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LEAN quality improvement

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https://www.readbyqxmd.com/read/28410831/feasibility-and-efficacy-of-presurgical-exercise-in-survivors-of-rectal-cancer-scheduled-to-receive-curative-resection
#1
Favil Singh, Robert U Newton, Michael K Baker, Nigel A Spry, Dennis R Taaffe, Daniel A Galvão
BACKGROUND: Localized rectal carcinoma is invasive, with surgical resection the standard treatment. The aim of this study was to determine the feasibility of a supervised presurgical exercise intervention in patients with rectal cancer prior to rectal resection. PATIENTS AND METHODS: Twelve patients volunteered to undertake twice-weekly aerobic and resistance exercise for ∼16 weeks prior to surgery. At baseline, presurgery, and ∼8 weeks postsurgery, muscle strength and physical performance, body composition, quality of life, and fatigue were assessed...
March 21, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28410337/adaptation-of-lean-six-sigma-methodologies-for-the-evaluation-of-veterans-choice-program-at-3-urban-veterans-affairs-medical-centers
#2
Sherry L Ball, Lauren D Stevenson, Amy C Ladebue, Marina S McCreight, Emily C Lawrence, Taryn Oestreich, Anne C Lambert-Kerzner
OBJECTIVE: The Veterans Healthcare Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. RESEARCH DESIGN: LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers...
April 13, 2017: Medical Care
https://www.readbyqxmd.com/read/28397330/is-meat-quality-of-forage-fed-steers-comparable-to-the-meat-quality-of-conventional-beef-from-concentrate-fed-bulls
#3
M Blanco, I Casasús, G Ripoll, P Albertí, B Panea, M Joy
BACKGROUND: Replacing concentrates with forages in the diet of finishing cattle to satisfy societal demands and for economic reasons is a target for beef farmers, but this change may affect meat acceptance. In the Mediterranean area, young bulls are usually finished on concentrates (Conventional beef). Alternatively, steers can be finished on grass with supplements (G-supp); however, if carcasses are too lean, meat quality may be negatively affected. To increase fat deposition, grazing steers were finished on a total mixed ration composed of alfalfa hay and corn (TMR)...
April 11, 2017: Journal of the Science of Food and Agriculture
https://www.readbyqxmd.com/read/28387575/nutritional-considerations-for-bouldering
#4
Edward J Smith, Ryan Storey, Mayur K Ranchordas
Bouldering competitions are held up to International level and governed by the International Federation of Sport Climbing. Bouldering has been selected to feature at the 2020 Olympic Games in Tokyo, however, physiological qualities and nutritional requirements to optimise performance remain inadequately defined due to large gaps in the literature. The primary goals of training include optimising the capacity of the anaerobic energy systems and developing sport-specific strength, with emphasis on the isometric function of the forearm flexors responsible for grip...
April 7, 2017: International Journal of Sport Nutrition and Exercise Metabolism
https://www.readbyqxmd.com/read/28385026/scaling-lean-in-primary-care-impacts-on-system-performance
#5
Dorothy Y Hung, Michael I Harrison, Meghan C Martinez, Harold S Luft
OBJECTIVES: We examined a wide range of performance outcomes after Lean methodology-a leading strategy to enhance efficiency and patient value-was implemented and scaled across all primary care clinics in a nonprofit, ambulatory care delivery system. STUDY DESIGN: Using a stepped wedge approach, we assessed changes associated with the phased introduction of Lean-based redesigns across 46 primary care departments in 17 different clinic locations. Longitudinal analysis of operational metrics included: workflow efficiency, physician productivity, operating expenses, clinical quality, and satisfaction among patients, physicians, and staff...
March 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28381529/lean-season-food-transfers-affect-children-s-diets-and-household-food-security-evidence-from-a-quasi-experiment-in-malawi
#6
Aulo Gelli, Noora-Lisa Aberman, Amy Margolies, Marco Santacroce, Bob Baulch, Ephraim Chirwa
Background: There is evidence that social transfers increase food consumption, improving the quantity and quality of food consumed by poor households. Questions remain on how to improve the effectiveness of social programs.Objective: The aim was to assess the impact of a lean-season food transfer on household food security, diet, and nutrition status of young children during the lean season in Malawi and to understand processes through which transfers operated.Methods: This was a longitudinal, quasi-experimental study based on 2 survey rounds in the Zomba district in Malawi...
