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"Quality improvement" driver

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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
#1
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
#2
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...
February 9, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28181969/a-population-health-driver-diagram-to-address-neonatal-abstinence-syndrome
#3
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
#4
EDITORIAL
J A Fishman
Transparency in clinical data has been identified as a driver of improved clinical outcomes in transplantation by many including Porter (1). Transparency in this context includes the broad availability of outcomes data including clinical outcomes adjusted for risk, the costs of care, and the experience of the center in providing those services - as a basis for comparing the "value" of healthcare services at various clinical centers. At the same time, and perhaps of greater importance, dramatic advances in transplant immunology and immunosuppression, microbiologic diagnosis and therapy, surgical techniques, organ procurement and allocation, and in clinical management of complex patients have been major drivers of improved transplant outcomes...
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
January 4, 2017: Pediatrics
https://www.readbyqxmd.com/read/28025929/hemophilia-management-via-data-collection-and-reporting-initial-findings-from-the-comprehensive-care-sustainability-collaborative
#11
Michael D Tarantino, Vanita K Pindolia
BACKGROUND: Despite being a rare disorder, hemophilia represents a significant driver of health care resource utilization and requires expert hematologic and multidisciplinary services to achieve optimal outcomes. Since their inception nearly 40 years ago, hemophilia treatment centers (HTCs) have served as centers of excellence in providing the intensive care and ancillary services necessary for this unique patient base; however, the full capabilities of these centers may be underused in the current framework of managed care, largely because of a lack of communication and information shared between payers and HTC stakeholders...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28017586/operative-variables-are-better-predictors-of-postdischarge-infections-and-unplanned-readmissions-in-vascular-surgery-patients-than-patient-characteristics
#12
Caitlin W Hicks, Michael Bronsert, Karl E Hammermeister, William G Henderson, Douglas R Gibula, James H Black, Natalia O Glebova
OBJECTIVE: Although postoperative readmissions are frequent in vascular surgery patients, the reasons for these readmissions are not well characterized, and effective approaches to their reduction are unknown. Our aim was to analyze the reasons for vascular surgery readmissions and to report potential areas for focused efforts aimed at readmission reduction. METHODS: The 2012 to 2013 American College of Surgeons National Quality Improvement Program (ACS NSQIP) data set was queried for vascular surgery patients...
December 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27964775/hygiene-on-maternity-units-lessons-from-a-needs-assessment-in-bangladesh-and-india
#13
Suzanne Cross, Kaosar Afsana, Morsheda Banu, Dileep Mavalankar, Emma Morrison, Atiya Rahman, Tapash Roy, Deepak Saxena, Kranti Vora, Wendy J Graham
BACKGROUND: As the proportion of deliveries in health institutions increases in low- and middle-income countries, so do the challenges of maintaining standards of hygiene and preventing healthcare-associated infections (HCAIs) in mothers and babies. Adequate water, sanitation, and hygiene (WASH) and infection prevention and control (IPC) in these settings should be seen as integral parts of the broader domain of quality care. Assessment approaches are needed which capture standards for both WASH and IPC, and so inform quality improvement processes...
