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LEAN quality improvement

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https://www.readbyqxmd.com/read/28635297/medical-students-leading-quality-improvement-a-lean-six-sigma-approach-to-pain-management
#1
David Droullard, Samuel Porter, Anna Zuckerman, Daphne Monie, Judi Brendle, Henry Weil
No abstract text is available yet for this article.
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28614127/a-hospital-is-not-just-a-factory-but-a-complex-adaptive-system-implications-for-perioperative-care
#2
Aman Mahajan, Salim D Islam, Michael J Schwartz, Maxime Cannesson
Many methods used to improve hospital and perioperative services productivity and quality of care have assumed that the hospital is essentially a factory, and therefore, that industrial engineering and manufacturing-derived redesign approaches such as Six Sigma and Lean can be applied to hospitals and perioperative services just as they have been applied in factories. However, a hospital is not merely a factory but also a complex adaptive system (CAS). The hospital CAS has many subsystems, with perioperative care being an important one for which concepts of factory redesign are frequently advocated...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28612831/abdominal-obesity-and-type-2-diabetes-in-asian-indians-dietary-strategies-including-edible-oils-cooking-practices-and-sugar-intake
#3
REVIEW
S Gulati, A Misra
Obesity and type 2 diabetes are increasing in rural and urban regions of South Asia including India. Pattern of fat deposition in abdomen, ectopic fat deposition (liver, pancreas) and also low lean mass are contributory to early-onset insulin resistance, dysmetabolic state and diabetes in Asian Indians. These metabolic perturbations are further exacerbated by changing lifestyle, diet urbanization, and mechanization. Important dietary imbalances include increasing use of oils containing high amount of trans fatty acids and saturated fats (partially hydrogenated vegetable oil, palmolein oil) use of deep frying method and reheating of oils for cooking, high intake of saturated fats, sugar and refined carbohydrates, low intake of protein, fiber and increasing intake of processed foods...
June 14, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28600706/effects-of-resistance-exercise-in-prostate-cancer-patients-a-meta-analysis
#4
REVIEW
M Keilani, T Hasenoehrl, L Baumann, R Ristl, M Schwarz, M Marhold, T Sedghi Komandj, R Crevenna
PURPOSE: The aim of the present meta-analysis was to quantify effects of resistance exercise (RE) on physical performance and function, body composition, health-related quality of life (HRQoL), and fatigue in patients with prostate cancer. METHODS: Trial data were obtained from the databases PubMed, MEDLINE, EMBASE, SCOPUS, and the Cochrane Library as of inception to 31st of December 2016. Thirty-two trials with 1199 patients were included. Results that were measured by using the same assessment method in five or more of the original studies were pooled in a meta-analysis...
June 10, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28594351/exploring-diet-quality-between-urban-and-rural-dwelling-women-of-reproductive-age
#5
Julie C Martin, Lisa J Moran, Helena J Teede, Sanjeeva Ranasinha, Catherine B Lombard, Cheryce L Harrison
Health disparities, including weight gain and obesity exist between urban and rural dwelling women. The primary aim was to compare diet quality in urban and rural women of reproductive age, and secondary analyses of the difference in macronutrient and micronutrient intake in urban and rural women, and the predictors of diet quality. Diet quality was assessed in urban (n = 149) and rural (n = 394) women by a modified version of the Dietary Guideline Index (DGI) energy, macronutrient and micronutrient intake from a food frequency questionnaire (FFQ) and predictors of diet quality...
June 8, 2017: Nutrients
https://www.readbyqxmd.com/read/28593444/efficacy-of-dietary-supplementation-of-fatty-acid-compound-on-performance-and-production-in-finishing-pigs
#6
Santi Devi Upadhaya, Hyeok Min Yun, Shuaiqi Huang, In Ho Kim
The present study was conducted to evaluate the efficacy of dietary supplementation of 0.5 and 1% of fatty acid (FA) compound containing conjugated linoleic acid as active component on growth performance, apparent nutrient digestibility, serum lipid profile, meat quality, and fatty acid profiles in muscle and adipose tissue in finishing pigs. A total of 90 finishing pigs ([Yorkshire × Landrace] × Duroc) were used in 5-week trial. The growth performance and nutrient digestibility were unaffected with FA supplementation...
June 8, 2017: Tropical Animal Health and Production
https://www.readbyqxmd.com/read/28572967/which-product-characteristics-are-preferred-by-chinese-consumers-when-choosing-pork-a-conjoint-analysis-on-perceived-quality-of-selected-pork-attributes
#7
Xiu Q Ma, Julia M Verkuil, Helene C Reinbach, Lene Meinert
Due to the economic growth achieved by China over the past 20 years, Chinese consumers have changed their purchasing behavior regarding meat. Instead of buying locally produced pork, they are increasingly willing to purchase imported pork. A conjoint analysis investigated how intrinsic pork attributes (fat content and processing) and extrinsic pork attributes (origin, price, and packaging) relate to the perceived quality of pork and the choices made by Chinese consumers. A questionnaire distributed among a sample of Chinese consumers (n = 81) revealed that processing (fresh/frozen) is the most important determinant of pork choice (36%), followed by fat content (27%), origin (18%), price (12%), and packaging (6...
