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https://www.readbyqxmd.com/read/29144874/evaluation-of-interfacial-gap-volume-of-two-low-shrinkage-composites-using-micro-computed-tomography
#1
Hna Al Nahedh, N S Sibai
OBJECTIVES: To investigate the efficacy of X-ray micro-computed tomography (μCT) in the detection and quantification of interfacial gap formation in standardized Class I and Class II resin composite restorations, to compare the interfacial gaps for two low-shrinkage resin composites with a methacrylate composite material, and to determine any correlation between the cavity configuration factor (C-factor) and the volume of gaps formed. METHODS AND MATERIALS: Sixty standardized Class I and Class II cavities were prepared and divided into six groups...
November 2017: Operative Dentistry
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#2
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29136390/assurance-of-myeloid-growth-factor-administration-in-an-infusion-center-pilot-quality-improvement-initiative
#3
Pamela Maree Ramirez, Barry Peterson, Christine Holtshopple, Kristina Borja, Vincent Torres, Lucille Valdivia-Peppers, Julio Harriague, Melanie D Joe
PURPOSE: Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0...
November 14, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#4
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
November 3, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29072887/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#5
Gabriele Arcidiacono, Dominik T. Matt, Erwin Rauch
Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29065578/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#6
Gabriele Arcidiacono, Dominik T Matt, Erwin Rauch
Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29040063/validation-of-the-six-sigma-z-score-for-the-quality-assessment-of-clinical-laboratory-timeliness
#7
Cristiano Ialongo, Sergio Bernardini
BACKGROUND: The International Federation of Clinical Chemistry and Laboratory Medicine has introduced in recent times the turnaround time (TAT) as mandatory quality indicator for the postanalytical phase. Classic TAT indicators, namely, average, median, 90th percentile and proportion of acceptable test (PAT), are in use since almost 40 years and to date represent the mainstay for gauging the laboratory timeliness. In this study, we investigated the performance of the Six Sigma Z-score, which was previously introduced as a device for the quantitative assessment of timeliness...
October 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29025066/supply-and-demand-application-of-lean-six-sigma-methods-to-improve-drug-round-efficiency-and-release-nursing-time
#8
Maríosa Kieran, Mary Cleary, Aoife De Brún, Aileen Igoe
Objective: To improve efficiency, reduce interruptions and reduce the time taken to complete oral drug rounds. Design: Lean Six Sigma methods were applied to improve drug round efficiency using a pre- and post-intervention design. Setting: A 20-bed orthopaedic ward in a large teaching hospital in Ireland. Participants: Pharmacy, nursing and quality improvement staff. Intervention(s): A multifaceted intervention was designed which included changes in processes related to drug trolley organization and drug supply planning...
August 19, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28993662/stochastic-resonance-improves-vision-in-the-severely-impaired
#9
Elena Itzcovich, Massimo Riani, Walter G Sannita
We verified whether a stochastic resonance paradigm (SR), with random interference ("noise") added in optimal amounts, improves the detection of sub-threshold visual information by subjects with retinal disorder and impaired vision as it does in the normally sighted. Six levels of dynamic, zero-mean Gaussian noise were added to each pixel of images (13 contrast levels) in which alphabet characters were displayed against a uniform gray background. Images were presented with contrast below the subjective threshold to 14 visually impaired subjects (age: 22-53 yrs...
October 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28987033/trem2-expression-in-the-human-brain-a-marker-of-monocyte-recruitment
#10
Marie Fahrenhold, Sonja Rakic, John Classey, Carol Brayne, Paul G Ince, James A R Nicoll, Delphine Boche
Mutation in the triggering receptor expressed on myeloid cells (TREM) 2 gene has been identified as a risk factor for several neurodegenerative diseases including Alzheimer's disease (AD). Experimental studies using animal models of AD have highlighted a number of functions associated with TREM2 and its expression by microglial cells. It has therefore been assumed that this is also the case in humans. However, there is very limited information concerning the cellular expression of TREM2 in the human brain. As part of investigations of microglia using post-mortem resources provided by the Medical Research Council Cognitive Function and Ageing Studies (MRC-CFAS), we immunostained the cerebral cortex of 299 participants for TREM2 using the Sigma antibody HPA010917 and compared with the macrophage/microglial markers Iba1 and CD68...
