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AJMQ Newsletter
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Varkey, P., Lyles, M., Nagy, P., Johnson, H. Tags: AJMQ Newsletter Source Type: research

No Neonate Left Behind: A QI Approach to Critical Congenital Heart Screening in the NICU
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Drennan, S., Clarke-Pounder, J., Koricke, M. W. Tags: Q-Tip Source Type: research

Measuring Quality in Ambulatory Orthopedic Surgery
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Vaswani, R., Hutzler, L., Bosco, J. Tags: Commentary Source Type: research

Partnering With VA Stakeholders to Develop a Comprehensive Patient Safety Data Display: Lessons Learned From the Field
Health care systems are increasingly burdened by the large numbers of safety measures currently being reported. Within the Veterans Administration (VA), most safety reporting occurs within organizational silos, with little involvement by the frontline users of these measures. To provide a more integrated picture of patient safety, the study team partnered with multiple VA stakeholders and engaged potential frontline users at 2 hospitals to develop a Guiding Patient Safety (GPS) tool. The GPS is currently in its fourth generation; once approval is obtained from senior leadership, implementation will begin. Stakeholders were...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Chen, Q., Shin, M. H., Chan, J. A., Sullivan, J. L., Borzecki, A. M., Shwartz, M., Rivard, P. E., Hatoun, J., Rosen, A. K. Tags: Articles Source Type: research

Alabama Physicians and Accountable Care Organizations: Will What We Dont Know Hurt Us?
Accountable care organizations (ACOs) were designed to improve the quality of care delivered to Medicare beneficiaries while also halting the growth in Medicare spending. Many existing health systems in the Northeast, Midwest, and West have formed ACOs, whereas implementation in Southern states has been slower. The study team conducted a survey of all physician members of the Medical Association of the State of Alabama to determine the likelihood of their participation in an ACO and their attitudes toward some of the characteristics, such as quality measures, regulations, and risks versus rewards. The team found that many ...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Powell, M. P., Post, L. R., Bishop, B. A. Tags: Articles Source Type: research

Interdisciplinary Quality Improvement Conference: Using a Revised Morbidity and Mortality Format to Focus on Systems-Based Patient Safety Issues in a VA Hospital: Design and Outcomes
The Veterans Healthcare Administration (VA) has embraced patient safety and quality improvement in the quest to improve care for veterans. The New Mexico VA Health Care System introduced a new morbidity and mortality conference, called the Interdisciplinary Quality Improvement Conference (IQIC), using patient case presentations to focus on underlying systems in the clinical care environment. The revised conference design also effectively teaches the 6 Accreditation Council for Graduate Medical Education (ACGME) core requirements for resident education. A formal process was established for case selection, presentation, syst...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Gerstein, W. H., Ledford, J., Cooper, J., Lloyd, M. G., Moore, T., Harji, F., Twitty, V., Brooks, A., Oliver, R. C., Goff, J. M. Tags: Articles Source Type: research

An Education- and Telephone-Based Intervention to Improve Follow-up to Vision Care in Patients With Diabetes: A Prospective, Single-Blinded, Randomized Trial
The aim was to evaluate the effectiveness of a multipronged intervention on diabetic dilated fundus examination (DFE) adherence. In a prospective trial, 521 patients with diabetes who were due for follow-up DFEs were randomized to usual care or the intervention group. Usual care received a form letter reminder to schedule and an automated reminder phone call prior to their appointment. Intervention participants received an educational brochure about diabetic eye disease and a personalized letter reminder to schedule. A research assistant called intervention participants to help schedule the appointment, and they received a...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Zangalli, C. S., Murchison, A. P., Hale, N., Hark, L. A., Pizzi, L. T., Dai, Y., Leiby, B. E., Haller, J. A. Tags: Articles Source Type: research

