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Lean health care

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https://www.readbyqxmd.com/read/29787405/introducing-a-clinical-documentation-specialist-to-improve-coding-and-collectability-on-a-surgical-service
#1
Maria Castaldi, John McNelis
INTRODUCTION: Inadequate electronic medical record (EMR) documentation remains a significant source of revenue loss. The Department of Surgery in a trauma and tertiary care teaching hospital developed a revenue optimization initiative for inpatients on general, vascular, and trauma surgery and surgical intensive care unit services to enhance clinical documentation and increase revenue capture. METHODS: Clinical documentation management program included six trained clinical documentation specialists (CDSs), five physician assistants (PAs), directors of health information management (HIM), and two surgical champions...
May 18, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29778256/hepatitis-c-care-in-the-department-of-veterans-affairs-building-a-foundation-for-success
#2
REVIEW
Pamela S Belperio, Maggie Chartier, Rachel I Gonzalez, Angela M Park, David B Ross, Tim R Morgan, Lisa I Backus
The Department of Veterans Affairs (VA) has made significant progress in treating hepatitis C virus, experiencing more than a 75% reduction in veterans remaining to be treated since the availability of oral direct-acting antivirals. Hepatitis C Innovation Teams use lean process improvement and system redesign, resulting in practice models that address gaps in care. The key to success is creative improvements in veteran access to providers, including expanded use of nonphysician providers, video telehealth, and electronic technologies...
June 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29722750/a-survey-of-canadian-occupational-therapy-practices-to-prevent-pressure-injuries-among-wheelchair-users-via-weight-shifting
#3
W Ben Mortenson, Sarah C Thompson, Alison L Wright, Jeanette Boily, Kevin Waldorf, Sandy Leznoff
PURPOSE: The purpose of this study was to describe occupational therapy weight-shifting practices and explore recommended strategies for patients, healthcare staff, and family/caregivers across healthcare settings. DESIGN: Cross-sectional survey. SUBJECTS AND SETTING: Respondents included 97 currently practicing occupational therapists working in 5 main practice settings (ie, acute care, inpatient rehabilitation, outpatient rehabilitation, home and community care, and residential) from 9 out of 10 Canadian provinces...
May 2018: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29691161/experiences-and-perspectives-of-dietary-management-among-patients-on-hemodialysis-an-interview-study
#4
Jessica Stevenson, Allison Tong, Talia Gutman, Katrina L Campbell, Jonathan C Craig, Mark A Brown, Vincent W Lee
OBJECTIVES: Diet and fluid management can reduce mortality, serious comorbidities, and debilitating symptoms in patients on hemodialysis, but restrictions may also be a major burden, and nonadherence remains high. We aimed to describe the perspectives and experiences of patients on hemodialysis regarding their dietary management to understand both facilitators and barriers to adherence and to identify strategies to improve care. DESIGN AND METHODS: Semi-structured interviews were conducted with 35 people on maintenance hemodialysis from six dialysis units in New South Wales, Australia...
April 21, 2018: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29681169/system-wide-lean-implementation-in-health-care-a-multiple-case-study
#5
Federica Centauri, Pamela Mazzocato, Stefano Villa, Marta Marsilio
Background Lean practices have been widely used by health care organizations to meet efficiency, performance and quality improvement needs. The lean health care literature shows that the effective implementation of lean requires a holistic system-wide approach. However, there is still limited evidence on what drives effective system-wide lean implementation in health care. The existing literature suggests that a deeper understanding of how lean interventions interact with the organizational context is necessary to identify the critical variables to successfully sustain system-wide lean strategies...
January 1, 2018: Health Services Management Research
https://www.readbyqxmd.com/read/29673888/quantifying-the-burden-of-out-of-pocket-health-expenditure-in-india
#6
R Thakur, S Sangar, B Ram, M Faizan
OBJECTIVES: This study aims at analyzing the dimensions of the burden of out-of-pocket (OOP) health expenditure in rural and urban India between 1999-2000 and 2011-2012. STUDY DESIGN: Consumer Expenditure Survey data of the National Sample Survey for the period of 1999-2000 (55th round), 2004-2005 (61st round), and 2011-2012 (68th round) have been used in this study. METHODS: To analyze the dimension of OOP healthcare expenditure, this study has used headcount measure, which includes change in the percentage of population paying OOP health expenditure, concentration index of headcount, rank-weighted headcount, and gap measures, which includes average per capita gap (health expenditure), mean positive gap, concentration index, and rank-weighted gap for rural, urban, and all India level between 1999-2000 and 2011-2012...
