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https://www.readbyqxmd.com/read/28538055/high-reliability-principles-must-be-tied-to-value-based-outcomes
#1
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
#2
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/28526019/mass-anti-malarial-administration-in-western-cambodia-a-qualitative-study-of-factors-affecting-coverage
#3
Christopher Pell, Rupam Tripura, Chea Nguon, Phaikyeong Cheah, Chan Davoeung, Chhouen Heng, Lim Dara, Ma Sareth, Arjen Dondorp, Lorenz von Seidlein, Thomas J Peto
BACKGROUND: Mass anti-malarial administration has been proposed as a key component of the Plasmodium falciparum malaria elimination strategy in the Greater Mekong sub-Region. Its effectiveness depends on high levels of coverage in the target population. This article explores the factors that influenced mass anti-malarial administration coverage within a clinical trial in Battambang Province, western Cambodia. METHODS: Qualitative data were collected through semi-structured interviews and focus group discussions with villagers, in-depth interviews with study staff, trial drop-outs and refusers, and observations in the communities...
May 19, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28515213/rapid-identification-of-five-classes-of-carbapenem-resistance-genes-directly-from-rectal-swabs-using-the-xpert%C3%A2-carba-r-assay
#4
Nicholas M Moore, Rafael Cantón, Edoardo Carretto, Lance R Peterson, Robert L Sautter, Maria M Traczewski
Carbapenemase-producing organisms (CPO) have been identified by global health leaders as an urgent threat. Detection of patients with gastrointestinal carriage of CPO is necessary to interrupt their spread within healthcare facilities. In this multi-site study, we assessed the performance of the Xpert® Carba-R test, a rapid real-time PCR (qPCR) assay that detects five families of carbapenemase genes (blaIMP, blaKPC, blaNDM, blaOXA-48, and blaVIM) directly from rectal swab specimens. Using dual swabs, specimens from 755 patients were collected and tested prospectively...
May 17, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28513887/geriatrics-for-specialists-initiative-an-eleven-specialty-collaboration-to-improve-care-of-older-adults
#5
Andrew G Lee, John A Burton, Nancy E Lundebjerg
In the early 1990s, visionary leaders at the American Geriatrics Society and The John A. Hartford Foundation recognized that the marked and growing shortage of geriatrics healthcare professionals would lead to a U.S. healthcare system ill prepared to provide optimal care for the ever-increasing number of older Americans. Led by the late Dennis W. Jahnigen, MD, they set forth a plan to address this shortage by collaborating with surgical and related medical specialists to create a series of programs to foster the highest quality care of older adults...
May 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28492008/physician-industry-collaboration-organizational-considerations-for-the-future-of-innovation-and-growth-in-dermatology
#6
EDITORIAL
Wendy E Roberts, Neil S Sadick, Wilma F Bergfeld, Amy S Paller, Valerie D Callender, Lynn A Drake
The U.S. medical environment continues to evolve with issues from Privacy to EMR, Insurance regulations, Physician Access and Healthcare Reform, and MACRA (Medicare Access and CHIP Reauthorization Act) on the discussion table. Not since the advent of Medicare and Medicaid in the mid 1960's, have we seen such widespread changes in the medical healthcare environment (Centers for Medicare and Medicaid Services). Physicians, industry, patients and consumers are affected by the changes. These four groups have historically worked as separate entities, but are now key stakeholders in the future of dermatology...
June 2016: International Journal of Women's Dermatology
https://www.readbyqxmd.com/read/28486953/sustainability-in-health-care-by-allocating-resources-effectively-share-3-examining-how-resource-allocation-decisions-are-made-implemented-and-evaluated-in-a-local-healthcare-setting
#7
Claire Harris, Kelly Allen, Cara Waller, Vanessa Brooke
BACKGROUND: This is the third in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Leaders in a large Australian health service planned to establish an organisation-wide, systematic, integrated, evidence-based approach to disinvestment. In order to introduce new systems and processes for disinvestment into existing decision-making infrastructure, we aimed to understand where, how and by whom resource allocation decisions were made, implemented and evaluated...
