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https://www.readbyqxmd.com/read/29232471/cytoreductive-surgery-for-ovarian-cancer-quality-assessment
#1
A H Brand, P A DiSilvestro, J Sehouli, J S Berek
Surgery is the cornerstone of treatment of ovarian cancer. Given the importance of achieving no or minimal macroscopic residual disease at primary surgery, performing an assessment of the quality of ovarian cancer surgery is crucial. Assessing the quality of care and surgical outcome allows us to establish baseline information, set standards of care and clear priorities, enable benchmarking against peers, and sustain quality improvement. We know that suboptimal care exists and variation in outcomes results...
November 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29232079/behavioral-design-teams-the-next-frontier-in-clinical-delivery-innovation
#2
Ted Robertson, Matthew Darling, Jennifer Leifer, Owen Footer, Dani Gordski
Issue: A deep understanding of human behavior is critical to designing effective health care delivery models, tools, and processes. Currently, however, few mechanisms exist to systematically apply insights about human behavior to improve health outcomes. Behavioral design teams (BDTs) are a successful model for applying behavioral insights within an organization. Already operational within government, this model can be adapted to function in a health care setting. Goal: To explore how BDTs could be applied to clinical care delivery and review models for integrating these teams within health care organizations...
November 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29231899/do-individual-and-neighborhood-characteristics-influence-perceived-air-quality
#3
Séverine Deguen, Manon Padilla, Cindy Padilla, Wahida Kihal-Talantikite
Background: Despite improvements, air pollution still remains a major public health issue. Numerous epidemiological studies have demonstrated the adverse health effects of air pollution exposure based on modeled measures, but only a few have considered the health impact of perceived air quality. Improving our knowledge of individual perceptions is crucial to defining targeted actions and promoting appropriate intervention measures. Our objective is to investigate the relationship between subjective and objective measures of air pollution and to focus on how individual characteristics combined with the neighborhood socioeconomic deprivation index, measured at a fine spatial scale, may or may not alter this relationship...
December 12, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29231787/using-a-quality-improvement-approach-to-improve-maternal-and-neonatal-care-in-north-kivu-democratic-republic-of-congo
#4
Michelle Hynes, Kate Meehan, Janet Meyers, Leon Mashukano Maneno, Erin Hulland
Providing quality health care services in humanitarian settings is challenging due to population displacement, lack of qualified staff and supervisory oversight, and disruption of supply chains. This study explored whether a participatory quality improvement (QI) intervention could be used in a protracted conflict setting to improve facility-based maternal and newborn care. A longitudinal quasi-experimental design was used to examine delivery of maternal and newborn care components at 12 health facilities in eastern Democratic Republic of Congo...
December 12, 2017: Reproductive Health Matters
https://www.readbyqxmd.com/read/29230952/children-tolerate-intradialytic-oral-nutrition
#5
Andrew M South, Bonnie Fainman, Scott M Sutherland, Cynthia J Wong
BACKGROUND: People undergoing haemodialysis (HD) often have poor nutrition, which in turn can contribute to worse outcomes. Inadequate nutrition has a particularly deleterious effect on growth and neurocognitive development, as well as mortality, in children and adolescents. Nutritional supplementation can improve outcomes but can be difficult to administer. OBJECTIVE: Determine the tolerability of intradialytic oral nutrition in children and adolescents. DESIGN: A cross-sectional quality improvement study in an outpatient paediatric HD unit...
December 12, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/29230711/hospital-wide-education-committees-and-high-quality-residency-training-a%C3%A2-qualitative-study
#6
Milou E W M Silkens, Irene A Slootweg, Albert J J A Scherpbier, Maas Jan Heineman, Kiki M J M H Lombarts
INTRODUCTION: High-quality residency training is of utmost importance for residents to become competent medical specialists. Hospital-wide education committees have been adopted by several healthcare systems to govern postgraduate medical education and to support continuous quality improvement of residency training. To understand the functioning and potential of such committees, this study examined the mechanisms through which hospital-wide education committees strive to enable continuous quality improvement in residency training...
December 11, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29230514/-guideline-recommendations-and-quality-indicators-for-invasive-treatment-of-peripheral-arterial-disease-in-germany-the-idomeneo-study-for-quality-improvement-and-research-in-vascular-medicine
#7
REVIEW
Christian-Alexander Behrendt, Henrik Rieß, Martin Härter, Levente Kriston, Hannes Federrath, Ursula Marschall, Eike Sebastian Debus
Due to the paucity of independent trials, practical guidelines for the diagnosis and treatment of peripheral arterial disease (PAD) contain several recommendations developed by expert consensus. Furthermore, there is a lack of commonly defined quality indicators and valid data on real world treatment. Therefore, it remains challenging to scrutinize if treatment reality is conforming to guideline recommendations. This article aims to give a short overview on existing guideline recommendations. It further aims to introduce the multistage multimethodological IDOMENEO study, utilizing primary registry data (GermanVasc) and health insurance claims data (BARMER) in PAD treatment...
