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Continuous quality improvement

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https://www.readbyqxmd.com/read/28343306/the-ins-and-outs-of-molecular-pathology-reporting
#1
REVIEW
Véronique Tack, Kelly Dufraing, Zandra C Deans, Han J van Krieken, Elisabeth M C Dequeker
The raid evolution in molecular pathology resulting in an increasing complexity requires careful reporting. The need for standardisation is clearer than ever. While synoptic reporting was first used for reporting hereditary genetic diseases, it is becoming more frequent in pathology, especially molecular pathology reports too. The narrative approach is no longer feasible with the growing amount of essential data present on the report, although narrative components are still necessary for interpretation in molecular pathology...
March 26, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28343203/developing-the-professional-competence-of-future-doctors-in-the-instructional-setting-of-higher-medical-educational-institutions
#2
Halyna Yu Morokhovets, Yuliia V Lysanets
INTRODUCTION: The main objectives of higher medical education is the continuous professional improvement of physicians to meet the needs dictated by the modern world both at undergraduate and postgraduate levels. In this respect, the system of higher medical education has undergone certain changes - from determining the range of professional competences to the adoption of new standards of education in medicine. AIM: The article aims to analyze the parameters of doctor's professionalism in the context of competence-based approach and to develop practical recommendations for the improvement of instruction techniques...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28342700/nicotine-replacement-therapy-in-patients-with-aneurysmal-subarachnoid-hemorrhage-systematic-review-of-the-literature-and-survey-of-canadian-practice
#3
REVIEW
Ricky D Turgeon, Stephano J Chang, Charlotte Dandurand, Peter A Gooderham, Camille Hunt
Tobacco smoke increases the risk of aneurysmal subarachnoid hemorrhage (SAH), as well as complications such as vasospasm. Most patients presenting with aneurysmal SAH smoke, and many survivors continue to smoke after discharge. Neurosurgeons often hesitate to use nicotine replacement therapy (NRT) during hospitalization of patients with SAH due to concerns of inducing vasospasm. We aimed to evaluate the safety and efficacy, and patterns of use of NRT in smokers hospitalized for SAH. We performed a systematic review of MEDLINE, CENTRAL, Embase, and unpublished sources of literature to October 2016 for randomized and observational studies comparing exposure to non-exposure of smoking cessation products in the acute phase of aneurysmal SAH...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28339950/improving-the-quality-of-radiological-examinations-effectiveness-of-an-internal-participatory-approach
#4
Francisco Manuel Batista Mamede, Zenewton André da Silva Gama, Pedro Jesus Saturno-Hernández
Quality problem or issue: To assess the quality of radiological examinations (REs) and to evaluate the effectiveness of a participatory continuous improvement approach to ensure best practices in a Portuguese hospital imaging department. Initial assessment: At baseline, we found 232 (10.2%) non-compliances, mostly related to the criteria image centering and framing in chest radiography (CXR), proper use of radiological protection equipment in other conventional RE (CR) and X-ray beam collimation (CXR/CR)...
March 2, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339735/triage-quality-control-is-missing-tools-a-new-observation-technique-for-ed-quality-improvement
#5
Tomi Malmström, Veli-Pekka Harjola, Paulus Torkki, Salla Kumpulainen, Raija Malmström
Objective: Correct assessment of patient urgency is critical to ensuring patient safety in emergency departments (EDs). Although significant time and effort have been devoted to developing triage systems, less attention has been paid to the development of quality control. The aim of this study is to introduce and test observation technique, which enables identifying of patient groups at risk of erroneous assessment in triage. The introduced technique is aimed to be less laborious to use than existing triage quality control methods...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339494/facility-type-and-primary-care-performance-in-sub-district-health-promotion-hospitals-in-northern-thailand
#6
Nithra Kitreerawutiwong, Sue Jordan, David Hughes
BACKGROUND: Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses...
2017: PloS One
https://www.readbyqxmd.com/read/28339444/a-review-of-long-term-pain-relief-after-genicular-nerve-radiofrequency-ablation-in-chronic-knee-osteoarthritis
#7
Ferdinand Iannaccone, Samuel Dixon, Andrew Kaufman
BACKGROUND: Studies of radiofrequency ablation (RFA) of genicular nerves have reportedly significantly decreased pain up to 3 months post ablation, but no longer term effects have been reported. We performed an analysis of long-term pain relief of 31 RFA procedures of the genicular nerves to analyze the degree of pain relief past 3 months, culminating at 6 months. STUDY DESIGN: Chart review and study design was approved by Newark Health Sciences Institutional Review Board (IRB)...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#8
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339387/introduction-to-quality-control-in-a-compounding-pharmacy
#9
Loyd V Allen
A quality-based program is vital in every compounding pharmacy to ensure that each preparation is compounded properly and is stable for its expected duration of use. This article discusses quality control, quality assurance, continuous quality improvement, and also describes the components of an in-house (in-pharmacy) quality program, as well as the role of outside laboratories.
