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.

Successful Implementation of an Automated Sedation Vacation Process in Intensive Care Units
This quality improvement initiative sought to develop a sedation vacation (SV) protocol to increase SV performance and ensure sustainability. A standardized, nurse-driven SV protocol within the electronic medical record was implemented in adult intensive care units (ICUs) at Boston Medical Center. For 6 months, data were collected on the number of assessments performed, SV completion, SV eligibility, and reason for exclusion. Secondary outcomes included ICU length of stay (LOS) and ventilator LOS. Of 1730 patient-days during this 6-month period, SV assessments were performed 70% (n = 1211) of the time. SVs were conducted o...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Ackrivo, J., Horbowicz, K. J., Mordino, J., El Kherba, M., Ellingwood, J., Sloan, K., Murphy, J. Tags: Articles Source Type: research

Interventions to Improve the Quality of Outpatient Specialty Referral Requests: A Systematic Review
Requests for outpatient specialty consultations occur frequently but often are of poor quality because of incompleteness. The authors searched bibliographic databases, trial registries, and references during October 2014 for studies evaluating interventions to improve the quality of outpatient specialty referral requests compared to usual practice. Two reviewers independently extracted data and assessed quality. Findings were qualitatively summarized for completeness of information relayed in a referral request within naturally emerging intervention categories. Of 3495 articles screened, 11 were eligible. All 3 studies eva...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Hendrickson, C. D., Lacourciere, S. L., Zanetti, C. A., Donaldson, P. C., Larson, R. J. Tags: Articles Source Type: research

ICD-9 Code-Based Venous Thromboembolism Performance Targets Fail to Measure Up
Venous thromboembolism (VTE) is a common complication among hospitalized patients. Suboptimal prevention practices have prompted payers to consider hospital-associated VTE as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed all cases of hospital-associated VTE at the Johns Hopkins Hospital between July 1, 2010, and June 30, 2011, that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program. Of 157 patients identified as having developed hospital-associated, potentially preventable VTE, only 92...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Lau, B. D., Haut, E. R., Hobson, D. B., Kraus, P. S., Maritim, C., Austin, J. M., Shermock, K. M., Maheshwari, B., Allen, P. X., Almario, A., Streiff, M. B. Tags: Articles Source Type: research

Psychometric Evaluation of an Instrument for Measuring Organizational Climate for Quality: Evidence From a National Sample of Infection Preventionists
This study tested the psychometric properties of the Leading a Culture of Quality for Infection Prevention (LCQ-IP) instrument measuring the infection prevention climate in a sample of 972 infection preventionists from acute care hospitals. An exploratory principal component analysis showed that the instrument had structural validity and captured 4 factors related to the climate for infection prevention: Psychological Safety, Prioritization of Quality, Supportive Work Environment, and Improvement Orientation. LCQ-IP exhibited excellent internal consistency, with a Cronbach α of .926. Criterion validity was supported ...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Pogorzelska-Maziarz, M., Nembhard, I. M., Schnall, R., Nelson, S., Stone, P. W. Tags: Articles Source Type: research

Use of a Tablet-Based Risk Assessment Program to Improve Health Counseling and Patient-Provider Relationships in a Federally Qualified Health Center
This study evaluates the impact of an interactive, tablet-based lifestyle behavior questionnaire prior to a patient’s primary care visit on counseling for health behaviors and patient–provider relationships. Using a quasi-experimental design at 2 federally qualified health centers, adults aged 18 to 35 years were asked to complete a tablet-based assessment about nutrition, physical activity, weight, smoking status, and alcohol use to identify unhealthy behaviors and their desire to discuss them with their provider. In the intervention group, participants were more likely to trust their providers (83% vs 71%, P ...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Diaz, V. A., Mainous, A. G., Gavin, J. K., Player, M. S., Wright, R. U. Tags: Articles Source Type: research

Code R: Redesigning Hospital-wide Peer Review for Academic Hospitals
In most health care institutions, physician peer review is the primary method for maintaining and measuring physician competency and quality of care issues. However, many teaching hospitals do not have a method of tracking resident trainees’ involvement in adverse cases. At the study institution, Code R was introduced as a measure to capture resident trainee involvement in the hospital-wide peer review process. The authors conducted a retrospective review of all peer review cases from January 2008 to December 2011 in an academic medical center and determined the quantity and type of resident errors that occurred comp...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Kim, D. I., Au, H., Fargo, R., Garrison, R. C., Thompson, G., Yu, M., Loo, L. K. Tags: Articles Source Type: research

