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https://www.readbyqxmd.com/read/27899338/high-touch-and-high-tech-ht2-proposal-transforming-patient-engagement-throughout-the-continuum-of-care-by-engaging-patients-with-portal-technology-at-the-bedside
#1
Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Alison M Aldrich, Daniel M Walker, Milisa K Rizer, Susan D Moffatt-Bruce, Timothy R Huerta
BACKGROUND: For patients with complex care needs, engagement in disease management activities is critical. Chronic illnesses touch almost every person in the United States. The costs are real, personal, and pervasive. In response, patients often seek tools to help them manage their health. Patient portals, personal health records tethered to an electronic health record, show promise as tools that patients value and that can improve health. Although patient portals currently focus on the outpatient experience, the Ohio State University Wexner Medical Center (OSUWMC) has deployed a portal designed specifically for the inpatient experience that is connected to the ambulatory patient portal available after discharge...
November 29, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27893170/safety-profiles-of-iron-chelators-in-young-patients-with-haemoglobinopathies
#2
REVIEW
Sebastian Botzenhardt, Niya Li, Esther W Chan, Chor Wing Sing, Ian C K Wong, Antje Neubert
BACKGROUND: This review describes the safety of deferoxamine (DFO), deferiprone (DFP), deferasirox (DFX), and combined therapy in young patients less than 25 years of age with haemoglobinopathies. METHOD: Searches in electronic literature databases were performed. Studies reporting adverse events associated with iron chelation therapy were included. Study and reporting quality was assessed using AHRQ Risk of Bias Assessment Tool and McMaster Quality Assessment Scale of Harms...
November 28, 2016: European Journal of Haematology
https://www.readbyqxmd.com/read/27892625/progress-at-the-intersection-of-patient-safety-and-medical-liability-insights-from-the-ahrq-patient-safety-and-medical-liability-demonstration-program
#3
M Susan Ridgely, Michael D Greenberg, Michelle B Pillen, James Bell
OBJECTIVE: To identify lessons learned from the experience of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety and Medical Liability (PSML) Demonstration Program. DATA SOURCES/STUDY SETTING: On September 9, 2009, President Obama directed the Secretary of Health and Human Services to authorize demonstration projects that put "patient safety first" with the intent of reducing preventable adverse outcomes and stemming liability costs. Seven demonstration projects received 3 years of funding from AHRQ in the summer of 2010, and the program formally came to a close in June 2015...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27891603/using-harm-based-weights-for-the-ahrq-patient-safety-for-selected-indicators-composite-psi-90-does-it-affect-assessment-of-hospital-performance-and-financial-penalties-in-veterans-health-administration-hospitals
#4
Qi Chen, Amy K Rosen, Ann Borzecki, Michael Shwartz
OBJECTIVE: To assess whether hospital profiles for public reporting and pay-for-performance, measured by the Agency for Healthcare Research and Quality (AHRQ) Patient Safety for Selected Indicators (PSI-90) composite measure, were affected by using the recently developed harm-based weights. DATA SOURCES/STUDY SETTING: Retrospective analysis of 2012-2014 data from the Veterans Health Administration (VA). STUDY DESIGN: The AHRQ PSI software (v5...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#5
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27886626/describing-clinical-faculty-experiences-with-patient-safety-and-quality-care-in-acute-care-settings-a-mixed-methods-study
#6
Linda Roney, Catherine Sumpio, Audrey M Beauvais, Eileen R O'Shea
BACKGROUND: A major safety initiative in acute care settings across the United States has been to transform hospitals into High Reliability Organizations. The initiative requires developing cognitive awareness, best practices, and infrastructure so that all healthcare providers including clinical faculty are accountable to deliver quality and safe care. OBJECTIVE: To describe the experience of baccalaureate clinical nursing faculty concerning safety and near miss events, in acute care hospital settings...
November 18, 2016: Nurse Education Today
https://www.readbyqxmd.com/read/27851708/the-relationship-between-nurse-reported-safety-culture-and-the-patient-experience
#7
Kathleen Abrahamson, Zach Hass, Kristopher Morgan, Bradley Fulton, Rangaraj Ramanujam
OBJECTIVE: The purpose of this study was to better understand the relationship between nurse-reported safety culture and the patient experience in a multistate sample of nurses and patients, matched by hospital unit/service line and timeframe of care delivery. BACKGROUND: Nurses play a key role in the patient experience and patient safety. A strong safety culture may produce positive spillover effects throughout the nurse caregiving experience, resulting in patient perception of a high-quality experience...
