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Continuous quality improvement

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https://www.readbyqxmd.com/read/27926675/improvement-in-total-joint-replacement-quality-metrics-year-one-versus-year-three-of-the-bundled-payments-for-care-improvement-initiative
#1
John M Dundon, Joseph Bosco, James Slover, Stephen Yu, Yousuf Sayeed, Richard Iorio
BACKGROUND: In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#2
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27925451/improving-access-and-systems-of-care-for-evidence-based-childhood-obesity-treatment-conference-key-findings-and-next-steps
#3
REVIEW
Denise E Wilfley, Amanda E Staiano, Myra Altman, Jeanne Lindros, Angela Lima, Sandra G Hassink, William H Dietz, Stephen Cook
OBJECTIVE: To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e., clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 h over 6 to 12 months to improve weight status) and to expand payment for these services. METHODS: In July 2015, 43 cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society...
December 7, 2016: Obesity
https://www.readbyqxmd.com/read/27925047/a-pioneering-healthcare-model-applying-large-scale-production-concepts-principles-and-performance-after-more-than-11-000-transplants-at-hospital-do-rim
#4
José Medina Pestana
The kidney transplant program at Hospital do Rim (hrim) is a unique healthcare model that applies the same principles of repetition of processes used in industrial production. This model, devised by Frederick Taylor, is founded on principles of scientific management that involve planning, rational execution of work, and distribution of responsibilities. The expected result is increased efficiency, improvement of results and optimization of resources. This model, almost completely subsidized by the Unified Health System (SUS, in the Portuguese acronym), has been used at the hrim in more than 11,000 transplants over the last 18 years...
October 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27924459/patient-reported-outcomes-and-quality-of-life-with-sunitinib-versus-placebo-for-pancreatic-neuroendocrine-tumors-results-from-an-international-phase-iii-trial
#5
Aaron Vinik, Andrew Bottomley, Beata Korytowsky, Yung-Jue Bang, Jean-Luc Raoul, Juan W Valle, Peter Metrakos, Dieter Hörsch, Rajiv Mundayat, Arlene Reisman, Zhixiao Wang, Richard C Chao, Eric Raymond
OBJECTIVE: The objective of this analysis was to compare patient-reported outcomes and health-related quality of life (HRQoL) in a pivotal phase III trial of sunitinib versus placebo in patients with progressive, well-differentiated pancreatic neuroendocrine tumors (NCT00428597). PATIENTS AND METHODS: Patients received sunitinib 37.5 mg (n = 86) or placebo (n = 85) on a continuous daily-dosing schedule until disease progression, unacceptable adverse events (AEs), or death...
December 6, 2016: Targeted Oncology
https://www.readbyqxmd.com/read/27924352/-prerequisites-skills-and-productivity-of-young-academic-urologists-in-germany
#6
H Borgmann, J Bründl, J Huber, C Ruf, U Schagdarsurgengin, B Wullich, J Salem
BACKGROUND: To safeguard scientific and clinical progress, German urology requires properly trained junior scientists. Before initiating or continuing actions aiming at quality improvement an analysis of the status quo is necessary. OBJECTIVE: To assess the conditions to pursue research, research skills and research output of junior scientists in urology in Germany. MATERIAL UND METHODS: A 16-item online questionnaire was sent to 95 junior scientists in urology within the research network GeSRU Academics...
December 6, 2016: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/27924241/sleep-and-fatigue-among-seafarers-the-role-of-environmental-stressors-duration-at-sea-and-psychological-capital
#7
Sigurd W Hystad, Jarle Eid
BACKGROUND: Seafaring is an inherently stressful environment. Because working time and leisure time is spent in the same confined environment for a prolonged period of time, many stressors present in seafaring can also be conceived of as chronic. We explored the effects of duration at sea, seafaring experience, environmental stressors, and psychological capital (PsyCap) on the sleep quality and fatigue of seafarers. PsyCap is a construct that draws upon ideas from positive psychology and positive organizational behavior, and is intended to capture an individual's psychological capacities that can be developed and utilized for performance improvements...
December 2016: Safety and Health At Work
https://www.readbyqxmd.com/read/27924187/evaluating-outcomes-in-patients-with-overactive-bladder-within-an-integrated-healthcare-delivery-system-using-a-treatment-patterns-analyzer
#8
Daniel B Ng, Melissa McCart, Christopher Klein, Chelsey Campbell, Robert Schoenhaus, Todd Berner
BACKGROUND: Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly. OBJECTIVE: To demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting...
