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https://www.readbyqxmd.com/read/28439134/pharmacy-dashboard-an-innovative-process-for-pharmacy-workload-and-productivity
#1
Ashley Kinney, Quyen Bui, Jane Hodding, Jennifer Le
Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#2
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28430956/achieving-high-reliability-in-histology-%C3%A2-an-improvement-series-to-reduce-errors
#3
Yael K Heher, Yigu Chen, Sergey Pyatibrat, Edward Yoon, Jeffrey D Goldsmith, Kenneth E Sands
Objectives: Despite sweeping medical advances in other fields, histology processes have by and large remained constant over the past 175 years. Patient label identification errors are a known liability in the laboratory and can be devastating, resulting in incorrect diagnoses and inappropriate treatment. The objective of this study was to identify vulnerable steps in the histology workflow and reduce the frequency of labeling errors (LEs). Methods: In this 36-month study period, a numerical step key (SK) was developed to capture LEs...
November 1, 2016: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28423041/modeling-the-shape-and-composition-of-the-human-body-using-dual-energy-x-ray-absorptiometry-images
#4
John A Shepherd, Bennett K Ng, Bo Fan, Ann V Schwartz, Peggy Cawthon, Steven R Cummings, Stephen Kritchevsky, Michael Nevitt, Adam Santanasto, Timothy F Cootes
There is growing evidence that body shape and regional body composition are strong indicators of metabolic health. The purpose of this study was to develop statistical models that accurately describe holistic body shape, thickness, and leanness. We hypothesized that there are unique body shape features that are predictive of mortality beyond standard clinical measures. We developed algorithms to process whole-body dual-energy X-ray absorptiometry (DXA) scans into body thickness and leanness images. We performed statistical appearance modeling (SAM) and principal component analysis (PCA) to efficiently encode the variance of body shape, leanness, and thickness across sample of 400 older Americans from the Health ABC study...
2017: PloS One
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
#5
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/28408068/quercus-infectoria-inhibits-set7-nf-%C3%AE%C2%BAb-inflammatory-pathway-in-macrophages-exposed-to-a-diabetic-environment
#6
Julalak Chokpaisarn, Norifumi Urao, Supayang P Voravuthikunchai, Timothy J Koh
Chronic inflammation plays a key role in the pathogenesis of myriad complications associated with diabetes and thus anti-inflammatory therapies may ameliorate these complications. Quercus infectoria (Qi) extract has been shown to downregulate inflammatory processes; however, the molecular mechanisms of this anti-inflammatory activity remain unclear. The hypothesis of our study was that Qi extract exerts its anti-inflammatory effect by downregulating the Set7/NF-κB pathway. Bone marrow-derived macrophages (BMM) were treated with high glucose plus palmitate medium (HG/Pa) to simulate the diabetic environment...
April 10, 2017: Cytokine
https://www.readbyqxmd.com/read/28389078/improving-operating-room-efficiency-in-academic-children-s-hospital-using-lean-six-sigma-methodology
#7
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/28388927/exposure-to-gestational-diabetes-mellitus-induces-neuroinflammation-derangement-of-hippocampal-neurons-and-cognitive-changes-in-rat-offspring
#8
Billy Vuong, Gary Odero, Stephanie Rozbacher, Mackenzie Stevenson, Stephanie M Kereliuk, Troy J Pereira, Vernon W Dolinsky, Tiina M Kauppinen
BACKGROUND: Birth cohort studies link gestational diabetes mellitus (GDM) with impaired cognitive performance in the offspring. However, the mechanisms involved are unknown. We tested the hypothesis that obesity-associated GDM induces chronic neuroinflammation and disturbs the development of neuronal circuitry resulting in impaired cognitive abilities in the offspring. METHODS: In rats, GDM was induced by feeding dams a diet high in sucrose and fatty acids. Brains of neonatal (E20) and young adult (15-week-old) offspring of GDM and lean dams were analyzed by immunohistochemistry, cytokine assay, and western blotting...
