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https://www.readbyqxmd.com/read/28109033/a-quality-improvement-initiative-to-decrease-the-rate-of-solitary-blood-cultures-in-the-emergency-department
#1
Joseph Choi, Sahand Ensafi, Lucas Brien Chartier, Oliver Van Praet
OBJECTIVES: Best practice guidelines recommend that at least two sets of blood cultures (BCs) be sent when blood cultures are required. However, high rates of solitary BCs are still common in the emergency department (ED). The aim of this study was to evaluate the efficacy of different quality improvement initiatives aimed at reducing the rate of solitary blood cultures being sent to the lab on patients ultimately discharged from our ED. METHODS: This was a multi-centre, multi-phase, prospective study evaluating a comprehensive education-based intervention and a second intervention that combined a computerized forcing function along with a brief education-based intervention...
January 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28108821/the-relationship-between-patient-activation-confidence-to-self-manage-side-effects-and-adherence-to-oral-oncolytics-a-pilot-study-with-michigan-oncology-practices
#2
Teresa M Salgado, Emily Mackler, Jane A Severson, Jamie Lindsay, Peter Batra, Laura Petersen, Karen B Farris
PURPOSE: The Michigan Oncology Quality Consortium (MOQC) is a continuous quality improvement collaborative seeking to improve oncology care in Michigan, including for patients taking oral chemotherapy. The aim of this study was to assess the relationship between patient activation, confidence to self-manage side effects, and adherence to oral oncolytics to inform future oncology care. METHODS: A multicenter cross-sectional observational study was conducted using an online survey to examine patient activation (patient activation measure, PAM), health literacy, symptom burden (Edmonton Symptom Assessment System, ESAS), confidence to self-manage side effects (fatigue, nausea, and diarrhea), and adherence to oral oncolytics...
January 20, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28108581/reduced-emergency-department-utilization-by-patients-with-epilepsy-using-qi-methodology
#3
Anup D Patel, Eric G Wood, Daniel M Cohen
BACKGROUND: Epilepsy or seizure care is the most common neurologic condition that presents to an emergency department (ED) and accounts for a large number of annual cases. Our aim was to decrease seizure-related ED visits from our baseline of 17 ED visits per month per 1000 patients to 13.6 ED visits per month per 1000 patients (20%) by July 2014. METHODS: Our strategy was to develop a quality improvement (QI) project utilizing the Institute for Healthcare Improvement model...
January 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28107785/blood-management-strategies-to-reduce-transfusions-after-elective-lower-extremity-joint-arthroplasty-surgeries
#4
Ankit Kansagra, Chester Andrzejewski, Robert Krushell, Andrew Lehman, Jordan Greenbaum, Paul Visintainer, Joan McGirr, Kathleen Mahoney, Darlene Cloutier, Alice Ehresman, Mihaela S Stefan
Blood loss associated with lower-extremity total joint arthroplasty (TJA) often results in anemia and the need for red blood cell transfusions (RBCTs). This article reports on a quality improvement initiative aimed at improving blood management strategies in patients undergoing TJA. A multifaceted intervention (preoperative anemia assessment, use of tranexamic acid, discouragement of autologous preoperative blood collection, restrictive RBCT protocols) was implemented. The results were stratified into 3 intervention periods: 1, pre; 2, peri; and 3, post...
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#5
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107295/healthcare-transformation-and-changing-roles-for-nursing
#6
Susan W Salmond, Mercedes Echevarria
Factors driving healthcare transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities. Cost and quality concerns along with changing social and disease-type demographics created the greatest urgency for the need for change. Caring for and paying for medical treatments for patients suffering from chronic health conditions are a significant concern. The Affordable Care Act includes programs now led by the Centers for Medicare & Medicaid Services aiming to improve quality and control cost...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28106609/should-we-fear-computers-or-the-lack-of-them-technology-digital-quality-improvement-and-the-care-redesign-process
#7
Allan F Simpao, Jorge A Gálvez, Maxime Cannesson
No abstract text is available yet for this article.
