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https://www.readbyqxmd.com/read/28486632/a-quality-improvement-project-using-statistical-process-control-methods-for-type-2-diabetes-control-in-a-resource-limited-setting
#1
David Flood, Kate Douglas, Vera Goldberg, Boris Martinez, Pablo Garcia, MaryCatherine Arbour, Peter Rohloff
Quality issue: Quality improvement (QI) is a key strategy for improving diabetes care in low- and middle-income countries (LMICs). This study reports on a diabetes QI project in rural Guatemala whose primary aim was to improve glycemic control of a panel of adult diabetes patients. Initial assessment: Formative research suggested multiple areas for programmatic improvement in ambulatory diabetes care. Choice of solution: This project utilized the Model for Improvement and Agile Global Health, our organization's complementary healthcare implementation framework...
May 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28456065/improving-hiv-post-exposure-prophylaxis-rates-after-pediatric-acute-sexual-assault
#2
Samantha Schilling, Stephanie A Deutsch, Rebecca Gieseker, Jennifer Molnar, Jane M Lavelle, Philip V Scribano
The purpose of our study was to increase the rate of children with appropriate HIV-PEP regimens among those diagnosed with sexual assault in The Children's Hospital of Philadelphia Emergency Department (ED). The outcome measure was the percent of patients receiving correct HIV-PEP. We retrospectively reviewed 97 charts over 31 months to define the baseline rate of children receiving appropriate HIV-PEP regimens (pre QI-implementation period: 2/2012-8/2014). Among children in which HIV-PEP was indicated following sexual assault, 40% received the recommended 28-day course...
April 26, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28408415/impact-of-international-quality-improvement-collaborative-on-congenital-heart-surgery-in-pakistan
#3
Amina Khan, Ahmed Abdullah, Huzaifa Ahmad, Arjumand Rizvi, Sehrish Batool, Kathy J Jenkins, Kimberlee Gauvreau, Muneer Amanullah, Anwar Haq, Nadeem Aslam, Fauzia Minai, Babar Hasan
BACKGROUND: The International Quality Improvement Collaborative (IQIC) was formed to reduce mortality and morbidity from congenital heart disease (CHD) surgeries in low/middle-income countries. OBJECTIVES: We conducted this study to compare the postoperative outcomes of CHD surgeries at a centre in Pakistan before and after joining IQIC. METHODS: The IQIC provides guidelines targeting key drivers responsible for morbidity and mortality in postoperativepatients with CHD...
April 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28372579/va-residential-substance-use-disorder-treatment-program-providers-perceptions-of-facilitators-and-barriers-to-performance-on-pre-admission-processes
#4
Laura S Ellerbe, Luisa Manfredi, Shalini Gupta, Tyler E Phelps, Thomas R Bowe, Anna D Rubinsky, Jennifer L Burden, Alex H S Harris
BACKGROUND: In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics...
April 4, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28371924/implementation-of-a-quality-improvement-initiative-improved-congenital-muscular-torticollis-outcomes-in-a-large-hospital-setting
#5
Mariann L Strenk, Michelle Kiger, Jesse L Hawke, Amy Mischnick, Catherine Quatman-Yates
Background.: The American Physical Therapy Association (APTA) published a guideline for Congenital Muscular Torticollis (CMT) in 2013. Our division adopted the guideline as the institutional practice standard and engaged in a quality improvement (QI) initiative to increase the percentage of patients who achieved resolution of CMT within six months of evaluation. Objective.: The aims of this report are to describe the QI activities we conducted to improve patient outcomes and discuss the results and implications for other institutions and patient populations...
March 24, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28365143/applying-human-factors-and-ergonomics-to-the-misuse-of-nonsterile-clinical-gloves-in-acute-care
#6
Jennie Wilson, Aggie Bak, Heather P Loveday
BACKGROUND: Health care workers (HCWs) are recommended to wear nonsterile clinical gloves (NSCG) for direct contact with blood and body fluids. However, there is evidence of extensive inappropriate NSCG use. METHODS: A mixed-methods study comprising observation of NSCG use in 2 acute hospitals and semistructured HCW interviews. Qualitative data were categorized using thematic analysis. Findings were mapped to the Systems Engineering Initiative for Patient Safety model and used to develop a strategy for improving NSCG use...
