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.

Eat Walk Engage: An Interdisciplinary Collaborative Model to Improve Care of Hospitalized Elders
This report describes Eat Walk Engage, a collaborative care model on a general medical ward in Brisbane, Australia. The model focused on early mobilization, feeding assistance, and cognitive stimulation. Using the Promoting Action on Research Implementation in Health Services implementation framework, the facilitation team enabled the clinical team to recognize barriers and develop solutions. Challenges included unclear responsibility, workload concerns, and risk aversion. Implementation strategies included engaging champions, education, audit and feedback, task delineation and delegation, improving physical resources, and...
Source: American Journal of Medical Quality - January 14, 2015 Category: Health Management Authors: Mudge, A. M., McRae, P., Cruickshank, M. Tags: Articles Source Type: research

A New Direction for the College
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Lyles, M. Tags: Articles Source Type: research

Book Review: Reinventing American Health Care
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Harper, L. Tags: Articles Source Type: research

Halting the Revolving Door: How a Focus on Patient- and Community-Level Risks May Help Curb Readmissions After Surgery
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Odonkor, C. A., Hurst, P., Kondo, N., Makary, M. A., Pronovost, P. J. Tags: Articles Source Type: research

Is It Time to Change Directions of Quality Measures?
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: James, T. Tags: Articles Source Type: research

Developing, Implementing, and Evaluating a Multifaceted Quality Improvement Intervention to Promote Sleep in an ICU
Critically ill patients commonly experience poor sleep quality in the intensive care unit (ICU) because of various modifiable factors. To address this issue, an ICU-wide, multifaceted quality improvement (QI) project was undertaken to promote sleep in the Johns Hopkins Hospital Medical ICU (MICU). To supplement previously published results of this QI intervention, the present article describes the specific QI framework used to develop and implement this intervention, which consists of 4 steps: (a) summarizing the evidence to create a list of sleep-promoting interventions, (b) identifying and addressing local barriers to im...
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Kamdar, B. B., Yang, J., King, L. M., Neufeld, K. J., Bienvenu, O. J., Rowden, A. M., Brower, R. G., Collop, N. A., Needham, D. M. Tags: Articles Source Type: research

Innovation and Transformation in California's Safety Net Health Care Settings: An Inside Perspective
Health reform requires safety net settings to transform care delivery, but how they will innovate in order to achieve this transformation is unknown. Two series of key informant interviews (N = 28) were conducted in 2012 with leadership from both California’s public hospital systems and community health centers. Interviews focused on how innovation was conceptualized and solicited examples of successful innovations. In contrast to disruptive innovation, interviewees often defined innovation as improving implementation, making incremental changes, and promoting integration. Many leaders gave examples of existing innov...
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Lyles, C. R., Aulakh, V., Jameson, W., Schillinger, D., Yee, H., Sarkar, U. Tags: Articles Source Type: research

Use of the Modified Early Warning Score and Serum Lactate to Prevent Cardiopulmonary Arrest in Hematology-Oncology Patients: A Quality Improvement Study
This process improvement project aimed to improve the early identification of clinically deteriorating hematology-oncology patients in order to prevent the development of critical illness and to facilitate timely intensive care unit (ICU) transfers. Using failure modes and effects analysis, a protocol employing the Modified Early Warning Score and serum lactate level was implemented to identify deteriorating patients who required the attention of the rapid response team. Control charts revealed a significant decrease in codes and preventable codes, while ICU transfers remained stable. A retrospective analysis to control fo...
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Young, R. S., Gobel, B. H., Schumacher, M., Lee, J., Weaver, C., Weitzman, S. Tags: Articles Source Type: research

Focus on Transitions of Care: Description and Evaluation of an Educational Intervention for Internal Medicine Residents
Transitions of care between physicians and from inpatient to outpatient settings leave patients vulnerable to medical errors and adverse events. A transitions of care workshop consisting of 2 sessions, Sign-Out Success (SOS) and Transition To Home (TTH), taught sign-out and discharge skills to incoming internal medicine interns during orientation. The workshop used role-playing exercises, didactics, demonstrations, and peer and self-evaluations. Interns completed a survey at 3 months post workshop. Using pre–post workshop measures, SOS increased the quality of intern-rated sign-outs (P = .004). Interns reported more ...
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Aboumatar, H., Allison, R. D., Feldman, L., Woods, K., Thomas, P., Wiener, C. Tags: Articles Source Type: research