May 2017: Food Science & Nutrition
https://www.readbyqxmd.com/read/28572857/changes-in-health-related-quality-of-life-in-elderly-men-after-12%C3%A2-weeks-of-strength-training
#8
Kristin Haraldstad, Gudrun Rohde, Tonje Holte Stea, Hilde Lohne-Seiler, Ken Hetlelid, Gøran Paulsen, Sveinung Berntsen
BACKGROUND: Muscular strength is associated with functional ability in elderly, and older adults are recommended to perform muscle-strengthening exercise. Understanding how improved muscle strength and -mass influence general and specific domains of quality of life is important when planning health promotion efforts targeting older adults. The aims of the present study were to describe changes in health-related quality of life (HRQOL) in older men participating in 12 weeks of systematic strength training, and to investigate whether improvements in muscle strength and muscle mass are associated with enhancements in HRQOL...
2017: European Review of Aging and Physical Activity
https://www.readbyqxmd.com/read/28558814/approach-to-growth-hormone-therapy-in-children-with-chronic-kidney-disease-varies-across-north-america-the-midwest-pediatric-nephrology-consortium-report
#9
Oleh M Akchurin, Amy J Kogon, Juhi Kumar, Christine B Sethna, Hoda T Hammad, Paul J Christos, John D Mahan, Larry A Greenbaum, Robert Woroniecki
BACKGROUND: Growth impairment remains common in children with chronic kidney disease (CKD). Available literature indicates low level of recombinant human growth hormone (rhGH) utilization in short children with CKD. Despite efforts at consensus guidelines, lack of high-level evidence continues to complicate rhGH therapy decision-making and the level of practice variability in rhGH treatment by pediatric nephrologists is unknown. METHODS: Cross-sectional online survey electronically distributed to pediatric nephrologists through the Midwest Pediatric Nephrology Consortium and American Society of Pediatric Nephrology...
May 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28552386/tools-and-methods-for-quality-improvement-and-patient-safety-in-perinatal-care
#10
Amy T Nathan, Heather C Kaplan
The quality of health care is now recognized to vary widely in all medical specialties, including perinatal medicine. A national focus on quality improvement (QI) and patient safety is prompting providers to change and improve the care given to patients. All QI and safety efforts require the use of an improvement model to manage the complex process of improving care. This article reviews the most common frameworks in use today, including the Model for Improvement, Six Sigma, and Lean. Specific tools such as affinity, key driver and fishbone diagrams, process maps and statistical process control, as well as checklists are reviewed, with examples from the perinatal literature to illustrate their use in perinatal QI efforts...
April 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28550704/integrating-engagement-and-improvement-work-in-a-pediatric-hospital
#11
Mireille Brosseau, Diane Gagnon, Kristina Rohde, Jennifer Schellinck
Although geared towards a common goal - improved patient-centred care - quality improvement strategies and patient engagement-focused approaches are often developed and conducted in silos. The lack of integration may lead, on the one hand, to the uptake of patient suggestions that do not always take into consideration implications for the delivery of quality care and, on the other hand, to inadequate understanding of patient views required to create optimal services. The Children's Hospital of Eastern Ontario (CHEO)'s action plans to address gaps in patient engagement and quality improvement, two of its priority areas, were initially carried out in isolation of each other...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28545164/loss-of-appendicular-muscle-mass-in-haemodialysis-patients-is-associated-with-increased-self-reported-depression-anxiety-and-lower-general-health-scores
#12
Helen Alston, Aine Burns, Andrew Davenport
AIMS: Depressive symptoms are commonly reported by haemodialysis (HD) patients. Previous reports have suggested an association between depression and nutritional status. To investigate this, we measured muscle mass in HD patients screened for depression. METHODS: The Beck Depression Inventory-II (BDI-II), Hospital Anxiety and Depression Scale (HADS) were used to screen for depression, and quality of life assessed by the short form 36 (SF36), and measured appendicular lean mass (ALM) post-dialysis with segmental bioimpedance...
