORD. METHODS: Four English and four Chinese databases were searched through June 2016. Randomised controlled trials investigating the effectiveness of manual acupuncture or electroacupuncture (MA/EA) for GORD versus or as an adjunct to Western medicine (WM) were selected...
July 8, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/28667208/assessment-of-the-effect-of-an-interactive-dynamic-referral-interface-idri-on-the-quality-of-referral-letters-from-general-practitioners-to-gastroenterologists-a-randomised-cross-over-vignette-trial
#16
Sigrun Losada Eskeland, Cathrine Brunborg, Corina Silvia Rueegg, Lars Aabakken, Thomas de Lange
OBJECTIVES: We evaluated whether interactive, electronic, dynamic, diagnose-specific checklists improve the quality of referral letters in gastroenterology and assessed the general practitioners' (GPs') acceptance of the checklists. DESIGN: Randomised cross-over vignette trial. SETTING: Primary care in Norway. PARTICIPANTS: 25 GPs. INTERVENTION: The GPs participated in the trial and were asked to refer eight clinical vignettes in an internet-based electronic health record simulator...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28648767/quality-indicators-for-esophagogastroduodenoscopy-a-comparative-study-of-outcomes-after-an-improvement-programme-in-a-tertiary-hospital
#17
Henry Córdova, Cristina Sánchez-Montes, Pedro G Delgado-Guillena, Victor J Morales, Oriol Sendino, Begoña González-Suárez, Andrés Cárdenas, Maria Pellisé, Isis K Araujo, Àngels Ginés, Josep Llach, Gloria Fernández-Esparrach
INTRODUCTION: There is an opportunity for improvement in the recording and measuring of quality indicators. However, no previous experiences exist in our field in terms of their compliance in esophagogastroduodenoscopy (EGD). OBJECTIVE: To analyse compliance with EGD quality criteria and evaluate improvement after conducting a training programme. PATIENTS AND METHODS: Comparative study of 2 cohorts: one retrospective (control group) and one prospective (intervention group), before and after a training programme consisting of an information session and the report writing improvement programme...
June 22, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28648577/impact-of-cap-assisted-colonoscopy-on-the-learning-curve-and-quality-in-colonoscopy-a-randomized-controlled-trial
#18
Zhouwen Tang, Daniel S Zhang, Aaron P Thrift, Kalpesh K Patel
BACKGROUND AND AIMS: Colonoscopy competency assessment in trainees traditionally has been informal. Comprehensive metrics such as the Assessment of Competency in Endoscopy (ACE) tool suggest that competency thresholds are higher than assumed. Cap-assisted colonoscopy (CAC) may improve competency, but data regarding novice trainees are lacking. We compared CAC versus standard colonoscopy (SC) performed by novice trainees in a randomized controlled trial. METHODS: All colonoscopies performed by 3 gastroenterology fellows without prior experience were eligible for the study...
June 23, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28648219/primary-care-collaboration-to-improve-diagnosis-and-screening-for-colorectal-cancer
#19
Gordon D Schiff, Trudy Bearden, Lindsay Swain Hunt, Jennifer Azzara, Jay Larmon, Russell S Phillips, Sara Singer, Brandon Bennett, Jonathan R Sugarman, Asaf Bitton, Andrew Ellner
BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer death, reducible by screening and early diagnosis, yet many patients fail to receive recommended screening. As part of an academic improvement collaborative, 25 primary care practices worked to improve CRC screening and diagnosis. METHODS: The project featured triannual learning sessions, monthly conference calls, practice coach support, and monthly reporting. The project phases included literature review and interviews with national leaders/organizations, development of driver diagrams to identify key factors and change ideas, project launch and practice team planning, and a practice improvement phase...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28646886/implementation-science-for-ambulatory-care-safety-a-novel-method-to-develop-context-sensitive-interventions-to-reduce-quality-gaps-in-monitoring-high-risk-patients
#20
Kathryn M McDonald, George Su, Sarah Lisker, Emily S Patterson, Urmimala Sarkar
BACKGROUND: Missed evidence-based monitoring in high-risk conditions (e.g., cancer) leads to delayed diagnosis. Current technological solutions fail to close this safety gap. In response, we aim to demonstrate a novel method to identify common vulnerabilities across clinics and generate attributes for context-flexible population-level monitoring solutions for widespread implementation to improve quality. METHODS: Based on interviews with staff in otolaryngology, pulmonary, urology, breast, and gastroenterology clinics at a large urban publicly funded health system, we applied journey mapping to co-develop a visual representation of how patients are monitored for high-risk conditions...
June 24, 2017: Implementation Science: IS
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