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Quality improvment

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https://www.readbyqxmd.com/read/27926892/do-mobile-phone-applications-improve-glycemic-control-hba1c-in-the-self-management-of-diabetes-a-systematic-review-meta-analysis-and-grade-of-14-randomized-trials
#1
REVIEW
Can Hou, Ben Carter, Jonathan Hewitt, Trevor Francisa, Sharon Mayor
OBJECTIVE: To investigate the effect of mobile phone applications (apps) on glycemic control (HbA1c) in the self-management of diabetes. RESEARCH DESIGN AND METHODS: Relevant studies that were published between 1 January 1996 and 1 June 2015 were searched from five databases: Medline, CINAHL, Cochrane Library, Web of Science, and Embase. Randomized controlled trials that evaluated diabetes apps were included. We conducted a systematic review with meta-analysis and GRADE (Grading of Recommendations Assessment, Development and Evaluation) of the evidence...
November 2016: Diabetes Care
https://www.readbyqxmd.com/read/27926773/associations-of-specific-postoperative-complications-with-outcomes-after-elective-colon-resection-a-procedure-targeted-approach-toward-surgical-quality-improvement
#2
John E Scarborough, Jessica Schumacher, K Craig Kent, Charles P Heise, Caprice C Greenberg
Importance: Numerous quality initiatives have been implemented in an effort to minimize the onus of postoperative complications on clinical and economic outcomes after major surgery. It is unknown which complications have the greatest overall effect on these outcomes. Objective: To quantify the associations of specific postoperative complications with outcomes after elective colon resection. Design, Setting, and Participants: Patients undergoing elective colon resection between January 1, 2012, and December 31, 2013, who were included in the Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program were assessed for the development of specific types of postoperative complications...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27926687/an-initiative-to-standardize-the-identification-of-and-acute-response-to-postoperative-lower-extremity-neurological-deficits-effects-on-provider-knowledge-confidence-and-communication-skills
#3
Peter B Derman, Sravisht Iyer, Matthew Garner, Steven Orr, Karla J Felix, Allison Goldberg, Titilayo Ologhobo, Minlun Wu, Laura Robbins, Charles Cornell
BACKGROUND: Although relatively uncommon, neurological deficits following hip and knee arthroplasty can have permanent and debilitating consequences. This study was conducted to quantify the effectiveness of an educational curriculum aimed at standardizing the identification of and acute response to postoperative neurological deficits in the inpatient setting, specifically with respect to improvements in clinician knowledge, confidence levels, and communication skills. METHODS: A multidisciplinary committee at a single, high-volume academic institution created an algorithm delineating the appropriate clinical actions and escalation procedures in the setting of a postoperative neurological deficit for each clinical practitioner involved in care for patients who undergo arthroplasty...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27926678/cost-minimization-analysis-of-open-and-endoscopic-carpal-tunnel-release
#4
Steven Zhang, Molly Vora, Alex H S Harris, Laurence Baker, Catherine Curtin, Robin N Kamal
BACKGROUND: Carpal tunnel release is the most common upper-limb surgical procedure performed annually in the U.S. There are 2 surgical methods of carpal tunnel release: open or endoscopic. Currently, there is no clear clinical or economic evidence supporting the use of one procedure over the other. We completed a cost-minimization analysis of open and endoscopic carpal tunnel release, testing the null hypothesis that there is no difference between the procedures in terms of cost. METHODS: We conducted a retrospective review using a private-payer and Medicare Advantage database composed of 16 million patient records from 2007 to 2014...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
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
#5
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/27926671/of-20-376-lumbar-discectomies-2-6-of-patients-readmitted-within-30-days-surgical-site-infection-pain-and-thromboembolic-events-are-the-most-common-reasons-for-readmission
#6
Matthew L Webb, Stephen J Nelson, Ameya Save, Jonathan Cui, Adam M Lukasiewicz, Andre M Samuel, Pablo J Diaz-Collado, Daniel D Bohl, Nathaniel T Ondeck, Ryan P McLynn, Jonathan N Grauer
STUDY DESIGN: A retrospective cohort study of prospectively collected data. OBJECTIVE: As an initial effort to address readmissions after lumbar discectomy, reasons for hospital readmission are identified and discussed. SUMMARY OF BACKGROUND DATA: Lumbar discectomy is a commonly performed procedure. The Affordable Care Act codifies penalties for hospital readmissions. New quality-based reimbursements tied to readmissions call for a better understanding of the causes of readmission after procedures such as lumbar discectomy...
