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https://www.readbyqxmd.com/read/28453821/quality-of-antenatal-care-and-client-satisfaction-in-kenya-and-namibia
#1
Mai Do, Wenjuan Wang, John Hembling, Paul Ametepi
Objective: Despite much progress in maternal health service coverage, the quality of care has not seen parallel improvement. This study assessed the quality of antenatal care (ANC), an entry point to the health system for many women. Design: The study used data from recent Service Provision Assessment (SPA) surveys of nationally representative health facilities in Kenya and Namibia. Setting: Kenya and Namibia represent the situation in much of sub-Saharan Africa, where ANC is relatively common but maternal mortality remains high...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28453440/median-analysis-of-repeated-measures-associated-with-recurrent-events-in-presence-of-terminal-event
#2
Rajeshwari Sundaram, Ling Ma, Subhashis Ghoshal
Recurrent events are often encountered in medical follow up studies. In addition, such recurrences have other quantities associated with them that are of considerable interest, for instance medical costs of the repeated hospitalizations and tumor size in cancer recurrences. These processes can be viewed as point processes, i.e. processes with arbitrary positive jump at each recurrence. An analysis of the mean function for such point processes have been proposed in the literature. However, such point processes are often skewed, leading to median as a more appropriate measure than the mean...
April 28, 2017: International Journal of Biostatistics
https://www.readbyqxmd.com/read/28449529/do-hospitals-need-oncological-critical-care-units
#3
EDITORIAL
Abby Koch, William Checkley
Since the inception of critical care as a formal discipline in the late 1950s, we have seen rapid specialization to many types of intensive care units (ICUs) to accommodate evolving life support technologies and novel therapies in various disciplines of medicine. Indeed, the field has expanded such that specialized ICUs currently exist to address critical care problems in medicine, cardiology, neurology and neurosurgery, trauma, burns, organ transplant and cardiothoracic surgeries. Specialization does not only need new infrastructure, but also training and staffing of health care providers, ancillary staff, and development and implementation of processes of care...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449302/prescribing-safety-assessment-2016-delivery-of-a-national-prescribing-assessment-to-7-343-uk-final-year-medical-students
#4
Simon R J Maxwell, Jamie J Coleman, Lynne Bollington, Celia Taylor, David J Webb
AIM(S): Newly graduated doctors write a large proportion of prescriptions in UK hospitals but recent studies have shown that they frequently make prescribing errors. The Prescribing Safety Assessment (PSA) has been developed as an assessment of competence in relation to prescribing and supervising the use of medicines. This report describes the delivery of the PSA to all UK final-year medical students in 2016 (PSA2016). METHODS: The PSA is a 2-hour online assessment comprising eight sections which cover various aspects of prescribing defined within the outcomes of undergraduate education identified by the UK General Medical Council...
April 27, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28449032/comparing-outcomes-and-cost-of-3-surgical-treatments-for-sagittal-synostosis-a-retrospective-study-including-procedure-related-cost-analysis
#5
Sarah T Garber, Michael Karsy, John R W Kestle, Faizi Siddiqi, Stephen P Spanos, Jay Riva-Cambrin
BACKGROUND: Neurosurgical techniques for repair of sagittal synostosis include total cranial vault (TCV) reconstruction, open sagittal strip (OSS) craniectomy, and endoscopic strip (ES) craniectomy. OBJECTIVE: To evaluate outcomes and cost associated with these 3 techniques. METHODS: Via retrospective chart review with waiver of informed consent , the last consecutive 100 patients with sagittal synostosis who underwent each of the 3 surgical correction techniques before June 30, 2013, were identified...
April 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28449017/a-multifaceted-intervention-to-improve-primary-care-radiology-referral-quality-and-value-in-canterbury
#6
Kieran Holland, Graham McGeoch, Carolyn Gullery
AIMS: This article describes a seven-year multifaceted intervention leading to sustained improvement in primary care radiology referral quality and value in Canterbury, New Zealand, and discusses the transferability to other health systems. METHODS: Access criteria were developed with input from general practitioners and hospital-based specialists, and embedded in locally developed clinical pathways. A referral management service was created to streamline referral processes...
April 28, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28448780/integration-strategies-of-pharmacists-in-primary-care-based-accountable-care-organizations-a-report-from-the-accountable-care-organization-research-network-services-and-education
#7
Tina Joseph, Genevieve M Hale, Sara M Eltaki, Yesenia Prados, Renee Jones, Matthew J Seamon, Cynthia Moreau, Stephanie A Gernant
BACKGROUND: The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. PROGRAM DESCRIPTION: As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28447899/the-american-college-of-surgeons-minimum-standards-for-hospitals-and-the-provision-of-high-quality-laboratory-services
#8
James R Wright
CONTEXT: - The first major project of the American College of Surgeons (Chicago, Illinois), founded in 1913, was implementing Minimum Standards for Hospitals. The 1918 standard (1) established medical staff organizations in hospitals; (2) restricted membership to licensed practitioners in good standing; (3) mandated that the medical staff work with hospital administration to develop and adopt regulations and policies governing their professional work; (4) required standardized, accessible medical records; and (5) required availability of diagnostic and therapeutic facilities...
