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https://www.readbyqxmd.com/read/28077623/a-quality-improvement-project-to-decrease-human-milk-errors-in-the-nicu
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28046644/tu-fg-bra-01-treatment-planning-process-management-and-optimization-in-clinical-environmental
#7
W 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/28046335/su-g-jep4-09-impact-of-interfractional-motion-on-hypofractionated-pencil-beam-scanning-proton-therapy-for-prostate-cancer
#8
M Moteabbed, A Trofimov, G Sharp, Y Wang, A Zietman, J Efstathiou, H Lu
PURPOSE: To investigate the impact of anatomy/setup variations on standard vs. hypofractionated anterolateral pencil beam scanning (PBS) proton therapy for prostate cancer. METHODS: Six prostate cancer patients treated with double-scattering proton therapy, who underwent weekly verification CT scans were selected. Implanted fiducials were used for localization, and endorectal balloons for immobilization. New PBS plans using combination of lateral and anterior-oblique (AO) (±35 deg) beams were created...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045650/reduction-in-alert-fatigue-in-an-assisted-electronic-prescribing-system-through-the-lean-six-sigma-methodology
#9
Mª Jesús Cuéllar Monreal, Jorge Reig Aguado, Isabel Font Noguera, José Luis Poveda Andrés
OBJECTIVE: To reduce the alert fatigue in our Assisted Electronic Prescribing System (AEPS), through the Lean Six Sigma (LSS) methodology. METHOD: An observational (transversal) and retrospective study, in a general hospital with 850 beds and AEPS. The LSS methodology was followed in order to evaluate the alert fatigue situation in the AEPS system, to implement improvements, and to assess outcomes. The alerts generated during two trimesters studied (before and after the intervention) were analyzed...
January 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28044309/improving-histopathology-laboratory-productivity-process-consultancy-and-a3-problem-solving
#10
Kutsal Yörükoğlu, Erdener Özer, Birsen Alptekin, Cem Öcal
OBJECTIVE: The ISO 17020 quality program has been run in our pathology laboratory for four years to establish an action plan for correction and prevention of identified errors. In this study, we aimed to evaluate the errors that we could not identify through ISO 17020 and/or solve by means of process consulting. Process consulting is carefully intervening in a group or team to help it to accomplish its goals. MATERIAL AND METHOD: The A3 problem solving process was run under the leadership of a 'workflow, IT and consultancy manager'...
2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28025540/nanostructured-tip-shaped-biosensors-application-of-six-sigma-approach-for-enhanced-manufacturing
#11
Seong-Joong Kahng, Jong-Hoon Kim, Jae-Hyun Chung
Nanostructured tip-shaped biosensors have drawn attention for biomolecule detection as they are promising for highly sensitive and specific detection of a target analyte. Using a nanostructured tip, the sensitivity is increased to identify individual molecules because of the high aspect ratio structure. Various detection methods, such as electrochemistry, fluorescence microcopy, and Raman spectroscopy, have been attempted to enhance the sensitivity and the specificity. Due to the confined path of electrons, electrochemical measurement using a nanotip enables the detection of single molecules...
December 23, 2016: Sensors
https://www.readbyqxmd.com/read/28006762/h2s-attenuates-lps-induced-acute-lung-injury-by-reducing-oxidative-nitrative-stress-and-inflammation
#12
Hong-Xia Zhang, Shu-Juan Liu, Xiao-Lu Tang, Guo-Li Duan, Xin Ni, Xiao-Yan Zhu, Yu-Jian Liu, Chang-Nan Wang
BACKGROUND: Hydrogen sulfide (H2S), known as the third endogenous gaseous transmitter, has received increasing attention because of its diverse effects, including angiogenesis, vascular relaxation and myocardial protection.We aimed to investigate the role of H2S in oxidative/nitrative stress and inflammation in acute lung injury (ALI) induced by endotoxemia. METHODS: Male ICR mice were divided in six groups: (1) Control group; (2) GYY4137treatment group; (3) L-NAME treatment group; (4) lipopolysaccharide (LPS) treatment group; (5) LPS with GYY4137 treatment group; and (6) LPS with L-NAME treatment group...
2016: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28005677/an-exploratory-analysis-for-lean-and-six-sigma-implementation-in-hospitals-together-is-better
#13
Jung Young Lee, Kathleen L McFadden, Charles R Gowen
BACKGROUND: Despite the increasing interest for Lean and Six Sigma implementations in hospitals, there has been little empirical evidence that goes beyond descriptive case studies to address the current status and the effectiveness of the implementations. PURPOSE: The aim of this study was to explore existing patterns of Lean and Six Sigma implementation in U.S. hospitals and compare the performance of the different patterns. METHODOLOGY/APPROACH: We collected data from 215 U...