December 6, 2016: Spine
https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#7
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/27926630/the-analgesic-effect-of-ropivacaine-combined-with-dexmedetomidine-for-incision-infiltration-after-laparoscopic-cholecystectomy
#8
Jun-Ma Yu, Hao Sun, Chao Wu, Chun-Shan Dong, Yao Lu, Ye Zhang
BACKGROUND: Local anesthetics infiltration is one consensus efficient strategy for pain relief after laparoscopic cholecystectomy (LC). The aim of this study was to investigate analgesia efficacy of incisional infiltration with ropivacaine plus dexmedetomidine. METHODS: Patients scheduled for LC were assigned to 4 groups by different medications for trocar wound infiltration. The incidence of adverse events and the analgesic effect of ropivacaine combined with dexmedetomidine for incision infiltration were recorded...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27926624/improving-the-use-of-evidence-based-practice-and-research-utilization-through-the-identification-of-barriers-to-implementation-in-a-critical-access-hospital
#9
Dawn Carol Stavor, Judith Zedreck-Gonzalez, Rosemary L Hoffmann
OBJECTIVE: This study explored the relationship between perceived barriers to research use and the implementation of evidence-based practice (EBP) among rural hospital nurses. BACKGROUND: The Institute of Medicine recommends that 90% of clinical decisions be evidence based by 2020. METHODS: This descriptive, quality improvement study used a convenience sampling of registered nurses (RNs). Participants completed multiple questionnaires. RESULTS: Overall the attitude toward EBP was positive...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926622/reducing-chronic-obstructive-pulmonary-disease-30-day-readmissions-a-nurse-led-evidence-based-quality-improvement-project
#10
Joan Agee
Chronic obstructive pulmonary disease (COPD) is a debilitating disease resulting in frequent hospitalizations and increased healthcare costs. As leaders of multidisciplinary teams, acute care nurse leaders are challenged to reduce readmissions and costs. In October 2014, the Centers for Medicare and Medicaid Services expanded readmission penalties for 30-day readmissions to include COPD, making this an important issue for nurse leaders. This article describes how a regional medical center was able to decrease COPD readmissions...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926620/tapping-magnet%C3%A2-s-culture-of-innovation-to-improve-the-patient-experience
#11
Jennifer Rainer
As incentives grow for healthcare organizations to improve the patient experience, an increasing number choose to add consumers directly into their leadership structures. In this final installment about the value of patient and family advisory councils, the senior director of quality at a large, Magnet®-recognized Texas hospital explains how tapping into a well-established Magnet culture helped the organization adopt innovative approaches that produced positive change. Based on an interview with the author, she notes that seeing basic issues through patients' eyes challenged long-held beliefs and led to improvements in a wide variety of areas...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926563/truth-in-reporting-how-data-capture-methods-obfuscate-actual-surgical-site-infection-rates-within-a-health-care-network-system
#12
Liliana Bordeianou, Christy E Cauley, Donna Antonelli, Sarah Bird, David Rattner, Matthew Hutter, Sadiqa Mahmood, Deborah Schnipper, Marc Rubin, Ronald Bleday, Pardon Kenney, David Berger
BACKGROUND: Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. OBJECTIVE: This study aimed to compare database concordance...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926562/long-term-experience-of-magnetic-anal-sphincter-augmentation-in-patients-with-fecal-incontinence
#13
Jeremy Sugrue, Paul-Antoine Lehur, Robert D Madoff, Shane McNevin, Steen Buntzen, Søren Laurberg, Anders Mellgren
BACKGROUND: Magnetic anal sphincter augmentation is a novel technique for the treatment of patients with fecal incontinence. OBJECTIVE: The current study reports the long-term effectiveness and safety of this new treatment modality. DESIGN: This was a prospective multicenter pilot study. SETTINGS: The study was performed at 4 clinical sites in Europe and the United States. PATIENTS: The cohort included patients with severe fecal incontinence for ≥6 months who had previously failed conservative therapy and were implanted with a magnetic anal sphincter device between 2008 and 2011...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926559/preoperative-immunonutrition-and-elective-colorectal-resection-outcomes
#14
