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What is quality in medical care?

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https://www.readbyqxmd.com/read/27920089/world-endometriosis-society-consensus-on-the-classification-of-endometriosis
#1
Neil P Johnson, Lone Hummelshoj, G David Adamson, Jörg Keckstein, Hugh S Taylor, Mauricio S Abrao, Deborah Bush, Ludwig Kiesel, Rulla Tamimi, Kathy L Sharpe-Timms, Luk Rombauts, Linda C Giudice
STUDY QUESTION: What is the global consensus on the classification of endometriosis that considers the views of women with endometriosis? SUMMARY ANSWER: We have produced an international consensus statement on the classification of endometriosis through systematic appraisal of evidence and a consensus process that included representatives of national and international, medical and non-medical societies, patient organizations, and companies with an interest in endometriosis...
December 5, 2016: Human Reproduction
https://www.readbyqxmd.com/read/27917391/adrift-in-the-gray-zone-irb-perspectives-on-research-in-the-learning-health-system
#2
Sandra Soo-Jin Lee, Maureen Kelley, Mildred K Cho, Stephanie Alessi Kraft, Cyan James, Melissa Constantine, Adrienne N Meyer, Douglas Diekema, Alexander M Capron, Benjamin S Wilfond, David Magnus
BACKGROUND: Human subjects protection in healthcare contexts rests on the premise that a principled boundary distinguishes clinical research and clinical practice. However, growing use of evidence-based clinical practices by health systems makes it increasingly difficult to disentangle research from a wide range of clinical activities that are sometimes called "research on medical practice" (ROMP), including quality improvement activities and comparative effectiveness research. The recent growth of ROMP activities has created an ethical and regulatory gray zone with significant implications for the oversight of human subjects research...
2016: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/27917219/experience-of-collaboration-between-a-dutch-surgical-team-in-a-ghanaian-orthopaedic-teaching-hospital
#3
T K Timmers, E Kortekaas, Bpc Beyer, E Huizinga, S M V Hezik van, E Twagirayezu, M Bemelman
BACKGROUND: Surgery is an indivisible, indispensable part of healthcare. In Africa, surgery may be thought of as the neglected stepchild of global public health. We describe our experience over a 3-year period of intensive collaboration between specialized teams from a Dutch hospital and local teams of an orthopaedic hospital in Effiduase-Koforidua, Ghana. INTERVENTION: During 2010-2012, medical teams from our hospital were deployed to St. Joseph's Hospital. These teams were completely self-supporting...
September 2016: African Health Sciences
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#4
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27898175/interventions-for-promoting-participation-in-shared-decision-making-for-children-with-cancer
#5
REVIEW
Imelda Coyne, Dónal P O'Mathúna, Faith Gibson, Linda Shields, Edith Leclercq, Greg Sheaf
BACKGROUND: This is an update of the Cochrane systematic review of shared decision-making (SMD) making published in 2013. Children's rights to have their views heard in matters that affect their lives are now well established since the publication of the UN Convention treaty (1989). Children with cancer generally prefer to be involved in decision-making and consider it important that they have the opportunity to take part in decision-making concerning their health care, even in end-of-life decisions...
November 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27876636/concordance-between-veterans-self-report-and-documentation-of-surrogate-decision-makers-implications-for-quality-measurement
#6
Kimberly K Garner, Patricia Dubbert, Shelly Lensing, Dennis H Sullivan
CONTEXT: The Measuring What Matters (MWM) initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. OBJECTIVES: To better understand the potential implementation of this MWM quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker...
November 19, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27860051/the-professional-psychiatric-mental-health-nurse-skills-competencies-and-supports-required-to-adopt-recovery-orientated-policy-in-practice
#7
E Cusack, F Killoury, L E Nugent
: WHAT IS KNOWN ON THE SUBJECT?: Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery. At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland...
November 18, 2016: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/27856381/what-questionnaires-to-use-when-measuring-quality-of-life-in-sacral-tumor-patients-the-updated-sacral-tumor-survey
#8
Olivier D R van Wulfften Palthe, Stein J Janssen, Jay S Wunder, Peter C Ferguson, Guo Wei, Peter S Rose, Micheal J Yaszemski, Franklin H Sim, Patrick J Boland, John H Healey, Francis J Hornicek, Joseph H Schwab
BACKGROUND CONTEXT: Patient reported outcomes are becoming increasingly important when investigating results of patient and disease management. In sacral tumor patients symptoms can vary substantially, therefore no single questionnaire can adequately account for the full spectrum of symptoms and disability. PURPOSE: The purpose of this study is to analyze redundancy within the current sacral tumor survey and make a recommendation for an updated version based on the results and patient and expert opinions...
