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Quality of physician care

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https://www.readbyqxmd.com/read/29791921/does-gastroplus-support-similarity-and-dissimilarity-factors-of-in-vitro-in-vivo-prediction-in-biowaiver-studies-a-lower-strength-amlodipine-as-a-model-drug
#1
Abdel Naser Zaid, Naser Shraim, Asmaa Radwan, Nidal Jaradat, Samah Hirzallah, Ibrahim Issa, Aya Khraim
BACKGROUND: Many generic pharmaceutical products are currently available on the market place worldwide. Recently, there is a growing concern on the quality and efficacy of generic products. However, health care professionals such as physicians and pharmacists are in difficult situations to choose among alternatives. PURPOSE: The aim of this study is to assess the effectiveness of the in silico technique (Gastro Plus® ) in the biowaiver study and whether similarity and dissimilarity factors ( f 2 and f 1 respectively) are effective in this regard...
May 23, 2018: Drug Research
https://www.readbyqxmd.com/read/29791190/the-comprehensive-primary-care-initiative-effects-on-spending-quality-patients-and-physicians
#2
Deborah Peikes, Stacy Dale, Arkadipta Ghosh, Erin Fries Taylor, Kaylyn Swankoski, Ann S O'Malley, Timothy J Day, Nancy Duda, Pragya Singh, Grace Anglin, Laura L Sessums, Randall S Brown
The Comprehensive Primary Care Initiative (CPC), a health care delivery model developed by the Centers for Medicare and Medicaid Services (CMS), tested whether multipayer support of 502 primary care practices across the country would improve primary care delivery, improve care quality, or reduce spending. We evaluated the initiative's effects on care delivery and outcomes for fee-for-service Medicare beneficiaries attributed to initiative practices, relative to those attributed to matched comparison practices...
May 23, 2018: Health Affairs
https://www.readbyqxmd.com/read/29790660/drama-to-promote-non-verbal-communication-skills
#3
Martina Kelly, Lara Nixon, Kirsten Broadfoot, Marianna Hofmeister, Tim Dornan
BACKGROUND: Non-verbal communication skills (NVCS) help physicians to deliver relationship-centred care, and the effective use of NVCS is associated with improved patient satisfaction, better use of health services and high-quality clinical care. In contrast to verbal communication skills, NVCS training is under developed in communication curricula for the health care professions. One of the challenges teaching NVCS is their tacit nature. In this study, we evaluated drama exercises to raise awareness of NVCS by making familiar activities 'strange'...
May 23, 2018: Clinical Teacher
https://www.readbyqxmd.com/read/29790445/a-study-of-deficiencies-in-teamwork-skills-among-jordan-caregivers
#4
Omar Al-Araidah, Nader Al Theeb, Mariam Bader, Nabeel Mandahawi
Purpose The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire. Design/methodology/approach A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790371/clinical-quality-and-patient-experience-in-the-adult-ambulatory-setting
#5
Susan Congiusta, Philip Solomon, Joseph Conigliaro, Roseanne O'Gara-Shubinsky, Nina Kohn, Ira S Nash
Quality and patient experience are important dimensions of care delivery. The extent to which they are related in the adult outpatient setting is unknown. This brief study utilized data from a large integrated health system over a 1-year period in 2015 and measured the degree of correlation between physicians' patient experience scores and 8 standardized quality metrics. These quality measures were paired into similar groups to create 4 composite measures: outcome, screening, vaccination, and adherence. Measures of outcome ( r = 0...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29788783/a-mixed-methods-approach-to-understanding-the-palliative-needs-of-parkinson-s-patients
#6
Lindsay P Prizer, Jennifer L Gay, Mark G Wilson, Kerstin G Emerson, Anne P Glass, Janis M Miyasaki, Molly M Perkins
Parkinson's disease (PD) is the second-most common age-related neurodegenerative disorder. Despite recommendations for a palliative approach, little is known about what palliative needs are unmet by standard care. This study aims to (a) identify palliative needs of PD patients, (b) determine the relationship between palliative needs and health-related quality of life (HRQoL), and (c) probe into factors affecting HRQoL. PD patients and neurologists were recruited for a survey on palliative need; a subset of patients was interviewed...
