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Joint Commission Journal on Quality and Patient Safety

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https://read.qxmd.com/read/30777665/please-stop-using-venous-thromboembolism-vte-outcomes-for-pay-for-performance-and-public-reporting
#1
EDITORIAL
Elliott R Haut
No abstract text is available yet for this article.
February 15, 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30733139/don-t-get-stuck-a-quality-improvement-project-to-reduce-perioperative-blood-borne-pathogen-exposure
#2
Juan P Gurria, Heather Nolan, Stephanie Polites, Melody Threlkeld, Katherine Arata, Lisa Phipps, Alison Muth, Richard A Falcone
BACKGROUND: Blood-borne pathogen exposure (BBPE) represents a significant safety and resource burden, with more than 380,000 events reported annually across hospitals in the United States. The perioperative environment is a high-risk area for BBPE, and efforts to reduce exposures are not well defined. A multidisciplinary group of nurses, surgical technologists, surgeons, and employee health specialists created a BBPE prevention bundle to reduce Occupational Safety and Health Administration (OSHA) recordable cases...
February 4, 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30686706/gaps-in-ambulatory-patient-safety-for-immunosuppressive-specialty-medications
#3
Sarah Patterson, Gabriela Schmajuk, Michael Evans, Ishita Aggarwal, Zara Izadi, Milena Gianfrancesco, Jinoos Yazdany
OBJECTIVES: New specialty drugs such as biologics are now available in record numbers, presenting increased safety risks for people with immune-mediated diseases. However, comprehensive assessments of patient safety for these drugs are lacking. We examined performance on key patient safety measures, such as screening for latent tuberculosis (LTBI), hepatitis B virus (HBV), and hepatitis C virus (HCV), for new users of a broad group of specialty medications. METHODS: Data were extracted via electronic health record data warehouses of a large university health system using structured queries, and extensive chart review was performed to confirm measure elements...
January 24, 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30665836/an-academic-medical-center-based-incubator-to-promote-clinical-innovation-and-financial-value
#4
Lisa S Rotenstein, Paige Wickner, Lauren Hauser, Melissa Littlefield, Sarah Abbett, Jessica Desrosiers, David W Bates, Jessica Dudley, Karl R Laskowski
INTRODUCTION: Within a health care landscape characterized by increasing financial pressures, fluctuating payment models, and an increasing prevalence of clinician burnout, structures to strategically support innovation are imperative to financial and clinical success. METHODS: We developed the Brigham Care Redesign Incubator and Startup Program (BCRISP), a flexible model to test, evaluate, and scale innovative care redesign proposals. We evaluated its impact via analysis of programmatic and financial data, as well as through exploration of individual project outcomes...
January 18, 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30642774/an-organization-specific-and-modifiable-inpatient-safety-composite-measure
#5
Patrick K Smith, Andy Amster
In early 2013, seeking to apply the principles of value-based purchasing to all Kaiser Permanente hospitals as part of an existing organizationwide value-based performance incentive plan, Kaiser Permanente developed an inpatient safety composite measure that tracks hospital-level performance improvement related to 10 key inpatient safety events. The elements of the composite are weighted equally, and the tool draws on scoring methodologies used by the National Committee for Quality Assurance and the Centers for Medicare & Medicaid Services Hospital Inpatient Value-Based Purchasing Program...
January 11, 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30638974/use-of-systems-engineering-to-design-a-hospital-command-center
#6
Erin M Kane, James J Scheulen, Adrian Püttgen, Diego Martinez, Scott Levin, Bree A Bush, Linda Huffman, Mary Margaret Jacobs, Hetal Rupani, David T Efron
BACKGROUND: In hospitals and health systems across the country, patient flow bottlenecks delay care delivery-emergency department boarding and operating room exit holds are familiar examples. In other industries, such as oil, gas, and air traffic control, command centers proactively manage flow through complex systems. METHODS: A systems engineering approach was used to analyze and maximize existing capacity in one health system, which led to the creation of the Judy Reitz Capacity Command Center...
