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https://www.readbyqxmd.com/read/28334556/impact-of-a-hospitalwide-quality-improvement-initiative-on-emergency-department-throughput-and-crowding-measures
#1
James D Melton, Fred Blind, A Brad Hall, Maureen Leckie, April Novotny
BACKGROUND: This pre- and postintervention analysis evaluates the impact of a systemwide, comprehensive, executively supported quality improvement (QI) project on emergency department (ED) throughput measures and crowding in a large nonacademic community hospital. METHODS: The two primary endpoints used to assess the impact of the project were (1) the percentage of all patients who were door-in to door-out in less than three hours and (2) the percentage of patients who left without being seen (LWBS)...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28277047/patients-with-chronic-pain-may-need-extra-support-when-prescribed-physical-activity-in-primary-care-a-qualitative-study
#2
Monica Joelsson, Susanne Bernhardsson, Maria E H Larsson
BACKGROUND: Physical activity plays an important role in the prevention and treatment of chronic musculoskeletal pain, but chronic pain may implicate a poor rehabilitation outcome. The concept of physical activity on prescription (PAP) is a therapeutic option for various diseases, but there is a lack of knowledge about how patients with chronic musculoskeletal pain experience receiving the prescription. OBJECTIVES: The objective of this study was to describe the experiences of and thoughts about receiving a prescription for physical activity of people with chronic musculoskeletal pain...
March 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28249938/remifentanil-for-procedural-sedation-a-systematic-review-of-the-literature
#3
Magdalena Kisilewicz, Hans Rosenberg, Christian Vaillancourt
OBJECTIVE: We sought to determine the performance characteristics of remifentanil as an agent of procedural sedation and analgesia (PSA) for adult and paediatric patients undergoing procedures similar to those executed in the ED. METHODS: We systematically reviewed electronically published literature, grey literature, conference proceedings and trial registries from 1946 to 2015. Outcome measures included PSA effectiveness, recovery time, patient safety and resource management...
March 1, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28249636/adopting-new-medical-technologies-in-russian-hospitals-what-causes-inefficiency-qualitative-study
#4
Sergey Shishkin, Liudmila Zasimova
The adoption of new medical technologies often generates losses in efficiency associated with the excess or insufficient acquisition of new equipment, an inappropriate choice (in terms of economic and clinical parameters) of medical equipment, and its poor use. Russia is a good example for exploring the problem of the ineffective adoption of new medical technologies due to the massive public investment in new equipment for medical institutions in 2006-2013. This study examines the procurement of new technologies in Russian hospitals to find the main causes of inefficiency...
March 2, 2017: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/28237001/radioiodine-therapy
#5
REVIEW
Markus Luster, Andreas Pfestroff, Heribert Hänscheid, Frederik A Verburg
Radioiodine therapy for benign and malignant thyroid disease rose at the birth of nuclear medicine. Since then, this procedure has been performed countless of times in adult and in pediatric patients alike, and has contributed to a normalization of life expectancy in all but I-131 refractory differentiated thyroid cancer (DTC) cases. As (131)I therapy in children is almost exclusively given for DTC, this review of radioiodine therapy in children focuses on patients with malignant thyroid disease. The aim of the present review is to provide an overview of the indications, practical execution, and controversies surrounding (131)I therapy for malignant tumors in pediatric patients...
March 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28219100/-current-developments-of-the-interdisciplinary-subject-rehabilitation-physical-medicine-naturopathic-treatment-in-the-german-medical-faculties-results-of-the-dgrw-faculty-survey-in-2015
#6
S Schmidt, C Bergelt, R Deck, G Krischak, M Morfeld, M Michel, S R Schwarzkopf, K Spyra, S Walter, W Mau
To ascertain the current development of the rehabilitation-related medical teaching in the interdisciplinary subject Rehabilitation, Physical Medicine, Naturopathic Treatment (Q12) regarding its execution, content, exams and evaluation of teaching at the Medical Faculties the German Society of Rehabilitation Science conducted another faculty survey in 2015. Representatives of all degree courses of human medicine in German Universities (n=41) received a pseudonymised standardised questionnaire in summer 2015...
February 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28217305/redesigning-care-delivery-with-patient-support-personnel-learning-from-accountable-care-organizations
#7
Ksenia O Gorbenko, Taressa Fraze, Valerie A Lewis
INTRODUCTION: Accountable care organizations (ACOs) are a value-based payment model in the United States rooted in holding groups of healthcare providers financially accountable for the quality and total cost of care of their attributed population. To succeed in reaching their quality and efficiency goals, ACOs implement a variety of care delivery changes, including workforce redesign. Patient support personnel (PSP)-non-physician staff such as care coordinators, community health workers, and others-are critical to restructuring care delivery...
