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.

Off-Label Drug Use: Whose Interests Are Served?
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Braillon, A., Lexchin, J. Tags: Letter to the Editor Source Type: research

Improving the Medication Reconciliation Discharge Prescription Documentation of Rationale for New or Changed Medications at the Niagara Health System
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Atyani, A. H., Sellers, C., Shaffaf, J., Niven, A., Ismail, Z., Forgione, A., Law, M. P., Greenway, M., Cubelic, S., Delrue, A. Tags: Q-Tip Source Type: research

Just What the Doctor Ordered? Physician Participation in Health Care Organization Corporate Boards
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Sidorov, J. Tags: Commentary Source Type: research

A Tale of Two Systems: Combining Forces to Improve Veteran and Military Health Care
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Elnahal, S. M., Herman, J. M., Pronovost, P. J. Tags: Commentary Source Type: research

Using Innovative Methodologies From Technology and Manufacturing Companies to Reduce Heart Failure Readmissions
This study investigated the impact of a framework blending Lean Sigma, design thinking, and Lean Startup on 30-day all-cause readmissions among HF patients. This was a prospective study in an academic hospital in Baltimore, Maryland. Thirty-day all-cause readmission was assessed using the hospital’s electronic medical record. The baseline readmission rate for HF was 28.4% in 2010 with 690 discharges. The framework was developed and interventions implemented in the second half of 2011. The impact of the interventions was evaluated through 2012. The rate declined to 18.9% among 703 discharges (P < .01). There was no...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Johnson, A. E., Winner, L., Simmons, T., Eid, S. M., Hody, R., Sampedro, A., Augustine, S., Sylvester, C., Parakh, K. Tags: Articles Source Type: research

Reflective Practice: A Tool for Readmission Reduction
The objective was to decrease 30-day hospital readmissions. The intervention involved retrospective review by hospitalists of their own patients’ readmissions, using reflective practice guided by a chart review tool. Subjects were patients discharged by hospitalists and readmitted to a tertiary care academic medical center. Hospitalists reviewed 193 readmissions of 170 patients. Factors contributing to readmission were grouped under patient characteristics, operational factors, and care transition. After reflection, physicians scheduled earlier follow-up appointments while nurse practitioners and physician assistants...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Kashiwagi, D. T., Burton, M. C., Hakim, F. A., Manning, D. M., Klocke, D. L., Caine, N. A., Hembre, K. M., Varkey, P. Tags: Articles Source Type: research

Can Physicians Deliver Chronic Medications at the Point of Care?
Interventions aimed at improving medication adherence are challenging to integrate into clinical practice. Point-of-care medication delivery systems (POCMDSs) are an emerging approach that may be sustainable. A mixed methods approach was used to evaluate the implementation of a POCMDS in a capitated network of clinics serving vulnerable populations. The analytical approach was informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) and CFIR (Consolidated Framework for Implementation Research) theoretical frameworks. Data were obtained through key informant interviews, site visits, patient surve...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Palacio, A., Keller, V. F., Chen, J., Tamariz, L., Carrasquillo, O., Tanio, C. Tags: Articles Source Type: research

A Successful Model for a Comprehensive Patient Flow Management Center at an Academic Health System
This article reports on an innovative approach to managing patient flow at a multicampus academic health system, integrating multiple services into a single, centralized Patient Flow Management Center that manages supply and demand for inpatient services across the system. Control of bed management was centralized across 3 campuses and key services were integrated, including bed management, case management, environmental services, patient transport, ambulance and helicopter dispatch, and transfer center. A single technology platform was introduced, as was providing round-the-clock patient placement by critical care nurses,...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Lovett, P. B., Illg, M. L., Sweeney, B. E. Tags: Articles Source Type: research

Integrating Quality Improvement With Graduate Medical Education: Lessons Learned From the AIAMC National Initiatives
This article describes the National Initiatives (NIs) and the reflections of NI participants, including their reflections on the goals they set for integrating GME with QI, the barriers they encountered along the way, and their advice to others beginning the challenge. These reflections provide some insight into the pathways of promoting organizational change and offer practical insight and inspiring advice for others embarking on the journey. (Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Blanchard, R. D., Pierce-Boggs, K., Visintainer, P. F., Hinchey, K. T. Tags: Articles Source Type: research