May 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28482768/leadership-quality-a-factor-important-for-social-capital-in-healthcare-organizations
#8
Marcus Strömgren, Andrea Eriksson, Linda Ahlstrom, David Kristofer Bergman, Lotta Dellve
Purpose The purpose of this paper is to investigate the relation between leadership and social capital and what qualities of leadership are important for social capital among employees in hospital settings over time. Design/methodology/approach A cohort of employees in hospitals answered a questionnaire at three occasions. Five small (approx. 100-bed) or mid-sized (approx. 500-bed) hospitals were included. The response rate was 54 percent at baseline ( n=865), 59 percent at one-year follow-up ( n=908) and 67 percent at two-year follow-up ( n=632)...
April 10, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28476491/the-project-protect-infection-prevention-fellowship-a-model-for-advancing-infection-prevention-competency-quality-improvement-and-patient-safety
#9
Janine D Reisinger, Anna Wojcik, Ian Jenkins, Barbara Edson, David A Pegues, Linda Greene
BACKGROUND: The Centers for Disease Control and Prevention 2016 Healthcare-Associated Infections (HAI) Progress Report documented no change in catheter-associated urinary tract infections (CAUTIs) between 2009 and 2014. There is a need for investment in additional efforts to reduce HAIs, specifically CAUTI. Quality improvement fellowships are 1 approach to expand the capacity of dedicated leaders and infection prevention champions. METHODS: The fellowship used a model that expanded collaboration among disciplines and focused on partnership by recruiting a diverse cohort of fellows and by providing 1-on-1 mentoring to enhance leadership development...
May 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28471857/fix-these-first-how-the-world-s-leading-companies-point-the-way-toward-high-reliability-in-the-military-health-system
#10
Brad Beauvais, Jason Richter, Paul Brezinski
The 2014 Military Health System Review calls for healthcare system leaders to implement effective strategies used by other high-performing organizations. The authors state, " the [military health system] MHS can create an optimal healthcare environment that focuses on continuous quality improvement where every patient receives safe, high-quality care at all times" (Military Health System, 2014, p. 1). Although aspirational, the document does not specify how a highly reliable health system is developed or what systemic factors are necessary to sustain highly reliable performance...
May 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28471853/blueprint-for-sustainable-change-in-diversity-management-and-cultural-competence-lessons-from-the-national-center-for-healthcare-leadership-diversity-demonstration-project
#11
Janice L Dreachslin, Robert Weech-Maldonado, Judith Gail, Josué Patien Epané, Joyce Anne Wainio
How can healthcare leaders build a sustainable infrastructure to leverage workforce diversity and deliver culturally and linguistically appropriate care to patients? To answer that question, two health systems participated in the National Center for Healthcare Leadership's diversity leadership demonstration project, November 2008 to December 2013. Each system provided one intervention hospital and one control hospital.The control hospital in each system participated in pre- and postassessments but received no preassessment feedback and no intervention support...
May 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28448229/breaking-through-the-glass-ceiling-consumers-in-mental-health-organisations-hierarchies
#12
Brett Scholz, Julia Bocking, Brenda Happell
Contemporary mental health policies call for consumers to be engaged in all levels of mental health service planning, implementation, and delivery. Critical approaches to traditional healthcare hierarchies can effectively challenge barriers to better engagement with consumers in mental health organisations. This qualitative exploratory study analyses how particular strategies for consumer leadership facilitate or hinder relationships between consumers and mental health services, and how these strategies influence hierarchical structures...
May 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28439447/the-development-of-a-veterans-health-administration-emergency-management-research-agenda
#13
Aram Dobalian, Maria Claver, Deborah Riopelle, Tamar Wyte-Lake, Ismelda Canelo
INTRODUCTION: The Veterans Health Administration (VHA), the largest integrated healthcare delivery system in the United States, is charged with ensuring timely access to high-quality care for veterans during disasters, and supporting national, state, local, and tribal emergency management and homeland security efforts. In 2008, the VHA Office of Public Health (OPH) sponsored the first VHA Emergency Management Research Agenda-setting conference to develop research priorities that address the needs of veterans and to position VHA as a national leader in emergency management by having VHA serve as a "laboratory" for the development of evidence-based emergency management practices...
