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https://www.readbyqxmd.com/read/28431419/creation-and-validation-of-an-automated-algorithm-to-determine-postoperative-ventilator-requirements-after-cardiac-surgery
#1
Eilon Gabel, Ira S Hofer, Nancy Satou, Tristan Grogan, Richard Shemin, Aman Mahajan, Maxime Cannesson
BACKGROUND: In medical practice today, clinical data registries have become a powerful tool for measuring and driving quality improvement, especially among multicenter projects. Registries face the known problem of trying to create dependable and clear metrics from electronic medical records data, which are typically scattered and often based on unreliable data sources. The Society for Thoracic Surgery (STS) is one such example, and it supports manually collected data by trained clinical staff in an effort to obtain the highest-fidelity data possible...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430052/predicting-complication-risk-in-spine-surgery-a-prospective-analysis-of-a-novel-risk-assessment-tool
#2
Anand Veeravagu, Amy Li, Christian Swinney, Lu Tian, Adrienne Moraff, Tej D Azad, Ivan Cheng, Todd Alamin, Serena S Hu, Robert L Anderson, Lawrence Shuer, Atman Desai, Jon Park, Richard A Olshen, John K Ratliff
OBJECTIVE The ability to assess the risk of adverse events based on known patient factors and comorbidities would provide more effective preoperative risk stratification. Present risk assessment in spine surgery is limited. An adverse event prediction tool was developed to predict the risk of complications after spine surgery and tested on a prospective patient cohort. METHODS The spinal Risk Assessment Tool (RAT), a novel instrument for the assessment of risk for patients undergoing spine surgery that was developed based on an administrative claims database, was prospectively applied to 246 patients undergoing 257 spinal procedures over a 3-month period...
April 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28429970/taking-data-seriously-the-value-of-actor-network-theory-in-rethinking-patient-experience-data
#3
Amit Desai, Giulia Zoccatelli, Mary Adams, Davina Allen, Sally Brearley, Anne Marie Rafferty, Glenn Robert, Sara Donetto
Hospitals are awash with patient experience data, much of it collected with the ostensible purpose of improving the quality of patient care. However, there has been comparatively little consideration of the nature and capacities of data itself. Using insights from actor-network theory, we propose that paying attention to patient experience data as having agency in particular hospital interactions allows us to better trace how and in what circumstances data lead (or fail to lead) to quality improvement.
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28429207/organizational-and-welfare-mode-of-breast-centers-network-a-survey-of-sicilian-radiologists
#4
Maria Adele Marino, Orazio Pennisi, Annalisa Donia, Carmelo Sofia, Claudio Guerra, Carmelo Privitera, Placido Romeo
The European Society of Breast Cancer Specialists has created quality indicators for breast units to establish the minimum standards of care for patients. In Italy, each region differs, indeed, in terms of health care and services warranted to patients suffering from breast cancer. Since Sicilian Regional Administration today is still disregarding implementation of the provisions contained in the proposal of the Ministry of Health entitled "Guidelines on Organizational and Health Care Methods of Breast Centers Network" in November 2015 the Sicilian Regional Group of the Italian Society of Radiology (SIRM) decided to carry out a survey to see the position of the Sicilian Healthcare System and define the gap to bridge over...
April 20, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28429077/-implementation-of-the-german-s3-guidelines-on-dementia-in-clinical-practice-wish-or-reality
#5
H Lohmann, F Kulessa, H Holling, A Johnen, S Reul, G Lueg, T Duning
BACKGROUND: Published in 2009, the German S3 guidelines on dementia define a milestone in quality improvement of the diagnostics and treatment of dementia. In clinical practice patients suffering from dementia are primarily treated by physicians in private practice; therefore, this study examined how the guidelines are implemented in outpatient clinical settings. Furthermore, it aimed at the identification of behavioral determinants that govern the actual diagnostic and therapeutic approach in clinical practice...
April 20, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28427873/risk-factors-for-hospital-admission-after-anterior-cruciate-ligament-reconstruction
#6
Steven L Bokshan, Steven F DeFroda, Brett D Owens
PURPOSE: To determine patient and surgical risk factors for admission after anterior cruciate ligament reconstruction (ACLR) using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. METHODS: All instances of ACLR from 2005 to 2014 from the ACS NSQIP prospective database were analyzed. Both univariate analysis and binary logistic regression were performed to determine which patient demographics and medical comorbidities were associated with admission after surgery...
April 17, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28427782/prospective-study-of-a-non-restrictive-decision-rule-for-acute-aortic-syndrome
#7
Judah Goldschmiedt, Jeffrey M Levsky, Eran Y Bellin, Esther Mizrachi, David Esses, Linda B Haramati
OBJECTIVES: To determine the impact of a non-restrictive clinical decision rule on CT utilization for Emergency Department patients suspected of having an acute aortic syndrome (AAS). METHODS: We prospectively assessed the performance of a previously described, collaboratively designed, non-restrictive clinical decision rule for AAS. Emergency Department patients with suspected AAS were stratified into low and high-risk groups based on decision rule results, from July 2013-August 2014...
