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Hospital quality

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https://www.readbyqxmd.com/read/27926797/cesarean-outcomes-in-us-birth-centers-and-collaborating-hospitals-a-cohort-comparison
#1
Patrick Thornton, Barbara L McFarlin, Chang Park, Kristin Rankin, Mavis Schorn, Susan Stapleton
INTRODUCTION: High rates of cesarean birth are a significant health care quality issue, and birth centers have shown potential to reduce rates of cesarean birth. Measuring this potential is complicated by lack of randomized trials and limited observational comparisons. Cesarean rates vary by provider type, setting, and clinical and nonclinical characteristics of women, but our understanding of these dynamics is incomplete. METHODS: We sought to isolate labor setting from other risk factors in order to assess the effect of birth centers on the odds of cesarean birth...
December 7, 2016: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/27926773/associations-of-specific-postoperative-complications-with-outcomes-after-elective-colon-resection-a-procedure-targeted-approach-toward-surgical-quality-improvement
#2
John E Scarborough, Jessica Schumacher, K Craig Kent, Charles P Heise, Caprice C Greenberg
Importance: Numerous quality initiatives have been implemented in an effort to minimize the onus of postoperative complications on clinical and economic outcomes after major surgery. It is unknown which complications have the greatest overall effect on these outcomes. Objective: To quantify the associations of specific postoperative complications with outcomes after elective colon resection. Design, Setting, and Participants: Patients undergoing elective colon resection between January 1, 2012, and December 31, 2013, who were included in the Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program were assessed for the development of specific types of postoperative complications...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27926675/improvement-in-total-joint-replacement-quality-metrics-year-one-versus-year-three-of-the-bundled-payments-for-care-improvement-initiative
#3
John M Dundon, Joseph Bosco, James Slover, Stephen Yu, Yousuf Sayeed, Richard Iorio
BACKGROUND: In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27926671/of-20-376-lumbar-discectomies-2-6-of-patients-readmitted-within-30-days-surgical-site-infection-pain-and-thromboembolic-events-are-the-most-common-reasons-for-readmission
#4
Matthew L Webb, Stephen J Nelson, Ameya Save, Jonathan Cui, Adam M Lukasiewicz, Andre M Samuel, Pablo J Diaz-Collado, Daniel D Bohl, Nathaniel T Ondeck, Ryan P McLynn, Jonathan N Grauer
STUDY DESIGN: A retrospective cohort study of prospectively collected data. OBJECTIVE: As an initial effort to address readmissions after lumbar discectomy, reasons for hospital readmission are identified and discussed. SUMMARY OF BACKGROUND DATA: Lumbar discectomy is a commonly performed procedure. The Affordable Care Act codifies penalties for hospital readmissions. New quality-based reimbursements tied to readmissions call for a better understanding of the causes of readmission after procedures such as lumbar discectomy...
December 6, 2016: Spine
https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#5
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27926632/a-pooled-analysis-of-robotic-versus-laparoscopic-surgery-for-colon-cancer
#6
Bo-Shi Duan, Guo-Hua Zhao, Helen Yang, Yue Wang
OBJECTIVE: An increasing number of studies have been reported since the "Da Vinci" Robotic System was used in gastrointestinal disease. Thus, we conducted this meta-analysis to evaluate the safety and efficacy of robotic colectomy (RC) compared with laparoscopic colectomy (LC) in the treatment of colon cancer. METHOD: A systematic search of Medline, Embase databases, and the Cochrane Library was performed to identify studies that compared RC and LC and were published up to February 2015...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27926626/frailty-assessed-by-the-forecast-is-a-valid-tool-to-predict-short-term-outcome-after-transcatheter-aortic-valve-replacement
#7
Adrian R Kobe, Alexander Meyer, Hassan Elmubarak, Jörg Kempfert, Jovana Pavicevic, Francesco Maisano, Thomas Walther, Volkmar Falk, Simon H Sündermann
OBJECTIVE: The term frailty is frequently used during decision-making in transcatheter heart valve procedures. Nevertheless, frailty is still measured by eyeballing rather than by using standardized frailty assessments. In a previous study, we developed a frailty score in a cardiac surgical patient population including patients, who underwent transcatheter aortic valve replacement (TAVR). Here, we present the results from the subsequent validation study focusing on the TAVR cohort. METHODS: One hundred thirty patients underwent TAVR...