Improving the Rate of Colposcopy in an Urban Population of Patients With Known Abnormal Pap Smears
This project was designed to improve the colposcopy rate in an urban patient population with known abnormal Pap smears within 75 days of the test to rapidly identify and treat premalignant lesions. Using Plan-Do-Study-Act cycles, Lean techniques, and the electronic health record, the authors created a protocol to verify all Pap smears, then created a process whereby a phone-triage team contacted patients with abnormal Pap smears to educate them and schedule colposcopy. As a result, 100% of Pap smears were verified, compared with 95% prior to plan implementation. The mean time from Pap to colposcopy was 38.5 days, with 85% ...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Montella, J. M., Pelegano, J. F. Tags: Articles Source Type: research

The Armstrong Institute Resident/Fellow Scholars: A Multispecialty Curriculum to Train Future Leaders in Patient Safety and Quality Improvement
The objective was to determine if a year-long, multispecialty resident and fellow quality improvement (QI) curriculum is feasible and leads to improvements in QI beliefs and self-reported behaviors. The Armstrong Institute Resident/Fellow Scholars (AIRS) curriculum incorporated (a) a 2-day workshop in lean sigma methodology, (b) year-long interactive weekly small-group lectures, (c) mentored QI projects, and (d) practicum-based components to observe frontline QI efforts. Pre–post evaluation was performed with the Quality Improvement Knowledge Application Tool (QIKAT) and the Systems Thinking Scale (STS) using the Wil...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Rinke, M. L., Mock, C. K., Persing, N. M., Sawyer, M., Haut, E. R., Neufeld, N. J., Nagy, P. Tags: Articles Source Type: research

Maintenance of Certification, Medicare Quality Reporting, and Quality of Diabetes Care
This study compared changes in quality measures from American Board of Family Medicine Performance in Practice Modules (PPMs), Physician Quality Reporting System (PQRS), and a combined PQRS/PPM for diabetes between 2008 and 2012. Physicians completed 7264 diabetes PPMs, 297 only reported PQRS measures 2 or more times, and 675 completed a combination project, representing more than 200 000 patients. After adjustment, PQRS and PQRS/PPM projects were associated with greater blood pressure and cholesterol control improvement than PPM only (P < .05). PPM-only projects had greater improvement than PQRS-only projects on 4 of 6...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Phillips, R. L., Blackburn, B., Peterson, L. E., Puffer, J. C. Tags: Articles Source Type: research

Quality Improvement Education for Health Professionals: A Systematic Review
Effective quality improvement (QI) education should improve patient care, but many curriculum studies do not include clinical measures. The research team evaluated the prevalence of QI curricula with clinical measures and their association with several curricular features. MEDLINE, Embase, CINAHL, and ERIC were searched through December 31, 2013. Study selection and data extraction were completed by pairs of reviewers. Of 99 included studies, 11% were randomized, and 53% evaluated clinically relevant measures; 85% were from the United States. The team found that 49% targeted 2 or more health professions, 80% required a QI ...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Starr, S. R., Kautz, J. M., Sorita, A., Thompson, K. M., Reed, D. A., Porter, B. L., Mapes, D. L., Roberts, C. C., Kuo, D., Bora, P. R., Elraiyah, T. A., Murad, M. H., Ting, H. H. Tags: Articles Source Type: research

Improving the Ambulatory Patient Experience Within an Academic Department of Medicine
Academic departments of medicine (ADOM) can provide an important vehicle to drive the sharing and dissemination of best practices in clinical care delivery. With the increased focus on improving the patient experience, particularly in the ambulatory setting, ADOM also should lead efforts to cultivate improvements in this arena. To address this need, the study ADOM established a Patient Experience Working Group (PEWG) that brought together physician and nonphysician leaders, set improvement goals, and created a structure for sharing and learning. Since initiation, the PEWG has implemented more than 20 performance improvemen...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Neeman, N., Sehgal, N. L. Tags: Articles Source Type: research

Sustaining Reductions in Central Line-Associated Bloodstream Infections in Michigan Intensive Care Units: A 10-Year Analysis
This article describes the interventions that sustained low central line–associated bloodstream infection (CLABSI) rates in the Michigan Keystone ICU Project. This analysis included data from March 2004 to December 2013 for 121 intensive care units (ICUs) in 73 hospitals. The Keystone Project was a cohort collaborative with an improvement team in each ICU. During the sustainability period, teams integrated the intervention into staff orientation, collected and submitted monthly data, and reported infection rates to leaders. The annual mean rate of BSIs dropped from 2.5 infections/1000 catheter-days in 2004 to 0.76 in...
Source: American Journal of Medical Quality - April 28, 2016 Category: Health Management Authors: Pronovost, P. J., Watson, S. R., Goeschel, C. A., Hyzy, R. C., Berenholtz, S. M. Tags: Articles Source Type: research