November 2016: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28339098/quality-of-life-with-cediranib-in-relapsed-ovarian-cancer-the-icon6-phase-3-randomized-clinical-trial
#10
Dan P Stark, Adrian Cook, Julia M Brown, Michael D Brundage, Andrew C Embleton, Richard S Kaplan, Fharat A Raja, Ann Marie W Swart, Galina Velikova, Wendi Qian, Jonathan A Ledermann
BACKGROUND: The ICON6 trial showed that cediranib, an oral inhibitor of vascular endothelial growth factor receptors 1, 2, and 3, improved clinical outcomes for patients with platinum-sensitive relapsed ovarian cancer when it was used with chemotherapy and was continued as maintenance therapy. This study describes health-related quality of life (QOL) during the first year of treatment. METHODS: Four hundred fifty-six women were randomly allocated to receive standard chemotherapy only, chemotherapy with concurrent cediranib, or chemotherapy with cediranib administered concurrently and continued as maintenance...
March 24, 2017: Cancer
https://www.readbyqxmd.com/read/28338497/using-selective-serotonin-reuptake-inhibitors-and-serotonin-norepinephrine-reuptake-inhibitors-in-critical-care-a-systematic-review-of-the-evidence-for-benefit-or-harm
#11
John M Kelly, Gordon D Rubenfeld, Neil Masson, Arimie Min, Neill K J Adhikari
OBJECTIVE: Selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitors are among the most commonly prescribed drugs in patients admitted to the ICU. Our objective was to systematically review available literature for evidence of benefit or harm in ICU patients resulting from chronic effects, continued use, or withdrawal. DATA SOURCES: Medline, Embase, and Cochrane Central Register of Controlled Trials (1990 to November 2014). STUDY SELECTION: We searched for studies of ICU patients with recorded selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor prescription before or during admission, and reporting morbidity, mortality, adverse events, and resource measures like ICU length of stay...
March 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28338039/coronally-advanced-flap-combined-with-connective-tissue-graft-treatment-of-choice-for-root-coverage-following-recession
#12
Ed Madeley, Brett Duane
Data sourcesMedline, The Cochrane Database Trials Register, Embase, supplemented by handsearching of five prominent periodontal journals, references from reviewed papers and contact with experts in the field of mucogingival surgery.Study selectionRandomised controlled trials (RCTs) with or without a split-mouth design, on human patients. RCTs had to compare at least two different surgical interventions on clearly specified recession defects, be over six months in duration and have clearly specified clinical measurements regarding root coverage...
March 2017: Evidence-based Dentistry
https://www.readbyqxmd.com/read/28336345/dancing-for-parkinson-s-a-randomized-trial-of-irish-set-dancing-compared-to-usual-care
#13
Joanne Shanahan, Meg E Morris, Orfhlaith Ni Bhriain, Daniele Volpe, Tim Lynch, Amanda M Clifford
OBJECTIVE: This pilot trial examined the feasibility of a randomised controlled study design and explored the benefits of the set dancing intervention compared to usual care. DESIGN: Randomised controlled design, with participants randomised to Irish set dance classes or a usual care control group. SETTING: Community based PARTICIPANTS: Individuals with idiopathic PD INTERVENTIONS: The dance group attended a 1.5 hour dancing class each week for 10 weeks and undertook a home dance programme for 20 minutes three times per week...
March 21, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28336184/atrial-fibrillation-management-in-a-breeding-stallion
#14
N Heliczer, K Mitchell, O Lorello, J Dauvillier, D Burger, C C Schwarzwald, C Navas de Solis
A 20-year-old warmblood breeding stallion presented to a University practice for semen collection and evaluation was incidentally diagnosed with atrial fibrillation (AF). Electrocardiogram recordings during breeding revealed inappropriately rapid tachycardia and occasional ventricular premature depolarizations/aberrant ventricular conduction. Transvenous electrical cardioversion was performed. After successful cardioversion the horse displayed supraventricular ectopy and atrial contractile dysfunction and was administered sotalol hydrochloride in an attempt to decrease the risk of AF recurrence...
