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Quality of physician care

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https://www.readbyqxmd.com/read/28742774/improving-adherence-to-intraoperative-lung-protective-ventilation-strategies-at-a-university-medical-center
#1
Sean A Josephs, Gretchen A Lemmink, Judith A Strong, Cassandra L Barry, William E Hurford
BACKGROUND: Intraoperative lung-protective ventilation (ILPV) is defined as tidal volumes <8 mL/kg ideal bodyweight and is increasingly a standard of care for major abdominal surgical procedures performed under general anesthesia. In this study, we report the result of a quality improvement initiative targeted at improving adherence to ILPV guidelines in a large academic teaching hospital. METHODS: We performed a time-series study to determine whether anesthesia provider adherence to ILPV was affected by certain improvement interventions and patient ideal body weight (IBW)...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742681/targeting-value-driven-quality-improvement-for-laparoscopic-cholecystectomy-in-michigan
#2
Kyle H Sheetz, Brooke Kenney, James M Dupree, Darrell A Campbell, Michael J Englesbe
OBJECTIVE: The purpose of this study was to evaluate complete episode expenditures for laparoscopic cholecystectomy, a common and lower-risk operation, to characterize novel targets for value-based quality improvement. SUMMARY BACKGROUND DATA: Despite enthusiasm for improving the overall value of surgical care, most efforts have focused on high-risk inpatient surgery. METHODS: We identified 19,213 patients undergoing elective laparoscopic cholecystectomy from 2012 to 2015 using data from Medicare and a large private payer...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28741051/a-nationwide-prospective-cohort-study-of-patients-with-advanced-chronic-kidney-disease-in-japan-the-reach-j-ckd-cohort-study
#3
Junichi Hoshino, Kei Nagai, Hirayasu Kai, Chie Saito, Yukiko Ito, Koichi Asahi, Masahide Kondo, Kunitoshi Iseki, Chiho Iseki, Hirokazu Okada, Naoki Kashihara, Ichiei Narita, Takashi Wada, Christian Combe, Ronald L Pisoni, Bruce M Robinson, Kunihiro Yamagata
BACKGROUND: Epidemiology and outcomes of Japanese patients with advanced chronic kidney disease (CKD)-an estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m(2)-has remained largely unexamined. METHODS: We conducted a nationwide survey to determine the distribution of Japanese CKD patients, and are conducting a cohort study of these patients. A questionnaire eliciting details about facilities and their CKD practices was sent to all clinics/hospitals with nephrologists...
July 24, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28740890/satisfaction-of-breast-cancer-patients-regarding-surgery-and-radiation-therapy-a-survey-in-japan
#4
Anneyuko I Saito, Masaru Suda, Keisuke Sasai, Reshma Jagsi
PURPOSE: To evaluate patient satisfaction in Japan and factors, including timing factors, cost, and specific medical practices derived from Western influence (shared decision-making and second opinion), which might affect satisfaction. METHODS AND MATERIALS: All patients who presented to 1 large Japanese department of radiation oncology for postoperative radiation therapy for breast cancer from September 2010 to November 2013 were included in this study. The questionnaire was distributed to patients after the radiation oncologist consultation, and patients were asked to complete it anonymously by the end of treatment...
October 2016: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28739651/improving-asthma-care-by-building-statewide-quality-improvement-infrastructure
#5
Judith C Dolins, Jennifer Powell, Edward Wise, Kimberly Giuliano, Peggy Stemmler, Wes Stubblefield, P Cooper White, James Wiley, Dennis Z Kuo
BACKGROUND AND OBJECTIVES: Pediatric medical professionals have an increasing desire for quality improvement (QI) methods that produce sustainable changes in health care delivery. Previous reports have described QI in single settings or single coordinating entities that work with multiple sites. The objectives of this project are (1) to improve care for children with asthma across multiple practice settings and (2) to develop state-level expertise to support QI projects across entities in multiple states...
July 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28739080/tools-for-enhancement-and-quality-improvement-of-peer-assessment-and-clinical-care-in-endocrinology-and-metabolism
#6
REVIEW
Aliya Khan, Anne Kenshole, Shereen Ezzat, Jeannette Goguen, Karen Gomez-Hernandez, Rob Hegele, Robyn Houlden, Tisha Joy, Erin Keely, Donald Killinger, André Lacroix, Sheila Laredo, Ally P H Prebtani, M Z Shrayyef, Chris Tran, Stan Van Uum, Rhoda Reardon, Antiope Papageorgiou, William Tays, Merrill Edmonds
Members of the College of Physicians and Surgeons of Ontario Endocrinology and Metabolism Peer Review Network have been involved in a quality improvement project to help standardize the peer assessment of physicians practicing in endocrinology and metabolism. This has included developing state-of-the-art summaries of common endocrine problems by Canadian experts in endocrinology and metabolism. These tools have been developed in response to the educational needs, as identified by peer reviewers, of practicing endocrinologists in Ontario...
