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https://www.readbyqxmd.com/read/28651351/applying-a-theory-driven-framework-to-guide-quality-improvement-efforts-in-nursing-homes-the-lock-model
#1
Whitney L Mills, Camilla B Pimentel, Jennifer A Palmer, A Lynn Snow, Nancy J Wewiorski, Rebecca S Allen, Christine W Hartmann
Purpose of the Study: Implementing quality improvement (QI) programs in nursing homes continues to encounter significant challenges, despite recognized need. QI approaches provide nursing home staff with opportunities to collaborate on developing and testing strategies for improving care delivery. We present a theory-driven and user-friendly adaptable framework and facilitation package to overcome existing challenges and guide QI efforts in nursing homes. Design and development: The framework is grounded in the foundational concepts of strengths-based learning, observation, relationship-based teams, efficiency, and organizational learning...
June 23, 2017: Gerontologist
https://www.readbyqxmd.com/read/28651345/prioritizing-quality-measure-concepts-at-the-interface-of-behavioral-and-physical-healthcare
#2
Harold Alan Pincus, Mingjie Li, Deborah M Scharf, Brigitta Spaeth-Rublee, Matthew L Goldman, Parashar P Ramanuj, Erin K Ferenchick
Objective: Integrated healthcare models can increase access to care, improve healthcare quality, and reduce cost for individuals with behavioral and general medical healthcare needs, yet there are few instruments for measuring the quality of integrated care. In this study, we identified and prioritized concepts that can represent the quality of integrated behavioral health and general medical care. Design: We conducted a literature review to identify candidate measure concepts...
June 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28651340/linking-quality-indicators-to-clinical-trials-an-automated-approach
#3
Enrico Coiera, Miew Keen Choong, Guy Tsafnat, Peter Hibbert, William B Runciman
Objective: Quality improvement of health care requires robust measurable indicators to track performance. However identifying which indicators are supported by strong clinical evidence, typically from clinical trials, is often laborious. This study tests a novel method for automatically linking indicators to clinical trial registrations. Design: A set of 522 quality of care indicators for 22 common conditions drawn from the CareTrack study were automatically mapped to outcome measures reported in 13 971 trials from ClinicalTrials...
June 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28651296/early-discharge-hospital-at-home
#4
REVIEW
Daniela C Gonçalves-Bradley, Steve Iliffe, Helen A Doll, Joanna Broad, John Gladman, Peter Langhorne, Suzanne H Richards, Sasha Shepperd
BACKGROUND: Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. OBJECTIVES: To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. SEARCH METHODS: We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28651166/air-quality-inside-subway-metro-indoor-environment-worldwide-a-review
#5
REVIEW
Bin Xu, Jinliang Hao
The air quality in the subway metro indoor microenvironment has been of particular public concern. With specific reference to the growing demand of green transportation and sustainable development, subway metro systems have been rapidly developed worldwide in last decades. The number of metro commuters has continuously increased over recent years in metropolitan cities. In some cities, metro system has become the primary public transportation mode. Although commuters typically spend only 30-40min in metros, the air pollutants emitted from various interior components of metro system as well as air pollutants carried by ventilation supply air are significant sources of harmful air pollutants that could lead to unhealthy human exposure...
June 23, 2017: Environment International
https://www.readbyqxmd.com/read/28651159/health-related-quality-of-life-results-from-the-phase-iii-checkmate-067-study
#6
Dirk Schadendorf, James Larkin, Jedd Wolchok, F Stephen Hodi, Vanna Chiarion-Sileni, Rene Gonzalez, Piotr Rutkowski, Jean-Jacques Grob, C Lance Cowey, Christopher Lao, John Wagstaff, Margaret K Callahan, Michael A Postow, Michael Smylie, Pier Francesco Ferrucci, Reinhard Dummer, Andrew Hill, Fiona Taylor, Javier Sabater, Dana Walker, Srividya Kotapati, Amy Abernethy, Georgina V Long
BACKGROUND: Nivolumab, a monoclonal antibody of immune checkpoint programmed death 1 on T cells (PD-1), combined with ipilimumab, an immune checkpoint cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor, as combination therapy on the one hand and nivolumab as monotherapy on the other, have both demonstrated improved efficacy compared with ipilimumab alone in the CheckMate 067 study. However, the combination resulted in a higher frequency of grade 3/4 adverse events (AEs), which could result in diminished health-related quality of life (HRQoL)...
June 22, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28651070/assessment-of-temporal-predictive-models-for-health-care-using-a-formal-method
#7
Ward van Breda, Mark Hoogendoorn, A E Eiben, Matthias Berking
Recent developments in the field of sensor devices provide new possibilities to measure a variety of health related aspects in a precise and fine-grained manner. Subsequently, more empirical data will be generated than ever before. While this greatly improves the opportunities for creating accurate predictive models, other types of models besides the more traditional machine learning approaches can provide insights into temporal relationships in the data. Models that express temporal relationships between states in a mathematical manner are examples of such models...
