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Identifying Severe Sepsis via Electronic Surveillance
An electronic sepsis surveillance system (ESSV) was developed to identify severe sepsis and determine its time of onset. ESSV sensitivity and specificity were evaluated during an 11-day prospective pilot and a 30-day retrospective trial. ESSV diagnostic alerts were compared with care team diagnoses and with administrative records, using expert adjudication as the standard for comparison. ESSV was 100% sensitive for detecting severe sepsis but only 62.0% specific. During the pilot, the software identified 477 patients, compared with 18 by adjudication. In the 30-day trial, adjudication identified 164 severe sepsis patients,...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Brandt, B. N., Gartner, A. B., Moncure, M., Cannon, C. M., Carlton, E., Cleek, C., Wittkopp, C., Simpson, S. Q. Tags: Articles Source Type: research

Evaluating the Effect of Safety Culture on Error Reporting: A Comparison of Managerial and Staff Perspectives
Although medical error reporting has been studied, underreporting remains pervasive. The study aims were to identify the organizational factors with the greatest perceived effect on error reporting and to determine whether associations differ for management and clinical staff. A total of 515 637 respondents from 1052 hospitals completed the Hospital Survey on Patient Safety Culture. Nine organizational factors were tested as predictors of error reporting using weighted least-squares multiple regression. Error feedback was perceived as the most significant predictor, while organizational learning was another significant fac...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Richter, J. P., McAlearney, A. S., Pennell, M. L. Tags: Articles Source Type: research

SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised Publication Guidelines From a Detailed Consensus Process
In the past several years, the science of health care improvement has advanced considerably. In this article, we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015 using (1) interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group, (2) face-to-face consensus meetings to develop interim drafts, and (3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasizes 3 key components of systematic efforts to improve the quality, value, and safety of health care: formal and informal theory in planning, impleme...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., Stevens, D. Tags: Articles Source Type: research

Adherence to Standard of Care in the Diagnosis and Treatment of Suspected Bacterial Meningitis
Acute bacterial meningitis (ABM) is a rare but deadly neurological emergency. Accordingly, Infectious Diseases Society of America (IDSA) guidelines summarize current evidence into a straightforward algorithm for its management. The goal of this study is to evaluate the overall compliance with these guidelines in patients with suspected ABM. A retrospective cross-sectional study was conducted of adult patients who underwent lumbar puncture for suspected ABM to ascertain local adherence patterns to IDSA guidelines for bacterial meningitis. Primary outcomes included appropriate utilization of neuroimaging, blood cultures, ant...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Chia, D., Yavari, Y., Kirsanov, E., Aronin, S. I., Sadigh, M. Tags: Articles Source Type: research

Training in Quality and Safety: The Current Landscape
This article offers a new resource that details the basic characteristics of such physician-inclusive training programs. Specifically, program type, objectives, eligibility, cost, training length, and modality are aggregated and displayed to provide health care professionals with a new tool to facilitate individual education in the field of quality improvement and patient safety. (Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Karasick, A. S., Nash, D. B. Tags: Articles Source Type: research

Governance Practices and Performance in US Academic Medical Centers
In this study, the chief executive officers (CEOs) of US academic medical centers were surveyed to elicit their perceptions of board structures, activities, and attitudes reflecting 6 widely identified governance best practices; the relationship between use of these practices and organizational performance, based on the University HealthSystem Consortium’s Quality & Accountability rankings, was assessed. High-performing hospitals showed greater use of all 6 practices, but the strongest evidence supported a focus on board member education and development, the rigorous use of performance measures to guide quality i...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Szekendi, M., Prybil, L., Cohen, D. L., Godsey, B., Fardo, D. W., Cerese, J. Tags: Articles Source Type: research

The Meaningful Use of Electronic Health Records and Health Care Quality
The federal government is investing approximately $30 billion in incentives for adoption and meaningful use (MU) of electronic health records (EHRs). Whether achieving MU improves quality of care is unclear. The researchers conducted a longitudinal study of 514 primary care physicians in New York State from 2010 to 2011. Quality of care provided by those who achieved stage 1 MU was compared with the quality provided by those who used EHRs but did not achieve stage 1 MU. Generalized estimating equations were used to determine whether receipt of MU incentives was independently associated with performance on 9 MU quality meas...
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Kern, L. M., Edwards, A., Kaushal, R., with the HITEC Investigators Tags: Articles Source Type: research

How Meaningful Is Meaningful Use?
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - October 23, 2015 Category: Health Management Authors: Gill, J. M. Tags: Editorial Source Type: research

AJMQ Newsletter: The New Third Science in Medical Education--Medical Quality
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - August 24, 2015 Category: Health Management Authors: Abraham, J., Huang, D., Lyles, M. Tags: AJMQ Newsletter Source Type: research

Who Needs a Jackhammer When a Hammer Is All That May Be Needed?
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - August 24, 2015 Category: Health Management Authors: Homa, K. Tags: Letters to the Editor Source Type: research

Comment on "Patient-Reported Reasons for Emergency Department Visits in the Urban Medicaid Population"
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - August 24, 2015 Category: Health Management Authors: Ruan, X., Kaye, A. D. Tags: Letters to the Editor Source Type: research

Book Review: Accountable Care Organizations: Value Metrics and Capital Formation
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - August 24, 2015 Category: Health Management Authors: Thompson, N. Tags: Book Review Source Type: research

Rounding on Rounds: Creating a Checklist for Patient- and Family-Centered Rounds
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - August 24, 2015 Category: Health Management Authors: Holton, R., Patel, R., Eggebrecht, M., Von Hoff, B., Garrison, O., McHale, S., Bednar, J., Olson, A. Tags: Q-Tip Source Type: research

Health Care Quality: A Question of Supply and Demand
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - August 24, 2015 Category: Health Management Authors: Cantor, M. N. Tags: Commentaries Source Type: research

Facing the Tension Between Quality Measures and Patient Satisfaction
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - August 24, 2015 Category: Health Management Authors: Moffatt-Bruce, S., Hefner, J. L., McAlearney, A. S. Tags: Commentaries Source Type: research