December 6, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27926624/improving-the-use-of-evidence-based-practice-and-research-utilization-through-the-identification-of-barriers-to-implementation-in-a-critical-access-hospital
#8
Dawn Carol Stavor, Judith Zedreck-Gonzalez, Rosemary L Hoffmann
OBJECTIVE: This study explored the relationship between perceived barriers to research use and the implementation of evidence-based practice (EBP) among rural hospital nurses. BACKGROUND: The Institute of Medicine recommends that 90% of clinical decisions be evidence based by 2020. METHODS: This descriptive, quality improvement study used a convenience sampling of registered nurses (RNs). Participants completed multiple questionnaires. RESULTS: Overall the attitude toward EBP was positive...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926622/reducing-chronic-obstructive-pulmonary-disease-30-day-readmissions-a-nurse-led-evidence-based-quality-improvement-project
#9
Joan Agee
Chronic obstructive pulmonary disease (COPD) is a debilitating disease resulting in frequent hospitalizations and increased healthcare costs. As leaders of multidisciplinary teams, acute care nurse leaders are challenged to reduce readmissions and costs. In October 2014, the Centers for Medicare and Medicaid Services expanded readmission penalties for 30-day readmissions to include COPD, making this an important issue for nurse leaders. This article describes how a regional medical center was able to decrease COPD readmissions...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926620/tapping-magnet%C3%A2-s-culture-of-innovation-to-improve-the-patient-experience
#10
Jennifer Rainer
As incentives grow for healthcare organizations to improve the patient experience, an increasing number choose to add consumers directly into their leadership structures. In this final installment about the value of patient and family advisory councils, the senior director of quality at a large, Magnet®-recognized Texas hospital explains how tapping into a well-established Magnet culture helped the organization adopt innovative approaches that produced positive change. Based on an interview with the author, she notes that seeing basic issues through patients' eyes challenged long-held beliefs and led to improvements in a wide variety of areas...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926563/truth-in-reporting-how-data-capture-methods-obfuscate-actual-surgical-site-infection-rates-within-a-health-care-network-system
#11
Liliana Bordeianou, Christy E Cauley, Donna Antonelli, Sarah Bird, David Rattner, Matthew Hutter, Sadiqa Mahmood, Deborah Schnipper, Marc Rubin, Ronald Bleday, Pardon Kenney, David Berger
BACKGROUND: Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. OBJECTIVE: This study aimed to compare database concordance...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926559/preoperative-immunonutrition-and-elective-colorectal-resection-outcomes
#12
Lucas W Thornblade, Thomas K Varghese, Xu Shi, Eric K Johnson, Amir Bastawrous, Richard P Billingham, Richard Thirlby, Alessandro Fichera, David R Flum
BACKGROUND: Randomized controlled trials demonstrate the efficacy of arginine-enriched nutritional supplements (immunonutrition) in reducing complications after surgery. The effectiveness of preoperative immunonutrition has not been evaluated in a community setting. OBJECTIVE: This study aims to determine whether immunonutrition before elective colorectal surgery improves outcomes in the community at large. DESIGN: This is a prospective cohort study with a propensity score-matched comparative effectiveness evaluation...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27925422/preventing-hospital-acquired-venous-thromboembolism-improving-patient-safety-with-interdisciplinary-teamwork-quality-improvement-analytics-and-data-transparency
#13
REVIEW
Anneliese M Schleyer, Ellen Robinson, Roxana Dumitru, Mark Taylor, Kimberly Hayes, Ronald Pergamit, Daphne M Beingessner, Mark C Zaros, Joseph Cuschieri
BACKGROUND: Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. OBJECTIVE: To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27925095/peritoneal-dialysis-family-care-for-chronic-kidney-disease-patients-in-home-based-treatment
#14
Joyce Martins Arimatea Branco Tavares, Marcia Tereza Luz Lisboa, Márcia de Assunção Ferreira, Glaucia Valente Valadares, Frances Valéria Costa E Silva
Objective: to propose a family care model for patients with chronic kidney disease in peritoneal dialysis based on evidence indicated by family members. Method: this was a qualitative descriptive study that used the Convergent Care Research method. It was conducted at a state hospital in Rio de Janeiro, including techniques for recording individual interviews and consisted of a group of 19 study participants. Data were analyzed according to the stages proposed by the method, generating a category that used a cultural question as the basis for patient care resulting in a proposal for home-based family care...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27925047/a-pioneering-healthcare-model-applying-large-scale-production-concepts-principles-and-performance-after-more-than-11-000-transplants-at-hospital-do-rim
#15
José Medina Pestana
The kidney transplant program at Hospital do Rim (hrim) is a unique healthcare model that applies the same principles of repetition of processes used in industrial production. This model, devised by Frederick Taylor, is founded on principles of scientific management that involve planning, rational execution of work, and distribution of responsibilities. The expected result is increased efficiency, improvement of results and optimization of resources. This model, almost completely subsidized by the Unified Health System (SUS, in the Portuguese acronym), has been used at the hrim in more than 11,000 transplants over the last 18 years...
