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Reconceptualizing Continuing Professional Development to Close Long-Standing Quality Gaps in Palliative Care
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Plourde-Cole, F., Davis, D. A., Davis, N. L. Tags: Commentaries Source Type: research

Patients' Perceptions of Care Are Associated With Quality of Hospital Care: A Survey of 4605 Hospitals
Favorable patient experience and low complication rates have been proposed as essential components of patient-centered medical care. Patients’ perception of care is a key performance metric and is used to determine payments to hospitals. It is unclear if there is a correlation between technical quality of care and patient satisfaction. The study authors correlated patient perceptions of care measured by the Hospital Consumer Assessment of Healthcare Providers and Systems scores with accepted quality of care indicators. The Hospital Compare database (4605 hospitals) was used to examine complication rates and patient-r...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Stein, S. M., Day, M., Karia, R., Hutzler, L., Bosco, J. A. Tags: Articles Source Type: research

Technology Integration Performance Assessment Using Lean Principles in Health Care
This study assesses the impact of an automated infusion system (AIS) integration at a positron emission tomography (PET) center based on "lean thinking" principles. The authors propose a systematic measurement system that evaluates improvement in terms of the "8 wastes." This adaptation to the health care context consisted of performance measurement before and after integration of AIS in terms of time, utilization of resources, amount of materials wasted/saved, system variability, distances traveled, and worker strain. The authors’ observations indicate that AIS stands to be very effective in a busy PET department, s...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Rico, F., Yalcin, A., Eikman, E. A. Tags: Articles Source Type: research

Consumers' Understanding of and Interest in Provider- Versus Practice-Level Quality Characteristics: Findings From a Focus Group Study
Quality measures are currently reported almost exclusively at the facility level. Forthcoming physician quality data are expected to be reported primarily at the level of the group practice. Little is known about consumers’ understanding of and interest in practice-level measures. The research team conducted 4 focus groups, half with individuals who had a chronic illness and half with individuals who did not. Most consumers correctly understand the concept of a physician practice. However, consumers exhibit little interest in practice-level characteristics, preferring information about their personal doctor. Understa...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Smith, B., Lynch, W. D., Markow, C., Lifsey, S., Slover, M. Tags: Articles Source Type: research

Evaluation of the Role of Training in the Implementation of a Depression Screening and Treatment Protocol in 2 Academic Outpatient Internal Medicine Clinics Utilizing the Electronic Medical Record
This study describes the successful implementation of a stepped-care approach to depression care. The positive association of training with compliance with protocol procedures indicates the importance of training in the implementation of practice change. (Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Loeb, D., Sieja, A., Corral, J., Zehnder, N. G., Guiton, G., Nease, D. E. Tags: Articles Source Type: research

Feedback to Achieve Improved Sign-out Technique
To maximize the quality of sign-out documents within the internal medicine residency, a quality improvement intervention was developed and implemented. Written sign-outs were collected from general medicine ward teams and graded using an 11-point checklist; in-person feedback was then given directly to the ward teams. Documentation of many of the 11 elements improved: mental status (22% to 66%, P < .0001), decisionality (40% to 66%, P < .0001), lab/test results (63% to 69%, P < .0001), level of acuity (34% to 50%, P < .0001), anticipatory guidance (69% to 82%, P < .0001), and future plans (35% to 38%, P <...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Doers, M. E., Beniwal-Patel, P., Kuester, J., Fletcher, K. E. Tags: Articles Source Type: research

Enhanced Assessment of Chest Pain and Related Symptoms in the Primary Care Setting Through the Use of a Novel Personalized Medicine Genomic Test: Results From a Prospective Registry Study
Novel approaches for assessing patients with chest pain and related symptoms may improve outpatient care. The REGISTRY I study measured the impact of a personalized gene expression score (GES) on subsequent cardiac referral decisions by primary care providers. Of the 342 stable, nonacute patients evaluated, the mean age was 55 years, 53% were female, and mean (SD) GES was 16 (±10) (range = 1-40). Low GES (≤15), indicating a low current likelihood of obstructive coronary artery disease (CAD), was observed in 49% of patients. After clinical covariate adjustment, each 10-point GES decrease was associated with a 14-f...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Ladapo, J. A., Lyons, H., Yau, M., Rich, P., Newton, D., Bruce-Mensah, K., Johnson, A., Zhou, Y., Stemkowski, S., Monane, M. Tags: Articles Source Type: research

