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https://www.readbyqxmd.com/read/29136390/assurance-of-myeloid-growth-factor-administration-in-an-infusion-center-pilot-quality-improvement-initiative
#1
Pamela Maree Ramirez, Barry Peterson, Christine Holtshopple, Kristina Borja, Vincent Torres, Lucille Valdivia-Peppers, Julio Harriague, Melanie D Joe
PURPOSE: Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0...
November 14, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29136150/using-value-stream-mapping-to-improve-quality-of-care-in-low-resource-facility-settings
#2
Rohit Ramaswamy, Claire Rothschild, Funmi Alabi, Eric Wachira, Faith Muigai, Nick Pearson
Quality problem or issue: Jacaranda Health (JH) is a Kenya-based organization that attempts to provide affordable, high-quality maternal and newborn healthcare through a chain of private health facilities in Nairobi. Initial assessment: JH needed to adopted quality improvement as an organization-wide strategy to optimize effectiveness and efficiency. Choice of solution: Value Stream Mapping, a Lean Management tool, was used to engage staff in prioritizing opportunities to improve clinical outcomes and patient-centered quality of care...
November 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29115768/lean-thinking-in-emergency-departments-concepts-and-tools-for-quality-improvement
#3
Frances Bruno
The lean approach is a viable framework for reducing costs and enhancing the quality of patient care in emergency departments (EDs). Reports on lean-inspired quality improvement initiatives are rapidly growing but there is little emphasis on the philosophy behind the processes, which is the essential ingredient in sustaining transformation. This article describes lean philosophy, also referred to as lean, lean thinking and lean healthcare, and its main concepts, to enrich the knowledge and vocabulary of nurses involved or interested in quality improvement in EDs...
October 12, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29110077/exploring-the-relationship-between-threat-related-changes-in-anxiety-attention-focus-and-postural-control
#4
Kyle J Johnson, Martin Zaback, Craig D Tokuno, Mark G Carpenter, Allan L Adkin
Individuals report directing attention toward and away from multiple sources when standing under height-related postural threat, and these changes in attention focus are associated with postural control modifications. As it is unknown whether these changes generalize to other types of threat situations, this study aimed to quantify changes in attention focus and examine their relationship with postural control changes in response to a direct threat to stability. Eighty young adults stood on a force plate fixed to a translating platform...
November 6, 2017: Psychological Research
https://www.readbyqxmd.com/read/29106028/association-of-high-anti-cyclic-citrullinated-peptide-seropositivity-and%C3%A2-lean-mass-index-with-low-bone-mineral-density-in-rheumatoid-arthritis
#5
Katherine D Wysham, Dolores M Shoback, John B Imboden, Patricia P Katz
OBJECTIVE: Osteoporotic fractures are associated with high morbidity and mortality. Persons with rheumatoid arthritis (RA) have twice the risk of osteoporosis-related fracture than age-matched controls, the causes for which remain unknown. We investigated contributions of RA characteristics, medication use, and body composition to low bone mineral density (BMD) in patients with RA. METHODS: Data were from the Arthritis, Body Composition, and Disability Study (n=138; 82 women, 56 men)...
November 5, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29103713/short-communication-circulating-fatty-acylcarnitines-are-elevated-in-overweight-periparturient-dairy-cows-in-association-with-sphingolipid-biomarkers-of-insulin-resistance
#6
J E Rico, Y Zang, N J Haughey, A G Rius, J W McFadden
Defects in mitochondrial fatty acid processing are associated with the development of fatty liver disease, inflammation, and insulin resistance in overweight nonruminants. Surplus fatty acids (FA) and defects in FA oxidation favor the accumulation of fatty acylcarnitines (FAC) and the sphingolipid ceramide. Moreover, elevated circulating FAC and ceramide concentrations are inversely related to insulin action. Because we have previously demonstrated that plasma ceramide levels increase during the transition from gestation to lactation, our aim was to determine whether changes in plasma medium- and long-chain FAC levels are related to circulating FA and sphingolipids in peripartal dairy cows...
