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QI in Mental Health

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52 papers 0 to 25 followers
Gail L Daumit, Emma E McGinty, Peter Pronovost, Lisa B Dixon, Eliseo Guallar, Daniel E Ford, Elizabeth K Cahoon, Romsai T Boonyasai, David Thompson
OBJECTIVE: This study explored the risk of patient safety events and associated nonfatal physical harms and mortality in a cohort of persons with serious mental illness. This group experiences high rates of medical comorbidity and premature mortality and may be at high risk of adverse patient safety events. METHODS: Medical record review was conducted for medical-surgical hospitalizations occurring during 1994-2004 in a community-based cohort of Maryland adults with serious mental illness...
May 16, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
John C Fortney, Jürgen Unützer, Glenda Wrenn, Jeffrey M Pyne, G Richard Smith, Michael Schoenbaum, Henry T Harbin
OBJECTIVE: Measurement-based care involves the systematic administration of symptom rating scales and use of the results to drive clinical decision making at the level of the individual patient. This literature review examined the theoretical and empirical support for measurement-based care. METHODS: Articles were identified through search strategies in PubMed and Google Scholar. Additional citations in the references of retrieved articles were identified, and experts assembled for a focus group conducted by the Kennedy Forum were consulted...
September 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Simon C Mathews, Renee Demski, Jody E Hooper, Lee Daugherty Biddison, Stephen A Berry, Brent G Petty, Allen R Chen, Peter M Hill, Marlene R Miller, Frank R Witter, Lisa Allen, Elizabeth C Wick, Tracey S Stierer, Lori Paine, Hans A Puttgen, Rafael J Tamargo, Peter J Pronovost
As quality improvement and patient safety come to play a larger role in health care, academic medical centers and health systems are poised to take a leadership role in addressing these issues. Academic medical centers can leverage their large integrated footprint and have the ability to innovate in this field. However, a robust quality management infrastructure is needed to support these efforts. In this context, quality and safety are often described at the executive level and at the unit level. Yet, the role of individual departments, which are often the dominant functional unit within a hospital, in realizing health system quality and safety goals has not been addressed...
September 6, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Brock Polnaszek, Andrea Gilmore-Bykovskyi, Melissa Hovanes, Rachel Roiland, Patrick Ferguson, Roger Brown, Amy J H Kind
BACKGROUND: Unstructured data encountered during retrospective electronic medical record (EMR) abstraction has routinely been identified as challenging to reliably abstract, as these data are often recorded as free text, without limitations to format or structure. There is increased interest in reliably abstracting this type of data given its prominent role in care coordination and communication, yet limited methodological guidance exists. OBJECTIVES: As standard abstraction approaches resulted in substandard data reliability for unstructured data elements collected as part of a multisite, retrospective EMR study of hospital discharge communication quality, our goal was to develop, apply and examine the utility of a phase-based approach to reliably abstract unstructured data...
October 2016: Medical Care
Lianne Jeffs, Julie McShane, Virginia Flintoft, Peggy White, Alyssa Indar, Maria Maione, A J Lopez, Sue Bookey-Bassett, Lauren Scavuzzo
BACKGROUND: The use of interorganizational, collaborative approaches to build capacity in quality improvement (QI) in health care is showing promise as a useful model for scaling up and accelerating the implementation of interventions that bridge the "know-do" gap to improve clinical care and provider outcomes. Fundamental to a collaborative approach is interorganizational learning whereby organizations acquire, share, and combine knowledge with other organizations and have the opportunity to learn from their respective successes and challenges in improvement areas...
2016: BMC Health Services Research
Bruce L Lambert, Nichola M Centomani, Kelly M Smith, Lorens A Helmchen, Dulal K Bhaumik, Yash J Jalundhwala, Timothy B McDonald
OBJECTIVE: To determine whether a communication and resolution approach to patient harm is associated with changes in medical liability processes and outcomes. DATA SOURCES/STUDY SETTING: Administrative, safety, and risk management data from the University of Illinois Hospital and Health Sciences System, from 2002 to 2014. STUDY DESIGN: Single health system, interrupted time series design. Using Mann-Whitney U tests and segmented regression models, we compared means and trends in incident reports, claims, event analyses, patient communication consults, legal fees, costs per claim, settlements, and self-insurance expenses before and after the implementation of the "Seven Pillars" communication and resolution intervention...
August 24, 2016: Health Services Research
Sara Adi Kreindler
BACKGROUND: Although well-established principles exist for improving the timeliness and efficiency of care, many organisations struggle to achieve more than small-scale, localised gains. Where care processes are complex and include segments under different groups' control, the elegant solutions promised by improvement methodologies remain elusive. This study sought to identify common design flaws that limit the impact of flow initiatives. METHODS: This qualitative study was conducted within an explanatory case study of a Canadian regional health system in which multitudinous flow initiatives had yielded no overall improvement in system performance...
July 27, 2016: BMJ Quality & Safety
Elvan Akyuz, Amit Jain, Declan Phelan, Susham Gupta
Improving physical healthcare to reduce premature mortality in people with SMI (Serious Mental Illness) is a priority for ELFT (East London NHS Foundation Trust) and NHS England. It is well know that people with schizophrenia have a life expectancy which is approximately 20% shorter than that of the general population and a substantial mortality difference exists between people with schizophrenia and the general community.[1-2] Among other risk factors, such as poor diet, physical inactivity, and high rates of smoking, the iatrogenic effects of anti-psychotic medications have been found to increase the risk of metabolic syndrome...