July 21, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28739067/the-unique-role-of-the-pediatric-clinical-research-nurse-in-anesthesia-an-interdisciplinary-collaboration
#7
Christine Dube, Vanessa Young, Michelle Anderson, Brenda Barton, Izabela Leahy
This article describes the distinctive function of the pediatric clinical research nurse (CRN) in the anesthesia setting. The pediatric CRN in anesthesia acts as a liaison between families and the research team and is the major nexus between the principal investigator or anesthesiologist on a study, and the collaborating surgeons from many different departments. This is unique because the CRNs collaborate with physicians in specialties that can include plastics, urology, neurosurgery, orthopaedics, otolaryngology, cardiology, critical care, and many other departments...
August 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28738723/patients-expectations-for-the-functional-and-psychosocial-outcomes-of-orbital-decompression-surgery-for-thyroid-eye-disease-a-qualitative-study
#8
Sadie Wickwar, Hayley McBain, Matthew R Edmunds, Daniel G Ezra, Geoffrey E Rose, Stanton P Newman
Patients with appearance-altering conditions may be dissatisfied with the outcomes of reconstructive surgery due to unmet expectations. This study explored patients' expectations of orbital decompression surgery for thyroid eye disease (TED) and whether these were met. Semi-structured interviews were conducted at two times: (1) in the weeks after patients were listed for decompression surgery and before surgery; (2) up to 12 months after surgery. Thematic analysis was performed for each time point, to identify themes within the data...
July 25, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28737045/pharmacist-s-demand-for-optimal-primary-care-service-delivery-in-a-community-pharmacy-the-optipharm-study
#9
Mark A Munger, Michael Walsh, Jon Godin, Michael Feehan
BACKGROUND: The US population continues to expand providing the need for primary health care services. Community pharmacies integrated with medicine may provide greater access while providing high quality care. OBJECTIVE: To gauge pharmacists' demand for primary health care services delivered through community pharmacies. METHODS: An online survey was administered to determine community pharmacists' preferences for varying primary care services that could be offered in the community pharmacy setting...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28734951/emergency-department-management-of-diabetic-ketoacidosis-and-hyperosmolar-hyperglycemic-state-national-survey-of-attitudes-and-practice
#10
Alexandra L Hamelin, Justin W Yan, Ian G Stiell
OBJECTIVES: In 2013, the Association, now Diabetes Canada, published national clinical practice guidelines for the effective management of diabetic ketoacidosis and hyperosmolar hyperglycemic states in adults. We sought to determine emergency physician compliance rates and attitudes toward these guidelines and to identify potential barriers to their use in Canadian emergency departments. METHODS: An online survey consisting of questions related to the awareness and use of the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada was distributed to 500 randomly selected members of the Canadian Association of Emergency Physicians...
July 19, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28734859/provider-health-and-wellness
#11
REVIEW
Anil Nanda, Anita Wasan, James Sussman
Provider health and wellness is a significant issue and can impact patient care, including patient satisfaction, quality of care, medical errors, malpractice risk, as well as provider and office staff turnover and early retirement. Health and wellness encompasses various areas including burnout, depression, divorce, and suicide and affects providers of all specialties and at all levels of training. Providers deal with many everyday stresses, including electronic health records, office politics, insurance and billing issues, dissatisfied patients, and their own personal and family issues...
July 19, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28733273/whatsapp-messenger-as-an-adjunctive-tool-for-telemedicine-an-overview
#12
Vincenzo Giordano, Hilton Koch, Alexandre Godoy-Santos, William Dias Belangero, Robinson Esteves Santos Pires, Pedro Labronici
BACKGROUND: The advent of telemedicine has allowed physicians to deliver medical treatment to patients from a distance. Mobile apps such as WhatsApp Messenger, an instant messaging service, came as a novel concept in all fields of social life, including medicine. The use of instant messaging services has been shown to improve communication within medical teams by providing means for quick teleconsultation, information sharing, and starting treatment as soon as possible. OBJECTIVE: The aim of this study was to perform a comprehensive systematic review of present literature on the use of the WhatsApp Messenger app as an adjunctive health care tool for medical doctors...
July 21, 2017: Interactive Journal of Medical Research
https://www.readbyqxmd.com/read/28733271/telerehabilitation-review-of-the-state-of-the-art-and-areas-of-application
#13
REVIEW
Alessandro Peretti, Francesco Amenta, Seyed Khosrow Tayebati, Giulio Nittari, Syed Sarosh Mahdi
BACKGROUND: Telemedicine applications have been increasing due to the development of new computer science technologies and of more advanced telemedical devices. Various types of telerehabilitation treatments and their relative intensities and duration have been reported. OBJECTIVE: The objective of this review is to provide a detailed overview of the rehabilitation techniques for remote sites (telerehabilitation) and their fields of application, with analysis of the benefits and the drawbacks related to use...