April 7, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28388373/protein-kinetics-and-metabolic-effects-related-to-disease-states-in-the-intensive-care-unit
#9
Robert G Martindale, Daren K Heyland, Saúl J Rugeles, Jan Wernerman, Peter J M Weijs, Jayshil J Patel, Stephen A McClave
Evaluating protein kinetics in the critically ill population remains a very difficult task. Heterogeneity in the intensive care unit (ICU) population and wide spectrum of disease processes creates complexity in assessing protein kinetics. Traditionally, protein has been delivered in the context of total energy. Focus on energy delivery has recently come into question, as the importance of supplemental protein in patient outcomes has been shown in several recent trials. The ICU patient is prone to catabolism, immobilization, and impaired immunity, which is a perfect storm for massive loss of lean body tissue with a unidirectional flow of amino acids from muscle to immune tissue for immunoglobulin production, as well as liver for gluconeogenesis and acute phase protein synthesis...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28381529/lean-season-food-transfers-affect-children-s-diets-and-household-food-security-evidence-from-a-quasi-experiment-in-malawi
#10
Aulo Gelli, Noora-Lisa Aberman, Amy Margolies, Marco Santacroce, Bob Baulch, Ephraim Chirwa
Background: There is evidence that social transfers increase food consumption, improving the quantity and quality of food consumed by poor households. Questions remain on how to improve the effectiveness of social programs.Objective: The aim was to assess the impact of a lean-season food transfer on household food security, diet, and nutrition status of young children during the lean season in Malawi and to understand processes through which transfers operated.Methods: This was a longitudinal, quasi-experimental study based on 2 survey rounds in the Zomba district in Malawi...
April 5, 2017: Journal of Nutrition
https://www.readbyqxmd.com/read/28375955/using-lean-management-to-reduce-emergency-department-length-of-stay-for-medicine-admissions
#11
Nazima Allaudeen, Anita Vashi, Julia S Breckenridge, Farnoosh Haji-Sheikhi, Sarah Wagner, Keith A Posley, Steven M Asch
BACKGROUND: The practice of boarding admitted patients in the emergency department (ED) carries negative operational, clinical, and patient satisfaction consequences. Lean tools have been used to improve ED workflow. Interventions focused on reducing ED length of stay (LOS) for admitted patients are less explored. OBJECTIVE: To evaluate a Lean-based initiative to reduce ED LOS for medicine admissions. DESIGN, SETTING, PATIENTS: Prospective quality improvement initiative performed at a single university-affiliated Department of Veterans Affairs (VA) medical center from February 2013 to February 2016...
April 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28358788/an-application-of-business-process-management-to-health-care-facilities
#12
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/28348479/non-alcoholic-fatty-liver-disease-connections-with-fat-free-tissues-a-focus-on-bone-and-skeletal-muscle
#13
REVIEW
Eleonora Poggiogalle, Lorenzo Maria Donini, Andrea Lenzi, Claudio Chiesa, Lucia Pacifico
The estimates of global incidence and prevalence of non-alcoholic fatty liver disease (NAFLD) are worrisome, due to the parallel burden of obesity and its metabolic complications. Indeed, excess adiposity and insulin resistance represent two of the major risk factors for NAFLD; interestingly, in the last years a growing body of evidence tended to support a novel mechanistic perspective, in which the liver is at the center of a complex interplay involving organs and systems, other than adipose tissue and glucose homeostasis...
March 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28347217/the-evolution-of-publication-hotspots-in-the-field-of-telemedicine-from-1962-to-2015-and-differences-among-six-countries
#14
Yanjun Wang, Ye Zhao, Jianzhong Zheng, Ailian Zhang, Haiyuan Dong
Introduction Telemedicine has been implemented in many countries and has captured the attention of many researchers. Herein, we aim to quantify publication hotspots in the field of telemedicine, analyse their evolution, compare them in different countries, and provide visual representations. Methods We used software tools to process PubMed entries for a 54-year period and identified publication hotspots using keyword frequency analysis. We employed a keyword co-occurrence analysis, principal component analysis, multidimensional scaling analysis, and network visualization technology...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28340573/a-questionnaire-measuring-staff-perceptions-of-lean-adoption-in-healthcare-development-and-psychometric-testing
#15
Monica Kaltenbrunner, Lars Bengtsson, Svend Erik Mathiassen, Maria Engström
BACKGROUND: During the past decade, the concept of Lean has spread rapidly within the healthcare sector, but there is a lack of instruments that can measure staff's perceptions of Lean adoption. Thus, the aim of the present study was to develop a questionnaire measuring Lean in healthcare, based on Liker's description of Lean, by adapting an existing instrument developed for the service sector. METHODS: A mixed-method design was used. Initially, items from the service sector instrument were categorized according to Liker's 14 principles describing Lean within four domains: philosophy, processes, people and partners and problem-solving...
