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Patient turnaround time

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https://www.readbyqxmd.com/read/27914768/selective-staining-of-gastric-biopsies-for-h-pylori-does-not-affect-detection-rates-or-turnaround-time-and-improves-cost-compared-to-reflexive-staining
#1
Lauren Decker, Joshua Keith Routh, Jessica Sara Snider, Joshua Anspach Hanson
AIMS: To evaluate how reflexive versus selective H. pylori stains affect detection rates, turnaround time (TAT), and cost savings in a real life practice environment following an institutional policy change. METHODS: The aforementioned parameters were evaluated in all cases in the year preceding and the year following an institutional policy change from reflexive to selective staining. RESULTS: 1497 patients comprised the reflexive stain (RS) group of which 228 (15...
September 13, 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27913483/atypical-hemolytic-uremic-syndrome
#2
Vahid Afshar-Kharghan
Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy (TMA) that affects multiple organs and the kidneys in particular. aHUS can be sporadic or familial and is most commonly caused by dysregulation of the alternative complement pathway. The initial attack of aHUS can occur at any age, and is associated with a high rate of progression to end stage renal disease. Many aHUS patients relapse in the native or transplanted kidneys, and require close monitoring and long-term management. Availability of anticomplement therapy has revolutionized the management of aHUS, and can change the natural course of aHUS by inducing hematologic remission, improving or stabilizing kidney functions, and preventing graft failure...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27895341/bringing-efficiency-into-practice-a-quality-improvement-initiative-to-reduce-operating-room-turnaround-time
#3
Hasanat Sharif, Noman Shehzad, Joveria Farooqi, Sana Karim, Sana Akbar
Operating room (OR) turnaround time (TAT) is the minimal essential time required for cleaning of OR and preparation for the next case. The TAT inversely affects OR efficiency. Several factors related to personnel, equipment and scheduling have been identified as causes of increased TAT. We conducted the study to identify factors that affect OR TAT and to propose recommendations for its reduction. The retrospective study, conducted at Aga Khan University Hospital, Karachi, comprised TAT records related to March 2014...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27879409/new-technologies-for-rapid-bacterial-identification-and-antibiotic-resistance-profiling
#4
REVIEW
Shana O Kelley
Conventional approaches to bacterial identification and drug susceptibility testing typically rely on culture-based approaches that take 2 to 7 days to return results. The long turnaround times contribute to the spread of infectious disease, negative patient outcomes, and the misuse of antibiotics that can contribute to antibiotic resistance. To provide new solutions enabling faster bacterial analysis, a variety of approaches are under development that leverage single-cell analysis, microfluidic concentration and detection strategies, and ultrasensitive readout mechanisms...
November 22, 2016: Journal of Laboratory Automation
https://www.readbyqxmd.com/read/27875685/progressive-disseminated-histoplasmosis-a-systematic-review-on-the-performance-of-non-culture-based-diagnostic-tests
#5
Diego R Falci, Elias R Hoffmann, Diego D Paskulin, Alessandro C Pasqualotto
The diagnosis of progressive disseminated histoplasmosis is often a challenge to clinicians, especially due to the low sensitivity and long turnaround time of the classic diagnostic methods. In recent years, studies involving a variety of non-culture-based diagnostic tests have been published in the literature. The aim of this paper is to perform a systematic review by selecting articles evaluating non-culture-based diagnostic methods in the diagnosis of progressive disseminated histoplasmosis. We searched for articles evaluating detection of antibody, antigens, and DNA methods...
November 19, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27866173/a-rapid-uplc-ms-ms-assay-for-the-simultaneous-measurement-of-fluconazole-voriconazole-posaconazole-itraconazole-and-hydroxyitraconazole-concentrations-in-serum
#6
Sankha S Basu, Athena Petrides, Donald S Mason, Petr Jarolim
BACKGROUND: Triazole antifungals are essential to the treatment and prophylaxis of fungal infections. Significant pharmacokinetic variability combined with a clinical need for faster turnaround times has increased demand for in-house therapeutic drug monitoring of these drugs, which is best performed using mass spectrometry-based platforms. However, technical and logistical obstacles to implementing these platforms in hospital laboratories have limited their widespread utilization. Here, we present the development and validation of a fast and simple ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method to measure fluconazole, voriconazole, posaconazole, itraconazole, and hydroxyitraconazole in human serum suitable for incorporation into a hospital clinical laboratory...
