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https://www.readbyqxmd.com/read/28668197/improving-healthcare-value-through-clinical-community-and-supply-chain-collaboration
#1
Lisa Ishii, Renee Demski, K H Ken Lee, Zishan Mustafa, Steve Frank, Jean Paul Wolisnky, David Cohen, Jay Khanna, Joshua Ammerman, Harpal S Khanuja, Anthony S Unger, Lois Gould, Patricia Ann Wachter, Lauren Stearns, Ronald Werthman, Peter Pronovost
BACKGROUND: We hypothesized that integrating supply chain with clinical communities would allow for clinician-led supply cost reduction and improved value in an academic health system. METHODS: Three clinical communities (spine, joint, blood management) and one clinical community-like physician led team of surgeon stakeholders partnered with the supply chain team on specific supply cost initiatives. The teams reviewed their specific utilization and cost data, and the physicians led consensus-building conversations over a series of team meetings to agree to standard supply utilization...
March 2017: Healthcare
https://www.readbyqxmd.com/read/28665909/what-a-real-preoccupation-with-failure-could-look-like
#2
Peter J Pronovost, Lori Paine, Eileen M Kasda, Melinda D Sawyer
No abstract text is available yet for this article.
July 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28665844/review-of-mastery-of-care-toward-communitarian-regulation-by-pronovost-p-and-higgins-rs-in-ann-surg-265-271-272-2017
#3
Kristina P Marsack, Aurelia T Perdanasari, Larry H Hollier
No abstract text is available yet for this article.
June 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28640023/preventing-harm-in-the-icu-building-a-culture-of-safety-and-engaging-patients-and-families
#4
Kevin C Thornton, Jennifer J Schwarz, A Kendall Gross, Wendy G Anderson, Kathleen D Liu, Mark C Romig, Hildy Schell-Chaple, Peter J Pronovost, Adam Sapirstein, Michael A Gropper, Angela K M Lipshutz
OBJECTIVE: Preventing harm remains a persistent challenge in the ICU despite evidence-based practices known to reduce the prevalence of adverse events. This review seeks to describe the critical role of safety culture and patient and family engagement in successful quality improvement initiatives in the ICU. We review the evidence supporting the impact of safety culture and provide practical guidance for those wishing to implement initiatives aimed at improving safety culture and more effectively integrate patients and families in such efforts...
June 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28557885/patient-provider-and-system-factors-contributing-to-patient-safety-events-during-medical-and-surgical-hospitalizations-for-persons-with-serious-mental-illness
#5
Emma E McGinty, David A Thompson, Peter J Pronovost, Lisa B Dixon, Eliseo Guallar, Daniel E Ford, Elizabeth Khaykin Cahoon, Romsai Boonyasai, Gail L Daumit
This study aimed to explore patient-, provider-, and system-level factors that may contribute to elevated risk of patient safety events among persons with serious mental illness (SMI). We conducted a medical record review of medical/surgical admissions in Maryland hospitals from 1994 to 2004 for a community-based sample of adults with SMI (N = 790 hospitalizations). We estimated the prevalence of multiple patient, provider, and system factors that could influence patient safety among persons with SMI. We conducted a case crossover analysis to examine the relationship between these factors and adverse patient safety events...
June 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28546510/towards-high-reliability-organising-in-healthcare-a-strategy-for-building-organisational-capacity
#6
Hanan J Aboumatar, Sallie J Weaver, Dianne Rees, Michael A Rosen, Melinda D Sawyer, Peter J Pronovost
In a high-reliability organisation (HRO), safety and quality (SQ) is an organisational priority, and all workforce members are engaged, continuously learning and improving their work. To build organisational capacity for SQ work, we have developed a role-tailored capacity-building framework that we are currently employing at the Johns Hopkins Armstrong Institute for Patient Safety and Quality as part of an organisational strategy towards HRO. This framework considers organisation-wide competencies for SQ that includes all staff and faculty and is integrated into a broader organisation-wide operating management system for improving quality...
