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Quality improvement in primary care

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https://www.readbyqxmd.com/read/29226798/long-term-effects-of-a-swedish-lifestyle-intervention-programme-on-lifestyle-habits-and-quality-of-life-in-people-with-increased-cardiovascular-risk
#1
Matthias Lidin, Elin Ekblom-Bak, Monica Rydell Karlsson, Mai-Lis Hellénius
AIMS: The aim of this study was to evaluate the effects of a structured intervention programme on lifestyle habits and quality of life after six months and one year in participants with increased cardiovascular risk. METHODS: Participants aged ≥18 years with increased cardiovascular risk were referred from primary health care and hospitals. The programme was launched at an outpatient clinic in a department of cardiology at a university hospital. It consisted of individual visits to a nurse for a health check-up and lifestyle counselling at baseline, after six months and at one year...
December 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/29226448/better-measurement-for-performance-improvement-in-low-and-middle-income-countries-the-primary-health-care-performance-initiative-phcpi-experience-of-conceptual-framework-development-and-indicator-selection
#2
Jeremy Veillard, Krycia Cowling, Asaf Bitton, Hannah Ratcliffe, Meredith Kimball, Shannon Barkley, Laure Mercereau, Ethan Wong, Chelsea Taylor, Lisa R Hirschhorn, Hong Wang
Policy Points: Strengthening accountability through better measurement and reporting is vital to ensure progress in improving quality primary health care (PHC) systems and achieving universal health coverage (UHC). The Primary Health Care Performance Initiative (PHCPI) provides national decision makers and global stakeholders with opportunities to benchmark and accelerate performance improvement through better performance measurement. Results from the initial PHC performance assessments in low- and middle-income countries (LMICs) are helping guide PHC reforms and investments and improve the PHCPI's instruments and indicators...
December 2017: Milbank Quarterly
https://www.readbyqxmd.com/read/29225932/potential-applications-of-telenephrology-to-enhance-global-kidney-care
#3
REVIEW
Mohamed A Osman, Julius Okel, Ikechi G Okpechi, Kailash Jindal, Aminu K Bello
Chronic kidney disease (CKD) is an important public health issue that increasingly affects more patients globally and is associated with adverse clinical consequences with huge economic impact. Effective management of patients with CKD requires delivery of kidney care in a primary care setting where possible and at a higher level with a nephrologist when necessary to improve outcomes. In many instances and for various reasons, it is not possible to follow this pathway of care delivery. With improving telecommunication technologies worldwide, it is hoped that increasing utilisation of electronic communication devices can be used to facilitate kidney care to improve the quality of care delivered to patients, especially those who live in remote regions...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225926/does-expanding-primary-healthcare-improve-hospital-efficiency-evidence-from-a-panel-analysis-of-avoidable-hospitalisations-in-5506-municipalities-in-brazil-2000-2014
#4
Everton Nunes da Silva, Timothy Powell-Jackson
Background: Hospitals account for the major share of health expenditure. Primary healthcare may improve efficiency at the hospital level by reducing avoidable admissions. We examined whether rapid expansion of primary healthcare in the context of Brazil's Family Health Strategy (FHS) was associated with a reduction in avoidable hospitalisations. Methods: We constructed panel data for 5506 municipalities over 2000-2014. Our primary outcome was the rate of avoidable hospitalisations, defined with reference to the official list of ambulatory care sensitive conditions (ACSC)...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225889/efficacy-of-sonographic-and-biological-pleurodesis-indicators-of-malignant-pleural-effusion-simple-protocol-of-a-randomised-controlled-trial
#5
Ioannis Psallidas, Hania E G Piotrowska, Ahmed Yousuf, Nikolaos I Kanellakis, Gayathri Kagithala, Seid Mohammed, Lei Clifton, John P Corcoran, Nicky Russell, Melissa Dobson, Robert F Miller, Najib M Rahman
Introduction: Malignant pleural effusion (MPE) is common and currently in UK there are an estimated 50 000 new cases of MPE per year. Talc pleurodesis remains one of the most popular methods for fluid control. The value of thoracic ultrasound (TUS) imaging, before and after pleurodesis, in improving the quality and efficacy of care for patients with MPE remains unknown. Additionally, biomarkers of successful pleurodesis including measurement of pleural fluid proteins have not been validated in prospective studies...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29224702/early-intervention-to-restore-function-and-maintain-healthy-trajectory
#6
REVIEW
Juan Jover, Lydia Abasolo
The health of the global population has undergone rapid transformation. Life expectancy and chronic conditions are increasing, and persons aged 65 years or older have become the fastest growing segment of population. The worldwide picture of disease burden is increasingly defined by disability instead of premature mortality. Population growth, ageing and sedentary lifestyles, particularly in developing countries, will result in a crisis for the population health that requires a multi-system response. The growing awareness of the diseases burden increases the need for accurate measurement and assessment of the burden and measurement of the impact of any public health action...
