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(Quality improvement) AND (medical education)

Aine Cafferkey, Elizabeth Coyle, David Greaney, Sinead Harte, Niamh Hayes, Miriam Langdon, Birgitt Straub, Crina Burlacu
BACKGROUND: Simulation-based education is a modern training modality that allows healthcare professionals to develop knowledge and practice skills in a safe learning environment. The College of Anaesthetists of Ireland (CAI) was the first Irish postgraduate medical training body to introduce mandatory simulation training into its curriculum. Extensive quality assurance and improvement data has been collected on all simulation courses to date. AIMS: Describe The College of Anaesthetists of Ireland Simulation Training (CAST) programme and report the analysis of course participants' feedback...
March 20, 2018: Irish Journal of Medical Science
Allison Brown, Aditya Nidumolu, Alexandra Stanhope, Justin Koh, Matthew Greenway, Lawrence Grierson
BACKGROUND: Quality Improvement (QI) training for health professionals is essential to strengthen health systems. However, QI training during medical school is constrained by students' lack of contextual understanding of the health system and an already saturated medical curriculum. The Program for Improvement in Medical Education (PRIME), an extracurricular offered at the Michael G. DeGroote School of Medicineat McMaster University (Hamilton, Canada), addresses these obstacles by having first-year medical students engage in QI by identifying opportunities for improvement within their own education...
March 19, 2018: BMJ Quality & Safety
Elliott Mark Weiss, Dawei Xie, Noah Cook, Katherine Coughlin, Steven Joffe
Importance: Little is known about how characteristics of particular clinical decisions influence decision-making preferences by patients or their surrogates. A better understanding of the factors underlying preferences is essential to improve the quality of shared decision making. Objective: To identify the characteristics of particular decisions that are associated with parents' preferences for family- vs medical team-centered decision making across the spectrum of clinical decisions that arise in the neonatal intensive care unit (NICU)...
March 19, 2018: JAMA Pediatrics
Paul R King, Gregory P Beehler, Bonnie M Vest, Kerry Donnelly, Laura O Wray
PURPOSE/OBJECTIVE: Explore cognitive, affective, and experiential factors that inform veterans' traumatic brain injury (TBI)-related beliefs. Research Method/Design: Qualitative descriptive study of 22 veterans who received care for TBI at a VA Medical Center in the Northeastern United States using directed content analysis. Measures included a semistructured interview, demographic survey, the Alcohol Use Disorders Identification Test-Consumption Items (AUDIT-C), Patient Health Questionnaire-9 (PHQ-9), PTSD Checklist (PCL), Neurobehavioral Symptom Inventory (NSI), and Insomnia Severity Index (ISI)...
February 2018: Rehabilitation Psychology
Zoheir Elkahtib
BACKGROUND: Most health-care organisations are increasingly interested in assessing the quality of their services. Patient satisfaction has a central role in the quality assessment in health care because it reflects the appropriateness of services from the clients' perspectives. The aim of this study was to assess the level of satisfaction in patients with non-communicable diseases (mainly diabetes and hypertension) who receive services from UNRWA health centres in Gaza governorates. METHODS: In this cross-sectional study we chose a random sample of participants who presented to the randomly selected six health centres for treatment of non-communicable diseases...
February 21, 2018: Lancet
Eatimad Shalabi-Abbas, Saba Dweikat, Israa Al Gazawy, Sajeda Draghmah
BACKGROUND: Menstruation is a natural phenomenon that occurs throughout the reproductive life of every woman. The aim of this study was to explore knowledge and self-care practices among Palestinian adolescent girls during their menstrual period. Reproductive health issues in adolescent girls is an important but neglected area of Palestinian research. METHODS: For this cross-sectional study we recruited girls from grades seven, eight, and nine in the three biggest schools for girls in Nablus district...
February 21, 2018: Lancet
Nathan D Shippee, Michael Finch, Douglas R Wholey
OBJECTIVES: Patient-centered medical homes (PCMHs) represent a widespread model of healthcare transformation. Despite evidence that PCMHs can improve care quality, the mechanisms by which they improve outcomes are relatively unexamined. We aimed to assess the mechanisms linking certification as a Health Care Home (HCH), a statewide PCMH initiative, with asthma care quality and outcomes. We compared direct certification effects versus indirect clinical effects (via improved care process)...
