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Quality and safety in Healthcare

Simon J Craddock Lee, Katelyn K Jetelina, Emily Marks, Eric Shaw, Kevin Oeffinger, Deborah Cohen, Noel O Santini, John V Cox, Bijal A Balasubramanian
BACKGROUND: The growing numbers of cancer survivors challenge delivery of high-quality survivorship care by healthcare systems. Innovative ways to improve care coordination for patients with cancer and multiple chronic conditions ("complex cancer survivors") are needed to achieve better care outcomes, improve patient experience of care, and lower cost. Our study, Project CONNECT, will adapt and implement three evidence-based care coordination strategies, shown to be effective for primary care conditions, among complex cancer survivors...
December 4, 2018: BMC Cancer
Siddhant Palekar, Pavan Kumar Nukala, Saurabh M Mishra, Thomas Kipping, Ketan Patel
Pediatric population is a sensitive sector of the healthcare and pharmaceutical field with additional needs compared to the adult population. Extemporaneous formulations for children are generally prepared by manipulating adult formulations, but medication errors can result in suboptimal efficacy and with significant safety concerns. The aim of proposed project was to explore a 3D printing technology for the development of customized minicaplets of baclofen for the pediatric population. Based on results of 3-point bend test, polyvinyl alcohol (PVA) with sorbitol (10% w/w) were selected for preparation of baclofen loaded filaments using hot melt extrusion (HME)...
December 1, 2018: International Journal of Pharmaceutics
Ben Bowers, Richella Ryan, Isla Kuhn, Stephen Barclay
BACKGROUND: The anticipatory prescribing of injectable medications to provide end-of-life symptom relief is an established community practice in a number of countries. The evidence base to support this practice is unclear. AIM: To review the published evidence concerning anticipatory prescribing of injectable medications for adults at the end of life in the community. DESIGN: Systematic review and narrative synthesis. Registered in PROSPERO: CRD42016052108, on 15 December 2016 ( https://www...
December 4, 2018: Palliative Medicine
Anna-Riia Holmström, Riina Järvinen, Raisa Laaksonen, Timo Keistinen, Persephone Doupi, Marja Airaksinen
BACKGROUND: Medication errors are common in healthcare. Medication error reporting systems can be established for learning from medication errors and risk prone processes, and their data can be analysed and used for improving medication processes in healthcare organisations. However, data reliability testing is crucial to avoid biases in data interpretation and misleading findings informing patient safety improvement. OBJECTIVE: To assess the inter-rater reliability of medication error classifications in a voluntary patient safety incident reporting system (HaiPro) widely used in Finland, and to explore reported medication errors and their contributing factors...
November 28, 2018: Research in Social & Administrative Pharmacy: RSAP
Chanu Rhee, Rui Wang, Maximilian S Jentzsch, Carly Broadwell, Heather Hsu, Robert Jin, Kelly Horan, Grace M Lee
National policies target healthcare-associated infections using medical claims and National Healthcare Safety Network surveillance data. We found low concordance between the 2 data sources in rates and rankings for surgical site infection following colon surgery in 155 hospitals, underscoring the limitations in evaluating hospital quality by claims data.
December 4, 2018: Infection Control and Hospital Epidemiology
Helen Lloyd, Ben Fosh, Ben Whalley, Richard Byng, James Close
Background: Measuring patient experiences of healthcare is increasingly emphasized as a mechanism to measure, benchmark and drive quality improvement, clinical effectiveness and patient safety at both national and local NHS level. Person-centred coordinated care (P3C) is the conjunction of two constructs; person-centred care and care coordination. It is a complex intervention requiring support for changes to organizational structure and the behaviour of professionals and patients. P3C can be defined as: 'care and support that is guided by and organized effectively around the needs and preferences of individuals'...
