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Quality improvement in primary care

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https://www.readbyqxmd.com/read/28225345/results-of-xpert-%C3%A2-mtb-rif-implementation-in-kyrgyzstan
#1
G Kurbaniyazova, M Joncevska, S Kalon, G Kalmambetova, T Mohr, A Toktogonova, K Takieva, K M Monirul Islam, F Luelmo
INTRODUCTION: In July 2012, the United States Agency for International Development (USAID) Quality Health Care Project introduced the Xpert® MTB/RIF assay at the facility level of the primary health care system in Kyrgyzstan. This study analysed the results of the implementation of Xpert. MATERIALS AND METHODS: Test results from 2734 patients from July 2012 to December 2014 were analysed. The sensitivity and specificity of Xpert in routine programme conditions were evaluated using culture and phenotypic drug susceptibility testing (DST) as gold standard...
March 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28224443/report-of-the-clinical-and-functional-primary-outcomes-in-men-of-the-acl-sports-trial-similar-outcomes-in-men-receiving-secondary-prevention-with-and-without-perturbation-training-1-and-2-years-after-acl-reconstruction
#2
Amelia J H Arundale, Kathleen Cummer, Jacob J Capin, Ryan Zarzycki, Lynn Snyder-Mackler
BACKGROUND: Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28224099/using-quality-improvement-methods-to-increase-use-of-pain-prevention-strategies-for-childhood-vaccination
#3
Jennifer Verrill Schurman, Amanda D Deacy, Rebecca J Johnson, Jolynn Parker, Kristi Williams, Dustin Wallace, Mark Connelly, Lynn Anson, Kevin Mroczka
AIM: To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology. METHODS: Specific intervention strategies (i.e., comfort positioning, nonnutritive sucking and sucrose analgesia, distraction) were identified, selected and introduced in three waves, using a Plan-Do-Study-Act framework. System-wide change was measured from baseline to post-intervention by: (1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and (2) caregiver satisfaction ratings following the visit...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28222805/use-of-activity-tracking-in-major-visceral-surgery-the-enhanced-perioperative-mobilization-epm-trial-study-protocol-for-a-randomized-controlled-trial
#4
Steffen Wolk, Theresa Meißner, Sebastian Linke, Benjamin Müssle, Ann Wierick, Andreas Bogner, Dorothée Sturm, Nuh N Rahbari, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: Enhanced recovery after surgery (ERAS) programs are aimed at minimizing postoperative stress and accelerating postoperative recovery by implementing multiple perioperative principles. "Early mobilization" is one such principle, but the quality of assessment and monitoring is poor, and evidence of improved outcome is lacking. Activity trackers allow precise monitoring and automatic feedback to the patients to enhance their motivation for early mobilization. The aim of the study is to monitor and increase the postoperative mobilization of patients by giving them continuous automatic feedback in the form of a step count using activity-tracking wristbands...
February 21, 2017: Trials
https://www.readbyqxmd.com/read/28220251/triple-aim-improvement-for-individuals-services-and-society-in-dementia-care-the-dementianet-collaborative-care-approach
#5
M S Nieuwboer, A Richters, M A van der Marck
BACKGROUND: A redesigning of primary care is required to meet dementia patients' needs. In the Netherlands, current dementia care still falls short in areas including ad hoc collaboration, lack of feedback on quality to professionals involved, and insufficient implementation of established multidisciplinary guidelines. OBJECTIVE: DementiaNet is a collaborative care approach, which aims to reduce the burden of the disease on individuals, healthcare services and society via network-based care that encourages collaboration, enhances knowledge and skills and stimulates quality improvement cycles...
February 20, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28219452/stop-stroke-a-brief-report-on-door-to-needle-times-and-performance-after-implementing-an-acute-care-coordination-medical-application-and-implications-to-emergency-medical-services
#6
Robert Dickson, Adrian Nedelcut, Melissa McPeek Nedelcut
OBJECTIVE: The objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS). METHODS: This was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period...
February 21, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28219445/a-cross-sectional-study-of-the-income-sources-of-primary-care-health-workers-in-the-democratic-republic-of-congo
#7
Rishma Maini, David R Hotchkiss, Josephine Borghi
BACKGROUND: In the Democratic Republic of Congo (DRC), the state system to remunerate health workers is poorly functional, encouraging diversification of income sources and corruption. Given the central role that health workers play in health systems, policy-makers need to ensure health workers are remunerated in a way which best incentivises them to provide effective and good quality services. This study describes the different sources and quantities of income paid to primary care health workers in Equateur, Maniema, Kasai Occidental, Province Orientale and Kasai Oriental provinces...
