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https://www.readbyqxmd.com/read/28334563/quality-improvement-initiatives-lead-to-reduction-in-nulliparous-term-singleton-vertex-cesarean-delivery-rate
#1
Mary A Vadnais, Michele R Hacker, Neel T Shah, JoAnn Jordan, Anna M Modest, Molly Siegel, Toni H Golen
BACKGROUND: The nulliparous term singleton vertex (NTSV) cesarean delivery rate has been recognized as a meaningful benchmark. Variation in the NTSV cesarean delivery rate among hospitals and providers suggests many hospitals may be able to safely improve their rates. The NTSV cesarean delivery rate at the authors' institution was higher than state and national averages. This study was conducted to determine the influence of a set of quality improvement interventions on the NTSV cesarean delivery rate...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28330409/guidelines-on-constructing-funnel-plots-for-quality-indicators-a-case-study-on-mortality-in-intensive-care-unit-patients
#2
Ilona Wm Verburg, Rebecca Holman, Niels Peek, Ameen Abu-Hanna, Nicolette F de Keizer
Funnel plots are graphical tools to assess and compare clinical performance of a group of care professionals or care institutions on a quality indicator against a benchmark. Incorrect construction of funnel plots may lead to erroneous assessment and incorrect decisions potentially with severe consequences. We provide workflow-based guidance for data analysts on constructing funnel plots for the evaluation of binary quality indicators, expressed as proportions, risk-adjusted rates or standardised rates. Our guidelines assume the following steps: (1) defining policy level input; (2) checking the quality of models used for case-mix correction; (3) examining whether the number of observations per hospital is sufficient; (4) testing for overdispersion of the values of the quality indicator; (5) testing whether the values of quality indicators are associated with institutional characteristics; and (6) specifying how the funnel plot should be constructed...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28316039/public-health-data-in-action-an-analysis-of-using-louisiana-vital-statistics-for-quality-improvement-and-payment-reform
#3
Valery A Danilack, Rebekah E Gee, Danielle P Berthelot, Rebecca Gurvich, Janet H Muri
Introduction In 2012, the Louisiana (LA) Department of Health and Hospitals revised the LA birth certificate to include medical reasons for births before 39 completed weeks' gestation. We compared the completeness and validity of these data with hospital discharge records. Methods For births occurring 4/1/2012-9/30/2012 at Woman's Hospital of Baton Rouge, we linked maternal delivery and newborn birth data collected through the National Perinatal Information Center with LA birth certificates. Among early term births (37-38 completed weeks' gestation), we quantified the reasons for early delivery listed on the birth certificate and compared them with ICD-9-CM codes from Woman's discharge data...
March 18, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28293422/regional-disparities-in-immunization-services-in-ghana-through-a-bottleneck-analysis-approach-implications-for-sustaining-national-gains-in-immunization
#4
A E Yawson, G Bonsu, L K Senaya, A O Yawson, J B Eleeza, J K Awoonor-Williams, H K Banskota, E E A Agongo
BACKGROUND: Immunization is considered one of the most cost effective public health interventions for reducing child morbidity, mortality and disability. The aim of this work is to describe the application of the Bottleneck analysis (BNA) process to assess gaps in immunization services in Ghana and implications for sustaining the gains in Immunization coverage. METHODS: A national assessment was conducted in May 2015, through use of desk reviews, field visits and key informant interviews...
2017: Archives of Public Health, Archives Belges de Santé Publique
https://www.readbyqxmd.com/read/28289939/patient-dose-in-interventional-radiology-a-multicentre-study-of-the-most-frequent-procedures-in-france
#5
Cécile Etard, Emeline Bigand, Cécile Salvat, Vincent Vidal, Jean Paul Beregi, Amaury Hornbeck, Joël Greffier
OBJECTIVES: A national retrospective survey on patient doses was performed by the French Society of Medical physicists to assess reference levels (RLs) in interventional radiology as required by the European Directive 2013/59/Euratom. METHODS: Fifteen interventional procedures in neuroradiology, vascular radiology and osteoarticular procedures were analysed. Kerma area product (KAP), fluoroscopy time (FT), reference air kerma and number of images were recorded for 10 to 30 patients per procedure...
