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Continuous quality improvement

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https://www.readbyqxmd.com/read/28651351/applying-a-theory-driven-framework-to-guide-quality-improvement-efforts-in-nursing-homes-the-lock-model
#1
Whitney L Mills, Camilla B Pimentel, Jennifer A Palmer, A Lynn Snow, Nancy J Wewiorski, Rebecca S Allen, Christine W Hartmann
Purpose of the Study: Implementing quality improvement (QI) programs in nursing homes continues to encounter significant challenges, despite recognized need. QI approaches provide nursing home staff with opportunities to collaborate on developing and testing strategies for improving care delivery. We present a theory-driven and user-friendly adaptable framework and facilitation package to overcome existing challenges and guide QI efforts in nursing homes. Design and development: The framework is grounded in the foundational concepts of strengths-based learning, observation, relationship-based teams, efficiency, and organizational learning...
June 23, 2017: Gerontologist
https://www.readbyqxmd.com/read/28651166/air-quality-inside-subway-metro-indoor-environment-worldwide-a-review
#2
REVIEW
Bin Xu, Jinliang Hao
The air quality in the subway metro indoor microenvironment has been of particular public concern. With specific reference to the growing demand of green transportation and sustainable development, subway metro systems have been rapidly developed worldwide in last decades. The number of metro commuters has continuously increased over recent years in metropolitan cities. In some cities, metro system has become the primary public transportation mode. Although commuters typically spend only 30-40min in metros, the air pollutants emitted from various interior components of metro system as well as air pollutants carried by ventilation supply air are significant sources of harmful air pollutants that could lead to unhealthy human exposure...
June 23, 2017: Environment International
https://www.readbyqxmd.com/read/28650921/effect-of-continuity-of-care-on-drug-drug-interactions
#3
Jiun-Yu Guo, Yiing-Jenq Chou, Christy Pu
BACKGROUND: Drug-drug interaction (DDI) is a critical concern in health care systems because it is directly associated with patient outcomes and is generally preventable. However, few studies have been conducted on whether poor continuity of care (COC) is a determinant of DDIs and whether this effect varies by level of comorbidity. Patients with higher comorbidity normally require more complex treatment regimens than other patients, and hence their COC is more critical for ensuring the accuracy of their medication information...
June 23, 2017: Medical Care
https://www.readbyqxmd.com/read/28650873/perceptions-of-ambulatory-workflow-changes-in-an-academic-primary-care-setting
#4
Michael A Hanak, Colleen McDevitt, Daniel P Dunham
As health care moves to a value-based system, the need for team-based models of care becomes increasingly important to adequately address the growing number of clinical quality metrics required of health care providers. Finding ways to better engage certified medical assistants (CMAs) in the process allows providers to focus on more complex tasks while improving the efficiency of each office visit. Although the roles and responsibilities for CMAs across the specialties can vary widely, standardizing the work can be a helpful step in scaling best practices across an institution...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28650359/outcomes-of-concurrent-operations-results-from-the-american-college-of-surgeons-national-surgical-quality-improvement-program
#5
Jason B Liu, Julia R Berian, Kristen A Ban, Yaoming Liu, Mark E Cohen, Peter Angelos, Jeffrey B Matthews, David B Hoyt, Bruce L Hall, Clifford Y Ko
OBJECTIVE: To determine whether concurrently performed operations are associated with an increased risk for adverse events. BACKGROUND: Concurrent operations occur when a surgeon is simultaneously responsible for critical portions of 2 or more operations. How this practice affects patient outcomes is unknown. METHODS: Using American College of Surgeons' National Surgical Quality Improvement Program data from 2014 to 2015, operations were considered concurrent if they overlapped by ≥60 minutes or in their entirety...
June 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28649602/using-a-smartphone-based-self-management-platform-to-support-medication-adherence-and-clinical-consultation-in-parkinson-s-disease
#6
Rashmi Lakshminarayana, Duolao Wang, David Burn, K Ray Chaudhuri, Clare Galtrey, Natalie Valle Guzman, Bruce Hellman, Ben James, Suvankar Pal, Jon Stamford, Malcolm Steiger, R W Stott, James Teo, Roger A Barker, Emma Wang, Bastiaan R Bloem, Martijn van der Eijk, Lynn Rochester, Adrian Williams
The progressive nature of Parkinson's disease, its complex treatment regimens and the high rates of comorbid conditions make self-management and treatment adherence a challenge. Clinicians have limited face-to-face consultation time with Parkinson's disease patients, making it difficult to comprehensively address non-adherence. Here we share the results from a multi-centre (seven centres) randomised controlled trial conducted in England and Scotland to assess the impact of using a smartphone-based Parkinson's tracker app to promote patient self-management, enhance treatment adherence and quality of clinical consultation...
