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Quality improvement in health care

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https://www.readbyqxmd.com/read/28453825/leveraging-the-full-value-and-impact-of-accreditation
#1
Wendy Nicklin, Triona Fortune, Paul van Ostenberg, Elaine O'Connor, Nicola McCauley
Providing high quality and safe patient care is a challenge in the current rapidly changing and complex health care environment. A variety of independent tools and methodologies contribute to this effort, e.g. regulatory requirements, quality improvement tools and accreditation methodologies. A concern is that each alone will not achieve the tipping point in health care quality that is required. This paper suggests that the methodology and application of accreditation have the potential to be the force to bring these approaches into alignment and ultimately measurably improve the quality of care...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28453821/quality-of-antenatal-care-and-client-satisfaction-in-kenya-and-namibia
#2
Mai Do, Wenjuan Wang, John Hembling, Paul Ametepi
Objective: Despite much progress in maternal health service coverage, the quality of care has not seen parallel improvement. This study assessed the quality of antenatal care (ANC), an entry point to the health system for many women. Design: The study used data from recent Service Provision Assessment (SPA) surveys of nationally representative health facilities in Kenya and Namibia. Setting: Kenya and Namibia represent the situation in much of sub-Saharan Africa, where ANC is relatively common but maternal mortality remains high...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28453605/outlier-practice-patterns-in-mohs-micrographic-surgery-defining-the-problem-and-a-proposed-solution
#3
Aravind Krishnan, Tim Xu, Susan Hutfless, Angela Park, Thomas Stasko, Allison T Vidimos, Barry Leshin, Brett M Coldiron, Richard G Bennett, Victor J Marks, Rebecca Brandt, Martin A Makary, John G Albertini
Importance: Outlier physician practices in health care can represent a significant burden to patients and the health system. Objective: To study outlier physician practices in Mohs micrographic surgery (MMS) and the associated factors. Design, Setting, and Participants: This retrospective analysis of publicly available Medicare Part B claims data from January 2012 to December 2014 includes all physicians who received Medicare payments for MMS from any practice performing MMS on the head and neck, genitalia, hands, and feet region of Medicare Part B patients...
April 28, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28449017/a-multifaceted-intervention-to-improve-primary-care-radiology-referral-quality-and-value-in-canterbury
#4
Kieran Holland, Graham McGeoch, Carolyn Gullery
AIMS: This article describes a seven-year multifaceted intervention leading to sustained improvement in primary care radiology referral quality and value in Canterbury, New Zealand, and discusses the transferability to other health systems. METHODS: Access criteria were developed with input from general practitioners and hospital-based specialists, and embedded in locally developed clinical pathways. A referral management service was created to streamline referral processes...
April 28, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28448777/effect-of-an-advanced-pharmacy-practice-experience-on-medication-therapy-management-services-in-a-centralized-retail-pharmacy-program
#5
Joseph P Vande Griend, Melissa Rodgers, Wesley Nuffer
BACKGROUND: Medication therapy management (MTM) delivery is increasingly important in managed care. Successful delivery positively affects patient health and improves Centers for Medicare & Medicaid Services star ratings, a measure of health plan quality. As MTM services continue to grow, there is an increased need for efficient and effective care models. The primary objectives of this project were to describe the delivery of MTM services by fourth-year Advanced Pharmacy Practice Experience (APPE) students in a centralized retail pharmacy system and to evaluate and quantify the clinical and financial contributions of the students...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448570/disease-burden-for-patients-with-primary-immunodeficiency-diseases-identified-at-reference-hospitals-in-guanajuato-mexico
#6
Eduardo Guaní-Guerra, Ana Isabel Jiménez-Romero, Ulises Noel García-Ramírez, José Manuel Velázquez-Ávalos, Edgar Martínez-Guzmán, Eunice Sandoval-Ramírez, Ignacio Camacho-Meza
BACKGROUND: In addition to the deleterious effect on health, there is considerable economic and psychosocial morbidity associated with primary immunodeficiency diseases (PID). Also, the cost of a late diagnosis frequently results in a heavy disease burden on the patient. The objective of this study was to collect and analyze data on patients with PID in the state of Guanajuato in Mexico, to indirectly estimate the burden of the disease. METHODS: An observational, longitudinal, and comparative study was conducted...
2017: PloS One
https://www.readbyqxmd.com/read/28448327/community-osteoporosis-screening-services-for-the-prevention-of-osteoporotic-fractures-in-population-health-a-literature-review
#7
Vu H Nguyen
AIM: To determine the implications of the reviewed literature in population health improvement. METHOD: A review of the literature was conducted with the search of four databases: PubMed, PsycINFO, ERIC, and Google Scholar. Search terms entered into these databases were 'osteoporosis community'. After a thorough review of all search results, 11 studies were found to be community osteoporosis screening services, and descriptions of each study's participants and location, details and descriptions of each study's community osteoporosis screening service, and effectiveness on outcome measure(s) for each study's objective were reviewed and examined to determine their implications on population health...
