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National benchmark

Federico Coccolini, Yoram Kluger, Luca Ansaloni, Ernest E Moore, Raul Coimbra, Gustavo P Fraga, Andrew Kirkpatrick, Andrew Peitzman, Ron Maier, Gianluca Baiocchi, Vanni Agnoletti, Emiliano Gamberini, Ari Leppaniemi, Rao Ivatury, Michael Sugrue, Massimo Sartelli, Salomone Di Saverio, Walt Biffl, Fausto Catena
Optimal management of emergency surgical patients represents one of the major health challenges worldwide. Emergency general surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital. EGS represents the easiest viable way to provide affordable and high-quality level of care to emergency surgical and trauma patients. It may result from the association of different physicians with other specialties in a cooperative model...
2018: World Journal of Emergency Surgery: WJES
Joseph Guarisco, Adam Salup
Background: Pain management is one of the most common reasons patients visit the emergency department. Understanding the contributions of emergency medicine-and specifically Ochsner Health System's emergency providers-to the opioid crisis is important. Benchmark prescribing data indicated that Ochsner Health System emergency medicine providers' opioid prescription rates were significantly higher than the national average in emergency medicine. Methods: Data relevant to visit and opioid prescription counts were extracted from the organization's electronic health record system...
2018: Ochsner Journal
Gwyn Bevan, Alice Evans, Sabina Nuti
This paper explores what motivates improved health care performance. Previously, many have thought that performance would either improve via choice and competition or by relying on trust and altruism. But neither assumption is supported by available evidence. So instead we explore a third approach of reciprocal altruism with sanctions for unacceptably poor performance and rewards for high performance. These rewards and sanctions, however, are not monetary, but in the form of reputational effects through public reporting of benchmarking of performance...
March 16, 2018: Health Economics, Policy, and Law
Timothy Feeney, Manuel Castillo-Angeles, John W Scott, Stephanie L Nitzschke, Ali Salim, Adil H Haider, Joaquim M Havens
BACKGROUND: Emergency general surgery (EGS) is an independent risk factor for morbidity and mortality, and seven procedures account for 80% of the National burden of operative EGS. We aimed to characterize the excess morbidity and mortality attributable to these procedures based on the level of procedural risk. METHODS: Retrospective analysis of the ACS National Surgical Quality Improvement Project (ACS-NSQIP) database. (2005-2014). Seven EGS procedures were stratified as high risk and low risk...
March 7, 2018: American Journal of Surgery
Kevin Woo
Maintaining skin integrity is espoused by several international authorities as a benchmark for patient safety and quality of care. National guidelines advocate the use of prophylactic multi-layer foam dressings over bony prominences for the prevention of pressure ulcers or injuries. The purpose of this study was to evaluate the implementation of best practice guidelines including the use of multi-layer foam dressings for the prevention of pressure injuries. The analysis involved data from a total number of 62 unique patients...
March 12, 2018: Surgical Technology International
Robert Hecht, Lindsey Hiebert, Wendy C Spearman, Mark W Sonderup, Teresa Guthrie, Timothy B Hallett, Shevanthi Nayagam, Homie Razavi, Shan Soe-Lin, Kgomotso Vilakazi-Nhlapo, Yogan Pillay, Stephen Resch
Even though WHO has approved global goals for hepatitis elimination, most countries have yet to establish programs for hepatitis B and C, which account for 320 million infections and over a million deaths annually. One reason for this slow response is the paucity of robust, compelling analyses showing that national HBV/HCV programs could have a significant impact on these epidemics and save lives in a cost-effective, affordable manner. In this context, our team used an investment case approach to develop a national hepatitis action plan for South Africa, grounded in a process of intensive engagement of local stakeholders...
February 26, 2018: Health Policy and Planning
Ian A Anderson, Louise F Saukila, James M W Robins, Christopher Y Akhunbay-Fudge, John R Goodden, Atul K Tyagi, Nick Phillips, Paul D Chumas
OBJECTIVE The aim of this study was to provide a comprehensive benchmark of 30-day ventriculoperitoneal (VP) shunt failure rates for a single institution over a 5-year study period for both adult and pediatric patients, to compare this with the results in previously published literature, and to establish factors associated with shunt failure. METHODS A retrospective database search was undertaken to identify all VP shunt operations performed in a single, regional neurosurgical unit during a 5-year period. Data were collected regarding patient age, sex, origin of hydrocephalus, and whether the shunt was a primary or secondary shunt...
