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Quality of physician care

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https://www.readbyqxmd.com/read/27930995/predictors-of-clinicians-underuse-of-daily-sedation-interruption-and-sedation-scales
#1
B Sneyers, S Henrard, P F Laterre, M M Perreault, C Beguin, D Wouters, N Speybroeck, A Spinewine
PURPOSE: The purpose of the study is to identify predictors of underuse of sedation scales and daily sedation interruption (DSI). METHODS: We surveyed all physicians and seven nurses in every Belgian intensive care unit (ICU), addressing practices and perceptions on guideline recommendations. Underuse was defined for sedation scales as use less than 3× per day and for DSI as never using it. Classification trees and logistic regressions identified predictors of underuse...
August 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27930764/decision-making-quality-in-parents-considering-adenotonsillectomy-or-tympanostomy-tube-insertion-for-their-children
#2
Paul Hong, Erin Maguire, Mary Purcell, Krista C Ritchie, Jill Chorney
Importance: Shared decision making is a process in which clinicians and patients make health care decisions in a collaborative manner using the most up-to-date evidence, while considering patient values and preferences. Shared decision making is thought to have a positive influence on the decision-making process in medicine. Objective: To describe the level of decisional conflict and decisional regret experienced by parents considering surgery for their children and to determine relations among decisional conflict, decisional regret, and shared decision making...
December 8, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27929734/assessment-of-the-validity-and-reliability-of-a-questionnaire-on-knowledge-and-attitude-of-general-practitioners-about-andropause
#3
Maliheh Abootalebi, Marzieh Kargar, Alireza Aminsharifi
BACKGROUND AND OBJECTIVE: Andropause is one of the clinical and biochemical syndromes in aging men associated with the decrease in serum testosterone levels. With the increase in aging male population, life span in Iran, and focus on quality of life, andropause will become a major health issue that needs to be addressed in order to prevent disability. General practitioners, as the first level of health care providers, are in the best position to assess their knowledge and attitude about andropause period, so a structured instrument is necessary to assess them...
December 8, 2016: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/27929722/medical-attention-seeking-dance-injuries-systematic-review-of-case-reports
#4
Akilesh Anand Prakash
OBJECTIVE: The objective of this study was to conduct a systematic review of case reports documenting the epidemiology of unique and rare musculoskeletal injuries in dancers. STUDY DESIGN: Systematic Review Method: A systematic review was conducted online using PubMed and Google Scholar, as per PRISMA guidelines up to July 30, 2016. Predefined eligibility criteria were applied, and the data thus compiled was analysed. Study quality was assessed based on CARE guidelines...
December 8, 2016: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/27928433/psychopathology-and-psychotherapeutic-intervention-in-diabetes-particularities-challenges-and-limits
#5
REVIEW
Popa-Velea O, Bubulac L, Petrescu L, Purcarea Rm
Diabetes is a problem of great public health importance, creating a considerable burden to the affected individuals and society. The psychological approach of this disease implies the early acknowledging of behavioral symptoms and the construction of effective psychotherapeutic interventions. Regarding the psychological symptoms, cognitive malfunctions in diabetes include a slowing of information processing, attention, memory, and concentration, which, in turn, can significantly diminish motivation for therapy, compliance, and ability for self-care...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27927827/introduction-to-drug-allergy-and-whom-to-refer-for-specialist-assessment
#6
Bogusia Kasternow, Mohammed Yousuf Karim
Drug allergy is defined as an adverse drug reaction with an established immunological mechanism. The National Institute for Health and Care Excellence published clinical guidelines on drug allergy in 2014 and quality standards in 2015. The intention of this article is to highlight indications for referral to specialists for management of drug allergy. Accurate diagnosis of drug allergy is critical of course for patient safety, but also for better use of the drugs that we have available and to reduce unnecessary avoidance of drugs...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927522/adult-spinal-deformity-epidemiology-health-impact-evaluation-and-management
#7
Christopher P Ames, Justin K Scheer, Virginie Lafage, Justin S Smith, Shay Bess, Sigurd H Berven, Gregory M Mundis, Rajiv K Sethi, Donald A Deinlein, Jeffrey D Coe, Lloyd A Hey, Michael D Daubs
Spinal deformity in the adult is a common medical disorder with a significant and measurable impact on health-related quality of life. The ability to measure and quantify patient self-reported health status with disease-specific and general health status measures, and to correlate health status with radiographic and clinical measures of spinal deformity, has enabled significant advances in the assessment of the impact of deformity on our population, and in the evaluation and management of spinal deformity using an evidence-based approach...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27926687/an-initiative-to-standardize-the-identification-of-and-acute-response-to-postoperative-lower-extremity-neurological-deficits-effects-on-provider-knowledge-confidence-and-communication-skills