March 13, 2017: European Radiology
https://www.readbyqxmd.com/read/28287610/multivariate-simulation-framework-reveals-performance-of-multi-trait-gwas-methods
#6
Heather F Porter, Paul F O'Reilly
Burgeoning availability of genome-wide association study (GWAS) results and national biobank data has led to growing interest in performing multi-trait genetic analyses. Numerous multi-trait GWAS methods that exploit either summary statistics or individual-level data have been developed, but their relative performance is unclear. Here we develop a simulation framework to model the complex networks underlying multivariate genetic epidemiology, enabling the vast model space of genetic effects on multiple correlated traits to be explored systematically...
March 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28283492/prevalence-of-latent-tb-infection-and-tb-disease-among-adolescents-in-high-tb-burden-countries-in-africa-a-systematic-review-protocol
#7
Erick Wekesa Bunyasi, Bey-Marrie Schmidt, Leila Hussein Abdullahi, Humphrey Mulenga, Michele Tameris, Angelique Luabeya, Justin Shenje, Thomas Scriba, Hennie Geldenhuys, Robin Wood, Mark Hatherill
INTRODUCTION: Almost a third of the world population has latent tuberculosis (TB) infection (LTBI), ∼10 million of whom develop TB disease annually, despite existence of effective, but lengthy, preventive and curative drug regimens. Although adolescents appear to have a very high force of LTBI, their reported incidence of TB disease is less than that of their corresponding general population. The few available studies on adolescent TB infection and disease prevalence are not sufficient to address the apparent discordance between rates of infection and disease in high TB burden countries in Africa...
March 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28278067/recommended-test-methods-and-pass-fail-criteria-for-a-respirator-fit-capability-test-of-half-mask-air-purifying-respirators
#8
Ziqing Zhuang, Michael Bergman, Zhipeng Lei, George Niezgoda, Ronald Shaffer
This study assessed key test parameters and pass/fail criteria options for developing a respirator fit capability (RFC) test for half-mask air-purifying particulate respirators. Using a 25-subject test panel, benchmark RFC data were collected for 101 National Institute for Occupational Safety and Health-certified respirator models. These models were further grouped into 61 one-, two- or three-size families. Fit testing was done using a PortaCount® Plus with N95-Companion accessory and an Occupational Safety and Health Administration-accepted quantitative fit test protocol...
February 25, 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/28277262/eliminating-blood-culture-false-positives-harnessing-the-power-of-nursing-shared-governance
#9
Dawn Moeller
Our emergency department struggled with unacceptable blood culture contamination rates for several years. The objective of this project was to create a self-governing culture within nursing that would generate and sustain the achievement of monthly blood culture contamination rates below the national benchmark of 3% and the hospital laboratory acceptable threshold of 2.3%. METHODS: The ED shared governance council partnered with the laboratory team to review the monthly epidemiology reports for all adult and pediatric ED patients having blood cultures performed from January 2010 through December 2015...
October 26, 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28258642/benchmarking-recent-national-practice-in-rectal-cancer-treatment-with-landmark-randomised-controlled-trials
#10
Wernard Aat Antoine Borstlap, Pieter Tanis
AIM: A Snapshot study design eliminates changes in treatment and outcome over time. This population based Snapshot study aimed to determine current practice and outcome of rectal cancer treatment with published landmark randomised controlled trials (RCTs) as a benchmark. METHODS: In this collaborative research project, the dataset of the Dutch Surgical Colorectal Audit was extended with additional treatment and long-term outcome data. All registered patients who underwent resection for rectal cancer in 2011 were eligible...
