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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/28651345/prioritizing-quality-measure-concepts-at-the-interface-of-behavioral-and-physical-healthcare
#2
Harold Alan Pincus, Mingjie Li, Deborah M Scharf, Brigitta Spaeth-Rublee, Matthew L Goldman, Parashar P Ramanuj, Erin K Ferenchick
Objective: Integrated healthcare models can increase access to care, improve healthcare quality, and reduce cost for individuals with behavioral and general medical healthcare needs, yet there are few instruments for measuring the quality of integrated care. In this study, we identified and prioritized concepts that can represent the quality of integrated behavioral health and general medical care. Design: We conducted a literature review to identify candidate measure concepts...
June 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28651340/linking-quality-indicators-to-clinical-trials-an-automated-approach
#3
Enrico Coiera, Miew Keen Choong, Guy Tsafnat, Peter Hibbert, William B Runciman
Objective: Quality improvement of health care requires robust measurable indicators to track performance. However identifying which indicators are supported by strong clinical evidence, typically from clinical trials, is often laborious. This study tests a novel method for automatically linking indicators to clinical trial registrations. Design: A set of 522 quality of care indicators for 22 common conditions drawn from the CareTrack study were automatically mapped to outcome measures reported in 13 971 trials from ClinicalTrials...
June 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28651222/assessing-habitat-quality-in-relation-to-the-spatial-distribution-of-protected-areas-in-italy
#4
Lorenzo Sallustio, Andrea De Toni, Andrea Strollo, Mirko Di Febbraro, Elena Gissi, Laura Casella, Davide Geneletti, Michele Munafò, Matteo Vizzarri, Marco Marchetti
The conservation of species and habitats is increasingly threatened by anthropogenic impacts, particularly land use change, from local to global scales. Although many efforts have been carried out so far to halt or at least reduce the biodiversity loss (e.g., the establishment of protected areas' networks), there are still both knowledge and policy gaps slowing the conservation of species and habitats in complex environments, such as the Mediterranean region. In particular, the human-driven impacts and threats on biodiversity need more careful analysis...
June 23, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28651166/air-quality-inside-subway-metro-indoor-environment-worldwide-a-review
#5
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/28651159/health-related-quality-of-life-results-from-the-phase-iii-checkmate-067-study
#6
Dirk Schadendorf, James Larkin, Jedd Wolchok, F Stephen Hodi, Vanna Chiarion-Sileni, Rene Gonzalez, Piotr Rutkowski, Jean-Jacques Grob, C Lance Cowey, Christopher Lao, John Wagstaff, Margaret K Callahan, Michael A Postow, Michael Smylie, Pier Francesco Ferrucci, Reinhard Dummer, Andrew Hill, Fiona Taylor, Javier Sabater, Dana Walker, Srividya Kotapati, Amy Abernethy, Georgina V Long
BACKGROUND: Nivolumab, a monoclonal antibody of immune checkpoint programmed death 1 on T cells (PD-1), combined with ipilimumab, an immune checkpoint cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor, as combination therapy on the one hand and nivolumab as monotherapy on the other, have both demonstrated improved efficacy compared with ipilimumab alone in the CheckMate 067 study. However, the combination resulted in a higher frequency of grade 3/4 adverse events (AEs), which could result in diminished health-related quality of life (HRQoL)...
June 22, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28650981/health-situation-of-migrant-and-minority-nurses-a-systematic-review
#7
Benjamin Schilgen, Albert Nienhaus, Oriana Handtke, Holger Schulz, Mike Mösko
INTRODUCTION: Globally, life expectancy together with multimorbidity and chronic diseases are increasing. This leads to a growing demand for care and hence for healthcare personnel and nurses. To meet this demand, healthcare workers from abroad are increasingly hired. The nurses' workplace in general is characterized by physically and psychologically demanding tasks, while that of migrant and minority nurses is additionally characterized by discriminatory practices. The present knowledge about the health of migrant and minority nurses and the terminology in this context are diverse...
