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Journals Journal for Healthcare Quality...

Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality

https://read.qxmd.com/read/37919958/an-initiative-to-stop-antibiotics-prescribed-for-urinary-symptoms-when-urine-culture-is-negative
#21
JOURNAL ARTICLE
Benjamin Kofoed, Jacob Morris, Jennifer Rich
Urinary symptoms pose frequent diagnostic and management challenges in the emergency department (ED). In our regional health system, we identified the problem of patients started on antibiotics for urinary symptoms in the ED without a process for eventual review or discontinuation if urine culture (UC) later resulted as negative. To address this gap, we implemented a pharmacist-driven follow-up process to discontinue antibiotics after a negative UC. After project implementation, cases reviewed by a pharmacist increased from 0% to 96...
November 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37919957/barriers-to-health-information-exchange-among-ambulatory-physicians-results-from-a-nationally-representative-sample
#22
JOURNAL ARTICLE
Elizabeth B Matthews, Victoria Stanhope, Yuanyuan Hu
PURPOSE: Health information exchange (HIE) improves healthcare quality, but is underutilized by providers. This study used a nationally representative survey of ambulatory physicians to examine barriers to HIE, and identify which barriers have the greatest impact on providers' use of HIE. METHODS: A pooled sample of 1,292 physicians from the 2018-2019 National Electronic Health Record Survey was used. Univariate statistics described rates and patterns of eight common barriers to HIE...
November 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37919956/diagnostic-accuracy-of-a-trauma-risk-assessment-tool-among-geriatric-patients-with-crash-injuries
#23
JOURNAL ARTICLE
Oluwaseun John Adeyemi, Kester Gibbons, Luke B Schwartz, Ariana T Meltzer-Bruhn, Garrett W Esper, Corita Grudzen, Charles DiMaggio, Joshua Chodosh, Kenneth A Egol, Sanjit R Konda
The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a risk stratification tool. We evaluated the STTGMA's accuracy in predicting 30-day mortality and the odds of unfavorable clinical trajectories among crash-related trauma patients. This retrospective cohort study (n = 912) pooled adults aged 55 years and older from a single institutional trauma database. The data were split into training and test data sets (70:30 ratio) for the receiver operating curve analysis and internal validation, respectively...
November 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37919955/interventions-to-reduce-inappropriate-physical-therapy-consultation-in-the-inpatient-setting-a-quality-improvement-initiative
#24
JOURNAL ARTICLE
Moksha Patel, Tiffany A Gardner, Christopher White, Angela Keniston, Becky Maassen, Emily Gottenborg
Physical therapy (PT) in inpatient settings is a limited and valuable resource. Inappropriate PT consultation is costly and can lead to delays in care and discharge planning. Baseline data at an academic hospital revealed that approximately one in four PT consults were inappropriate (n = 29,230) across all services, as defined by an activity measure post-acute care "6-Clicks" basic mobility score of >22. Our interdisciplinary quality improvement team used the Six Sigma methodology to address this problem...
November 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37820242/improving-utilization-of-a-nursing-initiated-supportive-medication-order-panel-in-the-inpatient-setting
#25
JOURNAL ARTICLE
Alexandra W Tatara, Samuel D Lipten
BACKGROUND: Many medications are low-risk but must undergo the same ordering process as high-risk medications in the inpatient setting. Nurses identify the need for supportive medications and notify providers. An order panel and policy were developed to allow nurses to order low-risk, supportive medications. PURPOSE: The aim of this study was to increase order panel utilization from a 6% to a goal of 15%. METHODS: This was a quality improvement study at a 1000-bed academic medical center...