April 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29224511/measuring-and-improving-student-engagement-in-clinical-training
#7
Simin Lee, Yannis K Valtis, Tomi Jun, David Wang, Biqi Zhang, Esther H Chung, Amy Yu, Rachael Williams, Marya J Cohen
Purpose Volunteer service learning activities, including Student Run Clinics (SRCs), are becoming an increasingly popular extracurricular component of medical education. While there are reports that student clinicians generally enjoy their educational experiences at SRCs, it is not understood how to optimize and measure student engagement in them. To identify key drivers of student engagement a tool was created to measure volunteer experience at the Crimson Care Collaborative (CCC), a primary care SRC. Methods CCC volunteers were asked to complete an online engagement survey...
December 11, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/29223416/cost-variation-across-centers-for-the-norwood-operation
#8
Kimberly E McHugh, Sara K Pasquali, Matthew A Hall, Mark A Scheurer
BACKGROUND: The Norwood operation is associated with high health care utilization, and prior studies reported substantial variability in Norwood costs across centers. However, specific factors driving this cost variation are unclear. We assessed center variability in Norwood costs and underlying mechanisms in a multicenter cohort. METHODS: Clinical data from the Pediatric Heart Network Single Ventricle Reconstruction trial were linked with cost data from the Children's Hospital Association Inpatient Essentials database...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29221645/primary-care-led-weight-management-for-remission-of-type-2-diabetes-direct-an-open-label-cluster-randomised-trial
#9
Michael Ej Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Renae Stefanetti, Michael Trenell, Paul Welsh, Sharon Kean, Ian Ford, Alex McConnachie, Naveed Sattar, Roy Taylor
BACKGROUND: Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. METHODS: We did this open-label, cluster-randomised trial (DiRECT) at 49 primary care practices in Scotland and the Tyneside region of England. Practices were randomly assigned (1:1), via a computer-generated list, to provide either a weight management programme (intervention) or best-practice care by guidelines (control), with stratification for study site (Tyneside or Scotland) and practice list size (>5700 or ≤5700)...
December 4, 2017: Lancet
https://www.readbyqxmd.com/read/29221501/lean-methodology-reduces-inappropriate-use-of-antipsychotics-for-agitation-at-a-psychiatric-hospital
#10
Joshana K Goga, Antonio Depaolo, Sunil Khushalani, J Ken Walters, Robert Roca, Marc Zisselman, Christopher Borleis
OBJECTIVE: To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. DESIGN: Historically Controlled Study. SETTING: Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29221442/general-practitioners-awareness-of-depressive-symptomatology-is-not-associated-with-quality-of-life-in-heart-failure-patients-cross-sectional-results-of-the-observational-recode-hf-study
#11
Marion Eisele, Sigrid Boczor, Anja Rakebrandt, Eva Blozik, Jens-Martin Träder, Stefan Störk, Christoph Herrmann-Lingen, Martin Scherer
BACKGROUND: Depression is a common comorbidity in patients with chronic heart failure (HF) and linked to a wider range of symptoms which, in turn, are linked to a decreased health-related quality of life (HRQOL). Treatment of depression might improve HRQOL but detecting depression is difficult due to the symptom overlap between HF and depression. Therefore, clinical guidelines recommend to routinely screen for depression in HF patients. No studies have so far investigated the treatment after getting aware of a depressive symptomatology and its correlation with HRQOL in primary care HF patients...
December 8, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/29219922/multimodal-prehabilitation-programs-as-a-bundle-of-care-in-gastrointestinal-cancer-surgery-a-systematic-review
#12
Vladimir Bolshinsky, Michael H-G Li, Hilmy Ismail, Kate Burbury, Bernhard Riedel, Alexander Heriot
BACKGROUND: Prehabilitation reflects a proactive process of preoperative optimization undertaken between cancer diagnosis and definitive surgical treatment, with the intent of improving physiological capacity to withstand the major insult of surgery. Prehabilitation before GI cancer surgery is currently not widely adopted, and most research has focused on unimodal interventions such as exercise therapy, nutritional supplementation, and hematinic optimization. A review of the existing literature was undertaken to investigate the impact of multimodal prehabilitation programs as a "bundle of care...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29219876/effectiveness-of-patient-centered-interventions-on-falls-in-the-acute-care-setting-compared-to-usual-care-a-systematic-review
#13
Donna Avanecean, Dawn Calliste, Teresita Contreras, Yeogyeong Lim, Aileen Fitzpatrick
BACKGROUND: Unintentional falls during hospitalization remain a concern for healthcare institutions globally despite implementation of various improvement strategies. Although the incidence of falls has been of heightened focus for many years and numerous studies have been done evaluating different approaches for fall prevention, fall rates remain high in acute care settings. Patient fall risk scales tend to address only particular intrinsic and extrinsic factors but do not adequately assess a patient's current fall risk status, subsequently warranting more patient-centered risk assessments and interventions...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29219828/improving-care-for-older-patients-in-the-acute-setting-a-qualitative-study-with-healthcare-providers
#14
C Brouwers, H Merten, M Willems, D J Habraken, F W Bloemers, T H Biesheuvel, L S van Galen, P W B Nanayakkara, C Wagner
BACKGROUND: The proportion of older people needing acute care is rapidly growing, thereby posing an increased burden on the acute care chain. The aim of this study is to gain more insight into the obstacles and potential improvement opportunities of the acute care process for older patients arriving at the hospital. METHODS: Semi-structured interviews were conducted to determine the experiences of 18 different primary (i.e. general practitioner, community nurse) and secondary healthcare professionals (i...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29218966/building-compassion-literacy-enabling-care-in-primary-health-care-nursing
#15
Letitia Helen Burridge, Sarah Winch, Margaret Kay, Amanda Henderson
This paper introduces the concept of compassion literacy and discusses its place in nursing within the general practice setting. Compassion literacy is a valuable competency for sustaining the delivery of high quality care. Being compassion literate enables practice nurses to provide compassionate care to their patients and to recognise factors that may constrain this. A compassion literate practice nurse may be more protected from compassion fatigue and its negative consequences. Understanding how to enable self-compassion and how to support the delivery of compassionate care within the primary care team can enhance the care experienced by the patient while improving the positive engagement and satisfaction of the health professionals...
