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https://www.readbyqxmd.com/read/29784865/opportunistic-pulse-checks-in-primary-care-to-improve-recognition-of-atrial-fibrillation-a-retrospective-analysis-of-electronic-patient-records
#1
James Cole, Payam Torabi, Isabel Dostal, Kate Homer, John Robson
BACKGROUND: Atrial fibrillation (AF) is an important and modifiable risk factor for stroke. Earlier identification may reduce stroke-related morbidity and mortality. Trial evidence shows that opportunistic pulse regularity checks in individuals aged ≥65 years increases detection of AF. However, this is not currently recommended by the National Screening Programme or implemented by most clinical commissioning groups (CCGs). AIM: To evaluate the impact of a systematic programme to promote pulse regularity checks, the programme's uptake in general practice, and the prevalence of AF...
May 21, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29779717/the-design-and-evaluation-of-an-antimicrobial-resistance-surveillance-system-for-neonatal-intensive-care-units-in-iran
#2
Peyman Rezaei-Hachesu, Taha Samad-Soltani, Sajad Yaghoubi, Marjan GhaziSaeedi, Kayvan Mirnia, Hossein Masoumi-Asl, Reza Safdari
INTRODUCTION: Neonatal intensive care units (NICUs) have complex patients in terms of their diagnoses and required treatments. Antimicrobial treatment is a common therapy for patients in NICUs. To solve problems pertaining to empirical therapy, antimicrobial stewardship programs have recently been introduced. Despite the success of these programs in terms of data collection, there is still inefficiency in terms of analyzing and reporting the data. Thus, to successfully implement these stewardship programs, the design of antimicrobial resistance (AMR) surveillance systems is recommended as a first step...
July 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29777325/developing-an-interactive-data-visualization-tool-to-assess-the-impact-of-decision-support-on-clinical-operations
#3
Timothy C Huber, Arun Krishnaraj, Dayna Monaghan, Cree M Gaskin
Due to mandates from recent legislation, clinical decision support (CDS) software is being adopted by radiology practices across the country. This software provides imaging study decision support for referring providers at the point of order entry. CDS systems produce a large volume of data, providing opportunities for research and quality improvement. In order to better visualize and analyze trends in this data, an interactive data visualization dashboard was created using a commercially available data visualization platform...
May 18, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/29752289/interventions-to-reduce-over-utilized-tests-and-treatments-in-bronchiolitis
#4
Amy Tyler, Paige Krack, Leigh Anne Bakel, Kimberly O'Hara, Douglas Scudamore, Irina Topoz, Julia Freeman, Angela Moss, Renee Allen, Angela Swanson, Lalit Bajaj
OBJECTIVES: The American Academy of Pediatrics published bronchiolitis clinical practice guidelines in 2014 recommending against the routine use of bronchodilators, chest radiographs, or respiratory viral testing in children with a clinical diagnosis of bronchiolitis. Our aim in this project was to align care with the American Academy of Pediatrics clinical practice guidelines by decreasing the overuse of these interventions. METHODS: This study included patients who were admitted to a non-ICU setting with a primary or secondary diagnosis of bronchiolitis...
May 11, 2018: Pediatrics
https://www.readbyqxmd.com/read/29707260/can-composite-digital-monitoring-biomarkers-come-of-age-a-framework-for-utilization
#5
REVIEW
Christopher Kovalchick, Rhea Sirkar, Oliver B Regele, Lampros C Kourtis, Marie Schiller, Howard Wolpert, Rhett G Alden, Graham B Jones, Justin M Wright
Introduction: The application of digital monitoring biomarkers in health, wellness and disease management is reviewed. Harnessing the near limitless capacity of these approaches in the managed healthcare continuum will benefit from a systems-based architecture which presents data quality, quantity, and ease of capture within a decision-making dashboard. Methods: A framework was developed which stratifies key components and advances the concept of contextualized biomarkers...
