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"Quality improvement" driver

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https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#1
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28642742/microbial-resources-and-enological-significance-opportunities-and-benefits
#2
REVIEW
Leonardo Petruzzi, Vittorio Capozzi, Carmen Berbegal, Maria R Corbo, Antonio Bevilacqua, Giuseppe Spano, Milena Sinigaglia
Among the innovative trends in the wine sector, the continuous exploration of enological properties associated with wine microbial resources represents a cornerstone driver of quality improvement. Since the advent of starter cultures technology, the attention has been focused on intraspecific biodiversity within the primary species responsible for alcoholic fermentation (Saccharomyces cerevisiae) and, subsequently, for the so-called 'malolactic fermentation' (Oenococcus oeni). However, in the last decade, a relevant number of studies proposed the enological exploitation of an increasing number of species (e...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28607676/evaluating-the-quality-improvement-impact-of-the-global-tracheostomy-collaborative-in-four-diverse-nhs-hospitals
#3
Brendan A McGrath, James Lynch, Barbarella Bonvento, Sarah Wallace, Val Poole, Ann Farrell, Cristina Diaz, Sadie Khwaja, David W Roberson
Tracheostomies are predominantly used in Head & Neck Surgery and the critically ill. The needs of these complex patients frequently cross traditional speciality working boundaries and locations and any resulting airway problems can rapidly lead to significant harm. The Global Tracheostomy Collaborative (GTC) was formed in 2012 with the aim of bringing together international expertise in tracheostomy care in order to bring about rapid adoption of best practices and to improve the quality and safety of care to this vulnerable group...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28585163/engaging-multilevel-stakeholders-in-an-implementation-trial-of-evidence-based-quality-improvement-in-va-women-s-health-primary-care
#4
Alison B Hamilton, Julian Brunner, Cindy Cain, Emmeline Chuang, Tana M Luger, Ismelda Canelo, Lisa Rubenstein, Elizabeth M Yano
The Veterans Health Administration (VHA) has undertaken primary care transformation based on patient-centered medical home (PCMH) tenets. VHA PCMH models are designed for the predominantly male Veteran population, and require tailoring to meet women Veterans' needs. We used evidence-based quality improvement (EBQI), a stakeholder-driven implementation strategy, in a cluster randomized controlled trial across 12 sites (eight EBQI, four control) that are members of a Practice-Based Research Network. EBQI involves engaging multilevel, inter-professional leaders and staff as stakeholders in reviewing evidence and setting QI priorities...
June 5, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28552386/tools-and-methods-for-quality-improvement-and-patient-safety-in-perinatal-care
#5
Amy T Nathan, Heather C Kaplan
The quality of health care is now recognized to vary widely in all medical specialties, including perinatal medicine. A national focus on quality improvement (QI) and patient safety is prompting providers to change and improve the care given to patients. All QI and safety efforts require the use of an improvement model to manage the complex process of improving care. This article reviews the most common frameworks in use today, including the Model for Improvement, Six Sigma, and Lean. Specific tools such as affinity, key driver and fishbone diagrams, process maps and statistical process control, as well as checklists are reviewed, with examples from the perinatal literature to illustrate their use in perinatal QI efforts...
April 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28545652/using-quality-improvement-to-increase-human-milk-use-for-preterm-infants
#6
Margaret G Parker, Aloka L Patel
This review will provide an overview of quality improvement methods that have been used to improve human milk use (mother's own milk and donor milk) for very low-birth-weight infants in the hospital setting in the last decade. We will review the following: (1) evidence-based practices known to increase mother's own milk for very low-birth-weight infants; (2) individual hospitals with exemplary lactation programs and past and current US-based statewide quality improvement collaboratives focused on increasing mother's own milk; and (3) existing quality metrics for human milk and gaps in metrics...
April 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28542063/drivers-motivating-community-health-improvement-plan-completion-by-local-public-health-agencies-and-community-partners-in-the-rocky-mountain-region-and-western-plains
#7
Anne Hill, Holly J Wolf, Elaine Scallan, Jenny Case, Yvonne Kellar-Guenther
CONTEXT: There are numerous drivers that motivate completion of community health improvement plans (CHIPs). Some are more obvious and include voluntary public health accreditation, state requirements, federal and state funding, and nonprofit hospital requirements through IRS regulations. Less is known about other drivers, including involvement of diverse partners and belief in best practices, that may motivate CHIP completion. OBJECTIVE: This research investigated the drivers that motivated CHIP completion based on experiences of 51 local public health agencies (LPHAs)...
July 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28541422/where-women-go-to-deliver-understanding-the-changing-landscape-of-childbirth-in-africa-and-asia
#8
Dominic Montagu, May Sudhinaraset, Nadia Diamond-Smith, Oona Campbell, Sabine Gabrysch, Lynn Freedman, Margaret E Kruk, France Donnay
Growing evidence from a number of countries in Asia and Africa documents a large shift towards facility deliveries in the past decade. These increases have not led to the improvements in health outcomes that were predicted by health policy researchers in the past. In light of this unexpected evidence, we have assessed data from multiple sources, including nationally representative data from 43 countries in Asia and Africa, to understand the size and range of changing delivery location in Asia and Africa. We have reviewed the policies, programs and financing experiences in multiple countries to understand the drivers of changing practices, and the consequences for maternal and neonatal health and the health systems serving women and newborns...
May 25, 2017: Health Policy and Planning
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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...
April 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
#17
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
#18
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...
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
#19
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
#20
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
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