March 29, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#7
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28255067/reducing-head-ct-use-for-children-with-head-injuries-in-a-community-emergency-department
#8
Rebecca M Jennings, Jennifer J Burtner, Joseph F Pellicer, Deepthi K Nair, Miranda C Bradford, Michele Shaffer, Neil G Uspal, Joel S Tieder
BACKGROUND AND OBJECTIVE: Clinical decision rules have reduced use of computed tomography (CT) to evaluate minor pediatric head injury in pediatric emergency departments (EDs). CT use remains high in community EDs, where the majority of children seek medical care. We sought to reduce the rate of CT scans used to evaluate pediatric head injury from 29% to 20% in a community ED. METHODS: We evaluated a quality improvement (QI) project in a community ED aimed at decreasing the use of head CT scans in children by implementing a validated head trauma prediction rule for traumatic brain injury...
March 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28243440/adopting-and-sustaining-a-virtual-fracture-clinic-model-in-the-district-hospital-setting-a-quality-improvement-approach
#9
Kartik Logishetty
Virtual Fracture Clinics (VFCs) are an alternative to the conventional fracture clinics, to manage certain musculoskeletal injuries. This has recently been reported as a safe, cost-effective and efficient care model. As demonstrated at vanguard sites in the United Kingdom, VFCs can enhance patient care by standardising treatment and reducing outpatient appointments. This project demonstrates how a Quality Improvement approach was applied to introduce VFCs in the District General Hospital setting. We demonstrate how undertaking Process Mapping, Driver Diagrams, and Stakeholder Analysis can assist implementation...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28237984/effect-of-a-quality-improvement-program-to-improve-guideline-adherence-and-attainment-of-clinical-standards-in-dialysis-care-report-of-outcomes-in-year-1
#10
Sajeda Youssouf, Azri Nache, Chandrakumaran Wijesekara, Rachel J Middleton, David Lewis, Aladdin E Shurrab, Edmond O'Riordan, Lesley P Lappin, Donal O'Donoghue, Philip A Kalra, Janet Hegarty
BACKGROUND: Best practice in dialysis is synthesised in clear international guidelines. However, a large gap remains between the international guidelines and the actual delivery of care. In this paper, we report outcomes for the first year of a multifaceted dialysis improvement programme in our network. METHODS: One year collaborative involving 3 haemodialysis units and a peritoneal dialysis (PD) programme involving 299 dialysis patients. Each unit addressed a different indicator (unit A - catheter-related bloodstream infection [CRBSI], unit B - pre-dialysis blood pressure [BP], unit C - dialysis dose, unit D - anaemia) with a shared aim to match the top 10% in the UK...
February 25, 2017: Nephron
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#11
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28190572/prioritising-local-action-for-water-quality-improvement-using-citizen-science-a-study-across-three-major-metropolitan-areas-of-china
#12
Ian Thornhill, Jonathan G Ho, Yuchao Zhang, Huashou Li, Kin Chung Ho, Leticia Miguel-Chinchilla, Steven A Loiselle
Streams in urban areas are prone to degradation. While urbanization-induced poor water quality is a widely observed and well documented phenomenon, the mechanism to pinpoint local drivers of urban stream degradation, and their relative influence on water quality, is still lacking. Utilizing data from the citizen science project FreshWater Watch, we use a machine learning approach to identify key indicators, potential drivers, and potential controls to water quality across the metropolitan areas of Shanghai, Guangzhou and Hong Kong...
April 15, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28181969/a-population-health-driver-diagram-to-address-neonatal-abstinence-syndrome
#13
Paul Campbell Erwin, Laurie L Meschke, Samantha F Ehrlich, John W Moran
This article describes the process for developing a population health driver diagram to address a priority health issue in East Tennessee: neonatal abstinence syndrome (NAS). Population health driver diagrams are used in quality improvement processes for determining and aligning actions that a community can take to achieve a specified outcome. The Tennessee Department of Health contracted with the University of Tennessee's Department of Public Health to conduct a community participatory process to contribute to a statewide health improvement plan...
February 8, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28168821/metrics-and-data-analysis-in-transplantation-quality-improvement-via-transparency
#14
EDITORIAL
J A Fishman
No abstract text is available yet for this article.
