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https://www.readbyqxmd.com/read/28339698/learning-from-errors-analysis-of-medication-order-voiding-in-cpoe-systems
#1
Thomas G Kannampallil, Joanna Abraham, Anna Solotskaya, Sneha G Philip, Bruce L Lambert, Gordon D Schiff, Adam Wright, William L Galanter
Objective: Medication order voiding allows clinicians to indicate that an existing order was placed in error. We explored whether the order voiding function could be used to record and study medication ordering errors. Materials and Methods: We examined medication orders from an academic medical center for a 6-year period (2006-2011; n  = 5 804 150). We categorized orders based on status (void, not void) and clinician-provided reasons for voiding. We used multivariable logistic regression to investigate the association between order voiding and clinician, patient, and order characteristics...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28338480/the-challenges-in-predicting-ecmo-survival-and-a-path-forward
#2
Marco Huesch, Christopher Brehm
Extracorporeal membrane oxygenation (ECMO) support is a life-saving but complex technique for patients suffering from severe cardiac and/or pulmonary dysfunction. Increasingly greater utilization in the last 15 years means that a suite of mortality risk analytics is both feasible for researchers and required by clinicians, patients, administrators and insurers. We argue that to date, research into such risk analytics has been insufficient and does not adequately reflect the various indications and configurations of ECLS...
March 22, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28328372/psychiatric-genomics-and-mental-health-treatment-setting-the-ethical-agenda
#3
Camillia Kong, Michael Dunn, Michael Parker
Realizing the benefits of translating psychiatric genomics research into mental health care is not straightforward. The translation process gives rise to ethical challenges that are distinctive from challenges posed within psychiatric genomics research itself, or that form part of the delivery of clinical psychiatric genetics services. This article outlines and considers three distinct ethical concerns posed by the process of translating genomic research into frontline psychiatric practice and policy making...
April 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28327852/-person-centered-clinical-care-principles-and-strategies
#4
Juan Enrique Mezzich, Alberto Perales
The development of person-centered clinical care is inscribed within an international programmatic movement towards a medicine focused on the totality of the person. This movement, with broad historical bases, has been maturing since 2008 through conferences among global health institutions, research projects and academic publications. This paper is aimed at elucidating the conceptual principles of person-centered medicine (PCM) and to delineate strategies for the practical application of such principles in clinical care services...
October 2016: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28302126/systematic-meta-review-of-supported-self-management-for-asthma-a-healthcare-perspective
#5
Hilary Pinnock, Hannah L Parke, Maria Panagioti, Luke Daines, Gemma Pearce, Eleni Epiphaniou, Peter Bower, Aziz Sheikh, Chris J Griffiths, Stephanie J C Taylor
BACKGROUND: Supported self-management has been recommended by asthma guidelines for three decades; improving current suboptimal implementation will require commitment from professionals, patients and healthcare organisations. The Practical Systematic Review of Self-Management Support (PRISMS) meta-review and Reducing Care Utilisation through Self-management Interventions (RECURSIVE) health economic review were commissioned to provide a systematic overview of supported self-management to inform implementation...
March 17, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28298324/the-esrd-quality-incentive-program-can-we-bridge-the-chasm
#6
Daniel Weiner, Suzanne Watnick
The ESRD Quality Incentive Program (QIP) is the first mandatory federal pay for performance program launched on January 1, 2012. The QIP is tied to the ESRD prospective payment system and mandated by the Medicare Improvements for Patients and Providers Act of 2008, which directed the Centers for Medicare and Medicaid Services to expand the payment bundle for renal dialysis services and legislated that payment be tied to quality measures. The QIP links 2% of the payment that a dialysis facility receives for Medicare patients on dialysis to the facility's performance on quality of care measures...
March 15, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28288484/pharmacologic-therapy-for-type-2-diabetes-synopsis-of-the-2017-american-diabetes-association-standards-of-medical-care-in-diabetes
#7
James J Chamberlain, William H Herman, Sandra Leal, Andrew S Rhinehart, Jay H Shubrook, Neil Skolnik, Rita Rastogi Kalyani
Description: The American Diabetes Association (ADA) annually updates the Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes. Methods: For the 2017 Standards, the ADA Professional Practice Committee updated previous MEDLINE searches performed from 1 January 2016 to November 2016 to add, clarify, or revise recommendations based on new evidence...
