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QI in Mental Health

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117 papers 0 to 25 followers
https://www.readbyqxmd.com/read/29342387/nudge-units-to-improve-the-delivery-of-health-care
#1
Mitesh S Patel, Kevin G Volpp, David A Asch
The final common pathway for the application of nearly every advance in medicine is human behavior. No matter how effective a drug, how protective a vaccine, or how targeted a therapy may be, a clinician usually has to prescribe it, and a patient accept and use it as directed, for it to improve..
January 18, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29306903/implementation-of-diagnostic-pauses-in-the-ambulatory-setting
#2
Grace C Huang, Gila Kriegel, Carolyn Wheaton, Scot Sternberg, Kenneth Sands, Jeremy Richards, Katherine Johnston, Mark Aronson
BACKGROUND: Diagnostic errors result in preventable morbidity and mortality. The outpatient setting may be at increased risk, where time constraints, the indolent nature of outpatient complaints and single decision-maker practice models predominate. METHODS: We developed a self-administered diagnostic pause to address diagnostic error. Clinicians (physicians and nurse practitioners) in an academic primary care setting received the tool if they were seeing urgent care patients who had previously been seen in the past two weeks in urgent care...
January 6, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29317463/task-errors-by-emergency-physicians-are-associated-with-interruptions-multitasking-fatigue-and-working-memory-capacity-a-prospective-direct-observation-study
#3
Johanna I Westbrook, Magda Raban, Scott R Walter, Heather Douglas
BACKGROUND: Interruptions and multitasking have been demonstrated in experimental studies to reduce individuals' task performance. These behaviours are frequently used by clinicians in high-workload, dynamic clinical environments, yet their effects have rarely been studied. OBJECTIVE: To assess the relative contributions of interruptions and multitasking by emergency physicians to prescribing errors. METHODS: 36 emergency physicians were shadowed over 120 hours...
January 9, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28502244/evaluating-the-implementation-of-integrated-mental-health-care-a-systematic-review-to-guide-the-development-of-quality-measures
#4
Nadiya Sunderji, Allyson Ion, Abbas Ghavam-Rassoul, Amanda Abate
OBJECTIVE: Although the effectiveness of integrated mental health care has been demonstrated, its implementation in real-world settings is highly variable, may not conform to evidence-based practice, and has rarely been evaluated. Quality indicators can guide improvements in integrated care implementation. However, the literature on indicators for this purpose is limited. This article reports findings from a systematic review of existing measures by which to evaluate integrated care models in primary care settings...
September 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29327162/explication-of-a-behavioral-health-primary-care-integration-learning-collaborative-and-its-quality-improvement-implications
#5
Martha Okafor, Victor Ede, Rosemary Kinuthia, David Satcher
In an effort to tackle fragmented care in the US healthcare delivery system, we explored the use of learning collaborative (LC) to advance integration of behavioral health and primary care as one of the potential solutions to a holistic approach to the delivery of quality healthcare to individuals with physical and mental illness. How a diverse group of primary care and behavioral health providers formed a Community of Practice (CoP) with a common purpose and shared vision to advance integrated care using a LC approach is described...
January 11, 2018: Community Mental Health Journal
https://www.readbyqxmd.com/read/29282080/safety-analysis-over-time-seven-major-changes-to-adverse-event-investigation
#6
Charles Vincent, Jane Carthey, Carl Macrae, Rene Amalberti
BACKGROUND: Every safety-critical industry devotes considerable time and resource to investigating and analysing accidents, incidents and near misses. The systematic analysis of incidents has greatly expanded our understanding of both the causes and prevention of harm. These methods have been widely employed in healthcare over the last 20 years but are now subject to critique and reassessment. In this paper, we reconsider the purpose and value of incident analysis and methods appropriate to the healthcare of today...
December 28, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29169397/application-of-discrete-choice-experiments-to-enhance-stakeholder-engagement-as-a-strategy-for-advancing-implementation-a-systematic-review
#7
REVIEW
Ramzi G Salloum, Elizabeth A Shenkman, Jordan J Louviere, David A Chambers
BACKGROUND: One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE) is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement...
