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https://www.readbyqxmd.com/read/29311200/remote-patient-management-in-automated-peritoneal-dialysis-a-promising-new-tool
#1
Valérie Jotterand Drepper, Pierre-Yves Martin, Catherine Stoermann Chopard, James A Sloand
Remote patient management (RPM) has the potential to help clinicians detect early issues, allowing intervention prior to development of more significant problems. A 23-year-old end-stage kidney disease patient required urgent start of renal replacement therapy. A newly available automated peritoneal dialysis (APD) RPM system with cloud-based connectivity was implemented in her care. Pre-defined RPM threshold parameters were set to identify clinically relevant issues. Red flag dashboard alerts heralded prolonged drain times leading to clinical evaluation with subsequent diagnosis of and surgical repositioning for catheter displacement, although it took several days for newly-RPM-exposed staff to recognize this issue...
January 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29295811/stage-based-mobile-intervention-for-substance-use-disorders-in-primary-care-development-and-test-of-acceptability
#2
Deborah Levesque, Cindy Umanzor, Emma de Aguiar
BACKGROUND: In 2016, 21 million Americans aged 12 years and older needed treatment for a substance use disorder (SUD). However, only 10% to 11% of individuals requiring SUD treatment received it. Given their access to patients, primary care providers are in a unique position to perform universal Screening, Brief Intervention, and Referral to Treatment (SBIRT) to identify individuals at risk, fill gaps in services, and make referrals to specialty treatment when indicated. Major barriers to SBIRT include limited time among providers and low motivation to change among many patients...
January 2, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29273926/a-dutch-nationwide-bariatric-quality-registry-dato
#3
Youri Q M Poelemeijer, Ronald S L Liem, Simon W Nienhuijs
INTRODUCTION: In the Netherlands, the number of bariatric procedures increased exponentially in the 90s. To ensure and improve the quality of bariatric surgery, the nationwide Dutch Audit for Treatment of Obesity (DATO) was established in 2014. The audit was coordinated by the Dutch Institute for Clinical Auditing (DICA). This article provides a review of the aforementioned process in establishing a nationwide registry in the Netherlands. MATERIALS AND METHODS: In collaboration with the DATO's scientific committee and other stakeholders, an annual list of several external quality indicators was formulated...
December 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29229592/a-human-centered-platform-for-hiv-infection-reduction-in-new-york-development-and-usage-analysis-of-the-ending-the-epidemic-ete-dashboard
#4
Ashish Joshi, Chioma Amadi, Benjamin Katz, Sarah Kulkarni, Denis Nash
BACKGROUND: Dashboards have been increasingly used in clinic-based interventions, such as clinical performance improvement and monitoring risk of hospital readmissions, and are now gaining traction in population-based interventions, especially in disease assessment. OBJECTIVE: We describe the design, development, and usage analysis of a geovisualization dashboard, the Ending the Epidemic (ETE) Dashboard. The ETE dashboard is a tool developed to track New York's progress towards achieving the goal of its ETE Initiative, to reduce new HIV infections from 3000 per year to 750 per year by the end of 2020...
December 11, 2017: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/29175856/effect-of-a-population-level-performance-dashboard-intervention-on-maternal-newborn-outcomes-an-interrupted-time-series-study
#5
Deborah Weiss, Sandra I Dunn, Ann E Sprague, Deshayne B Fell, Jeremy M Grimshaw, Elizabeth Darling, Ian D Graham, JoAnn Harrold, Graeme N Smith, Wendy E Peterson, Jessica Reszel, Andrea Lanes, Mark C Walker, Monica Taljaard
OBJECTIVES: To assess the effect of the Maternal Newborn Dashboard on six key clinical performance indicators in the province of Ontario, Canada. DESIGN: Interrupted time series using population-based data from the provincial birth registry covering a 3-year period before implementation of the Dashboard and 2.5 years after implementation (November 2009 through March 2015). SETTING: All hospitals in the province of Ontario providing maternal-newborn care (n=94)...
November 24, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29173787/therapeutic-drug-monitoring-in-inflammatory-bowel-disease-history-and-future-directions
#6
REVIEW
Elizabeth A Spencer, Marla C Dubinsky
Clinical trials for the most effective drugs in the armamentarium of medications for inflammatory bowel disease (IBD) have shown only a 50-60% response rate, and this drops to 30% in maintenance. However, therapeutic drug monitoring (TDM) to adjust dosing to account for patient-specific characteristics, which has been shown to improve outcomes, was not utilized in these trials. This review will detail the development of TDM within the IBD space as it evolved from thiopurines to biologics and continues to evolve with loftier treat-to-target goals and more sophisticated dashboard systems...
