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Quality improvement in primary care

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https://www.readbyqxmd.com/read/28821527/systematic-review-of-economic-analyses-in-patient-safety-a-protocol-designed-to-measure-development-in-the-scope-and-quality-of-evidence
#1
Alexander W Carter, Rishi Mandavia, Erik Mayer, Joachim Marti, Elias Mossialos, Ara Darzi
INTRODUCTION: Recent avoidable failures in patient care highlight the ongoing need for evidence to support improvements in patient safety. According to the most recent reviews, there is a dearth of economic evidence related to patient safety. These reviews characterise an evidence gap in terms of the scope and quality of evidence available to support resource allocation decisions. This protocol is designed to update and improve on the reviews previously conducted to determine the extent of methodological progress in economic analyses in patient safety...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28818691/multi-center-evaluation-of-the-cobas-%C3%A2-liat-%C3%A2-influenza-a-b-rsv-assay-for-rapid-point-of-care-diagnosis
#2
Jane Gibson, Elissa M Schechter-Perkins, Patricia Mitchell, Sharon Mace, Yu Tian, Kemi Williams, Robert Luo, Belinda Yen-Lieberman
Point of Care Testing (POCT) provides the capability for rapid laboratory test results in patient care environments where a traditional clinical laboratory is not available. POCTs have shorter turn-around times (TATs), they may be performed by non-laboratory personnel, and the need for transport time is eliminated. The Food and Drug Administration (FDA) recently granted Clinical Laboratory Improvements Amendment (CLIA) waiver status to the cobas(®) Influenza A/B & RSV assay, a rapid, accurate point-of-care test for Influenza and respiratory syncytial virus (RSV) performed on the Liat(®) System...
August 8, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28818227/impact-of-an-educational-program-on-the-quality-of-life-of%C3%A2-patients-with-lymphedema-a-preliminary-evaluation
#3
Sophie Blaise, Bernadette Satger, Gilles Pernod, Cécile Richaud, Béatrice Villemur, Patrick H Carpentier
OBJECTIVE: We report on the preliminary evaluation of a well-designed program, Living with Lymphedema. This longitudinal cohort study assessed patients' quality of life using questionnaires. Our main objective was to evaluate the satisfaction of the patients and their adherence to the program. This was done using a specific questionnaire of satisfaction as well as by noting patients' adherence to the program (number of patients attending all three consultations). The secondary objective was to assess the effect of the program on the patient's quality of life...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28818047/second-opinion-for-degenerative-spinal-conditions-an-option-or-a-necessity-a-prospective-observational-study
#4
Mario Lenza, Rachelle Buchbinder, Margaret P Staples, Oscar F P Dos Santos, Reynaldo A Brandt, Claudio L Lottenberg, Miguel Cendoroglo, Mario Ferretti
BACKGROUND: Second opinions may improve quality of patient care. The primary objective of this study was to determine the concordance between first and second diagnoses and opinions regarding need for spinal surgery among patients with back or neck pain that have been recommended spinal surgery. METHODS: We performed a prospective observational study of patients who had been recommended for spinal surgery and received a second opinion between May 2011 and May 2012 at the Hospital Israelita Albert Einstein on the advice of their health insurance company...
