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Continuous quality improvement

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https://www.readbyqxmd.com/read/28821444/circumferential-fusion-a-comparative-analysis-between-anterior-lumbar-interbody-fusion-with-posterior-pedicle-screw-fixation-and-transforaminal-lumbar-interbody-fusion-for-l5-s1-isthmic-spondylolisthesis
#1
Erik Y Tye, Joseph E Tanenbaum, Andrea S Alonso, Roy Xiao, Michael P Steinmetz, Thomas E Mroz, Jason W Savage
BACKGROUND CONTEXT: Transforaminal lumbar interbody fusion (TLIF) or anterior lumbar interbody fusion with percutaneous pedicle screws (ALIFPS) offer significantly higher radiographic fusion rates than other fusion techniques for L5-S1 isthmic spondylolisthesis (IS). As it stands, there is a relative paucity of comparative data of the two techniques. PURPOSE: To define the clinical, radiographic, and financial differences between TLIF and ALIFPS for L5-S1 IS. STUDY DESIGN/SETTING: A retrospective cohort study conducted at a single-tertiary care center...
August 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28821421/exploring-canadian-physicians-experiences-with-diabetes-care-for-indigenous-patients
#2
Lynden Lindsay Crowshoe, Rita I Henderson, Michael E Green, Kristen M Jacklin, Leah M Walker, Betty Calam
OBJECTIVES: The perspectives of physicians caring for Indigenous patients with diabetes offer important insights into the provision of health-care services. The purpose of this study was to describe Canadian physicians' perspectives on diabetes care of Indigenous patients, a preliminary step in developing a continuing medical education intervention described elsewhere. METHODS: Through in-depth semistructured interviews, Canadian family physicians and specialists with sizeable proportions of Indigenous clientele shared their experiences of working with Indigenous patients who have type 2 diabetes...
August 15, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#3
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
August 17, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28820763/concept-evaluation-using-the-pdsa-cycle-for-continuous-quality-improvement
#4
Delois Meyer Laverentz, Sharon Kumm
As concept-based nursing education gains popularity, there is little literature on how to sustain quality after initiation of the curriculum. Critical appraisal of concepts in a university program revealed varying definitions, attributes, and exemplars resulting in student confusion. The Plan, Do, Study, Act (PDSA) cycle for continuous quality improvement was used for concept evaluation. The goals of the evaluation project were: 1) to develop common definition and attributes for concepts and 2) to develop horizontal and vertical leveling of exemplars to build on prior student learning...
September 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/28820743/sleep-apnea-a-review-of-diagnostic-sensors-algorithms-and-therapies
#5
Mehdi Shokoueinejad, Chris Fernandez, Emily Carroll, Fa Wang, Jake Levin, Sam Rusk, Nick Glattard, Ashley Mulchrone, Xuan Zhang, Ailiang Xie, Mihaela Teodorescu, Jerome Dempsey, John Webster
While public awareness of sleep related disorders is growing, sleep apnea syndrome (SAS) remains a public health and economic challenge. Over the last two decades, extensive controlled epidemiologic research has clarified the incidence, risk factors including the obesity epidemic, and global prevalence of obstructive sleep apnea (OSA), as well as establishing a growing body of literature linking OSA with cardiovascular morbidity, mortality, metabolic dysregulation, and neurocognitive impairment. The US Institute of Medicine Committee on Sleep Medicine estimates that 50-70 million US adults have sleep or wakefulness disorders...
August 18, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28820718/water-sanitation-and-hygiene-in-rural-health-care-facilities-a-cross-sectional-study-in-ethiopia-kenya-mozambique-rwanda-uganda-and-zambia
#6
Amy Guo, J Michael Bowling, Jamie Bartram, Georgia Kayser
Safe and sufficient water, sanitation, and hygiene (WaSH) prevent the spread of disease in health-care facilities (HCFs). Little research has been conducted on WaSH in HCF in sub-Saharan Africa. We carried out a cross-sectional study of WaSH in 1,318 randomly selected rural HCF (hospitals, health centers, health posts, and clinics) in regions throughout Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. Methods included questionnaires with head doctors and nurses to document WaSH access, continuity, quality, quantity and reliability, and analysis of drinking water samples for Escherichia coli...
July 31, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28819983/an-evaluation-of-the-effectiveness-of-a-risk-based-monitoring-approach-implemented-with-clinical-trials-involving-implantable-cardiac-medical-devices
#7
Christopher A Diani, Angie Rock, Phil Moll
Background Risk-based monitoring is a concept endorsed by the Food and Drug Administration to improve clinical trial data quality by focusing monitoring efforts on critical data elements and higher risk investigator sites. BIOTRONIK approached this by implementing a comprehensive strategy that assesses risk and data quality through a combination of operational controls and data surveillance. This publication demonstrates the effectiveness of a data-driven risk assessment methodology when used in conjunction with a tailored monitoring plan...