April 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28427302/increasing-influenza-immunization-rates-among-retail-employees-an-evidence-based-approach
#8
Leigh Montejo, Rachel Richesson, B Iris Padilla, Michael E Zychowicz, Crystal Hambley
Influenza has a significant impact on the health of Americans and the U.S. economy. Annual influenza immunization can decrease the burden of influenza-related illnesses for both employees and employers. This project evaluated a nurse practitioner-led intervention to increase influenza immunization rates among retail employees from August through December of the 2015-2016 influenza season. The sample included employees from retail locations with on-site convenience care clinics staffed by nurse practitioners...
April 1, 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/28426563/routine-inclusion-of-long-term-functional-and-patient-reported-outcomes-pros-into-trauma-registries-the-forte-project
#9
Arturo J Rios-Diaz, Juan P Herrera-Escobar, Elizabeth J Lilley, Jessica R Appelson, Belinda Gabbe, Karen Brasel, Terri deRoon-Cassini, Eric B Schneider, George Kasotakis, Haytham Kaafarani, George Velmahos, Ali Salim, Adil H Haider
BACKGROUND: The National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) recently recommended inclusion of post-discharge health-related quality of life (HRQoL) and patient-reported outcomes (PROs) metrics to benchmark the quality of trauma care. Currently, these measures are not routinely collected at most trauma centers. We sought to determine the feasibility and value of adding such long-term outcome measures to trauma registries. METHODS: As part of the Functional Outcomes and Recovery after Trauma Emergencies (FORTE) project we included patients with an ISS ≥9, admitted to the Brigham and Women's Hospital in Boston, MA who were identified retrospectively using the institutional trauma registry and contacted 6 or 12-months post-injury to participate in a telephone survey evaluating: HRQoL (Short Form-12 [SF-12]), PROs (Trauma Quality of Life [T-QoL]), post-traumatic stress disorder (PTSD), return to work, residential status, and healthcare utilization...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426561/unfractionated-heparin-versus-low-molecular-weight-heparin-for-venous-thromboembolism-prophylaxis-in-trauma
#10
Benjamin N Jacobs, Anne H Cain-Nielsen, Jill L Jakubus, Judy N Mikhail, John J Fath, Scott E Regenbogen, Mark R Hemmila
BACKGROUND: Venous thromboembolism (VTE) is a common complication in trauma patients. Pharmacologic prophylaxis is utilized in trauma patients to reduce their risk of a VTE event. The Eastern Association for the Surgery of Trauma guidelines recommend use of low molecular weight heparin (LMWH) as the preferred agent in these patients. However, there is literature suggesting that unfractionated heparin (UFH) is an acceptable, and less costly, alternative VTE prophylaxis agent with equivalent efficacy in trauma patients...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426302/innovations-in-population-health-surveillance-using-electronic-health-records-for-chronic-disease-surveillance
#11
Sharon E Perlman, Katharine H McVeigh, Lorna E Thorpe, Laura Jacobson, Carolyn M Greene, R Charon Gwynn
With 87% of providers using electronic health records (EHRs) in the United States, EHRs have the potential to contribute to population health surveillance efforts. However, little is known about using EHR data outside syndromic surveillance and quality improvement. We created an EHR-based population health surveillance system called the New York City (NYC) Macroscope and assessed the validity of diabetes, hyperlipidemia, hypertension, smoking, obesity, depression, and influenza vaccination indicators. The NYC Macroscope uses aggregate data from a network of outpatient practices...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28426186/issue-at-the-heart-of-advancing-the-de-adoption-of-low-value-care-proceedings-from-an-expert-roundtable
#12
Janet Weiner, Rebecka Rosenquist
Identifying and paying for value has become a recurrent theme of health care reforms. Its corollary, reducing the prevalence of, and resources directed to, ineffective or marginally effective care, has received far less attention. In July 2016, the University of Pennsylvania’s Leonard Davis Institute of Health Economics (LDI) convened a diverse set of national leaders and stakeholders representing industry, think-tanks, provider and patient groups, and academic experts to tackle how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable...
April 2017: LDI Issue Brief
https://www.readbyqxmd.com/read/28425574/factors-associated-with-sustainability-of-2-quality-improvement-programs-after-achieving-early-implementation-success-a-qualitative-case-study
#13
Stephanie M C Ament, Freek Gillissen, Albine Moser, José M C Maessen, Carmen D Dirksen, Maarten F von Meyenfeldt, Trudy van der Weijden
RATIONALE, AIMS, AND OBJECTIVES: Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. METHOD: An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery...