#8
Peter B Derman, Sravisht Iyer, Matthew Garner, Steven Orr, Karla J Felix, Allison Goldberg, Titilayo Ologhobo, Minlun Wu, Laura Robbins, Charles Cornell
BACKGROUND: Although relatively uncommon, neurological deficits following hip and knee arthroplasty can have permanent and debilitating consequences. This study was conducted to quantify the effectiveness of an educational curriculum aimed at standardizing the identification of and acute response to postoperative neurological deficits in the inpatient setting, specifically with respect to improvements in clinician knowledge, confidence levels, and communication skills. METHODS: A multidisciplinary committee at a single, high-volume academic institution created an algorithm delineating the appropriate clinical actions and escalation procedures in the setting of a postoperative neurological deficit for each clinical practitioner involved in care for patients who undergo arthroplasty...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27926678/cost-minimization-analysis-of-open-and-endoscopic-carpal-tunnel-release
#9
Steven Zhang, Molly Vora, Alex H S Harris, Laurence Baker, Catherine Curtin, Robin N Kamal
BACKGROUND: Carpal tunnel release is the most common upper-limb surgical procedure performed annually in the U.S. There are 2 surgical methods of carpal tunnel release: open or endoscopic. Currently, there is no clear clinical or economic evidence supporting the use of one procedure over the other. We completed a cost-minimization analysis of open and endoscopic carpal tunnel release, testing the null hypothesis that there is no difference between the procedures in terms of cost. METHODS: We conducted a retrospective review using a private-payer and Medicare Advantage database composed of 16 million patient records from 2007 to 2014...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27924106/inpatient-care-of-small-and-sick-newborns-in-healthcare-facilities
#10
REVIEW
S B Neogi, R Khanna, M Chauhan, J Sharma, G Gupta, R Srivastava, P K Prabhakar, A Khera, R Kumar, S Zodpey, V K Paul
Neonatal units in teaching and non-teaching hospitals both in public and private hospitals have been increasing in number in the country since the sixties. In 1994, a District Newborn Care Programme was introduced as a part of the Child Survival and Safe Motherhood Programme (CSSM) in 26 districts. Inpatient care of small and sick newborns in the public health system got a boost under National Rural Health Mission with the launch of the national programme on facility-based newborn care (FBNC). This has led to a nationwide creation of Newborn Care Corners (NBCC) at every point of child birth, newborn stabilization units (NBSUs) at First Referral Units (FRUs) and special newborn care units (SNCUs) at district hospitals...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#11
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27921257/impact-of-community-health-workers-on-use-of-healthcare-services-in-the-united-states-a-systematic-review
#12
Helen E Jack, Sophia D Arabadjis, Lucy Sun, Erin E Sullivan, Russell S Phillips
BACKGROUND: As the US transitions to value-based healthcare, physicians and payers are incentivized to change healthcare delivery to improve quality of care while controlling costs. By assisting with the management of common chronic conditions, community health workers (CHWs) may improve healthcare quality, but physicians and payers who are making choices about care delivery also need to understand their effects on healthcare spending. METHODS: We searched PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PsycINFO, Embase, and Web of Science from the inception of each database to 22 June 2015...
December 5, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27921046/weight-management-in-primary-care
#13
REVIEW
Susanne Maurer
BACKGROUND: Obesity is one of the greatest public health challenges worldwide. It is not only a medical but also a philosophical, ecological, economic, sociocultural, and psychological problem as well as a severe consequence of our modern value definition to 'receive more and more'. Therefore, physicians are not able to treat obesity broadly and should not be used as tools to achieve certain weight goals. METHODS: This article presents an outline of conservative obesity therapy...
October 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27920119/randomized-trial-to-reduce-emergency-visits-or-hospital-admissions-using-telephone-coaching-to-complex-patients
#14
María González-Ortega, Joan Gené-Badia, Belchin Kostov, Vicente García-Valdecasas, Carmen Pérez-Martín
BACKGROUND: Comorbidity remains a matter of international interest, given growing prevalence of chronic conditions. OBJECTIVE: To evaluate the impact that adding a telephone coaching intervention by a family physician to usual care has on reducing resource consumption and improving health status, caregiver burden and quality of life among complex chronic patients (CCP) compared with usual care. METHODS: A randomized controlled trial was conducted on a random sample of CCP from three primary care teams in Barcelona...