December 1, 2018: International Journal for Quality in Health Care
Lorelei Jones, Fiona Moss
OBJECTIVE: To ask those most affected by continuing professional development for senior doctors - patients, other professional groups and doctors themselves - what it needs to encompass. DESIGN: The nominal group technique. PARTICIPANTS: Six groups of between seven and nine members (n = 49). Separate groups were held for nurses and therapists (n = 9), patient representatives (n = 8), medical directors (n = 8), consultants (n = 8) and medical trainees (n = 7)...
December 3, 2018: Journal of the Royal Society of Medicine
Erin Sarzynski, Mark Ensberg, Amy Parkinson, Laurie Fitzpatrick, Laura Houdeshell, Charles Given, Kevin Brooks
Despite patient safety initiatives to improve care transitions, prior research largely neglects to elicit feedback from home health nurses regarding health information exchange. The goal of this quality improvement study was to identify opportunities to facilitate information transfer during hospital-to-home-health-care transitions for older adults with heart failure. We conducted focus groups with 19 nurses employed by a single healthcare system using two commercially available electronic health record (EHR) vendors...
November 28, 2018: Geriatric Nursing
Hui Cai, Kent Spreckelmeyer, Amy Mendenhall, Dan Li, Cheryl Holmes, Michelle Levy
OBJECTIVES: This study aims to explore the rural residents' preferences on various aspects of the patient-centered medical home (PCMH) model and the associated physical environment features. BACKGROUND: The PCMH model has gained popularity as an innovative care model that intends to improve patient experience and outcomes while reducing costs. Yet few studies focused on patients' perspective, even less considered the needs of the rural communities. METHOD: Using a convenience sample, an exploratory survey was completed by 362 rural residents in the Midwestern region...
December 3, 2018: HERD
Andrew Guidry, Kevin Crutchfield
Neurologic disease does not discriminate, even among athletes. Common neurologic diseases among athletes include multiple sclerosis, seizures, headaches, and sleep disorders. Although concrete guidelines for sport participation among athletes with neurologic diseases do not exist, evidence-based and consensus statements can aid healthcare providers in determining whether and to what extent such athletes should participate in sports. Moreover, sport participation is important, since multiple studies indicate that exercise improves disease-specific symptoms, manifestations, and overall quality of life...
2018: Handbook of Clinical Neurology
Rona Weerasuriya, Claire Henderson-Wilson, Mardie Townsend
This review describes the facilitators and barriers impacting on passive access to green spaces within healthcare settings. A systematic mixed-studies review was undertaken to review the quantitative and qualitative evidence on access to green spaces within healthcare settings, as well as to review the methodological quality of the studies eligible for inclusion. A total of 24 articles met the inclusion criteria and were included in the review. The barriers to access were grouped into three themes: "awareness," "accessibility," and "comfort...
November 27, 2018: HERD
Marie Bismark, Holly Tibble, Jennifer Schulz Moore, Jennifer Michelle Morris, Ron Paterson, Martin Fletcher, David Studdert
OBJECTIVE: The aim of the study was to describe the sources of notifications of concern ("notifications") regarding the health, performance, and conduct of health practitioners from 14 registered professions in Australia. METHODS: This retrospective cohort study analyzed 43,256 notifications lodged with the Australian Health Practitioner Regulation Agency and the Health Professional Councils Authority between 2011 and 2016. We used descriptive statistical analysis to describe the characteristics of these notifications, including their source, issue and domain, and subject...
November 21, 2018: Journal of Patient Safety
Nicole Weber, Andrea L Martinsen, Amidou Sani, Elom Kokou Eric Assigbley, Chedly Azzouz, Arabella Hayter, Komlan Ayite, Amivi Afefa Bibiane Baba, Kokou Mawulé Davi, Rick Gelting
Water, sanitation, and hygiene (WASH) services in healthcare facilities are essential to ensure quality health care and to facilitate infection, prevention, and control practices. They are critical to responding to outbreaks and preventing healthcare-associated infections and, therefore, critical to global health security. Many healthcare facilities in low- and middle-income settings have limited WASH services. One tool to address this issue is the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) Water and Sanitation for Health Facility Improvement Tool, or "WASH FIT...
