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"Quality improvement" driver

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https://www.readbyqxmd.com/read/29881737/framework-to-guide-the-collection-and-use-of-patient-reported-outcome-measures-in-the-learning-healthcare-system
#1
Patricia Franklin, Kate Chenok, Danielle Lavalee, Rebecca Love, Liz Paxton, Courtney Segal, Erin Holve
Background: Web-based collection of patient-reported outcome measures (PROMs) in clinical practice is expanding rapidly as electronic health records include web portals for patients to report standardized assessments of their symptoms. As the value of PROMs in patient care expands, a framework to guide the implementation planning, collection, and use of PROs to serve multiple goals and stakeholders is needed. Methods: We identified diverse clinical, quality, and research settings where PROMs have been successfully integrated into care and routinely collected and analyzed drivers of successful implementation...
September 4, 2017: EGEMS
https://www.readbyqxmd.com/read/29795322/introduction-to-quality-improvement-tools-for-the-clinician
#2
Alan Peter Picarillo
As physicians continue search for ways to deliver high quality care to their patients and families, newer tools and methods are being introduced. Initially developed by manufacturing, quality improvement methods have been slowly adopted by healthcare and are now standard curriculum in medical schools. The IHI Model for Improvement allows for teams to create. model for change, test proposed changes in clinical situations, measure the results and then accept or modify the proposed changes. Additional tools such as process maps, Pareto charts, Ishikawa diagrams, and key driver diagrams provide structure and visual representation to the team during the creation and implementation of...
May 24, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29718299/improving-quality-in-the-care-of-patients-with-inflammatory-bowel-diseases
#3
Matthew D Egberg, Ajay S Gulati, Ziad F Gellad, Gil Y Melmed, Michael D Kappelman
Efforts to improve healthcare quality were firmly established before the Institute of Medicine (IOM) historic 2000 and 2001 reports, To Err is Human Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century Despite the long-standing healthcare quality improvement (QI) efforts that date back to the turn of the 20th century, the IOM reports significantly advanced the awareness of healthcare quality deficits and the resulting risk to patients from those gaps in care...
April 27, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29700849/have-out-of-pocket-health-care-payments-risen-under-free-health-care-policy-the-case-of-sri-lanka
#4
Asankha Pallegedara, Michael Grimm
Compared to its neighbors, Sri Lanka performs well in terms of health. Health care is provided for free in the public sector, yet households' out-of-pocket health expenditures are steadily increasing. We explore whether this increase can be explained by supply shortages and insufficient public health care financing or whether it is rather the result of an income-induced demand for supplementary and higher quality services from the private sector. We focus on total health care expenditures and health care expenditures for specific services such as expenses on private outpatient treatments and expenses on laboratory and other diagnostic services...
April 26, 2018: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29679047/a-quality-improvement-initiative-to-reduce-necrotizing-enterocolitis-across-hospital-systems
#5
Amy T Nathan, Laura Ward, Kurt Schibler, Laurel Moyer, Andrew South, Heather C Kaplan
OBJECTIVE: Necrotizing enterocolitis (NEC) is a devastating intestinal disease in premature infants. Local rates of NEC were unacceptably high. We hypothesized that utilizing quality improvement methodology to standardize care and apply evidence-based practices would reduce our rate of NEC. STUDY DESIGN: A multidisciplinary team used the model for improvement to prioritize interventions. Three neonatal intensive care units (NICUs) developed a standardized feeding protocol for very low birth weight (VLBW) infants, and employed strategies to increase the use of human milk, maximize intestinal perfusion, and promote a healthy microbiome...