June 17, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28651030/clinical-alerts-to-decrease-high-risk-medication-use-in-older-adults
#8
Wilhelmina Lord-Adem, Nicole J Brandt
High-risk medications (HRMs) account for 14.6% to 54.6% of all medications used in older adults, and have been linked to >50% of adverse drug events (ADEs). HRM-related ADEs lead to increased morbidity and mortality, increased hospital length of stay, and financial costs for patients and health care systems. It has been well documented that incorporating information technology in patient care in the form of clinical alert systems can effectively decrease HRM use and improve patient safety. The current article seeks to identify and discuss clinical alert systems focusing on HRMs, their impact on prescribing for older adults, and challenges to the implementation of electronic decision systems...
July 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28650981/health-situation-of-migrant-and-minority-nurses-a-systematic-review
#9
Benjamin Schilgen, Albert Nienhaus, Oriana Handtke, Holger Schulz, Mike Mösko
INTRODUCTION: Globally, life expectancy together with multimorbidity and chronic diseases are increasing. This leads to a growing demand for care and hence for healthcare personnel and nurses. To meet this demand, healthcare workers from abroad are increasingly hired. The nurses' workplace in general is characterized by physically and psychologically demanding tasks, while that of migrant and minority nurses is additionally characterized by discriminatory practices. The present knowledge about the health of migrant and minority nurses and the terminology in this context are diverse...
2017: PloS One
https://www.readbyqxmd.com/read/28650921/effect-of-continuity-of-care-on-drug-drug-interactions
#10
Jiun-Yu Guo, Yiing-Jenq Chou, Christy Pu
BACKGROUND: Drug-drug interaction (DDI) is a critical concern in health care systems because it is directly associated with patient outcomes and is generally preventable. However, few studies have been conducted on whether poor continuity of care (COC) is a determinant of DDIs and whether this effect varies by level of comorbidity. Patients with higher comorbidity normally require more complex treatment regimens than other patients, and hence their COC is more critical for ensuring the accuracy of their medication information...
June 23, 2017: Medical Care
https://www.readbyqxmd.com/read/28650884/can-surgeon-demographic-factors-predict-postoperative-complication-rates-after-elective-spinal-fusion
#11
Danielle S Chun, Ralph W Cook, Joseph A Weiner, Michael S Schallmo, Kathryn A Barth, Sameer K Singh, Ryan D Freshman, Alpesh A Patel, Wellington K Hsu
STUDY DESIGN: Retrospective cohort. OBJECTIVE: Determine whether surgeon demographic factors influence postoperative complication rates after elective spine fusion procedures. BACKGROUND: Surgeon demographic factors have been shown to impact decision making in the management of degenerative disease of the lumbar spine. Complication rates are frequently reported outcome measurements used to evaluate surgical treatments, quality-of-care, and determine health care reimbursements...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650874/lean-daily-management-exploring-the-effectiveness-in-reducing-product-returns-and-overnight-shipment-occurrences-in-a-materials-management-department
#12
Savanah Hopkins, Marcea Walter, Sandra Collins
Lean Daily Management (LDM) is a performance improvement process used by health care organizations to reduce waste and increase value. Designed to transform health care professionals into organizational problem solvers, LDM tools have been used throughout the health care industry, but full integration of this performance improvement initiative has largely evaded health care organizations. To demonstrate the effectiveness of LDM, research was conducted to evaluate the costs associated with product returns and overnighted products as monitored by a materials management department, which found that these were specific areas where excessive resources were frequently used...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28650873/perceptions-of-ambulatory-workflow-changes-in-an-academic-primary-care-setting
#13
Michael A Hanak, Colleen McDevitt, Daniel P Dunham
As health care moves to a value-based system, the need for team-based models of care becomes increasingly important to adequately address the growing number of clinical quality metrics required of health care providers. Finding ways to better engage certified medical assistants (CMAs) in the process allows providers to focus on more complex tasks while improving the efficiency of each office visit. Although the roles and responsibilities for CMAs across the specialties can vary widely, standardizing the work can be a helpful step in scaling best practices across an institution...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28650752/characteristics-predicting-the-outcome-in-individuals-with-diabetic-foot-ulcerations
#14
Lourdes Vella, Cynthia Formosa
BACKGROUND: We sought to determine patient and ulcer characteristics that predict wound healing in patients living with diabetes. METHODS: A prospective observational study was conducted on 99 patients presenting with diabetic foot ulceration. Patient and ulcer characteristics were recorded. Patients were followed up for a maximum of 1 year. RESULTS: After 1 year of follow-up, ulcer characteristics were more predictive of ulcer healing than were patient characteristics...
