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Quality improvement in primary care

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https://www.readbyqxmd.com/read/28350636/the-impact-of-hospital-health-network-affiliation-on-discharge-communication-preferences-of-primary-care-providers
#1
David Y Ming, Alyssa M Stephany, John A Gallis, Benjamin J Powers
Primary care physicians (PCPs) experience differential postdischarge access to electronic health records, depending upon affiliation with the discharging hospital's health network. To better understand whether this affiliation impacts discharge communication preferences, we surveyed a convenience sample of PCPs in and out of our hospital's health network. We also surveyed hospitalists and compared PCPs' and hospitalists' responses. We found that PCP discharge communication preferences differed by hospital health network affiliation...
March 27, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28350561/reducing-pediatric-sternal-wound-infections-a-quality-improvement-project
#2
Claudia Delgado-Corcoran, Charlotte S Van Dorn, Charles Pribble, Emily A Thorell, Andrew T Pavia, Camille Ward, Randall Smout, Susan L Bratton, Phillip T Burch
OBJECTIVES: To evaluate whether a quality improvement intervention reduces sternal wound infection rates in children after cardiac surgery. DESIGN: This is a pre- and postintervention quality improvement study. SETTING: A 16-bed cardiac ICU in a university-affiliated pediatric tertiary care children's hospital. PATIENTS: All patients undergoing cardiac surgery via median sternotomy from January 2010 to December 2014 are included...
March 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28345538/current-trends-for-st-segment-elevation-myocardial-infarction-during-the-past-5-years-in-rural-areas-of-china-s-liaoning-province-a-multicenter-study
#3
Guang-Xiao Li, Bo Zhou, Guo-Xian Qi, Bo Zhang, Da-Ming Jiang, Gui-Mei Wu, Bing Ma, Peng Zhang, Qiong-Rui Zhao, Juan Li, Ying Li, Jing-Pu Shi
BACKGROUND: Since 2010, two versions of National Guidelines aimed at promoting the management of ST-segment elevation myocardial infarction (STEMI) have been formulated by the Chinese Society of Cardiology. However, little is known about the changes in clinical characteristics, management, and in-hospital outcomes in rural areas. METHODS: In the present multicenter, cross-sectional study, participants were enrolled from rural hospitals located in Liaoning province in Northeast China, during two different periods (from June 2009 to June 2010 and from January 2015 to December 2015)...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28343658/text-message-intervention-teach-improves-quality-of-life-and-patient-activation-in-celiac-disease-a-randomized-clinical-trial
#4
Kelly Haas, Andrew Martin, K T Park
OBJECTIVE: To determine the impact of the Text Message Educational Automated Compliance Help (TEACH) text message intervention as a pragmatic approach for patient engagement among adolescents with celiac disease (CD) as measured by gluten-free diet (GFD) adherence, patient activation, and quality of life (QOL). STUDY DESIGN: Randomized controlled trial with patient recruitment at a pediatric, university-based hospital and through social media; 61 participants ages 12-24 years with CD diagnosed at least 1 year were enrolled...
March 23, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28342688/in-hospital-mortality-30-day-readmission-and-length-of-hospital-stay-after-surgery-for-primary-colorectal-cancer-a-national-population-based-study
#5
S Pucciarelli, M Zorzi, N Gennaro, G Gagliardi, A Restivo, M Saugo, A Barina, M Rugge, M Zuin, I Maretto, D Nitti
INTRODUCTION: The simultaneous assessment of multiple indicators for quality of care is essential for comparisons of performance between hospitals and health care systems. The aim of this study was to assess the rates of in-hospital mortality and 30-day readmission and length of hospital stay (LOS) in patients who underwent surgical procedures for colorectal cancer between 2005 and 2014 in Italy. METHODS: All patients in the National Italian Hospital Discharge Dataset who underwent a surgical procedure for colorectal cancer during the study period were included...
March 16, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28342621/how-nurse-led-practices-perceive-implementation-of-the-patient-centered-medical-home
#6
Rosemary Frasso, A Golinkoff, Heather Klusaritz, Katherine Kellom, Helen Kollar-McArthur, Michelle Miller-Day, Robert Gabbay, Peter F Cronholm
PURPOSE: The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. METHODS: Data were collected through in-depth interviews with providers and staff in nurse-led practices...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28342119/returns-to-operating-room-after-colon-and-rectal-surgery-in-a-tertiary-care-academic-medical-center-a-valid-measure-of-surgical-quality
#7
Amy L Lightner, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima
INTRODUCTION: Returns to the operating room (ROR) have been suggested as a marker of surgical quality. Increasingly, quality and value metrics are utilized for reimbursement as well as public reporting to inform health care consumers. We sought to understand the etiology of ROR and assess the validity of simple ROR as a quality metric. METHODS: This was a single referral center retrospective review of all colon and rectal operations between January 1, 2014 and December 31, 2014...
