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https://www.readbyqxmd.com/read/29290247/can-we-do-that-here-establishing-the-scope-of-surgical-practice-at-a-new-safety-net-community-hospital-through-a-transparent-collaborative-review-of-physician-privileges
#1
Sean M O'Neill, Sarah Seresinghe, Arun Sharma, Tara A Russell, L'Orangerie Crawford, Stanley K Frencher
PROBLEM DEFINITION: Stewarding of physician privileges wisely is imperative, but no guidelines exist for how to incorporate system-level factors in privileging decisions. A newly opened, safety-net community hospital tailored the scope of surgical practice through review of physician privileges. Martin Luther King, Jr. Community Hospital is a public-private partnership, safety-net institution in South Los Angeles that opened in July 2015. It has 131 beds, including a 28-bed emergency department, a 20-bed ICU, and 5 operating rooms...
January 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29283131/the-diagnostic-accuracy-of-single-and-five-field-fundus-photography-in-diabetic-retinopathy-screening-by-primary-care-physicians
#2
Parinya Srihatrai, Thanita Hlowchitsieng
PURPOSE: The aim is to evaluate the diagnostic accuracy of digital fundus photography in diabetic retinopathy (DR) screening at a single university hospital. METHODS: This was a cross-sectional hospital-based study. One hundred and ninety-eight diabetic patients were recruited for comprehensive eye examination by two ophthalmologists. Five-field fundus photographs were taken with a digital, nonmydriatic fundus camera, and trained primary care physicians then graded the severity of DR present by single-field 45° and five-field fundus photography...
January 2018: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29280907/a-quality-improvement-initiative-to-reduce-out-of-icu-cardiopulmonary-arrests-in-a-tertiary-care-hospital-in-india-a-2-year-learning-experience
#3
Vidya P Menon, Preetha Prasanna, Fabia Edathadathil, Sabarish Balachandran, Merlin Moni, Dipu Sathyapalan, Rajesh D Pai, Sanjeev Singh
QUALITY PROBLEM OR ISSUE: To assess impact of medical emergency team (MET) in reducing "out-of-ICU" cardiopulmonary arrests and identify barriers to its optimal utilization. INITIAL ASSESSMENT: Frequently observed critical clinical signs and laboratory values of "out-of-ICU" crashes were used to develop Amrita Early Warning Criteria. CHOICE OF SOLUTION: A physician-led MET was established to respond to code MET, activated by a primary nurse...
January 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29275918/double-scan-ct-rates-an-opportunity-for-facility-based-radiologist-measures-in-the-quality-payment-program
#4
Andrew B Rosenkrantz, James S Babb, Gregory N Nicola, Ezequiel Silva, Wenyi Wang, Richard Duszak
PURPOSE: The Medicare Access and CHIP Reauthorization Act (MACRA) provides CMS flexibility to evaluate radiologists using hospital outpatient quality measures in place of conventional physician measures. We explore radiologist characteristics associated with variation in performance in two such measures: abdomen and chest CT "double scan" rates (percentage of total examinations performed both with and without intravenous contrast). METHODS: Radiologists' claims for abdomen and chest CT examinations in a facility setting were identified using 2014 Medicare Physician and Other Supplier data...
December 21, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29247454/dermatologists-across-europe-underestimate-depression-and-anxiety-results-from-3635-dermatological-consultations
#5
F J Dalgard, Å Svensson, U Gieler, L Tomas-Aragones, L Lien, F Poot, G B E Jemec, L Misery, C Szabo, D Linder, F Sampogna, A W M Evers, J Anders Halvorsen, F Balieva, J Szepietowski, A Lvov, S E Marron, I K Alturnay, A Y Finlay, S S Salek, J Kupfer
BACKGROUND: It was recently demonstrated that a significant number of patients with common skin diseases across Europe are clinically depressed and anxious. Studies have shown that physicians not trained as psychiatrist underdiagnose depression. This has not been explored among dermatologists. OBJECTIVES: To estimate the concordance between clinical assessment of depression and anxiety by a dermatologist and assessment with the Hospital Anxiety and Depression Scale...
December 16, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/29239899/stroke-severity-quantification-by-critical-care-physicians-in-a-mobile-stroke-unit
#6
Maren R Hov, Jo Røislien, Thomas Lindner, Erik Zakariassen, Kristi C G Bache, Volker M Solyga, David Russell, Christian G Lund
BACKGROUND: Cerebral revascularization in acute stroke requires robust diagnostic tools close to symptom onset. The quantitative National Institute of Health Stroke Scale (NIHSS) is widely used in-hospital, whereas shorter and less specific stroke scales are used in the prehospital field. This study explored the accuracy and potential clinical benefit of using NIHSS prehospitally. PATIENTS AND METHODS: Thirteen anesthesiologists trained in prehospital critical care enrolled patients with suspected acute stroke in a mobile stroke unit...