December 2016: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27837359/emergency-department-visits-and-hospitalizations-for-the-uninsured-in-illinois-before-and-after-affordable-care-act-insurance-expansion
#8
Aabha I Sharma, Scott M Dresden, Emilie S Powell, Raymond Kang, Joe Feinglass
We describe changes in emergency department (ED) visits and the proportion of patients with hospitalizations through the ED classified as Ambulatory Care Sensitive Hospitalization (ACSH) for the uninsured before (2011-2013) and after (2014-2015) Affordable Care Act (ACA) health insurance expansion in Illinois. Hospital administrative data from 201 non-federal Illinois hospitals for patients age 18-64 were used to analyze ED visits and hospitalizations through the ED. ACSH was defined using Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQIs)...
November 12, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/27806170/costs-and-consequences-associated-with-misdiagnosed-lower-extremity-cellulitis
#9
Qing Yu Weng, Adam B Raff, Jeffrey M Cohen, Nicole Gunasekera, Jean-Phillip Okhovat, Priyanka Vedak, Cara Joyce, Daniela Kroshinsky, Arash Mostaghimi
Importance: Inflammatory dermatoses of the lower extremity are often misdiagnosed as cellulitis (aka "pseudocellulitis") and treated with antibiotics and/or hospitalization. There is limited data on the cost and complications from misdiagnosed cellulitis. Objective: To characterize the national health care burden of misdiagnosed cellulitis in patients admitted for treatment of lower extremity cellulitis. Design, Setting, and Participants: Cross-sectional study using patients admitted from the emergency department (ED) of a large urban hospital with a diagnosis of lower extremity cellulitis between June 2010 and December 2012...
November 2, 2016: JAMA Dermatology
https://www.readbyqxmd.com/read/27802478/management-of-gout-a-systematic-review-in-support-of-an-american-college-of-physicians-clinical-practice-guideline
#10
Paul G Shekelle, Sydne J Newberry, John D FitzGerald, Aneesa Motala, Claire E O'Hanlon, Abdul Tariq, Adeyemi Okunogbe, Dan Han, Roberta Shanman
Background: Gout is a common type of inflammatory arthritis in patients seen by primary care physicians. Purpose: To review evidence about treatment of acute gout attacks, management of hyperuricemia to prevent attacks, and discontinuation of medications for chronic gout in adults. Data Sources: Multiple electronic databases from January 2010 to March 2016, reference mining, and pharmaceutical manufacturers. Study Selection: Studies of drugs approved by the U...
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27789628/implementation-of-care-management-an-analysis-of-recent-ahrq-research
#11
Andrada Tomoaia-Cotisel, Timothy W Farrell, Leif I Solberg, Carolyn A Berry, Neil S Calman, Peter F Cronholm, Katrina E Donahue, David L Driscoll, Diane Hauser, Jeanne W McAllister, Sanjeev N Mehta, Robert J Reid, Ming Tai-Seale, Christopher G Wise, Michael D Fetters, Jodi Summers Holtrop, Hector P Rodriguez, Cherie P Brunker, Erin L McGinley, Rachel L Day, Debra L Scammon, Michael I Harrison, Janice L Genevro, Robert A Gabbay, Michael K Magill
Care management (CM) is a promising team-based, patient-centered approach "designed to assist patients and their support systems in managing medical conditions more effectively." As little is known about its implementation, this article describes CM implementation and associated lessons from 12 Agency for Healthcare Research and Quality-sponsored projects. Two rounds of data collection resulted in project-specific narratives that were analyzed using an iterative approach analogous to framework analysis. Informants also participated as coauthors...
October 20, 2016: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/27736111/the-practice-integration-profile-rationale-development-method-and-research
#12
C R Macchi, Rodger Kessler, Andrea Auxier, Juvena R Hitt, Daniel Mullin, Constance van Eeghen, Benjamin Littenberg
Insufficient knowledge exists regarding how to measure the presence and degree of integrated care. Prior estimates of integration levels are neither grounded in theory nor psychometrically validated. They provide scant guidance to inform improvement activities, compare integration efforts, discriminate among practices by degree of integration, measure the effect of integration on quadruple aim outcomes, or address the needs of clinicians, regulators, and policymakers seeking new models of health care delivery and funding...
October 13, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/27724950/use-of-existing-systematic-reviews-for-evidence-assessments-in-infectious-disease-prevention-a-comparative-case-study
#13
Thomas Harder, Cornelius Remschmidt, Sebastian Haller, Tim Eckmanns, Ole Wichmann
BACKGROUND: Given limited resources and time constraints, the use of existing systematic reviews (SR) for the development of evidence-based public health recommendations has become increasingly important. Recently, a five-step approach for identifying, analyzing, appraising and using existing SRs based on recent guidance by the US Agency for Healthcare Research and Quality (AHRQ) was proposed within the Project on a Framework for Rating Evidence in Public Health (PRECEPT). However, case studies are needed to test whether this approach is useful, what challenges arise and how problems can be solved...
