American journal of medical quality : the official journal of the American College of Medical Quality最新文献_第2页

Words That Heal: A Quality Improvement Intervention to Reduce Stigmatizing Language in Gastroenterology Documentation. 治愈的话语：一种质量改进干预，以减少胃肠病学文献中的污名化语言。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 Epub Date: 2026-03-23 DOI: 10.1097/JMQ.0000000000000297

Abdelrhman Refaey, Anushka Deogaonkar, Maria Elena Ruiz, Mrudula Bandaru, Marie L Borum

{"title":"Words That Heal: A Quality Improvement Intervention to Reduce Stigmatizing Language in Gastroenterology Documentation.","authors":"Abdelrhman Refaey, Anushka Deogaonkar, Maria Elena Ruiz, Mrudula Bandaru, Marie L Borum","doi":"10.1097/JMQ.0000000000000297","DOIUrl":"10.1097/JMQ.0000000000000297","url":null,"abstract":"Introduction: Stigmatizing language in medical documentation can erode patient trust and worsen health disparities. Gastroenterology (GI) notes often include descriptions of weight, substance use, bowel preparation, and adherence, making them prone to biased phrasing.Methods: In this retrospective quality improvement study at an urban academic center, 3417 outpatient and colonoscopy records were reviewed over 4 months (pre- and postintervention). Clinicians received a single educational session promoting evidence-based, patient-centered terminology (eg, body mass index instead of adjectival \"obesity,\" Boston Bowel Preparation Scale instead of \"poor prep,\" person-first substance use language). Frequencies of stigmatizing versus recommended terms were compared using Fisher exact test, stratified by race and gender.Results: Use of adjectival \"obesity\" declined from 5.6% to 3.6% ( P = 0.012), while body mass index documentation increased from 8.8% to 16.6% ( P < 0.001). \"Poor prep\" decreased from 51.5% to 23.2% ( P = 0.002), and Boston Bowel Preparation Scale use rose from 48.5% to 76.8% ( P = 0.001). Racial disparities improved; gender differences persisted.Discussion: A single educational session was associated with reductions in certain stigmatizing or subjective terms and increased use of objective alternatives in gastroenterology documentation, though changes varied across domains. Sustained training may further improve equity and patient-centered care.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"103-109"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Predictors of Observation Unit Failure in Patients with Acute Heart Failure Exacerbation: A Quality Improvement Initiative. 急性心力衰竭加重患者观察单元衰竭的临床预测因素：一项质量改进倡议。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 DOI: 10.1097/JMQ.0000000000000301

Benjamin Fairbanks, Kaleb Kramer, Samuel Parnell, Colin Danko

引用次数: 0

Enhancing the Patient Experience in Cardiac Procedures: A Mixed-Methods Quality Improvement Study. 增强心脏手术患者体验：一项混合方法质量改善研究。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 Epub Date: 2026-03-25 DOI: 10.1097/JMQ.0000000000000290

Sarah Daoudi, Christina Jewell, Michael Carlozzi, Eric Harrington, Christine Williams, Susannah Quinlan, Caroline Drummond, Laurie Bergeron, Cory Gallant, Peter Zimetbaum