2017: PloS One
https://www.readbyqxmd.com/read/28650971/a-lab-on-phone-instrument-with-varifocal-microscope-via-a-liquid-actuated-aspheric-lens-lal
#8
Yiin-Kuen Fuh, Zheng-Hong Lai, Li-Han Kau, Hung-Jui Huang
In this paper, we introduce a novel concept of liquid-actuated aspheric lens (LAL) with a built-in aspheric polydimethylsiloxane lens (APL) to enable the design of compact optical systems with varifocal microscopic imaging. The varifocal lens module consists of a sandwiched structures such as 3d printed syringe pump functionally serves as liquid controller. Other key components include two acrylic cylinders, a rigid separator, a APL/membrane composite (APLMC) embedded PDMS membrane. In functional operation, the fluidic controller was driven to control the pressure difference and ALPMC deformation...
2017: PloS One
https://www.readbyqxmd.com/read/28650948/hip-fracture-treatment-at-orthopaedic-teaching-hospitals-better-care-at-a-lower-cost
#9
Sanjit R Konda, Ariana Lott, Arthur Manoli, Karan Patel, Kenneth A Egol
OBJECTIVE: To compare the cost and outcomes of patients treated at orthopaedic teaching hospitals (OTH) compared to those treated at non-teaching hospitals (NTH) DESIGN:: Retrospective study SETTING:: The Statewide Planning and Research Cooperative Systems (SPARCS) database, which includes all admissions to New York State hospitals from 2000-2011. PATIENTS/PARTICIPANTS: 165,679 isolated closed hip fracture patients aged 65 and older met inclusion criteria. Of these, 57,279 were treated at OTH and 108,400 were treated at NTH...
June 12, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28650934/congenital-cytomegalovirus-infection-child-development-quality-of-life-and-impact-on-daily-life
#10
Marjolein J Korndewal, Anne Marie Oudesluys-Murphy, Aloys C M Kroes, Ann C T M Vossen, Hester E de Melker
BACKGROUND: Congenital cytomegalovirus infection (cCMV) is the most common congenital infection worldwide and can lead to long-term impairments such as developmental delay. It is currently unknown how this affects the daily life of children and their parents. METHODS: Children with cCMV were identified by testing stored dried blood spots of 31.484 five-year-old children born in 2008 in the Netherlands. Parents of 133 children with cCMV and 274 children without cCMV participated and filled in questionnaires on the child's development, the child's and parents' quality of life, care provided for the children, and consequences of cCMV on daily life...
June 23, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28650922/randomized-trial-of-reducing-ambulatory-malpractice-and-safety-risk-results-of-the-massachusetts-promises-project
#11
Gordon D Schiff, Harry Reyes Nieva, Paula Griswold, Nicholas Leydon, Judy Ling, Frank Federico, Carol Keohane, Bonnie R Ellis, Cathy Foskett, E John Orav, Catherine Yoon, Don Goldmann, Joel S Weissman, David W Bates, Madeleine Biondolillo, Sara J Singer
OBJECTIVE: Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. STUDY SETTING: In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. STUDY DESIGN: Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools...