Finding Order in Chaos: A Review of Hospital Ratings
This study takes a systematic approach to review the main features of 9 existing hospital rating systems, each of which is described using 9 areas of evaluation. The hospital rating systems included in this study vary widely in scope, methodology, transparency, and presentation of their results. Their results often present conflicting conclusions regarding the performance of the same hospital. This review of hospital rating systems demonstrates how public reporting may add confusion to patients’ health care decision making. (Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Hwang, W., Derk, J., LaClair, M., Paz, H. Tags: Articles Source Type: research

Organization Complexity and Primary Care Providers Perceptions of Quality Improvement Culture Within the Veterans Health Administration
This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers’ (PCPs’) perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohi...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Korom-Djakovic, D., Canamucio, A., Lempa, M., Yano, E. M., Long, J. A. Tags: Articles Source Type: research

Reduction in Central Line-Associated Bloodstream Infection Rates After Implementations of Infection Control Measures at a Level 3 Neonatal Intensive Care Unit
The objective was to decrease CLABSIs using evidence-based measures. The retrospective review compared CLABSI incidence during and after changes in catheter care. In April 2011, intravenous (IV) tubing changed from Interlink to Clearlink; IV tubing changing interval increased from 24 to 72 hours. CLABSIs increased. The following measures were implemented: July 2011, reeducation of neonatal intensive care staff on Clearlink; August 2011, IV tubing changing interval returned to 24 hours; September 2011, changed from Clearlink back to Interlink; November 2011, review of entire IV process and in-service on hand hygiene; Decemb...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Dumpa, V., Adler, B., Allen, D., Bowman, D., Gram, A., Ford, P., Sannoh, S. Tags: Articles Source Type: research

Clinical Quality Improvement Curriculum for Faculty in an Academic Medical Center
Interested faculty enrolled in this 6-month-long quality improvement (QI) course to facilitate independent QI project work. The course included monthly 1.5-hour sessions: 20-minute presentations covering key QI concepts, then small group activities to facilitate project work. Faculty were required to identify, construct, and implement an independent QI project. They met individually with mentors twice during the course, with additional guidance offered virtually via phone or e-mail, and completed pretests and posttests of QI knowledge (maximum score = 15) and self-assessed confidence. A statistically significant difference...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Yanamadala, M., Criscione-Schreiber, L. G., Hawley, J., Heflin, M. T., Shah, B. R. Tags: Articles Source Type: research

Performance Feedback Improves Compliance With Quality Measures
Cirrhotic complications portend high morbidity and mortality and burden the health care system. Established quality measures in management of cirrhotics include screening for esophageal varices (EV), screening for hepatocellular carcinoma (HCC), and hepatitis A and B immunization. A retrospective review was conducted to identify adherence to cirrhosis. Baseline rates were shared with providers. Compliance with quality measures was measured prospectively at 1-month, 2-month, 1-year, and 3-year follow-up after provision of performance feedback. Baseline HCC rate was 60%, EV was 68%, and hepatitis A and B immunization was 51%...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Loy, V., Kwiatt, J., Dodda, A., Martin, E., Dua, A., Saeian, K. Tags: Articles Source Type: research

Improving Depression Care Through an Online Learning Collaborative
This study aimed to examine the impact of a practice improvement intervention on screening and managing patients with depression in primary care. This pre–post study design included a physician practice survey designed to capture what the physicians believed they were doing in practice, a chart audit tool to capture what physicians were actually doing in practice, and an intervention that included an evidence-based educational program, online toolkit, and practice improvement coaching conference calls that promoted group learning. Following completion of the intervention, participants increasingly used the Patient He...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Starkey, M., Wiest, D., Qaseem, A. Tags: Articles Source Type: research

Clinical Decision Support for Early Recognition of Sepsis
This study focused on a patient cohort screened-in before infection was suspected; median time from arrival to CDS activation was 3.5 hours, and system activation to diagnostic collect was another 8.6 hours. (Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Amland, R. C., Hahn-Cover, K. E. Tags: Articles Source Type: research

Off-Label Prescribing: Justified or Not?
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Ruan, X., Kaye, A. D. Tags: Editorial Source Type: research