March 23, 2017: PLoS Currents
https://www.readbyqxmd.com/read/28436926/using-moral-distress-for-organizational-improvement
#14
James E Sabin
Moral distress is a major problem for nurses, other clinicians, and the health system itself. But if properly understood and responded to, it is also a promising guide for healthcare improvement. When individuals experience moral distress or burnout, their reports must be seen as crucial data requiring careful attention to the individuals and to the organization. Distress and burnout will often point to important opportunities for system improvements, which may in turn reduce the experience of distress. For this potential virtuous cycle to happen, individuals must be able to articulate their concerns without fear of retribution, and organizational leaders must be able to listen in an undefensive, improvement-oriented manner...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28428731/governing-mobile-technology-use-for-continuing-professional-development-in-the-australian-nursing-profession
#15
Carey Ann Mather, Fred Gale, Elizabeth Anne Cummings
BACKGROUND: The rapid growth in the use of mobile technology in Australia has outpaced its governance, especially in healthcare settings. Whilst some Australian professional bodies and organisations have developed standards and guidelines to direct appropriate use of social media and mobile technology, clear governance arrangements regarding when, where and how to use mobile technology at point of care in nursing are currently lacking. DISCUSSION: This paper analyses how the use of mobile technology by nurses at point of care is governed...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28426536/exploring-the-interaction-between-nursing-decision-making-and-patient-outcomes-in-2-european-cancer-centers-a-qualitative-study
#16
Dario Valcarenghi, Annamaria Bagnasco, Giuseppe Aleo, Gianluca Catania, Milko Zanini, Bruno Cavaliere, Franco Carnevale, Loredana Sasso
BACKGROUND: In some clinical settings, nurses have difficulty describing the outcomes of their caring activities. Understanding the reasons for this could help nurse leaders to improve the effectiveness and visibility of nursing practice and safeguard nurses' working conditions. OBJECTIVE: The aims of this study were to understand how nurses working in 2 different adult cancer centers make healthcare decisions and assess the respective outcomes on their patients...
April 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28423856/improving-handovers-between-hospitals-and-primary-care-implementation-of-e-messages-and-the-importance-of-training
#17
Grete Netteland
The transfer of information and responsibility for care of a patient from one healthcare provider to another is referred to as a handover. While some handovers are effective and achieve high quality communication, others represent a barrier to continuity of care. To increase the patient safety, Norway decided to replace handovers with an electronic e-message system (EMS). This paper refers to a quantitative study of this implementation and examines the opinions of first-line leaders and nurses (N = 108) on how organisational factors were taken into account and how the implementation might be improved...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28422928/are-nurse-leaders-prepared-to-lead-across-the-continuum-of-care-in-the-new-paradigm
#18
O Ed Reitz, Shelly Malin
The movement toward linking reimbursement with outcomes necessitates providing care across a continuum of settings, leading to the need for a new healthcare paradigm. Issues related to shifting to this new paradigm include disagreement about what this paradigm encompasses, the fragmentation of the healthcare system, and overreliance on the medical model as a framework for driving health policy decisions. We advocate for nurse leaders to guide the development of this new paradigm.
May 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28421600/lay-led-and-peer-support-interventions-for-adolescents-with-asthma
#19
REVIEW
Kayleigh M Kew, Robin Carr, Iain Crossingham
BACKGROUND: Adolescents with asthma are at high risk of poor adherence with treatment. This may be compounded by activities that worsen asthma, in particular smoking. Additional support above and beyond routine care has the potential to encourage good self-management. We wanted to find out whether sessions led by their peers or by lay leaders help to reduce these risks and improve asthma outcomes among adolescents. OBJECTIVES: To assess the safety and efficacy of lay-led and peer support interventions for adolescents with asthma...
April 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28414407/medical-student-teaching-and-recruiting-50-years-of-balancing-two-educational-aims
#20
Benjamin N Schneider, Alexander Chessman, William Toffler, Lara Handler, Beat Steiner, Frances Emily Biagioli
Family medicine (FM) undergraduate medical educators have had two distinct missions, to increase the knowledge, skills, and attitudes of all students while also striving to attract students to the field of family medicine. A five decade literature search was conducted gathering FM curricular innovations and the parallel trends in FM medical student interest. Student interest in FM had a rapid first-decade rise to 14%, a second 1990's surge, followed by a drop to the current plateau of 8-9%. This falls far short of the 30-50% generalist benchmark needed to fill the country's health care needs...
April 2017: Family Medicine
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