2016: BMJ Quality Improvement Reports
E Etchells, M Ho, K G Shojania
No abstract text is available yet for this article.
March 2016: BMJ Quality & Safety
Daisy Goodman, Greg Ogrinc, Louise Davies, G Ross Baker, Jane Barnsteiner, Tina C Foster, Kari Gali, Joanne Hilden, Leora Horwitz, Heather C Kaplan, Jerome Leis, John C Matulis, Susan Michie, Rebecca Miltner, Julia Neily, William A Nelson, Matthew Niedner, Brant Oliver, Lori Rutman, Richard Thomson, Johan Thor
Since its publication in 2008, SQUIRE (Standards for Quality Improvement Reporting Excellence) has contributed to the completeness and transparency of reporting of quality improvement work, providing guidance to authors and reviewers of reports on healthcare improvement work. In the interim, enormous growth has occurred in understanding factors that influence the success, and failure, of healthcare improvement efforts. Progress has been particularly strong in three areas: the understanding of the theoretical basis for improvement work; the impact of contextual factors on outcomes; and the development of methodologies for studying improvement work...
April 13, 2016: BMJ Quality & Safety
Sigall K Bell, Roanne Mejilla, Melissa Anselmo, Jonathan D Darer, Joann G Elmore, Suzanne Leveille, Long Ngo, James D Ralston, Tom Delbanco, Jan Walker
BACKGROUND: Patient advocates and safety experts encourage adoption of transparent health records, but sceptics worry that shared notes may offend patients, erode trust or promote defensive medicine. As electronic health records disseminate, such disparate views fuel policy debates about risks and benefits of sharing visit notes with patients through portals. METHODS: Presurveys and postsurveys from 99 volunteer doctors at three US sites who participated in OpenNotes and postsurveys from 4592 patients who read at least one note and submitted a survey...
May 18, 2016: BMJ Quality & Safety
Caroline Lubick Goldzweig
No abstract text is available yet for this article.
June 24, 2016: BMJ Quality & Safety
Mohammad Farhad Peerally, Susan Carr, Justin Waring, Mary Dixon-Woods
No abstract text is available yet for this article.
June 23, 2016: BMJ Quality & Safety
Marc T Edwards
Despite concerted effort to improve quality and safety, high reliability remains a distant goal. Although this likely reflects the challenge of organizational change, persistent controversy over basic issues suggests that weaknesses in conceptual models may contribute. The essence of operational improvement is organizational learning. This article presents a framework for identifying leverage points for improvement based on organizational learning theory and applies it to an analysis of current practice and controversy...
February 25, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Rakesh Patel
No abstract text is available yet for this article.
July 2016: Medical Education
Maria Theresa Mariano, Victoria Brooks, Michael DiGiacomo
BACKGROUND: The substantial adverse impact of miscommunication during transitions in care has highlighted the importance of teaching proper patient handoff practices. Although handoff standardization has been suggested, a universal system has been difficult to adopt, given the unique characteristics of the different fields of medicine. A form of standardization that has emerged is a discipline-specific handoff mnemonic: a memory aid that can serve to assist a provider in communicating pertinent information to the succeeding treatment team...
July 2016: Joint Commission Journal on Quality and Patient Safety
Sharat P Iyer, Brigitta Spaeth-Rublee, Harold A Pincus
Interest in measuring the quality of mental health services has increased, but challenges remain in moving from general standards of quality and best practices to specific, implementable quality measures. The International Initiative for Mental Health Leadership identified 656 mental health quality measures and then applied a modified Delphi approach to assess various available alternative quality measures. Panel members considered issues of data source, segmentation, and thresholds. Policy makers and organizations will need to make difficult choices about accountability, purpose, feasibility, and validity in order to operationalize quality measurement...
June 15, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Jo Shapiro, Pamela Galowitz
Burnout is plaguing the culture of medicine and is linked to several primary causes including long work hours, increasingly burdensome documentation, and resource constraints. Beyond these, additional emotional stressors for physicians are involvement in an adverse event, especially one that involves a medical error, and malpractice litigation. The authors argue that it is imperative that health care institutions devote resources to programs that support physician well-being and resilience. Doing so after adverse and other emotionally stressful events, such as the death of a colleague or caring for victims of a mass trauma, is crucial as clinicians are often at their most vulnerable during such times...
September 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Harold Alan Pincus, Sarah Hudson Scholle, Brigitta Spaeth-Rublee, Kimberly A Hepner, Jonathan Brown
Following up on its Crossing the Quality Chasm report, in 2006 the Institute of Medicine issued a report that included sweeping recommendations to improve the quality of behavioral health care in the United States. To date, few of those recommendations have been implemented, and there is little evidence that behavioral health care quality has improved significantly over the past ten years. However, the advent of health care reform, parity of insurance coverage, and growing recognition of the impact of behavioral health disorders on population health and health care costs have created new demands and opportunities for expanded and innovative strategies to assess the quality of care for this patient population...
June 1, 2016: Health Affairs
Piper A Ranallo, Amy M Kilbourne, Angela S Whatley, Harold Alan Pincus
The use of health information technology (IT) in general health care has been shown to have significant potential to facilitate the delivery of safe, high-quality, and cost-effective care. However, its application to behavioral health care has been slow, limiting the extent to which consumers seeking care for mental health or substance use disorders can derive its benefits. The goal of this article is to provide an overview of the use of health IT in behavioral health and to describe some unique challenges experienced in that domain...
June 1, 2016: Health Affairs
2016-06-20 04:48:11
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