April 16, 2018: Public Health
https://www.readbyqxmd.com/read/29667699/lean-perspectives-a-case-for-implementing-parent-child-relational-problem-screening
#7
Bryson C Okeoma
The purpose of the current study was to make a case for instituting parent-child relational problem (PCRP) screening as a standard of care in pediatric inpatient psychiatric units due to increasing evidence that PCRP may be an underreported problem that affects more adolescents than currently realized. Adolescents who are admitted to the hospital for mood exacerbation, suicidal ideation, self-harm behavior, or behavioral escalation may improve and be discharged. However, these adolescents often are readmitted, which may be associated with parent-child relational factors...
April 17, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29642955/successful-implementation-of-lean-as-a-managerial-principle-in-health-care-a-conceptual-analysis-from-systematic-literature-review
#8
Riikka Maijala, Sini Eloranta, Tero Reunanen, Tuija S Ikonen
PURPOSE: The aim of this study was to identify and analyze the characteristics of leadership and management associated with a successful Lean thinking adaptation in healthcare. DESIGN: A systematic literature review was undertaken using electronic databases: PubMed, PubMed Systematic Review, ABI/INFORM, Business Source Complete, Emerald, JBI, and Cinahl. Inclusion criteria were: (i) a description of Lean management or leadership in health care, (ii) a reference to Lean thinking, (iii) a peer-reviewed original research article or a literature review, and (iv) a full text article available in English...
April 12, 2018: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29615014/assessing-the-implementation-processes-of-a-large-scale-multi-year-quality-improvement-initiative-survey-of-health-care-providers
#9
Donna Goodridge, Masud Rana, Elizabeth L Harrison, Thomas Rotter, Roy Dobson, Gary Groot, Sonia Udod, Joshua Lloyd
BACKGROUND: Beginning in 2012, Lean was introduced to improve health care quality and promote patient-centredness throughout the province of Saskatchewan, Canada with the aim of producing coordinated, system-wide change. Significant investments have been made in training and implementation, although limited evaluation of the outcomes have been reported. In order to better understand the complex influences that make innovations such as Lean "workable" in practice, Normalization Process Theory guided this study...
April 3, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29604604/an-exploration-of-peer-assisted-learning-in-undergraduate-nursing-students-in-paediatric-clinical-settings-an-ethnographic-study
#10
Matthew C Carey, Anna Chick, Bridie Kent, Jos M Latour
BACKGROUND: Peer-assisted leaning relates to the acquisition of knowledge and skills through shared learning of matched equals. The concept has been explored within the field of nurse education across a range of learning environments, but its impact in practice is still relatively unknown. This paper reports on findings when observing paediatric undergraduate nursing students who engage in PAL within the clinical practice setting. OBJECTIVES: The aim of this paper is to report the findings of a study undertaken to explore peer-assisted learning in undergraduate nursing students, studying children's health, in the clinical practice setting...
March 22, 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29589385/evolution-of-diabetes-care-in-hong-kong-from-the-hong-kong-diabetes-register-to-jade-pearl-program-to-ramp-and-pep-program
#11
REVIEW
Ivy H Y Ng, Kitty K T Cheung, Tiffany T L Yau, Elaine Chow, Risa Ozaki, Juliana C N Chan
The rapid increase in diabetes prevalence globally has contributed to large increases in health care expenditure on diabetic complications, posing a major health burden to countries worldwide. Asians are commonly observed to have poorer β-cell function and greater insulin resistance compared to the Caucasian population, which is attributed by their lower lean body mass and central obesity. This "double phenotype" as well as the rising prevalence of young onset diabetes in Asia has placed Asians with diabetes at high risk of cardiovascular and renal complications, with cancer emerging as an important cause of morbidity and mortality...
March 2018: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29555095/continuing-conversations-about-adverse-childhood-experiences-aces-screening-a-public-health-perspective
#12
Shanta R Dube
Currently, in the U.S. and worldwide, childhood trauma is a public health crisis. Childhood adversities, such as abuse, neglect, and related household stressors, are common, interrelated and contribute to multiple adverse social, behavioral and health outcomes throughout the lifespan. The present article provides further discussion regarding adverse childhood experiences (ACEs) screening in healthcare utilizing the etic and emic perspectives. Screening in the healthcare system leans toward the etic view: objective observations of symptoms, which may then lead to intervention delivery...
March 16, 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29549212/protocol-for-a-1-year-prospective-longitudinal-cohort-study-of-patients-undergoing-roux-en-y-gastric-bypass-and-sleeve-gastrectomy-the-bari-lifestyle-observational-study
#13
Friedrich C Jassil, Alisia Carnemolla, Helen Kingett, Bruce Paton, Aidan G O'Keeffe, Jacqueline Doyle, Stephen Morris, Neville Lewis, Amy Kirk, Andrea Pucci, Kusuma Chaiyasoot, Rachel L Batterham
INTRODUCTION: Roux-en-Y gastric bypass and sleeve gastrectomy are the two most common bariatric surgery performed in the UK that result in comparable weight loss and remission of obesity-associated comorbidities. However, there is a paucity of studies examining the impact of these procedures on body composition, physical activity levels, sedentary behaviour, physical function and strength, dietary intake, health-related quality of life and costs. METHODS AND ANALYSIS: The BARI-LIFESTYLE observational study is a 1-year prospective, longitudinal cohort study within a real-world routine clinical care setting aiming to recruit 100 patients with severe obesity undergoing either primary Roux-en-Y gastric bypass or sleeve gastrectomy from two bariatric centres in London, UK...
