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Creating a Fellowship Curriculum in Patient Safety and Quality
The authors sought to create a curriculum suitable for a newly created clinical fellowship curriculum across Harvard Medical School–affiliated teaching hospitals as part of a newly created 2-year quality and safety fellowship program described in the companion article "Design and Implementation of the Harvard Fellowship in Patient Safety and Quality." The aim of the curriculum development process was to define, coordinate, design, and implement a set of essential skills for future physician-scholars of any specialty to lead operational quality and patient safety efforts. The process of curriculum development and the ...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Abookire, S. A., Gandhi, T. K., Kachalia, A., Sands, K., Mort, E., Bommarito, G., Gagne, J., Sato, L., Weingart, S. N. Tags: Articles Source Type: research

Design and Implementation of the Harvard Fellowship in Patient Safety and Quality
The Harvard Fellowship in Patient Safety and Quality is a 2-year physician-oriented training program with a strong operational orientation, embedding trainees in the quality departments of participating hospitals. It also integrates didactic and experiential learning and offers the option of obtaining a master’s degree in public health. The program focuses on methodologically rigorous improvement and measurement, with an emphasis on the development and implementation of innovative practice. The operational orientation is intended to foster the professional development of future quality and safety leaders. The purpose...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Gandhi, T. K., Abookire, S. A., Kachalia, A., Sands, K., Mort, E., Bommarito, G., Gagne, J., Sato, L., Weingart, S. N. Tags: Articles Source Type: research

Creating a Patient-Centered Health Care Delivery System: A Systematic Review of Health Care Quality From the Patient Perspective
Patient experience is one of key domains of value-based purchasing that can serve as a measure of quality and be used to improve the delivery of health services. The aims of this study are to explore patient perceptions of quality of health care and to understand how perceptions may differ by settings and condition. A systematic review of multiple databases was conducted for studies targeting patient perceptions of quality of care. Two reviewers screened and extracted data independently. Data synthesis was performed following a meta-narrative approach. A total of 36 studies were included that identified 10 quality dimensio...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Mohammed, K., Nolan, M. B., Rajjo, T., Shah, N. D., Prokop, L. J., Varkey, P., Murad, M. H. Tags: Articles Source Type: research

Implementing Interdisciplinary Teams Does Not Necessarily Improve Primary Care Practice Climate
The complexity of successfully implementing interdisciplinary care team approaches in primary care has challenged many delivery system stakeholders. One-year changes in clinicians’ and staff experiences of practice climate among 5 practices implementing interdisciplinary primary care teams and 28 other practices were compared. In adjusted analyses, practices implementing care teams reported improved team structure (78.0 in 2011 vs 79.3 in 2012), team functioning (75.7 vs 77.7), readiness for change (77.6 vs 77.7), and perceptions of skills and knowledge (48.0 vs 53.6) over time. However, the improvements were not sig...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Grace, S. M., Rich, J., Chin, W., Rodriguez, H. P. Tags: Articles Source Type: research

The Proceedings of Medical Quality 2015
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Tags: Articles Source Type: research

AJMQ Newsletter: Education Committee Update
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Davis, N. Tags: AJMQ Newsletter Source Type: research

Delayed Awareness of Clinically Significant Test Results on Hospital Services Without an Automated Alert System
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Bates, R., Rosenbaum, A., McCoy, C., Yu, R. Tags: Letters to the Editor Source Type: research

Low Quality of Discharge Summaries for Patients With Poorly Controlled Diabetes on a Clinical Teaching Unit
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: MacMillan, T. E., Cavalcanti, R. B. Tags: Letters to the Editor Source Type: research

A Needs Assessment in Patient Safety Education for Fourth-Year Medical Students
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Jansson, P. S., An-Grogan, Y., Eller, S. G., Woods, D. M., Kontrick, A. V., Salzman, D. H. Tags: Q-Tip Source Type: research