October 7, 2017: Brain Pathology
https://www.readbyqxmd.com/read/28980514/determination-of-testosterone-esters-and-nortestosterone-esters-in-animal-blood-serum-by-lc-ms-ms
#11
Martina Rejtharová, Libor Rejthar, Katarína Čačková
A sensitive and robust confirmatory method for determination of steroid esters in blood serum is essential for reliable monitoring of possible illegal use of steroid hormones as growth promoters in meat production. A previously used sample preparation methodology was improved. The procedure consists of protein precipitation and removal of phospholipids by dispersive SPE Supel™ QuE Z-Sep (Sigma-Aldrich) followed by clean-up on alumina column and LC-MS/MS measurement. The modified method has been validated according to Commission Decision 2002/657/EC...
October 18, 2017: Food Additives & Contaminants. Part A, Chemistry, Analysis, Control, Exposure & Risk Assessment
https://www.readbyqxmd.com/read/28964688/administering-blood-products-before-selected-interventional-radiology-procedures-developing-applying-and-monitoring-a-standardized-protocol
#12
Nam S Hoang, Nishita Kothary, Seema Saharan, Jarrett Rosenberg, Andrew A Tran, Shaughnessy B Brown, David M Hovsepian
PURPOSE: To apply and monitor a single institution's adherence to internally established guidelines for the preoperative administration of platelets and/or fresh frozen plasma (FFP) before a specified subset of minimally invasive interventional radiology (IR) procedures. MATERIALS AND METHODS: Beginning in December 2008, we implemented a set of restrictive guidelines for preoperative platelet and/or FFP administration before IR procedures at a single academic hospital...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28948662/improving-performances-of-the-knee-replacement-surgery-process-by-applying-dmaic-principles
#13
Giovanni Improta, Giovanni Balato, Maria Romano, Alfonso Maria Ponsiglione, Eliana Raiola, Mario Alessandro Russo, Patrizia Cuccaro, Liberatina Carmela Santillo, Mario Cesarelli
RATIONALE, AIMS, AND OBJECTIVES: The work is a part of a project about the application of the Lean Six Sigma to improve health care processes. A previously published work regarding the hip replacement surgery has shown promising results. Here, we propose an application of the DMAIC (Define, Measure, Analyse, Improve, and Control) cycle to improve quality and reduce costs related to the prosthetic knee replacement surgery by decreasing patients' length of hospital stay (LOS) METHODS: The DMAIC cycle has been adopted to decrease the patients' LOS...
September 26, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28918132/assessing-precision-bias-and-sigma-metrics-of-53-measurands-of-the-alinity-ci-system
#14
Sten Westgard, Victoria Petrides, Sharon Schneider, Marvin Berman, Jörg Herzogenrath, Anthony Orzechowski
Assay performance is dependent on the accuracy and precision of a given method. These attributes can be combined into an analytical Sigma-metric, providing a simple value for laboratorians to use in evaluating a test method's capability to meet its analytical quality requirements. Sigma-metrics were determined for 37 clinical chemistry assays, 13 immunoassays, and 3 ICT methods on the Alinity ci system. METHODS: Analytical Performance Specifications were defined for the assays, following a rationale of using CLIA goals first, then Ricos Desirable goals when CLIA did not regular the method, and then other sources if the Ricos Desirable goal was unrealistic...
September 13, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28913646/computational-investigation-of-the-microstructural-characteristics-and-physical-properties-of-glycerol-based-deep-eutectic-solvents
#15
Tayeb Aissaoui, Yacine Benguerba, Mohamed Khalid AlOmar, Inas M AlNashef
Recently, there has been significant interest in the possibility of using deep eutectic solvents (DESs) as novel green media and alternatives to conventional solvents and ionic liquids (ILs) in many applications. Due to their attractive properties, such as their biodegradability, low cost, easy preparation, and nontoxicity, DESs appear to be very promising solvents for use in the field of green chemistry. This computational study investigated six glycerol-based DESs: DES1 (glycerol:methyl triphenyl phosphonium bromide), DES2 (glycerol:benzyl triphenyl phosphonium chloride), DES3 (glycerol:allyl triphenyl phosphonium bromide), DES4 (glycerol:choline chloride), DES5 (glycerol:N,N-diethylethanolammonium chloride), and DES6 (glycerol:tetra-n-butylammonium bromide)...