March 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29517189/strength-training-increases-skeletal-muscle-quality-but-not-muscle-mass-in-old-institutionalized-adults-a-randomized-multi-arm-parallel-and-controlled-intervention-study
#14
Eva-Maria Strasser, Marlene Hofmann, Bernhard Franzke, Barbara Schober-Halper, Stefan Oesen, Waltraud Jandrasits, Alexandra Graf, Markus Praschak, Barbara Horvath-Mechtler, Christine Krammer, Martin Ploder, Norbert Bachl, Michael Quittan, Karl-Heinz Wagner, Barbara Wessner
BACKGROUND: Age related loss of skeletal muscle mass is accompanied by changes in muscle quality leading to impairment of functional status. AIM: This study investigated the effect of resistance training and nutritional supply on muscle mass and muscle quality in very old institutionalized adults. DESIGN: Prospective, randomized, multi-arm parallel and controlled intervention study. SETTING: This study was conducted in five retirement care facilities...
March 7, 2018: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29496277/death-and-suffering-in-eastern-ghouta-syria-a-call-for-action-to-protect-civilians-and-health-care
#15
Samer Jabbour, Fouad M Fouad, Jennifer Leaning, Donna McKay, Rabie Nasser, Leonard S Rubenstein, Annie Sparrow, Paul Spiegel, Ahmad Tarakji, Ronald Waldman, Rola Hallam, Denis Mukwege, Ghanem Tayara
No abstract text is available yet for this article.
March 3, 2018: Lancet
https://www.readbyqxmd.com/read/29469024/association-between-body-composition-and-pulmonary-function-in-children-and-young-people-with-cystic-fibrosis
#16
Patrizia Calella, Giuliana Valerio, Matt Thomas, Helen McCabe, Jake Taylor, Malcolm Brodlie, Mario Siervo
OBJECTIVES: Body mass index (BMI) has significant limitations when assessing nutritional status in pediatric patients with cystic fibrosis (CF). We evaluated whether measurements of lean body mass (LBM) and fat mass (FM) are more sensitive nutritional parameters by testing their association with pulmonary function in adolescent patients with CF. METHODS: Sixty-nine male and female adolescents with CF were studied (age: 14.5 ± 2.3, BMI: 19.5 ± 2.3 kg/m2 )...
April 2018: Nutrition
https://www.readbyqxmd.com/read/29421068/lean-and-green-hand-surgery
#17
REVIEW
Robert E Van Demark, Vanessa J S Smith, Anthony Fiegen
Health care in the United States is both expensive and wasteful. The cost of health care in the United States continues to increase every year. Health care spending for 2016 is estimated at $3.35 trillion. Per capita spending ($10,345 per person) is more than twice the average of other developed countries. The United States also leads the world in solid waste production (624,700 metric tons of waste in 2011). The health care industry is second only to the food industry in annual waste production. Each year, health care facilities in the United States produce 4 billion pounds of waste (660 tons per day), with as much as 70%, or around 2...
February 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29413076/application-of-the-seips-model-to-analyze-medication-safety-in-a-crisis-residential-center
#18
Maria L Steele, Brenda Talley, Karen H Frith
PURPOSE: Medication safety and error reduction has been studied in acute and long-term care settings, but little research is found in the literature regarding mental health settings. Because mental health settings are complex, medication administration is vulnerable to a variety of errors from transcription to administration. The purpose of this study was to analyze critical factors related to a mental health work system structure and processes that threaten safe medication administration practices...
February 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29412091/the-finnish-healthcare-services-lean-management
#19
Susanna Hihnala, Lilja Kettunen, Marjo Suhonen, Hanna Tiirinki
Purpose The purpose of this paper is to discuss health services managers' experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers' work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews...
February 5, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29409641/health-care-clinicians-engagement-in-organizational-redesign-of-care-processes-the-importance-of-work-and-organizational-conditions
#20
L Dellve, M Strömgren, A Williamsson, R J Holden, A Eriksson
The Swedish health care system is reorienting towards horizontal organization for care processes. A main challenge is to engage health care clinicians in the process. The aim of this study was to assess engagement (i.e. attitudes and beliefs, the cognitive state and clinical engagement behaviour) among health care clinicians, and to investigate how engagement was related to work resources and demands during organizational redesign. A cohort study was conducted, using a questionnaire distributed to clinicians at five hospitals working with care process improvement approaches, two of them having implemented Lean production...
April 2018: Applied Ergonomics
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