November 14, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27845505/education-of-physical-and-rehabilitation-medicine-specialists-across-europe-a-call-for-harmonisation
#9
Carlotte Kiekens, Maximiliaan Moyaert, Maria G Ceravolo, Sasa Moslavac, Alvydas Juocevicius, Nicolas Christodoulou, Stefano Negrini
BACKGROUND: PRM is well established in Europe and officially recognised by the Union Européenne des Médecins Spécialistes (UEMS). The European PRM Board works to promote patient safety and quality of care through the development of the highest standards of medical training and healthcare across Europe as well as the harmonisation of PRM specialists' qualifications. In its Action Plan for 2014-2018, the UEMS PRM Board has included the harmonisation of the PRM curriculum among the EU countries, as one of its main goals...
November 15, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27837400/are-readmissions-after-tha-preventable
#10
Douglas S Weinberg, Matthew J Kraay, Steven J Fitzgerald, Vasu Sidagam, Glenn D Wera
BACKGROUND: Readmissions after total joint arthroplasty have become a key quality measure in elective surgery in the United States. The Affordable Care Act includes the Hospital Readmission Reduction Program, which calls for reduced payments to hospitals with excessive readmissions. This policy uses a method to determine excess readmission ratios and calculate readmission payment adjustments to hospitals, however, it is unclear whether readmission rates are an effective quality metric...
November 11, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27831481/a-scoping-literature-review-of-dementia-friendly-hospital-design
#11
REVIEW
Belinda Parke, Marie Boltz, Kathleen F Hunter, Thane Chambers, Karin Wolf-Ostermann, Mohamad Nadim Adi, Fabio Feldman, Gloria Gutman
PURPOSE: We report the findings of a knowledge synthesis research project on the topic of dementia-friendly acute care (D-FAC) design. This exploratory project systematically mapped what is known about D-FAC physical design in hospitals. We discuss our challenges in locating reportable evidence and the implications of such design for maximizing independent function while ensuring safety and harm reduction in older people living with dementia. DESIGN AND METHODS: Exploratory iterative design utilizing scoping literature review methodology...
November 9, 2016: Gerontologist
https://www.readbyqxmd.com/read/27829409/-i-just-think-that-we-should-be-informed-a-qualitative-study-of-family-involvement-in-advance-care-planning-in-nursing-homes
#12
Lisbeth Thoresen, Lillian Lillemoen
BACKGROUND: As part of the research project "End-of-life Communication in Nursing Homes. Patient Preferences and Participation", we have studied how Advance Care Planning (ACP) is carried out in eight Norwegian nursing homes. The concept of ACP is a process for improving patient autonomy and communication in the context of progressive illness, anticipated deterioration and end-of-life care. While an individualistic autonomy based attitude is at the fore in most studies on ACP, there is a lack of empirical studies on how family members' participation and involvement in ACP- conversations may promote nursing home patients' participation in decisions on future treatment and end-of-life care...
November 10, 2016: BMC Medical Ethics
https://www.readbyqxmd.com/read/27829014/systematic-review-of-screening-and-surveillance-programs-to-protect-workers-from-nanomaterials
#13
Mary Gulumian, Jos Verbeek, Charlene Andraos, Natasha Sanabria, Pieter de Jager
BACKGROUND: Screening and surveillance approaches for workers exposed to nanomaterials could aid in early detection of health effects, provide data for epidemiological studies and inform action to decrease exposure. The aim of this review is to identify such screening and surveillance approaches, in order to extract available data regarding (i) the studies that have successfully been implemented in present day, (ii) identification of the most common and/or toxic nano-related health hazards for workers and (iii) possible exposure surveillance markers...
2016: PloS One
https://www.readbyqxmd.com/read/27789510/the-patient-the-doctor-and-the-patient-s-loyalty-a-qualitative-study-in-french-general-practice
#14
Laura Gérard, Mathilde François, Marine de Chefdebien, Oliver Saint-Lary, Alain Jami
BACKGROUND: The term loyalty can be defined as the attachment that characterises someone who consistent in their feelings, affections, or habits. By introducing the Declaration of General Practitioner (or preferred doctor declaration) in 2004, France adopted a formal incentive for patients to be faithful to their doctor since it entailed optimal coverage of medical care by their national health insurance There has been no research evaluating the impact of this measure and to determine the components of doctor-patient loyalty...