December 2017: Journal of Clinical and Translational Science
https://www.readbyqxmd.com/read/29683053/multidisciplinary-prerounding-meeting-as-a-continuous-quality-improvement-tool-leveraging-to-reduce-continuous-benzodiazepine-use-at-an-academic-medical-center
#6
Alexander H Flannery, Melissa L Thompson Bastin, Ashley Montgomery-Yates, Corrine Hook, Evan Cassity, Phillip M Eaton, Peter E Morris
BACKGROUND: Evidence-based medicine often has many barriers to overcome prior to implementation in practice, hence the importance of continuous quality improvement. We report on a brief (≤10 minutes) multidisciplinary meeting prior to rounds to establish a dashboard for continuous quality improvement and studied the success of this meeting on a particular area of focus: continuous infusion benzodiazepine minimization. METHODS: This was a prospective observational study of patients admitted to the medical intensive care unit (MICU) of a large academic medical center over a 4-month period...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29677943/uptake-of-a-dashboard-designed-to-give-realtime-feedback-to-a-sentinel-network-about-key-data-required-for-influenza-vaccine-effectiveness-studies
#7
Sameera Pathirannehelage, Pushpa Kumarapeli, Rachel Byford, Ivelina Yonova, Filipa Ferreira, Simon de Lusignan
Dashboards are technologies that bringing together a range of data sources for observational or analytical purposes. We have created a customised dashboard that includes all the key data elements required for monitoring flu vaccine effectiveness (FVE). This delivers a unique dashboard for each primary care provider (general practice) providing data to the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), one of the oldest European surveillance systems. These FVE studies use a test negative case control (TNCC) design...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29622527/epic-allies-a-gamified-mobile-phone-app-to-improve-engagement-in-care-antiretroviral-uptake-and-adherence-among-young-men-who-have-sex-with-men-and-young-transgender-women-who-have-sex-with-men-protocol-for-a-randomized-controlled-trial
#8
Sara LeGrand, Kathryn E Muessig, Alyssa Platt, Karina Soni, Joseph R Egger, Nkechinyere Nwoko, Tobias McNulty, Lisa B Hightow-Weidman
BACKGROUND: In the United States, young men who have sex with men (YMSM) and transgender women who have sex with men (YTWSM) bear a disproportionate burden of prevalent and incident HIV infections. Once diagnosed, many YMSM and YTWSM struggle to engage in HIV care, adhere to antiretroviral therapy (ART), and achieve viral suppression. Computer-based interventions, including those focused on behavior change, are recognized as effective tools for engaging youth. OBJECTIVE: The purpose of the study described in this protocol is to evaluate the efficacy of Epic Allies, a theory-based mobile phone app that utilizes game mechanics and social networking features to improve engagement in HIV care, ART uptake, ART adherence, and viral suppression among HIV-positive YMSM and YTWSM...
April 5, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29605268/improving-the-value-of-care-for-appendectomy-through-an-individual-surgeon-specific-approach
#9
Jamie R Robinson, Nicholas H Carter, Corinne Gibson, Adam S Brinkman, Kyle Van Arendonk, Karen E Speck, Melissa E Danko, Gretchen P Jackson, Harold N Lovvorn, Martin L Blakely
PURPOSE: Standardized care via a unified surgeon preference card for pediatric appendectomy can result in significant cost reduction. The purpose of this study was to evaluate the impact of cost and outcome feedback to surgeons on value of care in an environment reluctant to adopt a standardized surgeon preference card. METHODS: Prospective observational study comparing operating room (OR) supply costs and patient outcomes for appendectomy in children with 6-month observation periods both before and after intervention...
