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https://www.readbyqxmd.com/read/28190702/analysis-of-low-appropriateness-score-exam-trends-in-decision-support-based-radiology-order-entry-system
#1
Supriya Gupta, Kandace Klein, Anand H Singh, James H Thrall
PURPOSE: Awareness of imaging utilization increased after implementation of Radiology Order Entry with decision support systems (ROE-DS). Our hypothesis is few exams with low Clinical Appropriateness Score (CAS) on ROE-DS are performed. Clinical indications of exams with CAS less than 3 (9-point scale) were re-reviewed and reports analyzed. MATERIALS AND METHODS: Structured Query Language-based query retrieved exams with CAS less than 3 in ROE-DS from January 2007 to December 2011...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28152815/development-of-an-integrated-practice-unit-utilizing-a-lean-approach-to-impact-value-of-care-for-brain-tumor-patients
#2
Christine Ahn, Preston White, Linda M Liau, Timothy Francis Cloughesy, Phioanh Leia Nghiemphu
99 Background: Lack of care coordination across subspecialty departments involved in the treatment of brain tumor patients at our institution has negatively impacted patient outcomes, patient experience, and costs. Meanwhile, value-based health care has become increasingly relevant as a means to respond to changing payment structures and improve quality. With the aim to increase value, we restructured medical practice across the continuum of care for brain tumor patients by developing a virtual (non co-located) Integrated Practice Unit (IPU)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28108091/implementation-of-a-simple-innovative-system-for-postprescription-antibiotic-review-based-on-computerized-tools-with-shared-access
#3
F Bouchand, A Dinh, A L Roux, B Davido, H Michelon, M Lepainteur, B Legendre, F El Sayed, I Pierre, J Salomon, C Lawrence, C Perronne, M Villart, A-C Crémieux
BACKGROUND: Controlling antibiotic use in healthcare establishments limits their consumption and the emergence of bacterial resistance. AIM: To evaluate the efficiency of an innovative antibiotic stewardship strategy implemented over three years in a university hospital. METHODS: An antimicrobial multi-disciplinary team (AMT) [pharmacist, microbiologist and infectious disease specialist (IDS)] conducted a postprescription review. Specific coding of targeted antibiotics (including broad-spectrum β-lactams, glycopeptides, lipopeptides, fluoroquinolones and carbapenems) in the computerized physician order entry allowed recording of all new prescriptions...
March 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27756401/the-use-of-a-policy-dialogue-to-facilitate-evidence-informed-policy-development-for-improved-access-to-care-the-case-of-the-winnipeg-central-intake-service-wcis
#4
Zaheed Damani, Gail MacKean, Eric Bohm, Brie DeMone, Brock Wright, Tom Noseworthy, Jayna Holroyd-Leduc, Deborah A Marshall
BACKGROUND: Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba...
October 18, 2016: Health Research Policy and Systems
https://www.readbyqxmd.com/read/27692475/procedural-training-and-assessment-of-competency-utilizing-simulation
#5
REVIEW
Taylor Sawyer, Megan M Gray
This review examines the current environment of neonatal procedural learning, describes an updated model of skills training, defines the role of simulation in assessing competency, and discusses potential future directions for simulation-based competency assessment. In order to maximize impact, simulation-based procedural training programs should follow a standardized and evidence-based approach to designing and evaluating educational activities. Simulation can be used to facilitate the evaluation of competency, but must incorporate validated assessment tools to ensure quality and consistency...
November 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27521350/a-motion-compensation-method-for-bi-plane-robot-assisted-internal-fixation-surgery-of-a-femur-neck-fracture
#6
Jian Song, Hui Ding, Wei Han, Junqiang Wang, Guangzhi Wang
Bi-plane robots have been widely applied in clinical use to place cannulated screws for internal fixation surgery of femur neck fractures, which is performed precisely and automatically using two online fluoroscopic images. However, the setup procedure of the bi-plane robot is empirical, and physicians usually have to re-run the setup procedure, exposing the patient to high doses of radiation in clinical applications. In this article, a motion compensation method is proposed by a novel use of the binocular vision principle to improve the bi-plane robot setup using two doses of radiation within 2 min...
October 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/27058777/order-set-to-improve-the-care-of-patients-hospitalized-for-an-exacerbation-of-chronic-obstructive-pulmonary-disease
#7
Kirstin E Brown, Kara J Johnson, Beth M DeRonne, Connie M Parenti, Kathryn L Rice
RATIONALE: Physicians' adherence to prescribing evidence-based inpatient and outpatient therapies for chronic obstructive pulmonary disease (COPD) is low, and there is a paucity of information about the utility of admission order sets for patients with COPD exacerbations. OBJECTIVES: To determine if implementation of a locally designed, evidence-based, multidisciplinary computer physician order entry set in the electronic health record improves the quality of physician pharmacologic prescribing for patients hospitalized for COPD exacerbations...