Effectiveness and Cost of Failure Mode and Effects Analysis Methodology to Reduce Neurosurgical Site Infections
Mercy Hospital Springfield is a tertiary care facility with 32 000 discharges and 15 000 inpatient surgeries in 2011. From June 2009 through January 2011, a stable inpatient elective neurosurgery infection rate of 2.15% was observed. The failure mode and effects analysis (FMEA) methodology to reduce inpatient neurosurgery infections was utilized. Following FMEA implementation, overall elective neurosurgery infection rates were reduced to 1.51% and sustained through May 2012. Compared with baseline, the post-FMEA deep-space and organ infection rate was reduced by 41% (P = .052). Overall hospital inpatient clean surgery infe...
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Hover, A. R., Sistrunk, W. W., Cavagnol, R. M., Scarrow, A., Finley, P. J., Kroencke, A. D., Walker, J. L. Tags: Articles Source Type: research

Creating a Physician-Led Quality Imperative
To emerge from a significant quality crisis, hospital administration recognized the need for physician leadership to drive improvements. A framework is presented for a physician-led Quality Summit to select best practice initiatives for implementation over 1 year. Results demonstrated statistically significant reductions in ventilator-associated pneumonia, decreasing from the first quarter 2009 baseline of 8.34 per 1000 ventilator days to 3.32 per 1000 ventilator days in second quarter 2010 (P = .0055). During the same time frame, catheter-associated urinary tract infections decreased from 4.35 per 1000 catheter days to 0....
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Nelson, M. F., Merriman, C. S., Magnusson, P. T., Thomassian, K. V., Strawn, A., Martin, J. Tags: Articles Source Type: research

Postadmission Sepsis as a Screen for Quality Problems: A Case-Control Study
The present on admission (POA) indicator used with diagnosis codes listed in hospital discharge abstracts makes it possible to screen for possible in-hospital complications, which may in turn point to quality of care problems. A case–control study was performed among 382 patients from 30 New York State hospitals to see if lapses in quality were associated with the development of postadmission sepsis. Cases with hospital-acquired sepsis (labeled not POA) were compared with matched controls without sepsis. The authors found that central venous catheters and emergently inserted peripheral intravenous catheters were asso...
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Hughes, J. S., Eisenhandler, J., Goldfield, N., Weinberg, P. G., Averill, R. Tags: Articles Source Type: research

Measuring Briefing and Checklist Compliance in Surgery: A Tool for Quality Improvement
Operating room briefings improve patient outcomes; however, implementation and methods to measure are lacking. A briefing audit tool was developed with 4 domains: briefing logistics, briefing basics, specific briefing content, and briefing participation. The tool evaluated preoperative briefings across surgical services at an academic medical center. Sixty-three preoperative briefings were observed. Introduction by name and role occurred in 15% of cases. There was a wide variation in discussion of the critical goals of the surgical procedure among services D (100%), A (26%), B (19%), and C (0%). Participation in the briefi...
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Johnston, F. M., Tergas, A. I., Bennett, J. L., Valero, V., Morrissey, C. K., Fader, A. N., Hobson, D. B., Weaver, S. J., Rosen, M. A., Wick, E. C. Tags: Articles Source Type: research

Reduction of Central Line-Associated Bloodstream Infections in a Pediatric Hematology/Oncology Population
This study reports the results of an initiative to reduce central line–associated bloodstream infections (CLABSIs) among pediatric hematology/oncology patients, a population at increased risk for CLABSI. The study design was a pre–post comparison of a series of specific interventions over 40 months. Logistic regression was used to determine if the risk of developing CLABSI decreased in the postintervention period, after controlling for covariates. The overall CLABSI rate fell from 9 infections per 1000 line days at the beginning of the study to zero in a cohort of 291 patients encompassing 2107 admissions. Admi...
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Wilson, M. Z., Deeter, D., Rafferty, C., Comito, M. M., Hollenbeak, C. S. Tags: Articles Source Type: research

The Seamless Transfer of Care: A Pilot Study Assessing the Usability of an Electronic Transfer of Care Communication Tool
The purpose of this pilot study was to explore the feasibility of implementing a new electronic transfer of care (TOC) tool. The study was conducted in a Canadian tertiary care center. Brief survey instruments were completed by acute care physicians, community-based physicians, and patients to assess providers’ perspectives on the usability of the novel electronic tool. The units of analysis were physician and patient perceptions. Mixed methods were used including descriptive statistical analyses and qualitative thematic analysis. Twenty-eight unique acute care physicians completed 100 electronic TOC summaries, and 4...
Source: American Journal of Medical Quality - October 22, 2014 Category: Health Management Authors: Santana, M. J., Holroyd-Leduc, J., Flemons, W. W., O'Beirne, M., White, D., Clayden, N., Forster, A. J., Ghali, W. A. Tags: Articles Source Type: research