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https://www.readbyqxmd.com/read/28727487/improving-care-with-a-portfolio-of-physician-led-cancer-quality-measures-at-an-academic-center
#1
Julie Bryar Porter, Eben Lloyd Rosenthal, Marcy Winget, Andrea Segura Smith, Sridhar Belavadi Seshadri, Yohan Vetteth, Eileen F Kiamanesh, Amogh Badwe, Ranjana H Advani, Mark K Buyyounouski, Steven Coutre, Frederick Dirbas, Vasu Divi, Oliver Dorigo, Kristen N Ganjoo, Laura J Johnston, Lawrence David Recht, Joseph B Shrager, Eila C Skinner, Susan M Swetter, Brendan C Visser, Douglas W Blayney
PURPOSE: Development and implementation of robust reporting processes to systematically provide quality data to care teams in a timely manner is challenging. National cancer quality measures are useful, but the manual data collection required is resource intensive, and reporting is delayed. We designed a largely automated measurement system with our multidisciplinary cancer care programs (CCPs) to identify, measure, and improve quality metrics that were meaningful to the care teams and their patients...
July 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28720558/my-team-of-care-study-a-pilot-randomized-controlled-trial-of-a-web-based-communication-tool-for-collaborative-care-in-patients-with-advanced-cancer
#2
Teja Voruganti, Eva Grunfeld, Trevor Jamieson, Allison M Kurahashi, Bhadra Lokuge, Monika K Krzyzanowska, Muhammad Mamdani, Rahim Moineddin, Amna Husain
BACKGROUND: The management of patients with complex care needs requires the expertise of health care providers from multiple settings and specialties. As such, there is a need for cross-setting, cross-disciplinary solutions that address deficits in communication and continuity of care. We have developed a Web-based tool for clinical collaboration, called Loop, which assembles the patient and care team in a virtual space for the purpose of facilitating communication around care management...
July 18, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28717900/elements-of-program-design-in-medicare-s-value-based-and-alternative-payment-models-a-narrative-review
#3
Karen E Joynt Maddox, Aditi P Sen, Lok Wong Samson, Rachael B Zuckerman, Nancy DeLew, Arnold M Epstein
Increasing emphasis on value in health care has spurred the development of value-based and alternative payment models. Inherent in these models are choices around program scope (broad vs. narrow); selecting absolute or relative performance targets; rewarding improvement, achievement, or both; and offering penalties, rewards, or both. We examined and classified current Medicare payment models-the Hospital Readmissions Reduction Program (HRRP), Hospital Value-Based Purchasing Program (HVBP), Hospital-Acquired Conditions Reduction Program (HACRP), Medicare Advantage Quality Star Rating program, Physician Value-Based Payment Modifier (VM) and its successor, the Merit-Based Incentive Payment System (MIPS), and the Medicare Shared Savings Program (MSSP) on these elements of program design and reviewed the literature to place findings in context...
July 17, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28716650/the-use-of-prostate-specific-antigen-screening-in-purchased-versus-direct-care-settings-data-from-the-tricare-military-database
#4
Alexander P Cole, Wei Jiang, Stuart R Lipsitz, Peter A Learn, Maxine Sun, Toni K Choueiri, Paul L Nguyen, Adam S Kibel, Mani Menon, Jesse D Sammon, Tracey Koehlmoos, Adil Haider, Quoc-Dien Trinh
PURPOSE: Fee for service (FFS) reimbursement incentives may affect care. We sought to compare odds of PSA screening among former and active duty United States (US) military service members based on receipt of primary care from integrated military health facilities versus community providers reimbursed via FFS. MATERIALS AND METHODS: We performed a retrospective study of all active duty and retired male service members (40-64) covered by the TRICARE military health benefit in 2010...
July 14, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28700508/hospitals-use-of-hospitalists-implications-for-financial-performance
#5
Josué Patien Epané, Robert Weech-Maldonado, Larry Hearld, Nir Menachemi, Bisakha Sen, Stephen O'Connor, Zo Ramamonjiarivelo
BACKGROUND: Hospitalists, or physicians specializing in hospital-based practice, have grown significantly since they were first introduced in the United States in the mid-1990s. Prior studies on the impact of hospitalists have focused on costs and length of stay. However, there is dearth of research exploring the relationship between hospitals' use of hospitalists and organizational performance. PURPOSE: Using a national longitudinal sample of acute care hospitals operating in the United States between 2007 and 2014, this study explores the impact of hospitalists staffing intensity on hospitals' financial performance...