October 10, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37820056/improving-interdisciplinary-communication-on-an-academic-hospitalist-service-a-quality-improvement-project
#26
JOURNAL ARTICLE
Stephen Biederman, Nargiza Sadr, Rehan Qayyum
Effective communication is essential for quality patient care, and paging remains among the most common forms of communication despite the introduction of secure texting platforms. The goal of this project was to use quantitative and qualitative analyses of paging to guide improvements in paging best practices. A retrospective analysis of pages sent over a 7-day period was completed, characterizing the volume, content, and effectiveness of pages both preintervention and 3-month postintervention. The content of each page was categorized into laboratories, medications, vital signs, diet, patient assessment/clinical change, pain, or miscellaneous/other...
October 10, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37788440/applying-the-urgent-maternal-warning-signs-initiative-in-a-novel-setting
#27
JOURNAL ARTICLE
Katherine Jenkins, Evelyn Quarshie, Crystal Phommasathit, Michelle Menegay, Allison Lorenz, Patrick Schneider, Reena Oza-Frank, Breanne Haviland, Heather Kristofzski-Raizor, Dyane Gogan Turner
Symptoms of urgent maternal warning signs (UMWS) may occur during pregnancy or after delivery and may have lasting effects or indicate a life-threatening situation if left untreated. The state department of health sponsored a quality improvement project (QIP) to broaden the reach of UMWS education beyond traditional clinical settings, to public health settings where prenatal and postpartum women are seen. Specifically, the QIP implemented process changes to provide education (written and verbal) and resources to individuals receiving services from Women, Infants, and Children clinics during pregnancy and up to 12 weeks postpartum...
October 3, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37788425/hospital-adaptions-to-mitigate-the-covid-19-pandemic-effects-on-marquis-toolkit-implementation-and-sustainability
#28
JOURNAL ARTICLE
Bethany Rhoten, Abigail C Jones, Cathy Maxwell, Deonni P Stolldorf
OBJECTIVE: To explore the perceived effects of COVID-19 on MARQUIS toolkit implementation and sustainability, challenges faced by hospitals in sustaining medication reconciliation efforts, and the strategies used to mitigate the negative effects of the pandemic. DATA SOURCES AND STUDY SETTINGS: Primary qualitative data were extracted from a Web-based survey. Data were collected from hospitals that participated in MARQUIS2 (n = 18) and the MARQUIS Collaborative (n = 5)...
October 3, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37788411/implementing-a-discharge-follow-up-phone-call-program-reduces-readmission-rates-in-an-integrated-health-system
#29
JOURNAL ARTICLE
Amy Lukanski, Shelley Watters, Andrew L Bilderback, Dan Buchanan, Jacob C Hodges, David Burwell, Amy Triola, Oscar C Marroquin, Susan C Martin, Rachel L Zapf, Paula L Kip, Tami E Minnier
In this study, we sought to determine the effect of implementing a large-scale discharge follow-up phone call program on hospital readmission rates. Previous work has shown that patients with unaddressed concerns during discharge have significantly higher rates of care complications and hospital readmissions. This study is an observational quality improvement project completed from April 17, 2020 to January 31, 2022 at 22 hospitals in a large, integrated academic health system. A nurse-led scripted discharge follow-up phone call program was implemented to contact all patients discharged from inpatient care within 72 hours of discharge...
October 3, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37788441/comparison-of-clinical-economic-and-humanistic-outcomes-between-blood-collection-approaches-a-systematic-literature-review
#30
JOURNAL ARTICLE
Cathy Perry, Kimberly Alsbrooks, Alicia Mares, Klaus Hoerauf
BACKGROUND: A systematic literature review was performed to understand the prevalence, advantages, and disadvantages of blood collection using different approaches (direct venipuncture or vascular access devices), and interventions used to mitigate the disadvantages. METHODS: The review included a broad range of study designs and outcomes. Database searches (Embase, MEDLINE, Cochrane library, and Centre for Reviews and Dissemination) were conducted in March 2021 and supplemented by hand searching...
