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https://www.readbyqxmd.com/read/28213382/pharmacist-involvement-on-a-rapid-response-team
#1
Joel Feih, William J Peppard, Michael Katz
PURPOSE: The effect of a pharmacist on a rapid response team (RRT) was investigated. METHODS: This study evaluated 234 patients before and 157 patients after pharmacist involvement on an RRT. The primary outcome was time to medication administration, with a goal turnaround time of less than 30 minutes. Secondary outcomes included most frequently used medications, readmissions to the intensive care unit (ICU) within 48 hours, number of rapid responses that resulted in ICU admission, length of hospital stay, and survival to hospital discharge...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28212606/the-implementation-of-health-promotion-in-primary-and-community-care-a-qualitative-analysis-of-the-prescribe-vida-saludable-strategy
#2
Catalina Martinez, Gonzalo Bacigalupe, Josep M Cortada, Gonzalo Grandes, Alvaro Sanchez, Haizea Pombo, Paola Bully
BACKGROUND: The impact of lifestyle on health is undeniable and effective healthy lifestyle promotion interventions do exist. However, this is not a fundamental part of routine primary care clinical practice. We describe factors that determine changes in performance of primary health care centers involved in piloting the health promotion innovation 'Prescribe Vida Saludable' (PVS) phase II. METHODS: We engaged four primary health care centers of the Basque Healthcare Service in an action research project aimed at changing preventive health practices...
February 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28211595/pharmacy-education-in-jordan-updates
#3
Qais Alefan, Mo'tasem M Alsmadi
OBJECTIVE: To describe the increasing number of pharmacy schools in Jordan. METHOD: A review for numbers of schools and their curricula was conducted. KEY FINDINGS: To date, there are 18 pharmacy schools in Jordan. PharmD program is offered by two public schools. PhD program is offered by one school; while MSc program is offered by seven schools. Public pharmacy schools have two similar programs in terms of curricula, 'regular' and 'parallel'...
February 17, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28197619/evaluating-a-modular-decision-support-application-for-colorectal-cancer-screening
#4
Laura G Militello, Julie B Diiulio, Morgan R Borders, Christen E Sushereba, Jason J Saleem, Donald Haverkamp, Thomas F Imperiale
BACKGROUND: There is a need for health information technology evaluation that goes beyond randomized controlled trials to include consideration of usability, cognition, feedback from representative users, and impact on efficiency, data quality, and clinical workflow. This article presents an evaluation illustrating one approach to this need using the Decision-Centered Design framework. OBJECTIVE: To evaluate, through a Decision-Centered Design framework, the ability of the Screening and Surveillance App to support primary care clinicians in tracking and managing colorectal cancer testing...
February 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28178878/disease-characterization-of-systemic-lupus-erythematosus-sle-patients-in-quebec
#5
R Ng, S Bernatsky, E Rahme
Objective Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by an array of organ manifestations that can appear during flares and disappear during remissions. The objectives of this study were: (i) to examine SLE manifestation groups longitudinally in an SLE cohort; and (ii) to assess the association between early antimalarial treatment and renal manifestations. Methods Seven SLE manifestation groups-cutaneous, hematologic, lung, musculoskeletal, neuropsychiatric, serositis, renal-were tracked using Kaplan-Meier survival curves in an incident SLE cohort from Quebec health administrative data ( n = 2010)...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28168041/developing-and-testing-an-electronic-medication-administration-monitoring-device-for-community-dwelling-seniors-a-feasibility-study
#6
Henry Yu-Hin Siu, Dee Mangin, Michelle Howard, David Price, David Chan
BACKGROUND: Medication non-adherence, polypharmacy, and adverse drug events are major healthcare issues leading to significant morbidity, mortality, and healthcare expenditures. Currently, there are no methods to systematically track medication usage in community-dwelling seniors. The eDosette prototype was created to make medication use patterns visible via the Internet. This study aims to demonstrate feasibility, usability, and acceptability of the eDosette in community-dwelling seniors in primary care...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28166804/addressing-the-gaps-in-diabetes-care-in-first-nations-communities-with-the-reorganizing-the-approach-to-diabetes-through-the-application-of-registries-radar-the-project-protocol
#7
Dean T Eurich, Sumit R Majumdar, Lisa A Wozniak, Allison Soprovich, Kari Meneen, Jeffrey A Johnson, Salim Samanani
BACKGROUND: Type-2 diabetes rates in First Nations communities are 3-5 times higher than the general Canadian population, resulting in a high burden of disease, complications and comorbidity. Limited community nursing capacity, isolated environments and a lack of electronic health records (EHR)/registries lead to a reactive, disorganized approach to diabetes care for many First Nations people. The Reorganizing the Approach to Diabetes through the Application of Registries (RADAR) project was developed in alignments with federal calls for innovative, culturally relevant, community-specific programs for people with type-2 diabetes developed and delivered in partnership with target communities...
