collection
https://read.qxmd.com/read/30455177/effect-of-two-behavioural-nudging-interventions-on-management-decisions-for-low-back-pain-a-randomised-vignette-based-study-in-general-practitioners
#1
JOURNAL ARTICLE
Jason Soon, Adrian C Traeger, Adam G Elshaug, Erin Cvejic, Chris G Maher, Jenny A Doust, Stephanie Mathieson, Kirsten McCaffery, Carissa Bonner
OBJECTIVE: 'Nudges' are subtle cognitive cues thought to influence behaviour. We investigated whether embedding nudges in a general practitioner (GP) clinical decision support display can reduce low-value management decisions . METHODS: Australian GPs completed four clinical vignettes of patients with low back pain. Participants chose from three guideline-concordant and three guideline-discordant (low-value) management options for each vignette, on a computer screen...
July 2019: BMJ Quality & Safety
https://read.qxmd.com/read/29274884/multifaceted-intervention-to-curb-in-hospital-over-prescription-of-proton-pump-inhibitors-a-longitudinal-multicenter-quasi-experimental-before-and-after-study
#2
MULTICENTER STUDY
Rosaria Del Giorno, Alessandro Ceschi, Michela Pironi, Anna Zasa, Angela Greco, Luca Gabutti
BACKGROUND: Proton pump inhibitors (PPIs) are indicated for a restricted number of clinical conditions, and their misuse can lead to several adverse effects. Despite that, the proportion of overuse is alarmingly high. OBJECTIVE: To test the efficacy of a multifaceted strategy in order to achieve a significant reduction of new PPI prescriptions at discharge in hospitalized patients. DESIGN: Multicenter longitudinal quasi-experimental before-and-after study conducted from July 1st, 2014 to June 30th, 2017...
April 2018: European Journal of Internal Medicine
https://read.qxmd.com/read/30129162/culturing-conversation-how-clinical-audits-can-improve-our-ability-to-choose-wisely
#3
EDITORIAL
Kerina J Denny, Gerben Keijzers
No abstract text is available yet for this article.
August 2018: Emergency Medicine Australasia: EMA
https://read.qxmd.com/read/30518598/overdiagnosis-and-industry-influence-how-cow-s-milk-protein-allergy-is-extending-the-reach-of-infant-formula-manufacturers
#4
JOURNAL ARTICLE
Chris van Tulleken
No abstract text is available yet for this article.
December 5, 2018: BMJ: British Medical Journal
https://read.qxmd.com/read/30301874/impact-of-decision-aids-used-during-clinical-encounters-on-clinician-outcomes-and-consultation-length-a-systematic-review
#5
REVIEW
Claudia Caroline Dobler, Manuel Sanchez, Michael R Gionfriddo, Neri A Alvarez-Villalobos, Naykky Singh Ospina, Gabriela Spencer-Bonilla, Bjorg Thorsteinsdottir, Raed Benkhadra, Patricia J Erwin, Colin P West, Juan P Brito, Mohammad Hassan Murad, Victor M Montori
BACKGROUND: Clinicians' satisfaction with encounter decision aids is an important component in facilitating implementation of these tools. We aimed to determine the impact of decision aids supporting shared decision making (SDM) during the clinical encounter on clinician outcomes. METHODS: We searched nine databases from inception to June 2017. Randomised clinical trials (RCTs) of decision aids used during clinical encounters with an unaided control group were eligible for inclusion...
June 2019: BMJ Quality & Safety
https://read.qxmd.com/read/30877149/bending-the-cost-curve-time-series-analysis-of-a-value-transformation-programme-at-an-academic-medical-centre
#6
JOURNAL ARTICLE
Steven C Chatfield, Frank M Volpicelli, Nicole M Adler, Kunhee Lucy Kim, Simon A Jones, Fritz Francois, Paresh C Shah, Robert A Press, Leora I Horwitz
BACKGROUND: Reducing costs while increasing or maintaining quality is crucial to delivering high value care. OBJECTIVE: To assess the impact of a hospital value-based management programme on cost and quality. DESIGN: Time series analysis of non-psychiatric, non-rehabilitation, non-newborn patients discharged between 1 September 2011 and 31 December 2017 from a US urban, academic medical centre. INTERVENTION: NYU Langone Health instituted an institution-wide programme in April 2014 to increase value of healthcare, defined as health outcomes achieved per dollar spent...
June 2019: BMJ Quality & Safety
https://read.qxmd.com/read/30508032/2018-update-on-medical-overuse
#7
REVIEW
Daniel J Morgan, Sanket S Dhruva, Eric R Coon, Scott M Wright, Deborah Korenstein
Importance: Overuse of medical care is a well-recognized problem in health care, associated with patient harm and costs. We sought to identify and highlight original research articles published in 2017 that are most relevant to understanding medical overuse. Observations: A structured review of English-language articles published in 2017 was performed, coupled with examination of tables of contents of high-impact journals to identify articles related to medical overuse in adult care...
February 1, 2019: JAMA Internal Medicine
https://read.qxmd.com/read/30105371/development-of-a-conceptual-map-of-negative-consequences-for-patients-of-overuse-of-medical-tests-and-treatments
#8
JOURNAL ARTICLE
Deborah Korenstein, Susan Chimonas, Brooke Barrow, Salomeh Keyhani, Aaron Troy, Allison Lipitz-Snyderman
Importance: Overuse of medical tests and treatments is an increasingly recognized problem across health systems; best practices for reducing overuse are not clear. Framing the problem in terms of the spectrum of potential patient harm is likely to be an effective strategy for clinician and patient engagement in efforts to reduce overuse, but the scope of negative consequences of overuse for patients has not been well described. Observations: We sought to generate a comprehensive conceptual map documenting the processes through which overused tests and treatments lead to multiple domains of negative consequences for patients...