January 10, 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30638973/impact-of-the-agency-for-healthcare-research-and-quality-s-safety-program-for-perinatal-care
#7
Leila C Kahwati, Asta V Sorensen, Stephanie Teixeira-Poit, Sara Jacobs, Samantha A Sommerness, Kristi K Miller, Elizabeth Pleasants, Hanna Margaret Clare, Charles L Hirt, Stanley E Davis, Thomas Ivester, Donna Caldwell, Janet H Muri, Kamila B Mistry
BACKGROUND: The Safety Program for Perinatal Care (SPPC) seeks to improve safety on labor and delivery (L&D) units through three mutually reinforcing components: (1) fostering a culture of teamwork and communication, (2) applying safety science principles to care processes; and (3) in situ simulation. The objective of this study was to describe the SPPC implementation experience and evaluate the short-term impact on unit patient safety culture, processes, and adverse events. METHODS: We supported SPPC implementation by L&D units with a program toolkit, trainings, and technical assistance...
January 10, 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30638871/using-a-potentially-aggressive-violent-patient-huddle-to-improve-health-care-safety
#8
Lori A Larson, Janet L Finley, Tera L Gross, Ann K McKay, Julie M Moenck, Mary A Severson, Casey M Clements
BACKGROUND: Unexpected situations of workplace violence are occurring in the United States at increasing rates in health care environments, warranting increased attention to processes supporting safety for health care workers. At a large, academic hospital, two patient safety incidents had occurred in a two-year period in which a patient had become violent at the time of admission from the emergency department (ED) to the medical unit. METHODS: A multidisciplinary quality improvement (QI) team was formed to address the risk of violent patient events...
January 9, 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30638870/workplace-violence-in-health-care-and-agitation-management-safety-for-patients-and-health-care-professionals-are-two-sides-of-the-same-coin
#9
EDITORIAL
Ambrose H Wong, Jessica M Ray, Joanne D Iennaco
No abstract text is available yet for this article.
January 9, 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30591269/balancing-patient-centered-and-safe-pain-care-for-nonsurgical-inpatients-clinical-and-managerial-perspectives
#10
Olena Mazurenko, Barbara T Andraka-Christou, Matthew J Bair, Areeba Y Kara, Christopher A Harle
BACKGROUND: Hospitals and clinicians aim to deliver care that is safe. Simultaneously, they are ensuring that care is patient centered, meaning that it is respectful of patients' values, preferences, and experiences. However, little is known about delivering care in cases in which these goals may not align. For example, hospitals and clinicians are facing the daunting challenge of balancing safe and patient-centered pain care for nonsurgical patients, due to lack of comprehensive care guidelines and complexity of this patient population...
December 24, 2018: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30583986/implementing-strategies-to-identify-and-mitigate-adverse-safety-events-a-case-study-with-unplanned-extubations
#11
L Dupree Hatch, Matthew Rivard, Joyce Bolton, Christa Sala, Wendy Araya, Melinda H Markham, Daniel J France, Peter H Grubb
BACKGROUND: Patient safety events result from failures in complex health care delivery processes. To ensure safety, teams must implement ways to identify events that occur in a nonrandom fashion and respond in a timely manner. To illustrate this, one children's hospital's experience with an outbreak of unplanned extubations (UEs) in the neonatal ICU (NICU) is described. METHODS: The quality improvement team measured UEs using three complementary data streams. Interventions to decrease the rate of UE were tested with success...
December 21, 2018: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30527394/leveraging-quality-improvement-science-to-reduce-c-difficile-infections-in-a-community-hospital
#12
Barbara B Lambl, Sarah Altamimi, Nathan E Kaufman, Mitchell S Rein, Monique Freeley, Maureen Duram, Wendy Krauss, Janice Kurowski, William E O'Neill, Paul Seeley, Mary Jo Gagnon, Duncan E Phillips, Marc S Rubin
BACKGROUND: The most common infection acquired in US hospitals is Clostridium difficile, which can lead to protracted diarrhea, severe abdominal cramping, and infectious colitis and an attributable mortality of 6.5% (Lessa FC, et al, Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015 Feb 26;372:825-834). The mortality associated with C. difficile is of major clinical importance. The best strategy to prevent such infections is an open question. METHODS: A multiyear quality improvement initiative was performed in our community hospital to determine where hospitals should focus their resources to achieve sustainable reductions in hospital-acquired C...
