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https://www.readbyqxmd.com/read/28061794/process-evaluation-of-the-data-driven-quality-improvement-in-primary-care-dqip-trial-active-and-less-active-ingredients-of-a-multi-component-complex-intervention-to-reduce-high-risk-primary-care-prescribing
#1
Aileen Grant, Tobias Dreischulte, Bruce Guthrie
BACKGROUND: Two to 4% of emergency hospital admissions are caused by preventable adverse drug events. The estimated costs of such avoidable admissions in England were £530 million in 2015. The data-driven quality improvement in primary care (DQIP) intervention was designed to prompt review of patients vulnerable from currently prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and anti-platelets and was found to be effective at reducing this prescribing. A process evaluation was conducted parallel to the trial, and this paper reports the analysis which aimed to explore response to the intervention delivered to clusters in relation to participants' perceptions about which intervention elements were active in changing their practice...
January 7, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28059689/an-integrated-health-neighbourhood-framework-to-optimise-the-use-of-ehr-data
#2
Siaw-Teng Liaw, Simon De Lusignan
 General practice should become the hub of integrated health neighbourhoods (IHNs), which involves sharing of information to ensure that medical homes are also part of learning organisations that use electronic health record (EHR) data for care, decision making, teaching and learning, quality improvement and research. The IHN is defined as the primary and ambulatory care services in a locality that relates largely to a single hospital-based secondary care service provider and is the logical denominator and unit of comparison for the optimal use of EHR data and health information exchange (HIE) to facilitate integration and coordination of care...
October 4, 2016: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/28052781/inpatient-urine-cultures-are-frequently-performed-without-urinalysis-or-microscopy-findings-from-a-large-academic-medical-center
#3
Abigail L Carlson, Satish Munigala, Anthony J Russo, Kathleen M McMullen, Helen Wood, Ronald Jackups, David K Warren
OBJECTIVE To describe the frequency of urine cultures performed in inpatients without additional testing for pyuria DESIGN Retrospective cohort study SETTING A 1,250-bed academic tertiary referral center PATIENTS Hospitalized adults METHODS This study included urine cultures drawn on 4 medical and 2 surgical wards from 2009 to 2013 and in the medical and surgical intensive care units (ICUs) from 2012 to 2013. Patient and laboratory data were abstracted from the hospital's medical informatics database. We identified catheter-associated urinary tract infections (CAUTIs) in the ICUs by routine infection prevention surveillance...
January 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28048918/su-f-r-11-designing-quality-and-safety-informatics-through-implementation-of-a-ct-radiation-dose-monitoring-program
#4
J M Wilson, E Samei
PURPOSE: Recent legislative and accreditation requirements have driven rapid development and implementation of CT radiation dose monitoring solutions. Institutions must determine how to improve quality, safety, and consistency of their clinical performance. The purpose of this work was to design a strategy and meaningful characterization of results from an in-house, clinically-deployed dose monitoring solution. METHODS: A dose monitoring platform was designed by our imaging physics group that focused on extracting protocol parameters, dose metrics, and patient demographics and size...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28028203/development-of-a-pediatric-adverse-events-terminology
#5
Debbie S Gipson, Eric S Kirkendall, Brenda Gumbs-Petty, Theresa Quinn, A Steen, Amanda Hicks, Ann McMahon, Savian Nicholas, Anna Zhao-Wong, Perdita Taylor-Zapata, Mark Turner, Emily Herreshoff, Charlotte Jones, Jonathan M Davis, Margaret Haber, Steven Hirschfeld
In 2009, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Pediatric Terminology Harmonization Initiative to establish a core library of terms to facilitate the acquisition and sharing of knowledge between pediatric clinical research, practice, and safety reporting. A coalition of partners established a Pediatric Terminology Adverse Event Working Group in 2013 to develop a specific terminology relevant to international pediatric adverse event (AE) reporting...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/28018897/patient-centered-tablet-application-for-improving-medication-adherence-after-a-drug-eluting-stent
#6
Vicki Shah, Anandu Dileep, Carolyn Dickens, Vicki Groo, Betty Welland, Jerry Field, Matthew Baumann, Jose D Flores, Adhir Shroff, Zhongsheng Zhao, Yingwei Yao, Diana J Wilkie, Andrew D Boyd
BACKGROUND/AIMS: This study's objective was to evaluate a patient-centered educational electronic tablet application, "My Interventional Drug-Eluting Stent Educational App" (MyIDEA) to see if there was an increase in patient knowledge about dual antiplatelet therapy (DAPT) and medication possession ratio (MPR) compared to treatment as usual. METHODS: In a pilot project, 24 elderly (≥50 years old) research participants were recruited after a drug-eluting stent...