2017: NPJ Parkinson's Disease
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#7
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28648396/25-years-of-serving-the-community-with-ribosomal-rna-gene-reference-databases-and-tools
#8
Frank Oliver Glöckner, Pelin Yilmaz, Christian Quast, Jan Gerken, Alan Beccati, Andreea Ciuprina, Gerrit Bruns, Pablo Yarza, Jörg Peplies, Ralf Westram, Wolfgang Ludwig
SILVA (lat. forest) is a comprehensive web resource, providing services around up to date, high-quality datasets of aligned ribosomal RNA gene (rDNA) sequences from the Bacteria, Archaea, and Eukaryota domains. SILVA dates back to the year 1991 when Dr. Wolfgang Ludwig from the Technical University Munich started the integrated software workbench ARB (lat. tree) to support high-quality phylogenetic inference and taxonomy based on the SSU and LSU rDNA marker genes. At that time, the ARB project maintained both, the sequence reference datasets and the software package for data analysis...
June 22, 2017: Journal of Biotechnology
https://www.readbyqxmd.com/read/28648217/integrating-research-quality-improvement-and-medical-education-for-better-handoffs-and-safer-care-disseminating-adapting-and-implementing-the-i-pass-program
#9
Amy J Starmer, Nancy D Spector, Daniel C West, Rajendu Srivastava, Theodore C Sectish, Christopher P Landrigan
BACKGROUND: In 2009 the I-PASS Study Group was formed by patient safety, medical education, health services research, and clinical experts from multiple institutions in the United States and Canada. When the I-PASS Handoff Program, which was developed by the I-PASS Study Group, was implemented in nine hospitals, it was associated with a 30% reduction in injuries due to medical errors and significant improvements in handoff processes, without any adverse effects on provider work flow. METHODS: To effectively disseminate and adapt I-PASS for use across specialties and disciplines, a series of federally and privately funded dissemination and implementation projects were carried out following the publication of the initial study...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28647465/french-registry-on-acute-st-elevation-and-non-st-elevation-myocardial-infarction-2015-fast-mi-2015-design-and-baseline-data
#10
Loïc Belle, Guillaume Cayla, Yves Cottin, Pierre Coste, Khalife Khalife, Jean-Noël Labèque, Bruno Farah, Thibaut Perret, Patrick Goldstein, Pierre-Yves Gueugniaud, François Braun, Jacques Gauthier, Martine Gilard, Jean-Yves Le Heuzey, Nicolas Naccache, Elodie Drouet, Vincent Bataille, Jean Ferrières, Etienne Puymirat, François Schiele, Tabassome Simon, Nicolas Danchin
BACKGROUND: The FAST-MI programme, consisting of 1-month surveys of patients admitted to hospital for acute myocardial infarction (AMI) in France, has run since 2005. AIM: To gather data on the characteristics, management and outcomes of patients hospitalized for AMI at the end of 2015 in France and to provide comparisons with the previous surveys. METHODS: Consecutive adults with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment-elevation myocardial infarction (NSTEMI) with symptom onset≤48hours were included over a 1-month period, with a possible extension of recruitment for 1 additional month...
June 21, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28646811/alternative-therapy-for-patients-with-obstructive-sleep-apnea-hypopnea-syndrome-a-1-year-single-blind-randomized-trial-of-tui-na
#11
Cheng-Nan Lu, Michael Friedman, Hsin-Ching Lin, Kuo-Wei Bi, Tun-Pin Hsueh, Hsueh-Wen Chang, Mao-Chang Su, Meng-Chih Lin
Context • Obstructive sleep apnea/hypopnea syndrome (OSAHS) is among the most prevalent of sleep-related breathing disorders. No long-term follow-up studies have documented the continued success of lifestyle changes in treatment; oral appliances have an approximate 50% success rate; compliance with continuous positive airway pressure is poor, ranging from 50% to 89%; and the success rate of upper-airway surgery is only 66.4%. Therefore, some OSAHS patients seek alternative treatments. Objectives • The study intended to examine the efficacy of traditional Chinese therapeutic massage (tui na) for patients with OSAHS...
July 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28646777/predicting-improved-optical-water-quality-in-rivers-resulting-from-soil-conservation-actions-on-land
#12
J R Dymond, R J Davies-Colley, A O Hughes, C D Matthaei
Deforestation in New Zealand has led to increased soil erosion and sediment loads in rivers. Increased suspended fine sediment in water reduces visual clarity for humans and aquatic animals and reduces penetration of photosynthetically available radiation to aquatic plants. To mitigate fine-sediment impacts in rivers, catchment-wide approaches to reducing soil erosion are required. Targeting soil conservation for reducing sediment loads in rivers is possible through existing models; however, relationships between sediment loads and sediment-related attributes of water that affect both ecology and human uses of water are poorly understood...
June 21, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28646217/why-do-physicians-lack-engagement-with-smoking-cessation-treatment-in-their-copd-patients-a-multinational-qualitative-study
#13
Eva Anne Marije van Eerd, Mette Bech Risør, Mark Spigt, Maciek Godycki-Cwirko, Elena Andreeva, Nick Francis, Anja Wollny, Hasse Melbye, Onno van Schayck, Daniel Kotz
Smoking cessation is the only effective intervention to slow down the accelerated decline in lung function in smokers with chronic obstructive pulmonary disease. Nevertheless, physicians often do not routinely provide evidence-based smoking cessation treatment to their patients. To understand underlying reasons, we explored how physicians engage in smoking cessation treatment in their chronic obstructive pulmonary disease patients. In total, 21 focus group discussions were held with general practitioners and pulmonologists in seven different countries in Europe and Asia...
