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"quality improvement"

Bethany A Matus, Kayla M Bridges, John V Logomarsino
BACKGROUND: Individualized feeding care plans and safe handling of milk (human or formula) are critical in promoting growth, immune function, and neurodevelopment in the preterm infant. Feeding errors and disruptions or limitations to feeding processes in the neonatal intensive care unit (NICU) are associated with negative safety events. Feeding errors include contamination of milk and delivery of incorrect or expired milk and may result in adverse gastrointestinal illnesses. PURPOSE: The purpose of this review was to evaluate the effect(s) of centralized milk preparation, use of trained technicians, use of bar code-scanning software, and collaboration between registered dietitians and registered nurses on feeding safety in the NICU...
June 21, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Odette Fisher-Glover, Barbara Edlund, Emily Johnson
This quality improvement project evaluated whether offering a series of 5 structured interdisciplinary diabetic educational teaching sessions would improve glycemic control as measured by random blood sugars (RBS) in a Program of All-Inclusive Care for the Elderly (PACE). Five diabetic educational sessions were held over a 4-week period with 50 participants (N = 50). Data were analyzed and displayed using descriptive statistics and figures. Average RBS remained steady from 176.34 pre- to 175.52 post-intervention...
July 2017: Journal of National Black Nurses' Association: JNBNA
Matteo Danielis, Martina Chittaro, Amato De Monte, Giulio Trillò, Davide Durì
BACKGROUND: The reporting and analysing of data of out-of-hospital cardiac arrests encourages the quality improvement of the emergency medical services. For this reason, the establishment of a sufficiently large patient database is intended to allow analysis of resuscitation treatments for out-of-hospital cardiac arrests and performances of different emergency medical services. AIMS: The aim of this study was to describe the demographics, characteristics, outcomes and determinant factors of survival for patients who suffered an out-of-hospital cardiac arrest...
June 1, 2018: European Journal of Cardiovascular Nursing
Kai-Jung Chen, Tsu-Ming Yeh, Fan-Yun Pai, Der-Fa Chen
People are paying greater attention to health. To maintain a good health status and obtain food fast, customers may go to healthy fast-food chain restaurants such as Subway more often than before in China and Taiwan. Healthy fast-food chain restaurants come with a healthy spin, seeking to differentiate themselves from other fast-food restaurants. This paper combined the refined Kano model and the quality function deployment (QFD) method. The refined Kano model was used to understand how customers perceive service attributes developed based on DINESERV measurements...
June 22, 2018: International Journal of Environmental Research and Public Health
Christine M McDonald, Sarah West, David Dushenski, Stephen E Lapinsky, Christine Soong, Kate van den Broek, Melanie Ashby, Gillian Wilde-Friel, Carrie Kan, Mark McIntyre, Andrew Morris
Objective: To develop a triage-based screening algorithm and treatment order-sets aimed at improving the quality of care of all patients with sepsis presenting to our emergency department (ED). Design: Retrospective cohort study conducted during a pre-intervention period from 1 April 2010 to 31 March 2011 and a post-intervention period from 1 September 2014 to 30 April 2015. Setting: A large teaching hospital located in Toronto, Ontario, Canada with a 35-bed ED...
June 20, 2018: International Journal for Quality in Health Care
Vincent Rusanganwa, Jean Bosco Gahutu, Innocent Nzabahimana, Jean Marie Vianney Ngendakabaniga, Anna-Karin Hurtig, Magnus Evander
Objectives: We investigated the quality system performance in Rwandan referral laboratories to determine their progress toward accreditation. Methods: We conducted audits across five laboratories in 2017, using the Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist. Laboratories were scored based on the World Health Organization grading scale (0-5 stars scale) and compared with earlier audits. Results: Between 2012 and 2017, only one laboratory progressed (from four to five stars)...
June 19, 2018: American Journal of Clinical Pathology
Samuel I Watson, Harvir Sahota, Celia A Taylor, Yen-Fu Chen, Richard J Lilford
Background: Low and middle income countries (LMICs) face severe resource limitations but the highest burden of disease. There is a growing evidence base on effective and cost-effective interventions for these diseases. However, questions remain about the most cost-effective method of delivery for these interventions. We aimed to review the scope, quality, and findings of economic evaluations of service delivery interventions in LMICs. Methods: We searched PUBMED, MEDLINE, EconLit, and NHS EED for studies published between 1st January 2000 and 30th October 2016 with no language restrictions...