September 27, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37428949/development-of-quality-measures-for-inpatient-diabetes-care-and-education-specialists-a-call-to-action
#31
JOURNAL ARTICLE
Gwen Klinkner, Leigh Bak, Jennifer N Clements, Eva H Gonzales
Diabetes and hyperglycemia are associated with an increased risk of in-hospital complications that lead to longer lengths of stay, increased morbidity, higher mortality, and risk of readmission. Diabetes care and education specialists (DCESs) working in hospital settings are uniquely prepared and credentialed to serve as content experts to facilitate change and implement processes and programs to improve glycemic-related outcomes. A recent survey of DCESs explored the topic of productivity and clinical metrics...
September 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37596242/improving-operating-room-efficiency-through-reducing-first-start-delays-in-an-academic-center
#32
JOURNAL ARTICLE
Dylan Singh, Lawrence Cai, Dominique Watt, Elise Scoggins, Samuel Wald, Rahim Nazerali
BACKGROUND: Delays in operating room (OR) first-case start times can cause additional costs for hospitals, healthcare team frustration and delay in patient care. Here, a novel process improvement strategy to improving first-case start times is presented. METHODS: First case in room start times were recorded for ORs at an academic medical center. Three interventions-automatic preoperative orders, dot phrases to permit re-creation of unavailable consent forms, and improved H&P linking to the surgical encounter-were implemented to target documentation-related delays...
July 13, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37387405/assessing-factors-influencing-commitment-to-a-disparities-reduction-intervention-social-justice-attitudes-and-organizational-mission
#33
JOURNAL ARTICLE
Jill A Marsteller, Yea-Jen Hsu, Kristina Weeks, Modupe Oduwole, Romsai T Boonyasai, Gideon D Avornu, Katherine B Dietz, Zehui Zhou, Deven Brown, Anika Hines, Suna Chung, Lisa Lubomski, Kathryn A Carson, Chidinma Ibe, Lisa A Cooper
This mixed-methods study aims to understand what the perceptions of leaders and healthcare professionals are regarding causes of disparities, cultural competence, and motivation before launching a disparity reduction project in hypertension care, contrasting perceptions in Federally Qualified Health Centers (FQHCs), and in a non-FQHC system. We interviewed leaders of six participating primary care systems and surveyed providers and staff. FQHC respondents reported more positive cultural competence attitudes and behavior, higher motivation to implement the project, and less concern about barriers to caring for disadvantaged patients than those in the non-FQHC practices; however, egalitarian beliefs were similar among all...
July 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37428942/what-are-effective-strategies-to-reduce-low-value-care-an-analysis-of-121-randomized-deimplementation-studies
#34
JOURNAL ARTICLE
Pauline Heus, Simone A van Dulmen, Jan-Willem Weenink, Christiana A Naaktgeboren, Toshihiko Takada, Eva W Verkerk, Isabelle Kamm, Maarten J van der Laan, Lotty Hooft, Rudolf B Kool
BACKGROUND: Low-value care is healthcare leading to no or little clinical benefit for the patient. The best (combinations of) interventions to reduce low-value care are unclear. PURPOSE: To provide an overview of randomized controlled trials (RCTs) evaluating deimplementation strategies, to quantify the effectiveness and describe different combinations of strategies. METHODS: Analysis of 121 RCTs (1990-2019) evaluating a strategy to reduce low-value care, identified by a systematic review...
June 29, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37428901/should-penicillin-allergy-testing-be-included-as-part-of-preoperative-testing
#35
JOURNAL ARTICLE
Svjetlana Lozo, Daniel Wagner, Nirav Shah, Roger Goldberg, Adam Gafni-Kane, Anthony Solomonides
INTRODUCTION: Penicillin allergy is the most commonly reported drug allergy in the United States. Patients labeled with penicillin allergy are at risk of receiving broad-spectrum antibiotics for surgical site infection prophylaxis, which can lead to increased antibiotic resistance, higher morbidity, suboptimal antibiotic therapy, and higher medical costs. This study aimed to determine the true prevalence of penicillin allergy among surgical patients and to decrease the unnecessary use of broad-spectrum antibiotics...