November 2, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/29099975/chylomicron-derived-fatty-acid-spillover-in-adipose-tissue-a-signature-of-metabolic-health
#7
Marie-Eve Piché, Siôn A Parry, Fredrik Karpe, Leanne Hodson
Context and Objective: Spillover of fatty acids (FAs) into the plasma non-esterified fatty acid (NEFA) pool, due to an inability of adipose tissue to accommodate sufficient fat uptake, has been suggested to be a contributing factor to insulin resistance in obesity. Using specific labelling techniques, we compared the proportion of spillover-derived NEFA across a range of adiposity. Participants and Methods: Seventy-one healthy men and women (22-64 years; BMI 20-35 kg/m2) were fed a mixed meal (40g fat) containing [U13C]palmitate to assess the contribution of chylomicron-derived spillover FAs...
November 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#8
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
November 3, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29094215/insulin-resistance-and-glycine-metabolism-in-humans
#9
REVIEW
M Adeva-Andany, G Souto-Adeva, E Ameneiros-Rodríguez, C Fernández-Fernández, C Donapetry-García, A Domínguez-Montero
Plasma glycine level is low in patients with obesity or diabetes and the improvement of insulin resistance increases plasma glycine concentration. In prospective studies, hypoglycinemia at baseline predicts the risk of developing type 2 diabetes and higher serum glycine level is associated with decreased risk of incident type 2 diabetes. Consistently, plasma glycine concentration is lower in the lean offspring of parents with type 2 diabetes compared to healthy subjects. Among patients with type 2 diabetes, hypoglycinemia occurs before clinical manifestations of the disease, but the pathophysiological mechanisms underlying glycine deficit and its potential clinical repercussions are unclear...
November 1, 2017: Amino Acids
https://www.readbyqxmd.com/read/29081311/nutrient-density-addressing-the-challenge-of-obesity
#10
Adam Drewnowski
Obesity rates are increasing worldwide. Potential reasons include excessive consumption of sugary beverages and energy-dense foods instead of more nutrient-rich options. On a per kJ basis, energy-dense grains, added sugars and fats cost less, whereas lean meats, seafood, leafy greens and whole fruit generally cost more. Given that consumer food choices are often driven by price, the observed social inequities in diet quality and health can be explained, in part, by nutrition economics. Achieving a nutrient-rich diet at an affordable cost has become progressively more difficult within the constraints of global food supply...
October 30, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/29073733/tracing-the-breeding-farm-of-domesticated-pig-using-feature-selection-sus-scrofa
#11
Taehyung Kwon, Joon Yoon, Jaeyoung Heo, Wonseok Lee, Heebal Kim
OBJECTIVE: Increasing food safety demands in the animal product market have created a need for a system to trace the food distribution process, from the manufacturer to the retailer, and genetic traceability is an effective method to trace the origin of animal products. In this study, we successfully achieved the farm tracing of 6,018 multi-breed pigs, using single nucleotide polymorphism (SNP) markers strictly selected through least absolute shrinkage and selection operator (LASSO) feature selection...
November 2017: Asian-Australasian Journal of Animal Sciences
https://www.readbyqxmd.com/read/29072887/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#12
Gabriele Arcidiacono, Dominik T. Matt, Erwin Rauch
Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29066466/dgk%C3%AE-deficiency-protects-against-peripheral-insulin-resistance-and-improves-energy-metabolism
#13
Boubacar Benziane, Melissa L Borg, Robby Z Tom, Isabelle Riedl, Julie Massart, Marie Björnholm, Marc Gilbert, Alexander V Chibalin, Juleen R Zierath
Diacylglycerol kinases (DGK) regulate the balance between diacylglycerol (DAG) and phosphatidic acid. DGKζ is highly abundant in skeletal muscle and induces fiber hypertrophy. We hypothesized DGKζ influences functional and metabolic adaptions in skeletal muscle and whole body fuel utilization. DAG content was increased in skeletal muscle and adipose tissue, but unaltered in liver of DGKζ knockout (KO) mice. Linear growth, body weight, fat mass, and lean mass was reduced in DGKζ KO versus wild-type mice...