April 20, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29643071/facilitating-the-timely-discharge-of-well-newborns-by-using-quality-improvement-methods
#6
Nicole T Rochester, Laurie P Banach, Wendy Hoffner, Deena Zeltser, Phyllis Lewis, Elizabeth Seelbach, Sandra Cuzzi
BACKGROUND AND OBJECTIVES: Discharges are a key driver of hospital throughput. Our pediatric hospitalist team sought to improve newborn nursery throughput by increasing the percentage of newborns on our service with a discharge order by 11 am. We hypothesized that implementing a discharge checklist would result in earlier discharge times for newborns who met discharge criteria. METHODS: We identified barriers to timely discharge through focus groups with key stakeholders, chart reviews, and brainstorming sessions...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29601424/an-acuity-tool-for-heart-failure-case-management-quantifying-workload-service-utilization-and-disease-severity
#7
Matthew D Kilgore
PURPOSE: The cardiology service line director at a health maintenance organization (HMO) in Washington State required a valid, reliable, and practical means for measuring workloads and other productivity factors for six heart failure (HF) registered nurse case managers located across three geographical regions. The Kilgore Heart Failure Case Management (KHFCM) Acuity Tool was systematically designed, developed, and validated to measure workload as a dependent function of the number of heart failure case management (HFCM) services rendered and the duration of times spent on various care duties...
May 2018: Professional Case Management
https://www.readbyqxmd.com/read/29596822/impact-of-regional-collaboration-on-quality-improvement-and-associated-cost-savings-in-coronary-artery-bypass-grafting
#8
Jeffrey B Rich, Clifford E Fonner, Mohammed A Quader, Gorav Ailawadi, Alan M Speir
BACKGROUND: Prolonged ventilation and acute renal failure were identified as the biggest cost drivers following isolated CABG in a statewide database. Reducing these complications through regional collaboration should improve outcomes and lower healthcare costs. METHODS: 27,978 patients who underwent isolated CABG were divided into pre- and post-quality improvement initiative groups (early era, 2008-2011, n=15,176 and later era, 2012-2015, n=12,802). Focused learning sessions on prolonged ventilation (PV) and post-op renal failure (RF) were undertaken in the earlier era...
March 26, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29589983/a-quality-improvement-initiative-to-improve-feeding-and-growth-of-infants-with-cleft-lip-and-or-palate
#9
Adriane L Baylis, Gregory D Pearson, Courtney Hall, Lauren L Madhoun, Caitlin Cummings, Nancy Neal, Amanda Smith, Katherine Eastman, Christina Stocker, Richard E Kirschner
OBJECTIVE: The purpose of this quality improvement initiative was to improve feeding and growth outcomes in infants with cleft lip and/or palate (CL/P). DESIGN: Institute for Healthcare Improvement quality improvement model. SETTING: Large pediatric academic medical center in the Midwestern United States. PARTICIPANTS: One hundred forty-five infants with nonsyndromic CL/P ages 0 to 12 months. INTERVENTIONS: Key drivers included (1) caregiver education and resources, (2) care coordination and flow, and (3) provider education and training...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29570048/key-drivers-of-patient-satisfaction-in-lumbar-spine-surgery
#10
Jay M Levin, Robert D Winkelman, Joseph E Tanenbaum, Edward C Benzel, Thomas E Mroz, Michael P Steinmetz
OBJECTIVE The Patient Experience of Care, composed of 9 dimensions derived from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, is being used by the Centers for Medicare & Medicaid Services to adjust hospital reimbursement. Currently, there are minimal data on how scores on the constituent HCAHPS items impact the global dimension of satisfaction, the Overall Hospital Rating (OHR). The purpose of this study was to determine the key drivers of overall patient satisfaction in the setting of inpatient lumbar spine surgery...
March 23, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29559504/increasing-pcp-and-hospital-medicine-physician-verbal-communication-during-hospital-admissions
#11
Matthew W Zackoff, Camille Graham, Denise Warrick, Kathleen Pulda, Craig Gosdin, Blair Simpson, Jessica Marischen, Paul Bunch, Michael Vossmeyer, Grant M Mussman
OBJECTIVES: During hospital admission, communication between primary care physicians (PCPs) and hospital medicine (HM) physicians provides an opportunity for collaboration. Two-way communication facilitates collaboration by allowing the receiver to ask and respond to questions. At our institution, most HM-to-PCP communication occurred by telephone call after discharge. Our specific aim was to increase the percentage of patients for whom a telephone conversation occurred between HM and PCPs during hospital admission from 40% to >80%...