February 20, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28219385/language-support-for-linguistic-minority-chronic-hepatitis-b-c-patients-an-exploratory-study-of-availability-and-clinicians-perceptions-of-language-barriers-in-six-european-countries
#8
Abby M Falla, Irene K Veldhuijzen, Amena A Ahmad, Miriam Levi, Jan Hendrik Richardus
BACKGROUND: Language support for linguistic minorities can improve patient safety, clinical outcomes and the quality of health care. Most chronic hepatitis B/C infections in Europe are detected among people born in endemic countries mostly in Africa, Asia and Central/Eastern Europe, groups that may experience language barriers when accessing health care services in their host countries. We investigated availability of interpreters and translated materials for linguistic minority hepatitis B/C patients...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28218158/influence-of-integrated-community-and-facility-based-interventions-on-select-maternal-and-neonatal-outcomes-in-northern-karnataka-india-lessons-for-implementation-and-measurement
#9
Rajaram Subramanian Potty, Mohan Harnahalli Lakkappa, Arin Kar, Mallika Bidappa, Ramesh Banadakoppa Manjappa, Krishnamurthy Jayanna
BACKGROUND: Sukshema project provided technical assistance to National Health Mission of government of Karnataka to improve maternal, newborn and child health (MNCH) outcomes in eight districts of Karnataka between 2009 and 2015. The project designed tools, processes and provided mentoring to frontline workers, community structures, and facilities to improve demand generation and quality of MNCH services. OBJECTIVES: To assess over time changes in selected MNCH care indicators among women who had delivered in the past 2 months in Bagalkot and Koppal districts...
January 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28217935/effects-of-individualized-exercise-program-on-physical-function-psychological-dimensions-and-health-related-quality-of-life-in-patients-with-chronic-kidney-disease-a-randomized-controlled-trial-in-china
#10
Qing Tang, Bin Yang, Fengyan Fan, Ping Li, Lei Yang, Yujie Guo
The aim of this study was to examine the effects of a 12-week home-based exercise program on physical function, psychological dimensions, and health-related quality of life for patients with chronic kidney disease. Ninety eligible patients were enrolled and randomly separated into the exercise group and the control group from November 2015 to May 2016. The exercise group received an individualized exercise program while the control group received only usual care and continued primary lifestyle. Physical function was measured using 6-minute walk test and 10 repetitions of the sit-to-stand test while psychological dimensions were assessed by the Hospital Anxiety and Depression scale and the Self-Efficacy for Exercise scale...
February 19, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28217876/identifying-primary-care-pathways-from%C3%A2-quality-of-care-to-outcomes-and-satisfaction-using-structural-equation-modeling
#11
Ignacio Ricci-Cabello, Sarah Stevens, Andrew R H Dalton, Robert I Griffiths, John L Campbell, Jose M Valderas
OBJECTIVE: To study the relationships between the different domains of quality of primary health care for the evaluation of health system performance and for informing policy decision making. DATA SOURCES: A total of 137 quality indicators collected from 7,607 English practices between 2011 and 2012. STUDY DESIGN: Cross-sectional study at the practice level. Indicators were allocated to subdomains of processes of care ("quality assurance," "education and training," "medicine management," "access," "clinical management," and "patient-centered care"), health outcomes ("intermediate outcomes" and "patient-reported health status"), and patient satisfaction...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217581/status-of-governmental-oral-health-care-delivery-system-in-haryana-india
#12
Ashish Vashist, Swati Parhar, Ramandeep Singh Gambhir, Ramandeep Kaur Sohi, Puneet Singh Talwar
BACKGROUND: Health system should be organized to meet the needs of entire population of the nation. This means that the state has the direct responsibility for the health of its population and improving the quality of life through research, education, and provision of health services. The present study was conducted to evaluate the government oral health care delivery system in Haryana, India. MATERIALS AND METHODS: The present cross-sectional study was conducted among 135 dental care units (DCUs) of various primary health centers (PHCs), community health centers (CHCs), and general hospitals (GHs) existing in the state by employing a cluster random sampling technique...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217378/role-of-clinical-pathway-in-improving-the-quality-of-care-for-patients-with-faecal-incontinence-a-randomised-trial
#13
Zeiad I Hussain, Michael Lim, Stevan Stojkovic
AIM: To assess the development and implementation of the Integrated Rapid Assessment and Treatment (IRAT) pathway for the management of patients with fecal incontinence and measure its impact on patients' care. METHODS: Patients referred to the colorectal unit in our hospital for the management of faecal incontinence were randomised to either the Standard Care pathway or the newly developed IRAT pathway in this feasibility study. The IRAT pathway is designed to provide a seamless multidisciplinary care to patients with faecal incontinence in a timely fashion...