November 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27781204/why-economic-analysis-of-health-system-improvement-interventions-matters
#15
Edward Ivor Broughton, Lani Marquez
There is little evidence to direct health systems toward providing efficient interventions to address medical errors, defined as an unintended act of omission or commission or one not executed as intended that may or may not cause harm to the patient but does not achieve its intended outcome. We believe that lack of guidance on what is the most efficient way to reduce medical errors and improve the quality of health-care limits the scale-up of health system improvement interventions. Challenges to economic evaluation of these interventions include defining and implementing improvement interventions in different settings with high fidelity, capturing all of the positive and negative effects of the intervention, using process measures of effectiveness rather than health outcomes, and determining the full cost of the intervention and all economic consequences of its effects...
2016: Frontiers in Public Health
https://www.readbyqxmd.com/read/27779352/prioritizing-patient-reported-outcomes-in-breast-cancer-surgery-quality-improvement
#16
Sara H Javid, Sarah O Lawrence, Danielle C Lavallee
Breast-cancer-specific tools that measure health-related quality of life (HRQOL) were developed for use in research or clinical practice, and little is known about these tools' performance ability for quality improvement. Furthermore, existing tools may not fully reflect all issues that contribute to quality care as seen by patients. Work is needed to identify and validate patient-reported outcome measures for use in quality improvement in breast cancer surgical care. We conducted an exploratory qualitative study in order to better understand what HRQOL domains and processes of care define high quality surgical care for women undergoing mastectomy for breast cancer from both the patient and clinician perspective...
October 25, 2016: Breast Journal
https://www.readbyqxmd.com/read/27774709/the-effect-of-korean-group-cognitive-behavioural-therapy-among-patients-with-panic-disorder-in-clinic-settings
#17
Y S Choi, E J Lee
: WHAT IS KNOWN ON THE SUBJECT?: Panic disorder patients display various panic-related physical symptoms and catastrophic misinterpretation of bodily sensations, which lower their quality of life by interfering with daily activities. Cognitive behavioural therapy (CBT) is a useful strategy for panic disorder patients to manage symptoms associated with inaccurate cognitive interpretation of situations resulting from the patient's cognitive vulnerability. In South Korea, however, despite the increasing prevalence of panic disorder, CBT is not a common element of nursing care plans for panic disorder patients...
October 24, 2016: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/27765958/diagnosis-therapy-and-follow-up-care-of-vulvar-cancer-and-its-precursors-guideline-of-the-dggg-and-dkg-s2k-level-awmf-registry-number-015-059-november-2015
#18
H G Schnürch, S Ackermann, C D Alt, J Barinoff, C Böing, C Dannecker, F Gieseking, A Günthert, P Hantschmann, L C Horn, R Kürzl, P Mallmann, S Marnitz, G Mehlhorn, C C Hack, M C Koch, U Torsten, W Weikel, L Wölber, M Hampl
Purpose: This is an official guideline, published and coordinated by the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Study Group for Gynecologic Oncology) of the Deutsche Krebsgesellschaft (DKG, German Cancer Society) and the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG, German Society for Gynecology and Obstetrics). The number of cases with vulvar cancer is on the rise, but because of the former rarity of this condition and the resulting lack of literature with a high level of evidence, in many areas knowledge of the optimal clinical management still lags behind what would be required...
October 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27754185/hw-02-3-ambulatory-central-blood-pressure-what-is-the-evidence-for-validation
#19
Thomas Weber
Validation of a medical device measuring a biomarker is a complex process, involving technical aspects (What is actually measured by the device, and how is this done ? Is the measurement reproducible ? Is there a gold standard for measurement of the particular biomarker ? If yes, how accurate and how precise are the measurements by the device, compared to the gold standard ?) and clinical aspects (Do the measurements predict outcome ? If yes, is there added value, when standard clinical parameters are considered ? Is there a treatment strategy, based on the mesurements of the novel device ? Is this strategy cost-effective ?)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27731861/enabling-access-to-medical-and-health-education-in-rwanda-using-mobile-technology-needs-assessment-for-the-development-of-mobile-medical-educator-apps
#20
Jean Christophe Rusatira, Brian Tomaszewski, Vincent Dusabejambo, Vincent Ndayiragije, Snedden Gonsalves, Aishwarya Sawant, Angeline Mumararungu, George Gasana, Etienne Amendezo, Anne Haake, Leon Mutesa
BACKGROUND: Lack of access to health and medical education resources for doctors in the developing world is a serious global health problem. In Rwanda, with a population of 11 million, there is only one medical school, hence a shortage in well-trained medical staff. The growth of interactive health technologies has played a role in the improvement of health care in developed countries and has offered alternative ways to offer continuous medical education while improving patient's care...
June 1, 2016: JMIR Medical Education
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