American Journal of Medical Quality This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Compliance Does Not Mean Quality: An In-Depth Analysis of the Safe Surgery Checklist at a Tertiary Care Health Facility
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Mahmood, T., Haji, F., Damignani, R., Bagli, D., Dubrowski, A., Manzone, J., Truong, J., Martin, R., Mylopoulos, M. Tags: Articles Source Type: research

Are Clinical Practice Guidelines for Cataract and Glaucoma Trustworthy?
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Young, B. K., Wu, C. M., Wu, A. M., Margo, C. E., Greenberg, P. B. Tags: Articles Source Type: research

The Maryland Medicare Waiver and Emergency Care: Mixed Experiences Deserve Close Scrutiny
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Pines, J. M., Farmer, S. A., Pimentel, L. Tags: Articles Source Type: research

Association Between Patient Satisfaction and Outcomes in Kidney Transplant
This was a cross-sectional cohort study analyzing aggregate publicly reported data integrated from 2 primary sources and included all US accredited kidney transplant programs that report data within the Scientific Registry of Transplant Recipients and Hospital Compare; 188 kidney transplant programs, representing 15 710 transplants were included in this study. In general, the scores for patient satisfaction questions were higher for higher-performing transplant programs; 5 questions reached statistically significant associations (P < .05). A composite of these 5 questions demonstrated a strong association with a center&...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Srinivas, R., Chavin, K. D., Baliga, P. K., Srinivas, T., Taber, D. J. Tags: Articles Source Type: research

Variability in Anesthetic Care for Total Knee Arthroplasty: An Analysis From the Anesthesia Quality Institute
Anesthetic practice utilization and related characteristics of total knee arthroplasties (TKAs) are understudied. The research team sought to characterize anesthesia practice patterns by utilizing National Anesthesia Clinical Outcomes Registry data of the Anesthesia Quality Institute. The proportions of primary TKAs performed between January 2010 and June 2013 using general anesthesia (GA), neuraxial anesthesia (NA), and regional anesthesia (RA) were determined. Utilization of anesthesia types was analyzed using anesthesiologist and patient characteristics and facility type. In all, 108 625 eligible TKAs were identified; 1...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Fleischut, P. M., Eskreis-Winkler, J. M., Gaber-Baylis, L. K., Giambrone, G. P., Faggiani, S. L., Dutton, R. P., Memtsoudis, S. G. Tags: Articles Source Type: research

First Time Rounding Experiences for Nonclinicians: The Cleveland Clinic Experience
Clinical rounds serve several key objectives in academic medical centers: providing a forum for patient communication, clinical decision making, and teaching. Nonclinical colleagues ordinarily do not have the opportunity to round, and the idea of implementing a rounding program that includes nonclinical colleagues has received little attention to date. Reasoning that a rounding program with nonclinicians could enhance (1) understanding of the organization’s clinical mission, (2) appreciation of caregivers’ roles, and (3) engagement, the authors created such a program. From 2010 to 2013, 51 nonclinicians within ...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Greenwald, L. R., Nowacki, A. S., Stoller, J. K. Tags: Articles Source Type: research

Health Systems Engineering Fellowship: Curriculum and Program Development
Industrial engineering and related disciplines have been used widely in improvement efforts in many industries. These approaches have been less commonly attempted in health care. One factor limiting application is the limited workforce resulting from a lack of specific education and professional development in health systems engineering (HSE). The authors describe the development of an HSE fellowship within the United States Department of Veterans Affairs, Veterans Health Administration (VA). This fellowship includes a novel curriculum based on specifically established competencies for HSE. A 1-year HSE curriculum was deve...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Watts, B. V., Shiner, B., Cully, J. A., Gilman, S. C., Benneyan, J. C., Eisenhauer, W. Tags: Articles Source Type: research

Patient-Reported Reasons for Emergency Department Visits in the Urban Medicaid Population
This study investigated patient-reported reasons for treat-and-release emergency department (ED) visits by Medicaid beneficiaries. An in-house-designed educational survey was conducted that consisted of 3 components: patient’s health, patient’s primary care, and patient’s ED visit. An ED patient was asked an open-ended question about the reason for a recent ED visit. The patient’s answer was classified into 1 of 3 types: health care service delivery issues, population behavior issues, and unavoidable ED visits. Among 2711 ED visits, 56% were related to health care service delivery issues (ie, access...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Wang, L., Tchopev, N., Kuntz-Melcavage, K., Hawkins, M., Richardson, R. Tags: Articles Source Type: research