September 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#9
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27922995/integrating-preventive-cardiovascular-healthcare-into-home-health-a-pilot-study
#10
Janet R Lynch, Cynthia K Sun, Stacie Deslich
The viability of measuring and integrating preventive cardiovascular care into home healthcare was investigated through a pilot study fielded during 2013 and 2014. The study tested the feasibility of using a data registry to measure preventive cardiovascular care delivered in home healthcare, examined opportunities for quality improvement, and looked at the association between exposure to evidence-based tools and improvement in aspirin use and blood pressure screening and control among a convenience sample of 20 agencies...
January 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/27922935/enhancing-memory-self-efficacy-during-menopause-through-a-group-memory-strategies-program
#11
Anne E Unkenstein, Bei Bei, Christina A Bryant
OBJECTIVE: Anxiety about memory during menopause can affect quality of life. We aimed to improve memory self-efficacy during menopause using a group memory strategies program. METHODS: The program was run five times for a total of 32 peri- and postmenopausal women, age between 47 and 60 years, recruited from hospital menopause and gynecology clinics. The 4-week intervention consisted of weekly 2-hour sessions, and covered how memory works, memory changes related to ageing, health and lifestyle factors, and specific memory strategies...
December 5, 2016: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/27922923/fear-of-recurrence-as-a-predictor-of-care-needs-for-long-term-breast-cancer-survivors
#12
Su-Ying Fang, Susan Jane Fetzer, Kuo-Ting Lee, Yao-Lung Kuo
BACKGROUND: The improved survival rate for breast cancer has increased the number of women living with the diagnosis for more than 5 years. Limited studies have focused on the care needs for long-term healthy survivors of breast cancer. OBJECTIVE: The aims of this study were to understand the care needs of long-term breast cancer survivors and identify related factors that influence these needs. METHODS: A convenience sampling with a correlational study design was used...
December 5, 2016: Cancer Nursing
https://www.readbyqxmd.com/read/27922448/the-second-randomised-evaluation-of-the-effectiveness-cost-effectiveness-and-acceptability-of-computerised-therapy-reeact-2-trial-does-the-provision-of-telephone-support-enhance-the-effectiveness-of-computer-delivered-cognitive-behaviour-therapy-a-randomised
#13
Sally Brabyn, Ricardo Araya, Michael Barkham, Peter Bower, Cindy Cooper, Ana Duarte, David Kessler, Sarah Knowles, Karina Lovell, Elizabeth Littlewood, Richard Mattock, Stephen Palmer, Jodi Pervin, David Richards, Debbie Tallon, David White, Simon Walker, Gillian Worthy, Simon Gilbody
BACKGROUND: Computerised cognitive behaviour therapy (cCBT) is an efficient form of therapy potentially improving access to psychological care. Indirect evidence suggests that the uptake and effectiveness of cCBT can be increased if facilitated by telephone, but this is not routinely offered in the NHS. OBJECTIVES: To compare the clinical effectiveness and cost-effectiveness of telephone-facilitated free-to-use cCBT [e.g. MoodGYM (National Institute for Mental Health Research, Australian National University, Canberra, ACT, Australia)] with minimally supported cCBT...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27921992/the-hubble-trial-haemorrhoidal-artery-ligation-hal-versus-rubber-band-ligation-rbl-for-symptomatic-second-and-third-degree-haemorrhoids-a-multicentre-randomised-controlled-trial-and-health-economic-evaluation
#14
Steven Brown, Jim Tiernan, Katie Biggs, Daniel Hind, Neil Shephard, Mike Bradburn, Allan Wailoo, Abualbishr Alshreef, Lizzie Swaby, Angus Watson, Simon Radley, Oliver Jones, Paul Skaife, Anil Agarwal, Pasquale Giordano, Marc Lamah, Mark Cartmell, Justin Davies, Omar Faiz, Karen Nugent, Andrew Clarke, Angus MacDonald, Phillip Conaghan, Paul Ziprin, Rohit Makhija
BACKGROUND: Optimal surgical intervention for low-grade haemorrhoids is unknown. Rubber band ligation (RBL) is probably the most common intervention. Haemorrhoidal artery ligation (HAL) is a novel alternative that may be more efficacious. OBJECTIVE: The comparison of HAL with RBL for the treatment of grade II/III haemorrhoids. DESIGN: A multicentre, parallel-group randomised controlled trial. PERSPECTIVE: UK NHS and Personal Social Services...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27920964/the-apprentice-an-innovative-approach-to-meet-the-behavior-analysis-certification-board-s-supervision-standards
#15
Breanne K Hartley, William T Courtney, Mary Rosswurm, Vincent J LaMarca
The Behavior Analysis Certification Board continues to increase the standards for supervision of trainees, which is needed in order for the field to continually improve. However, this presents a challenge for organizations to meet the needs of both their clients and their supervisees based on these increasing standards. Throughout the ages, experts in all trades have passed along their knowledge and skill through apprenticeship opportunities. An apprenticeship supervision model is described that allows Board Certified Behavior Analysts to supervise future behavior analysts by mentoring, educating, and training supervisees on the science of human behavior in a format that is mutually beneficial...