May 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28447144/-standardized-collection-of-presenting-complaints-in-the-emergency-room-integration-of-coded-presenting-complaints-into-the-electronic-medical-record-system-of-an-emergency-department-and-their-value-for-health-care-research
#9
F Greiner, D Brammen, M Kulla, F Walcher, B Erdmann
BACKGROUND: The point of entry of a patient in emergency care is a symptom or a complaint. To evaluate subsequent processes in an emergency department until a diagnosis is made, this information has to be taken into account. OBJECTIVES: We report the introduction of coded presenting complaints into the electronic medical record system of an emergency department and describe the patients based on these data. METHODS: The CEDIS presenting complaint list was integrated into the emergency department information system of an emergency department (38,000 patients/year)...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28446493/hospital-performance-on-percutaneous-coronary-intervention-process-and-outcomes-measures
#10
Philip W Chui, Craig S Parzynski, Brahmajee K Nallamothu, Frederick A Masoudi, Harlan M Krumholz, Jeptha P Curtis
BACKGROUND: The Physician Consortium for Performance Improvement recently proposed percutaneous coronary intervention (PCI)-specific process measures. However, information about hospital performance on these measures and the association of PCI process and outcomes measures are not available. METHODS AND RESULTS: We linked the National Cardiovascular Data Registry (NCDR) CathPCI Registry with Medicare claims data to assess hospital performance on established PCI process measures (aspirin, thienopyridines, and statins on discharge; door-to-balloon time; and referral to cardiac rehabilitation), newly proposed PCI process measures (documentation of contrast dose, glomerular filtration rate, and PCI indication; appropriate indication for elective PCI; and use of embolic protection device), and a composite of all process measures...
April 26, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28446446/the-cardiovascular-health-in-ambulatory-care-research-team-performance-indicators-for-the-primary-prevention-of-cardiovascular-disease-a-modified-delphi-panel-study
#11
Jack V Tu, Laura C Maclagan, Dennis T Ko, Clare L Atzema, Gillian L Booth, Sharon Johnston, Karen Tu, Douglas S Lee, Arlene Bierman, Ruth Hall, R Sacha Bhatia, Andrea S Gershon, Sheldon W Tobe, Claudia Sanmartin, Peter Liu, Anna Chu
BACKGROUND: High-quality ambulatory care can reduce cardiovascular disease risk, but important gaps exist in the provision of cardiovascular preventive care. We sought to develop a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. METHODS: As part of the Cardiovascular Health in Ambulatory Care Research Team initiative, we established a 14-member multidisciplinary expert panel to develop a set of indicators for measuring primary prevention performance in ambulatory cardiovascular care...
April 25, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28446203/clinicians-views-and-experiences-of-offering-two-alternative-consent-pathways-for-participation-in-a-preterm-intrapartum-trial-a-qualitative-study
#12
Celine Y Chhoa, Alexandra Sawyer, Susan Ayers, Angela Pushpa-Rajah, Lelia Duley
BACKGROUND: The Cord Pilot Trial compared alternative policies for timing of cord clamping at very preterm birth at eight UK hospitals. Preterm birth can be rapid and unexpected, allowing little time for the usual consent process. Therefore, in addition to the usual procedure for written consent, a two-stage pathway for consent for use when birth was imminent was developed. The aims of this study were to explore clinicians' views and experiences of offering two consent pathways for recruitment to a randomised trial of timing of cord clamping at very preterm birth...
April 26, 2017: Trials
https://www.readbyqxmd.com/read/28446045/telemonitoring-in-home-complex-chronic-patients-from-primary-care-in-routine-clinical-practice-impact-on-healthcare-resources-use
#13
Iñaki Martín-Lesende, Estibalitz Orruño, Maider Mateos, Elizabete Recalde, José Asua, Eva Reviriego, Juan Carlos Bayón
BACKGROUND: Recent evidence indicates that home telemonitoring of chronic patients reduces the use of healthcare resources. However, further studies exploring this issue are needed in primary care. OBJECTIVES: To assess the impact of a primary care-based home telemonitoring intervention for highly unstable chronic patients on the use of healthcare resources. METHODS: A one-year follow-up before and after exploratory study, without control group, was conducted...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28445559/association-of-us-centers-for-medicare-and-medicaid-services-hospital-30-day-risk-standardized-readmission-metric-with-care-quality-and-outcomes-after-acute-myocardial-infarction-findings-from-the-national-cardiovascular-data-registry-acute-coronary-treatment
#14
Ambarish Pandey, Harsh Golwala, Hurst M Hall, Tracy Y Wang, Di Lu, Ying Xian, Karen Chiswell, Karen E Joynt, Abhinav Goyal, Sandeep R Das, Dharam Kumbhani, Howard Julien, Gregg C Fonarow, James A de Lemos
Importance: The US Centers for Medicare and Medicaid Services Hospital Readmissions Reduction Program penalizes hospitals with higher-than-expected risk-adjusted 30-day readmission rates (excess readmission ratio [ERR] > 1) after acute myocardial infarction (MI). However, the association of ERR with MI care processes and outcomes are not well established. Objective: To evaluate the association between ERR for MI with in-hospital process of care measures and 1-year clinical outcomes...
