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https://www.readbyqxmd.com/read/29679214/improvement-of-radiology-reporting-in-a-clinical-cancer-network-impact-of-an-optimised-multidisciplinary-workflow
#1
A W Olthof, J Borstlap, W W Roeloffzen, P M C Callenbach, P M A van Ooijen
PURPOSE: To assess the effectiveness of implementing a quality improvement project in a clinical cancer network directed at the response assessment of oncology patients according to RECIST-criteria. METHODS: Requests and reports of computed tomography (CT) studies from before (n = 103) and after (n = 112) implementation of interventions were compared. The interventions consisted of: a multidisciplinary working agreement with a clearly described workflow; subspecialisation of radiologists; adaptation of the Picture Archiving and Communication System (PACS); structured reporting...
April 20, 2018: European Radiology
https://www.readbyqxmd.com/read/29679104/local-action-on-outdoor-air-pollution-to-improve-public-health
#2
REVIEW
Sotiris Vardoulakis, Rachel Kettle, Paul Cosford, Paul Lincoln, Stephen Holgate, Jonathan Grigg, Frank Kelly, David Pencheon
OBJECTIVES: The National Institute for Health and Care Excellence, jointly with Public Health England, have developed a guideline on outdoor air pollution and its links to health. The guideline makes recommendations on local interventions that can help improve air quality and prevent a range of adverse health outcomes associated with road-traffic-related air pollution. METHODS: The guideline was based on a rigorous assessment of the scientific evidence by an independent advisory committee, with input from public health professionals and other professional groups...
April 20, 2018: International Journal of Public Health
https://www.readbyqxmd.com/read/29679047/a-quality-improvement-initiative-to-reduce-necrotizing-enterocolitis-across-hospital-systems
#3
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/29678992/clinicians-and-researchers-perspectives-on-establishing-and-implementing-core-outcomes-in-haemodialysis-semistructured-interview-study
#4
Allison Tong, Sally Crowe, John S Gill, Tess Harris, Brenda R Hemmelgarn, Braden Manns, Roberto Pecoits-Filho, Peter Tugwell, Wim van Biesen, Angela Yee Moon Wang, David C Wheeler, Wolfgang C Winkelmayer, Talia Gutman, Angela Ju, Emma O'Lone, Benedicte Sautenet, Andrea Viecelli, Jonathan C Craig
OBJECTIVES: To describe the perspectives of clinicians and researchers on identifying, establishing and implementing core outcomes in haemodialysis and their expected impact. DESIGN: Face-to-face, semistructured interviews; thematic analysis. STETTING: Twenty-seven centres across nine countries. PARTICIPANTS: Fifty-eight nephrologists (42 (72%) who were also triallists). RESULTS: We identified six themes: reflecting direct patient relevance and impact (survival as the primary goal of dialysis, enabling well-being and functioning, severe consequences of comorbidities and complications, indicators of treatment success, universal relevance, stakeholder consensus); amenable and responsive to interventions (realistic and possible to intervene on, differentiating between treatments); reflective of economic burden on healthcare; feasibility of implementation (clarity and consistency in definition, easily measurable, requiring minimal resources, creating a cultural shift, aversion to intensifying bureaucracy, allowing justifiable exceptions); authoritative inducement and directive (endorsement for legitimacy, necessity of buy-in from dialysis providers, incentivising uptake); instituting patient-centredness (explicitly addressing patient-important outcomes, reciprocating trial participation, improving comparability of interventions for decision-making, driving quality improvement and compelling a focus on quality of life)...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678865/economic-evaluation-of-quality-improvement-interventions-designed-to-improve-glycemic-control-in-diabetes-a-systematic-review-and-weighted-regression-analysis
#5
REVIEW
Teryl K Nuckols, Emmett Keeler, Laura J Anderson, Jonas Green, Sally C Morton, Brian J Doyle, Kanaka Shetty, Aziza Arifkhanova, Marika Booth, Roberta Shanman, Paul Shekelle
OBJECTIVE: Quality improvement (QI) interventions can improve glycemic control, but little is known about their value. We systematically reviewed economic evaluations of QI interventions for glycemic control among adults with type 1 or type 2 diabetes. RESEARCH DESIGN AND METHODS: We used English-language studies from high-income countries that evaluated organizational changes and reported program and utilization-related costs, chosen from PubMed, EconLit, Centre for Reviews and Dissemination, New York Academy of Medicine's Grey Literature Report, and WorldCat (January 2004 to August 2016)...
May 2018: Diabetes Care
https://www.readbyqxmd.com/read/29678304/improving-postoperative-neonatal-nutritional-practices-in-an-intensive-care-unit-using-the-pdsa-cycle
#6
Jennifer Newcombe, Eileen Fry-Bowers
Quality Improvement models offer a framework for health care professionals to follow in implementing process improvement changes. Use of these models promotes a systematic approach to problem solving, keeps providers from eliminating important steps, facilitates team work, and provides a clear plan for ongoing communication. This paper describes use of the Plan-Do-Study-Act model to implement a unit-based quality improvement project that focused on improving postoperative nutritional practices for neonates with critical congenital heart disease following complex cardiac surgery...
