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https://www.readbyqxmd.com/read/28550706/st-michael-s-improvement-program-a-collaborative-approach-to-sustainable-cost-savings
#1
Anne Trafford, Danielle Jane
In response to a challenging financial environment and increasing patient demand, St. Michael's Hospital needed to find long-term sustainable solutions to continue to provide high-quality patient care and invest in key priorities. By conducting Operational Reviews in focused areas, the hospital achieved $7.4 million of in-year savings in the first year, found standardizations, process efficiencies and direct cost savings that positioned itself for success in future funding models. Initiatives were grounded in evidence and relied heavily on the effective execution by the leadership, front-line staff and physicians...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550703/improving-patient-engagement-and-satisfaction-lessons-from-a-patient-driven-care-initiative-in-a-community-based-hospital
#2
Lisa Shiozaki, Kirsten Burgomaster, Manon Lemonde
Lack of collaboration and alignment between members of the healthcare team interfere with the patient-centred care approach. The Patient-Driven Care Project was initiated in 2012. This model sought to advance a system of care that is patient-driven, family-centred and provider-guided to improve the value to patients and give them more control on their health journey. The evaluation revealed that the efforts should focus on sustainability and continuation of support and encouragement of hospital colleagues to ensure each patient and family experience is based on caring communication at every interaction with them...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550702/listening-to-improve-transforming-patient-relations-measurement-and-reporting-in-ontario
#3
Patricia Sullivan-Taylor, Rachel Frohlich, Anita Singh, Anna Greenberg
Effective patient relations are important to improve patient experience and deliver better care. Policy and legislative changes in Ontario have increased accountabilities for patient relations and expanded Health Quality Ontario (HQO)'s mandate. In response, HQO collaborated with patients, health sector organizations, associations and the Ministry of Health and Long-Term Care to co-design a patient relations measurement and reporting approach. Informed by an environmental scan, broad consultations, a multi-sector survey and a provincial advisory group, the approach includes standardized patient relations indicators to support measurement and public reporting across the hospital, home and long-term care sectors...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550693/healthcare-for-the-aging-citizen-and-the-aging-citizen-for-healthcare-involving-patient-advisors-in%C3%A2-elder-friendly-care-improvement
#4
Jennifer Verma, Patricia O'Connor, Jerold Hodge, Howard Abrams, Jocelyn Bennett, Samir Sinha
With an aging population and a healthcare system that is overly reliant on providing expensive and sometimes problematic hospital-based care for older Canadians, driving improvements that promote elder-friendly care has never been more critical. The Acute Care for Elders (ACE) Strategy at Toronto's Mount Sinai Hospital is the focus of a pan-Canadian collaborative delivered by the Canadian Foundation for Healthcare Improvement in partnership with the Canadian Frailty Network. The intent is to spread the ACE Strategy's elder-friendly models of care and practices to 18 participating healthcare delivery organizations...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28549778/stepwise-introduction-of-the-best-care-always-central-line-associated-bloodstream-infection-prevention-bundle-in-a-network-of-south-african-hospitals
#5
Guy A Richards, Adrian J Brink, Angeliki P Messina, Charles Feldman, Karin Swart, Dena van den Bergh
BACKGROUND: Health care associated infection (HAI) remains a major international problem. AIM: The "Best Care Always!" (BCA) campaign, was launched in South Africa to reduce common preventable HAI, including catheter associated bloodstream infection (CLABSI). METHODS: The intervention occurred in 43 Netcare Private Hospitals increasing later to 49 with 958 ICU and 439 high care (HC) beds and 1207 ICU and 493 HC beds, respectively. .Phase 1: April 2010-March 2011: ICU Infection Prevention and Control (IPC) nurse driven change: Commitment from management and doctors and training of IPC nurses...
May 23, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28549592/economic-outcomes-of-pharmacist-physician-medication-therapy-management-for-polypharmacy-elderly-a-prospective-randomized-controlled-trial
#6
Hsiang-Wen Lin, Chih-Hsueh Lin, Chin-Kai Chang, Che-Yi Chou, I-Wen Yu, Cheng-Chieh Lin, Tsai-Chung Li, Chia-Ing Li, Yow-Wen Hsieh
BACKGROUND/PURPOSE: With an increasing geriatric population, the need for effective management of chronic conditions and medication use in the elderly is growing. Medication use in the elderly presents significant challenges due to changes in pharmacodynamic and pharmacokinetic profiles. We aimed to examine the impact of a collaborative physician-pharmacist medication therapy management (MTM) program for polypharmacy elderly patients. METHODS: Elderly patients with multiple chronic conditions on polypharmacy were enrolled in this prospective, randomized, and controlled study over 16 months of implementation...