February 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#14
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28214234/reablement-reactivation-rehabilitation-and-restorative-interventions-with-older-adults-in-receipt-of-home-care-a-systematic-review
#15
REVIEW
Joanie Sims-Gould, Catherine E Tong, Lutetia Wallis-Mayer, Maureen C Ashe
OBJECTIVE: To systematically review the impact of reablement, reactivation, rehabilitation, and restorative (4R) programs for older adults in receipt of home care services. DESIGN: Systematic review. DATA SOURCES: We searched the following electronic bibliographic databases: MEDLINE, EMBASE, PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health), SPORTDiscus and The Cochrane Library and reference lists. STUDY SELECTION: Randomized controlled trials that describe original data on the impact of home-based rehabilitative care and were written in English...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28213993/healthcare-resources-and-needs-in-anticoagulant-therapy-for-patients-with-nonvalvular-atrial-fibrillation-samoa-study
#16
V Barrios, M I Egocheaga-Cabello, J Gállego-Culleré, E Ignacio-García, L Manzano-Espinosa, A Martín-Martínez, J Mateo-Arranz, J Polo-García, D Vargas-Ortega
INTRODUCTION AND OBJECTIVES: To determine, in the various medical specialties, the healthcare process for anticoagulated patients with nonvalvular atrial fibrillation, to determine the available and necessary resources and to identify potential areas of improvement in the care of these patients. METHODS: We performed a cross-sectional survey of primary care and specialised physicians involved in the care of anticoagulated patients. The questionnaires referred to the healthcare process, the indication and prescription of anticoagulant therapy and the barriers and deficiencies present for these patients...
February 14, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28210964/exploring-partners-experiences-in-living-with-patients-who-undergo-bariatric-surgery
#17
Anna Wallwork, Lynn Tremblay, Monica Chi, Sanjeev Sockalingam
BACKGROUND: Bariatric surgery is effective in assisting persons with severe obesity in achieving significant weight loss and improved health; however, success depends on one's lifelong commitment to lifestyle modifications post-operatively. Life partners can be essential to the success of bariatric patients as they can serve as a primary resource to patients and healthcare teams. This study aimed to explore bariatric patients' partner's experiences in order to help inform clinical practice in bariatric care to better address patient and partner needs...
February 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28210482/delayed-interval-delivery-can-save-the-second-twin-evidence-from-a-systematic-review
#18
REVIEW
S Feys, Y Jacquemyn
BACKGROUND: In case of preterm birth in twins, it is not well established if the second twin benefits from a delayed-interval delivery. OBJECTIVE: The main objective of this systematic review is to evaluate survival benefit of the second twin from delayed interval delivery compared to the first twin. Secondly, we will evaluate the survival benefit of the procedure when performed equal to or after 24 weeks gestational age of the first born. METHODS: Delayed interval delivery was defined as every attempt to perform a delayed interval delivery with at minimum placement of a high ligature of the umbilical cord and a delay of delivery of at least 24 hours...
December 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28210351/cross-continuum-tool-is-associated-with-reduced-utilization-and-cost-for-frequent-high-need-users
#19
Lauran Hardin, Adam Kilian, Leslie Muller, Kevin Callison, Michael Olgren
INTRODUCTION: High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209168/the-impact-of-preterm-birth-37%C3%A2-weeks-on-parents-and-families-a-cross-sectional-study-in-the-2%C3%A2-years-after-discharge-from-the-neonatal-intensive-care-unit
#20
Ashwini Lakshmanan, Meghana Agni, Tracy Lieu, Eric Fleegler, Michele Kipke, Philippe S Friedlich, Marie C McCormick, Mandy B Belfort
BACKGROUND: Little is known about the quality of life of parents and families of preterm infants after discharge from the neonatal intensive care unit (NICU). Our aims were (1) to describe the impact of preterm birth on parents and families and (2) and to identify potentially modifiable determinants of parent and family impact. METHODS: We surveyed 196 parents of preterm infants <24 months corrected age in 3 specialty clinics (82% response rate). Primary outcomes were: (1) the Impact on Family Scale total score; and (2) the Infant Toddler Quality of Life parent emotion and (3) time limitations scores...
February 16, 2017: Health and Quality of Life Outcomes
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