November 23, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29187217/the-effects-of-care-bundles-on-patient-outcomes-a-systematic-review-and-meta-analysis
#8
REVIEW
Jacqueline F Lavallée, Trish A Gray, Jo Dumville, Wanda Russell, Nicky Cullum
BACKGROUND: Care bundles are a set of three to five evidence-informed practices performed collectively and reliably to improve the quality of care. Care bundles are used widely across healthcare settings with the aim of preventing and managing different health conditions. This is the first systematic review designed to determine the effects of care bundles on patient outcomes and the behaviour of healthcare workers in relation to fidelity with care bundles. METHODS: This systematic review is reported in line with the PRISMA statement for reporting systematic reviews and meta-analyses...
November 29, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29122975/efficiency-and-thoroughness-trade-offs-in-high-volume-organisational-routines-an-ethnographic-study-of-prescribing-safety-in-primary-care
#9
Suzanne Grant, Bruce Guthrie
BACKGROUND: Prescribing is a high-volume primary care routine where both speed and attention to detail are required. One approach to examining how organisations approach quality and safety in the face of high workloads is Hollnagel's Efficiency and Thoroughness Trade-Off (ETTO). Hollnagel argues that safety is aligned with thoroughness and that a choice is required between efficiency and thoroughness as it is not usually possible to maximise both. This study aimed to ethnographically examine the efficiency and thoroughness trade-offs made by different UK general practices in the achievement of prescribing safety...
November 9, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29116022/enhancing-mental-and-physical-health-of-women-through-engagement-and-retention-empower-a-protocol-for-a-program-of-research
#10
Alison B Hamilton, Melissa M Farmer, Tannaz Moin, Erin P Finley, Ariel J Lang, Sabine M Oishi, Alexis K Huynh, Jessica Zuchowski, Sally G Haskell, Bevanne Bean-Mayberry
BACKGROUND: The Enhancing Mental and Physical health of Women through Engagement and Retention or EMPOWER program represents a partnership with the US Department of Veterans Health Administration (VA) Health Service Research and Development investigators and the VA Office of Women's Health, National Center for Disease Prevention and Health Promotion, Primary Care-Mental Health Integration Program Office, Women's Mental Health Services, and the Office of Patient Centered Care and Cultural Transformation...
November 7, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28842517/quantifying-low-value-care-a-patient-centric-versus-service-centric-lens
#11
EDITORIAL
Kelsey Chalmers, Sallie-Anne Pearson, Adam G Elshaug
No abstract text is available yet for this article.
October 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29055900/balancing-the-skills-the-need-for-an-improvement-pyramid
#12
EDITORIAL
John Gabbay, Andrée le May, Con Connell, Jonathan H Klein
No abstract text is available yet for this article.
October 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29055899/are-quality-improvement-collaboratives-effective-a-systematic-review
#13
REVIEW
Susan Wells, Orly Tamir, Jonathon Gray, Dhevaksha Naidoo, Mark Bekhit, Don Goldmann
BACKGROUND: Quality improvement collaboratives (QIC) have proliferated internationally, but there is little empirical evidence for their effectiveness. METHOD: We searched Medline, Embase, CINAHL, PsycINFO and the Cochrane Library databases from January 1995 to December 2014. Studies were included if they met the criteria for a QIC intervention and the Cochrane Effective Practice and Organisation of Care (EPOC) minimum study design characteristics for inclusion in a review...
October 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29097441/value-of-small-sample-sizes-in-rapid-cycle-quality-improvement-projects-2-assessing-fidelity-of-implementation-for-improvement-interventions
#14
REVIEW
Edward Etchells, Thomas Woodcock
No abstract text is available yet for this article.
November 2, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28971889/effects-of-efforts-to-optimise-morbidity-and-mortality-rounds-to-serve-contemporary-quality-improvement-and-educational-goals-a-systematic-review
#15
Andrew Smaggus, Marko Mrkobrada, Alanna Marson, Andrew Appleton
BACKGROUND: The quality and safety movement has reinvigorated interest in optimising morbidity and mortality (M&M) rounds. We performed a systematic review to identify effective means of updating M&M rounds to (1) identify and address quality and safety issues, and (2) address contemporary educational goals. METHODS: Relevant databases (Medline, Embase, PubMed, Education Resource Information Centre, Cumulative Index to Nursing and Allied Health Literature, Healthstar, and Global Health) were searched to identify primary sources...