May 23, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28549015/early-oral-feeding-following-mckeown-minimally-invasive-esophagectomy-an-open-label-randomized-controlled-noninferiority-trial
#7
Hai-Bo Sun, Yin Li, Xian-Ben Liu, Rui-Xiang Zhang, Zong-Fei Wang, Toni Lerut, Chia-Chuan Liu, Alfonso Fiorelli, Yin-Kai Chao, Daniela Molena, Robert J Cerfolio, Soji Ozawa, Andrew C Chang
OBJECTIVE: Our objective was to evaluate the impact of early oral feeding (EOF) on postoperative cardiac, respiratory, and gastrointestinal (CRG) complications after McKeown minimally invasive esophagectomy for esophageal cancer. SUMMARY BACKGROUND DATA: Nil-by-mouth with enteral tube feeding is routinely practiced after esophagectomy. METHODS: Patients were randomly allocated to receive oral feeding on the first postoperative day (EOF group) or late oral feeding (LOF group) 7 days after surgery...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548917/family-experiences-of-the-transition-to-palliative-care-in-aged-residential-care-arc-a-qualitative-study
#8
Rosemary Frey, Susan Foster, Michal Boyd, Jackie Robinson, Merryn Gott
PURPOSE: To address a gap in the literature by exploring bereaved families' perceptions of the transition to palliative care for their relative in long-term care. METHODS: In-depth interviews were conducted with a convenience sample of twenty-six family members who were most involved in the care of residents who had died within the last 12 months. Interviews explored care, perceptions of staff palliative care knowledge, communication with staff, care planning and decision-making...
May 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28547158/impact-of-prompt-intervention-in-response-to-positive-blood-culture-results-during-weekends-by-collaboration-between-infectious-disease-specialists-and-microbiology-laboratory-staff
#9
M Tsuboi, K Hayakawa, K Mezaki, Y Katanami, K Yamamoto, S Kutsuna, N Takeshita, N Ohmagari
The purpose of this investigation was to elucidate the impact of prompt intervention for patients whose blood culture results became positive during weekends, as this is not standard care in some countries. A retrospective cohort study was conducted in a tertiary referral hospital. From June 2015, results of positive blood cultures became available during weekends. If infectious disease specialists identified cases of bacteremia on suboptimal antimicrobial coverage, they contacted the primary team for modification of antibiotic treatment...
May 25, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28546866/a-diagnostic-protocol-designed-for-determining-allergic-causes-in-patients-with-blood-eosinophilia
#10
Jean-François Magnaval, Guy Laurent, Noémie Gaudré, Judith Fillaux, Antoine Berry
BACKGROUND: Blood eosinophilia is a common laboratory abnormality, and its characterization frequently represents a quandary for primary care physicians. Consequently, in France, specialists and particularly hematologists, often must investigate patients who present with blood eosinophilia that often, but not always, occurs because of allergic causes. Both the Departments of Hematology and Parasitology at Toulouse University Hospitals established a collaboration to rule out allergic causes of eosinophilia, particularly helminthiases, prior to initiating more sophisticated investigations...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28546619/the-dental-practicality-index-assessing-the-restorability-of-teeth
#11
A Dawood, S Patel
The Dental Practicality Index (DPI) has been designed to describe on a clinical level, the 'practicality' of dental restorative treatment. Applicable to everyday clinical practice, the DPI also aims to assist the clinician in deciding when to seek advice and/or refer a patient for secondary or tertiary dental care. It is hoped that this tool will aid in the systematic assessment of dental restorative problems, enhance communication between collaborating practitioners and help to manage patient expectations before carrying out restorative treatment(s)...
May 26, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28546379/tracheostomy-in-infants-and-children
#12
Karen F Watters
Over the last decade, tracheostomy has been increasingly performed in children, aligned with the improvements in neonatal and pediatric ICU care. Nowadays, the majority of children with tracheostomy represent a very complex cohort of patients with sustained reliance on tracheostomy and related medical technology for long-term survival. Tracheostomy is one of the most commonly performed procedures in the adult ICU. Contrary to adult practice, tracheostomy is a much less common procedure in the pediatric ICU, being performed in < 3% of patients...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28545846/is-diabetes-self-management-education-still-the-cinderella-of-diabetes-care
#13
Lorna Hurley, Máire O'Donnell, Mary Clare O'Hara, Marian E Carey, Ingrid Willaing, Heather Daly, Seán F Dinneen
This paper reflects on the status of diabetes self-management education (DSME) as a branch of diabetology in Europe and discusses some opportunities for better supporting DSME delivery. DSME (also commonly known as Therapeutic Patient Education) has been evolving as a therapy for diabetes for decades. As a continent, Europe is fortunate to have nurtured many pioneers in DSME, and currently has many experts in the field progressing the knowledge base and striving to improve access to DSME for people with diabetes...