January 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28105883/measuring-health-literate-discharge-practices
#8
Jennifer Innis, Jan Barnsley, Whitney Berta, Imtiaz Daniel
Purpose Health literate discharge practices meet patient and family health literacy needs in preparation for care transitions from hospital to home. The purpose of this paper is to measure health literate discharge practices in Ontario hospitals using a new organizational survey questionnaire tool and to perform psychometric testing of this new survey. Design/methodology/approach This survey was administered to hospitals in Ontario, Canada. Exploratory factor analysis and reliability testing were performed...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28105882/quality-improvement-in-hospitals-barriers-and-facilitators
#9
Dick E Zoutman, B Douglas Ford
Purpose The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety. Design/methodology/approach An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives. Findings The response rate was 37 percent, 46 surveys were completed from 125 acute care hospitals...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28105750/development-of-a-peer-review-framework-for-cancer-multi-disciplinary-meetings
#10
Claire E Johnson, Neli Slavova-Azmanova, Christobel Saunders
BACKGROUND: There is no mechanism in place for monitoring or quality improvement of cancer multidisciplinary meetings (MDMs) in Australia. OBJECTIVE: To develop a peer review process for quality improvement of MDMs. METHODS: This project involved three phases: 1) development of a draft peer review framework, supporting documents and peer review process; 2) consultation with key stakeholders; 3) refinement of the framework, documents and processes following a pilot study with three MDMs...
January 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28105692/the-price-of-free-tissue-transfer-after-tongue-reconstruction-quantifying-the-risks
#11
Mohemmed N Khan, Enrique Perez, Erden Goljo, Alfred Iloreta, Richard Chan Woo Park, Eric M Genden, Brett A Miles
OBJECTIVES/HYPOTHESIS: To evaluate the preoperative variables, mean operative time, morbidity, and mortality associated with reconstruction of partial glossectomy defects. STUDY DESIGN: Retrospective data analysis. METHODS: The National Surgical Quality Improvement Program database was queried for patients having undergone glossectomy procedures. The study sample was split into two groups based on the lack or presence of a flap reconstruction...
January 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28104490/increasing-trainee-reporting-of-adverse-events-with-monthly-trainee-directed-review-of-adverse-events
#12
Alla Smith, Jonathan Hatoun, James Moses
OBJECTIVE: Underreporting of adverse events by physicians is a barrier to improving patient safety. In an effort to increase resident and medical student (hereafter "trainee") reporting of adverse events, trainees developed and led a monthly conference during which they reviewed adverse-event reports, identified system vulnerabilities and designed solutions to those vulnerabilities. METHODS: Monthly conferences over the 22-month study period were led by pediatric trainees, and attended by fellow trainees, departmental leadership, and members of the hospital's quality improvement team...
January 16, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28104052/assessment-of-a-chronic-disease-self-management-program-to-increase-physical-activity-of-adults-with-severe-mental-illness
#13
Julia Ringgold Strong, Gail Schoen Lemaire, Lyn Stankiewicz Murphy
Individuals with severe mental illness (SMI) experience excessive co-morbidities and early mortality. Self-management programs have the potential to increase physical activity levels of individuals with SMI and reduce the incidence of co-morbidities. The purpose of this quality improvement project was to assess a chronic disease self-management program (CDSMP) to increase physical activity of adults with SMI measured by daily steps tracked with a pedometer. Results of data analysis indicated no statistically significant difference in steps across the six-week program...
February 2017: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/28103722/accreditation-of-medical-schools-in-saudi-arabia-a-qualitative-study
#14
S A Alrebish, B C Jolly, E K Molloy
CONTEXT: The accreditation of undergraduate medical education is a universal undertaking. Despite the widespread adoption of accreditation processes and an increasing focus on accreditation as a mechanism to ensure minimum standards are met in various fields, there is little evidence to support the effectiveness of accreditation. Traditionally, accreditation has worked toward achieving two ends: assuring and improving quality. Many recent articles emphasize the need for continuous quality improvement mechanisms to work, as well as the quality assurance role of accreditation...
January 20, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28102467/mypod-an-emr-based-tool-that-facilitates-quality-improvement-and-maintenance-of-certification
#15
Loren Berman, Brian Duffy, B Randall Brenn, Charles Vinocur
Maintenance of Certification (MOC) was designed to assess physician competencies including operative case volume and outcomes. This information, if collected consistently and systematically, can be used to facilitate quality improvement. Information automatically extracted from the electronic medical record (EMR) can be used as a prompt to compile these data. We developed an EMR-based program called MyPOD (My Personal Outcomes Data) to track surgical outcomes at our institution. We compared occurrences reported in the first 18 months to those captured in the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) over the same time period...