2017: Collegian: Journal of the Royal College of Nursing, Australia
https://www.readbyqxmd.com/read/29217389/competencies-for-engaging-high-needs-patients-in-primary-care
#16
Michael J Yedidia
BACKGROUND: Patients who heavily utilize hospitals and emergency departments frequently have complex needs requiring services spanning medical, behavioral, and social service sectors. This study identifies essential competencies for caring for high-needs patients and highlights their importance to primary care delivery. METHODS: Transcripts of in-depth interviews with 30 clinical and administrative staff at 23 complex care programs across the United States were analyzed using standard qualitative techniques...
December 4, 2017: Healthcare
https://www.readbyqxmd.com/read/29216748/quality-of-care-for-patients-with-diabetes-and-mulitmorbidity-registered-at-nurse-practitioner-led-clinics
#17
Roberta Heale, Elizabeth Wenghofer, Susan James, Marie-Luce Garceau
Background Nurse Practitioner-Led Clinics are a new model of primary healthcare in Ontario. Nurse Practitioner-Led Clinics are distinctive in that nurse practitioners are the primary care providers working with an interprofessional team. There have been no evaluations of the quality of care within the Nurse Practitioner-Led Clinic model. Purpose Evaluation of the Nurse Practitioner-Led Clinic model, specifically for complex clinical presentations, will provide insights that may be used to inform improvements to the delivery of care in the Nurse Practitioner-Led Clinics...
January 1, 2017: Canadian Journal of Nursing Research, Revue Canadienne de Recherche en Sciences Infirmières
https://www.readbyqxmd.com/read/29215657/-the-patient-and-the-crossing-between-primary-and-hospital-care-systematic-review-of-trials-for-the-implementation-of-tools-for-integration-in-spain
#18
REVIEW
L Corral Gudino, M Borao Cengotita-Bengoa, R J Jorge Sánchez, J García Aparicio
BACKGROUND: Health services are moving towards a complete integration to try and reduce fragmentation, increase efficiencies and improve health outcomes. Estimates the effectiveness in of different tools for integrated care in Spain. METHODS: We performed a systematic review of articles using MEDLINE (last search July31st, 2017). Randomized clinical trials reporting health outcomes of tools for integrated care used in Spain were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment...
December 7, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29215477/prophylactic-ureteral-catheters-for-colectomy-a-national-surgical-quality-improvement-program-based-analysis
#19
Kathleen M Coakley, Kevin R Kasten, Stephanie M Sims, Tanushree Prasad, B Todd Heniford, Bradley R Davis
BACKGROUND: Despite improvement in technique and technology, using prophylactic ureteral catheters to avoid iatrogenic ureteral injury during colectomy remains controversial. OBJECTIVE: The aim of this study was to evaluate outcomes and costs attributable to prophylactic ureteral catheters with colectomy. DESIGN: This was a retrospective study. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: The colectomy-targeted American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2014 was queried...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29214316/association-between-hospital-financial-distress-and-immediate-breast-reconstruction-surgery-after-mastectomy-among-women-with-ductal-carcinoma-in-situ
#20
Catherine A Richards, Andrew G Rundle, Jason D Wright, Dawn L Hershman
Importance: Hospital financial distress (HFD) is a state in which a hospital is at risk of closure because of its financial condition. Hospital financial distress may reduce the services a hospital can offer, particularly unprofitable ones. Few studies have assessed the association of HFD with quality of care. Objective: To examine the association between HFD and receipt of immediate breast reconstruction surgery after mastectomy among women diagnosed with ductal carcinoma in situ (DCIS)...
December 6, 2017: JAMA Surgery
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