March 8, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29600495/a-preliminary-study-of-telemedicine-for-patients-with-hepatic-glycogen-storage-disease-and-their-healthcare-providers-from-bedside-to-home-site-monitoring
#10
Irene J Hoogeveen, Fabian Peeks, Foekje de Boer, Charlotte M A Lubout, Tom J de Koning, Sebastiaan Te Boekhorst, Robert-Jan Zandvoort, Rob Burghard, Francjan J van Spronsen, Terry G J Derks
BACKGROUND: The purpose of this project was to develop a telemedicine platform that supports home site monitoring and integrates biochemical, physiological, and dietary parameters for individual patients with hepatic glycogen storage disease (GSD). METHODS AND RESULTS: The GSD communication platform (GCP) was designed with input from software developers, GSD patients, researchers, and healthcare providers. In phase 1, prototyping and software design of the GCP has occurred...
March 29, 2018: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/29595408/an-electronic-intervention-to-improve-safety-for-pain-patients-co-prescribed-chronic-opioids-and-benzodiazepines
#11
Tauheed Zaman, Tessa L Rife, Steven L Batki, David L Pennington
BACKGROUND: Co-prescribing opioids and benzodiazepines increases overdose risk. A paucity of literature exists evaluating strategies to improve safety of co-prescribing. This study evaluated an electronic intervention to improve safety for patients co-prescribed chronic opioids for pain and benzodiazepines at 3- and 6-months. METHODS: Prospective cohort study conducted December 2015 through May 2016 at San Francisco Veterans Affairs Health Care System. A clinical dashboard identified 145 eligible patients prescribed chronic opioids and benzodiazepines...
March 29, 2018: Substance Abuse
https://www.readbyqxmd.com/read/29594852/information-architecture-for-a-patient-specific-dashboard-in-head-and-neck-tumor-boards
#12
Alexander Oeser, Jan Gaebel, Andreas Dietz, Susanne Wiegand, Steffen Oeltze-Jafra
PURPOSE: Overcoming the flaws of current data management conditions in head and neck oncology could enable integrated information systems specifically tailored to the needs of medical experts in a tumor board meeting. Clinical dashboards are a promising method to assist various aspects of the decision-making process in such cognitively demanding scenarios. However, in order to provide extensive and intuitive assistance to the participating physicians, the design and development of such a system have to be user-centric...
March 28, 2018: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29582392/benefit-risk-monitoring-of-vaccines-using-an-interactive-dashboard-a-methodological-proposal-from-the-advance-project
#13
Kaatje Bollaerts, Tom De Smedt, Katherine Donegan, Lina Titievsky, Vincent Bauchau
INTRODUCTION: New vaccines are launched based on their benefit-risk (B/R) profile anticipated from clinical development. Proactive post-marketing surveillance is necessary to assess whether the vaccination uptake and the B/R profile are as expected and, ultimately, whether further public health or regulatory actions are needed. There are several, typically not integrated, facets of post-marketing vaccine surveillance: the surveillance of vaccination coverage, vaccine safety, effectiveness and impact...
March 26, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29564549/call-for-action-how-to-improve-use-of-patient-reported-outcomes-to-guide-clinical-decision-making-in-rheumatoid-arthritis
#14
REVIEW
Bruno Fautrel, Rieke Alten, Bruce Kirkham, Inmaculada de la Torre, Frederick Durand, Jane Barry, Thorsten Holzkaemper, Walid Fakhouri, Peter C Taylor
Current guidelines for the management of rheumatoid arthritis (RA) recommend early treatment and a treat-to-target goal of remission or low disease activity. Over the past decade, this approach has been extremely successful in reducing disease activity and joint damage in patients with RA. At the same time, however, overall patient perception of well-being appears to have decreased with respect to outcome measures considered important by patients themselves, such as pain, fatigue, physical function and quality of life...
March 21, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29507124/next-generation-audit-and-feedback-for-inpatient-quality-improvement-using-electronic-health-record-data-a-cluster-randomised-controlled-trial
#15
Sajan Patel, Alvin Rajkomar, James D Harrison, Priya A Prasad, Victoria Valencia, Sumant R Ranji, Michelle Mourad
BACKGROUND: Audit and feedback improves clinical care by highlighting the gap between current and ideal practice. We combined best practices of audit and feedback with continuously generated electronic health record data to improve performance on quality metrics in an inpatient setting. METHODS: We conducted a cluster randomised control trial comparing intensive audit and feedback with usual audit and feedback from February 2016 to June 2016. The study subjects were internal medicine teams on the teaching service at an urban tertiary care hospital...
