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https://www.readbyqxmd.com/read/28725791/quality-improvement-intervention-for-reduction-of-redundant-testing
#1
Alan M Ducatman, Danyel H Tacker, Barbara S Ducatman, Dustin Long, Peter L Perrotta, Hannah Lawther, Kelly Pennington, Owen Lander, Mary Warden, Conard Failinger, Kevin Halbritter, Ronald Pellegrino, Marney Treese, Jeffrey A Stead, Eric Glass, Lauren Cianciaruso, Konrad C Nau
Laboratory data are critical to analyzing and improving clinical quality. In the setting of residual use of creatine kinase M and B isoenzyme testing for myocardial infarction, we assessed disease outcomes of discordant creatine kinase M and B isoenzyme +/troponin I (-) test pairs in order to address anticipated clinician concerns about potential loss of case-finding sensitivity following proposed discontinuation of routine creatine kinase and creatine kinase M and B isoenzyme testing. Time-sequenced interventions were introduced...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28725487/expectations-of-persons-with-paraplegia-regarding-their-care-in-india-a-qualitative-study
#2
Nalina Gupta, Kavitha Raja
STUDY DESIGN: A qualitative study. OBJECTIVE: The aim of this study was to understand expectations of persons with paraplegia in India regarding their care. SETTING: India. METHODS: This study used a qualitative methodology to have a focus group interview of persons with paraplegia in India. Focus group consisted of two to four participants with paraplegia. Adults with level T6 and below, complete injury, duration of at least 6 months post injury and those living in the community were included...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28724420/legal-access-to-medications-a-threat-to-brazil-s-public-health-system
#3
Ana Luiza Chieffi, Rita De Cassia Barata Barradas, Moisés Golbaum
BACKGROUND: In Brazil, health is fundamental human right guaranteed by the Constitution of 1988, which created the Brazilian Universal Health System (Sistema Único de Saúde - SUS). The SUS provides medications for outpatient care via policy of pharmaceutical assistance (PA) programmes. Despite the advances in PA policies which include the improvement in access to medications, there has been a significant increase in lawsuits related to health products and services. This study aimed to characterize the medication processes filed between 2010 and 2014 against the Secretary of State for Health of São Paulo (State Health Department of São Paulo - SES/SP), in Brazil, following PA policies...
July 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28724368/utilizing-patient-data-from-the-veterans-administration-electronic-health-record-to-support-web-based-clinical-decision-support-informatics-challenges-and-issues-from-three-clinical-domains
#4
Nallakkandi Rajeevan, Kristina M Niehoff, Peter Charpentier, Forrest L Levin, Amy Justice, Cynthia A Brandt, Terri R Fried, Perry L Miller
BACKGROUND: The US Veterans Administration (VA) has developed a robust and mature computational infrastructure in support of its electronic health record (EHR). Web technology offers a powerful set of tools for structuring clinical decision support (CDS) around clinical care. This paper describes informatics challenges and design issues that were confronted in the process of building three Web-based CDS systems in the context of the VA EHR. METHODS: Over the course of several years, we implemented three Web-based CDS systems that extract patient data from the VA EHR environment to provide patient-specific CDS...
July 19, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28724152/cost-of-incremental-expansion-of-an-existing-family-medicine-residency-program
#5
Evan A Ashkin, Warren P Newton, Brian Toomey, Ronald Lingley, Cristen P Page
BACKGROUND AND OBJECTIVES: Expanding residency training programs to address shortages in the primary care workforce is challenged by the present graduate medical education (GME) environment. The Medicare funding cap on new GME positions and reductions in the Health Resources and Services Administration (HRSA) Teaching Health Center (THC) GME program require innovative solutions to support primary care residency expansion. Sparse literature exists to assist in predicting the actual cost of incremental expansion of a family medicine residency program without federal or state GME support...
July 2017: Family Medicine
https://www.readbyqxmd.com/read/28724036/clinical-pharmacology-profile-of-care-in-hepatology-clinic
#6
Talita Rocha Passos, Fabiana Silva Santos, Maria Cleusa Martins, Vanusa Barbosa Pinto, Flair José Carrilho, Suzane Kioko Ono
Since 2010, the Clinical Gastroenterology and Hepatology Division of the Central Institute of Hospital das Clínicas of the University of São Paulo Medical School (HC-FMUSP, in the Portuguese acronym) has been developing specialized electives assistance activities in the Outpatient Specialty Clinic, Secondary Level, in São Paulo NGA-63 Várzea do Carmo. The objective of this study was to analyze the pharmacotherapeutic profile of patients. This is a cross-sectional and retrospective study in which patients were seen at the Hepatology sector and the results were submitted to descriptive statistics...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28724014/prescription-medication-by-physiotherapists-a-brazilian-view-of-the-united-kingdom-canada-australia-and-new-zealand
#7
Valton da Silva Costa
Many health systems (HS) have adopted novel models of care which have included non-medical prescription (NMP) by physiotherapists. The aim of this study was to verify in the literature the existence of this practice and its possible benefits. A literature review was carried out through search on Science Direct, PubMed, SciELO, Lilacs and Google Scholar, and in the World Confederation for Physical Therapy and Chartered Society of Physiotherapy websites. In recent decades the United Kingdom adopted the NMP for health professionals, followed by Canada...