December 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29234837/injury-severity-in-polytrauma-patients-is-underestimated-using-the-injury-severity-score-a-single-center-correlation-study-in-air-rescue
#7
C Schröter, F Urbanek, C Frömke, M Winkelmann, P Mommsen, C Krettek, C Zeckey
PURPOSE: Prehospital estimation of injury severity is essential for prehospital therapy, deciding on the destination hospital and the associated emergency room care. The aim of this study was to compare prehospital estimates of the abbreviated injury scale (AIS) and the Injury Severity Score (ISS) by emergency physicians with the values of AIS and ISS of injury severity determined at the conclusion of diagnostics. METHODS: In this prospective study, the ISS was determined prehospital by emergency physicians...
December 12, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29223192/training-needs-for-dementia-care-in-china-from-the-perspectives-of-mental-health-providers-who-what-and-how
#8
Ling Xu, Hsin-Yi Hsiao, Wenchen Denq, Iris Chi
BACKGROUND: Acknowledging increasing demand of dementia care for patients in China, this paper aims to understand the training needs of dementia care from the perspectives of mental health providers by examining who should be the trainees, what should be the contents of training, and how to deliver the training in China. METHODS: Using purposive sampling, data were gathered via four focus group discussions with 40 mental health providers in Beijing, China, in 2011...
December 10, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/29215474/assessment-of-ileostomy-output-using-telemedicine-a-feasibility-trial
#9
Brian K Bednarski, Rebecca S Slack, Matthew Katz, Y Nancy You, John Papadopolous, Miguel A Rodriguez-Bigas, John M Skibber, Surena F Matin, George J Chang
BACKGROUND: Ileostomies are a routine part of the care of patients with rectal cancer, but are associated with significant risk for dehydration, readmission, and acute kidney injury. Telemedicine has proven beneficial in decreasing readmission in chronic medical illnesses, but its utility in patients with an ileostomy is not well studied. OBJECTIVE: The purpose of this study was to evaluate the feasibility of televideoconferencing in the assessment of ileostomy output...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29188913/-a-new-artificial-intelligence-tool-for-assessing-symptoms-in-patients-seeking-emergency-department-care-the-mediktor-application
#10
Elvira Moreno Barriga, Irene Pueyo Ferrer, Miquel Sánchez Sánchez, Montserrat Martín Baranera, Josep Masip Utset
OBJECTIVES: To analyze agreement between diagnoses issued by the Mediktor application and those of an attending physician, and to evaluate the usefulness of this application in patients who seek emergency care. MATERIAL AND METHODS: Prospective observational study in a tertiary care university hospital emergency department. Patients with medical problems and surgical conditions (surgery and injuries) who did not require immediate emergency care responded to the Mediktor questions on a portable computer tablet...
2017: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29182352/patients-perspectives-of-care-management-a-qualitative-study
#11
Ann S O'Malley, Deborah Peikes, Claire Wilson, Rachel Gaddes, Victoria Peebles, Timothy J Day, Janel Jin
OBJECTIVES: Risk-stratified care management is a cornerstone of patient-centered medical home models, but studies on patients' perspectives of care management are scarce. We explored patients' experiences with care management, what they found useful, and what needs improvement. STUDY DESIGN: Semi-structured qualitative telephone interviews. METHODS: We interviewed 43 high-risk patients or their caregivers who were receiving care management from 11 practices in CMS' Comprehensive Primary Care initiative, provided by nurse care managers (9 practices) or the physician (2 [solo] practices)...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29164969/accuracy-of-self-reported-family-history-of-cancer-mutation-status-and-tumor-characteristics-in-patients-with-early-onset-breast-cancer
#12
Annelie Augustinsson, Carolina Ellberg, Ulf Kristoffersson, Åke Borg, Håkan Olsson
BACKGROUND: The main objectives of this study were to evaluate the concordance between self-reported and registry-reported information regarding family history of breast cancer (BC), ovarian cancer (OvC) and other types of cancer in first-degree relatives of patients with early onset BC, and to determine the frequency of mutation carriers and non-mutation carriers. The secondary objective was to describe tumor characteristics for each mutation group. MATERIAL AND METHODS: Between 1993 and 2013, 231 women who were ≤35 years old when diagnosed with BC were registered at the Oncogenetic Clinic at Skåne University Hospital in Lund, Sweden...
November 22, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/29133321/can-physical-assessment-techniques-aid-diagnosis-in-people-with-chronic-fatigue-syndrome-myalgic-encephalomyelitis-a-diagnostic-accuracy-study
#13
Lucy Hives, Alice Bradley, Jim Richards, Chris Sutton, James Selfe, Bhaskar Basu, Kerry Maguire, Gail Sumner, Tarek Gaber, Annice Mukherjee, Raymond N Perrin
OBJECTIVE: To assess five physical signs to see whether they can assist in the screening of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and potentially lead to quicker treatment. METHODS: This was a diagnostic accuracy study with inter-rater agreement assessment. Participants recruited from two National Health Service hospitals, local CFS/ME support groups and the community were examined by three practitioners on the same day in a randomised order...