March 5, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29487044/a-mobile-health-platform-for-clinical-monitoring-in-early-psychosis-implementation-in-community-based-outpatient-early-psychosis-care
#16
Divya Kumar, Laura M Tully, Ana-Maria Iosif, Lauren N Zakskorn, Kathleen E Nye, Aqsa Zia, Tara Ann Niendam
BACKGROUND: A growing body of literature indicates that smartphone technology is a feasible add-on tool in the treatment of individuals with early psychosis (EP) . However, most studies to date have been conducted independent of outpatient care or in a research clinic setting, often with financial incentives to maintain user adherence to the technology. Feasibility of dissemination and implementation of smartphone technology into community mental health centers (CMHCs) has yet to be tested, and whether young adults with EP will use this technology for long periods of time without incentive is unknown...
February 27, 2018: JMIR Mental Health
https://www.readbyqxmd.com/read/29454393/health-professionals-perceptions-about-their-clinical-performance-and-the-influence-of-audit-and-feedback-on-their-intentions-to-improve-practice-a-theory-based-study-in-dutch-intensive-care-units
#17
Wouter T Gude, Marie-José Roos-Blom, Sabine N van der Veer, Dave A Dongelmans, Evert de Jonge, Jill J Francis, Niels Peek, Nicolette F de Keizer
BACKGROUND: Audit and feedback aims to guide health professionals in improving aspects of their practice that need it most. Evidence suggests that feedback fails to increase accuracy of professional perceptions about clinical performance, which likely reduces audit and feedback effectiveness. This study investigates health professionals' perceptions about their clinical performance and the influence of feedback on their intentions to change practice. METHODS: We conducted an online laboratory experiment guided by Control Theory with 72 intensive care professionals from 21 units...
February 17, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29440013/the-impact-of-new-forms-of-large-scale-general-practice-provider-collaborations-on-england-s-nhs-a-systematic-review
#18
Luisa M Pettigrew, Stephanie Kumpunen, Nicholas Mays, Rebecca Rosen, Rachel Posaner
BACKGROUND: Over the past decade, collaboration between general practices in England to form new provider networks and large-scale organisations has been driven largely by grassroots action among GPs. However, it is now being increasingly advocated for by national policymakers. Expectations of what scaling up general practice in England will achieve are significant. AIM: To review the evidence of the impact of new forms of large-scale general practice provider collaborations in England...
March 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29436806/-development-of-a-care-performance-management-system-in-a-swiss-university-hospital
#19
Joachim Rapin, Danielle D Amour, Thierry Penseyres, Gabrielle Santos, Vincent Adatte, Isabelle Lehn, Cédric Mabire
Studies show high variability in the quality of care and a significant incidence of adverse events. The care management direction of a university hospital center (CHU) has developed a care performance measuring system. The aim of the article is to present the different development stages of this system. The authors used May's Normalization Process Theory, which focuses on factors influencing the engagement of individuals, groups, and organizations in sustaining change.The CHU's approach led to the following results : 1) reaching a consensus on performance concept and identifying five areas of performance, 2) selection of 12 priority indicators to assess performance, 3) measures development, 4) setting up the method of collecting information 5) creation of a mechanism for analyzing the results by care teams and 6) dissemination of results via dashboards...
December 2017: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/29419821/the-use-of-individual-provider-performance-reports-by-us-hospitals
#20
Joshua A Rolnick, Kira L Ryskina
Medicare reimbursement for hospitals is increasingly tied to performance. The use of individual provider performance reports offers the potential to improve clinical outcomes through social comparison, and isolated cases of clinical dashboard uses at specific institutions have been previously reported. However, little is known about overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. We used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles...
February 7, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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