2016: Frontiers in Public Health
https://www.readbyqxmd.com/read/28011593/an-informatics-based-approach-to-reducing-heart-failure-all-cause-readmissions-the-stanford-heart-failure-dashboard
#7
Dipanjan Banerjee, Christine Thompson, Charlene Kell, Rajesh Shetty, Yohan Vetteth, Helene Grossman, Aria DiBiase, Michael Fowler
BACKGROUND: Reduction of 30-day all-cause readmissions for heart failure (HF) has become an important quality-of-care metric for health care systems. Many hospitals have implemented quality improvement programs designed to reduce 30-day all-cause readmissions for HF. Electronic medical record (EMR)-based measures have been employed to aid in these efforts, but their use has been largely adjunctive to, rather than integrated with, the overall effort. OBJECTIVES: We hypothesized that a comprehensive EMR-based approach utilizing an HF dashboard in addition to an established HF readmission reduction program would further reduce 30-day all-cause index hospital readmission rates for HF...
December 23, 2016: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/27957459/technological-ecosystems-in-health-informatics-a-brief-review-article
#8
REVIEW
Zhongmei Wu, Xiuxiu Zhang, Ying Chen, Yan Zhang
BACKGROUND: The existing models of information technology in health sciences have full scope of betterment and extension. The high demand pressures, public expectations, advanced platforms all collectively contribute towards hospital environment, which has to be kept in kind while designing of advanced technological ecosystem for information technology. Moreover, for the smooth conduct and operation of information system advanced management avenues are also essential in hospitals. It is the top priority of every hospital to deal with the essential needs of care for patients within the available resources of human and financial outputs...
September 2016: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/27913742/frailty-assessment-in-hospitalized-older-adults-using-the-electronic-health-record
#9
Deborah A Lekan, Debra C Wallace, Thomas P McCoy, Jie Hu, Susan G Silva, Heather E Whitson
INTRODUCTION: Frailty, a clinical syndrome of decreased physiologic reserve and dysregulation in multiple physiologic systems, is associated with increased risk for adverse outcomes. PURPOSE: The aim of this retrospective, cross-sectional, correlational study was to characterize frailty in older adults admitted to a tertiary-care hospital using a biopsychosocial frailty assessment and to determine associations between frailty and time to in-hospital mortality and 30-day rehospitalization...
December 2, 2016: Biological Research for Nursing
https://www.readbyqxmd.com/read/27893502/implementing-a-4c-approach-to-quality-improvement
#10
Michelle McGonigal
Designing a quality improvement activity can be labor intensive and intimidating to facilitators who have not been specially trained in process improvement methodologies. To simplify the process, a team was formed with the specific task of developing a basic model that addresses key concepts in change theory. The 2010 Institute of Medicine report stresses the importance of health care professionals working together, collaboratively, to use data to improve patient outcomes and improve care nationally. In addition, as noted in Quality and Safety Education for Nurses (2013), competencies have been developed to promote frontline problem solving including using data for quality improvement, providing safe care, functioning in collaborative teams, respecting and addressing patient and family concerns, applying evidence-based practice, and using informatics to make decisions...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27880746/notice-to-readers-nndss-tables-have-updated-n-indicators-for-2015-and-2016
#11
(no author information available yet)
CDC's National Notifiable Diseases Surveillance System (NNDSS) maintains and annually updates information about whether each Nationally Notifiable Infectious Condition (NNIC) is considered "reportable" (by health care providers, hospitals, laboratories, or other public health reporters) in each reporting jurisdiction. NNDSS personnel within the Division of Health Informatics and Surveillance performed assessments with each reporting jurisdiction to ascertain the reportable disease status of each NNIC for 2015 and 2016...
November 25, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27875988/common-data-elements-for-secondary-use-of-electronic-health-record-data-for-clinical-trial-execution-and-serious-adverse-event-reporting
#12
Philipp Bruland, Mark McGilchrist, Eric Zapletal, Dionisio Acosta, Johann Proeve, Scott Askin, Thomas Ganslandt, Justin Doods, Martin Dugas
BACKGROUND: Data capture is one of the most expensive phases during the conduct of a clinical trial and the increasing use of electronic health records (EHR) offers significant savings to clinical research. To facilitate these secondary uses of routinely collected patient data, it is beneficial to know what data elements are captured in clinical trials. Therefore our aim here is to determine the most commonly used data elements in clinical trials and their availability in hospital EHR systems...
November 22, 2016: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/27863959/transmission-of-staphylococcus-aureus-between-health-care-workers-the-environment-and-patients-in-an-intensive-care-unit-a-longitudinal-cohort-study-based-on-whole-genome-sequencing
#13
James R Price, Kevin Cole, Andrew Bexley, Vasiliki Kostiou, David W Eyre, Tanya Golubchik, Daniel J Wilson, Derrick W Crook, A Sarah Walker, Timothy E A Peto, Martin J Llewelyn, John Paul
BACKGROUND: Health-care workers have been implicated in nosocomial outbreaks of Staphylococcus aureus, but the dearth of evidence from non-outbreak situations means that routine health-care worker screening and S aureus eradication are controversial. We aimed to determine how often S aureus is transmitted from health-care workers or the environment to patients in an intensive care unit (ICU) and a high-dependency unit (HDU) where standard infection control measures were in place. METHODS: In this longitudinal cohort study, we systematically sampled health-care workers, the environment, and patients over 14 months at the ICU and HDU of the Royal Sussex County Hospital, Brighton, England...