April 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28424899/a-polysomnographic-study-in-parkinsonian-patients-treated-with-intestinal-levodopa-infusion
#14
Maurizio Zibetti, Alberto Romagnolo, Aristide Merola, Lorenzo Priano, Elisa Montanaro, Serena Angrisano, Antonella Tribolo, Alessandro Cicolin, Leonardo Lopiano
Sleep disorders are very common in advanced Parkinson's disease (PD) and have a significant negative impact on the quality of life of patients. Questionnaire-based studies suggest that sleep quality might improve following levodopa-carbidopa intestinal gel (LCIG) infusion. The objective of this study was to evaluate the impact of LCIG infusion and subsequent oral medication changes on polysomnography (PSG) and sleep symptoms in advanced PD patients. Eleven PD patients underwent PSG at baseline and after 3.8 ± 1...
April 19, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28424131/postoperative-complications-predict-30-day-readmission-in-geriatric-general-surgery-patients
#15
James D Dieterich, Celia M Divino
The Affordable Care Act has placed unplanned patient readmissions under more scrutiny than ever. Geriatric patients, in particular, suffer a disproportionate amount of complications from any kind of hospitalization, including readmissions. This study seeks to identify risk factors in this population that predispose them to an unplanned readmission within 30 days after index surgery. The National Surgical Quality Improvement Program database was used to select patients 65 years and older, who underwent general surgery procedures in 2012...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28423777/data-driven-quality-improvement-of-health-professions-education-design-and-development-of-clue-an-interactive-curriculum-data-visualization-tool
#16
Claire Ann Canning, Alan Loe, Kathryn Jane Cockett, Paul Gagnon, Nabil Zary
Curriculum Mapping and dynamic visualization is quickly becoming an integral aspect of quality improvement in support of innovations which drive curriculum quality assurance processes in medical education. CLUE (Curriculum Explorer) a highly interactive, engaging and independent platform was developed to support curriculum transparency, enhance student engagement, and enable granular search and display. Reflecting a design based approach to meet the needs of the school's varied stakeholders, CLUE employs an iterative and reflective approach to drive the evolution of its platform, as it seeks to accommodate the ever-changing needs of our stakeholders in the fast pace world of medicine and medical education today...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423205/the-impact-of-biogas-and-fuelwood-use-on-institutional-kitchen-air-quality-in-kampala-uganda
#17
Aleia Ingulli McCord, Sarah Adel Stefanos, Vianney Tumwesige, Dorothy Lsoto, Anna Hillstrom Meding, Angela Adong, James Jay Schauer, Rebecca Anne Larson
Experts have suggested that microscale biogas systems offer a source of renewable energy that improves indoor air quality, but such impacts have not been directly measured. This study documented cooking behaviors and measured 2.5 μm particulate matter (PM2.5 ), carbon monoxide (CO), and sulfur dioxide (SO2 ) concentrations within 14 institutional kitchens in Kampala, Uganda that prepare meals using biogas (n=5), a mixture of biogas and fuelwood (n=3), and fuelwood (n=6). Small institutions (10-30 people) with biogas kitchens had 99% lower concentrations of PM2...
April 19, 2017: Indoor Air
https://www.readbyqxmd.com/read/28423164/triple-aim-in-canada-developing-capacity-to-lead-to-better-health-care-and-cost
#18
Elina Farmanova, Christine Kirvan, Jennifer Verma, Geetha Mukerji, Nurdin Akunov, Kaye Phillips, Stephen Samis
Quality problem: Many modern health systems strive for 'Triple Aim' (TA)-better health for populations, improved experience of care for patients and lower costs of the system, but note challenges in implementation. Outcomes of applying TA as a quality improvement framework (QI) have started to be realized with early lessons as to why some systems make progress while others do not. Initial assessment: Limited evidence is available as to how organizations create the capacity and infrastructure required to design, implement, evaluate and sustain TA systems...
December 1, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28423163/metafrontier-frameworks-for-studying-hospital-productivity-growth-and-quality-changes
#19
Kuan-Chen Chen, Li-Nien Chien, Yi-Hsin Hsu, Ming-Miin Yu
Objective: The objective of this study was to evaluate productivity growth and quality changes among different levels of accredited hospitals. Design: This study used an attribute-incorporating Malmquist productivity index (MPI) under the metafrontier framework. This is the first attempt to compare productivity changes among hospitals operating under different production frontiers. Participants: The data consisted of 20 academic medical centers (AMCs), 61 metropolitan hospitals (MPs) and 112 local community hospitals (LCs) in Taiwan during the period 2007-2010...
December 1, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28422932/clarifying-the-conundrum-evidence-based-practice-quality-improvement-or-research-the-clinical-scholarship-continuum
#20
Eileen J Carter, Kari Mastro, Courtney Vose, Reynaldo Rivera, Elaine L Larson
Nurses' active involvement in clinical scholarship is necessary to advance the nursing profession and improve patient outcomes. Yet, definitional confusion and numerous barriers exist to clinical scholarship in and across academic and patient care settings. We discuss factors that pose barriers to the continuum of clinical scholarship and suggest opportunities for clinician-researcher collaborations that promote nurses' engagement in evidence-based practice, quality improvement, and research.
May 2017: Journal of Nursing Administration
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