2018: Global Health Research and Policy
Michael Stoto, Gareth Parry, Lucy Savitz
The last in a series of four papers on how learning health systems can use routinely collected electronic health data (EHD) to advance knowledge and support continuous learning, this review describes how delivery system science provides a systematic means to answer questions that arise in translating complex interventions to other practice settings. When the focus is on translation and spread of innovations, the questions are different than in evaluative research. Causal inference is not the main issue, but rather one must ask: How and why does the intervention work? What works for whom and in what contexts? How can a model be amended to work in new settings? In these settings, organizational factors and design, infrastructure, policies, and payment mechanisms all influence an intervention's success, so a theory-driven formative evaluation approach that considers the full path of the intervention from activities to engage participants and change how they act to the expected changes in clinical processes and outcomes is needed...
December 7, 2017: EGEMS
Seth Blumenthal
Introduction: The use of information from clinical registries for improvement and value-based payment is increasing, yet information about registry use is not widely available. We conducted a landscape survey to understand registry uses, focus areas and challenges. The survey addressed the structure and organization of registry programs, as well as their purpose and scope. Setting: The survey was conducted by the National Quality Registry Network (NQRN), a community of organizations interested in registries...
December 7, 2017: EGEMS
Pasha Normahani, Chira Mustafa, Nigel J Standfield, Claire Duguid, Martin Fox, Usman Jaffer
Background: We aimed to investigate podiatry practice in diagnosing peripheral arterial disease (PAD) in diabetes, decision making once PAD is suspected and limitations of referral pathways. Methods: A survey, comprising 26 questions was distributed to podiatrists across the UK via mailing lists of collaborating organizations including the College of Podiatry (UK). Response rates were estimated based on NHS workforce data. Analysis of responses from the open-ended questions was performed using inductive content analysis...
2018: Journal of Foot and Ankle Research
Chloe E Bird, Michael Manocchia, Brooke Tomblin, Peggy Payne, Mahesh Kulakodlu, Emily Iacolo, Allen M Fremont
BACKGROUND: Prior research documents gender gaps in cardiovascular risk management, with women receiving poorer quality routine care on average, even in managed care systems. Although population health management tools and quality improvement efforts have led to better overall care quality and narrowing of racial/ethnic gaps for a variety of measures, we sought to quantify persistent gender gaps in cardiovascular risk management and to assess the performance of routinely used commercial population health management tools in helping systems narrow gender gaps...
June 1, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Vijaya M Vemulakonda, Ruth A Bush, Michael G Kahn
BACKGROUND: The electronic health record (EHR) was designed as a clinical and administrative tool to improve clinical patient care. Electronic healthcare systems have been successfully adopted across the world through use of government mandates and incentives. METHODS: Using electronic health record, health information system, electronic medical record, health information systems, research, outcomes, pediatric, surgery, and urology as initial search terms, the literature focusing on clinical documentation data capture and the EHR as a potential resource for research related to clinical outcomes, quality improvement, and comparative effectiveness was reviewed...
June 9, 2018: Journal of Pediatric Urology
Yas Sanaiha, Yen-Yi Juo, Esteban Aguayo, Young-Ji Seo, Vishal Dobaria, Boback Ziaeian, Peyman Benharash
INTRODUCTION: Cardiovascular complications are the leading cause of death after noncardiac surgery. Major abdominal operations represent the largest category of procedures considered to have an increased risk of cardiovascular complications. The current aim was to examine trends in the incidence of mortality, perioperative myocardial infarction, and cardiac arrest to determine the presence of potential volume-outcome relationships. METHODS: We performed a retrospective analysis of the Nationwide Inpatient Sample for patients undergoing elective, open abdominal esophagectomy, gastrectomy, pancreatectomy, nephrectomy, hepatectomy, splenectomy, and colectomy (major abdominal surgery) during 2008-2014...