November 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/29113532/the-grounded-theory-of-trust-building
#14
Monir Ramezani, Fazlollah Ahmadi, Eesa Mohammadi, Anoshirvan Kazemnejad
BACKGROUND: Despite the growing importance of spiritual care, the delivery of spiritual care is still an area of disagreement among healthcare providers. OBJECTIVE: To develop a grounded theory about spiritual care delivery based on Iranian nurses' perceptions and experiences. A grounded theory approach: A qualitative study using the grounded theory approach. Participants and research context: Data were collected through holding 27 interviews with 25 participants (17 staff nurses, 3 physicians, 3 patients, 1 family member, and 1 nurse assistant)...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/29112522/implementing-the-national-institute-for-health-and-clinical-excellence-head-injury-2014-guidelines-in-a-major-children-s-hospital-emergency-department
#15
Natalie Ramjeeawon, Fiona Lecky, Derek P Burke, Shammi Ramlakhan
OBJECTIVES AND BACKGROUND: Head injury is a common paediatric emergency department presentation. The National Institute for Health and Clinical Excellence updated its guidance in January 2014 regarding imaging required for adults and children following a head injury (CG176). This study looked at the rates of computed tomography (CT) head scans performed and adherence rates to CG176. PATIENTS AND METHODS: A single-centre audit was carried out, examining imaging practice in children with head injuries...
November 6, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29103313/how-effective-are-patient-education-materials-in-educating-patients
#16
Ayla Keçeci, Sadiye Toprak, Seçil Kiliç
The aim of this research was to evaluate the patient education materials prepared and published by nurses and physicians in terms of the qualitative properties of these materials, including readability, understandability, and actionability. A total of 38 patient education materials prepared by nurses and physicians in a university hospital in Turkey were evaluated. The readability of the materials was assessed using the formulas proposed by Atesman and Cetinkaya. The Patient Education Materials Assessment Tool (PEMAT) form was used for estimating the understandability and actionability...
November 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/29091930/self-administered-vitamin-d-status-predictor-older-adults-are-able-to-use-a-self-questionnaire-for-evaluating-their-vitamin-d-status
#17
Cedric Annweiler, Anastasiia Kabeshova, Alix Callens, Marie-Liesse Paty, Guillaume T Duval, Michael F Holick
BACKGROUND: The 16-item Vitamin D Status Predictor (VDSP) questionnaire helps to identify, without resorting to a blood test, older adults with low vitamin D concentrations. Our objective was to determine whether a self-administered VDSP was concordant with the VDSP administered by a physician, and to examine the concordance of every single item of the VDSP. METHODS: A total of 349 older in- and outpatients (mean, 83.2±7.2years; 59% female) were consecutively recruited in the geriatric ward of the University Hospital of Angers, France...
2017: PloS One
https://www.readbyqxmd.com/read/29073982/drug-policy-in-hungary
#18
András Inotai, Marcell Csanádi, András Harsányi, Bertalan Németh
We present a brief overview of the health care system in Hungary, focusing particularly on the pricing and reimbursement procedures of medicines. The National Institute of Health Insurance Fund Management is responsible for the administration of the health insurance system and public reimbursement of health technologies. There are two major types of reimbursement techniques in the outpatient care: the normative reimbursement is applied to all physicians and may be used for all indications listed in the Summary of Product Characteristics, and the indication-linked reimbursement is applied only to specialists who are authorized to prescribe the drug...
September 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29059693/-ethics-consultation-on-the-icu-the-clinically-oriented-method-of-counselling
#19
Gerald Neitzke
When ethical conflicts arise on the ICU, an ethics case consultation is useful. The aim of this consult is a qualified reflection of the moral values, convictions and assumptions involved in the case. The "clinically oriented method of counselling" provides an adequate structure for case consultations on the ICU. The moral assumptions and estimations contained in medical indications, prognosis, therapeutic aims, risk-benefit assessment and issues of quality of life are discussed and a consensus is sought for...
October 23, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29052231/audit-of-appropriate-use-of-platelet-transfusions-validation-of-adjudication-criteria
#20
M Etchells, J Spradbrow, R Cohen, Y Lin, C Armali, L Lieberman, C Cserti-Gazdewich, J Pendergrast, J Callum
BACKGROUND AND OBJECTIVES: Platelet (PLT) transfusions must be used appropriately, as they are in chronic short supply, costly and risky to patients. The goals of this audit were to: (1) validate preset adjudication criteria through an audit of appropriateness at four large academic hospitals; (2) identify variability in appropriateness across medical services, physician specialties or hospital locations; and (3) inform logistical or educational interventions that may reduce inappropriate use...
October 19, 2017: Vox Sanguinis
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