April 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29504869/an-interdisciplinary-approach-to-improve-surgical-antimicrobial-prophylaxis
#12
Oisín Conaty, Leah Gaughan, Colum Downey, Noreen Carolan, Megan Joanne Brophy, Ruth Kavanagh, Deborah A A McNamara, Edmond Smyth, Karen Burns, Fidelma Fitzpatrick
Purpose The purpose of this paper is to improve surgical antimicrobial prophylaxis (SAP) prescribing in orthopaedic surgery using the model for improvement framework. Design/methodology/approach Orthopaedic patients receiving joint replacements, hip fracture repairs or open-reduction internal-fixation procedures were included. Antimicrobial(s); dose, time of administration and duration of SAP were evaluated for appropriateness based on the local SAP guidelines. After baseline data collection, a driver diagram was constructed with interventions devised for plan-do-study-act cycles...
March 12, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29453272/building-the-child-safety-collaborative-innovation-and-improvement-network-how-does-it-work-and-what-is-it-achieving
#13
Jennifer B Leonardo, Rebecca S Spicer, Maria Katradis, Jennifer Allison, Rebekah Thomas
OBJECTIVE: This study investigated whether the Child Safety Collaborative Innovation and Improvement Network (CS CoIIN) framework could be applied in the field of injury and violence prevention to reduce fatalities, hospitalizations and emergency department visits among 0-19 year olds. SAMPLE: Twenty-one states/jurisdictions were accepted into cohort 1 of the CS CoIIN, and 14 were engaged from March 2016 through April 2017. A quality improvement framework was used to test, implement and spread evidence-based change ideas (strategies and programs) in child passenger safety, falls prevention, interpersonal violence prevention, suicide and self-harm prevention and teen driver safety...
February 16, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/29329301/estimated-mortality-on-hiv-treatment-among-active-patients-and-patients-lost-to-follow-up-in-4-provinces-of-zambia-findings-from-a-multistage-sampling-based-survey
#14
Charles B Holmes, Izukanji Sikazwe, Kombatende Sikombe, Ingrid Eshun-Wilson, Nancy Czaicki, Laura K Beres, Njekwa Mukamba, Sandra Simbeza, Carolyn Bolton Moore, Cardinal Hantuba, Peter Mwaba, Caroline Phiri, Nancy Padian, David V Glidden, Elvin Geng
BACKGROUND: Survival represents the single most important indicator of successful HIV treatment. Routine monitoring fails to capture most deaths. As a result, both regional assessments of the impact of HIV services and identification of hotspots for improvement efforts are limited. We sought to assess true mortality on treatment, characterize the extent under-reporting of mortality in routine health information systems in Zambia, and identify drivers of mortality across sites and over time using a multistage, regionally representative sampling approach...
January 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29251701/lower-emergency-general-surgery-egs-mortality-among-hospitals-with-higher-quality-trauma-care
#15
John W Scott, Thomas C Tsai, Pooja U Neiman, Gregory J Jurkovich, Garth H Utter, Adil H Haider, Ali Salim, Joaquim M Havens
BACKGROUND: Patients undergoing emergency general surgery (EGS) procedures are up to eight times more likely to die than patients undergoing the same procedures electively. This excess mortality is often attributed to nonmodifiable patient factors including comorbidities and physiologic derangements at presentation, leaving few targets for quality improvement. Although the hospital-level traits that contribute to EGS outcomes are not well understood, we hypothesized that facilities with lower trauma mortality would have lower EGS mortality...