2018: Health Security
Marie-Conception Leocadie, Marie-Hélène Roy, Monique Rothan-Tondeur
Background: Due to the increase in the number of people with dementia, relatives often provide in-home care. This care constitutes a cornerstone of the healthcare system, and maintaining these caregivers' well-being is therefore of paramount importance. Although respite interventions are generally considered an effective support system, they tend to be underutilized. The aim of this integrative literature review is to highlight the factors that promote and impede the use of respite interventions...
2018: Archives of Public Health, Archives Belges de Santé Publique
Benjamin Magid, Cathryn Murphy, Julie Lankiewicz, Natalie Lawandi, Anthony Poulton
INTRODUCTION: Increasingly, over the past decade, there has been a global shift in healthcare away from fixed "fee for service" payment mechanisms towards value-based reimbursement models rewarding safety and quality patient outcomes. Curbing the burgeoning costs of healthcare while incentivising higher quality and safer patient care are key drivers of this approach. At face value, this is clearly a worthwhile endeavour. However, there is a lack of conclusive evidence to support the effectiveness of such schemes where they have been introduced internationally...
March 2018: Infection, disease & health
J Y Wang, Y H Wu, S J Liu, Y S Lin, P H Lu
BACKGROUND: Postherpetic neuralgia (PHN) is the most distressful complication of herpes zoster. PHN results in an impaired quality of life and higher healthcare utilization. Vitamin B12 has been proven to be effective in pain relief for various conditions. OBJECTIVE: We conducted a systematic review and a meta-analysis to evaluate the efficacy of vitamin B12 supplementation in PHN patients. METHODS: PubMed, Embase, Cochrane Library, CINAHL, and ClinicalTrials...
December 2018: Complementary Therapies in Medicine
Donella Piper, Jackie Lea, Cindy Woods, Vicki Parker
BACKGROUND: Effective handover is crucial for patient safety. Rural health care organisations have particular challenges in relation to handover of information, placing them at higher risk of adverse events. Few studies have examined the relationship between handover and patient safety in rural contexts, particularly in Australia. This study aimed to explore the effect of handover on overall perceptions of patient safety and the effect of other patient safety dimensions on handover in a rural Australian setting...
November 26, 2018: BMC Health Services Research
Yaolin Zhou
Background: Existing quality improvement (QI) models have been used with varied success in health care. We developed the EPIDEM Model of Quality Improvement to apply QI principles to health care and promote a widespread culture of quality and patient safety. Methods: The EPIDEM acronym can be used to teach and remember the steps of process improvement: explore relevant issues and contextual factors, promote to the right people, implement timely solutions, document steps, evaluate with meaningful measures, and make modifications to improve interventions further...
November 21, 2018: Laboratory Medicine
René Amalberti, Charles Vincent, Wendy Nicklin, Jeffrey Braithwaite
Health systems are under more pressure than ever before, and the challenges are multiplying and accelerating. Economic forces, new technology, genomics, AI in medicine, increasing demands for care-all are playing a part, or are predicted to increasingly do so. Above all, ageing populations in many parts of the world are exacerbating the disease burden on the system and intensifying the requirements to provide effective care equitably to citizens. In this first of two companion articles on behalf of the Innovation and Systems Change Working Group of the International Society for Quality in Health Care (ISQua), in consultation with representatives from over 40 countries, we assess this situation and discuss the implications for safety and quality...
November 22, 2018: International Journal for Quality in Health Care
John M Austin, Erin M Kirley, Michael A Rosen, Bradford D Winters
OBJECTIVE: To compare the Agency for Healthcare Research and Quality's Quality and Safety Review System (QSRS) and the proposed triadic structure for the 11th version of the International Classification of Disease (ICD-11) in their ability to capture adverse events in U.S. hospitals. DATA SOURCES/STUDY SETTING: One thousand patient admissions between 2014 and 2016 from three general, acute care hospitals located in Maryland and Washington D.C. STUDY DESIGN: The admissions chosen for the study were a random sample from all three hospitals...
November 25, 2018: Health Services Research
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