Epidemiology of Hospital System Patient Falls: A Retrospective Analysis
This study provides novel insights into variables found to be associated with falling, including location of falls within the hospital campus, efficacy of fall prevention protocols, and age groups. (Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Anderson, D. C., Postler, T. S., Dam, T.-T. Tags: Articles Source Type: research

Patient Complaints and Adverse Surgical Outcomes
The objective of this study was to assess the relationship between patient complaints and adverse surgical outcomes. A retrospective cohort study used American College of Surgeons National Surgical Quality Improvement Program data from an academic medical center and included 10 536 patients with surgical procedures performed by 66 general and vascular surgeons. The number of complaints for a surgeon was correlated with surgical occurrences (P < .01). Surgeons with more patient complaints had a greater rate of surgical occurrences if the surgeon’s aggregate preoperative risk was higher (β = .25, P < .05), w...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Catron, T. F., Guillamondegui, O. D., Karrass, J., Cooper, W. O., Martin, B. J., Dmochowski, R. R., Pichert, J. W., Hickson, G. B. Tags: Articles Source Type: research

TeamSTEPPS Improves Operating Room Efficiency and Patient Safety
The objective was to evaluate the effect of TeamSTEPPS on operating room efficiency and patient safety. TeamSTEPPS consisted of briefings attended by all health care personnel assigned to the specific operating room to discuss issues unique to each case scheduled for that day. The operative times, on-time start rates, and turnover times of all cases performed by the urology service during the initial year with TeamSTEPPS were compared to the prior year. Patient safety issues identified during postoperative briefings were analyzed. The mean case time was 12.7 minutes less with TeamSTEPPS (P < .001). The on-time first-sta...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Weld, L. R., Stringer, M. T., Ebertowski, J. S., Baumgartner, T. S., Kasprenski, M. C., Kelley, J. C., Cho, D. S., Tieva, E. A., Novak, T. E. Tags: Articles Source Type: research

Decision Analysis for Metric Selection on a Clinical Quality Scorecard
Clinical quality scorecards are used by health care institutions to monitor clinical performance and drive quality improvement. Because of the rapid proliferation of quality metrics in health care, BJC HealthCare found it increasingly difficult to select the most impactful scorecard metrics while still monitoring metrics for regulatory purposes. A 7-step measure selection process was implemented incorporating Kepner-Tregoe Decision Analysis, which is a systematic process that considers key criteria that must be satisfied in order to make the best decision. The decision analysis process evaluates what metrics will most appr...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Guth, R. M., Storey, P. E., Vitale, M., Markan-Aurora, S., Gordon, R., Prevost, T. Q., Dunagan, W. C., Woeltje, K. F. Tags: Articles Source Type: research

Evaluating Primary Care Physician Performance in Diabetes Glucose Control
This study demonstrates that it is possible to identify primary care physicians (PCPs) who perform better or worse than expected in managing diabetes. Study subjects were 14 033 adult diabetics and their 133 PCPs. Logistic regression was used to predict the odds that a patient would have uncontrolled diabetes (defined as HbA1c ≥8%) based on patient-level characteristics alone. A second model predicted diabetes control from physician-level identity and characteristics alone. A third model combined the patient- and physician-level models using hierarchical logistic regression. Physician performance is calculated from the ...
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: Brown, E. C., Robicsek, A., Billings, L. K., Barrios, B., Konchak, C., Paramasivan, A. M., Masi, C. M. Tags: Articles Source Type: research

Measuring Quality in Cancer Care: A Critical Need for Clinician Engagement
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - August 30, 2016 Category: Health Management Authors: James, T. A., Wong, S. L., Carp, N. Z. Tags: Editorial Source Type: research

AJMQ Newsletter: "The Doctor Will See You Now"
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - June 30, 2016 Category: Health Management Authors: Lyles, M., McElligott, J. T. Tags: AJMQ Newsletter Source Type: research

Do Physicians Adhere to Platelet Transfusion Guidelines?
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - June 30, 2016 Category: Health Management Authors: Sedhom, R., Willett, L. Tags: Letter to the Editor Source Type: research

Current Training in Quality and Safety: The Current Landscape in the Department of Veterans Affairs
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - June 30, 2016 Category: Health Management Authors: Watts, B. V., McKinney, K., Williams, L. C., Cully, J. A., Gilman, S. C., Brannen, J. L. Tags: Letter to the Editor Source Type: research