October 1, 2018: JAMA Internal Medicine
https://read.qxmd.com/read/30886120/measuring-outcomes-in-quality-improvement-education-success-is-in-the-eye-of-the-beholder
#9
COMMENT
Jennifer S Myers, Brian M Wong
No abstract text is available yet for this article.
May 2019: BMJ Quality & Safety
https://read.qxmd.com/read/30728186/bridging-the-gap-between-uncertainty-confidence-and-diagnostic-accuracy-calibration-is-key
#10
EDITORIAL
Laura Zwaan, Wolf E Hautz
No abstract text is available yet for this article.
May 2019: BMJ Quality & Safety
https://read.qxmd.com/read/29186209/penalizing-physicians-for-low-value-care-in-hospital-medicine-a-randomized-survey
#11
JOURNAL ARTICLE
Joshua M Liao, Amol S Navathe, Marilyn M Schapira, Arlene Weissman, Nandita Mitra, David A Asch
Low-value services-those for which there is little to no benefit, little benefit relative to cost, or outsized potential harm compared with benefit-persist widely despite professional consensus, guidelines, and national campaigns to reduce them. As policy makers consider financially penalizing physicians to deter low-value services, physician support for such penalties remains unknown. We conducted a randomized survey experiment among physicians to evaluate how the framing of harms from low-value care-in terms of those to patients, healthcare institutions, or society-influenced physician support of financial penalties for low-value care services...
January 1, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://read.qxmd.com/read/29350509/measuring-overuse-with-electronic-health-records-data
#12
JOURNAL ARTICLE
Thomas Isaac, Meredith B Rosenthal, Carrie H Colla, Nancy E Morden, Alexander J Mainor, Zhonghe Li, Kevin H Nguyen, Elizabeth A Kinsella, Thomas D Sequist
OBJECTIVES: To measure overuse of low-value care using electronic health record (EHR) data and manual chart review and to evaluate whether certain low-value services are better captured using EHR data. STUDY DESIGN: We implemented algorithms to extract performance on 13 Choosing Wisely-identified healthcare services using EHR data at a large physician practice group between 2011 and 2013. METHODS: We calculated rates of overuse using automated EHR extracts...
January 2018: American Journal of Managed Care
https://read.qxmd.com/read/26375491/choosing-wisely-%C3%A2-things-we-do-for-no-reason
#13
EDITORIAL
Leonard S Feldman
No abstract text is available yet for this article.
October 2015: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://read.qxmd.com/read/29555723/can-first-year-medical-students-acquire-quality-improvement-knowledge-prior-to-substantial-clinical-exposure-a-mixed-methods-evaluation-of-a-pre-clerkship-curriculum-that-uses-education-as-the-context-for-learning
#14
JOURNAL ARTICLE
Allison Brown, Aditya Nidumolu, Alexandra Stanhope, Justin Koh, Matthew Greenway, Lawrence Grierson
BACKGROUND: Quality Improvement (QI) training for health professionals is essential to strengthen health systems. However, QI training during medical school is constrained by students' lack of contextual understanding of the health system and an already saturated medical curriculum. The Program for Improvement in Medical Education (PRIME), an extracurricular offered at the Michael G. DeGroote School of Medicineat McMaster University (Hamilton, Canada), addresses these obstacles by having first-year medical students engage in QI by identifying opportunities for improvement within their own education...
July 2018: BMJ Quality & Safety
https://read.qxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#15
REVIEW
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
December 2018: BMJ Quality & Safety
https://read.qxmd.com/read/30100549/renaming-low-risk-conditions-labelled-as-cancer
#16
JOURNAL ARTICLE
Brooke Nickel, Ray Moynihan, Alexandra Barratt, Juan P Brito, Kirsten McCaffery
No abstract text is available yet for this article.
August 12, 2018: BMJ: British Medical Journal
https://read.qxmd.com/read/28505266/guidance-for-modifying-the-definition-of-diseases-a-checklist
#17
JOURNAL ARTICLE
Jenny Doust, Per O Vandvik, Amir Qaseem, Reem A Mustafa, Andrea R Horvath, Allen Frances, Lubna Al-Ansary, Patrick Bossuyt, Robyn L Ward, Ina Kopp, Laragh Gollogly, Holger Schunemann, Paul Glasziou
Importance: No guidelines exist currently for guideline panels and others considering changes to disease definitions. Panels frequently widen disease definitions, increasing the proportion of the population labeled as unwell and potentially causing harm to patients. We set out to develop a checklist of issues, with guidance, for panels to consider prior to modifying a disease definition. Observations: We assembled a multidisciplinary, multicontinent working group of 13 members, including members from the Guidelines International Network, Grading of Recommendations Assessment, Development and Evaluation working group, and the World Health Organisation...
July 1, 2017: JAMA Internal Medicine
https://read.qxmd.com/read/29907644/helping-patients-choose-wisely
#18
EDITORIAL
Jack Ross, Ramai Santhirapala, Carrie MacEwen, Angela Coulter
No abstract text is available yet for this article.
June 15, 2018: BMJ: British Medical Journal
https://read.qxmd.com/read/29572297/overdiagnosis-and-overtreatment-as-a-quality-problem-insights-from-healthcare-improvement-research
#19
JOURNAL ARTICLE
Natalie Armstrong
No abstract text is available yet for this article.
July 2018: BMJ Quality & Safety
https://read.qxmd.com/read/29317464/using-report-cards-and-dashboards-to-drive-quality-improvement-lessons-learnt-and-lessons-still-to-learn
#20
JOURNAL ARTICLE
Noah M Ivers, Jon Barrett
No abstract text is available yet for this article.
June 2018: BMJ Quality & Safety
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