January 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28993441/providing-feedback-following-leadership-walkrounds-is-associated-with-better-patient-safety-culture-higher-employee-engagement-and-lower-burnout
#16
J Bryan Sexton, Kathryn C Adair, Michael W Leonard, Terri Christensen Frankel, Joshua Proulx, Sam R Watson, Brooke Magnus, Brittany Bogan, Maleek Jamal, Rene Schwendimann, Allan S Frankel
BACKGROUND: There is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance. METHODS: This cross-sectional survey study evaluated associations between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture, employee engagement, burnout and work-life balance, across 829 work settings. RESULTS: 16 797 of 23 853 administered surveys were returned (70...
October 9, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29055901/balancing-measures-or-a-balanced-accounting-of-improvement-impact-a-qualitative-analysis-of-individual-and-focus-group-interviews-with-improvement-experts-in-scotland
#17
Madalina Toma, Tobias Dreischulte, Nicola M Gray, Diane Campbell, Bruce Guthrie
BACKGROUND: As quality improvement (QI) programmes have become progressively larger scale, the risks of implementation having unintended consequences are increasingly recognised. More routine use of balancing measures to monitor unintended consequences has been proposed to evaluate overall effectiveness, but in practice published improvement interventions hardly ever report identification or measurement of consequences other than intended goals of improvement. METHODS: We conducted 15 semistructured interviews and two focus groups with 24 improvement experts to explore the current understanding of balancing measures in QI and inform a more balanced accounting of the overall impact of improvement interventions...
October 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28973066/adherence-to-depression-treatment-in-primary-care-a-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Jo Anne Sirey, Samprit Banerjee, Patricia Marino, Martha L Bruce, Ashley Halkett, Molly Turnwald, Claire Chiang, Brian Liles, Amanda Artis, Fred Blow, Helen C Kales
Importance: Nonadherence to antidepressant medication is common and leads to poor outcomes. Early nonadherence is especially problematic. Objective: To test the effectiveness of a psychosocial intervention to improve early adherence among older patients whose primary care physician newly initiated an antidepressant for depression. Design, Setting, and Participants: The Treatment Initiation and Participation Program (TIP) was offered in a 2-site randomized clinical effectiveness study between January 2011 and December 2014 at primary care practices in New York, New York, and Ann Arbor, Michigan...
November 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28521782/combining-alcohol-interventions-with-tobacco-addictions-treatment-in-primary-care-the-combat-study-a-pragmatic-cluster-randomized-trial
#19
Nadia Minian, Dolly Baliunas, Laurie Zawertailo, Aliya Noormohamed, Norman Giesbrecht, Christian S Hendershot, Bernard Le Foll, Jürgen Rehm, Andriy Samokhvalov, Peter L Selby
BACKGROUND: Tobacco and alcohol use present multiplicative risk for aerodigestive cancers. Reducing alcohol consumption improves smoking cessation outcomes and reduces cancer risk. Risky alcohol consumption and smoking are often treated separately despite concurrent treatment potentially leading to better outcomes for each. However, no rapidly scalable program exists for combined interventions in primary care clinics spread across wide geographic areas. This cluster randomized trial aims to report on the effects of a novel clinical decision support system (CDSS) on intervention rates by primary care practitioners addressing risky alcohol use in a smoking cessation program...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28549480/improving-the-appropriateness-of-antipsychotic-prescribing-in-nursing-homes-a-mixed-methods-process-evaluation-of-an-academic-detailing-intervention
#20
L Desveaux, M Saragosa, J Rogers, L Bevan, H Loshak, A Moser, S Feldman, L Regier, L Jeffs, N M Ivers
BACKGROUND: In 2014, nursing home administration and government officials were facing increasing public and media scrutiny around the variation of antipsychotic medication (APM) prescribing across Ontario nursing homes. In response, policy makers partnered to test an academic detailing (AD) intervention to address appropriate prescribing of APM in nursing homes in a cluster-randomized trial. This mixed-methods study aimed to explore how and why the AD intervention may have resulted in changes in the nursing home context...
May 26, 2017: Implementation Science: IS
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