October 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27924374/pain-relief-after-triamcinolone-infiltration-in-patients-with-bladder-pain-syndrome-with-hunner-s-ulcers
#16
Laura Mateu, Laura Izquierdo, Agustín Franco, Meritxell Costa, Nathan Lawrentschuk, Antonio Alcaraz
INTRODUCTION AND HYPOTHESIS: Bladder pain syndrome (BPS) is a chronic condition with severe implications in the patient's quality of life with no definitive treatment. Our objective was to assess pain relief after triamcinolone injection in patients with BPS with Hunner's ulcers (HU). METHODS: Retrospective study of 20 consecutive patients with BPS treated at the Hospital Clinic of Barcelona with triamcinolone injection with flexible cystoscope between 2015 and 2016...
December 6, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27924240/buffering-effect-of-job-resources-in-the-relationship-between-job-demands-and-work-to-private-life-interference-a-study-among-health-care-workers
#17
Sara Viotti, Daniela Converso
BACKGROUND: The present study aims at investigating whether and how (1) job demands and job resources are associated with work-to-private-life interference (WLI) and (2) job resources moderate the relationship between job demands and WLI. METHODS: Data were collected by a self-report questionnaire from three hospitals in Italy. The sample consisted of 889 health-care workers. RESULTS: All job demands (i.e., quantitative demands, disproportionate patient expectations, and verbal aggression) and job resources (i...
December 2016: Safety and Health At Work
https://www.readbyqxmd.com/read/27924187/evaluating-outcomes-in-patients-with-overactive-bladder-within-an-integrated-healthcare-delivery-system-using-a-treatment-patterns-analyzer
#18
Daniel B Ng, Melissa McCart, Christopher Klein, Chelsey Campbell, Robert Schoenhaus, Todd Berner
BACKGROUND: Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly. OBJECTIVE: To demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting...
September 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27924144/sleep-disturbances-in-children-with-attention-deficit-hyperactivity-disorder-adhd-comparative-study-with-healthy-siblings
#19
Sreelakshmi Vaidyanathan, Henal Shah, Tejas Gayal
OBJECTIVES: Sleep disturbances in children with ADHD impact their functioning and overall Quality of Life. This paper's purpose is to study the occurrence of sleep disturbances in children with ADHD, in comparison to their healthy siblings and further, within the ADHD group, to look for correlation between sleep disturbances and age, severity of symptoms, presentations of ADHD and illness parameters. METHODS: The parents of 120 children of age group between 5-16 years, (60 children diagnosed with ADHD as per DSM-5 criteria and 60 of their healthy siblings) consecutively enrolled from a hospital's Child Psychiatry Outpatient services were interviewed using Child Sleep Habits Questionnaire (CSHQ) and severity of ADHD symptoms was rated using ADHD - RS...
2016: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/27924106/inpatient-care-of-small-and-sick-newborns-in-healthcare-facilities
#20
REVIEW
S B Neogi, R Khanna, M Chauhan, J Sharma, G Gupta, R Srivastava, P K Prabhakar, A Khera, R Kumar, S Zodpey, V K Paul
Neonatal units in teaching and non-teaching hospitals both in public and private hospitals have been increasing in number in the country since the sixties. In 1994, a District Newborn Care Programme was introduced as a part of the Child Survival and Safe Motherhood Programme (CSSM) in 26 districts. Inpatient care of small and sick newborns in the public health system got a boost under National Rural Health Mission with the launch of the national programme on facility-based newborn care (FBNC). This has led to a nationwide creation of Newborn Care Corners (NBCC) at every point of child birth, newborn stabilization units (NBSUs) at First Referral Units (FRUs) and special newborn care units (SNCUs) at district hospitals...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
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