Lucas W Thornblade, Thomas K Varghese, Xu Shi, Eric K Johnson, Amir Bastawrous, Richard P Billingham, Richard Thirlby, Alessandro Fichera, David R Flum
BACKGROUND: Randomized controlled trials demonstrate the efficacy of arginine-enriched nutritional supplements (immunonutrition) in reducing complications after surgery. The effectiveness of preoperative immunonutrition has not been evaluated in a community setting. OBJECTIVE: This study aims to determine whether immunonutrition before elective colorectal surgery improves outcomes in the community at large. DESIGN: This is a prospective cohort study with a propensity score-matched comparative effectiveness evaluation...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926542/measuring-quality-of-life-in-advanced-heart-failure
#15
Jane MacIver, Kirsten Wentlandt, Heather J Ross
PURPOSE OF REVIEW: Patients with Stage D heart failure can benefit from palliative care consultation to help them manage unpleasant symptoms and improve quality of life. Although guidelines describe how to manage symptoms, very little direction is provided on how to evaluate the effectiveness of those interventions. RECENT FINDINGS: Numerous studies have used the measurement of symptoms, emotional distress, functional capacity and quality of life to evaluate the effectiveness of interventions in heart failure...
December 6, 2016: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/27925785/accelerating-scientific-advancement-for-pediatric-rare-lung-disease-research-report-from-a-national-institutes-of-health-nhlbi-workshop-september-3-and-4-2015
#16
Lisa R Young, Bruce C Trapnell, Kenneth D Mandl, Daniel T Swarr, Jennifer A Wambach, Carol J Blaisdell
Pediatric rare lung disease (PRLD) is a term that refers to a heterogeneous group of rare disorders in children. In recent years, this field has experienced significant progress marked by scientific discoveries, multicenter and interdisciplinary collaborations, and efforts of patient advocates. Although genetic mechanisms underlie many PRLDs, pathogenesis remains uncertain for many of these disorders. Furthermore, epidemiology and natural history are insufficiently defined, and therapies are limited. To develop strategies to accelerate scientific advancement for PRLD research, the NHLBI of the National Institutes of Health convened a strategic planning workshop on September 3 and 4, 2015...
December 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27925607/therapeutic-touch-in-the-management-of-responsive-behavior-in-patients-with-dementia
#17
Ananthavalli Kumarappah, Helen Senderovich
Patients with dementia experience various behavioral symptoms in the course of their illnesses, which greatly affect their quality of life. Current treatment modalities are not always effective, and, thus, nonpharmacological approaches are the preferred first-line therapy for managing such symptoms. They generally address the basic needs of the person with dementia and provide humane care, often producing noticeable improvements in symptoms. Thus, such therapies should precede pharmacological interventions...
October 2016: Advances in Mind-body Medicine
https://www.readbyqxmd.com/read/27925604/sequence-based-deterministic-initialization-for-evolutionary-algorithms
#18
Saber Elsayed, Ruhul Sarker, Carlos A Coello Coello
It is well known that the performances of evolutionary algorithms are influenced by the quality of their initial populations. Over the years, many different techniques for generating an initial population by uniformly covering as much of the search space as possible have been proposed. However, none of these approaches considers any input from the function that must be evolved using that population. In this paper, a new initialization technique, which can be considered a heuristic space-filling approach, based on both function to be optimized and search space, is proposed...
December 1, 2016: IEEE Transactions on Cybernetics
https://www.readbyqxmd.com/read/27925451/improving-access-and-systems-of-care-for-evidence-based-childhood-obesity-treatment-conference-key-findings-and-next-steps
#19
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/27925422/preventing-hospital-acquired-venous-thromboembolism-improving-patient-safety-with-interdisciplinary-teamwork-quality-improvement-analytics-and-data-transparency
#20
REVIEW
Anneliese M Schleyer, Ellen Robinson, Roxana Dumitru, Mark Taylor, Kimberly Hayes, Ronald Pergamit, Daphne M Beingessner, Mark C Zaros, Joseph Cuschieri
BACKGROUND: Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. OBJECTIVE: To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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