June 23, 2017: Medical Care
https://www.readbyqxmd.com/read/28650921/effect-of-continuity-of-care-on-drug-drug-interactions
#12
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/28650884/can-surgeon-demographic-factors-predict-postoperative-complication-rates-after-elective-spinal-fusion
#13
Danielle S Chun, Ralph W Cook, Joseph A Weiner, Michael S Schallmo, Kathryn A Barth, Sameer K Singh, Ryan D Freshman, Alpesh A Patel, Wellington K Hsu
STUDY DESIGN: Retrospective cohort. OBJECTIVE: Determine whether surgeon demographic factors influence postoperative complication rates after elective spine fusion procedures. BACKGROUND: Surgeon demographic factors have been shown to impact decision making in the management of degenerative disease of the lumbar spine. Complication rates are frequently reported outcome measurements used to evaluate surgical treatments, quality-of-care, and determine health care reimbursements...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650873/perceptions-of-ambulatory-workflow-changes-in-an-academic-primary-care-setting
#14
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/28650872/barriers-and-facilitators-to-implementing-a-change-initiative-in-long-term-care-using-the-interact%C3%A2-quality-improvement-program
#15
Ruth M Tappen, David G Wolf, Zahra Rahemi, Gabriella Engstrom, Carolina Rojido, Jill M Shutes, Joseph G Ouslander
Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28650752/characteristics-predicting-the-outcome-in-individuals-with-diabetic-foot-ulcerations
#16
Lourdes Vella, Cynthia Formosa
BACKGROUND: We sought to determine patient and ulcer characteristics that predict wound healing in patients living with diabetes. METHODS: A prospective observational study was conducted on 99 patients presenting with diabetic foot ulceration. Patient and ulcer characteristics were recorded. Patients were followed up for a maximum of 1 year. RESULTS: After 1 year of follow-up, ulcer characteristics were more predictive of ulcer healing than were patient characteristics...
May 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28650682/de-escalation-training-to-medical-surgical-nurses-in-the-acute-care-setting
#17
Kimberly Lynn Ferrara, Mary Lynn Davis-Ajami, Joan Insalaco Warren, Lyn Stankiewicz Murphy
Violence is increasing on medical-surgical units as a "silent epidemic." This quality improvement project employs a small non-experimental, single-group, pre- and post-test design (N = 11) to determine the effectiveness of de-escalation training on medical-surgical nurses' confidence levels when dealing with agitated patients. Regardless of age, education, or years of experience, scores improved for each question on Thackrey's (1987) Confidence in Coping with Patient Aggression Instrument after implementing Ten Domains of De-escalation by Richmond et al...
June 26, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28650679/establishing-maximal-medical-improvement-after-arthroscopic-rotator-cuff-repair
#18
William A Zuke, Timothy S Leroux, Bonnie P Gregory, Austin Black, Brian Forsythe, Anthony A Romeo, Nikhil N Verma
BACKGROUND: As health care transitions from a pay-for-service to a pay-for-performance infrastructure, the value of orthopaedic care must be defined accurately. Significant efforts have been made in defining quality and cost in arthroplasty; however, there remains a lag in ambulatory orthopaedic care. PURPOSE: Two-year follow-up has been a general requirement for reporting outcomes after rotator cuff repair. However, this time requirement has not been established scientifically and is of increasing importance in the era of value-based health care...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28650410/identification-of-risk-factors-in-lymphatic-surgeries-for-melanoma-a-national-surgical-quality-improvement-program-review
#19
Mona Ascha, Mustafa S Ascha, Brian Gastman
INTRODUCTION: Sentinel lymph node biopsy (SLNB) and lymphadenectomy (LAD) are commonly performed in the staging and care of patients with malignant melanoma. These procedures are accompanied by complications that may result in hospital readmission, negatively affecting patient outcomes and potentially affecting surgical procedure reimbursement. The National Surgical Quality Improvement Program (NSQIP) database offers a large data set allowing physicians to evaluate 30-day readmission for surgical complications...
June 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28650384/incident-reporting-in-emergency-medicine-a-thematic-analysis-of-events
#20
Emily Loving Aaronson, David Brown, Theodore Benzer, Shaw Natsui, Elizabeth Mort
BACKGROUND: Incident reporting is a recognized tool for healthcare quality improvement. These systems, which aim to capture near-misses and harm events, enable organizations to gather critical information about failure modes and design mitigation strategies. Although many hospitals have employed these systems, little is known about safety themes in emergency medicine incident reporting. Our objective was to systematically analyze and thematically code 1 year of incident reports. METHODS: A mixed-methods analysis was performed on 1 year of safety reporting data from a large, urban tertiary-care emergency department using a modified grounded theory approach...
June 22, 2017: Journal of Patient Safety
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