August 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28819778/impact-of-jumihaidokuto-shi-wei-bai-du-tang-on-treatment-of-chronic-spontaneous-urticaria-a-randomized-controlled-study
#8
Hiroyuki Murota, Hiroaki Azukizawa, Ichiro Katayama
OBJECTIVE: To study the effect of Jumihaidokuto (Shi-Wei-Bai-Du-Tang, ) in the management of chronic spontaneous urticaria. METHODS: A randomized two-arm, parallel group study was conducted to compare the effect of Jumihaidokuto (6 g daily) with a control for 8 weeks. Concomitant therapy (e.g., antihistamines) was continued. Twenty-one subjects with severe chronic urticaria were enrolled in this study. The primary treatment outcome was the severity score proposed by the Japanese Dermatological Association...
August 17, 2017: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28819527/-evaluation-of-the-compliance-rate-of-partograph-use-in-a-tunisian-maternity-ward-a-targeted-clinical-audit
#9
Latifa Merzougui, Nedia Marwen, Tarek Barhoumi, Afef Ben Ltaeifa, Hajer Hannachi, Roukaya Jaballah, Ridha Fatnassi
Partograph is an essential tool in routine delivery room practices. It is a written reflection of the quality of mother and child health management during delivery and in the immediate post-partum period. Our study aims to assess compliance rate of partograph use within our maternity ward and to propose areas for improvement of its quality. We conducted a retrospective clinical audit of 400 patients? medical records who gave birth on the labour ward at University of Kairouan from 1 January to 31 December 2014...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28818300/birth-outcome-racial-disparities-a-result-of-intersecting-social-and-environmental-factors
#10
Heather H Burris, Michele R Hacker
Adverse birth outcomes such as preterm birth, low-birth weight, and infant mortality continue to disproportionately affect black and poor infants in the United States. Improvements in healthcare quality and access have not eliminated these disparities. The objective of this review was to consider societal factors, including suboptimal education, income inequality, and residential segregation, that together lead to toxic environmental exposures and psychosocial stress. Many toxic chemicals, as well as psychosocial stress, contribute to the risk of adverse birth outcomes and black women often are more highly exposed than white women...
August 14, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28817858/foundations-core-principles-values-and-necessary-competencies-of-interprofessional-team-based-health-care
#11
H Bruce Vogt, Jeremy J Vogt
Health care reform has focused on improving health care delivery, quality, and patient safety. An interprofessional, team-based approach to health care is considered by many experts to be essential to meeting these goals. The evidence for this is growing. Core principles for team-based care and the interprofessional competencies necessary for a team to function effectively have been identified and can be taught. Resources for interprofessional education, which must begin at the health professions student level, are available to academic institutions, healthcare systems, and professional organizations to prepare students and current health care professionals for this cultural change...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28817856/back-to-basics-the-effect-of-healthy-diet-and-exercise-on-chronic-disease-management
#12
Robert L Allison
INTRODUCTION: The increase in obesity rates in the U.S. and other less developed industrial countries have led to a worldwide epidemic of chronic disease states. Increased obesity rates are implicated in the treatment failures for illnesses such as coronary artery disease, diabetes, heart failure, hypertension and cancer. Effective prevention of obesity through diet and exercise contributes to the successful medical management of multiple chronic disease states. OBJECTIVE: Review the last 10 years of literature (2006-2016) on the effects of diet and exercise as they relate to the prevention of chronic disease...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28817841/-practical-use-of-continuous-apomorphine-infusion-via-pump
#13
Lars Tönges, Andrés Ceballos-Baumann, Holger Honig, Alexander Storch, Wolfgang H Jost
Parkinson's disease is the second most common neurodegenerative illness after Alzheimer's disease. In its advanced stages, it is characterized by various special symptoms. In addition to non-motor signs, motor complications are most prominent and most often can only be inadequately improved with pulsatile oral therapies. However, with the aid of continuous dopaminergic stimulation, improvements can be achieved even in advanced stages of the disease. This will not only alleviate motor and non-motor symptoms, but will also lead to a better quality of life...
August 17, 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28817431/challenges-in-health-care-simulation-are-we-learning-anything-new
#14
Kerm Henriksen, David Rodrick, Erin N Grace, P Jeffrey Brady
The growth of health care simulation in schools of medicine and nursing is noteworthy, as is the increasingly sophisticated simulation technology, support from funding agencies and foundations for research, well-attended annual conferences, and continued interest of accreditation and certification groups. Yet there are concerns preventing the full value of health care simulation to be realized when examined from a patient safety perspective. Basic questions are asked by funders of patient safety research when assessing past simulation projects undertaken to advance patient safety: Are the safety and quality of care to patients actually improved, and is something new being learned regarding the optimal use of simulation? Concerns focus on pursuing the right research questions to learn something new about the most effective use of simulation; doing more with simulation than simply providing an interesting, stand-alone educational experience; attending more seriously to how skill acquisition, maintenance, and progression get managed; and encouraging investigators, funders, and reviewers to expand their vision regarding what constitutes important inquiry and evidence in health care simulation...
