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Advance: A Report on the University HealthSystem Consortium Annual Conference 2015
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - February 29, 2016 Category: Health Management Authors: White, C. Tags: Articles Source Type: research

AJMQ Newsletter: Expanding ACMQ Membership Through Collaboration
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Lyles, M., Wegman, M., Ramsey, S. Tags: AJMQ Newsletter Source Type: research

Implementing High-Performance Teams: Strengths of a Standard Communication Tool in Neurosurgery
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Afsar-manesh, N., Namavar, A. A., Martin, N. Tags: Letter to the Editor Source Type: research

Quality Management in Epileptology: Can It Really Improve Care for Patients?
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Ugalde-Canitrot, A., Garcia-Fernandez, M., Garcia-Caballero, J. Tags: Letter to the Editor Source Type: research

Creating a Standardized Order Set for DKA Admissions to the PICU
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Blunden, C., Walsh Koricke, M. Tags: Q-Tip Source Type: research

Health Disparities: Will a Coalition of the Willing Make a Difference?
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Beltran, R. A. Tags: Commentary Source Type: research

Improved Knowledge, Attitudes, and Behaviors After Implementation of TeamSTEPPS Training in an Academic Emergency Department: A Pilot Report
TeamSTEPPS is a validated, formal patient safety curriculum created by the Agency for Healthcare Research and Quality (AHRQ) for the development of high-functioning multidisciplinary teams. TeamSTEPPS was implemented in an academic emergency department (ED), including all ED hospital staff as well as physicians and residents. It was hypothesized that extensive interprofessional education combined with implementation of specific tools would increase knowledge of TeamSTEPPS principles, attitudes, and behaviors. The TeamSTEPPS knowledge test and the AHRQ Hospital Survey attitude test were administered at 0, 45, and 90 days af...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Lisbon, D., Allin, D., Cleek, C., Roop, L., Brimacombe, M., Downes, C., Pingleton, S. K. Tags: Articles Source Type: research

Delphi Method Validation of a Procedural Performance Checklist for Insertion of an Ultrasound-Guided Internal Jugular Central Line
Placement of ultrasound-guided central lines is a critical skill for physicians in several specialties. Improving the quality of care delivered surrounding this procedure demands rigorous measurement of competency, and validated tools to assess performance are essential. Using the iterative, modified Delphi technique and experts in multiple disciplines across the United States, the study team created a 30-item checklist designed to assess competency in the placement of ultrasound-guided internal jugular central lines. Cronbach α was .94, indicating an excellent degree of internal consistency. Further validation of th...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Hartman, N., Wittler, M., Askew, K., Manthey, D. Tags: Articles Source Type: research

Outcomes of a Neonatal Golden Hour Implementation Project
The objective of this study was to implement and evaluate a quality improvement project (the golden hour pathway [GHP]) aimed at improving the quality and efficiency of care delivered to extremely low birth weight (ELBW) infants <28 weeks gestation and/or <1000 g birth weight during the first hour of life. Process improvement and patient data collected during the quality improvement cycles were compared with retrospective data for ELBW infants admitted to the study neonatal intensive care unit during the 2 years prior to GHP implementation. GHP implementation resulted in improvements compared with past internal perfo...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Ashmeade, T. L., Haubner, L., Collins, S., Miladinovic, B., Fugate, K. Tags: Articles Source Type: research

Hospital Bed Type, the Electronic Medical Record, and Safe Bed Elevation in the Intensive Care Setting
In mechanically ventilated patients, head of bed (HOB) elevation above 30° decreases the risk of ventilator-associated pneumonia. The research team studied (a) compliance with proper HOB elevation in their cardiac surgical intensive care unit, (b) the accuracy of HOB angles recorded in the electronic medical record (EMR), and (c) the effect of bed type on (a) and (b). Nurses were polled to discover how HOB angles were measured in practice. HOB angles were compliant in 80% of observations. Compliance was more frequent in beds with side-of-bed angle indicators (SBI) than beds with under-bed angle indicators (UBI; 88% vs ...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Fitch, Z. W., Duquaine, D., Ohkuma, R., Schneider, E. B., Whitman, G. J. R. Tags: Articles Source Type: research