August 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28817750/the-surgeon-on-service-model-for-timely-economically-viable-inpatient-care-of-tracheostomy-patients-in-academic-pediatric-otolaryngology
#5
Jennifer M Lavin, James W Schroeder, Dana M Thompson
Importance: The traditional practice model for pediatric otolaryngologists at high-volume academic centers is to simultaneously balance outpatient care responsibilities with those of the inpatient service, emergency department, and ambulatory care clinics. This model leads to challenges with care coordination, timeliness of nonemergency operative care, and consistent participation in care and consultation at the attending surgeon level. The "surgeon on service" (SOS) model-where faculty members rotate to manage the inpatient service in lieu of outpatient responsibilities-has been described as one method to address this conundrum...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28817481/incorporating-dynamic-assessment-of-fluid-responsiveness-into-goal-directed-therapy-a-systematic-review-and-meta-analysis
#6
Joseph M Bednarczyk, Jason A Fridfinnson, Anand Kumar, Laurie Blanchard, Rasheda Rabbani, Dean Bell, Duane Funk, Alexis F Turgeon, Ahmed M Abou-Setta, Ryan Zarychanski
OBJECTIVE: Dynamic tests of fluid responsiveness have been developed and investigated in clinical trials of goal-directed therapy. The impact of this approach on clinically relevant outcomes is unknown. We performed a systematic review and meta-analysis to evaluate whether fluid therapy guided by dynamic assessment of fluid responsiveness compared with standard care improves clinically relevant outcomes in adults admitted to the ICU. DATA SOURCES: Randomized controlled trials from MEDLINE, EMBASE, CENTRAL, clinicaltrials...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28816912/distance-learning-adhd-quality-improvement-in-primary-care-a-cluster-randomized-trial
#7
Alexander G Fiks, Stephanie L Mayne, Jeremy J Michel, Jeffrey Miller, Manju Abraham, Andrew Suh, Abbas F Jawad, James P Guevara, Robert W Grundmeier, Nathan J Blum, Thomas J Power
OBJECTIVE: To evaluate a distance-learning, quality improvement intervention to improve pediatric primary care provider use of attention-deficit/hyperactivity disorder (ADHD) rating scales. METHODS: Primary care practices were cluster randomized to a 3-part distance-learning, quality improvement intervention (web-based education, collaborative consultation with ADHD experts, and performance feedback reports/calls), qualifying for Maintenance of Certification (MOC) Part IV credit, or wait-list control...
August 9, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28814455/national-randomized-controlled-trial-of-virtual-house-calls-for-parkinson-disease
#8
Christopher A Beck, Denise B Beran, Kevin M Biglan, Cynthia M Boyd, E Ray Dorsey, Peter N Schmidt, Richard Simone, Allison W Willis, Nicholas B Galifianakis, Maya Katz, Caroline M Tanner, Kristen Dodenhoff, Jason Aldred, Julie Carter, Andrew Fraser, Joohi Jimenez-Shahed, Christine Hunter, Meredith Spindler, Suzanne Reichwein, Zoltan Mari, Becky Dunlop, John C Morgan, Dedi McLane, Patrick Hickey, Lisa Gauger, Irene Hegeman Richard, Nicte I Mejia, Grace Bwala, Martha Nance, Ludy C Shih, Carlos Singer, Silvia Vargas-Parra, Cindy Zadikoff, Natalia Okon, Andrew Feigin, Jean Ayan, Christina Vaughan, Rajesh Pahwa, Rohit Dhall, Anhar Hassan, Steven DeMello, Sara S Riggare, Paul Wicks, Meredith A Achey, Molly J Elson, Steven Goldenthal, H Tait Keenan, Ryan Korn, Heidi Schwarz, Saloni Sharma, E Anna Stevenson, William Zhu
OBJECTIVE: To determine whether providing remote neurologic care into the homes of people with Parkinson disease (PD) is feasible, beneficial, and valuable. METHODS: In a 1-year randomized controlled trial, we compared usual care to usual care supplemented by 4 virtual visits via video conferencing from a remote specialist into patients' homes. Primary outcome measures were feasibility, as measured by the proportion who completed at least one virtual visit and the proportion of virtual visits completed on time; and efficacy, as measured by the change in the Parkinson's Disease Questionnaire-39, a quality of life scale...
August 16, 2017: Neurology
https://www.readbyqxmd.com/read/28814380/the-effect-of-integration-of-self-management-web-platforms-on-health-status-in-chronic-obstructive-pulmonary-disease-management-in-primary-care-e-vita-study-interrupted-time-series-design
#9
Esther Pwa Talboom-Kamp, Noortje A Verdijk, Marise J Kasteleyn, Lara M Harmans, Irvin Jsh Talboom, Ingrid Looijmans-van den Akker, Nan van Geloven, Mattijs E Numans, Niels H Chavannes
BACKGROUND: Worldwide nearly 3 million people die from chronic obstructive pulmonary disease (COPD) every year. Integrated disease management (IDM) improves quality of life for COPD patients and can reduce hospitalization. Self-management of COPD through eHealth is an effective method to improve IDM and clinical outcomes. OBJECTIVES: The objective of this implementation study was to investigate the effect of 3 chronic obstructive pulmonary disease eHealth programs applied in primary care on health status...