March 20, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/28336097/ranking-current-and-prospective-no2-pollution-mitigation-strategies-an-environmental-and-economic-modelling-investigation-in-oxford-street-london
#15
A P R Jeanjean, J Gallagher, P S Monks, R J Leigh
Air pollution continues to be a problem in the urban environment. A range of different pollutant mitigation strategies that promote dispersion and deposition exist, but there is little evidence with respect to their comparative performance from both an environmental and economic perspective. This paper focuses on examining different NO2 mitigation strategies such as trees, buildings facades coated with photocatalytic paint and solid barriers in Oxford Street in London. The case study findings will support ranking the environmental and economic impacts of these different strategies to improve personal exposure conditions on the footpath and on the road in a real urban street canyon...
March 21, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28335717/genomic-regions-underlying-susceptibility-to-bovine-tuberculosis-in-holstein-friesian-cattle
#16
Kethusegile Raphaka, Oswald Matika, Enrique Sánchez-Molano, Raphael Mrode, Mike Peter Coffey, Valentina Riggio, Elizabeth Janet Glass, John Arthur Woolliams, Stephen Christopher Bishop, Georgios Banos
BACKGROUND: The significant social and economic loss as a result of bovine tuberculosis (bTB) presents a continuous challenge to cattle industries in the UK and worldwide. However, host genetic variation in cattle susceptibility to bTB provides an opportunity to select for resistant animals and further understand the genetic mechanisms underlying disease dynamics. METHODS: The present study identified genomic regions associated with susceptibility to bTB using genome-wide association (GWA), regional heritability mapping (RHM) and chromosome association approaches...
March 23, 2017: BMC Genetics
https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#17
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334588/applying-the-chronic-care-model-to-improve-care-and-outcomes-at-a-pediatric-medical-center
#18
Jennifer Lail, Pamela J Schoettker, Denise L White, Bhavna Mehta, Uma R Kotagal
BACKGROUND: Cincinnati Children's Hospital Medical Center launched the Condition Outcomes Improvement Initiative in 2012 to help disease-based teams use the principles of improvement science to implement components of the Chronic Care Model and improve outpatient care delivery for populations of children with chronic and complex conditions. The goal was to improve outcomes by 20% from baseline. METHODS: Initiative activities included review of the evidence to choose and measure outcomes, development of condition-specific patient registries and tools for data collection, patient stratification, planning and coordinating care before and after visits, and self-management support...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334563/quality-improvement-initiatives-lead-to-reduction-in-nulliparous-term-singleton-vertex-cesarean-delivery-rate
#19
Mary A Vadnais, Michele R Hacker, Neel T Shah, JoAnn Jordan, Anna M Modest, Molly Siegel, Toni H Golen
BACKGROUND: The nulliparous term singleton vertex (NTSV) cesarean delivery rate has been recognized as a meaningful benchmark. Variation in the NTSV cesarean delivery rate among hospitals and providers suggests many hospitals may be able to safely improve their rates. The NTSV cesarean delivery rate at the authors' institution was higher than state and national averages. This study was conducted to determine the influence of a set of quality improvement interventions on the NTSV cesarean delivery rate...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28331239/evaluation-of-a-marker-clip-system-in-sonographically-guided-core-needle-biopsy-for-breast-cancer-localization-before-and-after-neoadjuvant-chemotherapy
#20
R Schulz-Wendtland, P Dankerl, M R Bani, P A Fasching, K Heusinger, M P Lux, S M Jud, C Rauh, C M Bayer, M G Schrauder, M W Beckmann, M Uder, B Brehm, C R Loehberg
Introduction The placement of intramammary marker clips has proven to be helpful for tumor localization in patients undergoing neoadjuvant chemotherapy and breast-conserving surgery. The purpose of our study was to investigate the feasibility of using a clip marker system for breast cancer localization and its influence on the imaging assessment of treatment responses after neoadjuvant chemotherapy. Patients and Methods Between March and June 2015, a total of 25 patients (n = 25), with a suspicion of invasive breast cancer with diameters of at least 2 cm (cT2), underwent preoperative sonographically guided core needle biopsy using a single-use breast biopsy system (HistoCore™) and intramammary clip marking using a directly adapted clip system based on the established O-Twist Marker™, before their scheduled preoperative neoadjuvant chemotherapy...
February 2017: Geburtshilfe und Frauenheilkunde
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