March 1, 2018: American Journal of Managed Care
Amir S Steinberg, Anish B Parikh, Sara Kim, Damaris Peralta-Hernandez, Talaat Aggour, Luis Isola
OBJECTIVES: Antibiotic stewardship is an integral aspect of hospital care, limiting the potential for resistance while working to minimize waste. A similar system is needed in oncology, given the rapid proliferation of new therapies and the challenges of navigating a complicated reimbursement environment. A "cancer therapy stewardship program" has never been described in the literature. Here, we detail our efforts to design and implement such a program and share lessons learned to inform future projects...
March 2018: American Journal of Managed Care
Jun-Hua Zhang, You-Ping Li, Bo-Li Zhang
The introduction and popularization of evidence-based medicine has opened up a new research field of clinical efficacy evaluation of traditional Chinese medicine(TCM), produced new research ideas and methods, and promoted the progress of clinical research of TCM. After about 20 years assiduous study and earnest practice, the evidence based evaluation method and technique, which conforms to the characteristics of TCM theory and practice, has been developing continuously. Evidence-based Chinese medicine (EBCM) has gradually formed and become an important branch of evidence-based medicine...
January 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Alexander J M Dingemans, Wilfried Krois, Juan Craniotis Rios, Richard J Wood, Marc A Levitt, Carlos A Reck-Burneo
BACKGROUND/PURPOSE: We conduct an annual medical mission to Hospital Ruth Paz para Niños Quemados y Cirugía Pediátrica in Honduras to operate on cases of anorectal malformations (ARM). To improve our knowledge of these patients, we compared their health-related quality of life (HRQoL), and the health literacy of their caregivers from this hospital and ours in the United States. METHODS: The BRIEF Health Literacy Screen (BHLS) and Pediatric Quality of Life Inventory 4...
February 23, 2018: Journal of Pediatric Surgery
Imran Ahmed, Niall Safir Ahmad, Shahnaz Ali, Shair Ali, Anju George, Hiba Saleem Danish, Encarl Uppal, James Soo, Mohammad H Mobasheri, Dominic King, Benita Cox, Ara Darzi
BACKGROUND: Medication adherence is an expensive and damaging problem for patients and health care providers. Patients adhere to only 50% of drugs prescribed for chronic diseases in developed nations. Digital health has paved the way for innovative smartphone solutions to tackle this challenge. However, despite numerous apps available claiming to improve adherence, a thorough review of adherence apps has not been carried out to date. OBJECTIVE: The aims of this study were to (1) review medication adherence apps available in app repositories in terms of their evidence base, medical professional involvement in development, and strategies used to facilitate behavior change and improve adherence and (2) provide a system of classification for these apps...
March 16, 2018: JMIR MHealth and UHealth
Michelle M Valdez, Maureen Liwanag, Charles Mount, Rechell Rodriguez, Elisea Avalos-Reyes, Andrew Smith, David Collette, Michael Starsiak, Richard Green
Introduction: Inefficiencies in the command approval process for publications and/or presentations negatively impact DoD Graduate Medical Education (GME) residency programs' ability to meet ACGME scholarly activity requirements. A preliminary review of the authored works approval process at Naval Medical Center San Diego (NMCSD) disclosed significant inefficiency, variation in process, and a low level of customer satisfaction. In order to facilitate and encourage scholarly activity at NMCSD, and meet ACGME requirements, the Executive Steering Council (ESC) chartered an interprofessional team to lead a Lean Six Sigma (LSS) Rapid Improvement Event (RIE) project...
March 14, 2018: Military Medicine
Bonita Sasnett, Susie T Harris, Shelly White
Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators...