December 22, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27940243/sigch-an-extracytoplasmic-function-sigma-factor-of-porphyromonas-gingivalis-regulates-the-expression-of-cdhr-and-hmuyr
#14
Koki Ota, Yuichiro Kikuchi, Kentaro Imamura, Daichi Kita, Kouki Yoshikawa, Atsushi Saito, Kazuyuki Ishihara
Extracytoplasmic function (ECF) sigma factors play an important role in the bacterial response to various environmental stresses. Porphyromonas gingivalis, a prominent etiological agent in human periodontitis, possesses six putative ECF sigma factors. So far, information is limited on the ECF sigma factor, PGN_0319. The aim of this study was to investigate the role of PGN_0319 (SigCH) of P. gingivalis, focusing on the regulation of hmuY and hmuR, which encode outer-membrane proteins involved in hemin utilization, and cdhR, a transcriptional regulator of hmuYR...
December 8, 2016: Anaerobe
https://www.readbyqxmd.com/read/27917566/perioperative-hypothermia-in-neonatal-intensive-care-unit-patients-effectiveness-of-a-thermoregulation-intervention-and-associated-risk-factors
#15
Branden M Engorn, Stephanie L Kahntroff, Karen M Frank, Sarabdeep Singh, Helen A Harvey, Charles T Barkulis, Annika M Barnett, Olamide O Olambiwonnu, Eugenie S Heitmiller, Robert S Greenberg
BACKGROUND: Hypothermia in neonatal intensive care unit patients is associated with morbidity. Perioperative normothermia is the standard of care. AIMS: We hypothesized that a quality improvement intervention (transport protocol, transport education, ongoing monitoring) would decrease the incidence of perioperative hypothermia. Secondarily, we hypothesized that patients undergoing surgery at a postmenstrual age of <37 weeks or at a weight of <1.5 kg would be at higher risk for perioperative hypothermia...
December 5, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27902532/lean-six-sigma-to-reduce-intensive-care-unit-length-of-stay-and-costs-in-prolonged-mechanical-ventilation
#16
Stephen Trzeciak, Michael Mercincavage, Cory Angelini, William Cogliano, Emily Damuth, Brian W Roberts, Sergio Zanotti, Anthony J Mazzarelli
OBJECTIVE: Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. DESIGN: Before-and-after cohort study. SETTING: Multidisciplinary intensive care unit (ICU) in an academic medical center...
November 29, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27879005/transient-distention-of-right-posterior-located-sigma-a-new-sonographic-sign-for-the-prenatal-diagnosis-of-anal-atresia
#17
Moshe Bronshtein, Ayala Gover, Ron Beloosesky, Zeev Blumenfeld
We describe a new sonographic sign for the detection of anal atresia in the early midtrimester on transvaginal sonography. In six cases of fetal anal atresia, the finding of a transient, distended, and right-sided sigmoid colon was observed at 13-16 weeks' gestation. Three cases have undergone pregnancy termination due to multiple anomalies. In the other three, the colonic distension resolved by 19 weeks' gestation. In two of these, the finding was isolated, and no other anomalies were detected. In all six cases, anal atresia or cloaca was confirmed on postabortal autopsy or after delivery...
November 23, 2016: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/27862689/applying-lean-six-sigma-methodology-to-reduce-cesarean-section-rate
#18
Ze-Ying Chai, Hua-Min Hu, Xiu-Ling Ren, Bao-Jin Zeng, Ling-Zhi Zheng, Feng Qi
OBJECTIVES: This study aims to reduce cesarean section rate and increase rate of vaginal delivery. METHODS: By using Lean Six Sigma (LSS) methodology, the cesarean section rate was investigated and analyzed through a 5-phase roadmap consisting of Define, Measure, Analyze, Improve, and Control. The principal causes of cesarean section were identified, improvement measures were implemented, and the rate of cesarean section before and after intervention was compared...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27860065/the-application-of-lean-six-sigma-methodology-to-reduce-the-risk-of-healthcare-associated-infections-in-surgery-departments
#19
Emma Montella, Maria Vincenza Di Cicco, Anna Ferraro, Piera Centobelli, Eliana Raiola, Maria Triassi, Giovanni Improta
RATIONALE: Nowadays, the monitoring and prevention of healthcare-associated infections (HAIs) is a priority for the healthcare sector. AIMS AND OBJECTIVES: In this article, we report on the application of the Lean Six Sigma (LSS) methodology to reduce the number of patients affected by sentinel bacterial infections who are at risk of HAI. METHODS: The LSS methodology was applied in the general surgery department by using a multidisciplinary team of both physicians and academics...
November 18, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27830937/mass-vaccinations-at-the-united-states-naval-academy
#20
Chrysanthy Ha, Christopher Taylor, Jitendrakumar R Modi
We analyzed the mass influenza vaccination clinic process at the United States Naval Academy to identify gaps and implement changes for improvement. The Lean Six Sigma methodology was employed. Total number of staff members working the clinic and total hours worked were measured at baseline in August 2013 and after implementation in August 2014 to determine improvement. The clinic was moved from a hallway to an auditorium, and a linear patient flow was established. Staff members wore vests for easy identification, and the supply box was reorganized...
November 2016: Health Security
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