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https://www.readbyqxmd.com/read/28219677/nsqip-based-quality-improvement-curriculum-for-surgical-residents
#1
Mary M Mrdutt, Claire L Isbell, Justin L Regner, Bonnie R Hodges, Yolanda Munoz Maldonado, J Scott Thomas, Harry T Papaconstantinou
BACKGROUND: General surgery training has historically lacked a standardized approach to resident Quality Improvement (QI) education aside from traditional Morbidity and Mortality conference. In 2013, the Accreditation Council for Graduate Medical Education (ACGME) formalized QI as a component of residency training. Our residency chose the National Surgical Quality Improvement Program (NSQIP) Quality In-Training Initiative (QITI) as the foundation for our QI training. We hypothesized that a focused curriculum based on outcomes would produce change in culture and improve quality of patient care...
February 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28219544/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-2017-update-on-outcomes-and-quality
#2
Jeffrey P Jacobs, John E Mayer, Constantine Mavroudis, Sean M O'Brien, Erle H Austin, Sara K Pasquali, Kevin D Hill, David M Overman, James D St Louis, Tara Karamlou, Christian Pizarro, Jennifer C Hirsch-Romano, Donna McDonald, Jane M Han, Susan Becker, Christo I Tchervenkov, Francois Lacour-Gayet, Carl L Backer, Charles D Fraser, James S Tweddell, Martin J Elliott, Hal Walters, Richard A Jonas, Richard L Prager, David M Shahian, Marshall L Jacobs
The Society of Thoracic Surgeons Congenital Heart Surgery Database is the largest congenital and pediatric cardiac surgical clinical data registry in the world. It is the platform for all activities of The Society of Thoracic Surgeons related to the analysis of outcomes and the improvement of quality in this subspecialty. This report summarizes current aggregate national outcomes in congenital and pediatric cardiac surgery and reviews related activities in the areas of quality measurement, performance improvement, and transparency...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28217384/decreasing-hospital-length-of-stay-following-lumbar-fusion-utilizing-multidisciplinary-committee-meetings-involving-surgeons-and-other-caretakers
#3
Lisa B E Shields, Lisa Clark, Steven D Glassman, Christopher B Shields
BACKGROUND: Although hospital length of stay (LOS) following lumbar fusion has decreased for a variety of reasons, different institutions find their LOS over the benchmarks published by the national Agency for Healthcare Research and Quality (AHRQ). Over a 3-year period, this prospective study introduced utilization of multidisciplinary committee meetings between surgeons and other caretakers to decrease LOS following spinal fusion surgery without compromising the quality of care. METHODS: A multidisciplinary committee was established to assess factors and institute recommendations that influence hospital LOS following lumbar fusion compared to the national compared to the national AHRQ benchmark at baseline and at 1 and 2 years after adjusting our standard practice...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28214251/children-s-moderate-to-vigorous-physical-activity-attending-summer-day-camps
#4
Keith Brazendale, Michael W Beets, R Glenn Weaver, Jessica L Chandler, Allison B Randel, Gabrielle M Turner-McGrievy, Justin B Moore, Jennifer L Huberty, Dianne S Ward
INTRODUCTION: National physical activity standards call for all children to accumulate 60 minutes/day of moderate to vigorous physical activity (MVPA). The contribution of summer day camps toward meeting this benchmark is largely unknown. The purpose of this study was to provide estimates of children's MVPA during summer day camps. METHODS: Children (n=1,061, 78% enrollment; mean age, 7.8 years; 46% female; 65% African American; 48% normal weight) from 20 summer day camps wore ActiGraph GT3x+ accelerometers on the wrist during camp hours for up to 4 non-consecutive days over the summer of 2015 (July)...