March 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28252670/divergence-of-stable-isotopes-in-tap-water-across-china
#11
Sihan Zhao, Hongchang Hu, Fuqiang Tian, Qiang Tie, Lixin Wang, Yaling Liu, Chunxiang Shi
Stable isotopes in water (e.g., δ(2)H and δ(18)O) are important indicators of hydrological and ecological patterns and processes. Tap water can reflect integrated features of regional hydrological processes and human activities. China is a large country with significant meteorological and geographical variations. This report presents the first national-scale survey of Stable Isotopes in Tap Water (SITW) across China. 780 tap water samples have been collected from 95 cities across China from December 2014 to December 2015...
March 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28250915/the-reset-mindset-model-applied-on-decreasing-antibiotic-usage-in-dairy-cattle-in-the-netherlands
#12
REVIEW
T J G M Lam, J Jansen, R J Wessels
BACKGROUND: Prudent use of antibiotics is important to prevent antibiotic resistance in humans and in animals. For this reason politicians demanded a decrease of total antibiotic use and of use of critically important antibiotics in animal husbandry in the Netherlands. In the dairy sector the use of antibiotics almost halved in the years 2009-2015, with a decrease of the use of critically important antibiotics to very low levels. THEORY OF BEHAVIOUR CHANGE: To realize a sustainable decrease in antibiotic usage, the mindset towards the subject was considered crucial...
2017: Irish Veterinary Journal
https://www.readbyqxmd.com/read/28244803/national-performance-benchmarks-for-modern-diagnostic-digital-mammography-update-from-the-breast-cancer-surveillance-consortium
#13
Brian L Sprague, Robert F Arao, Diana L Miglioretti, Louise M Henderson, Diana S M Buist, Tracy Onega, Garth H Rauscher, Janie M Lee, Anna N A Tosteson, Karla Kerlikowske, Constance D Lehman
Purpose To establish contemporary performance benchmarks for diagnostic digital mammography with use of recent data from the Breast Cancer Surveillance Consortium (BCSC). Materials and Methods Institutional review board approval was obtained for active or passive consenting processes or to obtain a waiver of consent to enroll participants, link data, and perform analyses. Data were obtained from six BCSC registries (418 radiologists, 92 radiology facilities). Mammogram indication and assessments were prospectively collected for women undergoing diagnostic digital mammography and linked with cancer diagnoses from state cancer registries...
April 2017: Radiology
https://www.readbyqxmd.com/read/28244585/cancer-mortality-in-rieti-province-latium-region-italy-for-the-years-2006-2010-evaluation-of-temporal-and-spatial-trends-and-comparison-with-the-other-latium-provinces
#14
V Mattei, F Santilli, S Martellucci, J Di Pasquale, F Liberati, C Protano, M Vitali, M Sorice
BACKGROUND: The present research aims to obtain information on cancer deaths in the five Latium provinces in the years 2006-2010 and to highlight similarities and differences between them. METHODS: The survey was carried through statistical elaboration of cancer mortality data for the years 2006-2010 obtained from the National Institute of Statistics. RESULTS: The mortality due to oncological diseases in Rieti province showed a decreasing temporal trend for the years investigated...
March 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28242766/understanding-the-models-of-community-hospital-rehabilitation-activity-mocha-a-mixed-methods-study
#15
John Gladman, John Buckell, John Young, Andrew Smith, Clare Hulme, Satti Saggu, Mary Godfrey, Pam Enderby, Elizabeth Teale, Roberto Longo, Brenda Gannon, Claire Holditch, Heather Eardley, Helen Tucker
INTRODUCTION: To understand the variation in performance between community hospitals, our objectives are: to measure the relative performance (cost efficiency) of rehabilitation services in community hospitals; to identify the characteristics of community hospital rehabilitation that optimise performance; to investigate the current impact of community hospital inpatient rehabilitation for older people on secondary care and the potential impact if community hospital rehabilitation was optimised to best practice nationally; to examine the relationship between the configuration of intermediate care and secondary care bed use; and to develop toolkits for commissioners and community hospital providers to optimise performance...
