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https://www.readbyqxmd.com/read/28432844/evaluating-new-hba1c-methods-for-adoption-by-the-ifcc-and-ngsp-reference-networks-using-international-quality-targets
#1
Erna Lenters-Westra, Emma English
BACKGROUND: As a reference laboratory for HbA1c, it is essential to have accurate and precise HbA1c methods covering a range of measurement principles. We report an evaluation of the Abbott Enzymatic (Architect c4000), Roche Gen.3 HbA1c (Cobas c513) and Tosoh G11 using different quality targets. METHODS: The effect of hemoglobin variants, other potential interferences and the performance in comparison to both the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and the National Glycohemoglobin Standardization Program (NGSP) reference systems was assessed using certified evaluation protocols...
April 22, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28430083/hydrocephalus-treatment-in-children-long-term-outcome-in-975-consecutive-patients
#2
Pierre-Aurelien Beuriat, Stephanie Puget, Giuseppe Cinalli, Thomas Blauwblomme, Kevin Beccaria, Michel Zerah, Christian Sainte-Rose
OBJECTIVE Hydrocephalus remains one of the more common pathologies managed in pediatric neurosurgical units. Endoscopic third ventriculostomy (ETV) has an advantage over ventriculoperitoneal shunting as it enables patients to remain device free. Multiple shunt devices with various valve designs exist, with no one valve proven to be superior to another. The aim of this study was to describe the management of hydrocephalus and its long-term outcome. METHODS The authors retrospectively reviewed the medical records of all patients who had been treated for hydrocephalus at the Hôpital Necker-Enfants Malades in the period from 1985 to 1995...
April 21, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28421225/using-telephony-data-to-facilitate-discovery-of-clinical-workflows
#3
Donald W Rucker
BACKGROUND:  Discovery of clinical workflows to target for redesign using methods such as Lean and Six Sigma is difficult. VoIP telephone call pattern analysis may complement direct observation and EMR-based tools in understanding clinical workflows at the enterprise level by allowing visualization of institutional telecommunications activity. OBJECTIVE:  To build an analytic framework mapping repetitive and high-volume telephone call patterns in a large medical center to their associated clinical units using an enterprise unified communications server log file and to support visualization of specific call patterns using graphical networks...
April 19, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28410337/adaptation-of-lean-six-sigma-methodologies-for-the-evaluation-of-veterans-choice-program-at-3-urban-veterans-affairs-medical-centers
#4
Sherry L Ball, Lauren D Stevenson, Amy C Ladebue, Marina S McCreight, Emily C Lawrence, Taryn Oestreich, Anne C Lambert-Kerzner
OBJECTIVE: The Veterans Healthcare Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. RESEARCH DESIGN: LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers...
April 13, 2017: Medical Care
https://www.readbyqxmd.com/read/28389078/improving-operating-room-efficiency-in-academic-children-s-hospital-using-lean-six-sigma-methodology
#5
Edward P Tagge, Arul S Thirumoorthi, John Lenart, Carlos Garberoglio, Kenneth W Mitchell
BACKGROUND/PURPOSE: Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. METHODS: In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools...
March 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28358788/an-application-of-business-process-management-to-health-care-facilities
#6
Mohsen M D Hassan
The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella...
April 2017: Health Care Manager
https://www.readbyqxmd.com/read/28347721/extra-analytical-quality-indicators-and-laboratory-performances
#7
REVIEW
Laura Sciacovelli, Ada Aita, Mario Plebani
In the last few years much progress has been made in raising the awareness of laboratory medicine professionals about the effectiveness of quality indicators (QIs) in monitoring, and improving upon, performances in the extra-analytical phases of the Total Testing Process (TTP). An effective system for management of QIs includes the implementation of an internal assessment system and participation in inter-laboratory comparison. A well-designed internal assessment system allows the identification of critical activities and their systematic monitoring...
March 24, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28346244/a-six-sigma-approach-to-analyze-time-to-assembly-variance-of-surgical-trays-in-a-sterile-services-department
#8
Flavio S Fogliatto, Michel J Anzanello, Guilherme L Tortorella, Daniela S S Schneider, Cintia G R Pereira, Beatriz D Schaan
INTRODUCTION: We analyze the assembly of surgical trays in a hospital's sterile services department. The department assembles 520 different tray setups. However, tray assembly times are unknown, imposing a challenge to production planners. To respond to demand, workers from other departments are often called, leading to higher operational costs and more frequent quality problems due to workers' poor training and inconsistency. METHODS: Conducting traditional time-motion studies is infeasible in such a high variety production setting...
March 24, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28277381/working-toward-quality-in-obstetric-anesthesia-a-business-approach
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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