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https://www.readbyqxmd.com/read/28277381/working-toward-quality-in-obstetric-anesthesia-a-business-approach
#1
Grant C Lynde
PURPOSE OF REVIEW: Physicians are increasingly required to demonstrate that they provide quality care. How does one define quality? A significant body of literature in industries outside of health care provides guidance on how to define appropriate metrics, create teams to troubleshoot problem areas, and sustain those improvements. RECENT FINDINGS: The modern quality movement in the United States began in response to revolutionary gains in both quality and productivity in Japanese manufacturing in the 1980's...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28221958/using-a-six-sigma-fishbone-analysis-approach-to-evaluate-the-effect-of-extreme-weather-events-on-salmonella-positives-in-young-chicken-slaughter-establishments
#2
John W Linville, Douglas Schumann, Christopher Aston, Stephanie Defibaugh-Chavez, Scott Seebohm, Lucy Touhey
A six sigma fishbone analysis approach was used to develop a machine learning model in SAS, Version 9.4, by using stepwise linear regression. The model evaluated the effect of a wide variety of variables, including slaughter establishment operational measures, normal (30-year average) weather, and extreme weather events on the rate of Salmonella -positive carcasses in young chicken slaughter establishments. Food Safety and Inspection Service (FSIS) verification carcass sampling data, as well as corresponding data from the National Oceanographic and Atmospheric Administration and the Federal Emergency Management Agency, from September 2011 through April 2015, were included in the model...
December 2016: Journal of Food Protection
https://www.readbyqxmd.com/read/28212907/improving-preoperative-throughput
#3
Jennifer Franklin, Tony Franklin
Preoperative throughput is an important piece in achieving the perioperative goal for first case on time starts. An inefficient preoperative (preop) department can delay surgery starts and impact the patient flow throughout the day. Research is abundant in applying lean six sigma principles in the operating room, however there are minimal studies that specifically apply these tools in the preop. The perioperative process includes the preop, operating room, and the postoperative departments. All areas have to run like a well-oiled machine to improve performance and achieve positive outcomes...
February 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28205271/lean-six-sigma-methodologies-improve-clinical-laboratory-efficiency-and-reduce-turnaround-times
#4
Tamer C Inal, Ozlem Goruroglu Ozturk, Filiz Kibar, Salih Cetiner, Selcuk Matyar, Gulcin Daglioglu, Akgun Yaman
BACKGROUND: Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. METHODS: The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems...
February 15, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28183346/study-protocol-improving-the-transition-of-care-from-a-non-network-hospital-back-to-the-patient-s-medical-home
#5
Roman A Ayele, Emily Lawrence, Marina McCreight, Kelty Fehling, Jamie Peterson, Russell E Glasgow, Borsika A Rabin, Robert Burke, Catherine Battaglia
BACKGROUND: The process of transitioning Veterans to primary care following a non-Veterans Affairs (VA) hospitalization can be challenging. Poor transitions result in medical complications and increased hospital readmissions. The goal of this transition of care quality improvement (QI) project is to identify gaps in the current transition process and implement an intervention that bridges the gap and improves the current transition of care process within the Eastern Colorado Health Care System (ECHCS)...
February 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28164511/application-of-six-sigma-model-to-evaluate-the-analytical-quality-of-four-hba1c-analyzers
#6
Jos Eacute M Maesa, Patricia Fern Aacute Ndez-Riejos, Catalina S Aacute Nchez-Mora, Mar Iacute A De Toro-Crespo, Concepci Oacute N Gonz Aacute Lez-Rodriguez
BACKGROUND: The Six Sigma Model is a global quality management system applicable to the determination of glycated hemoglobin (HbA1c). In addition, this model can ensure the three characteristics influencing the patient risk: the correct performance of the analytical method with low inaccuracy and bias, the quality control strategy used by the laboratory, and the necessary quality of the analyte. The aim of this study is to use the Six Sigma Model for evaluating quality criteria in the determination of glycated hemoglobin HbA1c and its application to assess four different HbA1c analyzers...