April 26, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28448318/two-state-collaborative-study-of-a-multifaceted-intervention-to-decrease-ventilator-associated-events
#8
Nishi Rawat, Ting Yang, Kisha J Ali, Mary Catanzaro, Mariah D Cohen, Donna O Farley, Lisa H Lubomski, David A Thompson, Bradford D Winters, Sara E Cosgrove, Michael Klompas, Kathleen A Speck, Sean M Berenholtz
OBJECTIVES: Ventilator-associated events are associated with increased mortality, prolonged mechanical ventilation, and longer ICU stay. Given strong national interest in improving ventilated patient care, the National Institute of Health and Agency for Healthcare Research and Quality funded a two-state collaborative to reduce ventilator-associated events. We describe the collaborative's impact on ventilator-associated event rates in 56 ICUs. DESIGN: Longitudinal quasi-experimental study...
April 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28447864/the-use-of-cyproterone-acetate-ethinyl-estradiol-in-hyperandrogenic-skin-symptoms-a-review
#9
J Bitzer, T Römer, A Lopes da Silva Filho
INTRODUCTION: Hyperandrogenism affects approximately 10-20% of women of reproductive age. Hyperandrogenic skin symptoms such as hirsutism, acne, seborrhea and alopecia are associated with significant quality of life and psychological impairment. Women with abnormalities in androgen metabolism may have accompanying anovulation and/or polycystic ovary syndrome (PCOS), both of which have reproductive and metabolic implications if left untreated. Cyproterone acetate (CPA), combined with ethinylestradiol (EE), is indicated for the treatment of moderate to severe acne related to androgen-sensitivity (with or without seborrhea) and/or hirsutism, in women of reproductive age...
April 27, 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/28446522/improving-opioid-safety-practices-in-primary-care-protocol-for-the-development-and-evaluation-of-a-multifaceted-theory-informed-pilot-intervention-for-healthcare-providers
#10
Pamela Leece, Daniel Z Buchman, Michael Hamilton, Caitlyn Timmings, Yalnee Shantharam, Julia Moore, Andrea D Furlan
INTRODUCTION: In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. METHODS AND ANALYSIS: Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians...
April 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/28446446/the-cardiovascular-health-in-ambulatory-care-research-team-performance-indicators-for-the-primary-prevention-of-cardiovascular-disease-a-modified-delphi-panel-study
#11
Jack V Tu, Laura C Maclagan, Dennis T Ko, Clare L Atzema, Gillian L Booth, Sharon Johnston, Karen Tu, Douglas S Lee, Arlene Bierman, Ruth Hall, R Sacha Bhatia, Andrea S Gershon, Sheldon W Tobe, Claudia Sanmartin, Peter Liu, Anna Chu
BACKGROUND: High-quality ambulatory care can reduce cardiovascular disease risk, but important gaps exist in the provision of cardiovascular preventive care. We sought to develop a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. METHODS: As part of the Cardiovascular Health in Ambulatory Care Research Team initiative, we established a 14-member multidisciplinary expert panel to develop a set of indicators for measuring primary prevention performance in ambulatory cardiovascular care...
April 25, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28446258/touchscreen-interventions-and-the-well-being-of-people-with-dementia-and-caregivers-a-systematic-review
#12
Charlie Tyack, Paul M Camic
BACKGROUND: Dementia can have significant detrimental impacts on the well-being of those with the disease and their carers. A range of computer-based interventions, including touchscreen-based interventions have been researched for use with this population in the hope that they might improve psychological well-being. This article reviews touchscreen-based interventions designed to be used by people with dementia (PWD), with a specific focus in assessing their impact on well-being. METHOD: The data bases, PsycInfo, ASSIA, Medline, CINAHL, and Cochrane Reviews were searched for touchscreen-based interventions designed to be used by PWD with reported psychological well-being outcomes...
April 27, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28446238/changing-ethnic-inequalities-in-mortality-in-new-zealand-over-30%C3%A2-years-linked-cohort-studies-with-68-9-million-person-years-of-follow-up
#13
George Disney, Andrea Teng, June Atkinson, Nick Wilson, Tony Blakely
BACKGROUND: Internationally, ethnic inequalities in mortality within countries are increasingly recognized as a public health concern. But few countries have data to monitor such inequalities. We aimed to provide a detailed description of ethnic inequalities (Māori [indigenous], Pacific, and European/Other) in mortality for a country with high quality ethnicity data, using both standard and novel visualization methods. METHODS: Cohort studies of the entire New Zealand population were conducted, using probabilistically-linked Census and mortality data from 1981 to 2011 (68...