July 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28723244/evaluation-of-the-national-health-service-nhs-direct-pilot-telehealth-program-cost-effectiveness-analysis
#8
Malcolm Clarke, Joanna Fursse, Nancy Connolly, Urvashi Sharma, Russell Jones
OBJECTIVE: To evaluate the cost-effectiveness of a pilot telehealth program applied to a wide population of patients with chronic obstructive pulmonary disease (COPD). DESIGN: Vital signs data were transmitted from the home of the patient on a daily basis using a patient monitoring system for review by community nurse to assist decisions on management. SETTING: Community services for patients diagnosed with COPD. PARTICIPANTS: Two Primary Care Trusts (PCTs) enrolled 321 patients diagnosed with COPD into the telehealth program...
July 18, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28722636/physician-assistants-and-the-expanding-global-health-care-workforce
#9
Tara J Rick, Ruth Ballweg
The physician assistant and other types of medical providers with accelerated and focused training were developed to serve the specific health-care needs of individual countries. They have an important role in providing care globally in response to physician shortages. Working in over 50 nations, these clinicians increase access to team-based health care. This perspective explores the successes and challenges of these professionals as an international community. Steps are proposed to increase global awareness and acceptance of these professionals including platforms to increase discussion, scholarly activity, and collaboration...
June 26, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28722550/the-hub-and-spoke-organization-design-an-avenue-for-serving-patients-well
#10
James K Elrod, John L Fortenberry
BACKGROUND: The healthcare industry is characterized by intensive, never-ending change occurring on a multitude of fronts. Success in such tumultuous environments requires healthcare providers to be proficient in myriad areas, including the manner in which they organize and deliver services. Less efficient designs drain precious resources and hamper efforts to deliver the best care possible to patients, making it imperative that optimal pathways are identified and pursued. One particular avenue that offers great potential for serving patients efficiently and effectively is known as the hub-and-spoke organization design...
July 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28722122/wet-work-exposure-and-hand-eczema-among-healthcare-workers-a-cross-sectional-study
#11
N Hamnerius, C Svedman, O Bergendorff, J Björk, M Bruze, A Pontén
BACKGROUND: Hand eczema is more common in healthcare workers compared to the general population. The hands are subject to changing occupational exposures due to mandatory hygiene regulations for health care workers. OBJECTIVES: To describe the exposure due to hygiene procedures and investigate the associations between occupational hand washing, use of non-sterile gloves, and hand disinfectant and self-reported hand eczema. METHODS: Cross-sectional study with an electronic questionnaire distributed to 28 762 hospital employees in southern Sweden...
July 19, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28721691/occupational-therapy-for-adults-with-problems-in-activities-of-daily-living-after-stroke
#12
REVIEW
Lynn A Legg, Sharon R Lewis, Oliver J Schofield-Robinson, Avril Drummond, Peter Langhorne
BACKGROUND: A stroke occurs when the blood supply to part of the brain is cut off. Activities of daily living (ADL) are daily home-based activities that people carry out to maintain health and well-being. ADLs include the ability to: eat and drink unassisted, move, go to the toilet, carry out personal hygiene tasks, dress unassisted, and groom. Stroke causes impairment-related functional limitations that may result in difficulties participating in ADLs independent of supervision, direction, or physical assistance...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28721026/a-community-virtual-ward-model-to-support-older-persons-with-complex-health-care-and-social-care-needs
#13
C Lewis, Z Moore, F Doyle, A Martin, D Patton, L E Nugent
BACKGROUND: Globally the older population is increasing rapidly. As a result there is an increase in frail older persons living within the community, with increased risks of a hospital admission and higher mortality and morbidity rates. Due to complexity of care, health care professionals face challenges in providing effective case management and avoiding unplanned admissions to hospital. A community virtual ward (CVW) model was developed to assist health care professionals to support older persons at home during periods of illness and/or functional decline...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28720513/ahrq-series-on-complex-intervention-systematic-reviews-paper-7-prisma-ci-elaboration-explanation
#14
Jeanne-Marie Guise, Mary Butler, Christine Chang, Meera Viswanathan, Terri Pigott, Peter Tugwell
BACKGROUND: Complex interventions are widely used in health care, public health, education, criminology, social work, business, and welfare. They have increasingly become the subject of systematic reviews and are challenging to effectively report. The Complex Interventions Methods Workgroup developed an extension to the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Complex Interventions called PRISMA-CI. RATIONALE: Following the EQUATOR Network guidance for PRISMA extensions, this Explanation and Elaboration document accompanies the PRISMA-CI checklist to promote consistency in reporting of systematic reviews of complex interventions...
