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QI in Mental Health

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71 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27780317/the-perinatal-depression-treatment-cascade-baby-steps-toward-improving-outcomes
#1
Elizabeth Q Cox, Nathaniel A Sowa, Samantha E Meltzer-Brody, Bradley N Gaynes
OBJECTIVE: Perinatal depression is a common and costly health concern with serious implications for the mother and child. We sought to quantify the "Perinatal Depression Treatment Cascade"-the cumulative shortfalls in clinical recognition, initiation of treatment, adequacy of treatment, and treatment response for women with antenatal (AND) and postpartum depression (PPD). DATA SOURCES: A systematic search was conducted to identify articles about diagnostic rates, treatment rates, adequate treatment rates, and remission rates for AND and PPD...
September 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28057607/the-value-of-electronic-medical-record-implementation-in-mental-health-care-a-case-study
#2
Sanaz Riahi, Ilan Fischler, Melanie I Stuckey, Philip E Klassen, John Chen
BACKGROUND: Electronic medical records (EMR) have been implemented in many organizations to improve the quality of care. Evidence supporting the value added to a recovery-oriented mental health facility is lacking. OBJECTIVE: The goal of this project was to implement and customize a fully integrated EMR system in a specialized, recovery-oriented mental health care facility. This evaluation examined the outcomes of quality improvement initiatives driven by the EMR to determine the value that the EMR brought to the organization...
January 5, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28024315/patient-physician-and-health-system-factors-influencing-the-quality-of-antidepressant-and-sedative-prescribing-for-older-community-dwelling-adults
#3
Rian Marie Extavour, Matthew Perri
OBJECTIVE: To identify determinants of potentially inappropriate (PI) antidepressant and anxiolytic/sedative prescribing for older, community-dwelling adults. DATA SOURCES/STUDY SETTING: Office visits from the 2010 National Ambulatory Medical Care Survey. STUDY DESIGN: A cross-sectional study measuring associations between various patient and physician factors and prescribing of PI antidepressants, and PI sedatives among elderly, using Beers 2012/2015 criteria, a clinical decision model, and multivariate logistic regressions...
December 26, 2016: Health Services Research
https://www.readbyqxmd.com/read/28045348/the-impact-of-increasing-staff-resources-on-patient-flow-in-a-psychiatric-emergency-service
#4
Lara Chepenik, Edieal Pinker
OBJECTIVE: The study illustrates the use of approaches based on queuing theory to understand bottlenecks in patient flow. A queuing simulation was used to predict the potential benefits of additional clinical personnel on patient flow through a psychiatric emergency service (PES). METHODS: A discrete-event simulation model was calibrated on the basis of two months of data collected in a PES. This model examined the effects of adding between .5 (half-time) and three additional providers to the 8 a...
January 3, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28045352/antidepressant-prescribing-in-primary-care-to-older-adults-without-major-depression
#5
Donovan T Maust, Jo Anne Sirey, Helen C Kales
OBJECTIVE: The study compared distress levels among two groups of older adults who had been newly prescribed an antidepressant by their primary care physician, those with major depressive disorder (MDD) and those without MDD. METHODS: This analysis used a convenience sample of participants (N=231) who had been newly prescribed an antidepressant in a randomized controlled trial of a program to improve antidepressant adherence and depression outcomes among older adults (≥55)...
January 3, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27986900/a-primer-on-pdsa-executing-plan-do-study-act-cycles-in-practice-not-just-in-name
#6
Jerome A Leis, Kaveh G Shojania
No abstract text is available yet for this article.
December 16, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27516607/what-is-implementation-science-and-what-forces-are-driving-a-change-in-medical-education
#7
David C Thomas, Arnold Berry, Alexander M Djuricich, Simon Kitto, Kathy O'Kane Kreutzer, Thomas J Van Hoof, Patricia A Carney, Summers Kalishman, Dave Davis
Evidence-based interventions to improve health care and medical education face multiple complex barriers to adoption and success. Implementation science focuses on the period following research dissemination, which is necessary but insufficient to address important gaps in clinician performance and patient outcomes. This article describes the forces on health care institutions, medical schools, physician clinicians, and trainees that have created the imperative to design educational interventions to address the gap between evidence and practice...
August 10, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27535940/annotated-bibliography-understanding-ambulatory-care-practices-in-the-context-of-patient-safety-and-quality-improvement
#8
Maria F Montano, Harshal Mehdi, David B Nash
The ambulatory care setting is an increasingly important component of the patient safety conversation. Inpatient safety is the primary focus of the vast majority of safety research and interventions, but the ambulatory setting is actually where most medical care is administered. Recent attention has shifted toward examining ambulatory care in order to implement better health care quality and safety practices. This annotated bibliography was created to analyze and augment the current literature on ambulatory care practices with regard to patient safety and quality improvement...
November 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27777276/improving-health-care-quality-and-patient-safety-through-peer-to-peer-assessment-demonstration-project-in-two-academic-medical-centers
#9
Elizabeth Mort, Jeffrey Bruckel, Karen Donelan, Lori Paine, Michael Rosen, David Thompson, Sallie Weaver, Daniel Yagoda, Peter Pronovost
Despite decades of investment in patient safety, unintentional patient harm remains a major challenge in the health care industry. Peer-to-peer assessment in the nuclear industry has been shown to reduce harm. The study team's goal was to pilot and assess the feasibility of this approach in health care. The team developed tools and piloted a peer-to-peer assessment at 2 academic hospitals: Massachusetts General Hospital and Johns Hopkins Hospital. The assessment evaluated both the institutions' organizational approach to quality and safety as well as their approach to reducing 2 specific areas of patient harm...