March 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28275627/inappropriateness-in-laboratory-medicine-an-elephant-in-the-room
#8
Giuseppe Lippi, Chiara Bovo, Marcello Ciaccio
Appropriateness of diagnostic testing can be conventionally described as prescription of the right test, using the right method, at the right time, to the right patient, with the right costs and for producing the right outcome. There is ongoing debate about the real burden of inappropriateness in laboratory diagnostics. The media coverage of this issue has also recently led to either over- or under-emphasizing the clinical, organizational and economic consequences. This is quite problematic, inasmuch as some reliable data are available in the current scientific literature, showing that inappropriateness of laboratory testing can be as high as 70%...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28249596/implicit-bias-in-healthcare-professionals-a-systematic-review
#9
Chloë FitzGerald, Samia Hurst
BACKGROUND: Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. METHODS: PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria...
March 1, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28238524/development-of-a-database-to-record-orofacial-manifestations-in-patients-with-rare-diseases-a-status-report-from-the-romse-recording-of-orofacial-manifestations-in-people-with-rare-diseases-database
#10
M Hanisch, L Hanisch, K Benz, J Kleinheinz, J Jackowski
The aim of this working group was to establish a ROMSE (recording of orofacial manifestations in people with rare diseases) database to provide clinicians, patients, and their families with better information about these diseases. In 2011, we began to search the databases Orphanet, OMIM(®) (Online Mendelian Inheritance in Man(®)), and PubMed, for rare diseases with orofacial symptoms, and since 2013, the collected information has been incorporated into a web-based, freely accessible database. To date, 471 rare diseases with orofacial signs have been listed on ROMSE, and 10 main categories with 99 subcategories of signs such as different types of dental anomalies, changes in the oral mucosa, dysgnathia, and orofacial clefts, have been defined...
February 23, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28230575/patients-and-care-partners-perspectives-on-dignity-and-respect-during-acute-care-hospitalization
#11
Priscilla K Gazarian, Constance R C Morrison, Lisa Soleymani Lehmann, Orly Tamir, David W Bates, Ronen Rozenblum
BACKGROUND: Delivering patient-centered care (PCC) is essential to our healthcare system. Patient dignity and respect are foundational elements of PCC. Understanding patients' and their care partner's perspectives on the meaning of dignity and respect within a clinical care environment is critical to achieving our goal of PCC. OBJECTIVE: The aim of the study was to understand how patients and their care partners define, describe, and experience dignity and respect during hospitalization...
February 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28212621/feasibility-of-an-implementation-strategy-for-the-integration-of-health-promotion-in-routine-primary-care-a-quantitative-process-evaluation
#12
Alvaro Sanchez, Gonzalo Grandes, Josep M Cortada, Haizea Pombo, Catalina Martinez, Mary Helen Corrales, Enrique de la Peña, Justo Mugica, Esther Gorostiza
BACKGROUND: Process evaluation is recommended to improve the understanding of underlying mechanisms related to clinicians, patients, context and intervention delivery that may impact on trial or program results, feasibility and transferability to practice. The aim of this study was to assess the feasibility of the Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable") implementation strategy for enhancing the adoption and implementation of an evidence-based health promotion intervention in primary health care...
February 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28173724/patient-caregiver-and-clinician-use-of-comparative-effectiveness-research-findings-in-care-decisions-results-from-a-national-study
#13
Lori B Frank, Laura P Forsythe, Thomas A Workman, Tandrea Hilliard, Mary Lavelle, Daniel Harwell, Lauren Fayish
AIM: To assess awareness, use and attitudes concerning comparative effectiveness research (CER) findings. MATERIALS & METHODS: Online surveys of patients and caregivers managing rare (n = 560 patients, n = 609 caregivers) or chronic conditions (n = 762 patients, n = 776 caregivers), and practicing clinicians (n = 638). RESULTS: Less than half of patients and caregivers reported exposure to any type of CER findings in the past 12 months. Of those, over half identify healthcare professionals as the information source, yet only 10% of clinicians indicated they were 'very familiar' with CER...
February 8, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28165767/what-is-the-key-to-culturally-competent-care-reducing-bias-or-cultural-tailoring
#14
Adolfo G Cuevas, Kerth O'Brien, Somnath Saha
OBJECTIVE: To gain a better understanding as to whether disparities in patient-provider relationships arise from ethnic minority patients being treated differently than European American patients while they would prefer to be treated the same, or whether disparities arise when ethnic minority patients are treated the same as European American patients while they would prefer to be treated differently. METHOD: African-American, Latina/Latino and European American community members were recruited to participate in one of 27 focus group discussions...