July 11, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28694270/swimming-against-the-tide-primary-care-physicians-views-on-deprescribing-in-everyday-practice
#6
Katharine A Wallis, Abby Andrews, Michelle Henderson
PURPOSE: Avoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and facilitators to deprescribing in everyday practice to inform the development of an intervention to support safer prescribing. METHODS: We used a snowball sampling technique to identify potential participants...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28681175/optimizing-cooperation-between-general-practitioners-occupational-health-and-rehabilitation-physicians-in-germany-a-qualitative-study
#7
Jan Stratil, Monika A Rieger, Susanne Voelter-Mahlknecht
PURPOSE: To achieve successful medical rehabilitation and timely return to work, general practitioners, occupational health and rehabilitation physicians need to cooperate effectively. This cooperation, however, can be hampered by organizational, interpersonal, and structural barriers. In this article, we present and discuss suggestions proposed by physicians and patients on how these barriers can be overcome. METHODS: We conducted eight qualitative focus group discussions with general practitioners (GPs), occupational health physicians (OPs), rehabilitation physicians (RPs) and rehabilitation patients, which we analyzed with qualitative content analysis methods...
July 5, 2017: International Archives of Occupational and Environmental Health
https://www.readbyqxmd.com/read/28676415/emergency-department-flow-measures-for-adult-and-pediatric-patients-in-british-columbia-and-ontario-a-retrospective-repeated-cross-sectional-study
#8
Gregory Georgio, Astrid Guttmann, Quynh H Doan
BACKGROUND: Evidence suggests emergency department (ED) overcrowding is associated with poor health outcomes. Children comprise 20-25% of general ED visits, yet few studies have examined the differential impact of ED overcrowding on pediatric and adult populations. OBJECTIVE: The primary objective of this study was to compare flow measures, such as wait time to see a physician, length of stay (LOS), and rate of patients leaving without being seen by a physician (LWBS) between adults and children in British Columbia and Ontario, clustered by province, and then stratified by acuity level during the study period...
July 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28675578/a-time-series-analysis-of-the-effects-of-financial-incentives-and-mandatory-clinical-applications-as-interventions-to-improve-spontaneous-adverse-drug-reaction-reporting-by-hospital-medical-staff-in-china
#9
Feng Chang, Yue Xi, Jie Zhao, Xiaojian Zhang, Yun Lu
RATIONALE, AIMS, AND OBJECTIVES: Spontaneous reporting of adverse drug reactions (ADRs) in hospitals is often under-reported, which may lead to problems in patient management. This study was aimed to assess the effectiveness of a financial intervention based on a fine and a bonus for improving spontaneous reporting of ADRs by physicians in a hospital setting. METHODS: This study was conducted at the First Affiliated Hospital of Zhengzhou University (China). Starting in 2009, a bonus of 20 RMB (Chinese currency) was given for each spontaneous ADR report, and a fine of 50 RMB was given for any withheld ADR report...
July 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28674836/qualitative-analysis-of-direction-of-public-hospital-reforms-in-china
#10
Dahai Zhao, Zhiruo Zhang
Reforms in public hospitals are among the most important improvements in China's health care system over the last two decades. However, the reforms that should be implemented in public hospitals are unclear. Thus, a feasible direction of reforms in Chinese public hospitals is suggested and reliable policy suggestions are provided for the government to reform public hospitals. The data used in this study were mainly derived from a qualitative study. Focus group discussions and in-depth interviews were conducted in Shanghai, Guangdong, and Gansu between May and December 2014...
July 3, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28664439/sages-quality-initiative-an-introduction
#11
Anne Lidor, Dana Telem, Curtis Bower, Prashant Sinha, Rocco Orlando, John Romanelli
The Medicare program has transitioned to paying healthcare providers based on the quality of care delivered, not on the quantity. In May 2015, SAGES held its first ever Quality Summit. The goal of this meeting was to provide us with the information necessary to put together a strategic plan for our Society over the next 3-5 years, and to participate actively on a national level to help develop valid measures of quality of surgery. The transition to value-based medicine requires that providers are now measured and reimbursed based on the quality of services they provide rather than the quantity of patients in their care...
August 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28661763/resisting-throughput-pressures-physicians-and-patients-strategies-to-manage-hospital-discharge
#12
Hyeyoung Oh
In recent years, quickly discharging patients has become a collective goal at hospitals, as excessive medical workups and extended hospital stays have been associated with unnecessary healthcare spending. Physicians, however, frequently encounter numerous barriers when trying to discharge patients. Presenting ethnographic and interview data collected from September 2010 to September 2013, this paper examines one of the most difficult discharge cases physicians encounter on the internal medicine service at a U...
March 2017: Journal of Health and Social Behavior
https://www.readbyqxmd.com/read/28658340/surgery-in-brazilian-health-care-funding-and-physician-distribution
#13
Nivaldo Alonso, Benjamin B Massenburg, Rafael Galli, Lucas Sobrado, Dario Birolini
Objective: to analyze demographic Brazilian medical data from the national public healthcare system (SUS), which provides free universal health coverage for the entire population, and discuss the problems revealed, with particular focus on surgical care. Methods: data was obtained from public healthcare databases including the Medical Demography, the Brazilian Federal Council of Medicine, the Brazilian Institute of Geography and Statistics, and the National Database of Healthcare Establishments...
