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Institute of healthcare improvement

Saturnin Bertrand Nguenda Anya, Atanase Yene
This paper seeks to identify the determinants of the choice of treatment of pregnant women in Cameroon. Theoretically, the methodology is based on a discrete choice model with random utility. Empirically, the econometric specification is a Nested Multinomial Logit Model. The data used comes from the Demographic Health Survey (DHS) organized in 2011 by the National Institute of Statistics. The results reveal that uneducated women or those having only a primary education prefer to meet the traditional midwives than seek modern maternal health services...
December 2016: Health Economics Review
Navid Alem, Joseph Rinehart, Brian Lee, Doug Merrill, Safa Sobhanie, Kyle Ahn, Ran Schwarzkopf, Maxime Cannesson, Zeev Kain
BACKGROUND: Efforts to mitigate costs while improving surgical care quality have received much scrutiny. This includes the challenging issue of readmission subsequent to hospital discharge. Initiatives attempting to preclude readmission after surgery require planned and unified efforts extending throughout the perioperative continuum. Patient optimization prior to discharge, enhanced disease monitoring, and seamless coordination of care between hospitals and community providers is integral to this process...
2016: Perioperative Medicine
R M Paredes Esteban, J I Garrido Pérez, A Ruiz Palomino, G Guerrero Peña, F Vázquez Rueda, M J Berenguer García, R Miñarro Del Moral, M Tejedor Fernández
OBJECTIVES: In 2014 our department starts to apply the PatientSafety Strategic in Pediatric Surgery. Our aim is to describe the results obtained. METHODS: For the measurement of adverse events (AE) we used a modification of the Global Trigger Tool of the Institute for Healthcare Improvement. Population analysed: patients undergoing surgery with hospitalization. On a monthly basis, audits of the medical records of 12 patients discharged in the prior week of the assessment were performed...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Jack J Olney, Paula Braitstein, Jeffrey W Eaton, Edwin Sang, Monicah Nyambura, Sylvester Kimaiyo, Ellen McRobie, Joseph W Hogan, Timothy B Hallett
BACKGROUND: With expanded access to antiretroviral therapy (ART) in sub-Saharan Africa, HIV mortality has decreased, yet life-years are still lost to AIDS. Strengthening of treatment programmes is a priority. We examined the state of an HIV care programme in Kenya and assessed interventions to improve the impact of ART programmes on population health. METHODS: We created an individual-based mathematical model to describe the HIV epidemic and the experiences of care among adults infected with HIV in Kenya...
October 19, 2016: Lancet HIV
Anthony C Waddimba, Melissa Scribani, Nicole Krupa, John J May, Paul Jenkins
BACKGROUND: Widespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition...
October 22, 2016: BMC Health Services Research
David C Classen, William Munier, Nancy Verzier, Noel Eldridge, David Hunt, Mark Metersky, Chesley Richards, Yun Wang, P Jeffrey Brady, Amy Helwig, James Battles
The explicit declaration in the landmark 1999 Institute of Medicine report "To Err Is Human" that, in the United States, 44,000 to 98,000 patients die each year as a consequence of "medical errors" gave widespread validation to the magnitude of the patient safety problem and catalyzed a number of U.S. federal government programs to measure and improve the safety of the national healthcare system. After more than 10 years, one of those federal programs, the Medicare Patient Safety Monitoring System (MPSMS), has reached a level of maturity and stability that has made it useful for the consistent measurement of the safety of inpatient care...
October 20, 2016: Journal of Patient Safety
K Malkiewicz, E Malkiewicz, K A Eaton, E Widström
Poland is one of the largest European countries in terms of area and population. The country's economic situation does not allow for the allocation of sufficient public funds for healthcare in general and oral healthcare in particular. The health policy of the state focuses primarily on prophylaxis and treatment of diseases, directly threatening the health and lives of the inhabitants. Currently, expenditure on oral health accounts for only 2.7% of the public funds allocated to healthcare. In this context, providing oral care financed from public funds at an appropriate level constitutes a challenge for state institutions, centres providing medical and dental services and private practices...