Impact of Audit and Feedback and Pay-for-Performance Interventions on Pediatric Hospitalist Discharge Communication With Primary Care Providers
The study team sought to improve hospitalist communication with primary care providers (PCPs) at discharge through interventions consisting of (a) audit and feedback and (b) inclusion of a discharge communication measure in the incentive compensation for pediatric hospitalists. The setting was a 16-physician pediatric hospitalist group within a tertiary pediatric hospital. Discharge summaries were selected randomly for documentation of communication with PCPs. At baseline, 57% of charts had documented communication with PCPs, increasing to 84% during the audit and feedback period. Following the addition of a financial ince...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Tejedor-Sojo, J., Creek, T., Leong, T. Tags: Articles Source Type: research

Designing a Quality Improvement Program With Electronic Health Records: New York City's Health eQuits
Despite clear recommendations for identifying and intervening with smokers, clinical preventive practice is inconsistent in primary care. Use of electronic health records could facilitate improvement. Community health centers treating low-income and Medicaid recipients with greater smoking prevalence than the general population were recruited for a pilot program. Key design elements used to engage centers’ participation include designating a project champion at each organization, confirming ability to transmit data for reporting and participation, and offering money to facilitate initial engagement; however, financia...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Duquaine, D., Farley, S. M., Sacks, R., Mandel-Ricci, J., Silfen, S. L., Shih, S. C. Tags: Articles Source Type: research

Primary Care Access Barriers as Reported by Nonurgent Emergency Department Users: Implications for the US Primary Care Infrastructure
The objective was to explore variation by insurance status in patient-reported barriers to accessing primary care. The authors fielded a brief, anonymous, voluntary survey of nonurgent emergency department (ED) visits at a large academic medical center and conducted descriptive analysis and thematic coding of 349 open-ended survey responses. The privately insured predominantly reported primary care infrastructure barriers—wait time in clinic and for an appointment, constraints related to conventional business hours, and difficulty finding a primary care provider (because of geography or lack of new patient openings)....
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Hefner, J. L., Wexler, R., McAlearney, A. S. Tags: Articles Source Type: research

Barriers to and Facilitators of Interprofessional-Interdepartmental Interventions: Unearthing Departmental Culture
This study evaluates how emergency department (ED) and medical intensive care unit (MICU) providers interact in the setting of a quality improvement project designed to enhance transport/care for patients from the ED to the MICU. Focus groups were conducted with nurses, residents, physician assistants, and physicians from the ED and MICU at baseline and 6 months regarding their thoughts on and perspectives of the intervention and working with colleagues from another department. Data were then analyzed utilizing a multistep coding scheme that identified key barriers to and facilitators of the interprofessional-interdepartme...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Michalec, B., Reinhold, N., Dressler, R., Laskowski-Jones, L., Adarve, L., Elliott, D. Tags: Articles Source Type: research

Face-to-Face Handoff: Improving Transfer to the Pediatric Intensive Care Unit After Cardiac Surgery
The goal was to develop and implement a comprehensive, primarily face-to-face handoff process that begins in the operating room and concludes at the bedside in the intensive care unit (ICU) for pediatric patients undergoing congenital heart surgery. Involving all stakeholders in the planning phase, the framework of the handoff system encompassed a combination of a formalized handoff tool, focused process steps that occurred prior to patient arrival in the ICU, and an emphasis on face-to-face communication at the conclusion of the handoff. The final process was evaluated by the use of observer checklists to examine quality ...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Vergales, J., Addison, N., Vendittelli, A., Nicholson, E., Carver, D. J., Stemland, C., Hoke, T., Gangemi, J. Tags: Articles Source Type: research

Impact of Including Readmissions for Qualifying Events in the Patient Safety Indicators
This study sought to quantify the bias related to omission of readmissions for PSI-qualifying conditions. Using 2000-2009 California Office of Statewide Health Planning and Development Patient Discharge Data, the study team examined the change in PSI rates when including readmissions in the numerator, hospitals performing in the extreme deciles, and longitudinal performance. Including 7-day readmissions resulted in a 0.3% to 8.9% increase in average hospital PSI rates. Hospital PSI rates with and without PSI-qualifying 30-day readmissions were highly correlated for point estimates and within-hospital longitudinal change. M...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Davies, S. M., Saynina, O., Baker, L. C., McDonald, K. M. Tags: Articles Source Type: research

Meaningful Use and the Patient Portal: Patient Enrollment, Use, and Satisfaction With Patient Portals at a Later-Adopting Center
This study examined enrollment, use based on MU requirements, and satisfaction in a recently adopting fee-for-service multispecialty system. Between 2010 and 2012, overall portal enrollment increased from 13.2% to 23.1% but varied substantially by physician specialty. In 2013, more than 97% of physicians would have met requirements for a stage 2 MU utilization measure requiring that patients download personal health information, but only 38% of all physicians (87% of primary care physicians [PCPs] and 37% of other specialists) would have met e-mail requirements. Satisfaction with the portal overall and with portal-based e-...
Source: American Journal of Medical Quality - February 24, 2015 Category: Health Management Authors: Neuner, J., Fedders, M., Caravella, M., Bradford, L., Schapira, M. Tags: Articles Source Type: research