March 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28335529/effects-of-momordica-charantia-bitter-melon-on-ischemic-diabetic-myocardium
#16
Attila Czompa, Alexandra Gyongyosi, Kitti Szoke, Istvan Bak, Evelin Csepanyi, David D Haines, Arpad Tosaki, Istvan Lekli
Objective: A rat model is here used to test a hypothesis that Momordica charantia (Bitter melon (BM)) extract favorably alters processes in cardiovascular tissue and is systemically relevant to the pathophysiology of type 2 diabetes (T2DM) and related cardiovascular disease. Methods: Male Lean and Zucker Obese (ZO) rats were gavage-treated for six weeks with 400 mg/kg body weight bitter melon (BM) extract suspended in mucin-water vehicle, or with vehicle (Control). Animals were segregated into four treatment groups, 10 animals in each group, according to strain (Lean or ZO) and treatment (Control or BM)...
March 20, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#17
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333235/ovarian-hormones-and-obesity
#18
Brigitte Leeners, Nori Geary, Philippe N Tobler, Lori Asarian
BACKGROUND: Obesity is caused by an imbalance between energy intake, i.e. eating and energy expenditure (EE). Severe obesity is more prevalent in women than men worldwide, and obesity pathophysiology and the resultant obesity-related disease risks differ in women and men. The underlying mechanisms are largely unknown. Pre-clinical and clinical research indicate that ovarian hormones may play a major role. OBJECTIVE AND RATIONALE: We systematically reviewed the clinical and pre-clinical literature on the effects of ovarian hormones on the physiology of adipose tissue (AT) and the regulation of AT mass by energy intake and EE...
March 2, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28327084/a-transcriptome-multi-tissue-analysis-identifies-biological-pathways-and-genes-associated-with-variations-in-feed-efficiency-of-growing-pigs
#19
Florence Gondret, Annie Vincent, Magalie Houée-Bigot, Anne Siegel, Sandrine Lagarrigue, David Causeur, Hélène Gilbert, Isabelle Louveau
BACKGROUND: Animal's efficiency in converting feed into lean gain is a critical issue for the profitability of meat industries. This study aimed to describe shared and specific molecular responses in different tissues of pigs divergently selected over eight generations for residual feed intake (RFI). RESULTS: Pigs from the low RFI line had an improved gain-to-feed ratio during the test period and displayed higher leanness but similar adiposity when compared with pigs from the high RFI line at 132 days of age...
March 21, 2017: BMC Genomics
https://www.readbyqxmd.com/read/28322765/hair-cortisol-and-dehydroepiandrosterone-concentrations-in-naturally-taenia-solium-infected-pigs-in-tanzania
#20
Chiara Trevisan, Marta Montillo, Alberto Prandi, Ernatus M Mkupasi, Helena A Ngowi, Maria V Johansen
The aim of this study was to measure hair cortisol and dehydroepiandrosterone (DHEA) concentrations in naturally Taenia solium infected and non-infected control pigs and assess the effect of an environmental change on the aforementioned parameters. Three hair patches were obtained from 13 T. solium infected and 15 non-infected controls sows, respectively corresponding to 3 time points (prior to, at and approximately two weeks after arrival at the research facility). Cortisol and DHEA were extracted using methanol and analysed by radio immune assay...
May 15, 2017: General and Comparative Endocrinology
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