June 30, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28718797/socioeconomic-differences-in-and-predictors-of-home-based-palliative-care-health-service-use-in-ontario-canada
#15
Jiaoli Cai, Denise N Guerriere, Hongzhong Zhao, Peter C Coyte
The use of health services may vary across people with different socioeconomic statuses, and may be determined by many factors. The purposes of this study were (i) to examine the socioeconomic differences in the propensity and intensity of use for three main home-based health services, that is, home-based palliative care physician visits, nurse visits and personal support worker (PSW) hours; and (ii) to explore the determinants of the use of home-based palliative care services. A prospective cohort study was employed...
July 18, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28718499/-meeting-contraceptive-needs-of-hiv-positive-women-effect-on-elimination-of-vertical-transmission-of-hiv
#16
Marcela Gómez-Suárez
Nearly 38% of unplanned pregnancies occur because of unmet contraceptive needs. In HIV-positive women, these figures triple, a phenomenon explained by social determinants such as poverty, access to health services, violence, and forced displacement, all of which are frequent elements in the lives of these women. Unplanned pregnancies represent a psychological burden related to women's fear of transmitting the infection to their children, orphanhood, and assuming risks during pregnancy, in addition to family and social consequences that are expressed in lack of prenatal care, neglect of their health, and an increased likelihood of vertical transmission...
December 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28718382/establishing-clinical-pharmacy-services-with-prescribing-privileges-in-a-federally-qualified-health-center-primary-care-clinic
#17
Jeany K Jun
OBJECTIVES: To describe the process and cost of establishing clinical pharmacy services with prescribing privileges in a federally qualified health center (FQHC) primary care clinic. SETTING: The primary care clinic was located in a low-income area of Southern California and served patients with Medicaid and Medicare. The primary care clinic had preventive medicine and family medicine physicians, a family medicine residency program, behavioral health services, and a registered dietician...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28716704/-psychosocial-working-conditions-of-physician-assistants-results-from-a-qualitative-study-on-occupational-stress-resources-possible-approaches-to-prevention-and-intervention-needs
#18
Patricia Vu-Eickmann, Adrian Loerbroks
BACKGROUND: Numerous studies have documented adverse psychosocial working conditions among health care staff. Working conditions may not only impair the health outcomes of this professional group, but can also affect the quality of care they deliver to patients. Previous work stress research has mainly focused on physicians and nurses. Comparable evidence remains limited, however, for physician assistants (Medizinische Fachangestellte, MFAs), who represent the largest professional group in German primary care...
July 14, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28716350/progress-and-priorities-for-reproductive-maternal-newborn-and-child-health-in-kenya-a-countdown-to-2015-country-case-study
#19
Emily C Keats, Anthony Ngugi, William Macharia, Nadia Akseer, Emma Nelima Khaemba, Zaid Bhatti, Arjumand Rizvi, John Tole, Zulfiqar A Bhutta
BACKGROUND: Progress in reproductive, maternal, newborn, and child health (RMNCH) in Kenya has been inconsistent over the past two decades, despite the global push to foster accountability, reduce child mortality, and improve maternal health in an equitable manner. Although several cross-sectional assessments have been done, a systematic analysis of RMNCH in Kenya was needed to better understand the push and pull factors that govern intervention coverage and influence mortality trends...
August 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28716018/prediction-of-extubation-readiness-in-extremely-preterm-infants-by-the-automated-analysis-of-cardiorespiratory-behavior-study-protocol
#20
Wissam Shalish, Lara J Kanbar, Smita Rao, Carlos A Robles-Rubio, Lajos Kovacs, Sanjay Chawla, Martin Keszler, Doina Precup, Karen Brown, Robert E Kearney, Guilherme M Sant'Anna
BACKGROUND: Extremely preterm infants (≤ 28 weeks gestation) commonly require endotracheal intubation and mechanical ventilation (MV) to maintain adequate oxygenation and gas exchange. Given that MV is independently associated with important adverse outcomes, efforts should be made to limit its duration. However, current methods for determining extubation readiness are inaccurate and a significant number of infants fail extubation and require reintubation, an intervention that may be associated with increased morbidities...
July 17, 2017: BMC Pediatrics
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