December 4, 2018: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30522833/reasons-for-repeat-rapid-response-team-calls-and-associations-with-in-hospital-mortality
#13
Richard Chalwin, Lynne Giles, Amy Salter, Victoria Eaton, Karoline Kapitola, Jonathan Karnon
BACKGROUND: Previous publications noted increased mortality risk in patients subject to repeat rapid response team (RRT) calls. These patients were examined as a homogenous group, but there may be many reasons for repeat calls. Those potentially preventable by the rapid response system have not been investigated. METHODS: In a retrospective cohort study, patients with potentially preventable repeat calls were classified into two categories: type 1 (patients who had a repeat call following an initial call that ended despite the patient still triggering RRT calling criteria [T1-PRC]) and type 2 (patients with a repeat call within 24 hours of an initial call and for the same reason [T2-PRC])...
December 3, 2018: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30522832/the-time-for-opioid-stewardship-is-now
#14
EDITORIAL
Friedhelm Sandbrink, Raj Uppal
No abstract text is available yet for this article.
December 3, 2018: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30503812/inter-rater-agreement-for-abstraction-of-the-early-management-bundle-severe-sepsis-septic-shock-sep-1-quality-measure-in-a-multi-hospital-health-system
#15
Seth R Bauer, Judith A Gonet, Rebecca F Rosario, Lori A Griffiths, Tracy Kingery, Anita J Reddy
BACKGROUND: The Early Management Bundle, Severe Sepsis/Septic Shock (SEP-1) quality measure is complex to abstract, which may lead to discrepancies between abstractors. This study was designed to evaluate inter-rater agreement between abstractors at individual hospitals in a health system and a lead abstractor on abstraction elements and measure compliance for SEP-1. METHODS: Patient cases qualifying for abstraction for SEP-1 over a four-month period in 2016 were initially abstracted at a local hospital and then centrally by a lead abstractor...
November 29, 2018: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30166254/a-health-system-wide-initiative-to-decrease-opioid-related-morbidity-and-mortality
#16
Scott G Weiner, Christin N Price, Alev J Atalay, Elizabeth M Harry, Erika A Pabo, Rajesh Patel, Joji Suzuki, Shelly Anderson, Stanley W Ashley, Allen Kachalia
BACKGROUND: The opioid overdose crisis now claims more than 40,000 lives in the United States every year, and many hospitals and health systems are responding with opioid-related initiatives, but how best to coordinate hospital or health system-wide strategy and approach remains a challenge. METHODS: An organizational opioid stewardship program (OSP) was created to reduce opioid-related morbidity and mortality in order to provide an efficient, comprehensive, multidisciplinary approach to address the epidemic in one health system...
January 2019: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30447762/plaintiff-attorneys-in-communication-and-resolution-programs
#17
LETTER
(no author information available yet)
No abstract text is available yet for this article.
December 2018: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30447761/inclusion-of-plaintiff-attorneys-in-research-into-the-effects-of-harmful-events
#18
LETTER
(no author information available yet)
No abstract text is available yet for this article.
December 2018: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30447760/choosing-wisely-in-georgia-a-quality-improvement-initiative-in-25-adult-ambulatory-medicine-offices
#19
Scott Pugel, John L Stallworth, Leslie B Pugh, Carlee Terrell, Zuwere Bailey, Thomas Gramling, Helen Ward
BACKGROUND: Scant evidence exists of effective Choosing Wisely® initiatives, which are intended to reduce the use of unnecessary care. In 2013 substantial variations existed at Kaiser Permanente Georgia in the frequency of nonbeneficial services in ambulatory care. A Choosing Wisely campaign was implemented across 25 medical offices serving approximately 300,000 members. METHODS: The initiative was designed to reduce the use of complete blood counts (CBCs) and electrocardiograms (EKGs) as routine screening tests in physical examination visits, age-inappropriate dual-energy x-ray absorptiometry (DEXA) scans, and imaging for uncomplicated headache...
December 2018: Joint Commission Journal on Quality and Patient Safety
https://read.qxmd.com/read/30447759/implementation-of-choosing-wisely-promise-and-pitfalls
#20
EDITORIAL
R Sacha Bhatia, Eve A Kerr
No abstract text is available yet for this article.
December 2018: Joint Commission Journal on Quality and Patient Safety
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