June 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/26885652/-subintimal-recanalization-indications-technique-and-results
#8
REVIEW
B Radeleff, M Sumkauskaite, N Kortes, D Gnutzmann, T Mokry, H U Kauczor, U Stampfl
CLINICAL/METHODICAL ISSUE: This article gives an overview of the current importance of so-called subintimal recanalization in the lower extremities. STANDARD RADIOLOGICAL METHODS: The primary technical goal of endovascular interventions in the lower extremities is the endoluminal restoration of blood circulation from the iliac arteries into the feet. METHODICAL INNOVATIONS: If endoluminal recanalization of e.g. high-grade flow-relevant stenoses or chronic total occlusion (CTO) is technically not possible, subintimal recanalization is a promising option and the only remaining minimally invasive alternative...
March 2016: Der Radiologe
https://www.readbyqxmd.com/read/26815282/improving-radiation-awareness-and-feeling-of-personal-security-of-non-radiological-medical-staff-by-implementing-a-traffic-light-system-in-computed-tomography
#9
C Heilmaier, A Mayor, N Zuber, P Fodor, D Weishaupt
PURPOSE: Non-radiological medical professionals often need to remain in the scanning room during computed tomography (CT) examinations to supervise patients in critical condition. Independent of protective devices, their position significantly influences the radiation dose they receive. The purpose of this study was to assess if a traffic light system indicating areas of different radiation exposure improves non-radiological medical staff's radiation awareness and feeling of personal security...
March 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/26732516/-chase-crp-review-patient-improving-the-quality-of-weekend-medical-handover-at-a-london-teaching-hospital
#10
Aamir Saifuddin, Lucia Magee, Rachael Barrett
Clinical handover has been identified as a "major preventable cause of harm" by the Royal College of Physicians (RCP). Whilst working at a London teaching hospital from August 2013, we noted substandard weekend handover of medical patients. The existing pro forma was filled incompletely by day doctors so it was difficult for weekend colleagues to identify unwell patients, with inherent safety implications. Furthermore, on-call medical staff noted that poor accessibility of vital information in patients' files was affecting acute clinical management...
2015: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/26630712/physician-re-entry-i-ll-be-back
#11
EDITORIAL
Michael M Deren
No abstract text is available yet for this article.
October 2015: Connecticut Medicine
https://www.readbyqxmd.com/read/26558030/the-training-of-a-stone-doctor
#12
Jamsheer J Talati
OBJECTIVE: To propose alternative models of training for doctors treating patients with stones, and to identify their relative value, as such doctors are trained through urology programmes which sometimes cannot be expanded to meet the need, are short of teachers, too comprehensive and lengthy. This review explores new pathways for training to provide competence in the care of patients with stones. METHODS: Previous reports were identified and existing training models collectively categorised as Model 1...
September 2012: Arab Journal of Urology
https://www.readbyqxmd.com/read/26554805/demonstrating-a-conceptual-framework-to-provide-efficient-wound-management-service-for-a-wound-care-center-in-a-tertiary-hospital
#13
Yu-Tsung Chen, Chang-Cheng Chang, Jen-Hsiang Shen, Wei-Nung Lin, Mei-Yen Chen
Although the benefits of wound care services and multidisciplinary team care have been well elaborated on in the literature, there is a gap in the actual practice of wound care and the establishment of an efficient referral system. The conceptual framework for establishing efficient wound management services requires elucidation.A wound care center was established in a tertiary hospital in 2010, staffed by an integrated multidisciplinary team including plastic surgeons, a full-time coordinator, a physical therapist, occupational therapists, and other physician specialists...
November 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26470643/health-workforce-governance-in-italy
#14
Giovanna Vicarelli, Emmanuele Pavolini
More precise health workforce governance has become a prominent issue in healthcare systems. This issue is particularly important in Italy, given its strongly doctor-centered healthcare system and the dramatic aging of its physicians' labor force. Using different sources of information (statistical data, official planning documents and interviews with key informants), the article attempts to answer two questions. Why has the Italian healthcare systems found itself in the situation of a potential drastic reduction in the amount of doctors in the medium term without a rebalancing through a different mix of skills and professionals? How good is the capacity of the Italian healthcare system to plan healthcare workforce needs? The widespread presence of 'older' physicians is the result of the strong entry of doctors into the Italian healthcare system in the 1970s and 1980s...