February 14, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28214116/response-of-fish-communities-to-multiple-pressures-development-of-a-total-anthropogenic-pressure-intensity-index
#5
Sandra Poikane, David Ritterbusch, Christine Argillier, Witold Białokoz, Petr Blabolil, Jan Breine, Nicolaas G Jaarsma, Teet Krause, Jan Kubečka, Torben L Lauridsen, Peeter Nõges, Graeme Peirson, Tomas Virbickas
Lakes in Europe are subject to multiple anthropogenic pressures, such as eutrophication, habitat degradation and introduction of alien species, which are frequently inter-related. Therefore, effective assessment methods addressing multiple pressures are needed. In addition, these systems have to be harmonised (i.e. intercalibrated) to achieve common management objectives across Europe. Assessments of fish communities inform environmental policies on ecological conditions integrating the impacts of multiple pressures...
February 14, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28206829/validity-of-low-contrast-letter-acuity-as-a-visual-performance-outcome-measure-for-multiple-sclerosis
#6
Laura J Balcer, Jenelle Raynowska, Rachel Nolan, Steven L Galetta, Raju Kapoor, Ralph Benedict, Glenn Phillips, Nicholas LaRocca, Lynn Hudson, Richard Rudick
Low-contrast letter acuity (LCLA) has emerged as the leading outcome measure to assess visual disability in multiple sclerosis (MS) research. As visual dysfunction is one of the most common manifestations of MS, sensitive visual outcome measures are important in examining the effect of treatment. Low-contrast acuity captures visual loss not seen in high-contrast visual acuity (HCVA) measurements. These issues are addressed by the MS Outcome Assessments Consortium (MSOAC), including representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS...
February 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28206827/validity-of-the-symbol-digit-modalities-test-as-a-cognition-performance-outcome-measure-for-multiple-sclerosis
#7
Ralph Hb Benedict, John DeLuca, Glenn Phillips, Nicholas LaRocca, Lynn D Hudson, Richard Rudick
Cognitive and motor performance measures are commonly employed in multiple sclerosis (MS) research, particularly when the purpose is to determine the efficacy of treatment. The increasing focus of new therapies on slowing progression or reversing neurological disability makes the utilization of sensitive, reproducible, and valid measures essential. Processing speed is a basic elemental cognitive function that likely influences downstream processes such as memory. The Multiple Sclerosis Outcome Assessments Consortium (MSOAC) includes representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS...
February 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28206826/the-nine-hole-peg-test-as-a-manual-dexterity-performance-measure-for-multiple-sclerosis
#8
Peter Feys, Ilse Lamers, Gordon Francis, Ralph Benedict, Glenn Phillips, Nicholas LaRocca, Lynn D Hudson, Richard Rudick
Impaired manual dexterity is a frequently reported disability in people with multiple sclerosis (MS) and is increasingly prevalent with worsening disease. While various tests and patient-reported outcome measures are available, the Nine-Hole Peg Test (NHPT) is considered as a gold standard measure of manual dexterity and most frequently used in MS research and clinical practice. The MS Outcome Assessments Consortium (MSOAC) includes representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS...
February 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28190557/moving-the-needle-toward-high-quality-pediatric-surgical-care-how-can-we-achieve-this-goal-through-prioritization-measurement-and-more-effective-collaboration
#9
REVIEW
Shawn J Rangel
Over the past decade, the American College of Surgeons Pediatric National Surgical Quality Improvement Program (NSQIP-Pediatric) has greatly improved upon our ability to measure, benchmark and compare outcomes as they relate to pediatric surgical care. Several factors have served to mold the program's evolution and data collection paradigm over time. These have included a broader understanding of what quality measures should be captured and compared from the perspectives of different stakeholders, identification of conditions where quality and process improvement efforts may have the greatest relative impact from a public health perspective, and increasing evidence in support of collaborative networks to accelerate quality improvement through the dissemination of best practices...