May 25, 2017: Nephrology
https://www.readbyqxmd.com/read/28538055/high-reliability-principles-must-be-tied-to-value-based-outcomes
#13
Mitchell L Wasden
WellStar Health System and the Medical University of South Carolina (MUSC), highlighted in this issue's feature articles, are two organizations seeking to drive high reliability by educating leaders and incorporating high-reliability principles into their quality improvement (QI) efforts. The organizations have taken slightly different approaches to executing on high reliability, yet both are encouraged by the apparent success of high-reliability principles in other industries.The high-reliability framework is often applied to healthcare despite the limitations of comparing healthcare organizations to nuclear reactors, commercial airlines, and aircraft carriers...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28538054/achieving-high-reliability-with-people-processes-and-technology
#14
Candice L Saunders, John A Brennan
High reliability as a corporate value in healthcare can be achieved by meeting the "Quadruple Aim" of improving population health, reducing per capita costs, enhancing the patient experience, and improving provider wellness. This drive starts with the board of trustees, CEO, and other senior leaders who ingrain high reliability throughout the organization. At WellStar Health System, the board developed an ambitious goal to become a top-decile health system in safety and quality metrics. To achieve this goal, WellStar has embarked on a journey toward high reliability and has committed to Lean management practices consistent with the Institute for Healthcare Improvement's definition of a high-reliability organization (HRO): one that is committed to the prevention of failure, early identification and mitigation of failure, and redesign of processes based on identifiable failures...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28528621/using-lean-to-rapidly-and-sustainably-transform-a-behavioral-health-crisis-program-impact-on-throughput-and-safety
#15
Margaret E Balfour, Kathleen Tanner, Paul J Jurica, Dawn Llewellyn, Robert G Williamson, Chris A Carson
BACKGROUND: Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. METHODS: A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28526377/orange-juice-allied-to-a-reduced-calorie-diet-results-in-weight-loss-and-ameliorates-obesity-related-biomarkers-a-randomized-controlled-trial
#16
Carolina Ribeiro, Grace Dourado, Thais Cesar
OBJECTIVE: Assumptions have linked orange juice (OJ) consumption with weight gain and adverse effects on health due to its sugar content; however, epidemiologic studies have not shown increased risk for overweight or obesity with the consumption of 100% OJ. The aim of this study was to verify whether the combination of a reduced-calorie diet (RCD) and 100% OJ contribute to weight loss, promote changes in glucose and lipid metabolism, and improve diet quality in obese individuals. METHODS: A randomized controlled trial with 78 obese patients (age 36 ± 1 y, body mass index [BMI] 33 ± 3 kg/m(2)) were enrolled in two groups: Individuals in the OJ group submitted to an RCD that included OJ (500 mL/d), and individuals in the control group submitted to an RCD without OJ...
June 2017: Nutrition
https://www.readbyqxmd.com/read/28507015/preserving-healthy-muscle-during-weight-loss
#17
REVIEW
Edda Cava, Nai Chien Yeat, Bettina Mittendorfer
Weight loss is the cornerstone of therapy for people with obesity because it can ameliorate or completely resolve the metabolic risk factors for diabetes, coronary artery disease, and obesity-associated cancers. The potential health benefits of diet-induced weight loss are thought to be compromised by the weight-loss-associated loss of lean body mass, which could increase the risk of sarcopenia (low muscle mass and impaired muscle function). The objective of this review is to provide an overview of what is known about weight-loss-induced muscle loss and its implications for overall physical function (e...
May 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28494624/an-overview-of-the-performance-improvement-initiatives-by-the-ministry-of-health-in-the-kingdom-of-saudi-arabia
#18
Mazen Hassanain
Saudi Arabia's Ministry of Health (MOH) use corporate performance improvement methodologies to develop and implement performance improvement initiatives designed to continue building on the Ministry's vision of transforming hospital operations and instituting a culture of quality and performance focused on the "patient first" principle. We evaluated the feasibility of setting up a performance improvement unit (PIU) within the MOH to apply the principles of Lean Six Sigma and to change management methodologies...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28494385/l-leucine-dietary-supplementation-modulates-muscle-protein-degradation-and-increases-pro-inflammatory-cytokines-in-tumour-bearing-rats
#19
Bread Cruz, André Oliveira, Maria Cristina Cintra Gomes-Marcondes
Cancer cachexia is characterised by involuntary weight loss associated with systemic inflammation and metabolic changes. Studies aimed at maintaining lean body mass in cachectic tumour-bearing hosts have made important contributions reducing the number of deaths and improving the quality of life. In recent years, leucine has demonstrated effective action in maintaining lean body mass by decreasing muscle protein degradation. Currently, there is a growing need to understand how leucine stimulates protein synthesis and acts protectively in a cachectic organism...
May 8, 2017: Cytokine
https://www.readbyqxmd.com/read/28464081/a-multivariate-approach-to-determine-the-factors-affecting-response-level-of-growth-carcass-and-meat-quality-traits-in-finishing-pigs-fed-ractopamine
#20
M A Pompeu, L A Rodrigues, L F L Cavalcanti, D O Fontes, F L B Toral
The effect of ractopamine (RAC) supplementation on growth, carcass, and meat quality traits of finishing pigs was studied using a meta-analytical approach. The database was composed of 57 studies published from 2004 to 2016. The dependent variables extracted for the meta-analysis included final BW, ADG, ADFI, feed:gain ratio, HCW, dressing percentage, carcass length, lean yield, back fat thickness, loin muscle area, loin depth, postmortem pH, meat brightness, redness, and yellowness. The studies were grouped by similarity in 3 clusters (C1, C2, and C3) by hierarchical clustering on principle components...
April 2017: Journal of Animal Science
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