December 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29173289/user-centered-collaborative-design-and-development-of-an-inpatient-safety-dashboard
#7
Eli Mlaver, Jeffrey L Schnipper, Robert B Boxer, Dominic J Breuer, Esteban F Gershanik, Patricia C Dykes, Anthony F Massaro, James Benneyan, David W Bates, Lisa S Lehmann
Patient safety remains a key concern in hospital care. This article summarizes the iterative participatory development, features, functions, and preliminary evaluation of a patient safety dashboard for interdisciplinary rounding teams on inpatient medical services. This electronic health record (EHR)-embedded dashboard collects real-time data covering 13 safety domains through web services and applies logic to generate stratified alerts with an interactive check-box function. The technological infrastructure is adaptable to other EHR environments...
December 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29151719/reducing-social-distress-for-chronic-disease-patients-in-primary-care-an-intervention-for-latino-type-2-diabetes-patients-seen-at-community-health-centers
#8
Nancy A Allen, Sofija Zagarins, Garry Welch
Background: Social and behavioral factors have important direct and indirect effects on chronic disease onset and progression. The U.S. health care system is beginning to focus on assessment and management of social and behavioral problems through federal mandates related to meaningful use of electronic health records and improved patient outcomes. Methods: We examined the clinical adoption of a 20-item screening tool to measure social distress focusing on type 2 diabetes...
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29114619/incorporating-big-data-into-treatment-plan-evaluation-development-of-statistical-dvh-metrics-and-visualization-dashboards
#9
Charles S Mayo, John Yao, Avraham Eisbruch, James M Balter, Dale W Litzenberg, Martha M Matuszak, Marc L Kessler, Grant Weyburn, Carlos J Anderson, Dawn Owen, William C Jackson, Randall Ten Haken
Purpose: To develop statistical dose-volume histogram (DVH)-based metrics and a visualization method to quantify the comparison of treatment plans with historical experience and among different institutions. Methods and materials: The descriptive statistical summary (ie, median, first and third quartiles, and 95% confidence intervals) of volume-normalized DVH curve sets of past experiences was visualized through the creation of statistical DVH plots. Detailed distribution parameters were calculated and stored in JavaScript Object Notation files to facilitate management, including transfer and potential multi-institutional comparisons...
July 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29077195/developing-a-caries-risk-registry-to-support-caries-risk-assessment-and-management-for-children-a-quality-improvement-initiative
#10
Jesley C Ruff, Jill Boylston Herndon, Roger A Horton, Julie Lynch, Dawn C Mathwig, Audra Leonard, Krishna Aravamudhan
OBJECTIVES: Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children...
October 27, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/29063548/best-paper-selection
#11
(no author information available yet)
Anderson AE, Kerr WT, Thames A, Li T, Xiao J, Cohen MS. Electronic health record phenotyping improves detection and screening of type 2 diabetes in the general United States population: a crosssectional, unselected, retrospective study. J Biomed Inform 2016;60;162-8 http://www.sciencedirect.com/science/article/pii/S1532046415002865?via%3Dihub Badgeley MA, Shameer K, Glocksberg BS, Tomlinson MS, Levin MA, McCormick PJ, Kasarskis A, Reich DL, Dudley JT. EHDViz: clinical dashboard development using open-source technologies...
August 2017: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/29021108/effects-of-a-multifaceted-implementation-intervention-to-increase-utilization-of-pharmacological-treatments-for-alcohol-use-disorders-in-the-us-veterans-health-administration
#12
Alex H S Harris, Randall Brown, Michael Dawes, Eric Dieperink, Donald Hugh Myrick, Heather Gerould, Todd H Wagner, Jennifer P Wisdom, Hildi J Hagedorn
Over 16 million Americans meet diagnostic criteria for alcohol use disorder (AUD), but only 7.8% of them receive formal treatment each year. Safe and effective pharmacological treatments for AUD exist; however, they are rarely prescribed. Therefore, we developed and pilot tested a multifaceted implementation intervention to improve consideration and receipt of effective pharmacologic treatments for AUD, focusing on primary care settings where patients have the most frequent contact with healthcare systems. The intervention included training of local providers to serve as champions and a website for primary care providers that included educational materials, a case-finding dashboard, and contact information for local and national clinical experts...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28930362/rapid-development-of-specialty-population-registries-and-quality-measures-from-electronic-health-record-data-an-agile-framework
#13
Vaishnavi Kannan, Jason S Fish, Jacqueline M Mutz, Angela R Carrington, Ki Lai, Lisa S Davis, Josh E Youngblood, Mark R Rauschuber, Kathryn A Flores, Evan J Sara, Deepa G Bhat, DuWayne L Willett
BACKGROUND: Creation of a new electronic health record (EHR)-based registry often can be a "one-off" complex endeavor: first developing new EHR data collection and clinical decision support tools, followed by developing registry-specific data extractions from the EHR for analysis. Each development phase typically has its own long development and testing time, leading to a prolonged overall cycle time for delivering one functioning registry with companion reporting into production. The next registry request then starts from scratch...