April 5, 2017: Journal of Nutrition
https://www.readbyqxmd.com/read/28375955/using-lean-management-to-reduce-emergency-department-length-of-stay-for-medicine-admissions
#7
Nazima Allaudeen, Anita Vashi, Julia S Breckenridge, Farnoosh Haji-Sheikhi, Sarah Wagner, Keith A Posley, Steven M Asch
BACKGROUND: The practice of boarding admitted patients in the emergency department (ED) carries negative operational, clinical, and patient satisfaction consequences. Lean tools have been used to improve ED workflow. Interventions focused on reducing ED length of stay (LOS) for admitted patients are less explored. OBJECTIVE: To evaluate a Lean-based initiative to reduce ED LOS for medicine admissions. DESIGN, SETTING, PATIENTS: Prospective quality improvement initiative performed at a single university-affiliated Department of Veterans Affairs (VA) medical center from February 2013 to February 2016...
April 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28351156/long-term-exercise-training-and-soy-isoflavones-to-improve-quality-of-life-and-climacteric-symptoms
#8
A Fontvieille, I J Dionne, E Riesco
OBJECTIVE: To verify the efficacy of phytoestrogen supplementation combined with aerobic and resistance training on the improvement of climacteric symptoms and health-related quality of life (HRQoL) in postmenopausal women. METHODS: From a pool of women who had participated in a 1-year intervention study and were randomly assigned to either exercise + phytoestrogen (EX + PHY) or exercise + placebo (EX + PL), a total of 31 healthy but overweight women (mean age 59...
March 29, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28350314/integrating-quality-improvement-and-continuing-professional-development-at-an-academic-medical-center-a-partnership-between-practice-plan-hospital-and-medical-school
#9
Barbara Gold, Dawn England, William Riley, Ginny Jacobs-Halsey, Corinne Webb, Bobbi Daniels
INTRODUCTION: While quality improvement (QI) initiatives can be a highly effective means for improving health care delivery in academic medical centers (AMCs), many health care professionals are not formally trained in basic QI methodology, engaging clinicians in QI activities can be challenging, and there is often a lack of integration and coordination among QI functions (eg, Departments of Quality and Safety, Continuing Professional Development). In our AMC, we undertook a collaborative approach to achieve better vertical and horizontal integration of our QI education efforts...
October 2016: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28340044/oral-ghrelin-receptor-agonist-mk-0677-increases-serum-insulin-like-growth-factor-1-in-hemodialysis-patients-a-randomized-blinded-study
#10
Garland A Campbell, James T Patrie, Bruce D Gaylinn, Michael O Thorner, Warren K Bolton
Background: . Protein-energy wasting (PEW) in end-stage renal disease (ESRD) patients is associated with increased morbidity and mortality, but options for treatment are limited. Growth hormone (GH) increases insulin-like growth factor 1 (IGF-1), with improved nutritional parameters, but must be given subcutaneously and does not provide normal GH secretion patterns. MK-0677, an oral ghrelin receptor agonist (GRA), maintains normal GH secretion and increases lean body mass in normal subjects; it has not been studied in dialysis patients, an essential step in assessing efficacy and safety prior to clinical trials...
March 3, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28336392/diagnostic-laboratories-in-asia-pacific-region-investigation-on-quality-characteristics-and-time-of-reporting
#11
Tony C Badrick, Anton Gutscher, Nakako Sakamoto, Daniel Chin
This is the result of a Survey of various aspects of quality, cost and speed in a large sample of diagnostic laboratories in the Asia Pacific region. It is the first of its type to be published and represents a snapshot of the current performance in a large number of diagnostic laboratories in a broad range of countries in the Asia Pacific region. This demonstrates that there are common issues facing all the laboratories surveyed but also common solutions using a Quality Systems approach which involves Accreditation, Customer responsiveness, greater use of IT, automation and Lean principles...
March 20, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#12
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28298663/lean-flow-optimizing-cardiopulmonary-bypass-equipment-and-flow-for-obese-patients-a-technique-article
#13
Joshua M Blessing, Jeffrey B Riley
The goal of this chart review was to investigate the use of down-sized cardiopulmonary bypass (CPB) circuits for obese patients. The effects of transitioning from larger to smaller oxygenators, reservoirs, and arteriovenous tubing loops were evaluated through a retrospective review of 2,816 adult non-congenital procedure perfusion records. This technique report and case series is a continuation of our original prescriptive CPB circuit quality improvement project. An algorithm was derived to adjust body surface area (BSA) to lower body mass index (BMI) to provide down-sized extracorporeal circuit components capable of meeting the metabolic needs of the patient...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28277381/working-toward-quality-in-obstetric-anesthesia-a-business-approach
#14
Grant C Lynde
PURPOSE OF REVIEW: Physicians are increasingly required to demonstrate that they provide quality care. How does one define quality? A significant body of literature in industries outside of health care provides guidance on how to define appropriate metrics, create teams to troubleshoot problem areas, and sustain those improvements. RECENT FINDINGS: The modern quality movement in the United States began in response to revolutionary gains in both quality and productivity in Japanese manufacturing in the 1980's...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28276901/regular-consumption-of-holisfiit-a-polyphenol-rich-extract-based-food-supplement-improves-mind-and-body-well-being-of-overweight-and-slightly-obese-volunteers-a-randomized-double-blind-parallel-trial
#15
Cindy Romain, Pedro Emilio Alcaraz, Linda Haiwon Chung, Julien Cases
Modern lifestyles face growing demands for natural solutions to help improve general well-being. Accordingly, mind-body activities such as yoga have considerably grown. However, beneficial effects require regular workout. Besides, literature suggests that polyphenols may demonstrate positive effects on both mental and physical health. Overweight and obese volunteers, for which well-being might be perceived degraded, were included in a 16-week double-blind, randomized and parallel trial with a daily supplementation of HolisFiit(®), a polyphenol-rich food supplement...