June 29, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37428943/the-use-of-quality-improvement-in-the-physical-therapy-literature-a-scoping-review
#36
JOURNAL ARTICLE
James P Crick, Timothy J Rethorn, Tyler A Beauregard, Riley Summers, Zachary D Rethorn, Catherine C Quatman-Yates
INTRODUCTION: Quality improvement (QI) is a useful methodology for improving healthcare, often through iterative changes. There is no prior review on the application of QI in physical therapy (PT). PURPOSE AND RELEVANCE: To characterize and evaluate the quality of the QI literature in PT. METHODS: We searched four electronic databases from inception through September 1, 2022. Included publications focused on QI and included the practice of PT...
June 14, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37276257/meta-analysis-of-medication-administration-errors-in-african-hospitals
#37
JOURNAL ARTICLE
Wudma Alemu, Jeannie P Cimiotti
The incidence of medication administration errors (MAEs) and associated patient harm continue to plague hospitals worldwide. Moreover, there is a lack of evidence to address this problem, especially in Africa. This research synthesis was intended to provide current evidence to decrease the incidence of MAEs in Africa. Standardized search criteria were used to identify primary studies that reported the incidence and/or predictors of MAEs in Africa. Included studies met specifications and were validated with a quality-appraisal tool...
June 5, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37276248/value-of-using-a-structured-improvement-approach-a-dedicated-education-unit-exemplar
#38
JOURNAL ARTICLE
Shea Polancich, Elizabeth Byrd, Rebecca S Miltner, Greg Eagerton, Michele Talley, Linda Moneyham, Jill Stewart, Connie White-Williams
Using a structured approach to improvement that integrates methodological frameworks and commonly used improvement tools and techniques allows an improvement team to systematically implement and evaluate an intervention. Authors from one academic medical center will describe our four-step structured improvement approach in the design of a dedicated education unit (DEU) pilot to potentially meet a critical post-COVID-19 workforce need. Using our structured improvement approach, we successfully piloted a DEU with a unit-based clinical educator and 16 nursing students over 26 clinical days and received 13 preintervention surveys from participants...
June 5, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37039811/clinical-pharmacist-transition-of-care-model-improves-hospital-system-practice-by-reducing-readmissions
#39
JOURNAL ARTICLE
Nha Uyen Tuong Ngo, Soodtida Tangpraphaphorn, Deborah Kahaku, Catherine P Canamar, Andrew Young
PURPOSE: A primary cause of hospital readmission is medication-related problems (MRPs). Polypharmacy patients taking multiple medications concurrently experience an increased likelihood of MRPs and high occurrence of readmissions to the hospital within 30 days. This study assessed the ability of a pharmacist-led transition of care program to decrease readmissions in polypharmacy patients by evaluating and rectifying MRPs. METHODS: Over 16 months, patients admitted onto the medicine ward service with ≥10 home medications ( n = 536) received medication management interventions from a clinical pharmacist including admission interview, medication reconciliation and consultation, and postdischarge phone follow-up...
May 2, 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://read.qxmd.com/read/37141572/the-combined-effect-of-delirium-and-falls-on-length-of-stay-and-discharge
#40
JOURNAL ARTICLE
Benjamin Kalivas, Jingwen Zhang, Kristine Harper, Jennifer Dulin, Marc Heincelman, Justin Marsden, Kelly J Hunt, Patrick D Mauldin, William P Moran, Meghan K Thomas
INTRODUCTION: Delirium or a fall are associated with many negative outcomes including increased length of stay (LOS) and discharge to a facility; however, this relationship is incompletely understood. METHODS: A cross-sectional study of all hospitalizations in a large, tertiary care hospital evaluated the effect of delirium and a fall on the outcomes of LOS and risk of being discharged to a facility. RESULTS: The study included 29,655 hospital admissions...
May 2023: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
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