October 23, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/25606742/lessons-from-washington-state-s-medical-home-payment-pilot-what-it-will-take-to-change-american-health-care
#10
Reena A Koshy, Douglas A Conrad, David Grembowski
The Washington State Multi-Payer Medical Home Reimbursement Pilot (Pilot) tested a payment method for the patient-centered medical home (PCMH) model intended to reduce avoidable emergency department (ED) and hospitalization rates. Very little is known about the primary care clinic (clinic) experience with various payment methods designed for the medical home model. The objective was to elicit and describe the primary care clinic experience among various medical groups in Washington State's payment Pilot. This was a qualitative analysis of semi-structured interviews conducted in January 2014 to identify enabling features (or "facilitators") as well as barriers to successful implementation of PCMH in this multi-payer pilot...
August 2015: Population Health Management
https://www.readbyqxmd.com/read/27702961/rethinking-thirty-day-hospital-readmissions-shorter-intervals-might-be-better-indicators-of-quality-of-care
#11
David L Chin, Heejung Bang, Raj N Manickam, Patrick S Romano
Public reporting and payment programs in the United States have embraced thirty-day readmissions as an indicator of between-hospital variation in the quality of care, despite limited evidence supporting this interval. We examined risk-standardized thirty-day risk of unplanned inpatient readmission at the hospital level for Medicare patients ages sixty-five and older in four states and for three conditions: acute myocardial infarction, heart failure, and pneumonia. The hospital-level quality signal captured in readmission risk was highest on the first day after discharge and declined rapidly until it reached a nadir at seven days, as indicated by a decreasing intracluster correlation coefficient...
October 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27864567/remembering-to-learn-the-overlooked-role-of-remembrance-in-safety-improvement
#12
Carl Macrae
No abstract text is available yet for this article.
November 18, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27672123/calibrating-how-doctors-think-and-seek-information-to-minimise-errors-in-diagnosis
#13
EDITORIAL
Ashley N D Meyer, Hardeep Singh
No abstract text is available yet for this article.
September 26, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27653833/the-evolution-of-morbidity-and-mortality-conferences
#14
Darlene Tad-Y, Heidi L Wald
No abstract text is available yet for this article.
September 21, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27798049/the-big-picture-unfolds-using-photovoice-to-study-user-participation-in-mental-health-services
#15
Jessica Pui-Shan Tang, Samson Tse, Larry Davidson
BACKGROUND: User participation is advocated on the basis that consumers know their own needs better than anyone else. Photovoice is a participatory research method that empowers the grass-root population to give voice on concerned issues for eliciting social change. AIM: This study explores the experience and impact of user participation in mental health services (MHS) in Hong Kong through photovoice. It also examines the effects of this method in studying user participation...
December 2016: International Journal of Social Psychiatry
https://www.readbyqxmd.com/read/27620686/the-exnovation-of-chronic-care-management-processes-by-physician-organizations
#16
Hector P Rodriguez, Rachel Mosher Henke, Salma Bibi, Patricia P Ramsay, Stephen M Shortell
UNLABELLED: Policy Points The rate of adoption of chronic care management processes (CMPs) by physician organizations has been fairly slow in spite of demonstrated effectiveness of CMPs in improving outcomes of chronic care. Exnovation (ie, removal of innovations) by physician organizations largely explains the slow population-level increases in practice use of CMPs over time. Expanded health information technology functions may aid practices in retaining CMPs. Low provider reimbursement by Medicaid programs, however, may contribute to disinvestment in CMPs by physician organizations...
September 2016: Milbank Quarterly
https://www.readbyqxmd.com/read/27778321/patients-as-partners-in-learning-from-unexpected-events
#17
Jason M Etchegaray, Madelene J Ottosen, Aitebureme Aigbe, Emily Sedlock, William M Sage, Sigall K Bell, Thomas H Gallagher, Eric J Thomas
IMPORTANCE: Patient safety experts believe that patients/family members should be involved in adverse event review. However, it is unclear how aware patients/family members are about the causes of adverse events they experienced. OBJECTIVE: To determine whether patients/family members interviewed could identify at least one contributing factor for the event they experienced. Secondary objectives included understanding the way patients/family members became aware of adverse events, the types of contributing factors patients/family members identified for different types of adverse events, and recommendations provided by patients/family members to address the contributing factors...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27633982/multifaceted-academic-detailing-program-to-increase-pharmacotherapy-for-alcohol-use-disorder-interrupted-time-series-evaluation-of-effectiveness
#18
Alex H S Harris, Thomas Bowe, Hildi Hagedorn, Andrea Nevedal, Andrea K Finlay, Risha Gidwani, Craig Rosen, Chad Kay, Melissa Christopher
BACKGROUND: Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard of care, yet knowledge and use of these medications are very low across diverse settings. This study evaluated the overall effectiveness a multifaceted academic detailing program to address this persistent quality problem in the US Veterans Health Administration (VHA), as well as the context and process factors that explained variation in effectiveness across sites. METHODS: An interrupted time series design, analyzed with mixed-effects segmented logistic regression, was used to evaluate changes in level and rate of change in the monthly percent of patients with a clinically documented AUD who received naltrexone, acamprosate, disulfiram, or topiramate...
September 15, 2016: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/27468057/donabedian-s-lasting-framework-for-health-care-quality
#19
John Z Ayanian, Howard Markel
Though historians are often hesitant to declare any event a "first," one might safely claim that the contemporary health care quality movement had its "founding moment" in October 1965. Less than 3 months after the Medicare and Medicaid programs were enacted, the newly created Health Services..
July 21, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27181736/patient-safety-events-and-harms-during-medical-and-surgical-hospitalizations-for-persons-with-serious-mental-illness
#20
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...
October 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
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