July 21, 2017: JMIR Rehabil Assist Technol
https://www.readbyqxmd.com/read/28733171/are-residents-prepared-for-surgical-cases-implications-in-patient-safety-and-education
#14
Minh-Bao Mundschenk, Elizabeth B Odom, Trina D Ghosh, Grant M Kleiber, Andrew Yee, Kamlesh B Patel, Susan E Mackinnon, Marissa M Tenenbaum, Donald W Buck
OBJECTIVE: In surgical education, the areas of focus and evaluation are skewed toward technical skill and operative knowledge; less emphasized is familiarity with the patient's medical history. The purposes of this study were to characterize how surgical trainees prepare for cases and to determine the comprehensiveness of their preparation. DESIGN: A 27-question survey was created through a web-based software program and distributed to all resident physicians and fellows in the Departments of Surgery, Neurosurgery, and Otolaryngology at our institution...
July 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28733101/patterns-of-physician-prescribing-for-opioid-maintenance-treatment-in-ontario-canada-in-2014
#15
Qi Guan, Wayne Khuu, Sheryl Spithoff, Tara Kiran, Meldon Kahan, Mina Tadrous, Diana Martins, Pamela Leece, Tara Gomes
BACKGROUND: Despite concerns surrounding high patient volumes in methadone clinics, little is known about the practice patterns of opioid maintenance therapy (OMT) providers in Ontario. We examined the distribution of these services and how physician characteristics differ based on prescribing volume. METHODS: We conducted a cross-sectional study among prescribers of methadone or buprenorphine to Ontario public drug beneficiaries in 2014 by stratifying physicians into low- (lower 50%), moderate- (51-89%) and high-volume (top 10%) prescribers...
July 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28732455/comparison-of-births-by-provider-place-and-payer-in-new-hampshire
#16
Lynette Hamlin
This study examines maternity care in a rural state by birth attendant, place of birth, and payer of birth. It is a secondary analysis of birth certificate data in New Hampshire between the years 2005 and 2012. Results revealed that in New Hampshire, the majority of births occurred in the hospital setting (98.6%). Physicians attended 75.8% of births, certified nurse midwives attended 17%, and certified professional midwives attended 1%. Medicaid coverage was the payer source for 28% of all births, compared with 44...
January 1, 2017: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28732151/patients-attitudes-and-experiences-of-disease-modifying-anti-rheumatic-drugs-in-rheumatoid-arthritis-and-spondyloarthritis-a-qualitative-synthesis
#17
Ayano Kelly, Kathleen Tymms, David J Tunnicliffe, Daniel Sumpton, Chandima Perera, Kieran Fallon, Jonathan C Craig, Walter Abhayaratna, Allison Tong
OBJECTIVES: Non-adherence to disease-modifying anti-rheumatic drugs (DMARDS) in rheumatoid arthritis (RA) and spondyloarthritis (SpA) results in increased disease activity and symptoms and poorer quality of life. We aimed to describe patients' attitudes and experiences of DMARDs in RA and SpA to inform strategies to improve medication adherence. METHODS: Databases (MEDLINE, Embase, PsycINFO, CINAHL) were searched to January 2016. Thematic synthesis was used to analyze the findings...
July 21, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28731821/trust-in-physicians-continuity-and-coordination-of-care-and-quality-of-death-in-patients-with-advanced-cancer
#18
Jun Hamano, Tatsuya Morita, Sakiko Fukui, Yoshiyuki Kizawa, Satoru Tunetou, Yasuo Shima, Makoto Kobayakawa, Maho Aoyama, Mitsunori Miyashita
BACKGROUND: Provider-centered factors contribute to unexplained variation in the quality of death (QOD). The relationship between healthcare providers (HCPs) and patients, bidirectional communication, and consistency of longitudinal care planning are important provider-centered factors. OBJECTIVE: To explore whether the level of trust in HCPs, the quality of continuity of care, and the level of coordination of care among home HCPs are associated with the QOD for cancer patients dying at home...
July 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28731379/quasi-experimental-evaluation-of-a-multifaceted-intervention-to-improve-quality-of-end-of-life-care-and-quality-of-dying-for-patients-with-advanced-dementia-in-long-term-care-institutions
#19
René Verreault, Marcel Arcand, Lucie Misson, Pierre J Durand, Edeltraut Kroger, Michèle Aubin, Maryse Savoie, Thomas Hadjistavropoulos, Sharon Kaasalainen, Annick Bédard, Annie Grégoire, Pierre-Hughes Carmichael
BACKGROUND: Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. AIM: To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. DESIGN: Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#20
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
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