October 11, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27693764/improving-patient-safety-reporting-with-the-common-formats-common-data-representation-for-patient-safety-organizations
#14
Peter L Elkin, Henry C Johnson, Michael R Callahan, David C Classen
Medical errors and patient safety issues remain a significant problem for the healthcare industry in the United States. The Institute of Medicine report To Err is Human reported that there were as many as 98,000 deaths per year due to medical error as of 1999. Many authors and government officials believe that the first step on the path to improvement in patient safety is more comprehensive collection and analysis of patient safety events. The belief is that this will enable safety improvements based on data showing the nature and frequency of events that occur, and the effectiveness of interventions...
December 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/27689793/ahrq-director-sets-course-for-agency-s-health-services-research
#15
Joan Stephenson
No abstract text is available yet for this article.
October 25, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27637829/state-challenges-to-child-health-quality-measure-reporting-and-recommendations-for-improvement
#16
Ankoor Y Shah, Karen LLanos, Denise Dougherty, Stephen Cha, Patrick H Conway
OBJECTIVE: The Children's Health Insurance Program (CHIP) was re-authorized in 2009, ushering in an unprecedented focus on children's health care quality one of which includes identifying a core set of performance measures for voluntary reporting by states' Medicaid/CHIP programs. However, there is a wide variation in the quantity and quality of measures states chose to report to the Center's for Medicare & Medicaid Services (CMS). The objective of this study is to assess reporting barriers and to identify potential opportunities for improvement...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27595676/rationale-and-design-of-the-randomized-evaluation-of-patients-with-stable-angina-comparing-utilization-of-noninvasive-examinations-rescue-trial
#17
Arthur E Stillman, Constantine Gatsonis, João A C Lima, William C Black, Jean Cormack, Ilana Gareen, Udo Hoffmann, Tao Liu, Kreton Mavromatis, Mitchell D Schnall, James E Udelson, Pamela K Woodard
RESCUE is a phase III, randomized, controlled, multicenter, comparative efficacy study, designed to compare two diagnostic imaging/treatment paradigms that use coronary computed tomography angiography (CCTA) or single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) for assisting in the diagnosis of ischemic heart disease in patients with stable angina symptoms, and guiding subsequent treatment. The study is based on the hypothesis that CCTA as a diagnostic tool is associated with no increase in cardiac risk, decreased cost, and reduced radiation exposure compared with SPECT MPI...
September 2016: American Heart Journal
https://www.readbyqxmd.com/read/27582460/quality-improvement-initiatives-need-rigorous-evaluation-the-case-of-pressure-ulcers
#18
Richard F Averill, John S Hughes, Richard L Fuller, Norbert I Goldfield
The Partnership for Patients (PfP) and the Agency for Healthcare Research and Quality (AHRQ) have reported a 23.5% decline in hospital-acquired pressure ulcers (HAPU) over 4 years resulting in a cumulative cost savings of more than $10 billion and 49 000 averted deaths, claiming that this significant decline may have been spurred in part by Medicare payment incentives associated with severe (stage 3 or 4) HAPUs. Hospitals with a high rate of severe HAPUs have a payment penalty imposed, creating a financial disincentive to report severe HAPUs, possibly contributing to the magnitude of the reported decline...
August 30, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27578751/navigating-a-ship-with-a-broken-compass-evaluating-standard-algorithms-to-measure-patient-safety
#19
Jennifer L Hefner, Timothy R Huerta, Ann Scheck McAlearney, Barbara Barash, Tina Latimer, Susan D Moffatt-Bruce
OBJECTIVE: Agency for Healthcare Research and Quality (AHRQ) software applies standardized algorithms to hospital administrative data to identify patient safety indicators (PSIs). The objective of this study was to assess the validity of PSI flags and report reasons for invalid flagging. MATERIAL AND METHODS: At a 6-hospital academic medical center, a retrospective analysis was conducted of all PSIs flagged in fiscal year 2014. A multidisciplinary PSI Quality Team reviewed each flagged PSI based on quarterly reports...
August 30, 2016: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/27558180/chlorhexidine-and-mupirocin-susceptibility-of-methicillin-resistant-staphylococcus-aureus-isolates-in-the-reduce-mrsa-trial
#20
Mary K Hayden, Karen Lolans, Katherine Haffenreffer, Taliser R Avery, Ken Kleinman, Haiying Li, Rebecca E Kaganov, Julie Lankiewicz, Julia Moody, Edward Septimus, Robert A Weinstein, Jason Hickok, John Jernigan, Jonathan B Perlin, Richard Platt, Susan S Huang
Whether targeted or universal decolonization strategies for control of methicillin-resistant Staphylococcus aureus (MRSA) select for resistance to decolonizing agents is unresolved. The REDUCE MRSA trial provided an opportunity to investigate this question. REDUCE-MRSA was a 3-arm, cluster-randomized trial of screening and isolation without decolonization, targeted decolonization with chlorhexidine and mupirocin, or universal decolonization without screening to prevent MRSA infection in intensive care unit patients...
August 24, 2016: Journal of Clinical Microbiology
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