2016: Global Health Action
https://www.readbyqxmd.com/read/27960204/community-acquired-pneumonia-a-global-perspective
#14
Grant W Waterer
Community-acquired pneumonia (CAP) is a global disease responsible for a large proportion of deaths and having significant economic cost. As diagnostic tools have increased in sensitivity, our understanding of the etiology of CAP has begun to change with a significant increase in confirmed viral infections and the recognition that multiple pathogens are frequently present. Empiric therapy remains the standard of care and guidelines are mostly based on published data from the United States or Europe. Blindly applying guidelines without any consideration of local etiological differences can lead to a risk of under or overtreatment...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27940752/improving-guideline-based-care-of-acute-asthma-in-a-pediatric-emergency-department
#15
Matthew P Gray, Grant E Keeney, Michael J Grahl, Marc H Gorelick, Christopher D Spahr
BACKGROUND AND OBJECTIVE: Rapid repetitive administration of short-acting β-agonists (SABA) is the most effective means of reducing acute airflow obstruction in asthma. Little evidence exists that assesses process measures (ie, timeliness) and outcomes for asthma. We used quality improvement (QI) methods to improve emergency department care in accordance with national guidelines including timely SABA administration and use of asthma severity scores. METHODS: The Model for Improvement was used and interventions were targeted at 4 key drivers: knowledge, engagement, decision support, and workflow enhancement...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27940663/infusion-medication-error-reduction-by-two-person-verification-a-quality-improvement-initiative
#16
Rajeev Subramanyam, Mohamed Mahmoud, David Buck, Anna Varughese
OBJECTIVE: Errors made in the administration of intravenous medication can lead to catastrophic harm. The frequency of hospital settings in which medication pumps are being used are increasing. We sought to improve medication safety by implementing a 2-person verification system before medication administration. METHODS: Our quality improvement initiative took place in an anesthesia radiology imaging service at a tertiary pediatric hospital. Key drivers included frequent educational meetings with clinicians, written reminders, display of visual reminders, constant feedback in the clinical areas that carried out the processes, and sharing of knowledge on displayed run charts...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27933148/role-of-peer-support-workers-in-improving-patient-experience-in-tower-hamlets-specialist-addiction-unit
#17
Wiktor Kulik, Amar Shah
The aim of the project was to improve patient experience for people in Tower Hamlets Specialist Addictions Unit in order to increase satisfaction by 25% in 12 months starting in August 2014. The team used the model for improvement as part of ELFT's quality improvement programme to support iterative cycles of testing and learning. This involved support from the Trust's quality improvement team. The theory of change was visualised through a driver diagram. A number of outcomes were measured and plotted over time - patient satisfaction, staff satisfaction, and attendance to peer support groups...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27930279/use-of-a-novel-accounting-and-grouping-method-for-major-trunk-injuryanalysis-of-data-from-a-statewide-trauma-financial-survey
#18
Kyla D Joubert, Charles D Mabry, Kyle J Kalkwarf, Richard D Betzold, Horace J Spencer, Kara M Spinks, Austin Porter, Saleema Karim, Ronald D Robertson, Michael J Sutherland, Robert T Maxson
Major trunk trauma is common and costly, but comparisons of costs between trauma centers (TCs) are rare. Understanding cost is essential to improve quality, manage trauma service lines, and to facilitate institutional commitment for trauma. We have used results of a statewide trauma financial survey of Levels I to IV TC to develop a useful grouping method for costs and clinical characteristics of major trunk trauma. The trauma financial survey collected billing and clinical data on 75 per cent of the state trauma registry patients for fiscal year 2012...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27873443/assessing-long-term-effects-of-multiple-potentially-confounded-drivers-in-ecosystems-from-species-traits
#19
Mathieu Floury, Philippe Usseglio-Polatera, Cecile Delattre, Yves Souchon
Although species traits have the potential to disentangle long-term effects of multiple, potentially confounded drivers in ecosystems, this issue has received very little attention in the literature. We aimed at filling this gap by assessing the relative effects of hydroclimatic and water quality factors on the trait composition of invertebrate assemblages over 30 years in the Middle Loire River (France). Using a priori predictions on the long-term variation of trait-based adaptations over the three decades, we evaluated the ability of invertebrate traits to indicate the effects of warming, discharge reduction and water quality improvement...
November 22, 2016: Global Change Biology
https://www.readbyqxmd.com/read/27757588/a-contemporary-approach-to-the-prevention-of-peritoneal-dialysis-related-peritonitis-in-children-the-role-of-improvement-science
#20
Allison Redpath Mahon, Alicia M Neu
Peritonitis is a leading cause of hospitalizations, morbidity, and modality change in pediatric chronic peritoneal dialysis (CPD) patients. Despite guidelines published by the International Society for Peritoneal Dialysis aimed at reducing the risk of peritonitis, registry data have revealed significant variability in peritonitis rates among centers caring for children on CPD, which suggests variability in practice. Improvement science methods have been used to reduce a variety of healthcare-associated infections and are also being applied successfully to decrease rates of peritonitis in children...
October 18, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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