August 16, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28814281/impact-of-new-generation-hormone-therapy-on-cognitive-function-in-elderly-patients-treated-for-a-metastatic-prostate-cancer-cog-pro-trial-protocol
#10
Marie Lange, Heidi Laviec, Hélène Castel, Natacha Heutte, Alexandra Leconte, Isabelle Léger, Bénédicte Giffard, Aurélie Capel, Martine Dubois, Bénédicte Clarisse, Elodie Coquan, Frédéric Di Fiore, Sophie Gouérant, Philippe Bartélémy, Laure Pierard, Karim Fizazi, Florence Joly
BACKGROUND: New generation hormone-therapies (NGHT) targeting the androgen signalling pathway are nowadays proposed to elderly patients with metastatic castration-resistant prostate cancer (CRPCa). The impact of these treatments on cognitive function has never been evaluated whereas cognitive impairment may have an impact on the autonomy and the treatment adherence. The aim of this study is to prospectively assess the incidence of cognitive impairment in elderly men after treatment by NGHT for a metastatic CRPCa...
August 16, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28812056/initiating-a-standardized-regional-referral-and-counter-referral-system-in-guatemala-a-mixed-methods-study
#11
Rupa Kapoor, Leslie Avendaño, Maria Antonieta Sandoval, Andrea T Cruz, Esther M Sampayo, Miguel A Soto, Elizabeth A Camp, Heather L Crouse
Background:Few data exist for referral processes in resource-limited settings. We utilized mixed-methods to evaluate the impact of a standardized algorithm and training module developed for locally identified needs in referral/counter-referral procedures between primary health centers (PHCs) and a Guatemalan referral hospital. Methods: PHC personnel and hospital physicians participated in surveys and focus groups pre-implementation and 3, 6, and 12 months post-implementation to evaluate providers' experience with the system...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28811733/community-partners-in-care-6-month-outcomes-of-two-quality-improvement-depression-care-interventions-in-male-participants
#12
Pratik Mehta, Anthony Brown, Bowen Chung, Felica Jones, Lingqi Tang, James Gilmore, Jeanne Miranda, Kenneth Wells
OBJECTIVE: Limited data exist on approaches to improve depression services for men in under-resourced communities. This article explores this issue using a sub-analysis of male participants in Community Partners in Care (CPIC). DESIGN: Community partnered, cluster, randomized trial. SETTING: Hollywood-Metropolitan and South Los Angeles, California. PARTICIPANTS: 423 adult male clients with modified depression (PHQ-8 score≥10)...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28809591/reducing-inappropriate-non-steroidal-anti-inflammatory-prescription-in-primary-care-patients-with-chronic-kidney-disease
#13
David M Keohane, Thomas Dennehy, Kenneth P Keohane, Eamonn Shanahan
Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28809132/impact-of-primary-tracheoesophageal-puncture-on-outcomes-after-total-laryngectomy
#14
Aru Panwar, Oleg Militsakh, Robert Lindau, Andrew Coughlin, Harlan Sayles, Katherine R Rieke, William Lydiatt, Daniel Lydiatt, Russell Smith
Objectives To identify differences in postoperative wound complications associated with a primary tracheoesophageal puncture (TEP) at the time of laryngectomy versus no TEP. Study Design Retrospective review of large national data set. Setting Academic and nonacademic health care facilities in United States, contributing de-identified, risk-adjusted clinical data to the American College of Surgeons National Surgical Quality Improvement Program. Subjects and Methods The National Surgical Quality Improvement Program data set for years 2006 to 2012 identified 430 patients who underwent total laryngectomy with or without a primary TEP...
August 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28807977/can-secure-patient-provider-messaging-improve-diabetes-care
#15
Sukyung Chung, Laura Panattoni, Jeffrey Chi, Latha Palaniappan
OBJECTIVE: Internet-based secure messaging between patients and providers through a patient portal is now common in the practice of modern medicine. There is limited evidence on how messaging is associated with use and clinical quality measures among patients with type 2 diabetes. We examine whether messaging with physicians for medical advice is associated with fewer face-to-face visits and better diabetes management. RESEARCH DESIGN AND METHODS: Patients with diabetes who were enrolled in an online portal of an outpatient health care organization in 2011-2014 were studied (N = 37,762 patient-years)...
