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Quality improvement gastroenterology

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https://www.readbyqxmd.com/read/29174953/signature-celebration-of-gastroenterology-colorectal-cancer
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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/intestinal-rehabilitation-programs-in-the-management-of-pediatric-intestinal-failure-and-short-bowel-syndrome
#14
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 programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation...
November 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
#15
Sabina Beg, Krish Ragunath, Andrew Wyman, Matthew Banks, Nigel Trudgill, D Mark 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
#16
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
#17
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
#18
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
#19
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
#20
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
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