May 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29788110/long-term-compliance-with-a-validated-intravenous-insulin-therapy-protocol-in-cardiac-surgery-patients-a-quality-improvement-project
#7
Guillaume Besch, Andrea Perrotti, Lucie Salomon du Mont, Raphaelle Tucella, Guillaume Flicoteaux, Aline Bondy, Emmanuel Samain, Sidney Chocron, Sebastien Pili-Floury
Quality problem: Safe and efficient blood glucose (BG) level control after cardiac surgery relies on an intensive care unit (ICU) team-based approach, including implementation of a dynamic insulin therapy protocol (ITP). Long-term compliance with such a complex protocol is poorly addressed in the literature. The aim of this study was to assess the long-term compliance of nurses with the ITP, 7 years after its implementation in the ICU. Initial assessment: A professional practice evaluation, integrated in a process of quality improvement program, was retrospectively conducted on 224 consecutive cardiac surgery patients over a 6-month period (PHASE 1)...
May 18, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29784902/physician-practice-patterns-and-barriers-to-counselling-on-physical-activity-in-solid-organ-transplant-recipients
#8
Amy Pang, Sarangan Lingham, Weina Zhao, Stephanie Leduc, Agnès Räkel, Ruth Sapir-Pichhadze, Sunita Mathur, Tania Janaudis-Ferreira
BACKGROUND Many solid organ transplant (SOT) recipients fail to meet the recommended physical activity (PA) levels. "Physician recommendation" has previously been reported by SOT recipients as a key facilitator to being more physically active. The purpose of this study was to determine the proportion of Canadian SOT physicians providing PA counselling and identify barriers to including such counselling as part of the SOT recipients' routine care. MATERIAL AND METHODS We conducted a cross-sectional web-based survey study to evaluate physicians' PA counselling practices, including the prevalence and barriers to such practice...
May 22, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29783090/inter-and-intra-disciplinary-collaboration-and-patient-safety-outcomes-in-u-s-acute-care-hospital-units-a-cross-sectional-study
#9
Chenjuan Ma, Shin Hye Park, Jingjing Shang
BACKGROUND: Collaboration among healthcare providers has been considered a promising strategy for improving care quality and patient outcomes. Despite mounting evidence demonstrating the impact of collaboration on outcomes of healthcare providers, there is little empirical evidence on the relationship between collaboration and patient safety outcomes, particularly at the patient care unit level. OBJECTIVES: The purpose of this study is to identify the extent to which interdisciplinary collaboration between nurses and physicians and intradisciplinary collaboration among nurses on patient care units are associated with patient safety outcomes...
May 2, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29781385/procalcitonin-guided-use-of-antibiotics-for-lower-respiratory-tract-infection
#10
David T Huang, Donald M Yealy, Michael R Filbin, Aaron M Brown, Chung-Chou H Chang, Yohei Doi, Michael W Donnino, Jonathan Fine, Michael J Fine, Michelle A Fischer, John M Holst, Peter C Hou, John A Kellum, Feras Khan, Michael C Kurz, Shahram Lotfipour, Frank LoVecchio, Octavia M Peck-Palmer, Francis Pike, Heather Prunty, Robert L Sherwin, Lauren Southerland, Thomas Terndrup, Lisa A Weissfeld, Jonathan Yabes, Derek C Angus
Background The effect of procalcitonin-guided use of antibiotics on treatment for suspected lower respiratory tract infection is unclear. Methods In 14 U.S. hospitals with high adherence to quality measures for the treatment of pneumonia, we provided guidance for clinicians about national clinical practice recommendations for the treatment of lower respiratory tract infections and the interpretation of procalcitonin assays. We then randomly assigned patients who presented to the emergency department with a suspected lower respiratory tract infection and for whom the treating physician was uncertain whether antibiotic therapy was indicated to one of two groups: the procalcitonin group, in which the treating clinicians were provided with real-time initial (and serial, if the patient was hospitalized) procalcitonin assay results and an antibiotic use guideline with graded recommendations based on four tiers of procalcitonin levels, or the usual-care group...