January 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28183396/denheart-differences-in-physical-and-mental-health-across-cardiac-diagnoses-at-hospital-discharge
#10
Selina Kikkenborg Berg, Trine Bernholdt Rasmussen, Lars Thrysoee, Astrid Lauberg, Britt Borregaard, Anne Vinggaard Christensen, Ola Ekholm, Knud Juel, Jette Rolf Svanholm
OBJECTIVE: To describe: (i) differences in patient reported physical and mental health outcomes at hospital discharge between a) cardiac diagnostic groups and b) cardiac patients and a national representative reference population and to describe (ii) in-hospital predicting factors for patient reported outcomes. METHODS: A national cross-sectional survey combined with national register data. From April 2013 to April 2014 all patients (n=34,564) discharged or transferred from one of five Danish Heart Centres were invited to participate...
March 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28181262/descriptive-characteristics-and-in-hospital-mortality-of-critically-bleeding-patients-requiring-massive-transfusion-results-from-the-australian-and-new-zealand-massive-transfusion-registry
#11
R Ruseckaite, Z K McQuilten, J C Oldroyd, T H Richter, P A Cameron, J P Isbister, E M Wood
BACKGROUND AND OBJECTIVES: Critically bleeding patients requiring massive transfusion (MT) are clinically challenging, and limited data exist to support management decisions. This study describes patient characteristics, transfusion support and clinical outcomes from the Australian and New Zealand (NZ) Massive Transfusion Registry (ANZ-MTR). MATERIALS AND METHODS: Retrospective, cohort study of all adult patients receiving MT (≥5 units red blood cells [RBC] in 4 h) at participating ANZ-MTR hospitals, 2011-2015...
February 8, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28176334/cesarean-section-trends-in-the-nordic-countries-a-comparative-analysis-with-the-robson-classification
#12
Aura Pyykönen, Mika Gissler, Ellen Løkkegaard, Thomas Bergholt, Steen C Rasmussen, Alexander Smárason, Ragnheiður I Bjarnadóttir, Birna Björg Másdóttir, Karin Källén, Kari Klungsoyr, Susanne Albrechtsen, Finn Egil Skjeldestad, Anna-Maija Tapper
INTRODUCTION: The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. MATERIAL AND METHODS: Retrospective population-based registry study including all deliveries (3,398,586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four three-year time periods...
February 7, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28166779/assessing-the-impoverishing-effects-and-factors-associated-with-the-incidence-of-catastrophic-health-care-payments-in-kenya
#13
Edwine W Barasa, Thomas Maina, Nirmala Ravishankar
BACKGROUND: Monitoring the incidence and intensity of catastrophic health expenditure, as well as the impoverishing effects of out of pocket costs to access healthcare, is a key part of benchmarking Kenya's progress towards reducing the financial burden that households experience when accessing healthcare. METHODS: The study relies on data from the nationally-representative Kenya Household Expenditure and Utilization Survey conducted in 2013 (n =33,675). We undertook health equity analysis to estimate the incidence and intensity of catastrophic expenditure...
February 6, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28152967/enhancing-a-culture-of-patient-safety-in-an-oncologic-hospital-setting
#14
Shannon Bristow
: 135 Background: Patient safety is a priority for all hospitals and staff members. With approx. 1:10 hospitalized patients experiencing an adverse event(1), healthcare lags behind other industries with regards to safety. Oncology patients have an increased risk of adverse events due to an immunocompromised status, coupled with complex treatments. Cancer Treatment Centers of America at Eastern Regional Medical Center (ERMC) recognized the need to heighten patient safety while maintaining a positive patient experience...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152911/benchmarks-of-quality-breast-care-over-10-years
#15
F Lee Tucker, Barbara Rabinowitz, Teresa Heckel, Jennifer S Gass