The Effect of an Electronic SBAR Communication Tool on Documentation of Acute Events in the Pediatric Intensive Care Unit
The Situation, Background, Assessment, Recommendation (SBAR) handoff tool is designed to improve communication. The effects of integrating an electronic medical record (EMR) with a SBAR template are unclear. The research team hypothesizes that an electronic SBAR template improves documentation and communication between nurses and physicians. In all, 84 patient events were recorded from 542 admissions to the pediatric intensive care unit. Three time periods were studied: (a) paper documentation only, (b) electronic documentation, and (c) electronic documentation with an SBAR template. Documentation quality was assessed usin...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Panesar, R. S., Albert, B., Messina, C., Parker, M. Tags: Articles Source Type: research

Improving Outcomes in Patients With Sepsis
Sepsis mortality may be improved by early recognition and appropriate treatment based on evidence-based guidelines. An intervention was developed that focused on earlier identification of sepsis, early antimicrobial administration, and an educational program that was disseminated throughout all hospital units and services. There were 1331 patients with sepsis during the intervention period and 1401 patients with sepsis during the control period. After controlling for expected mortality, patients in the intervention period had 30% lower odds of dying (odds ratio = 0.70, 95% confidence interval [CI] = 0.57 to 0.84). They als...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Armen, S. B., Freer, C. V., Showalter, J. W., Crook, T., Whitener, C. J., West, C., Terndrup, T. E., Grifasi, M., DeFlitch, C. J., Hollenbeak, C. S. Tags: Articles Source Type: research

Development of a Quality Improvement Bundle to Reduce Tracheal Intubation-Associated Events in Pediatric ICUs
This report describes a methodology to develop a bundle to improve quality and safety of tracheal intubations. A prospective observational cohort study was performed with expert consensus opinion of 1715 children undergoing tracheal intubation at 15 PICUs. Baseline process and outcomes data in tracheal intubation were collected using the National Emergency Airway Registry for Children reporting system. Univariate analysis was performed to identify risk factors associated with adverse tracheal intubation–associated events. A multidisciplinary quality improvement committee was formed. Workflow analysis of tracheal intu...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Li, S., Rehder, K. J., Giuliano, J. S., Apkon, M., Kamat, P., Nadkarni, V. M., Napolitano, N., Thompson, A. E., Tucker, C., Nishisaki, A., for the National Emergency Airway Registry for Children (NEAR4KIDS) Investigators and Pediatric Acute Lung Injury an Tags: Articles Source Type: research

The Educational Needs of Clinicians Regarding Anticoagulation Therapy for Prevention of Thromboembolism and Stroke in Patients With Atrial Fibrillation
The objective is to identify practice patterns and attitudes of and barriers faced by US physicians assessing thromboembolism/stroke risk and managing anticoagulation in atrial fibrillation (AF) to determine educational needs. Case-based surveys were used to assess practice patterns, guideline use, barriers, and attitudes; 51 cardiologists and 50 primary care physicians (PCPs) were surveyed. Most cardiologists use validated risk scoring systems to assess thromboembolism/stroke risk, and more than half of PCPs use clinical experience. Assessment of bleeding risk varied; more than half of respondents rely on clinical judgmen...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Glauser, T. A., Barnes, J., Nevins, H., Cerenzia, W. Tags: Articles Source Type: research

Surgical Multidisciplinary Rounds: An Effective Tool for Comprehensive Surgical Quality Improvement
An analysis of outcomes, quality, and survey data was carried out to evaluate the impact of surgical multidisciplinary rounds (SMDR) at a community teaching hospital. Surgical inpatients were reviewed over a 4-year period. Real-time changes to clinical care, documentation, and programs were enacted during the rounds. SMDR contributed to reductions in length of stay (6.1 to 5.1 days), postoperative respiratory failure (15.5% to 6.8%), deep venous thrombosis/pulmonary embolism (2.8% to 2.3%), cardiac complications (7.0% to 1.6%), and catheter-associated urinary tract infection (5.2% to 1.5%), and increased Surgical Care Impr...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Counihan, T., Gary, M., Lopez, E., Tutela, S., Ellrodt, G., Glasener, R. Tags: Articles Source Type: research