February 6, 2017: Psychology & Health
https://www.readbyqxmd.com/read/28152836/an-interactive-video-based-approach-to-diet-education-for-patients-posthematopoietic-stem-cell-transplantation
#15
Amy Emmert, Robert Soiffer, Edwin Alyea, Joseph Harry Antin, Brett Glotzbecker
183 Background: Hematopoietic stem cell transplantation (HCT) is a complex process in which patient education is increasingly recognized as a critical element to enhance patient preparedness and survivorship. Diet-related education to prevent infectious complications is an essential part of HCT care. Current teaching methods include one-on-one clinician/patient discussion supported with printed materials. Video based teaching may strengthen the learning process of patients and their caregivers. The audio and interactive components may be particularly useful in older patients as sensory ability declines with age...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28133991/readiness-to-participate-in-advance-care-planning-a-qualitative-study-of-renal-failure-patients-families-and-healthcare-providers
#16
Lauren A Hutchison, Donna S Raffin-Bouchal, Charlotte A Syme, Patricia D Biondo, Jessica E Simon
Objectives Advance care planning is the process by which people reflect upon their wishes and values for healthcare, discuss their choices with family and friends and document their wishes. Readiness represents a key predictor of advance care planning participation; however, the evidence for addressing readiness is scarce within the renal failure context. Our objectives were to assess readiness for advance care planning and barriers and facilitators to advance care planning uptake in a renal context. Methods Twenty-five participants (nine patients, nine clinicians and seven family members) were recruited from the Southern Alberta Renal Program...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/28104711/m%C3%A4-ori-patients-experiences-and-perspectives-of-chronic-kidney-disease-a-new-zealand-qualitative-interview-study
#17
Rachael C Walker, Shayne Walker, Rachael L Morton, Allison Tong, Kirsten Howard, Suetonia C Palmer
OBJECTIVES: To explore and describe Māori (the indigenous people of New Zealand) patients' experiences and perspectives of chronic kidney disease (CKD), as these are largely unknown for indigenous groups with CKD. DESIGN: Face-to-face, semistructured interviews with purposive sampling and thematic analysis. SETTING: 3 dialysis centres in New Zealand (NZ), all of which offered all forms of dialysis modalities. PARTICIPANTS: 13 Māori patients with CKD and who were either nearing the need for dialysis or had started dialysis within the previous 12 months...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28103848/the-crisp-colorectal-cancer-risk-prediction-tool-an-exploratory-study-using-simulated-consultations-in-australian-primary-care
#18
Jennifer G Walker, Adrian Bickerstaffe, Nadira Hewabandu, Sanjay Maddumarachchi, James G Dowty, Mark Jenkins, Marie Pirotta, Fiona M Walter, Jon D Emery
BACKGROUND: In Australia, screening for colorectal cancer (CRC) with colonoscopy is meant to be reserved for people at increased risk, however, currently there is a mismatch between individuals' risk of CRC and the type of CRC screening they receive. This paper describes the development and optimisation of a Colorectal cancer RISk Prediction tool ('CRISP') for use in primary care. The aim of the CRISP tool is to increase risk-appropriate CRC screening. METHODS: CRISP development was informed by previous experience with developing risk tools for use in primary care and a systematic review of the evidence...
January 19, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28102924/current-practices-related-to-family-presence-during-acute-deterioration-in-adult-emergency-department-patients
#19
Megan J Youngson, Judy Currey, Julie Considine
AIMS: To explore the characteristics and interactions of clinicians, patients and family members during management of the deteriorating adult patient in the Emergency Department. BACKGROUND: Previous research into family presence during resuscitation has identified many positive outcomes when families are included. However, over that last three decades the epidemiology of acute clinical deterioration has changed, with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration...
January 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28061041/other-ways-of-knowing
#20
Negin Hajizadeh, Melissa J Basile, Andrzej Kozikowski, Meredith Akerman, Tara Liberman, Thomas McGinn, Michael A Diefenbach
BACKGROUND: Patients with advanced-stage chronic obstructive pulmonary disease (COPD) may suffer severe respiratory exacerbations and need to decide between accepting life-sustaining treatments versus foregoing these treatments (choosing comfort care only). We designed the InformedTogether decision aid to inform this decision and describe results of a pilot study to assess usability focusing on participants' trust in the content of the decision aid, acceptability, recommendations for improvement, and emotional reactions to this emotionally laden decision...
December 1, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
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