April 17, 2018: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29678168/self-competence-in-death-work-among-health-and-social-care-workers-a-region-wide-survey-in-hong-kong
#7
Johnny T K Cheung, Doreen W H Au, Wallace C H Chan, Jenny H Y Chan, Kenway Ng, Jean Woo
BACKGROUND: According to the Quality of Death Index, Hong Kong is lagging behind many other Western and Asian countries in the category of palliative and healthcare. To ensure the provision of high-quality palliative care, it is important to explore the self-competence of health and social care workers in coping with death work including palliative care. This region-wide study aims to assess the level of self-competence with a validated Self-Competence in Death Work Scale (SC-DWS) and examine its correlates...
April 20, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29678137/supporting-teams-to-optimize-function-and-independence-in-veterans-a-multi-study-program-and-mixed-methods-protocol
#8
Virginia Wang, Kelli Allen, Courtney H Van Houtven, Cynthia Coffman, Nina Sperber, Elizabeth P Mahanna, Cathleen Colón-Emeric, Helen Hoenig, George L Jackson, Teresa M Damush, Erika Price, Susan N Hastings
BACKGROUND: Successful implementation of new clinical programs depends on effectively establishing, reorganizing, or enhancing team structures and processes to coordinate the work of individuals who are interdependent in their tasks, manage relationships, and share responsibility for outcomes. However, a one-size-fits-all approach is rarely effective. In partnership with VA national clinical leaders and local clinical champions, the Optimizing Function and Independence VA Quality Enhancement Research Initiative program (Function QUERI) will evaluate efforts to implement team-based clinical programs for Veterans at risk for functional decline and disability...
April 20, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29677117/developing-interventional-radiology-anticoagulation-guidelines-process-and-benefits-%C3%A2
#9
J Scott Kriegshauser, Howard H Osborn, Sailen G Naidu, Eric A Huettl, Maitray D Patel
We created, posted, and updated radiology department anticoagulation guidelines and identified various steps in the process, including triggering events, consensus building, legal analysis, education, and distribution of the guidelines to nurses and clinicians. Supporting data collected retrospectively, before and after implementation, included nursing satisfaction survey results and the number of procedure cancellations. After the guidelines were developed and posted, significantly fewer procedures were cancelled, nursing satisfaction was higher, and radiologists performed procedures with less variability...
April 20, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29677085/surgical-antimicrobial-prophylaxis-among-pediatric-patients-in-south-africa-comparing-two-healthcare-settings
#10
Nicolene van der Sandt, Natalie Schellack, Lindi A Mabope, Mothahadini Pb Mawela, Danie Kruger, Brian Godman
BACKGROUND: Appropriate use of surgical antimicrobial prophylaxis (SAP) is a concern in view of its impact on morbidity, mortality and costs. Little is currently known about SAP in South Africa. OBJECTIVE: Assess compliance to SAP guidelines for pediatric patients undergoing surgery in one of four surgical sub-specialties among hospitals in South Africa. METHODS: Eight month retrospective chart review in both a teaching hospital and a private hospital between February and August 2015...
April 19, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29677059/pediatric-perioperative-cardiac-arrest-death-in-the-off-hours-a-report-from-wake-up-safe-the-pediatric-quality-improvement-initiative
#11
Robert E Christensen, Angela C Lee, Marie S Gowen, Mallikarjuna R Rettiganti, Jayant K Deshpande, Jeffrey P Morray
BACKGROUND: Pediatric perioperative cardiac arrest (CA) is a rare but catastrophic event. This case-control study aims to analyze the causes, incidence, and outcomes of all pediatric CA reported to Wake Up Safe. Factors associated with CA and mortality after arrest are examined and possible strategies for improving outcomes are considered. METHODS: CA in children was identified from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29674110/resident-specific-morbidity-reduced-following-acs-nsqip-data-driven-quality-program
#12
Florence E Turrentine, John B Hanks, Megan C Tracci, R Scott Jones, Bruce D Schirmer, Philip W Smith
BACKGROUND: The Accreditation Council for Graduate Medical Education Milestone Project for general surgery provided a more robust method for developing and tracking residents' competence. This framework enhanced systematic and progressive development of residents' competencies in surgical quality improvement. STUDY DESIGN: A 22-month interactive, educational program based on resident-specific surgical outcomes data culminated in a quality improvement project for postgraduate year 4 surgery residents...
April 16, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29673938/integrating-river-hydromorphology-and-water-quality-into-ecological-status-modelling-by-artificial-neural-networks
#13
Daniel Gebler, Gerhard Wiegleb, Krzysztof Szoszkiewicz
The aim of the study was to develop predictive models of the ecological status of rivers by using artificial neural networks. The relationships between five macrophyte indices and the combined impact of water pollution as well as hydromorphological degradation were examined. The dataset consisted of hydromorphologically modified rivers representing a wide water quality gradient. Three ecological status indices, namely the Macrophyte Index for Rivers (MIR), the Macrophyte Biological Index for Rivers (IBMR) and the River Macrophyte Nutrient Index (RMNI), were tested...