May 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28650703/program-implementation-of-option-b%C3%A2-at-a-president-s-emergency-plan-for-aids-relief-supported-hiv-clinic-improves-clinical-indicators-but-not-retention-in-care-in-mbarara-uganda
#15
Kathleen Miller, Winnie Muyindike, Lynn T Matthews, Michael Kanyesigye, Mark J Siedner
2013 WHO guidelines for prevention of mother to child transmission recommend combination antiretroviral therapy (ART) for all pregnant women, regardless of CD4 count (Option B/B+). We conducted a retrospective analysis of data from a government-operated HIV clinic in Mbarara, Uganda before and after implementation of Option B+ to assess the impact on retention in care. We limited our analysis to women not on ART at the time of their first reported pregnancy with CD4 count >350. We fit regression models to estimate relationships between calendar period (Option A vs...
June 26, 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28650679/establishing-maximal-medical-improvement-after-arthroscopic-rotator-cuff-repair
#16
William A Zuke, Timothy S Leroux, Bonnie P Gregory, Austin Black, Brian Forsythe, Anthony A Romeo, Nikhil N Verma
BACKGROUND: As health care transitions from a pay-for-service to a pay-for-performance infrastructure, the value of orthopaedic care must be defined accurately. Significant efforts have been made in defining quality and cost in arthroplasty; however, there remains a lag in ambulatory orthopaedic care. PURPOSE: Two-year follow-up has been a general requirement for reporting outcomes after rotator cuff repair. However, this time requirement has not been established scientifically and is of increasing importance in the era of value-based health care...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28650347/electronic-health-telemedicine-and-new-paradigms-for-training-and-care
#17
Catherine S Todd, Stephen J Mills, Anh L Innes
PURPOSE OF REVIEW: HIV prevention and care is changing rapidly; guideline revisions and programmatic scale-up require innovative approaches to in-service training and care extension to improve provider practice and care access. We assessed recent (≤12 months) peer-reviewed publications on electronic health (eHealth), telemedicine, and other innovative provider-targeted interventions for HIV-related care. RECENT FINDINGS: Key developments included systems merging electronic medical records (EMR) with provider clinical decision aids to prompt action, demonstration eHealth, and telemedicine projects, reviews or descriptions of technology to improve connectivity in lower resource settings, and a few trials on provider-centered interventions...
June 23, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28650029/nanoparticle-encapsulated-baicalein-markedly-modulates-pro-inflammatory-response-in-gingival-epithelial-cells
#18
Xuan Li, Wei Luo, Tsz Wing Ng, Ping Chung Leung, Chengfei Zhang, Ken Cham-Fai Leung, Lijian Jin
Severe gum disease (periodontitis), which is one of the major global oral diseases, results from microbe-host dysbiosis and dysregulated immuno-inflammatory responses. It seriously affects oral health and general wellbeing with significant socio-economic implications. It has been well documented that natural flavonoids such as baicalin (BA) and baicalein (BE) possess potent anti-inflammatory effects. However, their intrinsic poor solubility and low bioavailability severely limit their biomedical applications...
June 26, 2017: Nanoscale
https://www.readbyqxmd.com/read/28649928/beyond-the-medical-model
#19
Scott J Fitzpatrick, Jo River
The medical model continues to dominate research and shape policy and service responses to suicide. In this work we challenge the assumption that the medical model always provides the most effective and appropriate care for persons who are suicidal. In particular, we point to service user perspectives of health services which show that interventions are often experienced as discriminatory, culturally inappropriate, and incongruent with the needs and values of persons who are suicidal. We then examine "humanistic" approaches to care that have been proposed as a corrective to an overly medical model...
January 1, 2017: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/28649868/early-eye-movement-desensitisation-and-reprocessing-emdr-intervention-in-a-disaster-mental-health-care-context
#20
Anna Saltini, Daniela Rebecchi, Chiara Callerame, Isabel Fernandez, Elisa Bergonzini, Fabrizio Starace
'Early psychological intervention' is defined as commencing treatment within three months of the traumatic event, with the aim to prevent or treat posttraumatic stress disorder, ongoing distress or acute stress disorder. In natural disaster situations, specific issues may limit the amount of time available for treatment and the possibility of interventions. Eye Movement Desensitisation and Reprocessing (EMDR) can be used without regard to these limits. The aim of the study is to evaluate the effects of EMDR, Recent Traumatic Episode Protocol (R-TEP) provided within three months of the traumatic event to a large sample of individuals exposed to the earthquake that hit Emilia Romagna Region (Northern Italy) in 2012...
June 25, 2017: Psychology, Health & Medicine
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