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https://www.readbyqxmd.com/read/28209701/patient-and-citizen-innovation-council-in-family-practice
#1
Ron T Garnett, Jane Bowman, Joanne Ganton
PROBLEM ADDRESSED: Patient engagement is integral to the Patient's Medical Home model. Patient-centred care is more than what happens in the examination room. Decisions around clinic processes, work flow, and initiative prioritization also warrant a patient perspective. OBJECTIVE OF PROGRAM: The Academic Family Medicine Clinic at the South Health Campus in Calgary, Alta, identified a need for patient and community advisory expertise regarding clinic initiatives and quality improvement...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28196952/revalidation-and-quality-assurance-the-application-of-the-musiq-framework-in-independent-verification-visits-to-healthcare-organisations
#2
Ann Griffin, Alex McKeown, Rowena Viney, Antonia Rich, Trevor Welland, Irene Gafson, Katherine Woolf
OBJECTIVES: We present a national evaluation of the impact of independent verification visits (IVVs) performed by National Health Service (NHS) England as part of quality assuring medical revalidation. Organisational visits are central to NHS quality assurance. They are costly, yet little empirical research evidence exists concerning their impact, and what does exist is conflicting. SETTING: The focus was on healthcare providers in the NHS (in secondary care) and private sector across England, who were designated bodies (DBs)...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28193176/telemonitoring-and-or-self-monitoring-of-blood-pressure-in-hypertension-tasminh4-protocol-for-a-randomised-controlled-trial
#3
Marloes Franssen, Andrew Farmer, Sabrina Grant, Sheila Greenfield, Carl Heneghan, Richard Hobbs, James Hodgkinson, Susan Jowett, Jonathan Mant, Una Martin, Siobhan Milner, Mark Monahan, Emma Ogburn, Rafael Perera-Salazar, Claire Schwartz, Ly-Mee Yu, Richard J McManus
BACKGROUND: Self-monitoring of hypertension is associated with lower systolic blood pressure (SBP). However, evidence for the use of self-monitoring to titrate antihypertensive medication by physicians is equivocal. Furthermore, there is some evidence for the efficacy of telemonitoring in the management of hypertension but it is not clear what this adds over and above self-monitoring. This trial aims to evaluate whether GP led antihypertensive titration using self-monitoring results in lower SBP compared to usual care and whether telemonitoring adds anything to self-monitoring alone...
February 13, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28166640/what-matters-most-a-mixed-methods-study-of-critical-aspects-of-a-home-based-palliative-program
#4
Claire K Ankuda, Kaileen Kersting, Timothy C Guetterman, Jessica Haefner, Evan Fonger, Michael Paletta, Faith Hopp
BACKGROUND: Home-based palliative care programs have shown value in improving quality of care and lowering costs for seriously ill patients. It is unknown what specific elements of these programs matter most to patients and caregivers. AIM: To identify what services are critical and why they matter to patients in a home-based palliative program. SETTING/PARTICIPANTS: A mixed methods study of 18 participants in the At Home Support (AHS) program in Southeast Michigan...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28160771/a-realist-review-of-shared-medical-appointments-how-for-whom-and-under-what-circumstances-do-they-work
#5
Susan R Kirsh, David C Aron, Kimberly D Johnson, Laura E Santurri, Lauren D Stevenson, Katherine R Jones, Justin Jagosh
BACKGROUND: Shared medical appointments (SMAs) are doctor-patient visits in which groups of patients are seen by one or more health care providers in a concurrent session. There is a growing interest in understanding the potential benefits of SMAs in various contexts to improve clinical outcomes and reduce healthcare costs. This study builds upon the existing evidence base that suggests SMAs are indeed effective. In this study, we explored how they are effective in terms of the underlying mechanisms of action and under what circumstances...
February 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28155280/poor-consistency-in-evaluating-south-african-adults-with-neurogenic-dysphagia
#6
Mckinley Andrews, Mershen Pillay
BACKGROUND: Speech-language therapists are specifically trained in clinically evaluating swallowing in adults with acute stroke. Incidence of dysphagia following acute stroke is high in South Africa, and health implications can be fatal, making optimal management of this patient population crucial. However, despite training and guidelines for best practice in clinically evaluating swallowing in adults with acute stroke, there are low levels of consistency in these practice patterns. OBJECTIVE: The aim was to explore the clinical practice activities of speech-language therapists in the clinical evaluation of swallowing in adults with acute stroke...