November 21, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27854218/targeted-re-sequencing-emulsion-pcr-panel-for-myopathies-results-in-94-cases
#7
Jaya Punetha, Akanchha Kesari, Prech Uapinyoying, Mamta Giri, Nigel F Clarke, Leigh B Waddell, Kathryn N North, Roula Ghaoui, Gina L O'Grady, Emily C Oates, Sarah A Sandaradura, Carsten G Bönnemann, Sandra Donkervoort, Paul H Plotz, Edward C Smith, Carolina Tesi-Rocha, Tulio E Bertorini, Mark A Tarnopolsky, Bernd Reitter, Irena Hausmanowa-Petrusewicz, Eric P Hoffman
BACKGROUND: Molecular diagnostics in the genetic myopathies often requires testing of the largest and most complex transcript units in the human genome (DMD, TTN, NEB). Iteratively targeting single genes for sequencing has traditionally entailed high costs and long turnaround times. Exome sequencing has begun to supplant single targeted genes, but there are concerns regarding coverage and needed depth of the very large and complex genes that frequently cause myopathies. OBJECTIVE: To evaluate efficiency of next-generation sequencing technologies to provide molecular diagnostics for patients with previously undiagnosed myopathies...
May 27, 2016: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/27847380/the-added-cost-of-rapid-diagnostic-testing-and-active-antimicrobial-stewardship-is-it-worth-it
#8
Erin McElvania TeKippe
Rapid diagnostic testing reduces the turnaround time for pathogen identification in the clinical microbiology laboratory, but the impact on patient care and hospital costs are a matter of speculation A publication by Patel et al. in this issue of the Journal of Clinical Microbiology (Patel TS, Kaakeh R, Nagel JL, Newton DW, and Stevenson JG, 2016. J Clin Microbiol, vol:pages, 2016, http://dx.doi.org/10.1128/JCM.01452-16) investigates the impact of these interventions to determine if implementation is indeed worth it...
November 9, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27843737/does-elimination-of-a-laboratory-sample-clotting-stage-requirement-reduce-overall-turnaround-times-for-emergency-department-stat-biochemical-testing
#9
Sarah Compeau, Michael Howlett, Stephanie Matchett, Jennifer Shea, Jacqueline Fraser, Rose McCloskey, Paul Atkinson
INTRODUCTION:  Laboratory turnaround times (TAT) influence length of stay for emergency department (ED) patients. We studied biochemistry TATs around the implementation of a plasma separating tube (PST) that omitted a 20-minute clotting step in processing when compared to the standard serum separating tubes (SST). METHODS:  We compared laboratory TATs using PST vs SST in a prospective before-and-after study with a washout period. TATs for creatinine, urea, electrolytes, troponin, and N-terminal pro b-type natriuretic peptide (NT-proBNP), as well as hemolysis rates, were collected for all ED patients...
October 6, 2016: Curēus
https://www.readbyqxmd.com/read/27837325/reduced-length-of-hospital-stay-through-a-point-of-care-placed-automated-blood-culture-instrument
#10
M J Bruins, M J Egbers, T M Israel, S H A Diepeveen, M J H M Wolfhagen
Early appropriate antimicrobial treatment of patients with sepsis has a large impact on clinical outcome. To enable prompt and efficient processing of blood cultures, the inoculated vials should be placed into an automated continuously monitoring blood culture system immediately after sampling. We placed an extra BACTEC FX instrument at the emergency department of our hospital and validated the twice-daily re-entering of ongoing vials from this instrument into the BACTEC FX at the laboratory. We subsequently assessed the benefits of shortening the transport time between sampling and monitored incubation of blood culture vials by comparing the turnaround times of positive blood cultures from emergency department patients with a historical control group...