{"title":"Enhancing the Patient Experience in Cardiac Procedures: A Mixed-Methods Quality Improvement Study.","authors":"Sarah Daoudi, Christina Jewell, Michael Carlozzi, Eric Harrington, Christine Williams, Susannah Quinlan, Caroline Drummond, Laurie Bergeron, Cory Gallant, Peter Zimetbaum","doi":"10.1097/JMQ.0000000000000290","DOIUrl":"10.1097/JMQ.0000000000000290","url":null,"abstract":"This pilot study in the Interventional Cardiology and Electrophysiology units at Beth Israel Deaconess Medical Center (BIDMC) identified gaps in patient experience through follow-up phone surveys. Responses were collected from 104 patients using an unvalidated survey instrument to generate hypotheses and inform future quality improvement initiatives. Findings revealed high satisfaction with pain management and procedural comfort, but persistent concerns regarding postprocedural communication and wait times, with notable differences in satisfaction between patients who underwent electrophysiology procedures versus catheterization or structural interventions. Qualitative responses were coded by 2 independent reviewers (Cohen's κ = 0.80). Key themes included physician-patient communication, perceived wait times, and family involvement in care. Findings are contextualized within the broader literature on patient experience and quality improvement in cardiac procedural settings. Building on strategies from national and international studies, evidence-informed recommendations are offered to guide improvements, including targeted enhancements in communication and scheduling.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"119-125"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inviting You to Submit Research and Stories, With More Article Types to Choose. 邀请您提交研究和故事，有更多的文章类型可供选择。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-03-01 Epub Date: 2026-03-12 DOI: 10.1097/JMQ.0000000000000295

Pranavi V Sreeramoju

引用次数: 0

Determining Causes of Insulin-Induced Hypoglycemia Using an Electronic-Based Trigger. 使用电子触发器确定胰岛素诱导的低血糖的原因。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-03-01 Epub Date: 2026-01-13 DOI: 10.1097/JMQ.0000000000000280

Kamil Evy A Bantol, Yingchao Zhong, Joanne Bruno, Nandini Nair, Nathan Gollogly, Pradyuman Jhala, Brianna Knoll

{"title":"Determining Causes of Insulin-Induced Hypoglycemia Using an Electronic-Based Trigger.","authors":"Kamil Evy A Bantol, Yingchao Zhong, Joanne Bruno, Nandini Nair, Nathan Gollogly, Pradyuman Jhala, Brianna Knoll","doi":"10.1097/JMQ.0000000000000280","DOIUrl":"10.1097/JMQ.0000000000000280","url":null,"abstract":"Hypoglycemia (defined as blood glucose < 70 mg/dL) is a common medication-related harm event in the inpatient setting. In this study, an electronic-based trigger was developed to identify hypoglycemic cases and subsequently analyze reasons for insulin-mediated hypoglycemic events in hospitalized patients. After a multistep validation approach, the trigger identified 111 hypoglycemic events between January 1 and December 31, 2023. Qualitative analysis of these events revealed that the most common reason for hypoglycemia was related to insulin orders, particularly starting or adjusting insulin at too high of a dose and failing to discontinue insulin despite falling glucose levels. Other emerging themes that provided short-term areas for improvement included changes in dietary status and hyperkalemia treatment. Overall, given that multiple causative etiologies emerged during analysis, prevention of hypoglycemia in hospitalized patients will require multifaceted solutions, including the formation of educational groups for providers who prescribe insulin.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"69-77"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Automation in Surgical Adverse Event Documentation: Improving Completeness and Accuracy. 外科不良事件记录的自动化：提高完整性和准确性。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-03-01 Epub Date: 2026-02-25 DOI: 10.1097/JMQ.0000000000000292

Francis D Graziano, Charles Z Jiang, Bracha L Pollack, Arielle Roberts, Adana-Christine Campbell, Ronnie L Shammas, Lillian A Boe, Babak J Mehrara, Jonas A Nelson, Carrie S Stern