September 14, 2017: Journal of Molecular Modeling
https://www.readbyqxmd.com/read/28913487/perioperative-surgical-home-meeting-tomorrow-s-challenges
#16
REVIEW
Teodora O Nicolescu
New healthcare models pose a variety of changes for anesthesiologists, ranging from the need to improve quality and to cost containment: as such, the concept of Perioperative Surgical Home (PSH) has been developed. Modelled after the UK's Enhanced Recovery After Surgery (ERAS), PSH takes a step further by coordinating care starting from the time a surgical decision is made for the patient to as many as 30 days postoperatively, taking a logical evidenced-based approach to judicious preoperative testing. Perioperative surgical home also relies heavily on engineering imported strategies such as the use of Lean Six Sigma methodologies, and involves active participation of all stakeholders...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28870178/using-total-quality-management-approach-to-improve-patient-safety-by-preventing-medication-error-incidences
#17
Nadin Yousef, Farah Yousef
BACKGROUND: Whereas one of the predominant causes of medication errors is a drug administration error, a previous study related to our investigations and reviews estimated that the incidences of medication errors constituted 6.7 out of 100 administrated medication doses. Therefore, we aimed by using six sigma approach to propose a way that reduces these errors to become less than 1 out of 100 administrated medication doses by improving healthcare professional education and clearer handwritten prescriptions...
September 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28856213/analytical-verification-and-quality-assessment-of-the-tosoh-hlc-723gx-hba1c-analyzer
#18
Marko Ris, Sandra Božičević, Vanja Radišić Biljak, Marijana Vučić Lovrenčić
OBJECTIVES: Ion-exchange high-performance liquid chromatography (IE-HPLC) has long been used as a reproducible and versatile analytical tool for HbA1c measurement. In this study, we performed analytical verification and quality assessment of the recently introduced small IE-HPLC Tosoh HLC-723GX HbA1c analyzer, and a comparison of results to immunoassay (IA) and capillary electrophoresis (CE). DESIGN AND METHODS: The total imprecision of Tosoh HLC-723GX was verified according to CLSI EP15-A2 protocol using commercial control materials (C-QC) and pooled human whole blood samples (HWB)...
April 2017: Pract Lab Med
https://www.readbyqxmd.com/read/28852353/management-of-painful-patellar-clunk-and-crepitance-results-at-a-mean-follow-up-of-five-years
#19
J Joseph Gholson, Devon D Goetz, Robert W Westermann, John Hart, John J Callaghan
INTRODUCTION: Painful patellar clunk and crepitance (PCC) is a known complication of total knee arthroplasty (TKA) with posterior-stabilized designs. Arthroscopic management of PCC has been proposed as a treatment option for PCC. METHODS: We reviewed all cases of PCC from a consecutive single-surgeon series using a specific posterior stabilized (PS) design treated with arthroscopy for PCC. In a series of 1,488 TKA cases, forty-six patients (3.1%) were identified to have clinical signs and symptoms of PCC during post-operative clinic follow-up...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28828305/medical-and-scientific-writing-time-to-go-lean-and-mean
#20
REVIEW
Payal Bhardwaj, Sudip Sinha, Raj Kumar Yadav
The Lean Six Sigma methodology for process improvements and driving efficiency is old, but lean writing was adopted late by the pharmaceutical world in terms of size of the documents. The documents were lean earlier, and then became voluminous, and now we are about to complete a full circle in this regard, i.e., coming back to the lean documents again using e-formats and hyperlinking. Furthermore, writing has become more and more precise over time. The need for this lean and mean medical and scientific writing arose from voluminous research globally, both industry and academia which are abuzz with skyrocketing regulatory and scientific submission volumes...
July 2017: Perspectives in Clinical Research
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