: 272 Background: In 2005, the National Quality Measures for Breast Centers (NQMBC) was initiated as a web-based program to capture breast center performance using process of care measurements. The program participant enters data verified by the breast center director or administrator which was randomly audited. As a center submits data, their results are immediately compared with other similar centers as well as with all submitting centers. METHODS: Of the 31 measures, we focus on six pertinent measures of quality breast care; time from diagnostic mammogram to needle biopsy, time from needle biopsy to initial breast cancer surgery, breast conservation rate, use of radiation therapy for breast conserving patients, use of endocrine therapy, and use of chemotherapy...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152897/burden-of-bloodstream-infections-among-ambulatory-pediatric-hematology-oncology-patients-with-a-central-line
#16
David G Bundy, Aditya H Gaur, Jeffrey D Hord, Marlene R Miller, Eric J Werner, Cindi Winkle, Amy Billett
: 262 Background: Pediatric hematology/oncology (PHO) patients are at high risk of bloodstream infections (BSI). The burden of BSI in PHO patients in the ambulatory setting has not been well documented. METHODS: The Children's Hospital Association leads the Childhood Cancer and Blood Disorders Network, a multicenter United States quality improvement collaborative, working to reduce the incidence of inpatient and ambulatory Central Line-Associated BSI (CLABSI) among PHO patients...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152808/ambulatory-redesign-strategies-for-quality-improvement-in-patient-care
#17
Catherine A Lyons, Nancy Smith, Maureen McGlennon, Terri L Parker, Carolyn Truini, Maureen Major-Campos, Jill Lacy, Karen Michaels, Vanna Dest, Richard Lisitano, Kerin B Adelson, Rogerio Lilenbaum
: 85 Background: Growing outpatient volume poses patient flow challenges, making it difficult to accommodate the complexities of academic medical practice. Volume increases create operational inefficiencies like delays in lab turnaround time (TAT) and limited rooming capacity resulting in delays in patient access and reduced provider productivity. These bottlenecks negatively impact patient satisfaction. METHODS: Four multidisciplinary teams assessed barriers to patient flow in the lab, rooming and scheduling process...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152717/regional-initiative-to-use-data-transparency-to-improve-cancer-care
#18
Catherine R Fedorenko, Teah Hoopes, Gary H Lyman, Thomas David Brown, Eric Y Chen, Ted Conklin, John M Corman, Matt Lonergan, Daniel Lessler, Renato Martins, Csaba Mera, John Whitelaw Rieke, Elie P Saikaly, Julie C Smith, F Marc Stewart, Richard Whitten, Scott David Ramsey
: 39 Background: In the context of many initiatives aimed at measuring quality and value in cancer care, the Hutchinson Institute for Cancer Outcomes Research (HICOR) has adopted a multi-stakeholder approach to characterize oncology care, prioritize areas for improvement, design programs, and evaluate outcomes. Beginning in 2014, HICOR initiated a process to move towards data transparency in the reporting of regional quality and value metrics. METHODS: The HICOR team constructed clinic-level adherence reports for community-prioritized metrics and the 2012 ASCO Choosing Wisely recommendations using a registry-claims linked database...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152697/establishing-an-oncology-quality-dashboard-for-improvement
#19
Danielle Gross
: 223 Background: Cancer Treatment Centers of America (CTCA), a national network of five hospitals, formed a Quality Improvement Committee to bring together both clinical and administrative leadership (physician, nursing, pharmacy and quality) across the enterprise vested in the oversight of quality and patient safety. Tasked with facilitating and driving measurement and improvement the group established a Quality dashboard housing metrics of importance given current performance, evidence-based practice, and evolving external standards...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28134086/the-spectrum-of-early-rheumatoid-arthritis-practice-across-the-globe-results-from-a-multinational-cross-sectional-survey
#20
Elena Nikiphorou, James Galloway, Piet van Riel, Yusuf Yazici, Glenn Haugeberg, Andrew Ostor, Feride Gogus, Markku Kauppi, Tuulikki Sokka
OBJECTIVES: To explore patterns of real-world early RA (ERA) care across countries. METHODS: An online survey was disseminated to practising rheumatologists across Europe and the US, also made accessible on social media between April and May 2015. Survey questions (n=38) assessed the structure and setting of ERA clinics, times to diagnosis and treatment, patient monitoring, guideline use and data recording. RESULTS: A total of 212 rheumatologists from 39 countries (76% European) completed the survey...
January 27, 2017: Clinical and Experimental Rheumatology
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