Organizational Factors and Change Strategies Associated With Medical Home Transformation
There is limited information about how to transform primary care practices into medical homes. The research team surveyed leaders of the first 132 primary care practices in Minnesota to achieve medical home certification. These surveys measured priority for transformation, the presence of medical home practice systems, and the presence of various organizational factors and change strategies. Survey response rates were 98% for the Change Process Capability Questionnaire survey and 92% for the Physician Practice Connections survey. They showed that 80% to 100% of these certified clinics had 15 of the 18 organizational factor...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Solberg, L. I., Stuck, L. H., Crain, A. L., Tillema, J. O., Flottemesch, T. J., Whitebird, R. R., Fontaine, P. L. Tags: Articles Source Type: research

Hospital Variations in Severe Sepsis Mortality
This study sought to characterize variations in severe sepsis mortality between hospitals in the United States. Hospital discharge data (2012) were used from the University HealthSystem Consortium (UHC), a cooperative of US not-for-profit academic medical centers and affiliated hospitals. Discharge diagnosis codes were used to define severe sepsis as the presence of a serious infection with at least 1 organ dysfunction on hospital presentation. Expected mortality was determined from UHC risk adjustment mortality models. Among the 188 hospitals in the analysis, there were 256 509 patients with severe sepsis on admission. Th...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Wang, H. E., Donnelly, J. P., Shapiro, N. I., Hohmann, S. F., Levitan, E. B. Tags: Articles Source Type: research

The Power of Involving House Staff in Quality Improvement: An Interdisciplinary House Staff-Driven Vaccination Initiative
The objective was to improve compliance with inpatient vaccination core measures to >96%. An educational slide set was created and distributed by the Housestaff Patient Safety and Quality Council (HPSQC). A competition was established among departments. Finally, the HPSQC partnered with quality improvement staff to improve communication and optimize concurrent review processes. The average compliance prior to the HPSQC vaccination initiative was 78% for pneumococcal pneumonia and 84% for influenza; average compliance in the months following the intervention was 96% and 97.5%, respectively. This project yielded significa...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Peterson, S., Taylor, R., Sawyer, M., Nagy, P., Paine, L., Berenholtz, S., Miller, R., Petty, B. Tags: Articles Source Type: research

Impact of Throughput Optimization on Intensive Care Unit Occupancy
Intensive care unit (ICU) resources are scarce, yet demand is increasing at a rapid rate. Optimizing throughput efficiency while balancing patient safety and quality of care is of utmost importance during times of high ICU utilization. Continuous improvement methodology was used to develop a multidisciplinary workflow to improve throughput in the ICU while maintaining a high quality of care and minimizing adverse outcomes. The research team was able to decrease ICU occupancy and therefore ICU length of stay by implementing this process without increasing mortality or readmissions to the ICU. By improving throughput efficie...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Reddy, A. J., Pappas, R., Suri, S., Whinney, C., Yerian, L., Guzman, J. A. Tags: Articles Source Type: research

The Effect of Organizational Climate on Patient-Centered Medical Home Implementation
This study examined the association between primary care providers’ (PCPs’) perception of organization climate and medical home implementation in the Veterans Health Administration. Multivariate regression was used to test the hypothesis that organizational climate predicts medical home implementation. This analysis of 191 PCPs found that higher scores in 2 domains of organizational climate (communication and cooperation, and orientation to quality improvement) were associated with a statistically significantly higher percentage (from 7 to 10 percentage points) of PCPs implementing structural changes to support...
Source: American Journal of Medical Quality - July 7, 2015 Category: Health Management Authors: Reddy, A., Shea, J. A., Canamucio, A., Werner, R. M. Tags: Articles Source Type: research

Revolution: A Report on the UHC Annual Conference 2014
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - April 28, 2015 Category: Health Management Authors: White, C. Tags: Articles Source Type: research

AJMQ Newsletter: Two Years of Progress
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - April 28, 2015 Category: Health Management Authors: Cross, J. D. Tags: Articles Source Type: research

Clinical Laboratories Accreditation Program of the Brazilian Society of Clinical Pathology/Laboratory Medicine (PALC/SBPC-ML): 15-Year Experience
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - April 28, 2015 Category: Health Management Authors: Shcolnik, W., Chaves, C., Ferreira, C. E. d. S., Sanches, C., Roth, E., Fabri, L., Villela, L., Vieira, L. M. F., Tavora, P. Tags: Articles Source Type: research