August 14, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28806982/software-guided-versus-nurse-directed-blood-glucose-control-in-critically-ill-patients-the-logic-2-multicenter-randomized-controlled-clinical-trial
#16
Dieter Mesotten, Jasperina Dubois, Tom Van Herpe, Roosmarijn T van Hooijdonk, Ruben Wouters, Domien Coart, Pieter Wouters, Aimé Van Assche, Guy Veraghtert, Bart De Moor, Joost Wauters, Alexander Wilmer, Marcus J Schultz, Greet Van den Berghe
BACKGROUND: Blood glucose control in the intensive care unit (ICU) has the potential to save lives. However, maintaining blood glucose concentrations within a chosen target range is difficult in clinical practice and holds risk of potentially harmful hypoglycemia. Clinically validated computer algorithms to guide insulin dosing by nurses have been advocated for better and safer blood glucose control. METHODS: We conducted an international, multicenter, randomized controlled trial involving 1550 adult, medical and surgical critically ill patients, requiring blood glucose control...
August 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28806904/a-falls-prevention-programme-to-improve-quality-of-life-physical-function-and-falls-efficacy-in-older-people-receiving-home-help-services-study-protocol-for-a-randomised-controlled-trial
#17
Maria Bjerk, Therese Brovold, Dawn A Skelton, Astrid Bergland
BACKGROUND: Falls and fall-related injuries in older adults are associated with great burdens, both for the individuals, the health care system and the society. Previous research has shown evidence for the efficiency of exercise as falls prevention. An understudied group are older adults receiving home help services, and the effect of a falls prevention programme on health-related quality of life is unclear. The primary aim of this randomised controlled trial is to examine the effect of a falls prevention programme on quality of life, physical function and falls efficacy in older adults receiving home help services...
August 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28806495/international-uptake-of-a-proven-intervention-to-reduce-death-and-dependency-in-acute-stroke-a-cross-sectional-survey-following-the-qasc-trial
#18
Sandy Middleton, Dominik Bruch, Cintia Martinez-Garduno, Simeon Dale, Maria McNamara
BACKGROUND: Uptake of proven interventions requires dedicated resources that may only result in local implementation, thus precluding international practice change. We explored international uptake through online dissemination of the fever, sugar, and swallow (FeSS) protocols from the Quality in Acute Stroke Care (QASC) trial, which showed decreased death and dependency by 15.7% 90-day poststroke. AIMS: To identify: (a) the clinical discipline of healthcare professionals who downloaded the QASC resources; (b) the purpose for downloading; (c) successful implementation of any or all the FeSS protocols; (d) barriers to implementation; and (e) associations with self-reported successful implementation...
August 14, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28805580/tourette-syndrome-and-chronic-tic-disorders-the-clinical-spectrum-beyond-tics
#19
Davide Martino, Christos Ganos, Tamara M Pringsheim
The clinical surveillance and active management of Tourette syndrome (TS) and other primary chronic tic disorders cannot be limited to tics, as these patients manifest a spectrum of sensory-, behavioral-, cognitive-, and sleep-related problems that have a major impact on their functioning and quality of life, influencing enormously clinical decision making on a routine basis. The sensory phenomena of primary tic disorders consist of premonitory urges and heightened sensitivity to external somatosensory and interoceptive stimuli...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28805405/understanding-integrated-mental-health-care-in-real-world-primary-care-settings-what-matters-to-health-care-providers-and-clients-for-evaluation-and-improvement
#20
Allyson Ion, Nadiya Sunderji, Gwen Jansz, Abbas Ghavam-Rassoul
PURPOSE: The integration of mental health specialists into primary care has been widely advocated to deliver evidence-based mental health care to a defined population while improving access, clinical outcomes, and cost efficiency. Integrated care has been infrequently and inconsistently translated into real-world settings; as a result, the key individual components of effective integrated care remain unclear. METHOD: This article reports findings from a qualitative study that explored provider and client experiences of integrated care...
August 14, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
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