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https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#1
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29142575/the-attitudes-of-fertile-and-infertile-women-to-oocyte-donation-in-a-muslim-and-secular-population
#2
Mehmet Musa Aslan, Vedat Ugurel, Koray Elter
Objective: To determine general attitudes of fertile and infertile women to oocyte donation in a Muslim and secular population. Methods: The participants consisted of fertile women (n=133) who had at least one healthy living child spontaneously conceived without any fertility treatment and infertile women (n=133) who were diagnosed with primary infertility. Both groups were evaluated with charts comprised of 34 questions addressing demographic characteristics and the social aspects of oocyte and sperm donation...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29136390/assurance-of-myeloid-growth-factor-administration-in-an-infusion-center-pilot-quality-improvement-initiative
#3
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
#4
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/29072887/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#5
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/29068148/impact-of-obesity-on-annual-medical-expenditures-and-diabetes-care-in-japanese-patients-with-type-2-diabetes-mellitus
#6
Chisato Kusunoki-Tsuji, Shin-Ichi Araki, Shinji Kume, Masami Chin-Kanasaki, Norihisa Osawa, Katsutaro Morino, Osamu Sekine, Satoshi Ugi, Atsunori Kashiwagi, Hiroshi Maegawa
AIM/INTRODUCTION: Diabetes and obesity are important health and economic concerns. We investigated the influence of obesity on diabetes control, the annual medical expenditures, and medications in Japanese patients with type 2 diabetes who were relatively lean in comparison to those in Western countries. MATERIALS AND METHODS: A total of 402 Japanese patients with type 2 diabetes were enrolled and their annual medical expenditures investigated. Obesity was defined as body mass index over 25 kg/m(2) , according to the obesity classifications from the Japan Society for the Study of Obesity...
October 25, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29065578/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#7
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/29059115/using-lean-process-improvement-to-enhance-safety-and-value-in-orthopaedic-surgery-the-case-of-spine-surgery
#8
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/29035280/adipocyte-cannabinoid-receptor-cb1-regulates-energy-homeostasis-and-alternatively-activated-macrophages
#9
Inigo Ruiz de Azua, Giacomo Mancini, Raj Kamal Srivastava, Alejandro Aparisi Rey, Pierre Cardinal, Laura Tedesco, Cristina Maria Zingaretti, Antonia Sassmann, Carmelo Quarta, Claudia Schwitter, Andrea Conrad, Nina Wettschureck, V Kiran Vemuri, Alexandros Makriyannis, Jens Hartwig, Maria Mendez-Lago, Laura Bindila, Krisztina Monory, Antonio Giordano, Saverio Cinti, Giovanni Marsicano, Stefan Offermanns, Enzo Nisoli, Uberto Pagotto, Daniela Cota, Beat Lutz
Dysregulated adipocyte physiology leads to imbalanced energy storage, obesity, and associated diseases, imposing a costly burden on current health care. Cannabinoid receptor type-1 (CB1) plays a crucial role in controlling energy metabolism through central and peripheral mechanisms. In this work, adipocyte-specific inducible deletion of the CB1 gene (Ati-CB1-KO) was sufficient to protect adult mice from diet-induced obesity and associated metabolic alterations and to reverse the phenotype in already obese mice...
October 16, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29029690/identifying-and-eliminating-inefficiencies-in-information-system-usage-a-lean-perspective
#10
Vincent Blijleven, Kitty Koelemeijer, Monique Jaspers
OBJECTIVES: Mismatches frequently occur between information system (IS) dictated workflows and actual workflows of IS users. The resulting impeded workflows negatively influence the efficiency with which goods or services are produced and delivered to customers. Within a healthcare context, impeded workflows can additionally have a negative impact on the safety and effectiveness of care delivered to patients. METHODS: This study evaluates the impact of an electronic health record system of a large university hospital on workflows of healthcare professionals from a lean management waste perspective...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29026373/how-weight-during-pregnancy-influences-the-association-between-pre-pregnancy-body-mass-index-and-types-of-delivery-and-birth-a-comparison-of-urban-and-rural-areas
#11
Manoochehr Babanezhad
BACKGROUND: Women in study areas suffered from the problems of caesarean delivery (CD), low birth weight (LBW), and macrosomia. OBJECTIVE: To investigate how gestational weight gain (GWG) influences the effect of the pre-pregnancy body mass index (BMI) on the risks of CD, LBW, and macrosomia in urban and rural areas in a city of Iran. METHODS: We used 767 and 612 eligible subjects from the public health care centers in urban and rural areas respectively...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/29025038/selective-progesterone-receptor-modulators-for-fertility-preservation-in-women-with-symptomatic-uterine-fibroids
#12
Mohamed Ali, Ayman Al-Hendy
Uterine fibroids (UFs, AKA leiomyoma) are the most important benign neoplastic threat to women's health, with costs up to hundreds of billions of health care dollars worldwide. Uterine fibroids caused morbidities exert a tremendous health toll, impacting the quality of life of women of all ethnicities, especially women of color. Clinical presentations include heavy vaginal bleeding, pelvic pain, bulk symptoms, subfertility, and obstetric complications. Current management strategies heavily lean toward surgical procedures; nonetheless, the choice of treatment is generally subject to patient's age and her desire to preserve future fertility...
September 1, 2017: Biology of Reproduction
https://www.readbyqxmd.com/read/28988567/sfa-intake-among-japanese-schoolchildren-current-status-and-possible-intervention-to-prevent-excess-intake
#13
Keiko Asakura, Satoshi Sasaki
OBJECTIVE: Although a high intake of fat, particularly SFA, is a well-known risk factor for CVD, fat intake in Japan has attracted relatively little attention from health professionals to date due to the low intake in the Japanese population. However, recent surveys have shown an increase in fat intake in younger Japanese populations. Here, we described the fat intake and dietary sources of SFA in Japanese schoolchildren. Also, we experimentally exchanged a high-SFA food with a low-SFA substitute in the data, and calculated the resulting changes in nutrient intakes...