June 23, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28645945/how-can-we-ensure-that-the-coroner-s-autopsy-is-not-an-invasion-of-human-rights
#14
Stephen Leadbeatter, Ryk James
BACKGROUND: Despite public inquiries, and some changes to legislation following high-profile multiple homicides that were not detected by autopsy, coroners continue to rely largely on the autopsy. Regardless of the extent of quality failings and excess deaths at some hospitals, not detected through the coroner system, the autopsy is scarcely used by hospitals to monitor standards and educate. OBJECTIVE: To explore when a compulsory medicolegal autopsy should, and should not, be used...
June 23, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28645092/examining-effectiveness-of-tailorable-computer-assisted-therapy-programmes-for-substance-misuse-programme-usage-and-clinical-outcomes-data-from-breaking-free-online
#15
Sarah Elison, Andrew Jones, Jonathan Ward, Glyn Davies, Stephanie Dugdale
RATIONALE: When evaluating complex, tailorable digital behavioural interventions, additional approaches may be required alongside established methodologies such as randomised controlled trials (RCTs). Research evaluating a computer-assisted therapy (CAT) programme for substance misuse, Breaking Free Online (BFO), is informed by Medical Research Council (MRC) guidance recommending examination of 'mechanisms of action' of individual intervention strategies, which is relevant when evaluating digital interventions with content that may evolve over time...
May 23, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28644179/improving-heart-failure-patient-outcomes-utilizing-guideline-directed-therapy
#16
Beth Towery Davidson, Terri Lynn Allison
Heart failure (HF) prevalence continues to rise and remains a significant burden to patients, caregivers, providers, and the healthcare system. Guideline-directed medical therapy with standard neurohormonal blockade has been the cornerstone of medical management for many years. Despite aggressive utilization of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and aldosterone antagonists, HF hospitalizations and readmissions are common and residual mortality remains high...
July 21, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28643559/informing-healthcare-waiting-area-design-using-transparency-attributes-a-comparative-preference-study
#17
Shan Jiang, Matthew Powers, David Allison, Ellen Vincent
OBJECTIVE: This study aimed to explore people's visual preference for waiting areas in general hospital environments designed with transparency attributes that fully integrate nature. BACKGROUND: Waiting can be a tedious and frustrating experience among people seeking healthcare treatments and negatively affect their perception of the quality of care. Positive distractions and supportive designs have gained increasing attraction to improve people's waiting experience...
July 2017: HERD
https://www.readbyqxmd.com/read/28643183/dopaminergic-therapies-for-non-motor-symptoms-in-parkinson-s-disease
#18
REVIEW
Eva Schaeffer, Daniela Berg
Apart from the typical motor symptoms, Parkinson's disease is characterized by a wide range of different non-motor symptoms, which are highly prevalent in all stages of the disease and have an incisive influence on quality of life. Moreover, their treatment continues to be challenging. In this review, we critically summarize the evidence for the impact of dopaminergic therapies on non-motor symptoms in Parkinson's disease. We performed a PubMed search to identify relevant clinical studies that investigated the response of non-motor symptoms to dopaminergic therapy...
June 22, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28642999/continually-improving-standards-of-care-the-uk-renal-registry-as-a-translational-public-health-tool
#19
REVIEW
Lucy A Plumb, Alexander J Hamilton, Carol D Inward, Yoav Ben-Shlomo, Fergus J Caskey
A disease registry uses observational study methods to collect defined data on patients with a particular condition for a predetermined purpose. By providing comprehensive standardised data on patients with kidney disease, renal registries aim to provide a 'real world' representation of practice patterns, treatment and patient outcomes that may not be captured accurately by other methods, including randomised controlled trials. Additionally, using registries to measure variations in outcomes and audit care against standards is crucial to understanding how to improve quality of care for patients in an efficacious and cost-effective manner...
June 22, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28642742/microbial-resources-and-enological-significance-opportunities-and-benefits
#20
REVIEW
Leonardo Petruzzi, Vittorio Capozzi, Carmen Berbegal, Maria R Corbo, Antonio Bevilacqua, Giuseppe Spano, Milena Sinigaglia
Among the innovative trends in the wine sector, the continuous exploration of enological properties associated with wine microbial resources represents a cornerstone driver of quality improvement. Since the advent of starter cultures technology, the attention has been focused on intraspecific biodiversity within the primary species responsible for alcoholic fermentation (Saccharomyces cerevisiae) and, subsequently, for the so-called 'malolactic fermentation' (Oenococcus oeni). However, in the last decade, a relevant number of studies proposed the enological exploitation of an increasing number of species (e...
2017: Frontiers in Microbiology
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