January 23, 2017: South African Journal of Communication Disorders. die Suid-Afrikaanse Tydskrif Vir Kommunikasieafwykings
https://www.readbyqxmd.com/read/28152725/implementing-psychosocial-distress-screening-across-a-health-system-herding-cats-or-herding-cats
#7
(no author information available yet)
: 113 Background: With the American College of Surgeons Commission on Cancer 2015 Standards in hand, Penn Medicine embarked on a project to formulate an entity-wide plan for the provision of psychosocial distress screening. Identifying psychosocial distress and providing resources to meet those needs is an essential component of quality cancer care. Penn Medicine and the Abramson Cancer Center provided more than 91,000 chemotherapy treatments, 121,000 radiation treatments, and 14,000 proton therapy treatments in FY 15 in urban, suburban and rural settings with wide variations in resources...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152355/what-risks-do-herbal-products-pose-to-the-australian-community
#8
Roger W Byard, Ian Musgrave, Garth Maker, Michael Bunce
Traditional herbal products are widely used in Australia to treat a broad range of conditions and diseases. It is popularly believed that these products are safer than prescribed drugs. While many may be safe, it is worrying that the specific effects and harmful interactions of a number of their components with prescription medications is not well understood. Some traditional herbal preparations contain heavy metals and toxic chemicals, as well as naturally occurring organic toxins. The effects of these substances can be dire, including acute hepatic and renal failure, exacerbation of pre-existing conditions and diseases, and even death...
February 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28150173/implementation-of-routine-postpartum-depression-screening-and-care-initiation-across-a-multispecialty-health-care-organization-an-18-month-retrospective-analysis
#9
April Lind, Sara Richter, Cheryl Craft, Alice C Shapiro
Objectives Postpartum depression (PPD) affects approximately 10-20% of all mothers after giving birth. Adequate screening and follow-up care for the postpartum mother with depression is an essential component of quality care in this population. The purpose of this quality improvement project was to evaluate the quality and quantity of a postnatal PPD screening program and the subsequent initiation of needed PPD treatment in an integrated health system. Methods After implementing a standardized PPD screening process, we conducted an 18-month retrospective study of patient visits that required a PPD screen...
February 1, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28148207/clinical-cancer-advances-2017-annual-report-on-progress-against-cancer-from-the-american-society-of-clinical-oncology
#10
Harold J Burstein, Lada Krilov, Jeanny B Aragon-Ching, Nancy N Baxter, E Gabriela Chiorean, Warren Allen Chow, John Frederick De Groot, Steven Michael Devine, Steven G DuBois, Wafik S El-Deiry, Andrew S Epstein, John Heymach, Joshua Adam Jones, Deborah K Mayer, Rebecca A Miksad, Nathan A Pennell, Michael S Sabel, Richard L Schilsky, Lynn Mara Schuchter, Nadine Tung, Karen Marie Winkfield, Lori J Wirth, Don S Dizon
A MESSAGE FROM ASCO'S PRESIDENT I am pleased to present Clinical Cancer Advances 2017, which highlights the most promising advances in patient-oriented cancer research over the past year. The report gives us an opportunity to reflect on what an exciting time it is for cancer research and how swiftly our understanding of cancer has improved. One year ago, the White House announced the national Cancer Moonshot program to accelerate progress against cancer. This shared vision of progress has reinvigorated the research community, identified new areas of scientific collaboration, and raised our ambitions regarding what may be possible beyond the progress we have already made...
February 1, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28124648/combination-therapy-in-allergic-rhinitis-what-works-and-what-does-not-work
#11
Justin C Greiwe, Jonathan A Bernstein
: Allergic rhinitis and other rhinitis subtypes are increasingly becoming some of the most prevalent and expensive medical conditions that affect the U.S. POPULATION: Both direct health care costs and indirect costs significantly impact the health care system due to delays in diagnosis, lack of treatment, ineffective treatment, poor medication adherence, and associated comorbidities. Many patients who have AR turn to over-the-counter medications for relief but often find themselves dissatisfied with the results...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28120255/treating-mental-health-and-substance-use-disorders-in-adolescents-what-is-on-the-menu
#12
REVIEW
Stanley Brewer, Mark D Godley, Leslie A Hulvershorn
Specific treatments targeting adolescents with substance use disorders (SUDs) have been developed over the last couple of decades. Despite these developmentally tailored treatments, long-term abstinence rates remain relatively low among adolescents receiving care. Research over the last decade has increasingly focused on adolescents with comorbid substance use and psychiatric disorders, in recognition of the barriers caused by inadequate treatment of co-occurring psychiatric disorders. Treatments targeting dually diagnosed youth are now regarded as essential to improving SUD treatment outcomes, but remain underutilized...