August 16, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28817428/interprofessional-qi-training-enhances-competency-and-qi-productivity-among-graduates-findings-from-nationwide-children-s-hospital
#15
Thomas Bartman, Karen Heiser, Andrew Bethune, Wallace Crandall, Richard McClead, J Terrance Davis, Richard J Brilli
PURPOSE: Significant resources are expended on quality improvement (QI) training courses. The authors sought to determine whether education provided in QI course training improves self-assessed QI content competence and QI-related productivity among course graduates. METHOD: "Quality Improvement Essentials" is a four-month didactic and experiential course designed to prepare multidisciplinary professionals to participate in and lead QI efforts at Nationwide Children's Hospital (NCH)...
August 16, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28815353/perceptions-of-the-inpatient-training-experience-a-nationwide-survey-of-gastroenterology-program-directors-and-fellows
#16
EDITORIAL
Navin L Kumar, Molly L Perencevich, Jerry S Trier
BACKGROUND: Inpatient training is a key component of gastroenterology (GI) fellowship programs nationwide, yet little is known about perceptions of the inpatient training experience. AIM: To compare the content, objectives and quality of the inpatient training experience as perceived by program directors (PD) and fellows in US ACGME-accredited GI fellowship programs. METHODS: We conducted a nationwide, online-based survey of GI PDs and fellows at the conclusion of the 2016 academic year...
August 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28815316/health-related-quality-of-life-associated-with-regorafenib-treatment-in-refractory-advanced-gastric-adenocarcinoma
#17
Andrew J Martin, Emma Gibbs, Katrin Sjoquist, Nick Pavlakis, John Simes, Tim Price, Jenny Shannon, Sanjeev Gill, Vikram Jain, Geoffrey Liu, George Kannourakis, Yeul Hong Kim, Jin Won Kim, David Goldstein
BACKGROUND: The INTEGRATE phase II multinational randomized controlled trial demonstrated the activity of regorafenib on progression-free survival (PFS) in patients with refractory advanced gastric adenocarcinoma. We sought to evaluate whether these PFS gains had the potential to be offset by quality of life (QoL) impacts from treatment side effects and to thereby determine the appropriateness of continuing development to phase III. METHODS: QoL was assessed in INTEGRATE at baseline and at each 4 weeks thereafter, until discontinuation of study treatment, using the QLQ-C30, STO22, and EQ-5D questionnaires...
August 16, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28814674/rilonacept-maintains-long-term-inflammatory-remission-in-patients-with-deficiency-of-the-il-1-receptor-antagonist
#18
Megha Garg, Adriana A de Jesus, Dawn Chapelle, Paul Dancey, Ronit Herzog, Rafael Rivas-Chacon, Theresa L Wampler Muskardin, Ann Reed, James C Reynolds, Raphaela Goldbach-Mansky, Gina A Montealegre Sanchez
BACKGROUND: Deficiency of IL-1 receptor antagonist (DIRA) is a rare autoinflammatory disease that presents with life-threatening systemic inflammation, aseptic multifocal osteomyelitis, and pustulosis responsive to IL-1-blocking treatment. This study was performed (a) to investigate rilonacept, a long-acting IL-1 inhibitor, in maintaining anakinra-induced inflammatory remission in DIRA patients, (b) to determine doses needed to maintain remission, and (c) to evaluate the safety and pharmacokinetics of rilonacept in young children (<12 years)...
August 17, 2017: JCI Insight
https://www.readbyqxmd.com/read/28814539/forward-a-registry-and-longitudinal-clinical-database-to-study-fragile-x-syndrome
#19
Stephanie L Sherman, Sharon A Kidd, Catharine Riley, Elizabeth Berry-Kravis, Howard F Andrews, Robert M Miller, Sharyn Lincoln, Mark Swanson, Walter E Kaufmann, W Ted Brown
BACKGROUND AND OBJECTIVE: Advances in the care of patients with fragile X syndrome (FXS) have been hampered by lack of data. This deficiency has produced fragmentary knowledge regarding the natural history of this condition, healthcare needs, and the effects of the disease on caregivers. To remedy this deficiency, the Fragile X Clinic and Research Consortium was established to facilitate research. Through a collective effort, the Fragile X Clinic and Research Consortium developed the Fragile X Online Registry With Accessible Research Database (FORWARD) to facilitate multisite data collection...
June 2017: Pediatrics
https://www.readbyqxmd.com/read/28814341/a-review-of-national-policies-and-strategies-to-improve-quality-of-health-care-and-patient-safety-a-case-study-from-lebanon-and-jordan
#20
Fadi El-Jardali, Racha Fadlallah
BACKGROUND: Improving quality of care and patient safety practices can strengthen health care delivery systems, improve health sector performance, and accelerate attainment of health-related Sustainability Development Goals. Although quality improvement is now prominent on the health policy agendas of governments in low- and middle-income countries (LMICs), including countries of the Eastern Mediterranean Region (EMR), progress to date has not been optimal. The objective of this study is to comprehensively review existing quality improvement and patient safety policies and strategies in two selected countries of the EMR (Lebanon and Jordan) to determine the extent to which these have been institutionalized within existing health systems...
August 16, 2017: BMC Health Services Research
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