October 21, 2016: British Dental Journal
John M Collins, Ofer Reizes, Michael K Dempsey
Academic investigators are generating a plethora of insights and technologies that have the potential to significantly improve patient care. However, to address the imperative to improve the quality, cost and access to care with ever more constrained funding, the efficiency and the consistency with which they are translated into cost effective products and/or services need to improve. Healthcare commercialization programs (HCPs) are described and proposed as an option that institutions can add to their portfolio to improve translational research...
2016: IEEE Journal of Translational Engineering in Health and Medicine
Mohammad Alyahya, Heba Hijazi, Heather Harvey
BACKGROUND: While the main focus of accreditation initiatives has been on hospitals, the implementation of these programs is a relatively new notion among other types of healthcare facilities. Correspondingly, this study aims to understand how accreditation is perceived among primary public healthcare centers using an isomorphic institutional theory. DESIGN/METHODOLOGY: Semi-structured, in-depth interviews were conducted with 56 healthcare professionals and administrative staff from seven non-profit healthcare centers in Jordan using an explanatory case-study approach...
October 20, 2016: International Journal of Health Planning and Management
Gus P Cairns, Kane Race, Pedro Goicochea
Pre-exposure prophylaxis (PrEP) has been and continues to be an intervention that causes controversy and debate between stakeholders involved in providing or advocating for it, and within communities in need of it. These controversies extend beyond the intrinsically complex issues of making it available. In this commentary, some of the possible roots of the air of dissent and drama that accompanies PrEP are explored. The similarities between the controversies that dogged the earliest human trials of PrEP and the ones we see today in the era of licensing and implementation are explored...
2016: Journal of the International AIDS Society
Afsin Emre Kayipmaz, Orcun Ciftci, Cemil Kavalci, Emir Karacaglar, Haldun Muderrisoglu
BACKGROUND: This study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions. METHODS: We included 225 emergency medicine specialists working in all geographical regions of Turkey. We e-mailed them a 20-item questionnaire comprising questions related to their STEMI management practices and characteristics of STEMI presentation and patient admissions...
2016: PloS One
Fei Hu, Jiayan Zhang, Shupeng Shi, Zhang Zhou
BACKGROUND: Febrile illness in young children usually indicates an underlying infection and is a cause of concern for parents and carers. It is very important that healthcare professionals know how to recognize fever, assess children with fever, treat children with fever and role of nurses and parents. This paper outlines a best practice implementation project on the management of fever in children in an emergency department. OBJECTIVES: To audit current practice of fever management for children in an emergency department and to implement strategies to standardize pediatric fever management based on evidence-based practice guidelines...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
Cedric Mabire, Andrew Dwyer, Antoine Garnier, Joanie Pellet
BACKGROUND: Inadequate discharge planning for the growing elderly population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing's role or the specific components of these interventions. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be proven in practice. OBJECTIVES: To determine the best available evidence on the effectiveness of discharge planning interventions involving at least one nurse on health-related outcomes for elderly inpatients discharged home and to assess the relative impact of individual components of discharge planning interventions...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
Jessica Martin, Mark Wilcox
PURPOSE OF REVIEW: Clostridium difficile infection has attained high prominence given its prevalence and impacts on patients and healthcare institutions. Multiple new approaches to the prevention and treatment of C. difficile infection (CDI) are undergoing clinical trials. RECENT FINDINGS: Bezlotoxumab is a monoclonal antibody against toxin B that has successfully completed phase III studies, demonstrating a significant reduction in recurrent CDI when given with standard of care antibiotics...