February 6, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28160784/assistive-technology-pricing-in-australia-is-it-efficient-and-equitable
#8
Michael P Summers, George Verikios
Objective To examine available systematically collected evidence regarding prices for assistive technology (AT; e.g. disability aids and equipment) in Australia with other comparable countries. Issues of appropriate AT pricing are coming to the fore as a consequence of efforts to move to consumer-centric purchasing decisions with the National Disability Insurance Scheme (NDIS) and also in the recent aged care reforms.Methods We identified and present three sets of AT price comparisons. Two comparisons were based solely on the lowest prices advertised on the internet, and one comparison examined recommended retail prices...
February 6, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28157644/the-future-for-follow-up-of-gynaecological-cancer-in-europe-summary-of-available-data-and-overview-of-ongoing-trials
#9
REVIEW
S C Leeson, K Beaver, N P M Ezendam, R Mačuks, P L Martin-Hirsch, T Miles, M M Jeppesen, P T Jensen, P Zola
After completing treatment, most patients follow a pre-determined schedule of regular hospital outpatient appointments, which includes clinical examinations, consultations and routine tests. After several years of surveillance, patients are transferred back to primary care. However, there is limited evidence to support the effectiveness and efficiency of this approach. This paper examines the current rationale and evidence base for hospital-based follow-up after treatment for gynaecological cancer. We investigate what alternative models of care have been formally evaluated and what research is currently in progress in Europe, in order to make tentative recommendations for a model of follow-up...
January 19, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28156499/palliative-treatment-directives-for-bone-metastases-a-quality-directed-approach-to-guiding-institutional-practice
#10
Lucille Lee, Petrina Zuvic, Isabella Bingchan Zhang, Louis Potters, Beatrice Bloom
: 188 Background: The efficacy of single fraction (fx) radiation treatment (RT) has proven to have equipoise for palliation of bone metastases when compared to courses of 10 fx or more. Despite these data, there has been a slow adoption of this practice in the US and worldwide. Examination of our multicenter practice from 2004 - 2016 showed that single fx RT utilization has remained at 17% and hypofractionationed (HFX) courses (1 or 5 fx) have remained at 71% since 2009. We hypothesized that evidence-based, treatment-guiding directives could improve HFX utilization in this population...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152949/improving-screening-and-prophylaxis-of-hepatitis-b-in-immunosuppressed-patients
#11
Violeta Rabrenovich, David M Baer, Joanne E Schottinger
: 139 Background: Kaiser Permanente (KP) is an integrated health care delivery system that provides clinical services to over 10 million members in nine states and the District of Columbia. Since 2007, KP oncology community collaborates at the national level to systematically improve safety and quality of care. Our improvements are accelerated by rapid adoption of evidence based protocols, leveraging of EMR and integration of quality improvement methods into clinical operations. METHODS: KP created a team that included oncologists, hepatologists, rheumatologist, pharmacy, and quality improvement experts to evaluate safety of existing practice...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152916/defining-user-needs-for-an-electronic-tool-to-improve-chemotherapy-related-toxicity-management
#12
Laura Parente, Anthony Soung Yee, Melanie Powis, Katherine Enright, Sonal Gandhi, Eva Grunfeld, Rashida Haq, Amna Husain, Monika K Krzyzanowska
: 157 Background: Cancer drugs are associated with toxicities which can negatively impact patients' (pts) quality of life, outcomes and increase acute care use (ACU). There is increasing interest in leveraging technology to solve clinical problems in healthcare. We hypothesized that an electronic tool (toxicity module) targeting management of chemotherapy toxicities could decrease ACU by facilitating more effective symptom management. METHODS: Participatory design methodology consisting of end user needs assessment through ethnographic field study (shadowing and in-depth interviews) and focus groups was used to inform design of an interactive prototype toxicity module...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152890/utilizing-information-and-telehealth-technology-to-enhance-clinical-ethics-education-outreach
#13
Jessica Anne Moore, Brittany C Campbell
: 149 Background: Integrated Ethics provides continuing education monthly for physicians, nurses, social workers, and others to enhance knowledge and understanding of ethical challenges associated with patient care and research. These are offered live at the main campus. There are four regional centers within a thirty-five mile radius of the main campus. Participants from those locations used to have to come to the main campus to participate. This project was initiated to help alleviate rising financial costs associated with the online recording/redistributing of continuing education credit presentations, travel expenses for regional center employees, removal of employees for 4+ hours from the regional centers daily clinical operations to attend presentations, and payment to outside institutions to obtain required ethics CME and CEU credits...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152810/interdisciplinary-care-rounds-in-the-community-changing-the-paradigm-of-supportive-service-involvement-in-cancer-care
#14
Hal E Crosswell, Terra Dillard, Jennifer Bayne, Tina Redenz, Kyle Duggan, Angela Belew
: 83 Background: Although cancer centers have focused on optimizing seamless Multidisciplinary Care (MDC) at tumor boards and/or clinics, there has been little published on effective ways to involve supportive services into the management of cancer patients. Historically, supportive services have been initiated when there is an active need rather than in anticipation of that need. As an alternative to pursuing such "crisis management" in our patients, Bon Secours St. Francis Cancer Center (BSSF) initiated Interdisciplinary Care (IDC) Rounds in an effort to anticipate patient needs, enhance quality of life (QoL), and potentially limit avoidable emergency room and hospital admissions...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152747/connecting-specialty-practices-with-primary-care
#15
Suzanne Morton, Tyler Oberlander, Sarah Hudson Scholle, Michael Barr
: 47 Background: Public and private payers are beginning to adopt alternative payment structures that call for greater attention to patient-centered care and quality improvement activities (CMMI 2015; MACRA 2015). The National Committee for Quality Assurance (NCQA) developed standards for Patient-Centered Specialty Practice based on American College of Physicians principles. The report describes achievement on the standards among an initial cohort of recognized physicians. METHODS: We analyzed practice characteristics and determined how practices performed on each of the 21 elements in the PCSP program by showing the percent of practices scoring less than 50% of points, or 100% of points (i...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152422/street-level-diplomacy-communicative-and-adaptive-work-at-the-front-line-of-implementing-public-health-policies-in-primary-care
#16
Nicola Gale, George Dowswell, Sheila Greenfield, Tom Marshall
Public services are increasingly operating through network governance, requiring those at all levels of the system to build collaborations and adapt their practice. Agent-focused implementation theories, such as 'street-level bureaucracy', tend to focus on decision-making and the potential of actors to subvert national policy at a local level. While it is acknowledged that network leaders need to be adaptable and to build trust, much less consideration has been given to the requirement for skills of 'diplomacy' needed by those at the front line of delivering public services...