February 23, 2017: International Journal of Food Sciences and Nutrition
https://www.readbyqxmd.com/read/28274988/incorporation-of-lean-methodology-into-pharmacy-residency-programs
#16
Natalie John, Holly Snider, Lisa Edgerton, Laurie Whalin
PURPOSE: The implementation of lean methodology into pharmacy residency programs at a community teaching hospital is described. SUMMARY: New Hanover Regional Medical Center, a community teaching hospital in southeastern North Carolina, fully adopted a lean culture in 2010. Given the success of lean strategies organizationally, this methodology was used to assist with the evaluation and development of its pharmacy residency programs in 2014. Lean tools and activities have also been incorporated into residency requirements and rotation learning activities...
March 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28256930/the-effects-of-a-lean-transition-on-process-times-patients-and-employees
#17
Pascale Simons, Huub Backes, Jochen Bergs, Davy Emans, Madelon Johannesma, Maria Jacobs, Wim Marneffe, Dominique Vandijck
Purpose Treatment delays must be avoided, especially in oncology, to assure sustainable high-quality health care and increase the odds of survival. The purpose of this paper is to hypothesize that waiting times would decrease and patients and employees would benefit, when specific lean interventions are incorporated in an organizational improvement approach. Design/methodology/approach In 2013, 15 lean interventions were initiated to improve flow in a single radiotherapy institute. Process/waiting times, patient satisfaction, safety, employee satisfaction, and absenteeism were evaluated using a mixed methods methodology (2010-2014)...
March 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28241734/tetragonia-tetragonioides-pall-kuntze-protects-estrogen-deficient-rats-against-disturbances-of-energy-and-glucose-metabolism-and-decreases-proinflammatory-cytokines
#18
Jin Ah Ryuk, Byoung-Seob Ko, Hye Won Lee, Da Sol Kim, Suna Kang, Yong Hyen Lee, Sunmin Park
Tetragonia tetragonioides (Pall.) Kuntze (TTK) and JakYakGamCho-Tang (JGT) have been used for improving women's health and treating inflammatory diseases. We determined that the long-term consumption of these herbal extracts alleviates the progression of postmenopausal symptoms in high-fat-diet fed ovariectomized (OVX) rats, and further explored the mechanisms involved. Five groups of OVX rats were fed high fat diets that were supplemented with either 2% dextrin (control), 2% TTK (70% ethanol extract), 2% JGT (water extract), 1% JGT + 1% TTK (JGTT), or 30 µg/kg body weight/day of 17β-estradiol (positive control)...
March 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28205271/lean-six-sigma-methodologies-improve-clinical-laboratory-efficiency-and-reduce-turnaround-times
#19
Tamer C Inal, Ozlem Goruroglu Ozturk, Filiz Kibar, Salih Cetiner, Selcuk Matyar, Gulcin Daglioglu, Akgun Yaman
BACKGROUND: Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. METHODS: The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems...
February 15, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28183346/study-protocol-improving-the-transition-of-care-from-a-non-network-hospital-back-to-the-patient-s-medical-home
#20
Roman A Ayele, Emily Lawrence, Marina McCreight, Kelty Fehling, Jamie Peterson, Russell E Glasgow, Borsika A Rabin, Robert Burke, Catherine Battaglia
BACKGROUND: The process of transitioning Veterans to primary care following a non-Veterans Affairs (VA) hospitalization can be challenging. Poor transitions result in medical complications and increased hospital readmissions. The goal of this transition of care quality improvement (QI) project is to identify gaps in the current transition process and implement an intervention that bridges the gap and improves the current transition of care process within the Eastern Colorado Health Care System (ECHCS)...
February 10, 2017: BMC Health Services Research
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