April 7, 2018: Water Research
https://www.readbyqxmd.com/read/29672578/the-cost-effectiveness-of-three-methods-of-disseminating-information-to-improve-medical-male-circumcision-in-uganda
#14
Edward I Broughton, Esther Karamagi, Angella Kigonya, Anna Lawino, Lani Marquez, Sarah Smith Lunsford, Albert Twinomugisha
BACKGROUND: Uganda is working to increase voluntary medical male circumcision (VMMC) to prevent HIV infection. To support VMMC quality improvement, this study compared three methods of disseminating information to facilities on how to improve VMMC quality: M-providing a written manual; MH-providing the manual plus a handover meeting in which clinicians shared advice on implementing key changes and participated in group discussion; and MHC-manual, handover meeting, and three site visits to the facility in which a coach provided individualized guidance and mentoring on improvement...
2018: PloS One
https://www.readbyqxmd.com/read/29672402/postoperative-surgical-site-infections-understanding-the-discordance-between-surveillance-systems
#15
Mariam N Ali-Mucheru, Maria T Seville, Vickie Miller, Priya Sampathkumar, David A Etzioni
OBJECTIVE: To characterize agreement in the ascertainment of surgical site infections (SSIs) between the National Surgical Quality Improvement Program (NSQIP), National Healthcare Safety Network (NHSN), and administrative data. BACKGROUND: The NSQIP, NHSN, and administrative data are the primary systems used to monitor and report SSIs for the purpose of quality control and benchmarking of hospitals and surgeons. These systems have different methods for identifying SSIs...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29672380/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-be-careful-what-you-wish-for
#16
James A DiNardo, Peter J Davis
No abstract text is available yet for this article.
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29672356/improving-documentation-of-inpatient-problem-list-in-electronic-health-record-a-quality-improvement-project
#17
Prabi Rajbhandari, Moises Auron, Sarah Worley, Michelle Marks
BACKGROUND: The problem list is critical in electronic documentation. It is a powerful tool for clinical decision-making because it provides a concise view of all patient problems in one place and is also a criterion for the Medicare meaningful use incentive program. OBJECTIVE: To measure the rate of utilization of problem list in electronic health records (EHR) in a pediatric hospital medicine unit and implement sequential interventions to increase the rate of use of problem list to more than 80% by the end of 2015, as measured by at least one documented hospital problem at discharge...
April 19, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29672242/developing-and-implementing-a-heart-failure-data-mart-for-research-and-quality-improvement
#18
Erin Abu-Rish Blakeney, Seth Wolpin, Danielle C Lavallee, Todd Dardas, Richard Cheng, Brenda Zierler
OBJECTIVE: The purpose of this project was to build and formatively evaluate a near-real time heart failure (HF) data mart. Heart Failure (HF) is a leading cause of hospital readmissions. Increased efforts to use data meaningfully may enable healthcare organizations to better evaluate effectiveness of care pathways and quality improvements, and to prospectively identify risk among HF patients. METHODS AND PROCEDURES: We followed a modified version of the Systems Development Life Cycle: 1) Conceptualization, 2) Requirements Analysis, 3) Iterative Development, and 4) Application Release...
April 19, 2018: Informatics for Health & Social Care
https://www.readbyqxmd.com/read/29669148/evaluation-of-resident-and-faculty-performance-in-routinely-addressing-unmet-reproductive-health-needs-in-a-teaching-health-center
#19
Elizabeth Kvach, Hayley Marcus, Lucy Loomis
BACKGROUND AND OBJECTIVES: High rates of unintended pregnancy and poor pregnancy outcomes can be ameliorated by improved access to contraceptive and preconception care. Little data exists regarding application of routine pregnancy intention (PI) screening to reduce unintended pregnancy and optimize preconception health in family medicine residency education. This quality improvement (QI) project evaluated the rate at which family medicine residents and providers (attending physicians and nurse practitioners) addressed women's unmet reproductive health needs identified through PI screening...
April 2018: Family Medicine
https://www.readbyqxmd.com/read/29669040/improvement-capability-and-performance-a-qualitative-study-of-maternity-services-providers-in-the-uk
#20
Sarah Darley, Kieran Walshe, Ruth Boaden, Nathan Proudlove, Mhorag Goff
Objective: We explore variations in service performance and quality improvement across healthcare organisations using the concept of improvement capability. We draw upon a theoretically informed framework comprising eight dimensions of improvement capability, firstly to describe and compare quality improvement within healthcare organisations and, secondly to investigate the interactions between organisational performance and improvement capability. Design: A multiple qualitative case study using semi-structured interviews guided by the improvement capability framework...
April 16, 2018: International Journal for Quality in Health Care
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