June 14, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28887346/leveraging-electronic-medical-record-data-for-population-health-management-in-the-veterans-health-administration-successes-and-lessons-learned
#14
Jannet M Carmichael, Joy Meier, Amy Robinson, Janice Taylor, Diana T Higgins, Shardool Patel
PURPOSE: The process and operational elements to establish a population health program using electronic medical record data in a Veterans Health Administration region are described. SUMMARY: Pharmacists are uniquely qualified to assume important roles in population health through the use of their clinical knowledge, assisted by electronic tools that consolidate and report patient-specific data for clinical care. Veterans Integrated Services Network (VISN) 21 has developed 300 dashboards and reports to improve the quality, safety, and value of healthcare to veterans...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28884303/efficacy-and-safety-of-clindamycin-based-treatment-for-bone-and-joint-infections-a-cohort-study
#15
J Courjon, E Demonchy, E Cua, E Bernard, P-M Roger
Clindamycin has high bioavailability together with good diffusion in bone tissue and could represent an alternative antibiotic compound for the treatment of bone and joint infections (BJIs). However, data regarding the efficacy and safety of clindamycin for BJIs are limited. A monocentric cohort study based on our medical dashboard, which prospectively recorded 28 characteristics for all hospitalized patients since July 2005, was performed. BJIs were selected, and then, all mono-microbial BJI managed with clindamycin-based therapy were included...
December 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28883187/requirements-analysis-for-a-clinical-decision-support-system-aiming-at-improving-the-artificial-nutrition-of-critically-ill-patients
#16
Christina Schüttler, Marc Hinderer, Stefan Kraus, Anne-Katharina Lang, Hans-Ulrich Prokosch, Ixchel Castellanos
BACKGROUND: Nutrition support is an important aspect regarding the care of critically ill patients. Malnutrition affects the recovery process negatively. However, the impact on the clinical outcome is often underestimated in complex clinical settings due to several factors hindering optimization of nutrition. OBJECTIVE: To identify the requirements for a clinical decision support system that enables the medical staff to improve its patients' nutritional status. METHODS: A literature review and interviews with two senior physicians were conducted to refine the requirements for the support system as well as to determine the inclusion criteria for a subsequent intervention study...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28813191/effect-and-efficiency-of-an-embedded-palliative-care-nurse-practitioner-in-an-oncology-clinic
#17
Anne M Walling, Sarah F D'Ambruoso, Jennifer L Malin, Sara Hurvitz, Ann Zisser, Anne Coscarelli, Robin Clarke, Andrew Hackbarth, Christopher Pietras, Frances Watts, Bruce Ferrell, Samuel Skootsky, Neil S Wenger
PURPOSE: To test a simultaneous care model for palliative care for patients with advanced cancer by embedding a palliative care nurse practitioner (NP) in an oncology clinic. METHODS: We evaluated the effect of the intervention in two oncologists' clinics beginning March 2014 by using implementation strategies, including use of a structured referral mechanism, routine symptom screening, integration of a psychology-based cancer supportive care center, implementation team meetings, team training, and a metrics dashboard for continuous quality improvement...
September 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28738800/benchmarked-performance-charts-using-principal-components-analysis-to-improve-the-effectiveness-of-feedback-for-audit-data-in-hiv-care
#18
Skevi Michael, Mark Gompels, Caroline Sabin, Hilary Curtis, Margaret T May
BACKGROUND: Feedback tools for clinical audit data that compare site-specific results to average performance over all sites can be useful for quality improvement. Proposed tools should be simple and clearly benchmark the site's performance, so that a relevant action plan can be directly implemented to improve patient care services. We aimed to develop such a tool in order to feedback data to UK HIV clinics participating in the 2015 British HIV Association (BHIVA) audit assessing compliance with the 2011 guidelines for routine investigation and monitoring of adult HIV-1- infected individuals...
July 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28725791/quality-improvement-intervention-for-reduction-of-redundant-testing
#19
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: Academic Pathology
https://www.readbyqxmd.com/read/28659159/searching-for-management-approaches-to-reduce-hai-transmission-smart-a-study-protocol
#20
Ann Scheck McAlearney, Jennifer L Hefner, Cynthia J Sieck, Daniel M Walker, Alison M Aldrich, Lindsey N Sova, Alice A Gaughan, Caitlin M Slevin, Courtney Hebert, Erinn Hade, Jacalyn Buck, Michele Grove, Timothy R Huerta
BACKGROUND: Healthcare-associated infections (HAIs) impact patients' lives through prolonged hospitalization, morbidity, and death, resulting in significant costs to both health systems and society. Central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) are two of the most preventable HAIs. As a result, these HAIs have been the focus of significant efforts to identify evidence-based clinical strategies to reduce infection rates...
June 28, 2017: Implementation Science: IS
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