December 2016: Behavior Analysis in Practice
https://www.readbyqxmd.com/read/27920258/the-effects-of-three-different-exercise-modalities-on-markers-of-male-reproduction-in-healthy-subjects-a-randomized-controlled-trial
#16
Behzad Hajizadeh Maleki, Bakhtyar Tartibian, Mohammad Chehrazi
The aim of this study was to investigate the effects of moderate-intensity continuous training (MICT), high-intensity continuous training (HICT) and high-intensity interval training (HIIT) on markers of male reproduction including seminal markers of oxidative stress and inflammation as well as semen quality and sperm DNA integrity in healthy human subjects. A total of 397 healthy male volunteers were screened and 280 were randomly assigned to one of the MICT (n = 70), HICT (n = 70), HIIT (n = 70) and non-exercise (NON-EX, n = 70) groups...
February 2017: Reproduction: the Official Journal of the Society for the Study of Fertility
https://www.readbyqxmd.com/read/27920249/evaluating-the-impact-of-continuous-quality-improvement-methods-at-hospitals-in-tanzania-a-cluster-randomized-trial
#17
Yusuke Kamiya, Hisahiro Ishijma, Akiko Hagiwara, Shizu Takahashi, Henook A M Ngonyani, Eleuter Samky
OBJECTIVE: To evaluate the impact of implementing continuous quality improvement (CQI) methods on patient's experiences and satisfaction in Tanzania. DESIGN: Cluster-randomized trial, which randomly allocated district-level hospitals into treatment group and control group, was conducted. SETTING: Sixteen district-level hospitals in Kilimanjaro and Manyara regions of Tanzania. PARTICIPANTS: Outpatient exit surveys targeting totally 3292 individuals, 1688 in the treatment and 1604 in the control group, from 3 time-points between September 2011 and September 2012...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27920085/quality-of-prescribing-of-antipsychotic-medication-for-people-with-intellectual-disability-under-the-care-of-uk-mental-health-services-a-cross-sectional-audit-of-clinical-practice
#18
Carol Paton, Sumera Bhatti, Kiran Purandare, Ashok Roy, Tre Barnes
OBJECTIVES: To determine the prevalence and quality of antipsychotic prescribing for people with intellectual disability (ID). DESIGN: A clinical audit of prescribing practice in the context of a quality improvement programme. Practice standards for audit were derived from relevant, evidence-based guidelines, including NICE. Data were mainly collected from the clinical records, but to determine the clinical rationale for using antipsychotic medication in individual cases, prescribers could also be directly questioned...
December 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27919760/proton-therapy-present-and-future
#19
REVIEW
Radhe Mohan, David Grosshans
In principle, proton therapy offers a substantial clinical advantage over the conventional photon therapy. This is because of the unique depth-dose characteristics of protons, which can be exploited to achieve significant reductions in normal tissue doses proximal and distal to the target volume. These may, in turn, allow escalation of tumor doses, greater sparing of normal tissues, thus potentially improving local control and survival while at the same time reducing toxicity and improving quality of life. Protons, accelerated to therapeutic energies ranging from 70 to 250MeV, typically with a cyclotron or a synchrotron, are transported to the treatment room where they enter the treatment head mounted on a rotating gantry...
December 2, 2016: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/27919377/a-systematic-review-of-the-methodologies-used-to-evaluate-telemedicine-service-initiatives-in-hospital-facilities
#20
REVIEW
Sharifah AlDossary, Melinda G Martin-Khan, Natalie K Bradford, Anthony C Smith
BACKGROUND: The adoption of telemedicine into mainstream health services has been slower than expected. Many telemedicine projects tend not to progress beyond the trial phase; there are a large number of pilot or project publications and fewer 'service' publications. This issue has been noted since 1999 and continues to be acknowledged in the literature. While overall telemedicine uptake has been slow, some services have been successful. The reporting and evaluation of these successful services may help to improve future uptake and sustainability...
January 2017: International Journal of Medical Informatics
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