April 26, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28444406/-king-s-parkinson-s-disease-pain-scale-intercultural-adaptation-in-the-german-language
#15
REVIEW
W H Jost, A Rizos, P Odin, M Löhle, A Storch
BACKGROUND: Pain is a frequent symptom of idiopathic Parkinson's disease and has a substantial impact on quality of life. The King's Parkinson's disease pain scale (KPPS) has become internationally established and is an English-language, standardized, reliable and valid scale for evaluation of pain in idiopathic Parkinson's disease. This article presents a validated version in German. METHOD: The German translation was adapted interculturally and developed using an internationally recognized procedure in consultation with the authors of the original publication...
April 25, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28444116/effectiveness-of-in-hospital-geriatric-co-management-a-systematic-review-and-meta-analysis
#16
Bastiaan Van Grootven, Johan Flamaing, Bernadette Dierckx de Casterlé, Christophe Dubois, Katleen Fagard, Marie-Christine Herregods, Miek Hornikx, Annouschka Laenen, Bart Meuris, Steffen Rex, Jos Tournoy, Koen Milisen, Mieke Deschodt
Background: geriatric consultation teams have failed to impact clinical outcomes prompting geriatric co-management programmes to emerge as a promising strategy to manage frail patients on non-geriatric wards. Objective: to conduct a systematic review of the effectiveness of in-hospital geriatric co-management. Data sources: MEDLINE, EMBASE, CINAHL and CENTRAL were searched from inception to 6 May 2016. Reference lists, trial registers and PubMed Central Citations were additionally searched...
April 24, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28444031/health-policies-and-federative-gaps-in-brazil-an-analysis-of-regional-capacity-of-services-delivery
#17
José Mendes Ribeiro, Marcelo Rasga Moreira, Assis Mafort Ouverney, Cosme Marcelo Furtado Passos da Silva
This paper analyzes Brazilian health regions according to their service delivery capacity from the debate on the crisis of cooperative federalism in the SUS that resulted from decentralizing process established in the 1988 Constitution. Service delivery capacity tracer indicators were selected by regions and statistical analyses evidenced greater regional capacity in hospital care and large asymmetries with regard to the availability of physicians, high complexity equipment and private insurance coverage. In conclusion,we argue that further solutions are required to strengthen governmental capacity to reduce regional inequalities throughincreased central coordination...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28443976/women-s-autonomy-in-the-process-of-labour-and-childbirth-integrative-literature-review
#18
Thamiza Laureany da Rosa Dos Reis, Stela Maris de Mello Padoin, Thayla Rafaella Pasa Toebe, Cristiane Cardoso de Paula, Jacqueline Silveira de Quadros
Objective: To identify the available evidence in scientific literature on healthcare practices that interfere with the autonomy of Brazilian women in the labour and delivery process. Method: The search for papers was conducted in the databases LILACS, Scopus and PubMed, between 1996 and 2015, according to a guiding question and exclusion criteria, resulting in the selection of 22 papers to compose the analytic body. Results: The main practices that favoured the exercise of women's autonomy were out-of-hospital care practices; care practices of support and comfort; and educational care practices...
April 20, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28443974/nurses-training-in-the-use-of-a-delirium-screening-tool
#19
Regina Cláudia da Silva Souza, Mariana Davies Ribeiro Bersaneti, Ellen Maria Pires Siqueira, Luciana Meira, Daiana Lepre Brumatti, Nilda Rosa de Oliveira Prado
Objective: To narrate the nurses' training experience in the implementation of a systematic delirium screening tool using the Confusion Assessment Method for Intensive Care Unit. Method: Experience report covering the steps of situation diagnosis, planning, staff training and evaluation of the tool's implementation between January and March 2013 with nurses in the ICU of a tertiary hospital in São Paulo. Results: The implementation of the assessment, using the Confusion Assessment Method for Intensive Care Unit, obtained significant nurse adhesion and became a service indicator...
April 20, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28443808/-10-tips-for-improving-patient-handovers-from-hospital-to-other-health-care-settings
#20
R van Seben, S E Geerlings, B M Buurman
When patients are transferred from the hospital to other health care settings, responsibility for the patient is transferred from the treating physician, nurse, paramedic or pharmacist at the hospital to the next health care provider. Good patient handovers from hospital to other healthcare settings are essential to ensure continuity of care. However, handovers are often delayed or incomplete and the patient is barely involved in her or his own transfer. Risks related to an incomplete handover may be considerable...
2017: Nederlands Tijdschrift Voor Geneeskunde
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