March 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28101758/applying-collaborative-learning-and-quality-improvement-to-public-health-lessons-from-the-collaborative-improvement-and-innovation-network-coiin-to-reduce-infant-mortality
#16
Reem M Ghandour, Katherine Flaherty, Ashley Hirai, Vanessa Lee, Deborah Klein Walker, Michael C Lu
OBJECTIVES: Infant mortality remains a significant public health problem in the U.S. The Collaborative Improvement & Innovation Network (CoIIN) model is an innovative approach, using the science of quality improvement and collaborative learning, which was applied across 13 Southern states in Public Health Regions IV and VI to reduce infant mortality and improve birth outcomes. We provide an in-depth discussion of the history, development, implementation, and adaptation of the model based on the experience of the original CoIIN organizers and participants...
January 18, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28101333/behaviour-change-interventions-to-influence-antimicrobial-prescribing-a-cross-sectional-analysis-of-reports-from-uk-state-of-the-art-scientific-conferences
#17
T M Rawson, L S P Moore, A M Tivey, A Tsao, M Gilchrist, E Charani, A H Holmes
BACKGROUND: To improve the quality of antimicrobial stewardship (AMS) interventions the application of behavioural sciences supported by multidisciplinary collaboration has been recommended. We analysed major UK scientific research conferences to investigate AMS behaviour change intervention reporting. METHODS: Leading UK 2015 scientific conference abstracts for 30 clinical specialties were identified and interrogated. All AMS and/or antimicrobial resistance(AMR) abstracts were identified using validated search criteria...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28099725/maternal-and-newborn-outcomes-at-a-tertiary-care-hospital-in-lusaka-zambia-2008-2012
#18
Bellington Vwalika, Marie C D Stoner, Mulindi Mwanahamuntu, K Cherry Liu, Eugene Kaunda, Getrude G Tshuma, Somwe W Somwe, Yusuf Ahmed, Elizabeth M Stringer, Jeffrey S A Stringer, Benjamin H Chi
OBJECTIVE: To measure key obstetric and neonatal outcomes recorded at a tertiary hospital in Zambia over a 5-year period. METHODS: A retrospective analysis was conducted among women who had delivered at the University Teaching Hospital in Lusaka, between January 1, 2008, and December 31, 2012. Data were extracted from electronic medical records. The main outcomes were maternal mortality, cesarean delivery, prenatal or intrapartum hemorrhage, stillbirth, a 5-minute Apgar score of less than 7, and admission to the neonatal intensive care unit...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099450/advanced-neonatal-medicine-in-china-a-national-baseline-database
#19
Xiang-Peng Liao, Selma Chipenda-Dansokho, Antoine Lewin, Nadia Abdelouahab, Shu-Qin Wei
Previous surveys of neonatal medicine in China have not collected comprehensive information on workforce, investment, health care practice, and disease expenditure. The goal of the present study was to develop a national database of neonatal care units and compare present outcomes data in conjunction with health care practices and costs. We summarized the above components by extracting data from the databases of the national key clinical subspecialty proposals issued by national health authority in China, as well as publicly accessible databases...
2017: PloS One
https://www.readbyqxmd.com/read/28099373/deconstructing-clinical-workflow-identifying-teaching-learning-principles-for-barcode-electronic-medication-administration-with-nursing-students
#20
Richard G Booth, Barbara Sinclair, Gillian Strudwick, Laura Brennan, Lisa Morgan, Stephanie Collings, Jessica Johnston, Brittany Loggie, James Tong, Chantal Singh
The purpose of this quality improvement project was to better understand how to teach medication administration underpinned by an electronic medication administration record (eMAR) system used in simulated, prelicensure nursing education. Methods included a workflow and integration analysis and a detailed process mapping of both an oral and a sublingual medication administration. Procedural and curriculum development considerations related to medication administration using eMAR technology are presented for nurse educators...
January 18, 2017: Nurse Educator
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