January 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28153372/six-sigma-quality-management-system-and-design-of-risk-based-statistical-quality-control
#7
REVIEW
James O Westgard, Sten A Westgard
Six sigma concepts provide a quality management system (QMS) with many useful tools for managing quality in medical laboratories. This Six Sigma QMS is driven by the quality required for the intended use of a test. The most useful form for this quality requirement is the allowable total error. Calculation of a sigma-metric provides the best predictor of risk for an analytical examination process, as well as a design parameter for selecting the statistical quality control (SQC) procedure necessary to detect medically important errors...
March 2017: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/28153365/applying-sigma-metrics-to-reduce-outliers
#8
REVIEW
Joseph Litten
Sigma metrics can be used to predict assay quality, allowing easy comparison of instrument quality and predicting which tests will require minimal quality control (QC) rules to monitor the performance of the method. A Six Sigma QC program can result in fewer controls and fewer QC failures for methods with a sigma metric of 5 or better. The higher the number of methods with a sigma metric of 5 or better, the lower the costs for reagents, supplies, and control material required to monitor the performance of the methods...
March 2017: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/28153364/sunway-medical-laboratory-quality-control-plans-based-on-six-sigma-risk-management-and-uncertainty
#9
REVIEW
Jamuna Jairaman, Zarinah Sakiman, Lee Suan Li
Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory.
March 2017: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/28152722/integrating-lean-six-sigma-in-the-daily-operations-of-an-icu-to-achieve-safe-quality-patient-care
#10
Jacqueline Magurn, Joanne McGovern, Michelle Jetter, Sarah Beadling, Dorothy Gregoire
230 Background: Developing and maintaining a culture of safety and quality in delivering patient care is critical in the intensive care unit (ICU) especially an oncology ICU. Incorporating the Lean Six Sigma program into daily operations of the ICU achieves, simplifies, and sustains continuous improvement in the delivery of safe quality patient care. This program engages the ICU team through visual management of quality, safety, and budget indicators including medication scanning, falls, sharps exposure, infection prevention including blood stream, catheter, hospital and ventilator acquired pneumonias, venous embolism prevention, and staffing compliance...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28132939/interest-and-limits-of-the-six-sigma-methodology-in-medical-laboratory
#11
Florian Scherrer, Jean-Pierre Bouilloux, Ors'Anton Calendini, Didier Chamard, François Cornu
The mandatory accreditation of clinical laboratories in France provides an incentive to develop real tools to measure performance management methods and to optimize the management of internal quality controls. Six sigma methodology is an approach commonly applied to software quality management and discussed in numerous publications. This paper discusses the primary factors that influence the sigma index (the choice of the total allowable error, the approach used to address bias) and compares the performance of different analyzers on the basis of the sigma index...
February 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28129990/chiral-resolution-of-serial-potent-and-selective-%C3%AF-1-ligands-and-biological-evaluation-of-18-f-tz3108-in-rodent-and-the-nonhuman-primate-brain
#12
Xuyi Yue, Hongjun Jin, Zonghua Luo, Hui Liu, Xiang Zhang, Ethan D McSpadden, Linlin Tian, Hubert P Flores, Joel S Perlmutter, Stanley M Parsons, Zhude Tu
Twelve optically pure enantiomers were obtained using either crystallization or chiral high performance liquid chromatography (HPLC) separation methodologies to resolve six racemic sigma-1 (σ1) receptor ligands. The in vitro binding affinities of each enantiomer for σ1, σ2 receptors and vesicular acetylcholine transporter (VAChT) were determined. Out of the 12 optically pure enantiomers, five displayed very high affinities for σ1 (Ki<2nM) and high selectivity for σ1 versus σ2 and VAChT (>100-fold)...
February 15, 2017: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/28125455/the-role-of-accountable-care-organization-affiliation-and-ownership-in-promoting-physician-practice-participation-in-quality-improvement-collaboratives
#13
Vanessa B Hurley, Hector P Rodriguez, Stephen M Shortell
BACKGROUND: Quality improvement collaboratives (QICs) have emerged as an important strategy to improve processes and outcomes of clinical care through interorganizational learning. Little is known about the organizational factors that support or deter physician practice participation in QICs. PURPOSE: The aim of this study was to examine organizational influences on physician practices' propensity to participate in QICs. We hypothesized that practice affiliation with an accountable care organization (ACO) and practice ownership by a system or community health center (CHC) would increase the propensity of physician practices to participate in a QIC...