March 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28341576/effectiveness-of-interventions-to-reduce-household-air-pollution-and-or-improve-health-in-homes-using-solid-fuel-in-low-and-middle-income-countries-a-systematic-review-and-meta-analysis
#8
REVIEW
Reginald Quansah, Sean Semple, Caroline A Ochieng, Sanjar Juvekar, Frederick Ato Armah, Isaac Luginaah, Jacques Emina
BACKGROUND: Cookstove intervention programs have been increasing over the past two (2) decades in Low and Middle Income Countries (LMICs) across the globe. However, there remains uncertainty regarding the effects of these interventions on household air pollution concentrations, personal exposure concentrations and health outcomes. OBJECTIVES: The primary objective was to determine if household air pollution (HAP) interventions were associated with improved indoor air quality (IAQ) in households in LMICs...
March 21, 2017: Environment International
https://www.readbyqxmd.com/read/28341524/a-clinical-care-algorithmic-toolkit-for-promoting-screening-and-next-level-assessment-of-pediatric-depression-and-anxiety-in-primary-care
#9
Lisa Honigfeld, Susan J Macary, Damion J Grasso
With a documented shortage in youth mental health services, pediatric primary care (PPC) providers face increased pressure to enhance their capacity to identify and manage common mental health problems among youth, such as anxiety and depression. Because 90% of U.S. youth regularly see a PPC provider, the primary care setting is well positioned to serve as a key access point for early identification, service provision, and connection to mental health services. In the context of task shifting, we evaluated a quality improvement project designed to assist PPC providers in overcoming barriers to practice-wide mental health screening through implementing paper and computer-assisted clinical care algorithms...
March 21, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28340086/real-world-massage-therapy-produces-meaningful-effectiveness-signal-for-primary-care-patients-with-chronic-low-back-pain-results-of-a-repeated-measures-cohort-study
#10
William G Elder, Niki Munk, Margaret M Love, Geza G Bruckner, Kathryn E Stewart, Kevin Pearce
Objective.:  While efficacy of massage and other nonpharmacological treatments for chronic low back pain is established, stakeholders have called for pragmatic studies of effectiveness in "real-world" primary health care. The Kentucky Pain Research and Outcomes Study evaluated massage impact on pain, disability, and health-related quality of life for primary care patients with chronic low back pain. We report effectiveness and feasibility results, and make comparisons with established minimal clinically important differences...
March 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339996/fathers-perceptions-of-change-following-parenting-intervention-randomized-controlled-trial-of-triple-p-for-parents-of-children-with-asthma-or-eczema1
#11
Alina Morawska, Amy E Mitchell, Scott Burgess, Jennifer Fraser
 To test whether families' participation in an evidence-based parenting program can improve health-related outcomes reported by fathers of 2- to 10-year-old children with asthma and/or eczema.  A 2 (Triple P-Positive Parenting Program vs. care as usual) by 3 (baseline, postintervention, 6-month follow-up) design was used, with random group assignment. Of 107 families, 51.4% ( N  = 55) had a father participate alongside the child's mother, who was the primary intervention target. Fathers completed questionnaires assessing illness-related child behavior problems; self-efficacy with illness management and illness-related child behavior problems; and health-related quality of life...
March 2, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28339494/facility-type-and-primary-care-performance-in-sub-district-health-promotion-hospitals-in-northern-thailand
#12
Nithra Kitreerawutiwong, Sue Jordan, David Hughes
BACKGROUND: Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses...
2017: PloS One
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#13
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339327/raising-public-awareness-of-clinical-trials-development-of-messages-for-a-national-health-communication-campaign
#14
Holly A Massett, David M Dilts, Robert Bailey, Jennifer Berktold, Rebecca Ledsky, Nancy L Atkinson, Grace Mishkin, Andrea Denicoff, Rose Mary Padberg, Marin P Allen, Karen Silver, Kelli Carrington, Lenora E Johnson
Clinical trials are essential for developing new and effective treatments and improving patient quality of life; however, many trials cannot answer their primary research questions because they fall short of their recruitment goals. This article reports the results of formative research conducted in two populations, the public and primary care physicians, to identify messages that may raise awareness and increase interest in clinical trials and be used in a national communication campaign. Results suggested that participants were primarily motivated to participate in clinical trials out of a self-interest to help themselves first...