February 6, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28152892/establishing-achievable-benchmarks-for-quality-improvement-in-systemic-therapy-for-early-stage-breast-cancer
#15
Alejandro Gonzalez, Rinku Sutradhar, Katherine Enright, Nathan Taback, Christopher M Booth, Maureen E Trudeau, Monika K Krzyzanowska
263 Background: Setting realistic targets for performance on quality indicators (QI) is a consistent challenge in quality improvement. The purpose of this study was to utilize administrative data to define achievable targets for QI in the early stage breast cancer (EBC) population in relation to systemic therapy (ST) delivery based on best performers. METHODS: Deterministically linked administrative healthcare databases were used to identify EBC cases diagnosed 2006 - 2010 in Ontario, Canada...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152695/improving-anti-emetics-in-chemotherapy-induced-nausea-and-vomiting
#16
Ron Fung, Katherine Enright
220 Background: Chemotherapy induced nausea and vomiting (CINV) remains one of the most feared treatment-related toxicities in cancer patients. CINV has been shown to decrease quality of life and to increase dose modifications and unplanned hospital visits. Cancer Care Ontario (CCO) and the American Society of Clinical Oncology (ASCO) updated their CINV guidelines in 2013. These changes included a reclassification of many regimens from moderate (MEC) to highly emetogenic (HEC) and a decrease in the duration of serotonin inhibitors (5HT3i)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152684/the-kaiser-permanente-breast-cancer-survivorship-national-clinical-algorithm-regional-variation-in-implementation-processes-strategies-within-an-integrated-health-care-system
#17
Erin Elizabeth Hahn, Joanne E Schottinger, Susan E Kutner, Mark B Littlewood
104 Background: Kaiser Permanente (KP) is an integrated healthcare system providing comprehensive services to over 10 million members. The KP Interregional Breast Care Leaders, a multidisciplinary clinician group, developed a comprehensive evidence/consensus-based algorithm for breast cancer survivors, the KP Breast Cancer Survivorship National Clinical Algorithm (BCSNCA). The BCSNCA is intended to reduce variation in medical and psychosocial surveillance and improve outcomes by providing guidance to locally implemented survivorship programs, ie, recommendations for surveillance, late effects management, and risk reduction...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28076003/reducing-functional-mr-imaging-acquisition-times-by-optimizing-workflow
#18
Wilson B Chwang, Michael Iv, Jason Smith, Aleksandrs Kalnins, Jake Mickelsen, Roland Bammer, Dominik Fleischmann, David B Larson, Max Wintermark, Michael Zeineh
Functional magnetic resonance (MR) imaging is a complex, specialized examination that is able to noninvasively measure information critical to patient care such as hemispheric language lateralization ( 1 ). Diagnostic functional MR imaging requires extensive patient interaction as well as the coordinated efforts of the entire health care team. We observed in our practice at an academic center that the times to perform functional MR imaging examinations were excessively lengthy, making scheduling of the examination difficult...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28075621/key-principles-in-quality-and-safety-in-radiology
#19
REVIEW
Hani Abujudeh, Rathachai Kaewlai, Khalid Shaqdan, Michael A Bruno
OBJECTIVE: The purpose of this article is to introduce the reader to basic concepts of quality and safety in radiology. CONCLUSION: Concepts are introduced that are keys to identifying, understanding, and utilizing certain quality tools with the aim of making process improvements. Challenges, opportunities, and change drivers can be mapped from the radiology quality perspective. Best practices, informatics, and benchmarks can profoundly affect the outcome of the quality improvement initiative we all aim to achieve...
March 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28053222/improving-exclusive-breastfeeding-in-an-urban-academic-hospital
#20
Laura P Ward, Susan Williamson, Stephanie Burke, Ruby Crawford-Hemphill, Amy M Thompson
BACKGROUND AND OBJECTIVE: Breastfeeding has many well-established health benefits for infants and mothers. There is greater risk reduction in health outcomes with exclusive breastfeeding (EBF). Our urban academic facility has had long-standing low EBF rates, serving a population with breastfeeding disparities. We sought to improve EBF rates through a Learning Collaborative model by participating in the Best Fed Beginnings project. METHODS: Formal improvement science methods were used, including the development of a key driver diagram and plan-do-study-act cycles...
February 2017: Pediatrics
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