December 5, 2016: Family Practice
https://www.readbyqxmd.com/read/27920117/reliability-and-validity-of-the-dutch-version-of-the-consultation-and-relational-empathy-measure-in-primary-care
#15
Inge van Dijk, Nick Scholten Meilink Lenferink, Peter L B J Lucassen, Stewart W Mercer, Chris van Weel, Tim C Olde Hartman, Anne E M Speckens
BACKGROUND: Empathy is an essential skill in doctor-patient communication with positive effects on compliance, patient satisfaction and symptom duration. There are no validated patient-rated empathy measures available in Dutch. OBJECTIVE: To investigate the validity and reliability of a Dutch version of the Consultation and Relational Empathy (CARE) Measure, a widely used 10-item patient-rated questionnaire of physician empathy. METHODS: After translation and back translation, the Dutch CARE Measure was distributed among patients from 19 general practitioners in 5 primary care centers...
December 5, 2016: Family Practice
https://www.readbyqxmd.com/read/27918875/the-relationship-between-psychosocial-factors-in-the-patient-oncologist-relationship-and-quality-of-care-a-study-of-breast-cancer-patients
#16
Daniel Sikavi, Allyson J Weseley
This study examined the relationship between psychosocial factors in the patient-oncologist relationship and aspects of care among women with breast cancer. Breast cancer patients (N = 118) completed a questionnaire about their relationship with their oncologist, their treatment, and their health. While trust was related to several positive outcomes, physician supportiveness was most strongly related to satisfaction with care, and health care access was most strongly associated with general health. The results suggest that the addition of supportiveness and healthcare access to trust provide a more complete picture of patients' health outcomes...
December 5, 2016: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/27918864/comparison-of-emergency-medical-services-and-trauma-care-systems-among-pan-asian-countries-an-international-multicenter-population-based-survey
#17
Kyong Min Sun, Kyoung Jun Song, Sang Do Shin, Hideharu Tanaka, Goh E Shaun, Wen-Chu Chiang, Kentaro Kajino, Sabariah Faizah Jamaluddin, Akio Kimura, Young Sun Ro, Dae Han Wi, Ju Ok Park, Sung Woo Moon, Young Hee Jung, Min Jung Kim, James F Holmes
OBJECTIVE: Knowledge on the current trauma systems in Asian countries is limited. The objective of this study was to describe the emergency medical services (EMS) and trauma care systems among countries participating in the Pan-Asian Trauma Outcomes Study (PATOS) Clinical Research Network. METHODS: The PATOS network consists of 33 participating sites from 14 countries. Standardized data was collected from each site using an EMS survey form and included general information (population, population density, urbanization, EMS service fee, etc...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918623/the-effect-of-prescriber-education-on-medication-related-patient-harm-in-the-hospital-a-systematic-review
#18
J M Bos, P M L A van den Bemt, P A G M De Smet, C Kramers
INTRODUCTION: Educating prescribers is a strategy to reduce prescription errors in hospitals. This systematic review gives an overview of original research papers on education of prescribers, reporting outcomes on (potential) patient harm. METHODS: A search of the databases Embase and Medline using the Ovid interface was performed. Research on the effect of education of physicians in order to prevent medication related problems of inpatients, reporting original data and outcomes on prescribing errors and/or (potential) patient harm, was included...
December 5, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27918403/new-hampshire-nurse-practitioners-take-the-lead-in-forming-an-accountable-care-organization
#19
Wendy L Wright
In 2012, New Hampshire nurse practitioners (NPs), along with Anthem Blue Cross/Blue Shield, formed the first Patient Centered Shared Savings Program in the nation, composed of patients managed by nurse practitioners employed within NP-owned and operated clinics. In this accountable care organization (ACO), NP-attributed patients were grouped into one risk pool. Data from the ACO and the NP risk pool, now in its third year, have produced compelling statistics. Nurse practitioners participating in this program have met or exceeded the minimum scores for 29 quality metrics along with a demonstrated cost-savings in the first 2 years of the program...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27918340/obstetrical-anal-sphincter-injuries-does-obstetrical-care-provider-matter-a-quality-assurance-study-in-ontario
#20
Katerina Pizzuto, Jessica Pudwell, Graeme N Smith, Marie-Andrée Harvey
OBJECTIVES: We sought to determine the rates of obstetrical anal sphincter tears (OASIS) between types of obstetrical care providers at Kingston General Hospital (KGH) and in Ontario via the Better Outcomes Registry Network (BORN). METHODS: This cross-sectional study collected patient, demographic, and delivery data from all vaginal deliveries at KGH from June 2011 to June 2014 and all vaginal deliveries through the BORN database from June 2012 to June 2014. RESULTS: During this period, 4...
December 1, 2016: Female Pelvic Medicine & Reconstructive Surgery
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