October 24, 2017: Journal of Lipid Research
https://www.readbyqxmd.com/read/29065578/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#14
Gabriele Arcidiacono, Dominik T Matt, Erwin Rauch
Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29064827/mental-body-transformation-deficits-in-patients-with-chronic-balance-disorders
#15
J H J Allum, W Langewitz, M Sleptsova, A Welge-Luessen, F Honegger, T H Schatz, C L Biner, C Maguire, D A Schmid
BACKGROUND: Movements may be generated consistent with imagining one's own body transformed or "disembodied" to a new position. Based on this concept we hypothesized that patients with objective balance deficits (obj-BD) would have altered neural transformation processes executing own body transformation (OBT) with functional consequences on balance control. Also we examined whether feeling unstable due to dizziness only (DO), without an obj-BD, also lead to an impaired OBT. METHODS: 32 patients with chronic dizziness were tested: 16 patients with obj-BD as determined by balance control during a sequence of stance and gait tasks, 16 patients with dizziness only (DO)...
2017: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/29059115/using-lean-process-improvement-to-enhance-safety-and-value-in-orthopaedic-surgery-the-case-of-spine-surgery
#16
Rajiv Sethi, Vijay Yanamadala, Douglas C Burton, Robert Shay Bess
Lean methodology was developed in the manufacturing industry to increase output and decrease costs. These labor organization methods have become the mainstay of major manufacturing companies worldwide. Lean methods involve continuous process improvement through the systematic elimination of waste, prevention of mistakes, and empowerment of workers to make changes. Because of the profit and productivity gains made in the manufacturing arena using lean methods, several healthcare organizations have adopted lean methodologies for patient care...
November 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29058595/world-wide-immunoscore-task-force-meeting-report-from-the-melanoma-bridge-napoli-november-30th-december-3rd-2016
#17
Jerome Galon, Alessandro Lugli, Carlo Bifulco, Franck Pages, Giuseppe Masucci, Francesco M Marincola, Paolo A Ascierto
The predictive accuracy of the traditional staging system is based on disease progression as a tumour cell-autonomous process, but it fails to incorporate the effects of the host immune response. A precise analysis of the immune component of the tumour microenvironment by computer-based analysis may be essential to managing patients better, opening the road to an expertise in this new emerging field. The Immunoscore as a new possible approach in the classification of cancer, designated TNM-Immune, studied in colon cancer patients with predictive and prognostic value...
October 20, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29054303/cost-savings-of-standardization-of-thoracic-surgical-instruments-the-process-of-lean
#18
Kyle H Cichos, Paul L Linsky, Benjamin Wei, Douglas J Minnich, Robert J Cerfolio
BACKGROUND: Our objective is to show the effect that standardization of surgical trays has on the number of instruments sterilized and on cost. METHODS: We reviewed our most commonly used surgical trays with the 3 general thoracic surgeons in our division and agreed upon the least number of surgical instruments needed for mediastinoscopy, video-assisted thoracoscopic surgery, robotic thoracic surgery, and thoracotomy. RESULTS: We removed 59 of 79 instruments (75%) from the mediastinoscopy tray, 45 of 73 (62%) from the video-assisted thoracoscopic surgery tray, 51 of 84 (61%) from the robotic tray, and 50 of 113 (44%) from the thoracotomy tray...
October 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29051977/-industry%C3%A2-4-0-in-pathology-process-optimization-by-lean-management
#19
EDITORIAL
C Röcken
No abstract text is available yet for this article.
November 2017: Der Pathologe
https://www.readbyqxmd.com/read/29045684/lean-management-to-support-choosing-wisely-in-healthcare-the-first-evidence-from-a-systematic-literature-review
#20
Maria Crema, Chiara Verbano
Purpose: Choosing Wisely (CW) is an emergent approach to identify and reduce unnecessary care, such as tests and treatments that do not add value for patients and may even cause harm. The purpose of this paper is to investigate whether and how Lean Healthcare Management (LHM) can support CW objectives, focusing on customer needs and on waste elimination. Data sources: A systematic literature review has been performed in Scopus, PubMed and Web of Science. Study selection: Peer reviewed articles published in English language have been selected...
October 17, 2017: International Journal for Quality in Health Care
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