December 11, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29229889/admission-of-term-infants-to-the-neonatal-intensive-care-unit-in-a-saudi-tertiary-teaching-hospital-cumulative-incidence-and-risk-factors
#8
Heidi Al-Wassia, Mafaza Saber
BACKGROUND: An increasing number of term infants of appropriate birthweight receive care in neonatal intensive care units (NICUs). OBJECTIVES: This study assessed the prevalence, patterns, and risk factors for admission of term infants to a NICU to identify areas for quality improvement. DESIGN: Cross-sectional analytical study. SETTING: An academic and referral center in Jeddah, Saudi Arabia. PATIENTS AND METHODS: The cases were all term infants (>=37 weeks gestational age) admitted to the NICU between 1 January and 31 December 2015...
November 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29229258/perioperative-information-systems-opportunities-to-improve-delivery-of-care-and-clinical-outcomes-in-cardiac-and-vascular-surgery
#9
REVIEW
Robert E Freundlich, Jesse M Ehrenfeld
A variety of existing perioperative informatics tools offer clinicians and researchers the opportunity to improve the delivery of care and clinical outcomes for patients undergoing cardiac and vascular surgery. Many of these tools can be used to improve the reliability of the care delivery process through the application of clinical decision support tools and/or quality improvement methodologies at a number of junctures. In this review, the authors will offer a concise overview of the existing perioperative informatics literature, with a focus on tools considered to be of utility in confronting the unique challenges inherent to cardiac and vascular surgery...
November 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29229146/procedure-based-postoperative-risk-prediction-using-nsqip-data
#10
David E Clark, Timothy L Fitzgerald, Albert W Dibbins
BACKGROUND: The National Surgical Quality Improvement Program (NSQIP) has proposed using procedure-based hierarchical models to predict adverse outcomes, but it is not clear whether this approach was used to develop the NSQIP "Surgical Risk Calculator". We therefore wished to demonstrate how procedure-based hierarchical models can be constructed and to describe their results. METHODS: NSQIP data from 2015 were used to construct statistical models predicting 30-day postoperative mortality and morbidity, using two-level logistic regression with preoperative patient-level variables as fixed effects and procedure-specific codes as a random intercept...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229144/postoperative-neonatal-mortality-prediction-using-superlearning
#11
Jennifer N Cooper, Peter C Minneci, Katherine J Deans
BACKGROUND: The variable risks associated with neonatal surgery present a challenge to accurate mortality prediction. We aimed to apply superlearning, an ensemble machine learning method, to the prediction of 30-day neonatal postoperative mortality. MATERIALS AND METHODS: We included neonates in the 2012-2014 National Surgical Quality Improvement Program Pediatric. Patients treated in 2012-13 were used in model development (n = 6499), and patients treated in 2014 formed the validation sample (n = 3552)...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229124/mortality-after-emergency-hartmann-s-procedure-in-octogenarians-a-propensity-score-matched-analysis
#12
Ian C Bostock, Maureen V Hill, Timothy C Counihan, Srinivas Joga Ivatury
BACKGROUND: Complicated diverticulitis is associated with a postoperative mortality rate of 20%. We hypothesized that age ≥80 was an independent risk factor for mortality after Hartmann's procedure for diverticular disease when controlling for baseline comorbidities. METHODS: Patients who underwent an urgent or emergent Hartmann's procedure (Current Procedural Terminology codes 44143 and 44206) for diverticular disease (International Classification of Diseases-9:562...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29228959/micro-structural-bone-changes-in-early-rheumatoid-arthritis-persist-over-1-year%C3%A2-despite-use-of-disease-modifying-anti-rheumatic-drug-therapy
#13
Lynne M Feehan, Linda L Li, Heather A McKay
BACKGROUND: We used High Resolution - peripheral Quantitative CT (HR-pQCT) imaging to examine peri-articular bone quality in early rheumatoid arthritis (RA) and explore whether bone quality improved over 12-months in individuals receiving care consistent with practice guidelines. METHODS: A 1-year longitudinal cohort study (Baseline and 12-months) evaluating individuals with early RA compared to age/sex-matched peers. Personal demographic and health and lifestyle information were collected for all...