January 24, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28148543/ordering-interruptions-in-a-tertiary-care-center-a-prospective-observational-study
#17
Nina M Dadlez, Gabriella Azzarone, Mark J Sinnett, Micah Resnick, H Michael Ushay, Jason S Adelman, Molly Broder, Carol Duh-Leong, Joyce Huang, Victoria Kiely, Ariella Nadler, Vayola Nelson, Jared Simcik, Michael L Rinke
OBJECTIVES: By self-report, interruptions may contribute to up to 80% of ordering errors. A greater understanding of the frequency and context of interruptions during ordering is needed to identify targets for intervention. We sought to characterize the epidemiology of interruptions during order placement in the pediatric inpatient setting. METHODS: This prospective observational study conducted 1-hour-long structured observations on morning rounds and afternoons and evenings in the resident workroom...
February 1, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28135352/implementation-of-lung-cancer-screening-in-the-veterans-health-administration
#18
Linda S Kinsinger, Charles Anderson, Jane Kim, Martha Larson, Stephanie H Chan, Heather A King, Kathryn L Rice, Christopher G Slatore, Nichole T Tanner, Kathleen Pittman, Robert J Monte, Rebecca B McNeil, Janet M Grubber, Michael J Kelley, Dawn Provenzale, Santanu K Datta, Nina S Sperber, Lottie K Barnes, David H Abbott, Kellie J Sims, Richard L Whitley, R Ryanne Wu, George L Jackson
Importance: The US Preventive Services Task Force recommends annual lung cancer screening (LCS) with low-dose computed tomography for current and former heavy smokers aged 55 to 80 years. There is little published experience regarding implementing this recommendation in clinical practice. Objectives: To describe organizational- and patient-level experiences with implementing an LCS program in selected Veterans Health Administration (VHA) hospitals and to estimate the number of VHA patients who may be candidates for LCS...
January 30, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28123045/an-improvement-approach-to-integrate-teaching-teams-in-the-reporting-of-safety-events
#19
Alston E Dunbar, Marcie Cupit, Richard J Vath, Kyle Pontiff, Natalie Evans, Melissa Roy, Michael Bolton
BACKGROUND AND OBJECTIVE: Patient safety events are underreported by physicians. Baseline data demonstrated that physicians submitted 3% of event reports at Our Lady of the Lake Children's Hospital. Our aim was to increase the proportion of safety reports filed by residents and faculty to 6% of all reports within a 9-month period. METHODS: We used the Model for Improvement and serial Plan, Do, Study, Act cycles to test interventions we hypothesized would improve physician recognition and reporting of patient safety events...
January 25, 2017: Pediatrics
https://www.readbyqxmd.com/read/28104061/quality-of-life-in-brazil-s-family-health-strategy-common-mental-disorders-use-of-psychotropic-drugs-and-sociodemographic-factors
#20
Adriana Inocenti Miasso, Paulo Celso Prado Telles Filho, Tatiana Longo Borges, Assis do Carmo Pereira Junior, Kelly Graziani Giacchero Vedana, Rebecca O Shasanmi, Fernanda Raphael Escobar Gimenes
The aim of the study was to evaluate the patients' quality of life in Brazil's Family Health Strategy and its association with sociodemographic factors, presence of common mental disorders, and use of psychotropic drugs. Were interviewed 442 patients. Tools were: World Health Organization Quality of Life Assessment-Bref and Self Reporting Questionnaire. Male and low education were strongly associated with higher quality of life. Use of psychotropic drugs and the presence of CMD were strongly associated with poor quality of life...
February 2017: Archives of Psychiatric Nursing
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