May 20, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29781384/how-to-uncover-sources-of-unwarranted-practice-variation-a-case-study-in-emergency-medicine
#11
Markus A Feufel
Forty years of statistical database analyses have demonstrated the existence of unwarranted practice variation in care delivery, that is, variations independent of medical need, evidence, or patient preference. Alas, little is known about the underlying mechanisms and thus finding interventions to reduce unwarranted variations remains difficult, hampering quality, equity, and efficiency of care. Whereas statistical analyses describe deviations from ideal patterns, ethnographically inspired analyses aim at understanding when, how, and why variations occur in practice...
May 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29781286/medical-therapy-versus-balloon-sinus-dilation-in-adults-with-chronic-rhinosinusitis-merlot-12-month-follow-up
#12
J Pablo Stolovitzky, Neelesh Mehendale, Keith E Matheny, William J Brown, Anthony A Rieder, Douglas R Liepert, Ewen Tseng, Andrew Gould
Background Chronic rhinosinusitis (CRS) is a devastating disease affecting nearly 30 million people in the United States. An interim analysis of data from the present study suggested that, in patients who had previously failed medical therapy, balloon sinus dilation (BSD) plus medical management (MM) provides a significant improvement in the quality of life (QOL) at 24 weeks postprocedure compared to MM alone. Objective The primary objective of this final analysis was to evaluate the durability of treatment effects through the 52-week follow-up...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29779398/handoff-tool-enabling-standardized-transitions-between-the-emergency-department-and-the-hospitalist-inpatient-service-at-a-major-cancer-center
#13
Carmen E Gonzalez, Norman Brito-Dellan, Srinivas R Banala, David Rubio, Mohamed Ait Aiss, Terry W Rice, Karen Chen, Diane C Bodurka, Carmelita P Escalante
Communication failures during patient handoff can lead to serious errors. A quality improvement team created a standardized handoff tool/process (DE-PASS: Decisive problem requiring admission, Evaluation time, Patient summary, Acute issues/action list, Situation unfinished/awareness, Signed out to) for admitting patients from the emergency department (ED) to the hospitalist inpatient service of a tertiary cancer center. DE-PASS mirrors the institution's ED workflow, stratifies patients as stable/urgent/emergent, and establishes requirements for verbal and email communications between providers...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29778457/treatment-of-chronic-obstructive-pulmonary-disease-in-the-primary-care-setting-how-can-we-achieve-more-for-our-patients
#14
Barbara Yawn, Barry Make
Chronic obstructive pulmonary disease (COPD) is a debilitating and progressive disease that is both under-diagnosed and under-treated, affecting up to 1 in 10 older adults. Common symptoms, including dyspnea, productive cough, chest tightness, and fatigue, can reduce quality of life, ability to participate in all types of activities, and overall health status in patients. Minimizing the impact of symptoms on patients' quality of life should be a key goal for physicians and modest changes in current practice could make improvements in patients' lives...
May 17, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29777770/construction-and-feasibility-study-of-the-sofmer-activity-score-sas-a-new-assessment-of-physical-and-cognitive-activity
#15
M D Morard, S Gonzalez-Monge, P Rippert, S Roche, J C Bernard, D Lagauche, C Delvert, J Luauté, S Jacquin Courtois, F Caillet, J Di Marco, F Ghelfi, S Otmani, P Calmels, M Royet, P A Joseph, R Ecochard, G Rode, C Vuillerot
OBJECTIVES: For hospitalizations in rehabilitation centers (RCs) in France, the quantification of healthcare givers' activity is based on the dependency of the patients, defined as a total or partial inability to perform activities required for daily living without help. The tools currently used to quantify dependency are not sufficiently precise. Here we describe the construction of a new tool, the SOFMER Activity Score (SAS scoring), which allows for a good description of the level of activity of patients hospitalized in RCs, and a feasibility study of the tool...