May 17, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28545802/attitudes-towards-disorders-of-sex-development-nomenclature-among-affected-individuals
#14
Emilie K Johnson, Ilina Rosoklija, Courtney Finlayson, Diane Chen, Elizabeth B Yerkes, Mary Beth Madonna, Jane L Holl, Arlene B Baratz, Georgiann Davis, Earl Y Cheng
INTRODUCTION: Although now commonly used in medicine, the updated "disorders of sex development" (DSD) nomenclature formally introduced in 2006 has never been universally accepted by members of the affected community, particularly advocacy groups. Use of this nomenclature by medical professionals may unintentionally negatively affect access to healthcare and research for individuals with DSD conditions. OBJECTIVE: Among individuals affected by various DSD diagnoses, this study sought to (1) evaluate attitudes towards potentially controversial DSD terminology, (2) determine potential impact of terminology on how affected individuals access healthcare, and (3) explore alternate terms...
May 8, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28545476/prenatal-diagnosis-and-prevention-of-toxoplasmosis-in-pregnant-women-in-northern-vietnam-study-protocol
#15
G Suzanne A Smit, Thi Lam Binh Vu, Trung Dung Do, Niko Speybroeck, Brecht Devleesschauwer, Elizaveta Padalko, Ellen Roets, Pierre Dorny
BACKGROUND: In Vietnam, no systematic prenatal toxoplasmosis screening is in place, and only few studies have assessed the prevalence and importance of this zoonotic parasite infection. In addition, no studies have been conducted to assess the risk factors associated with toxoplasmosis. This study protocol was developed to determine the seroprevalence of toxoplasmosis in pregnant women in Hanoi and Thai Binh, Northern Vietnam, and to evaluate the association with risk factors and congenital toxoplasmosis...
May 25, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28544926/understanding-the-influence-of-power-and-empathic-perspective-taking-on-collaborative-natural-resource-management
#16
Dara M Wald, Elizabeth A Segal, Erik W Johnston, Ajay Vinze
Public engagement in collaborative natural resource management necessitates shared understanding and collaboration. Empathic perspective-taking is a critical facilitator of shared understanding and positive social interactions, such as collaboration. Yet there is currently little understanding about how to reliably generate empathic perspective-taking and collaboration, particularly in situations involving the unequal distribution of environmental resources or power. Here we examine how experiencing the loss or gain of social power influenced empathic perspective-taking and behavior within a computer-mediated scenario...
May 22, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28544672/providing-end-of-life-care-in-disability-community-living-services-an-organizational-capacity-building-model-using-a-public-health-approach
#17
Andrea Grindrod, Bruce Rumbold
BACKGROUND: There is broad consensus within the disability field that the end-of-life care offered to people with intellectual disabilities should be of a quality consistent with that advocated by contemporary palliative care. In practice, however, various barriers are encountered when applying palliative care strategies to the end-of-life care of people with intellectual disabilities, particularly those in disability community living services. METHODS: A mixed-methods approach was used...
May 24, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28544000/european-academy-of-neurology-european-association-for-palliative-care-taskforce-on-neurology-consensus-recommendations-on-palliative-care-for-patients-with-chronic-and-progressive-neurological-disease-acceptability-for-belgian-neurologists
#18
L J Vanopdenbosch, E Maes, D J Oliver
BACKGROUND AND PURPOSE: A Consensus document on palliative care and neurology has made recommendations on the care of people with chronic and progressive neurological disease. This study aimed to investigate whether these recommendations are understood by, acceptable to and used in practice by neurologists in Belgium. METHODS: An online survey was undertaken of 100 neurologists in Belgium, asking for their opinion on all of the recommendations in the Consensus document...
May 23, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28543671/patient-centred-dietetic-care-from-the-perspectives-of-older-malnourished-patients
#19
E Hazzard, L Barone, M Mason, K Lambert, A McMahon
BACKGROUND: Governing organisations for health services currently recommend a patient-centred (PC) approach to practice for all health professions, including dietetics. For the vulnerable older malnourished patient, this approach needs to be prioritised to improve outcomes. The paucity of patient experience data likely limits evidence-based, patient-centred care (PCC) from being implemented effectively. The present study aimed to identify quality indicators of dietetic services from the perspectives of older malnourished patients to inform evidence-based PC dietetic care...
May 22, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28543670/health-and-social-care-planning-in-collaboration-in-older-persons-homes-the-perspectives-of-older-persons-family-members-and-professionals
#20
Malin Sundström, Pia Petersson, Margareta Rämgård, Linda Varland, Kerstin Blomqvist
Providing health and social care to older persons is challenging, since older persons often have multiple diseases and a complex health situation. Hence many professions and organisations are involved. Lack of interprofessional and interorganisational collaboration leads to fragmented care. Care planning meetings before hospital discharge have long been used to overcome this fragmentation, but meetings conducted at the hospital have limitations in identifying long-term needs at home. A new model for health and social care planning in collaboration (HSCPC) in older persons' homes was introduced in two Swedish municipalities...
May 24, 2017: Scandinavian Journal of Caring Sciences
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