April 26, 2017: Population Health Metrics
https://www.readbyqxmd.com/read/28446232/continuous-quality-improvement-interventions-to-improve-long-term-outcomes-of-antiretroviral-therapy-in-women-who-initiated-therapy-during-pregnancy-or-breastfeeding-in-the-democratic-republic-of-congo-design-of-an-open-label-parallel-group-randomized-trial
#14
Marcel Yotebieng, Frieda Behets, Bienvenu Kawende, Noro Lantoniaina Rosa Ravelomanana, Martine Tabala, Emile W Okitolonda
BACKGROUND: Despite the rapid adoption of the World Health Organization's 2013 guidelines, children continue to be infected with HIV perinatally because of sub-optimal adherence to the continuum of HIV care in maternal and child health (MCH) clinics. To achieve the UNAIDS goal of eliminating mother-to-child HIV transmission, multiple, adaptive interventions need to be implemented to improve adherence to the HIV continuum. METHODS: The aim of this open label, parallel, group randomized trial is to evaluate the effectiveness of Continuous Quality Improvement (CQI) interventions implemented at facility and health district levels to improve retention in care and virological suppression through 24 months postpartum among pregnant and breastfeeding women receiving ART in MCH clinics in Kinshasa, Democratic Republic of Congo...
April 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28446141/a-mobile-application-of-breast-cancer-e-support-program-versus-routine-care-in-the-treatment-of-chinese-women-with-breast-cancer-undergoing-chemotherapy-study-protocol-for-a-randomized-controlled-trial
#15
Jiemin Zhu, Lyn Ebert, Xiangyu Liu, Sally Wai-Chi Chan
BACKGROUND: Women with breast cancer undergoing chemotherapy suffer from a number of symptoms and report receiving inadequate support from health care professionals. Innovative and easily accessible interventions are lacking. Breast Cancer e-Support is a mobile Application program (App) that provides patients with individually tailored information and a support group of peers and health care professionals. Breast Cancer e-Support aims to promote women's self-efficacy, social support and symptom management, thus improving their quality of life and psychological well-being...
April 26, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28446118/motor-neurone-disease-progress-and-challenges
#16
Thanuja Dharmadasa, Robert D Henderson, Paul S Talman, Richard Al Macdonell, Susan Mathers, David W Schultz, Merrillee Needham, Margaret Zoing, Steve Vucic, Matthew C Kiernan
Major progress has been made over the past decade in the understanding of motor neurone disease (MND), changing the landscape of this complex disease. Through identifying positive prognostic factors, new evidence-based standards of care have been established that improve patient survival, reduce burden of disease for patients and their carers, and enhance quality of life. These factors include early management of respiratory dysfunction with non-invasive ventilation, maintenance of weight and nutritional status, as well as instigation of a multidisciplinary team including neurologists, general practitioners and allied health professionals...
May 1, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28445806/patient-engagement-at-the-margins-health-care-providers-assessments-of-engagement-and-the-structural-determinants-of-health-in-the-safety-net
#17
Mark D Fleming, Janet K Shim, Irene Yen, Ariana Thompson-Lastad, Sara Rubin, Meredith Van Natta, Nancy J Burke
Increasing "patient engagement" has become a priority for health care organizations and policy-makers seeking to reduce cost and improve the quality of care. While concepts of patient engagement have proliferated rapidly across health care settings, little is known about how health care providers make use of these concepts in clinical practice. This paper uses 20 months of ethnographic and interview research carried out from 2015 to 2016 to explore how health care providers working at two public, urban, safety-net hospitals in the United States define, discuss, and assess patient engagement...
April 20, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28445790/improving-insomnia-in-primary-care-patients-a-randomized-controlled-trial-of-nurse-led-group-treatment
#18
Christina Sandlund, Jerker Hetta, Gunnar H Nilsson, Mirjam Ekstedt, Jeanette Westman
BACKGROUND: Insomnia is a common health problem, and most people who seek help for insomnia consult primary care. In primary care, insomnia treatment typically consists of hypnotic drugs, although cognitive behavioral therapy for insomnia is the recommended treatment. However, such treatment is currently available to few primary care patients. OBJECTIVES: To evaluate the effects of a group treatment program for insomnia led by nurses in primary care. OUTCOMES: were the Insomnia Severity Index, a 2-week sleep diary, and a questionnaire on frequency of hypnotic drug use...
April 14, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28445441/mining-productive-associated-periodic-frequent-patterns-in-body-sensor-data-for-smart-home-care
#19
Walaa N Ismail, Mohammad Mehedi Hassan
The understanding of various health-oriented vital sign data generated from body sensor networks (BSNs) and discovery of the associations between the generated parameters is an important task that may assist and promote important decision making in healthcare. For example, in a smart home scenario where occupants' health status is continuously monitored remotely, it is essential to provide the required assistance when an unusual or critical situation is detected in their vital sign data. In this paper, we present an efficient approach for mining the periodic patterns obtained from BSN data...
April 26, 2017: Sensors
https://www.readbyqxmd.com/read/28445217/why-health-insurance-matters-and-why-research-evidence-should-too
#20
Benjamin D Sommers
In the current debate over the future of the Affordable Care Act (ACA), research evidence on the impact of the law and the effects of health insurance coverage in general is critical. Studies of health insurance expansion over the past decade have demonstrated that coverage expansions can produce significant reductions in mortality-particularly among minorities, those living in poorer areas, and those with chronic conditions potentially treatable with timely medical care. More recent studies of the ACA in particular demonstrate that the law has produced historically large reductions in the uninsured rate, with resulting improvements in access to care, perceived quality of care, and self-reported health...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
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