May 16, 2018: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29776675/risk-factors-for-near-miss-events-and-safety-incidents-in-pediatric-radiation-therapy
#16
Nimrah Baig, Jiangxia Wang, Shereef Elnahal, Todd McNutt, Jean Wright, Theodore DeWeese, Stephanie Terezakis
BACKGROUND AND PURPOSE: Factors contributing to safety- or quality-related incidents (e.g. variances) in children are unknown. We identified clinical and RT treatment variables associated with risk for variances in a pediatric cohort. MATERIALS AND METHODS: Using our institution's incident learning system, 81 patients age ≤21 years old who experienced variances were compared to 191 pediatric patients without variances. Clinical and RT treatment variables were evaluated as potential predictors for variances using univariate and multivariate analyses...
May 15, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29771351/burn-surgeon-and-palliative-care-physician-attitudes-regarding-goals-of-care-delineation-for-burned-geriatric-patients
#17
Holly B Cunningham, Shannon A Scielzo, Paul A Nakonezny, Brandon R Bruns, Karen J Brasel, Kenji Inaba, Scott C Brakenridge, Jeffrey D Kerby, Bellal A Joseph, M J Mohler, Joseph Cuschieri, Mary E Paulk, Akpofure P Ekeh, Tarik D Madni, Luis R Taveras, Jonathan B Imran, Steven E Wolf, Herb A Phelan
Objective: Palliative care specialists and burn surgeons were surveyed regarding: 1) importance of goals of care conversations for burned seniors; 2) confidence in their own specialty's ability to conduct these conversations; and 3) confidence in the ability of the other specialty to do so. Methods: A 13-item survey was developed by the steering committee of a multi-center consortium dedicated to palliative care in the injured geriatric patient and beta-tested by burn surgeons and palliative care specialists unaffiliated with the consortium...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29771337/randomized-trial-of-the-impact-of-empowering-childhood-cancer-survivors-with-survivorship-care-plans
#18
Nina S Kadan-Lottick, Wilhelmenia L Ross, Hannah-Rose Mitchell, Jaime Rotatori, Cary P Gross, Xiaomei Ma
Background: A survivorship care plan (SCP), that is, individualized treatment summary and schedule of off-therapy surveillance, will be mandated by January 2019. It is unclear whether SCPs improve adherence to recommended follow-up care in the community. In this trial, we evaluated the impact of randomly assigning childhood cancer survivors to 1) SCPs to be taken to their primary care physician (PCP) to implement or 2) survivorship clinic (SC) on health care quality measures. Methods: Eligibility included cancer diagnosis younger than age 18 years (2000-2012), cancer free, one or more years off therapy, and no prior survivorship clinic attendance...
May 15, 2018: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/29771222/structure-of-health-care-dyad-leadership-an-organization-s-experience
#19
Anurag Saxena, Maura Davies, Don Philippon
Purpose This study aims to explore the structural aspects (roles, responsibilities and reporting) of dyad leadership in one health-care organization (HCO). Design/methodology/approach The perceptions of 32 leaders (17 physician leaders and 15 dyad co-leaders) in formal leadership positions (six first-level with formal authority limited to teams or divisions, 23 middle-level with wider departmental or program responsibility and three senior-level with institution-wide authority) were obtained through focus groups and surveys...
May 8, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29770076/the-use-of-technology-to-improve-health-care-to-saskatchewan-s-first-nations-communities
#20
I Khan, N Ndubuka, K Stewart, V McKinney, I Mendez
Background: Saskatchewan is a province of over one million people and over 13% are Indigenous peoples, many of whom live on reserve lands. Despite continued efforts, access to health care remains a significant challenge for these Indigenous people, especially those in the North. Objective: To address this challenge, Saskatchewan's health care providers have been incorporating the use of technology for various health services. This paper describes various ways technology has been used in First Nations communities in Saskatchewan...
June 1, 2017: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
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