March 24, 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/28338849/a-preventative-lifestyle-intervention-for-older-adults-lifestyle-matters-a-randomised-controlled-trial
#15
Gail Mountain, Gill Windle, Daniel Hind, Stephen Walters, Anju Keertharuth, Robin Chatters, Kirsty Sprange, Claire Craig, Sarah Cook, Ellen Lee, Tim Chater, R Woods, Louise Newbould, Lauren Powell, Katy Shortland, Jennifer Roberts
Objectives: to test whether an occupation-based lifestyle intervention can sustain and improve the mental well-being of adults aged 65 years or over compared to usual care, using an individually randomised controlled trial. Participants: 288 independently living adults aged 65 years or over, with normal cognition, were recruited from two UK sites between December 2011 and November 2015. Interventions: lifestyle Matters is a National Institute for Health and Care Excellence recommended multi-component preventive intervention designed to improve the mental well-being of community living older people at risk of decline...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28338454/impact-of-preoperative-diagnosis-on-patient-satisfaction-following-lumbar-spine-surgery
#16
Charles H Crawford, Leah Y Carreon, Mohamad Bydon, Anthony L Asher, Steven D Glassman
OBJECTIVE Patient satisfaction is a commonly used metric in the current health care environment. While factors that affect patient satisfaction following spine surgery are complex, the authors of this study hypothesized that specific diagnostic groups of patients are more likely to be satisfied after spine surgery and that this is reflected in patient-reported outcome measures. The purpose of this study was to determine if the preoperative diagnosis-disc herniation, stenosis, spondylolisthesis, adjacent segment degeneration, or mechanical disc collapse-would impact patient satisfaction following surgery...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28338449/development-of-a-preoperative-predictive-model-for-major-complications-following-adult-spinal-deformity-surgery
#17
Justin K Scheer, Justin S Smith, Frank Schwab, Virginie Lafage, Christopher I Shaffrey, Shay Bess, Alan H Daniels, Robert A Hart, Themistocles S Protopsaltis, Gregory M Mundis, Daniel M Sciubba, Tamir Ailon, Douglas C Burton, Eric Klineberg, Christopher P Ames
OBJECTIVE The operative management of patients with adult spinal deformity (ASD) has a high complication rate and it remains unknown whether baseline patient characteristics and surgical variables can predict early complications (intraoperative and perioperative [within 6 weeks]). The development of an accurate preoperative predictive model can aid in patient counseling, shared decision making, and improved surgical planning. The purpose of this study was to develop a model based on baseline demographic, radiographic, and surgical factors that can predict if patients will sustain an intraoperative or perioperative major complication...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28337821/mindfulness-based-stress-reduction-added-to-care-as-usual-for-lung-cancer-patients-and-or-their-partners-a-multi-centre-randomized-controlled-trial
#18
M P J Schellekens, D G M van den Hurk, J B Prins, A R T Donders, J Molema, R Dekhuijzen, M A van der Drift, A E M Speckens
BACKGROUND: Lung cancer patients report among the highest distress rates of all cancer patients. Partners report similar distress rates. The present study examined the effectiveness of additional Mindfulness-Based Stress Reduction (CAU + MBSR) versus solely care as usual (CAU) to reduce psychological distress in lung cancer patients and/or their partners. METHODS: We performed a multicentre, parallel-group, randomized controlled trial. MBSR is an 8-week group-based intervention, including mindfulness practice and teachings on stress...
March 23, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28336746/understanding-dutch-practice-nurses-adherence-to-evidence-based-smoking-cessation-guidelines-and-their-needs-for-web-based-adherence-support-results-from-semistructured-interviews
#19
D de Ruijter, E S Smit, H de Vries, L Goossens, C Hoving
OBJECTIVES: Practice nurses in general practices suboptimally adhere to smoking cessation guidelines. Since the effectiveness of their smoking cessation support is greatest when full adherence to these guidelines is achieved, interventions need to be developed to improve practice nurses' guideline adherence, for example, by tailoring their content to adherence determinants. However, the sociocognitive determinants explaining adherence have not yet been investigated. Therefore, this qualitative needs assessment aimed to explore practice nurses' current counselling practices, as well as their sociocognitive beliefs related to their smoking cessation guideline adherence and their needs regarding web-based adherence support...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28336345/dancing-for-parkinson-s-a-randomized-trial-of-irish-set-dancing-compared-to-usual-care
#20
Joanne Shanahan, Meg E Morris, Orfhlaith Ni Bhriain, Daniele Volpe, Tim Lynch, Amanda M Clifford
OBJECTIVE: This pilot trial examined the feasibility of a randomised controlled study design and explored the benefits of the set dancing intervention compared to usual care. DESIGN: Randomised controlled design, with participants randomised to Irish set dance classes or a usual care control group. SETTING: Community based PARTICIPANTS: Individuals with idiopathic PD INTERVENTIONS: The dance group attended a 1.5 hour dancing class each week for 10 weeks and undertook a home dance programme for 20 minutes three times per week...
March 21, 2017: Archives of Physical Medicine and Rehabilitation
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