March 16, 2018: Health Care Manager
Cho-Kai Wu, Jyh-Ming Jimmy Juang, Jiun-Yang Chiang, Yi-Heng Li, Chia-Ti Tsai, Fu-Tien Chiang
Taiwanese heart registries for the main cardiovascular diseases have been conducted in the past 10 years, with the goal of examining the quality of cardiovascular patient care, which cannot be guaranteed by the universal Taiwan National Health Insurance. The results show suboptimal adherence to guideline recommendations. Door-to-balloon time and dual antiplatelet therapy use in acute coronary syndrome, standard medications for management of heart failure, low-density lipoprotein cholesterol levels in dyslipidemia, anticoagulant agent use in atrial fibrillation, and the understanding of sudden arrhythmia death syndrome were all found to be inadequate...
March 20, 2018: Journal of the American College of Cardiology
Khe Foon Hew, Chung Kwan Lo
BACKGROUND: The use of flipped classroom approach has become increasingly popular in health professions education. However, no meta-analysis has been published that specifically examines the effect of flipped classroom versus traditional classroom on student learning. This study examined the findings of comparative articles through a meta-analysis in order to summarize the overall effects of teaching with the flipped classroom approach. We focused specifically on a set of flipped classroom studies in which pre-recorded videos were provided before face-to-face class meetings...
March 15, 2018: BMC Medical Education
Lisa Blom, Lucie Laflamme, Helle Mölsted Alvesson
BACKGROUND: Image-based teleconsultation between medical experts and healthcare staff at remote emergency centres can improve the diagnosis of conditions which are challenging to assess. One such condition is burns. Knowledge is scarce regarding how medical experts perceive the influence of such teleconsultation on their roles and relations to colleagues at point of care. METHODS: In this qualitative study, semi-structured interviews were conducted with 15 medical experts to explore their expectations of a newly developed App for burns diagnostics and care prior to its implementation...
2018: PloS One
Sameer Shaikh, Mohammad Aljanakh, Ibrahim Khalil Al Ibrahim, Mohammad Sohail Memon
Numerous substances may have an adverse influence on the oral region by virtue of their potentially harmful effects. Dental practitioners are often the first to see these effects in the head and neck region. Knowledge of the damaging consequences of agents such as alcohol, tobacco, areca nut, medications, alcohol-containing mouthwashes, dental devices and materials can assist the practitioners in clinical decision-making and accurate diagnosis of associated lesions. More importantly, timely diagnosis and prompt reporting of such harmful effects improve the quality of care...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Babatunde Aremu, Pamela D Hill, Joanne M McNeal, Mary A Petersen, Debbie Swanberg, Kathleen R Delaney
Addressing tense and escalating situations with noncoercive measures is an important element of inpatient psychiatric treatment. Although restraint rates are frequently monitored, the use of pro re nata (PRN) intramuscular (IM) injections to address agitation is also an important indicator. In 2015, at the current study site, a significant increase was noted in PRN IM medication use despite unit leadership's efforts to build a culture of trauma-informed care (TIC). The purpose of the current quality improvement project was to educate staff on methods to incorporate TIC into daily practice and the use of brief solution-focused therapy techniques in escalating situations...
March 14, 2018: Journal of Psychosocial Nursing and Mental Health Services
Joseph E Kerschner, Jerris R Hedges, Karen Antman, Edward Abraham, Edgar Colón Negrón, J Larry Jameson
Academic medical center (AMC) faculty, administrators, and leaders have the critical tasks of teaching and training the next generation of health care providers and biomedical researchers, as well as generating new knowledge that improves the health of all. In the United States, medical schools and their affiliated hospitals train remarkably high-quality physicians and scientists, and the research conducted at these institutions results in advances in health. To that end, AMCs have become essential engines for driving better health in the United States and the rest of the world; they also have become essential engines driving the economies of their respective communities and regions...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Vineet M Arora
With the advent of electronic medical records (EMRs) fueling the rise of big data, the use of predictive analytics, machine learning, and artificial intelligence are touted as transformational tools to improve clinical care. While major investments are being made in using big data to transform health care delivery, little effort has been directed toward exploiting big data to improve graduate medical education (GME). Because our current system relies on faculty observations of competence, it is not unreasonable to ask whether big data in the form of clinical EMRs and other novel data sources can answer questions of importance in GME such as when is a resident ready for independent practice...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
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