November 11, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27836225/impact-of-rapid-diagnostic-testing-for-chlamydia-and-gonorrhea-on-appropriate-antimicrobial-utilization-in-the-emergency-department
#11
Kaitlyn R Rivard, Lisa E Dumkow, Heather M Draper, Kasey L Brandt, David W Whalen, Nnaemeka E Egwuatu
Prolonged turnaround time of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) test results may delay time to notification and treatment of test-positive patients and result in unnecessary antimicrobial use in test-negative patients. This quasi-experimental study evaluated the impact of NG/CT rapid diagnostic testing (RDT) in an urban emergency department (ED) on treatment appropriateness, time to notification, and cost. Patients tested in December 2013-January 2014 (traditional group, n=200) were compared with those in December 2014-January 2015 (RDT group, n=200)...
October 18, 2016: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/27834297/identification-of-rate-limiting-steps-in-the-provision-of-thrombolytics-for-acute-ischemic-stroke
#12
Elise L Metts, Abby M Bailey, Kyle A Weant, Stephanie B Justice
BACKGROUND: Tissue plasminogen activator (tPA) is the only pharmacotherapy shown to improve outcomes in acute ischemic stroke. The American Heart Association (AHA) recommends a door-to-needle (DTN) time of <60 minutes in at least 50% of patients presenting with acute ischemic stroke. OBJECTIVE: The purpose of this study was to analyze the possible barriers that may delay tPA administration within the emergency department (ED) of an academic medical center. METHODS: A retrospective chart review was conducted from February 2011 to October 2013...
November 9, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27832552/current-limitations-of-the-assessment-of-haemostasis-in-adult-extracorporeal-membrane-oxygenation-patients-and-the-role-of-point-of-care-testing
#13
K Venkatesh, P S Nair, D J Hoechter, H Buscher
Haemostatic perturbations are commonly seen in extracorporeal membrane oxygenation (ECMO) patients and remain a clinical challenge, contributing significantly to morbidity and mortality. The approach to anticoagulation monitoring and the management of bleeding varies considerably across ECMO centres. Routine laboratory tests have their limitations in terms of turnaround time and specificity of information provided. Newer point-of-care testing (POCT) for coagulation may overcome these issues, as it provides information about the entire coagulation pathway from clot initiation to lysis...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27821087/comparing-culture-and-molecular-methods-for-the-identification-of-microorganisms-involved-in-necrotizing-soft-tissue-infections
#14
Vibeke Børsholt Rudkjøbing, Trine Rolighed Thomsen, Yijuan Xu, Rachael Melton-Kreft, Azad Ahmed, Steffen Eickhardt, Thomas Bjarnsholt, Steen Seier Poulsen, Per Halkjær Nielsen, Joshua P Earl, Garth D Ehrlich, Claus Moser
BACKGROUND: Necrotizing soft tissue infections (NSTIs) are a group of infections affecting all soft tissues. NSTI involves necrosis of the afflicted tissue and is potentially life threatening due to major and rapid destruction of tissue, which often leads to septic shock and organ failure. The gold standard for identification of pathogens is culture; however molecular methods for identification of microorganisms may provide a more rapid result and may be able to identify additional microorganisms that are not detected by culture...
November 8, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27815055/strengths-and-deficiencies-in-the-content%C3%A2-of-us-radiology-private-practices-%C3%A2-websites
#15
Evan J Johnson, Ankur M Doshi, Andrew B Rosenkrantz
PURPOSE: The Internet provides a potentially valuable mechanism for radiology practices to communicate with patients and enhance the patient experience. The aim of this study was to assess the websites of US radiology private practices, with attention to the frequency of content of potential patient interest. METHODS: The 50 largest private practice radiology facilities in the United States were identified from RadiologyBusiness.com. Websites were reviewed for information content and functionality...