May 25, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28514917/advancing-health-care-quality-and-safety-through-action-learning
#7
Simon Mathews, Sherita Golden, Renee Demski, Peter Pronovost, Lisa Ishii
Purpose The purpose of this study is to demonstrate how action learning can be practically applied to quality and safety challenges at a large academic medical health system and become fundamentally integrated with an institution's broader approach to quality and safety. Design/methodology/approach The authors describe how the fundamental principles of action learning have been applied to advancing quality and safety in health care at a large academic medical institution. The authors provide an academic contextualization of action learning in health care and then transition to how this concept can be practically applied to quality and safety by providing detailing examples at the unit, cross-functional and executive levels...
May 2, 2017: Leadership in Health Services
https://www.readbyqxmd.com/read/28447853/finding-balance-standardizing-practice-is-corseting-physician-judgement
#8
Peter J Pronovost, Stephen A Berry, Kathleen M Sutcliffe
No abstract text is available yet for this article.
April 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28434455/creating-a-pediatric-joint-council-to-promote-patient-safety-and-quality-governance-and-accountability-across-johns-hopkins-medicine
#9
Michael Rosen, Brigitta U Mueller, Aaron M Milstone, Denise R Remus, Renee Demski, Peter J Pronovost, Marlene R Miller
BACKGROUND: Large multihospital health systems with multiple children's hospitals are relatively few in number. With a paucity of national pediatric measures for quality and patient safety, there are unique challenges to ensuring consistent levels of care across diverse health care delivery settings. At Johns Hopkins Medicine, a Pediatric Joint Council was created to help ensure high-quality and safe care across a health system encompassing two full-service children's hospitals and two community hospitals with significant pediatric volumes across two states...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28376057/measurement-as-a-performance-driver-the-case-for-a-national-measurement-system-to-improve-patient-safety
#10
Thomas R Krause, Kristen J Bell, Peter Pronovost, Jason M Etchegaray
Safety metrics in healthcare settings stand apart from those in all other industries. Despite improvements in the measurement and prevention of adverse health outcomes following the 1999 Institute of Medicine report, no fully operational national-level program for monitoring patient harm exists. Here, we review the annual rate of fatal adverse events in healthcare settings in the United States on the basis of previous research, assess the current state of measurements of patient harm, propose a national standard to both quantify harm and act as a performance driver for improved safety, and discuss additional considerations such as accountability and implications for tort reform under this standard...
April 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28375960/transdisciplinary-teams-spur-innovation-for-patient-safety-and-quality-improvement
#11
Jennifer W Di Mattina, Peter J Pronovost, Christine G Holzmueller
No abstract text is available yet for this article.
April 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28345746/an-analysis-of-errors-discrepancies-and-variation-in-opioid-prescriptions-for-adult-outpatients-at-a-teaching-hospital
#12
Mark C Bicket, Deepa Kattail, Myron Yaster, Christopher L Wu, Peter Pronovost
OBJECTIVE: To determine opioid-prescribing patterns and rate of three types of errors, discrepancies, and variation from ideal practice. DESIGN: Retrospective review of opioid prescriptions processed at an outpatient pharmacy. SETTING: Tertiary institutional medical center. PATIENTS: We examined 510 consecutive opioid medication prescriptions for adult patients processed at an institutional outpatient pharmacy in June 2016 for patient, provider, and prescription characteristics...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28334581/a-gap-analysis-needs-assessment-tool-to-drive-a-care-delivery-and-research-agenda-for-integration-of-care-and-sharing-of-best-practices-across-a-health-system
#13
Sherita Hill Golden, Daniel Hager, Lois J Gould, Nestoras Mathioudakis, Peter J Pronovost
BACKGROUND: In a complex health system, it is important to establish a systematic and data-driven approach to identifying needs. The Diabetes Clinical Community (DCC) of Johns Hopkins Medicine's Armstrong Institute for Patient Safety and Quality developed a gap analysis tool and process to establish the system's current state of inpatient diabetes care. METHODS: The collectively developed tool assessed the following areas: program infrastructure; protocols, policies, and order sets; patient and health care professional education; and automated data access...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28326949/the-need-for-an-ethics-framework-for-the-use-of-opioids-in-the-treatment-of-chronic-nonmalignant-pain
#14
Michael A Erdek, Peter J Pronovost
No abstract text is available yet for this article.