A Continuous Quality Improvement Initiative for Electronic Prescribing in Ambulatory Care
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Dhavle, A. A., Rupp, M. T., Sow, M., Lengkong, V. Tags: Commentary Source Type: research

Relationship Between Time in the Operating Room and Incident Pressure Ulcers: A Matched Case-Control Study
The objective was to determine the relationship between time in the operating room (OR) and hospital-acquired pressure ulcers (HAPUs), controlling for temporality. The research team identified 931 HAPUs among surgical patients and matched them to 4 controls by hospital length of stay at the time the pressure ulcer (PU) was documented. A regression model estimated the relationship between OR time and HAPU after controlling for matching, age, sex, admission and current Braden score, weight, year, and American Society of Anesthesiologists physical status score. OR time in the 24 hours prior to PU documentation was associated ...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Hayes, R. M., Spear, M. E., Lee, S. I., Krauser Lupear, B. E., Benoit, R. A., Valerio, R., Dmochowski, R. R. Tags: Articles Source Type: research

A Novel Means of Assessing Institutional Adherence to Blood Transfusion Guidelines
Risk-adjusted institutional transfusion rates are not currently available on a national level. A surrogate means of benchmarking transfusion practices to use for internal quality improvement was studied. Blood utilization was prospectively studied among all colorectal surgery patients at the study institution (July 2010-November 2012), and these data were benchmarked with transfusion data from the National Surgical Quality Improvement Program (NSQIP) database by hospital type and size. Using NSQIP, the study institution’s colorectal surgery transfusion rate was 16.3% (150/920 cases), which was slightly higher than th...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Hicks, C. W., Frank, S. M., Wasey, J. O., Efron, J., Gearhart, S., Fang, S., Safar, B., Makary, M. A., Wick, E. C. Tags: Articles Source Type: research

Improved Perception of Communication and Compliance With a Revised, Intensive Care Unit-Specific Bedside Communication Sheet
Although many pediatric intensive care units (PICUs) use beside communication sheets (BCSs) to highlight daily goals, the optimal format is unknown. A site-specific BCS could improve both PICU communication and compliance completing the BCS. Via written survey, PICU staff at an academic children’s hospital provided recommendations for improving and revising an existing BCS. Pre- and post-BCS revision, PICU staff were polled regarding PICU communication and BCS effectiveness, and daily compliance for completing the BCS was monitored. After implementation of the revised BCS, staff reporting "excellent" or "very good" d...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Aponte-Patel, L., Sen, A. Tags: Articles Source Type: research

CT Pulmonary Angiography Utilization in the Emergency Department: Diagnostic Yield and Adherence to Current Guidelines
The aim is to investigate the patterns of computed tomography pulmonary angiography (CTPA) use and adherence to current guidelines. Medical records of patients investigated with CTPA for pulmonary embolism (PE) in a single academic hospital from January 2011 until December 2012 were reviewed. Wells scores were calculated retrospectively by researchers blinded to the results of the CTPA. "Avoidable imaging" was defined as imaging performed against current recommendations of the European Society of Cardiology or the PIOPED investigation group. A total of 646 patients underwent testing; 61 cases of PE were diagnosed (9.4%). P...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Perelas, A., Dimou, A., Saenz, A., Rhee, J. H., Teerapuncharoen, K., Rowden, A., Eiger, G. Tags: Articles Source Type: research

"Choosing Wisely" in an Academic Department of Medicine
The "Choosing Wisely" campaign seeks to reduce unnecessary care in the United States through self-published recommendations by professional societies. The research team sought to identify factors related to low-value care in the Department of Medicine at the University of California San Francisco, using a subset of clinical scenarios published by the American College of Physicians. The team further explored respondents’ values on cost consciousness. A notable minority disagreed with the identified low-value tests. In 6 of 8 scenarios, faculty were more likely to rate the scenarios as representing low-value testing (P...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Hines, J. Z., Sewell, J. L., Sehgal, N. L., Moriates, C., Horton, C. K., Chen, A. H. Tags: Articles Source Type: research