October 9, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/28948662/improving-performances-of-the-knee-replacement-surgery-process-by-applying-dmaic-principles
#14
Giovanni Improta, Giovanni Balato, Maria Romano, Alfonso Maria Ponsiglione, Eliana Raiola, Mario Alessandro Russo, Patrizia Cuccaro, Liberatina Carmela Santillo, Mario Cesarelli
RATIONALE, AIMS, AND OBJECTIVES: The work is a part of a project about the application of the Lean Six Sigma to improve health care processes. A previously published work regarding the hip replacement surgery has shown promising results. Here, we propose an application of the DMAIC (Define, Measure, Analyse, Improve, and Control) cycle to improve quality and reduce costs related to the prosthetic knee replacement surgery by decreasing patients' length of hospital stay (LOS) METHODS: The DMAIC cycle has been adopted to decrease the patients' LOS...
September 26, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28937925/effect-of-self-reported-distress-thermometer-score-on-the-maximal-handgrip-and-pinch-strength-measurements-in-hemodialysis-patients
#15
Stephanie Camilleri, Stephanie Chong, Kamonwan Tangvoraphonkchai, Suree Yoowannakul, Andrew Davenport
BACKGROUND: Muscle weakness is a risk factor for mortality in hemodialysis (HD) patients. Muscle strength measurements are routinely used as a screening tool but depend on patient cooperation and motivation. We wished to determine whether measuring maximal voluntary muscle strength was affected by patient self-reported distress. METHODS: We measured pinch strength (PS) and handgrip strength (HGS) in 382 adult HD patients with a corresponding self-reported distress thermometer (DT) scores...
October 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28930295/global-burden-of-nafld-and-nash-trends-predictions-risk-factors-and-prevention
#16
REVIEW
Zobair Younossi, Quentin M Anstee, Milena Marietti, Timothy Hardy, Linda Henry, Mohammed Eslam, Jacob George, Elisabetta Bugianesi
NAFLD is one of the most important causes of liver disease worldwide and will probably emerge as the leading cause of end-stage liver disease in the coming decades, with the disease affecting both adults and children. The epidemiology and demographic characteristics of NAFLD vary worldwide, usually parallel to the prevalence of obesity, but a substantial proportion of patients are lean. The large number of patients with NAFLD with potential for progressive liver disease creates challenges for screening, as the diagnosis of NASH necessitates invasive liver biopsy...
September 20, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28899988/impact-of-incident-heart-failure-on-body-composition-over-time-in-the-health-aging-and-body-composition-study-population
#17
MULTICENTER STUDY
Daniel E Forman, Adam J Santanasto, Robert Boudreau, Tamara Harris, Alka M Kanaya, Suzanne Satterfield, Eleanor M Simonsick, Javed Butler, Jorge R Kizer, Anne B Newman
BACKGROUND: Prevalence of heart failure (HF) increases significantly with age, coinciding with age-related changes in body composition that are common and consequential. Still, body composition is rarely factored in routine HF care. METHODS AND RESULTS: The Health, Aging, and Body Composition study is a prospective cohort study of nondisabled adults. Using yearly dual-energy x-ray absorptiometry, body composition was assessed in the Health, Aging, and Body Composition study over 6 years, comparing those who developed incident HF versus those who did not...
September 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28878719/different-and-similar-at-the-same-time-cultural-competence-through-the-leans-of-healthcare-providers
#18
Giuseppina Dell'Aversana, Andreina Bruno
Cultural competence (CC) for professionals and organizations has been recognized as a key strategy to reduce health care inequalities for migrants and to promote responsiveness to diversity. For decades its main aim has been matching health services to the cultural needs of migrant users. Otherwise literature highlighted the need to find a pragmatic middle way between the 'static' and the 'dynamic' views of culture that are recognizable in CC approaches. A pragmatic middle way to CC will be proposed as the way to respect diversity, even responding to cultural issues, without stereotyping or discriminating...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28877618/a-value-based-taxonomy-of-improvement-approaches-in-healthcare
#19
Christian Colldén, Ida Gremyr, Andreas Hellström, Daniella Sporraeus
Purpose The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The purpose of this paper is to construct a taxonomy that supports the management of parallel IAs in healthcare. Design/methodology/approach Based on previous research, this paper proposes a taxonomy that includes the dimensions of view on value and organizational focus; three contemporary IAs - lean, value-based healthcare, and patient-centered care - are related to the taxonomy...
June 19, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28874177/improving-diets-and-nutrition-through-an-integrated-poultry-value-chain-and-nutrition-intervention-selever-in-burkina-faso-study-protocol-for-a-randomized-trial
#20
Aulo Gelli, Elodie Becquey, Rasmane Ganaba, Derek Headey, Melissa Hidrobo, Lieven Huybregts, Hans Verhoef, Romain Kenfack, Sita Zongouri, Hannah Guedenet
BACKGROUND: The SELEVER study is designed to evaluate the impact of an integrated agriculture-nutrition package of interventions (including poultry value chain development, women's empowerment activities, and a behavior change communications strategy to promote improved diets and feeding, care, and hygiene practices) on the diets, health, and nutritional status of women and children in Burkina Faso. This paper presents the rationale and study design. METHODS: The impact evaluation involves a cluster randomized controlled trial design that will be implemented in 120 rural communities/villages within 60 communes supported by SELEVER in the Boucle de Mouhoun, Centre-Ouest, and Haut-Bassins regions of Burkina Faso...
September 6, 2017: Trials
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