March 9, 2018: Journal of Neurosurgery
Bram Hanse, Frans G J Tijink, Jurgen Maassen, Noud van Swaaij
The reform of the European Union's sugar regime caused potential decreasing beet prices. Therefore, the Speeding Up Sugar Yield (SUSY) project was initiated. At the start, a 3 × 15 target was formulated: in 2015 the national average sugar yield in the Netherlands equals 15 t/ha (60% of the sugar beet potential) and the total variable costs 15 euro/t sugar beet, aspiring a saving on total variable costs and a strong increase in sugar yield. Based on their average sugar yield in 2000-2004, 26 pairs of "type top" (high yielding) and "type average" (average yielding) growers were selected from all sugar beet growing regions in the Netherlands...
2018: Frontiers in Plant Science
Christopher W Seder, Daniel Raymond, Cameron D Wright, Henning A Gaissert, Andrew C Chang, Sydney Clinton, Susan Becker, Varun Puri, Robert Welsh, William Burfeind, Felix G Fernandez, Lisa M Brown, Benjamin D Kozower
For nearly 15 years the Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD) has provided participating institutions with risk-adjusted feedback reports that allow outcome comparisons relative to national benchmarks. With over 300 contributing centers across North America, the STS GTSD now includes over 530,000 cases. In 2017, the STS GTSD Task Force revised the data collection form with the goal of collecting more detailed and accurate information for the most important thoracic surgical cases without increasing the workload of registrars...
March 5, 2018: Annals of Thoracic Surgery
Mary E Cogswell, Catherine M Loria, Ana L Terry, Lixia Zhao, Chia-Yih Wang, Te-Ching Chen, Jacqueline D Wright, Christine M Pfeiffer, Robert Merritt, Claudia S Moy, Lawrence J Appel
Importance: In 2010, the Institute of Medicine (now the National Academy of Medicine) recommended collecting 24-hour urine to estimate US sodium intake because previous studies indicated 90% of sodium consumed was excreted in urine. Objective: To estimate mean population sodium intake and describe urinary potassium excretion among US adults. Design, Setting, and Participants: In a nationally representative cross-sectional survey of the US noninstitutionalized population, 827 of 1103 (75%) randomly selected, nonpregnant participants aged 20 to 69 years in the examination component of the National Health and Nutrition Examination Survey (NHANES) collected at least one 24-hour urine specimen in 2014...
March 7, 2018: JAMA: the Journal of the American Medical Association
F Senese, P Rucci, M P Fantini, D Gibertoni, E Semrov, M Nassisi, R Messina, C Travaglini
BACKGROUND: Information on individual mental healthcare costs and utilization patterns in Italy is scant. We analysed the use and the annual costs of community mental health services (MHS) in an Italian local health authority (LHA). Our aims are to compare the characteristics of patients in the top decile of costs with those of the remaining 90%, and to investigate the demographic and clinical determinants of costs. METHODS: This retrospective study is based on administrative data of adult patients with at least one contact with MHS in 2013...
March 4, 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
Corey A Kalbaugh, Nicole Jadue Gonzalez, Daniel J Luckett, Jason Fine, Thomas E Brothers, Mark A Farber, Adam W Beck, John W Hallett, William A Marston, Raghuveer Vallabhaneni
OBJECTIVE: Although smoking cessation is a benchmark of medical management of intermittent claudication, many patients require further revascularization. Currently, revascularization among smokers is a controversial topic, and practice patterns differ institutionally, regionally, and nationally. Patients who smoke at the time of revascularization are thought to have a poor prognosis, but data on this topic are limited. The purpose of this study was to evaluate the impact of smoking on outcomes after infrainguinal bypass for claudication...
March 2, 2018: Journal of Vascular Surgery
Emma M Smith, Lynn Roberts, Mary Ann McColl, Kathleen A Martin Ginis, William C Miller
BACKGROUND: Wheelchairs, scooters, and related equipment are essential for the well-being of individuals with limited mobility and impact participation, health, and quality of life. PURPOSE: Our objective was to identify and evaluate policies governing equipment funding for Canadian adults. We reviewed funding legislation and program documentation for adult Canadians (≥18 years of age) covered by their provincial, territorial, or federal health care plan. Documents were obtained online or through administrative staff...
February 2018: Canadian Journal of Occupational Therapy. Revue Canadienne D'ergothérapie
Annie Herbert, Georgios Lyratzopoulos, Jeremy Whelan, Rachel M Taylor, Julie Barber, Faith Gibson, Lorna A Fern
Background: Adolescents and young adults (AYAs) are thought to experience prolonged intervals to cancer diagnosis, but evidence quantifying this hypothesis and identifying high-risk patient subgroups is insufficient. We aimed to investigate diagnostic timeliness in a cohort of AYAs with incident cancers and to identify factors associated with variation in timeliness. Methods: We did a cross-sectional analysis of the BRIGHTLIGHT cohort, which included AYAs aged 12-24 years recruited within an average of 6 months from new primary cancer diagnosis from 96 National Health Service hospitals across England between July 1, 2012, and April 30, 2015...