January 25, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28099059/family-physician-readiness-for-value-based-payments-does-ownership-status-matter
#14
Heidy Robertson-Cooper, Bradley Neaderhiser, Laura E Happe, Roy A Beveridge
Value-based payments are rapidly replacing fee-for-service arrangements, necessitating advancements in physician practice capabilities and functions. The objective of this study was to examine potential differences among family physicians who are owners versus employed with respect to their readiness for value-based payment models. The authors surveyed more than 550 family physicians from the American Academy of Family Physician's membership; nearly 75% had made changes to participate in value-based payments...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28077623/a-quality-improvement-project-to-decrease-human-milk-errors-in-the-nicu
#15
Reena Oza-Frank, Rashmi Kachoria, James Dail, Jasmine Green, Krista Walls, Richard E McClead
BACKGROUD AND OBJECTIVE: Ensuring safe human milk in the NICU is a complex process with many potential points for error, of which one of the most serious is administration of the wrong milk to the wrong infant. Our objective was to describe a quality improvement initiative that was associated with a reduction in human milk administration errors identified over a 6-year period in a typical, large NICU setting. METHODS: We employed a quasi-experimental time series quality improvement initiative by using tools from the model for improvement, Six Sigma methodology, and evidence-based interventions...
January 11, 2017: Pediatrics
https://www.readbyqxmd.com/read/28048803/su-f-t-152-experimental-validation-and-calculation-benchmark-for-a-commercial-monte-carlo-pencil-beamscanning-proton-therapy-treatment-planning-system-in-heterogeneous-media
#16
L Lin, S Huang, M Kang, C Ainsley, C Simone, J McDonough, T Solberg
PURPOSE: Eclipse AcurosPT 13.7, the first commercial Monte Carlo pencil beam scanning (PBS) proton therapy treatment planning system (TPS), was experimentally validated for an IBA dedicated PBS nozzle in the CIRS 002LFC thoracic phantom. METHODS: A two-stage procedure involving the use of TOPAS 1.3 simulations was performed. First, Geant4-based TOPAS simulations in this phantom were experimentally validated for single and multi-spot profiles at several depths for 100, 115, 150, 180, 210 and 225 MeV proton beams, using the combination of a Lynx scintillation detector and a MatriXXPT ionization chamber array...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048698/tu-fg-bra-02-assure-the-quality-of-treatment-planning-when-time-is-constrained
#17
J Chang
Optimizing Radiation Therapy Process The radiotherapy (RT) process has evolved over the years with innovations in CT and MR simulations, treatment planning, and treatment delivery. Image-Guided Radiotherapy (IGRT) has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body Radiotherapy (SBRT) and Stereotactic Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the simulation/plan/treatment even if the number of treatments per day remains the same...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047314/tu-fg-bra-00-optimizing-the-treatment-planning-process
#18
Wenzheng Feng
Optimizing Radiation Therapy Process The radiotherapy (RT) process has evolved over the years with innovations in CT and MR simulations, treatment planning, and treatment delivery. Image-Guided Radiotherapy (IGRT) has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body Radiotherapy (SBRT) and Stereotactic Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the simulation/plan/treatment even if the number of treatments per day remains the same...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047234/tu-fg-bra-03-systems-engineering-and-treatment-planning-process-control-in-radiation-medicine
#19
A Kapur
Optimizing Radiation Therapy Process The radiotherapy (RT) process has evolved over the years with innovations in CT and MR simulations, treatment planning, and treatment delivery. Image-Guided Radiotherapy (IGRT) has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body Radiotherapy (SBRT) and Stereotactic Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the simulation/plan/treatment even if the number of treatments per day remains the same...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046925/su-d-brc-02-application-of-six-sigma-approach-to-improve-the-efficiency-of-patient-specific-qa-in-proton-therapy
#20
J Lah, D Shin, R Manger, G Kim
PURPOSE: To show how the Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control) can be used for improving and optimizing the efficiency of patient-specific QA process by designing site-specific range tolerances. METHODS: The Six Sigma tools (process flow diagram, cause and effect, capability analysis, Pareto chart, and control chart) were utilized to determine the steps that need focus for improving the patient-specific QA process. The patient-specific range QA plans were selected according to 7 treatment site groups, a total of 1437 cases...
June 2016: Medical Physics
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