November 15, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27856010/increased-capture-of-pediatric-surgical-complications-utilizing-a-novel-case-log-web-application-to-enhance-quality-improvement
#14
Jason C Fisher, Keith A Kuenzler, Sandra S Tomita, Prashant Sinha, Paresh Shah, Howard B Ginsburg
PURPOSE: Documenting surgical complications is limited by multiple barriers and is not fostered in the electronic health record. Tracking complications is essential for quality improvement (QI) and required for board certification. Current registry platforms do not facilitate meaningful complication reporting. We developed a novel web application that improves accuracy and reduces barriers to documenting complications. METHODS: We deployed a custom web application that allows pediatric surgeons to maintain case logs...
October 28, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27755055/default-drug-doses-in-anesthesia-information-management-systems
#15
Luis I Rodriquez, Todd J Smaka, Michael Mahla, Richard H Epstein
BACKGROUND: In the United States, anesthesia information management systems (AIMS) are well established, especially within academic practices. Many hospitals are replacing their stand-alone AIMS during migration to an enterprise-wide electronic health record. This presents an opportunity to review choices made during the original implementation, based on actual usage. One area amenable to this informatics approach is the configuration in the AIMS of quick buttons for typical drug doses...
October 11, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27747165/use-of-bio-informatics-assessment-schema-bias-to-improve-diagnosis-and-prognosis-of-myocardial-perfusion-data-results-from-the-nhlbi-sponsored-women-s-ischemia-syndrome-evaluation-wise
#16
Mark Doyle, Gerald M Pohost, C Noel Bairey Merz, Leslee J Shaw, George Sopko, William J Rogers, Barry L Sharaf, Carl J Pepine, Diane V Thompson, Geetha Rayarao, Lindsey Tauxe, Sheryl F Kelsey, Robert W W Biederman
BACKGROUND: We introduce an algorithmic approach to optimize diagnostic and prognostic value of gated cardiac single photon emission computed tomography (SPECT) and magnetic resonance (MR) myocardial perfusion imaging (MPI) modalities in women with suspected myocardial ischemia. The novel approach: bio-informatics assessment schema (BIAS) forms a mathematical model utilizing MPI data and cardiac metrics generated by one modality to predict the MPI status of another modality. The model identifies cardiac features that either enhance or mask the image-based evidence of ischemia...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27716194/design-of-an-orthopaedic-specific-discharge-summary
#17
Christine Soong, Bochra Kurabi, Kathleen Exconde, Faiqa Tajammal, Chaim M Bell
BACKGROUND: Patients undergoing orthopaedic procedures experience major changes in function and daily routines upon their return home. Discharge summaries are an important communication tool that may play a role in optimizing a safe transition from hospital. Current care gaps and key elements of an ideal discharge summary specific for orthopaedic population are unknown. We sought to identify the challenges of current orthopaedic discharge summaries and to determine key elements of an ideal document...
October 4, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27703503/telemedicine-in-clinical-setting
#18
Xiao-Ying Zhang, Peiying Zhang
The telemedicine department of a hospital is an emerging branch in upcoming hospitals and may become an essential component of every hospital. It basically utilizes the information technologies along with telecommunication systems in order to provide clinical care and assistance. Furthermore, the branch of telemedicine offers significant opportunities for the process of developmental freedom from illness, early death, and preventable diseases. It advances development by providing relevant drugs and the necessary care aimed to alleviate patient suffering...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27621509/taking-an-antibiotic-time-out-utilization-and-usability-of-a-self-stewardship-time-out-program-for-renewal-of-vancomycin-and-piperacillin-tazobactam
#19
EDITORIAL
Christopher J Graber, Makoto M Jones, Peter A Glassman, Charlene Weir, Jorie Butler, Kevin Nechodom, Chad L Kay, Amy E Furman, Thuong T Tran, Christopher Foltz, Lori A Pollack, Matthew H Samore, Matthew Bidwell Goetz
BACKGROUND: Antibiotic time-outs can promote critical thinking and greater attention to reviewing indications for continuation. OBJECTIVE: We pilot tested an antibiotic time-out program at a tertiary care teaching hospital where vancomycin and piperacillin-tazobactam continuation past day 3 had previously required infectious diseases service approval. METHODS: The time-out program consisted of 3 components: (1) an electronic antimicrobial dashboard that aggregated infection-relevant clinical data; (2) a templated note in the electronic medical record that included a structured review of antibiotic indications and that provided automatic approval of continuation of therapy when indicated; and (3) an educational and social marketing campaign...
November 2015: Hospital Pharmacy
https://www.readbyqxmd.com/read/27580094/front-matter-and-contents
#20
(no author information available yet)
The present study is primarily aimed at an audience of evolutionary biologists in the broad sense for Parts 1-3, as well as at scientists from other professional disciplines looking for new approaches to explore phenomena in nature. However, the content is in general not written as technical text or filled with equations that make it utterly incomprehensible for 'normal' people, although they would have to skip strictly professional biochemical and biological terms that are a constituent part of the evidence in a scientific sense...
2016: Studies in Health Technology and Informatics
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