December 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29228864/multimedia-education-reduces-anxiety-in-lung-transplant-patients
#14
Sandra L Gerity, Susan G Silva, John M Reynolds, Benson Hoffman, Marilyn H Oermann
CONTEXT: A significant contribution to the success of lung transplantation is the recipient's ability to self-manage a multidrug regimen and follow complex instructions. Effective education has always been an integral component of the process of preparing patients to care for themselves post lung transplant. Impaired cognition, anxiety, and psychological distress, however, can decrease the retention of posttransplant care information provided during education sessions. OBJECTIVE: This quality improvement project evaluated whether a multimedia education method compared to standard education method improves posttransplant care knowledge, anxiety, and satisfaction with the education experience in lung transplant patients and their caregivers...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29227433/integrating-essential-components-of-quality-improvement-into-a-new-paradigm-for-continuing-education
#15
Thomas J Van Hoof, Thomas P Meehan
Continuing education (CE) that strives to improve patient care in a complex health care system requires a different paradigm than CE that seeks to improve clinician knowledge and competence in an educational setting. A new paradigm for CE is necessary in order to change clinician behavior and to improve patient outcomes in an increasingly patient-centered, quality-oriented care context. The authors assert that a new paradigm should focus attention on an expanded and prioritized list of educational outcomes, starting with those that directly affect patients...
October 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29227430/continuing-education-meets-the-learning-organization-the-challenge-of-a-systems-approach-to-patient-safety
#16
John M Eisenberg
Since the release of the report of the Institute of Medicine on medical errors and patient safety in November 1999, health policy makers and health care leaders in several nations have sought solutions that will improve the safety of health care. This attention to patient safety has highlighted the importance of a learning approach and a systems approach to quality measurement and improvement. Balanced with the need for public disclosure of performance, confidential reporting with feedback is one of the prime ways that nations such as the United States, Canada, the United Kingdom, and Australia have approached this challenge...
October 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29227416/rurality-quality-improvement-maturity-and-accreditation-readiness-a-comparison-study-of-colorado-kansas-and-nebraska-local-health-departments
#17
Abbey Gregg, Sarbinaz Bekmuratova, David Palm, Lisa VanRaemdonck, Gianfranco Pezzino, Li-Wu Chen, Peter Manetta
OBJECTIVE: To compare local health department (LHD) accreditation readiness (AR) and quality improvement (QI) maturity in 3 states, between LHDs with varying levels of rurality, and across an LHD staffing-level continuum. DESIGN: This was a cross-sectional comparative study that included an online survey administered to LHD directors in Colorado, Kansas, and Nebraska. The survey included 10 questions assessed on a 5-point Likert scale covering 3 QI domains and 13 questions covering 5 AR domains...
December 7, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/29227371/a-quality-improvement-initiative-reduces-cast-complications-in-a-pediatric-hospital
#18
Julie Balch Samora, Walter P Samora, Kevin Dolan, Kevin E Klingele
BACKGROUND: Casts, while frequently used as routine treatment in pediatric orthopaedic practice, are not without complications. At our large tertiary care pediatric hospital, the baseline rate of all casting complications was 5.6 complications per 1000 casts applied (0.56%). We tested the hypothesis that we could use quality improvement (QI) methodology to decrease the overall cast complication rate and improve patient care. METHODS: We initiated a QI program implementing concepts derived from the Institute for Healthcare Improvement models, including Plan-Do-Study-Act cycles, to decrease our cast complication rate...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29226052/developing-a-continuous-quality-improvement-assessment-using-a-patient-centered-approach-in-optimizing-systemic-lupus-erythematosus-disease-control
#19
Katelyn Mariko Updyke, Brittany Urso, Shazia Beg, James Solomon
Systemic lupus erythematosus (SLE) is a multi-organ, autoimmune disease in which patients lose self-tolerance and develop immune complexes which deposit systemically causing multi-organ damage and inflammation. Patients often experience unpredictable flares of symptoms with poorly identified triggers. Literature suggests exogenous exposures may contribute to flares in symptoms. An online pilot survey was marketed globally through social media to self-reported SLE patients with the goal to identify specific subpopulations who are susceptible to disease state changes based on analyzed exogenous factors...
October 9, 2017: Curēus
https://www.readbyqxmd.com/read/29226007/houston-methodist-variant-viewer-an-application-to-support-clinical-laboratory-interpretation-of-next-generation-sequencing-data-for-cancer
#20
Paul A Christensen, Yunyun Ni, Feifei Bao, Heather L Hendrickson, Michael Greenwood, Jessica S Thomas, S Wesley Long, Randall J Olsen
Introduction: Next-generation-sequencing (NGS) is increasingly used in clinical and research protocols for patients with cancer. NGS assays are routinely used in clinical laboratories to detect mutations bearing on cancer diagnosis, prognosis and personalized therapy. A typical assay may interrogate 50 or more gene targets that encompass many thousands of possible gene variants. Analysis of NGS data in cancer is a labor-intensive process that can become overwhelming to the molecular pathologist or research scientist...
2017: Journal of Pathology Informatics
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