June 18, 2018: Surgery
Aixia Li, Shangang Jia, Abou Yobi, Zhengxiang Ge, Shirley Sato, Chi Zhang, Ruthie Angelovici, Tom E Clemente, David R Holding
Kafirins are the major storage proteins in sorghum (Sorghum bicolor) grains and form protein bodies with poor digestibility. Since kafirins are devoid of the essential amino acid lysine, they also impart poor protein quality to the kernel. The α-kafirins, which make up most of the total kafirins, are largely encoded by the k1C family of highly similar genes. We used a clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) gene editing approach to target the k1C genes to create variants with reduced kafirin levels and improved protein quality and digestibility...
June 20, 2018: Plant Physiology
Laura E Norton, Brian R Lee, Lory Harte, Keith Mann, Jason G Newland, R Alan Grimes, Angela L Myers
BACKGROUND AND OBJECTIVES: Acute pharyngitis is a common diagnosis in ambulatory pediatrics. The Infectious Diseases Society of America (IDSA) clinical practice guideline for group A streptococcal (GAS) pharyngitis recommends strict criteria for GAS testing to avoid misdiagnosis and unnecessary treatment of children who are colonized with group A Streptococcus . We sought to improve adherence to the IDSA guideline for testing and treatment of GAS pharyngitis in a large community pediatrics practice...
June 20, 2018: Pediatrics
Steven M Bradley, Katie Foag, Khua Monteagudo, Pam Rush, Craig E Strauss, Mario Gössl, Paul Sorajja
OBJECTIVE: To determine the implications of applying guideline-recommended definitions of aortic stenosis to echocardiographic data captured in routine clinical care. METHODS: Retrospective observational study of 213 174 patients who underwent transthoracic echocardiographic imaging within Allina Health between January 2013 and October 2017. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of echocardiographic measures for severe aortic stenosis were determined relative to the documented interpretation of severe aortic stenosis...
June 20, 2018: Heart: Official Journal of the British Cardiac Society
William Liu, Thomas Walsh
BACKGROUND: A goal of effective electronic health record provider documentation platforms is to provide an efficient, concise, and comprehensive notation system that will effectively reflect the clinical course, including the diagnoses, treatments, and interventions. OBJECTIVE: The aim is to fully redesign and standardize the provider documentation process, seeking improvement in documentation based on ongoing All Patient Refined Diagnosis Related Group-based coding records, while maintaining noninferiority comparing provider satisfaction to our existing documentation process...
June 20, 2018: JMIR Medical Informatics
Kathryn Tinsley Anderson, Marisa A Bartz-Kurycki, Mary T Austin, Akemi L Kawaguchi, Lillian S Kao, Kevin P Lally, Kuojen Tsao
BACKGROUND: Evidence-based guidelines recommend ultrasound (US) over computed tomography (CT) as the primary imaging modality for suspected pediatric appendicitis. Continued high rates of CT use may result in significant unnecessary radiation exposure in children. The purpose of this study was to evaluate variables associated with preoperative CT use in pediatric appendectomy patients. METHODS: A retrospective cohort study of pediatric patients who underwent appendectomy for acute appendicitis in 2015-2016 at National Surgical Quality Improvement Program for Pediatrics (NSQIP-P) hospitals was conducted...
May 29, 2018: Journal of Pediatric Surgery
Katherine E Bates, Sunkyung Yu, Ray Lowery, Sara K Pasquali, David W Brown, Peter B Manning, Karen Uzark
BACKGROUND: Although interstage mortality for infants with hypoplastic left heart syndrome has declined within the National Pediatric Cardiology Quality Improvement Collaborative, variation across centres persists. It remains unclear whether centres with lower interstage mortality have lower-risk patients or whether differences in care may explain this variation. We examined previously established risk factors across National Pediatric Cardiology Quality Improvement Collaborative centres with lower and higher interstage mortality rates...
June 21, 2018: Cardiology in the Young
Lucas B Chartier, Samuel Vaillancourt, Amy H Y Cheng, Antonia S Stang
CLINICIAN'S CAPSULE What is known about the topic? The first two articles of this quality improvement (QI) Primer Series for emergency medicine (EM) clinicians reviewed foundational steps to prepare for and execute a QI project. What did this study ask? This article focused on the measurement, evaluation, and sustainability of QI projects. What did this study find? Run charts are used to represent the temporal relationship visually between interventions and the measures of interest. Sustainability of projects can be achieved through the use of specific frameworks, tools, and cultural change...
June 21, 2018: CJEM
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