{"title":"Automation in Surgical Adverse Event Documentation: Improving Completeness and Accuracy.","authors":"Francis D Graziano, Charles Z Jiang, Bracha L Pollack, Arielle Roberts, Adana-Christine Campbell, Ronnie L Shammas, Lillian A Boe, Babak J Mehrara, Jonas A Nelson, Carrie S Stern","doi":"10.1097/JMQ.0000000000000292","DOIUrl":"10.1097/JMQ.0000000000000292","url":null,"abstract":"Manual recording of surgical adverse events (AEs) is often incomplete and inconsistent. Automated systems linking structured notes to surgical secondary events (SSE) databases may improve accuracy and efficiency. We retrospectively compared surgeries from October 2021 to April 2022 (manual reporting) and January to July 2023 (automated reporting). In the automated cohort, AEs were captured via a structured note-linked SSE database. Outcomes included completeness-the proportion of AEs in notes also recorded in the SSE database-and accuracy, defined by concordance for procedure, complication type/grade, and management. Baseline demographics were similar between cohorts. Completeness improved from 20% to 94% ( P < 0.001). Minor AE capture increased from 7% to 96% ( P < 0.001), and major AE capture from 29% to 92% ( P < 0.001). Automated SSE reporting substantially improved the completeness and accuracy of surgical AE documentation, particularly for minor events, supporting more reliable surgical quality data collection.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"84-89"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pharmacoequity: What Should be Done to Improve It? 药物公平：如何改善它？

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-03-01 Epub Date: 2026-01-13 DOI: 10.1097/JMQ.0000000000000283

Elizabeth Sottung, Vietbao Phan, Willie H Oglesby, Vittorio Maio

引用次数: 0

Advance Care Planning, Race, and Age. 提前护理计划，种族和年龄。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-03-01 Epub Date: 2026-02-19 DOI: 10.1097/JMQ.0000000000000285

Rebecca E Berger, Monika M Safford, Jennifer I Lee, Mangala Rajan, Margaret L McNairy, Andrea Card, Lisa M Kern

{"title":"Advance Care Planning, Race, and Age.","authors":"Rebecca E Berger, Monika M Safford, Jennifer I Lee, Mangala Rajan, Margaret L McNairy, Andrea Card, Lisa M Kern","doi":"10.1097/JMQ.0000000000000285","DOIUrl":"10.1097/JMQ.0000000000000285","url":null,"abstract":"There are well-documented racial disparities in the provision of end-of-life care and advance care planning (ACP). It is unclear whether these observed disparities are explained by other variables. This analysis sought to determine whether any apparent racial disparities among general medicine inpatients in the provision of ACP services persisted after adjustment for potential confounders. The authors conducted a secondary analysis of electronic health records data collected as baseline data for a quality improvement program. The analysis included all patients who were discharged by hospitalists at an academic medical center from 4 general medicine inpatient units from July 2022 to June 2023, and who were identified as having limited life expectancy. The independent variables were demographic and clinical characteristics. The dependent variable was a composite of 4 ACP process measures (palliative care consultation, hospice discharge, comfort care status, or ACP note). Poisson regression was used to determine the association between patient characteristics and any ACP service. The analysis included 580 hospitalizations for 552 eligible patients. Patients had an average age of 73.8 years (SD 17.1), 54.5% were female, 51.3% were non-Hispanic White, 74.6% had Medicare, 43.8% had cancer, 20.5% had dementia, and 7.8% had heart failure. In unadjusted analyses, non-Hispanic Black patients were less likely to receive ACP services. However, when adjusted for age, sex, insurance, and medical conditions, the apparent racial disparity did not persist. To accurately assess health disparities in the context of quality improvement, adjustment for potential confounders may be needed.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"78-83"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Targeted Deprescribing of PPIs in Ambulatory Care: Outcomes From a Resident-Led, Pharmacist Supported Intervention. 门诊护理中PPIs的目标处方：来自住院医师主导、药剂师支持干预的结果。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-03-01 Epub Date: 2026-03-12 DOI: 10.1097/JMQ.0000000000000288

Himsikhar Khataniar, Hany Habib, Ikram Khaliq, Helene Bloom, Kevin Taffe

引用次数: 0

Quality Improvement Assessment on Diversity, Equity, and Inclusion Initiatives in US Medical Schools. 美国医学院多样性、公平性和包容性倡议的质量改进评估。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-03-01 Epub Date: 2026-03-12 DOI: 10.1097/JMQ.0000000000000289

Munifa King, Maryam Edris, Renee Bicaba, Zavia King, Byron Scott

引用次数: 0