January 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28118919/what-is-the-impact-of-an-electronic-test-result-acknowledgement-system-on-emergency-department-physicians-work-processes-a-mixed-method-pre-post-observational-study
#13
Andrew Georgiou, Euan J McCaughey, Amina Tariq, Scott R Walter, Julie Li, Joanne Callen, Richard Paoloni, William B Runciman, Johanna I Westbrook
OBJECTIVE: To examine the impact of an electronic Results Acknowledgement (eRA) system on emergency physicians' test result management work processes and the time taken to acknowledge microbiology and radiology test results for patients discharged from an Emergency Department (ED). METHODS: The impact of the eRA system was assessed in an Australian ED using: a) semi-structured interviews with senior emergency physicians; and b) a time and motion direct observational study of senior emergency physicians completing test acknowledgment pre and post the implementation of the eRA system...
March 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#14
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28103925/protocol-for-a-realist-review-of-workplace-learning-in-postgraduate-medical-education-and-training
#15
Anel Wiese, Caroline Kilty, Colm Bergin, Patrick Flood, Na Fu, Mary Horgan, Agnes Higgins, Bridget Maher, Grainne O'Kane, Lucia Prihodova, Dubhfeasa Slattery, Deirdre Bennett
BACKGROUND: Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. The clinical learning environment (CLE), the context for PGMET, shapes the development of the doctors who learn and work within it, ultimately impacting the quality and safety of patient care. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities...
January 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28093443/impact-of-advanced-autonomous-non-medical-practitioners-in-emergency-care-protocol-for-a-scoping-study
#16
Mark Sujan, Hannah Howard-Franks, Garry Swann, Kirsti Soanes, Catherine Pope, Robert Crouch, Sophie Staniszewska, Elaine Maxwell, Huayi Huang, Matthew Cooke
INTRODUCTION: Emergency care services are looking for new models of care delivery to deal with changing patient demographics and increased pressures. It has been suggested that advanced non-medical practitioners might be valuable for delivering such new models of care. However, it is not clear what the impact of the deployment of advanced non-medical practitioners in emergency care is. This scoping study addresses the following research question: What is known from the literature about the different types of impact of the deployment of advanced (autonomous) non-medical practitioners in emergency care? METHODS AND ANALYSIS: A scoping study will be undertaken to examine and map the impact of the deployment of advanced non-medical practitioners in emergency care...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28089474/what-happened-to-the-complication-the-importance-of-acs-nsqip-pediatric-in-optimizing-quality-improvement-initiatives-for-resident-education
#17
Bennett W Calder, Joseph V Sakran, Christian J Streck, Robert A Cina
OBJECTIVE: Morbidity and Mortality (M&M) conference is considered the golden hour of surgical education. Most training programs lack standardized methods to evaluate self-reported outcomes and contributions to resident education. The purpose of this study was to determine whether residents underreport pediatric postoperative complications thereby limiting a comprehensive educational opportunity and the ability to adequately perform quality improvement during M&M conference. DESIGN: A retrospective analysis of resident reports submitted to the M&M committee at an academic medical center was conducted over 1 year...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28086813/information-exchange-networks-of-health-care-providers-and-evidence-based-cardiovascular-risk-management-an-observational-study
#18
Naomi Heijmans, Jan van Lieshout, Michel Wensing
BACKGROUND: Although a wide range of preventive and clinical interventions has targeted cardiovascular risk management (CVRM), outcomes remain suboptimal. Therefore, the question is what additional determinants of CVRM and outcomes can be identified and addressed to optimize CVRM. In this study, we aimed to identify new perspectives for improving healthcare delivery and explored associations between information exchange networks of health care providers and evidence-based CVRM. METHODS: This observational study was performed parallel to a randomized clinical trial which aimed to improve professional performance of practice nurses in the Netherlands...
January 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28080183/palliative-care-scorecard
#19
Sheri Kittelson, Read Pierce, Jeanie Youngwerth
BACKGROUND: In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public. OBJECTIVE: Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard...
January 12, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28078429/aims-and-tasks-in-parental-caregiving-for-children-receiving-palliative-care-at-home-a-qualitative-study
#20
Lisa M Verberne, Marijke C Kars, Antoinette Y N Schouten-van Meeteren, Diederik K Bosman, Derk A Colenbrander, Martha A Grootenhuis, Johannes J M van Delden
: In paediatric palliative care (PPC), parents are confronted with increasing caregiving demands. More children are cared for at home, and the need for PPC of children is lengthened due to technical and medical improvements. Therefore, a clear understanding of the content of parental caregiving in PPC becomes increasingly important. The objective is to gain insight into parental caregiving based on the lived experience of parents with a child with a life-limiting disease. An interpretative qualitative study using thematic analysis was performed...
January 11, 2017: European Journal of Pediatrics
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