March 3, 2017: Pain Management
https://www.readbyqxmd.com/read/28325204/from-board-to-bedside-how-the-application-of-financial-structures-to-safety-and-quality-can-drive-accountability-in-a-large-health-care-system
#15
J Matthew Austin, Renee Demski, Tiffany Callender, K H Ken Lee, Ann Hoffman, Lisa Allen, Deborah A Radke, Yungjin Kim, Ronald J Werthman, Ronald R Peterson, Peter J Pronovost
BACKGROUND: As the health care system in the United States places greater emphasis on the public reporting of quality and safety data and its use to determine payment, provider organizations must implement structures that ensure discipline and rigor regarding these data. An academic health system, as part of a performance management system, applied four key components of a financial reporting structure to support the goal of top-to-bottom accountability for improving quality and safety...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28321549/a-preoperative-medical-history-and-physical-should-not-be-a-requirement-for-all-cataract-patients
#16
Oliver D Schein, Peter J Pronovost
Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid Services and other regulatory bodies within 1 month of cataract surgery. Based on prior research and practice guidelines, there is professional consensus that preoperative laboratory testing confers no benefit when routinely performed on cataract surgical patients. Such testing remains commonplace. Although not yet tested in a large-scale trial, there is also no evidence that the required history and physical yields a benefit for most cataract surgical patients above and beyond the screening performed by anesthesia staff on the day of surgery...
July 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28260406/reducing-preventable-harm-observations-on-minimizing-bloodstream-infections
#17
Peter J Pronovost, Sally J Weaver, Sean M Berenholtz, Lisa H Lubomski, Lisa L Maragakis, Jill A Marsteller, Julius Cuong Pham, Melinda D Sawyer, David A Thompson, Kristina Weeks, Michael A Rosen
Purpose The purpose of this paper is to provide a practical framework that health care organizations could use to decrease preventable healthcare-acquired harms. Design/methodology/approach An existing theory of how hospitals succeeded in reducing rates of central line-associated bloodstream infections was refined, drawing from the literature and experiences in facilitating improvement efforts in thousands of hospitals in and outside the USA. Findings The following common interventions were implemented by hospitals able to reduce and sustain low infection rates...
March 20, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28248694/making-management-skills-a-core-component-of-medical-education
#18
Christopher G Myers, Peter J Pronovost
Physicians are being called upon to engage in greater leadership and management in increasingly complex and dynamic health care organizations. Yet, management skills are largely undeveloped in medical education. Without formal management training in the medical curriculum, physicians are left to cultivate their leadership and management abilities through a haphazard array of training programs or simply through trial and error, with consequences that may range from frustration among staff to reduced quality of care and increased risk of patient harm...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28124443/an-ethnographic-study-of-health-information-technology-use-in-three-intensive-care-units
#19
Myles Leslie, Elise Paradis, Michael A Gropper, Simon Kitto, Scott Reeves, Peter Pronovost
OBJECTIVES: To identify the impact of a full suite of health information technology (HIT) on the relationships that support safety and quality among intensive care unit (ICU) clinicians. DATA SOURCES: A year-long comparative ethnographic study of three academic ICUs was carried out. A total of 446 hours of observational data was collected in the form of field notes. A subset of these observations-134 hours-was devoted to job-shadowing individual clinicians and conducting a time study of their HIT usage...
January 25, 2017: Health Services Research
https://www.readbyqxmd.com/read/28067712/muscle-weakness-and-5-year-survival-in-acute-respiratory-distress-syndrome-survivors
#20
MULTICENTER STUDY
Victor D Dinglas, Lisa Aronson Friedman, Elizabeth Colantuoni, Pedro A Mendez-Tellez, Carl B Shanholtz, Nancy D Ciesla, Peter J Pronovost, Dale M Needham
OBJECTIVES: To longitudinally evaluate the association of post-ICU muscle weakness and associated trajectories of weakness over time with 5-year survival. DESIGN: Longitudinal prospective cohort study over 5 years of follow-up. SETTING: Thirteen ICUs in four hospitals in Baltimore, MD. PATIENTS: One hundred fifty-six acute respiratory distress syndrome survivors. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Strength was evaluated with standardized manual muscle testing using the Medical Research Council sum score (range, 0-60; higher is better), with post-ICU weakness defined as sum score less than 48...
March 2017: Critical Care Medicine
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