February 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28236918/morbidity-and-mortality-after-emergency-lower-extremity-embolectomy
#16
Sergio Casillas-Berumen, Lili Sadri, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Emergency lower extremity embolectomy is a common vascular surgical procedure that has poorly defined outcomes. Our goal was to define the perioperative morbidity for emergency embolectomy and develop a risk prediction model for perioperative mortality. METHODS: The American College of Surgeons National Surgical Quality Improvement database was queried to identify patients undergoing emergency unilateral and lower extremity embolectomy. Patients with previous critical limb ischemia, bilateral embolectomy, nonemergency indication, and those undergoing concurrent bypass were excluded...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28236043/cystic-fibrosis-in-austria
#17
Thomas Frischer, Ernst Eber, Helmut Ellemunter, Angela Zacharasiewicz, Ingrid Kaluza, Josef Riedler, Sabine Renner
Registry data for patients with cystic fibrosis (CF) are increasingly used to evaluate the natural history, for benchmarking of therapy and in order to identify eligible patients for clinical studies. So far, no data on frequency and clinical status of CF patients have been available for Austria on a national level. We collected data of CF patients treated 2014 in Austrian CF outpatient clinics by means of a European CF registry and on an individual search basis. A total of 773 CF patients with a median age of 18...
February 24, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28235647/pediatric-trauma-assessment-and-management-database-leveraging-existing-data-systems-to-predict-mortality-and-functional-status-after-pediatric-injury
#18
Katherine T Flynn-O'Brien, Mary E Fallat, Tom B Rice, Christine M Gall, Michael L Nance, Jeffrey S Upperman, David M Gourlay, John P Crow, Frederick P Rivara
BACKGROUND: Efforts to improve pediatric trauma outcomes need detailed data, optimally collected at lowest cost, to assess processes of care. We developed a novel database by merging two national data systems for five Pediatric Trauma Centers (PTC) to provide benchmarking metrics for mortality and non-mortality outcomes and to assess care provided throughout the care continuum. STUDY DESIGN: Trauma Registry (TR) and Virtual Pediatric Systems (VPS) from five PTCs were merged for children <18 discharged in 2013 from a PICU after traumatic injury...
February 21, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28231375/predictors-of-adverse-events-after-neck-dissection-an-analysis-of-the-2006-2011-national-surgical-quality-improvement-program-nsqip-database
#19
Umang Jain, Jessica Somerville, Sujata Saha, Jon P Ver Halen, Anuja K Antony, Sandeep Samant, John Y Kim
While neck dissection is an important primary and adjunctive procedure in the treatment of head and neck cancer, there is a paucity of studies evaluating outcomes. A retrospective review of the National Surgical Quality Improvement Program (NSQIP) database was performed to identify factors associated with adverse events (AEs) in patients undergoing neck dissection. A total of 619 patients were identified, using CPT codes specific to neck dissection. Of the 619 patients undergoing neck dissection, 142 (22.9%) experienced an AE within 30 days of the surgical procedure...
February 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28230445/benchmarking-insulin-treatment-persistence-among-patients-with-type-2-diabetes-across-different-u-s-payer-segments
#20
Wenhui Wei, Jenny Jiang, Youbei Lou, Sohini Ganguli, Mark S Matusik
BACKGROUND: Treatment persistence with basal insulins is crucial to achieving sustained glycemic control, which is associated with a reduced risk of microvascular disease and other complications of type 2 diabetes (T2D). However, studies suggest that persistence with basal insulin treatment is often poor. OBJECTIVE: To measure and benchmark real-world basal insulin treatment persistence among patients with T2D across different payer segments in the United States...
March 2017: Journal of Managed Care & Specialty Pharmacy
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