October 7, 2016: Current Opinion in Infectious Diseases
Jason Suh, Amishi Desai, Anish Desai, Josephine Dela Cruz, Anusiyanthan Mariampillai, Alexander Hindenburg
Venous thromboembolism (VTE) remains the number one preventable cause of hospital acquired mortality and morbidity. Each year, more than 12 million patients are at risk for VTE. The delivery of appropriate and timely VTE prophylaxis is still suboptimal in many healthcare institutions and can lead to increased readmissions, morbidity, as well as costs. To clarify this issue further, we performed a retrospective case control study at our institution to determine if poor adherence to the VTE prophylaxis guidelines could lead to an increase in VTE events...
October 17, 2016: Journal of Thrombosis and Thrombolysis
Paul E Farmer, Joseph J Rhatigan
Shortages of trained health care workers plague low- and middle-income countries around the world. When resources are scarce, the ability to support medical education is severely constrained. While there are many important "building blocks" of health systems that need to be bolstered in low- and middle-income countries, the authors propose that U.S. academic medicine can make unique contributions in the realm of human resource development-specifically, increasing the supply of physicians who directly provide health care to the populations they serve and who often manage and lead these health systems...
October 4, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Sairam Parthasarathy, Mary A Carskadon, Girardin Jean-Louis, Judith Owens, Adam Bramoweth, Daniel Combs, Lauren Hale, Elizabeth Harrison, Chantelle N Hart, Brant P Hasler, Sarah M Honaker, Elisabeth Hertenstein, Samuel Kuna, Clete Kushida, Jessica C Levenson, Caitlin Murray, Allan I Pack, Vivek Pillai, Kristi Pruiksma, Azizi Seixas, Patrick Strollo, Saurabh S Thosar, Natasha Williams, Daniel Buysse
A wealth of scientific knowledge is being generated in sleep and circadian science. In order for us to realize the return on investment for such scientific knowledge and to improve the health of the nation, we need to disseminate and implement research findings into practice. An implementation gap - termed a "quality chasm" by the Institutes of Medicine - separates the scientific knowledge we possess and the implementation of such knowledge into preventative interventions or healthcare treatments. It is frequently reported that a time lag of 17 years transpires before medical research reaches clinical practice...
October 10, 2016: Sleep
Filipa Alves da Costa, Luísa Silvestre, Catarina Periquito, Clara Carneiro, Pedro Oliveira, Ana Isabel Fernandes, Patrícia Cavaco-Silva
BACKGROUND: Currently, people live longer but often with poor quality of life. The decrease in healthy life-years is partly attributable to the institution of polypharmacy to treat various comorbidities. OBJECTIVES: The objectives of the study were to determine the prevalence and nature of drug-related problems (DRPs) in polypharmacy elderly patients residing in nursing homes and to test the acceptability of a pharmacist's intervention. METHODS: An exposure cohort was constituted in three Portuguese nursing homes, where all polypharmacy (five or more medicines) elderly patients (≥65 years of age) were analysed and then a random stratified sample was extracted to be subject to an intervention...
March 2016: Drugs—Real World Outcomes
Marten N Basta, Liza C Wu, Suhail K Kanchwala, Joseph M Serletti, Julia C Tchou, Stephen J Kovach, Joshua Fosnot, John P Fischer
BACKGROUND: Breast cancer-related lymphedema remains a significant complication post mastectomy. Identifying patients at highest risk may better inform targeted healthcare resource allocation and improve outcomes. This study aims to identify lymphedema predictors after mastectomy to develop a simple, accurate risk assessment tool. METHODS: An institutional retrospective review identified all women with breast cancer undergoing mastectomy between January 2000 and July 2013 with postmastectomy lymphedema as the primary outcome...
September 7, 2016: American Journal of Surgery
Ambrose Hon-Wai Wong, Joan Combellick, Beth Ann Wispelwey, Allison Squires, Maureen Gang
OBJECTIVES: The emergency department (ED) has been recognized as a high-risk environment for workplace violence. Acutely agitated patients who perpetrate violence against healthcare workers represent a complex care challenge in the ED. Recommendations to improve safety are often based on expert opinion rather than empirical data. In this study we aim to describe the lived experience of staff members caring for this population in order to provide a broad perspective of ED patient violence...
October 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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