March 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28655299/implementing-technology-in-healthcare-insights-from-physicians
#14
Maria Dolors Ruiz Morilla, Mireia Sans, Albert Casasa, Nuria Giménez
BACKGROUND: Technology has significantly changed the way health organizations operate. However, the role it plays in healthcare systems remains unclear. This aim of this study was to evaluate the opinion of physicians regarding e-health and determine what factors influence their opinion and describe the advantages, inconveniences and threats they may perceive by its use. METHODS: A cross-sectional questionnaire-based study. A questionnaire which had been previously designed and validated by the authors was used to interview physicians from the Barcelona Medical Association...
June 27, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28654621/measuring-provider-performance-for-physicians-participating-in-the-merit-based-incentive-payment-system
#15
Lee Squitieri, Kevin C Chung
In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28653221/effect-of-an-obesity-best-practice-alert-on-physician-documentation-and-referral-practices
#16
Stephanie L Fitzpatrick, Kirsten Dickins, Elizabeth Avery, Jennifer Ventrelle, Aaron Shultz, Ekta Kishen, Steven Rothschild
The Centers for Medicare & Medicaid Services Electronic Health Record Meaningful Use Incentive Program requires physicians to document body mass index (BMI) and a follow-up treatment plan for adult patients with BMI ≥ 25. To examine the effect of a best practice alert on physician documentation of obesity-related care and referrals to weight management treatment, in a cluster-randomized design, 14 primary care clinics at an academic medical center were randomized to best practice alert intervention (n = 7) or comparator (n = 7)...
June 26, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28651624/multifaceted-interventions-for-improving-spontaneous-reporting-of-adverse-drug-reactions-in-a-general-hospital-in-china
#17
Huan Fang, Xiaowen Lin, Jun Zhang, Zhen Hong, Kenji Sugiyama, Takao Nozaki, Tetsuro Sameshima, Susumu Kobayashi, Hiroki Namba, Tetsuya Asakawa
BACKGROUND: The present study investigates changes in spontaneous reporting (SR) compliance and ADR patterns following adoption of a new hospital SR system, and multiple interventions designed for its improvement use under modified drug administration guidelines. METHODS: In total, 1389 ADR cases were reviewed. Cases were divided into two groups, cases from period 1 (n = 557, from January 2006 to June 2011) under the old SR system and cases in period 2 (n = 832, from July 2011 to December 2016) under the new SR system with multiple interventions to improve physician SR compliance...
June 26, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28629486/the-collaboration-of-general-practitioners-and-nurses-in-primary-care-a-comparative-analysis-of-concepts-and-practices-in-slovenia-and-spain
#18
Kerstin Hämel, Carina Vössing
Aim A comparative analysis of concepts and practices of GP-nurse collaborations in primary health centres in Slovenia and Spain. BACKGROUND: Cross-professional collaboration is considered a key element for providing high-quality comprehensive care by combining the expertise of various professions. In many countries, nurses are also being given new and more extensive responsibilities. Implemented concepts of collaborative care need to be analysed within the context of care concepts, organisational structures, and effective collaboration...
June 20, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28614516/coordinated-care-for-tuberculosis-data-registration-and-implementation-of-a-computerized-system
#19
Nathalia Halax Orfão, Nathalia Yukie Crepaldi, Maria Eugênia Firmino Brunello, Rubia Laine de Paula Andrade, Aline Aparecida Monroe, Antonio Ruffino-Netto, Tereza Cristina Scatena Villa
Objective: to analyze sources of data for tuberculosis (TB) before and after the implementation of the Computerized System to Record Care for TB in Ribeirão Preto - SP. Method: Intervention, descriptive-analytical epidemiological study. Data was collected from secondary sources using a structured form, and analyzed using Chi-squared or Fisher's Exact Test, with a significance level of 5%. Results: We found an association between the period before implementation of the system and placing the Directly Observed Treatment Card in the file, and registration of instructions for the return visit by the nursing team...
June 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28605555/operationalizing-multidisciplinary-assessment-and-treatment-as-a-quality-metric-for-interventional-pain-practices
#20
Edward K Heres, David Itskevich, Ajay D Wasan
Objective.:  Quality improvement (QI) is an underutilized approach among pain medicine specialists to improve comprehensive pain assessment and the delivery of multimodal pain care. We report the results of a QI program that utilized peer review and financial incentives to improve these processes in interventional pain clinics. Design.:  Retrospective chart review. Setting.:  Eight academic and community-based practices that included separate hospital-based and non-hospital-based interventional pain clinics...
June 12, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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