September 2016: Int J Care Coord
https://www.readbyqxmd.com/read/28190508/navigating-the-clinical-trial-pathway-conception-design-execution-and-results-dissemination
#8
John S Sampalis, Joanne Watson, Stella Boukas, Marianna Boukas, Natalie Harvey, Sanjay Machado, Michel Bordeleau, Emmanouil Rampakakis
Dr Sampalis is founder, Chief Executive Officer, and Chief Scientific Officer of JSS Medical Research Inc, founded in 1997. He is a tenured professor of Surgery and Epidemiology & Biostatistics of McGill University, the University of Montreal and University of Laval. Recognized as a leading clinical epidemiologist and one of the top trauma researchers in Canada, he possesses extensive expertise in health services research, clinical trials, and offers services as a Research and Epidemiological Consultant for numerous pharmaceutical companies, hospitals and government organizations and agencies...
March 2017: Surgery
https://www.readbyqxmd.com/read/28177323/potential-consequences-of-the-immigration-ban-on-the-scientific-community
#9
Hossein Ardehali
On January 27, 2017, President Trump signed an executive order banning the citizens of 7 countries from obtaining US entry visas for the next 90 days. Since the announcement, the news media have devoted a large portion of their coverage to the ban and its political ramifications. There have been arguments made by both sides that the ban will make our country safer, while others have argued that this executive order will result in the weakening of our country and bolstering of our enemies. As a physician-scientist who was born in Iran and immigrated to the US, I will stay away from the politics of this executive order; rather, I want to discuss the impact of the immigration ban on scientific discourse, education, and research programs, and how it may influence the dissemination of knowledge to physicians and scientists in low- and middle-income countries...
March 1, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28166076/bedside-ultrasound-in-the-emergency-department-to-detect-hydronephrosis-for-the-evaluation-of-suspected-ureteric-colic
#10
R Shrestha, R M Shakya, A Khan A
Background Renal colic is a common emergency department presentation. Hydronephrosis is indirect sign of urinary obstruction which may be due to obstructing ureteric calculus and can be detected easily by bedside ultrasound with minimal training. Objective To compare the accuracy of detection of hydronephrosis performed by the emergency physician with that of radiologist's in suspected renal colic cases. Method This was a prospective observational study performed over a period of 6 months. Patients >8 years with provisional diagnosis of renal colic with both the bedside ultrasound and the formal ultrasound performed were included...
April 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/28157064/the-employers-perspective-on-how-phd-training-affects-physicians-performance-in-the-clinic
#11
Pernille Andreassen, Lise Wogensen, Mette Krogh Christensen
INTRODUCTION: An increase in the number of MD-PhDs has sparked debate as to how physicians with PhD research training contribute in the clinic. This study focuses on the development and employment situation of MD-PhDs from Aarhus University, Denmark, and on the impact of MD-PhDs in the clinic as seen from the employers' perspective. METHODS: The study is based on a mixed methods approach using both quantitative and qualitative data. Quantitative data hail from existing statistical data and reports, while the qualitative data stem from semi-structured interviews with six executive consultants and 36 members of appointment committees, mainly from hospitals in the Central Denmark Region...
February 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28152753/data-driven-quality-improvement-in-an-oncology-patient-centered-medical-home
#12
Maureen Lowry, Brian Flounders, Susan Higman Tofani
54 Background: In a 2012 abstract, Data driven transformation for an Oncology Patient-Centered Medical Home, Consultants in Medical Oncology (CMOH) demonstrated that standardized processes and enhanced IT capabilities (IRIS software app) provided a rapid learning system for the practice. Iris aggregated data became the basis for Quality Improvement Projects (QIPs) allowing CMOH to continue to improve in quality and cost measures. Deviation from performance trend is readily identifiable, providing operational direction...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28146449/a-taxonomy-of-delivery-and-documentation-deviations-during-delivery-of-high-fidelity-simulations
#13
William R McIvor, Arna Banerjee, John R Boulet, Tanja Bekhuis, Eugene Tseytlin, Laurence Torsher, Samuel DeMaria, John P Rask, Matthew S Shotwell, Amanda Burden, Jeffrey B Cooper, David M Gaba, Adam Levine, Christine Park, Elizabeth Sinz, Randolph H Steadman, Matthew B Weinger
INTRODUCTION: We developed a taxonomy of simulation delivery and documentation deviations noted during a multicenter, high-fidelity simulation trial that was conducted to assess practicing physicians' performance. Eight simulation centers sought to implement standardized scenarios over 2 years. Rules, guidelines, and detailed scenario scripts were established to facilitate reproducible scenario delivery; however, pilot trials revealed deviations from those rubrics. A taxonomy with hierarchically arranged terms that define a lack of standardization of simulation scenario delivery was then created to aid educators and researchers in assessing and describing their ability to reproducibly conduct simulations...