December 2015: Health Policy
https://www.readbyqxmd.com/read/26464298/reduction-in-chemotherapy-order-errors-with-computerised-physician-order-entry-and-clinical-decision-support-systems
#15
Muhammad Tahir Aziz, Tofeeq Ur-Rehman, Sadia Qureshi, Nadeem Irfan Bukhari
BACKGROUND: Medication errors in chemotherapy are frequent and lead to patient morbidity and mortality, as well as increased rates of re-admission and length of stay, and considerable extra costs. Objective: This study investigated the proposition that computerised chemotherapy ordering reduces the incidence and severity of chemotherapy protocol errors. METHOD: A computerised physician order entry of chemotherapy order (C-CO) with clinical decision support system was developed in-house, including standardised chemotherapy protocol definitions, automation of pharmacy distribution, clinical checks, labeling and invoicing...
2015: HIM Journal
https://www.readbyqxmd.com/read/26285401/re-entry-what-every-physician-leader-should-know
#16
Joseph Catapano
No abstract text is available yet for this article.
July 2015: Physician Leadership Journal
https://www.readbyqxmd.com/read/26265736/the-role-of-the-emergency-department-in-the-management-of-acute-heart-failure-an-international-perspective-on-education-and-research
#17
Peter S Pang, Sean P Collins, Òscar Miró, Hector Bueno, Deborah B Diercks, Salvatore Di Somma, Alasdair Gray, Veli-Pekka Harjola, Judd E Hollander, Ekaterini Lambrinou, Phillip D Levy, AnnMarie Papa, Martin Möckel
Emergency departments are a major entry point for the initial management of acute heart failure (AHF) patients throughout the world. The initial diagnosis, management and disposition - the decision to admit or discharge - of AHF patients in the emergency department has significant downstream implications. Misdiagnosis, under or overtreatment, or inappropriate admission may place patients at increased risk for adverse events, and add costs to the healthcare system. Despite the critical importance of initial management, data are sparse regarding the impact of early AHF treatment delivered in the emergency department compared to inpatient or chronic heart failure management...
August 11, 2015: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/26074445/effectiveness-of-a-computerized-alert-system-based-on-re-testing-intervals-for-limiting-the-inappropriateness-of-laboratory-test-requests
#18
Giuseppe Lippi, Marco Brambilla, Patrizia Bonelli, Rosalia Aloe, Antonio Balestrino, Anna Nardelli, Gian Paolo Ceda, Massimo Fabi
OBJECTIVES: There is consolidated evidence that the burden of inappropriate laboratory test requests is very high, up to 70%. We describe here the function of a computerized alert system linked to the order entry, designed to limit the number of potentially inappropriate laboratory test requests. DESIGN AND METHODS: A computerized alert system based on re-testing intervals and entailing the generation of pop-up alerts when preset criteria of appropriateness for 15 laboratory tests were violated was implemented in two clinical wards of the University Hospital of Parma...
November 2015: Clinical Biochemistry
https://www.readbyqxmd.com/read/25954327/factors-contributing-to-cpoe-opiate-allergy-alert-overrides
#19
Deborah Ariosto
CONTEXT: Increasing regulatory incentives to computerize provider order entry (CPOE) and connect stores of unvalidated allergy information with the electronic health record (EHR) has created a perfect storm to overwhelm clinicians with high volumes of low or no value drug allergy alerts. Data sources include the patient and family, non-clinical staff, nurses, physicians and medical record sources. There has been little written on how to collect hypersensitivity information suited for drug allergy alerting...
2014: AMIA ... Annual Symposium Proceedings
https://www.readbyqxmd.com/read/25417228/how-are-arrhythmias-managed-in-the-paediatric-population-in-europe-results-of-the-european-heart-rhythm-survey
#20
Antonio Hernández-Madrid, Mélèze Hocini, Jian Chen, Tatjana Potpara, Laurent Pison, Carina Blomström-Lundqvist
The aim of this survey was to provide insight into current practice regarding the management of paediatric arrhythmias in Europe. The survey was based on a questionnaire sent via the Internet to the European Heart Rhythm Association (EHRA) electrophysiology research network centres. The following topics were explored: patient and treatment selection, techniques and equipment, treatment outcomes and complications. The vast majority of paediatric arrhythmias concerns children older than 1 year and patients with grown-up congenital heart disease...
December 2014: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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