March 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29192315/clinical-factors-associated-with-reoperation-and-prolonged-length-of-stay-in-free-tissue-transfer-to-oncologic-head-and-neck-defects
#16
William W Thomas, Jason Brant, Jinbo Chen, Orly Coblens, John P Fischer, Jason G Newman, Ara A Chalian, Rabie M Shanti, Steven B Cannady
Importance: Prolonged hospitalization and reoperation after free tissue transfer may be associated with certain clinical factors. Objective: To determine patient and surgical factors associated with length of stay (LOS) and reoperation following surgical procedures for malignant neoplasm of the head and neck involving microvascular free tissue transfer reconstruction. Design, Setting, and Participants: This was a retrospective review of American College of Surgeons National Surgical Quality Improvement Program data from 2012 to 2014 using International Classification of Diseases, Ninth Revision (ICD-9), codes for malignant neoplasms of the head and neck...
March 1, 2018: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29162345/postacute-care-after-pediatric-hospitalizations-for-a-primary-mental-health-condition
#17
James C Gay, Bonnie T Zima, Tumaini R Coker, Stephanie K Doupnik, Matthew Hall, Jonathan Rodean, Margaret O'Neill, Rustin Morse, Kris P Rehm, Jay G Berry, Naomi S Bardach
OBJECTIVES: To determine the proportion of US children hospitalized for a primary mental health condition who are discharged to postacute care (PAC); whether PAC discharge is associated with demographic, clinical, and hospital characteristics; and whether PAC use varies by state. STUDY DESIGN: Retrospective cohort study of a nationally representative sample of US acute care hospitalizations for children ages 2-20 years with a primary mental health diagnosis, using the 2009 and 2012 Kids' Inpatient Databases...
February 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29144047/evaluation-of-patient-satisfaction-in-pediatric-dermatology
#18
Sarah Ahmed, Jonathan Miller, James F Burrows, Ben Khallouq Bertha, Paul Rosen
BACKGROUND/OBJECTIVES: There remains a lack of investigation into which factors patients and families value the most in their experience at pediatric dermatology clinics. Most of the current literature on quality improvement in dermatology does not encompass the pediatric population. To determine the drivers that are most predictive of a positive patient experience, we observed the indirect relationship between several factors of the patient experience and their role in patient satisfaction...
November 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/29093967/a-multisite-study-of-performance-drivers-among-institutional-review-boards
#19
Michael Caligiuri, Karen Allen, Nate Buscher, Lisa Denney, Cynthia Gates, Kip Kantelo, Anthony Magit, Rachael Sak, Gary S Firestein, John Fontanesi
Introduction: The time required to obtain Institutional Review Board (IRB) approval is a frequent subject of efforts to reduce unnecessary delays in initiating clinical trials. This study was conducted by and for IRB directors to better understand factors affecting approval times as a first step in developing a quality improvement framework. Methods: 807 IRB-approved clinical trials from 5 University of California campuses were analyzed to identify operational and clinical trial characteristics influencing IRB approval times...
June 2017: Journal of Clinical and Translational Science
https://www.readbyqxmd.com/read/29045256/a-quality-improvement-initiative-to-increase-scoring-consistency-and-accuracy-of-the-finnegan-tool-challenges-in-obtaining-reliable-assessments-of-drug-withdrawal-in-neonatal-abstinence-syndrome
#20
Wendy Timpson, Cheryl Killoran, Louise Maranda, Alan Picarillo, Elisabeth Bloch-Salisbury
BACKGROUND: Current practice for diagnosing neonatal abstinence syndrome and guiding pharmacological management of neonatal drug withdrawal is dependent on nursing assessments and repeated evaluation of clinical signs. PURPOSE: This single-center quality improvement initiative was designed to improve accuracy and consistency of Finnegan scores among neonatal nurses. METHODS: One-hundred seventy neonatal nurses participated in a single-session withdrawal-assessment program that incorporated education, scoring guidelines, and a restructured Finnegan scale...
February 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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