March 2018: The lancet child & adolescent health
Sarika Rane Parasuraman, Sarah Lindstrom Johnson, Dawn Magnusson, Tracy King
BACKGROUND: Health plans are increasingly implementing quality improvement strategies aimed at meeting adolescent clinical quality measures, yet clinics often struggle to meet these measures. This qualitative study was conducted to explore how efforts to meet the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) performance measure for adolescent well-care visits were perceived by a multidisciplinary group of stakeholders. METHODS: The research team conducted 26 in-depth, semistructured interviews with participants from three stakeholder groups: clinic staff with direct patient contact, health care institutional leaders, and representatives of a payer organization...
March 2018: Joint Commission Journal on Quality and Patient Safety
Mike English, Paul Mwaniki, Thomas Julius, Mercy Chepkirui, David Gathara, Paul O Ouma, Peter Cherutich, Emelda A Okiro, Robert W Snow
BACKGROUND: There is increasing focus on the strength of primary health care systems in low and middle-income countries (LMIC). There are important roles for higher quality district hospital care within these systems. These hospitals are also sources of information of considerable importance to health systems, but this role, as with the wider roles of district hospitals, has been neglected. KEY MESSAGES: As we make efforts to develop higher quality health systems in LMIC we highlight the critical importance of district hospitals focusing here on how data on hospital mortality offers value: i) in understanding disease burden; ii) as part of surveillance and impact monitoring; iii) as an entry point to exploring system failures; and iv) as a lens to examine variability in health system performance and possibly as a measure of health system quality in its own right...
March 1, 2018: BMC Medicine
Juanita L Wilson, Debra M Wolf, Kimberly A Olszewski
Obesity is recognized as a national and global health epidemic. Commercial truck drivers (CTDs) have a higher obesity rate and lower life expectancy compared with the general population. CTDs work sedentary jobs with long hours that pose barriers to healthy eating and regular exercise. An evidenced-based practice (EBP) change project that used motivational interviewing (MI) and education regarding diet and exercise over a 4-week period was found to have a positive impact on CTDs behavior. Results revealed an increase in aggregated self-efficacy for weight loss (14...
February 1, 2018: Workplace Health & Safety
Hilary Aroke, Ashley Buchanan, Xuerong Wen, Peter Ragosta, Jennifer Koziol, Stephen Kogut
BACKGROUND: Overuse and misuse of prescription opioids is associated with increased morbidity and mortality and places a significant cost burden on health systems. OBJECTIVE: To estimate annual statewide spending for prescription opioids in Rhode Island. METHODS: A cross-sectional study of opioids dispensed from retail pharmacies using data from the Rhode Island Prescription Drug Monitoring Program (PDMP) was performed. The study sample consisted of 651,227 opioid prescriptions dispensed to 197,062 patients between January 1, 2015, and December 31, 2015...
March 2018: Journal of Managed Care & Specialty Pharmacy
Andrew B Rosenkrantz, J David Prologo, Wenyi Wang, Danny R Hughes, Zachary L Bercu, Richard Duszak
PURPOSE: To study opioid prescribing behavior of US interventional radiologists (IRs). METHODS: Using Medicare Physician and Other Supplier Public Use File claims, we identified 2,133 radiologists whose practice in 2015 comprised predominantly interventional radiology. Cross-linking the Medicare Part D Prescriber File, their opioid prescription writing behavior was characterized. RESULTS: Most (52.2%) IRs wrote 10 or fewer prescriptions total for Medicare beneficiaries...
February 22, 2018: Journal of the American College of Radiology: JACR
Harriet L Mills, Andrea Turner, Lisa Morgans, Jonathan Massey, Hannah Schubert, Gwen Rees, David Barrett, Andrew Dowsey, Kristen K Reyher
The issue of antimicrobial resistance is of global concern across human and animal health. In 2016, the UK government committed to new targets for reducing antimicrobial use (AMU) in livestock. Although a number of metrics for quantifying AMU are defined in the literature, all give slightly different interpretations. This paper evaluates a selection of metrics for AMU in the dairy industry: total mg, total mg/kg, daily dose and daily course metrics. Although the focus is on their application to the dairy industry, the metrics and issues discussed are relevant across livestock sectors...
February 23, 2018: Veterinary Record
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