November 1, 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27784278/ras-testing-practices-and-ras-mutation-prevalence-among-patients-with-metastatic-colorectal-cancer-results-from-a-europe-wide-survey-of-pathology-centres
#16
Annemarie Boleij, Véronique Tack, Aliki Taylor, George Kafatos, Sophie Jenkins-Anderson, Lien Tembuyser, Els Dequeker, J Han van Krieken
BACKGROUND: Treatment options for patients with metastatic colorectal cancer (mCRC) include anti-epithelial growth factor therapies, which, in Europe, are indicated in patients with RAS wild-type tumours only and require prior mutation testing of "hot-spot" codons in exons 2, 3 and 4 of KRAS and NRAS. The aim of this study was to evaluate the implementation of RAS testing methods and estimate the RAS mutation prevalence in mCRC patients. METHODS: Overall, 194 pathology laboratories were invited to complete an online survey...
October 26, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27765617/a-rapid-highly-sensitive-and-culture-free-detection-of-pathogens-from-blood-by-positive-enrichment
#17
Manjula Ramya Vutukuru, Divya Khandige Sharma, M S Ragavendar, Susanne Schmolke, Yiwei Huang, Walter Gumbrecht, Nivedita Mitra
Molecular diagnostics is a promising alternative to culture based methods for the detection of bloodstream infections, notably due to its overall lower turnaround time when starting directly from patient samples. Whole blood is usually the starting diagnostic sample in suspected bloodstream infections. The detection of low concentrations of pathogens in blood using a molecular assay necessitates a fairly high starting volume of blood sample in the range of 5-10mL. This large volume of blood sample has a substantial accompanying human genomic content that interferes with pathogen detection...
October 17, 2016: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/27756354/use-of-point-of-care-testing-and-early-assessment-model-reduces-length-of-stay-for-ambulatory-patients-in-an-emergency-department
#18
Meri Kankaanpää, Maria Raitakari, Leila Muukkonen, Siv Gustafsson, Merja Heitto, Ari Palomäki, Kimmo Suojanen, Veli-Pekka Harjola
BACKGROUND: To assess whether the use of point-of-care testing (POCT) and early assessment team (EAT) model shortens emergency department (ED) length of stay (LOS). METHODS: This prospective, observational study with comparison between three study periods was performed in three phases in a metropolitan ED with 57,000 annual visits. Data were collected from adult ambulatory patients who were discharged home. Phase 1 served as a control (n = 1559 in one month)...
October 18, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27752312/improving-emergency-department-flow-through-optimized-bed-utilization
#19
Lucas Brien Chartier, Licinia Simoes, Meredith Kuipers, Barb McGovern
Over the last decade, patient volumes in the emergency department (ED) have grown disproportionately compared to the increase in staffing and resources at the Toronto Western Hospital, an academic tertiary care centre in Toronto, Canada. The resultant congestion has spilled over to the ED waiting room, where medically undifferentiated and potentially unstable patients must wait until a bed becomes available. The aim of this quality improvement project was to decrease the 90th percentile of wait time between triage and bed assignment (time-to-bed) by half, from 120 to 60 minutes, for our highest acuity patients...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27743679/quality-of-the-aetiological-diagnosis-of-ventilator-associated-pneumonia-in-spain-in-the-opinion-of-intensive-care-specialists-and-microbiologists
#20
Emilio Bouza, José Martínez-Alarcón, Emilio Maseda, Mercedes Palomar, Rafael Zaragoza, María Jesús Pérez-Granda, Patricia Muñoz, Almudena Burillo
INTRODUCTION: Current guidelines for the microbiological diagnosis of ventilator-associated pneumonia (VAP) are imprecise. Based on data provided by intensive care specialists (ICS) and microbiologists, this study defines the clinical practices and microbiological techniques currently used for an aetiological diagnosis of VAP and pinpoints deficiencies. METHODS: Eighty hospitals in the national health network with intensive care and microbiology departments were sent two questionnaires, one for each department, in order to collect data on VAP diagnosis for the previous year...
October 13, 2016: Enfermedades Infecciosas y Microbiología Clínica
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