February 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28145944/transforming-medical-assessment-integrating-uncertainty-into-the-evaluation-of-clinical-reasoning-in-medical-education
#14
Suzette Cooke, Jean-Francois Lemay
In an age where practicing physicians have access to an overwhelming volume of clinical information and are faced with increasingly complex medical decisions, the ability to execute sound clinical reasoning is essential to optimal patient care. The authors propose two concepts that are philosophically paramount to the future assessment of clinical reasoning in medicine: assessment in the context of "uncertainty" (when, despite all of the information that is available, there is still significant doubt as to the best diagnosis, investigation, or treatment), and acknowledging that it is entirely possible (and reasonable) to have more than "one correct answer...
January 31, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28138189/medical-students-perception-of-the-progress-test-as-a-quality-controlled-assessment-tool-for-improving-learning-and-teaching-at-a-public-sector-medical-college-in-saudi-arabia
#15
Kamran Sattar, Tauseef Ahmad, Mahmoud Salah Khalil, Mona Mohamed Soliman, Gominda Giatry Punnamperuma, Hamza Mohammad Abdulghani
Progress test's distinguishing characteristics make it pertinent worldwide. We explored medical students' perceptions and opinions about Progress Test (PT) with a view to identifying areas concomitant with it's execution. This cross-sectional study took place at College of Medicine, Saudi Arabia, during the academic year 2015-16. A questionnaire (14 items) was administered. Reason for majority n=96 (89.7%) of the total participants to take the PT was their keenness to compare their academic standing with their peers from other participating medical colleges...
February 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28129166/emulation-of-physician-tasks-in-eye-tracked-virtual
#16
Jason Orlosky, Yuta Itoh, Maud Ranchet, Kiyoshi Kiyokawa, John Morgan, Hannes Devos
For neurodegenerative conditions like Parkinson's disease, early and accurate diagnosis is still a difficult task. Evaluations can be time consuming, patients must often travel to metropolitan areas or different cities to see experts, and misdiagnosis can result in improper treatment. To date, only a handful of assistive or remote methods exist to help physicians evaluate patients with suspected neurological disease in a convenient and consistent way. In this paper, we present a low-cost VR interface designed to support evaluation and diagnosis of neurodegenerative disease and test its use in a clinical setting...
January 23, 2017: IEEE Transactions on Visualization and Computer Graphics
https://www.readbyqxmd.com/read/28128459/a-hybrid-methodology-for-modeling-risk-of-adverse-events-in-complex-health-care-settings
#17
Reza Kazemi, Ali Mosleh, Meghan Dierks
In spite of increased attention to quality and efforts to provide safe medical care, adverse events (AEs) are still frequent in clinical practice. Reports from various sources indicate that a substantial number of hospitalized patients suffer treatment-caused injuries while in the hospital. While risk cannot be entirely eliminated from health-care activities, an important goal is to develop effective and durable mitigation strategies to render the system "safer." In order to do this, though, we must develop models that comprehensively and realistically characterize the risk...
January 27, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/28127586/accrual-patterns-for-clinical-studies-involving-quantitative-imaging-results-of-an-nci-quantitative-imaging-network-qin-survey
#18
Brenda F Kurland, Sameer Aggarwal, Thomas E Yankeelov, Elizabeth R Gerstner, James M Mountz, Hannah M Linden, Ella F Jones, Kellie L Bodeker, John M Buatti
Patient accrual is essential for the success of oncology clinical trials. Recruitment for trials involving the development of quantitative imaging biomarkers may face different challenges than treatment trials. This study surveyed investigators and study personnel for evaluating accrual performance and perceived barriers to accrual and for soliciting solutions to these accrual challenges that are specific to quantitative imaging-based trials. Responses for 25 prospective studies were received from 12 sites...
December 2016: Tomography: a Journal for Imaging Research
https://www.readbyqxmd.com/read/28125456/coping-with-interdependencies-related-to-patient-choice-boundary-spanning-at-four-accountable-care-organizations
#19
Brian Hilligoss, Ann Scheck McAlearney, Paula H Song
BACKGROUND: Accountable care organizations (ACOs) are responsible for outcomes that are only partially under their control because patients may choose to self-refer outside the ACO, overuse resource-intensive services, or underuse evidence-based care. ACOs must devise boundary-spanning practices to manage these interdependencies related to patient choice. PURPOSE: The aim of this study was to identify, conceptualize, and categorize ACO efforts to cope with interdependencies related to patient choice...
January 25, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28121610/modern-physician-executives-not-your-father-s-cmo
#20
Zachary Hafner
The transformation of health care is fundamentally altering the environment in which health systems function, placing the CMO squarely at the center of a new reality where concepts like value, population health management, and outcomes-based payment are becoming key drivers of success.
November 2016: Managed Care
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