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

Promoting a Culture of Civility in High-Reliability Organizations. 在高可靠性组织中促进文明文化。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-03-01 Epub Date: 2025-02-28 DOI: 10.1097/JMQ.0000000000000219

John S Murray, Jeannine Campbell, Stacey Larson

引用次数: 0

Complications of Ambulatory Procedures: Prevalence and Hospital Outpatient Department Variation. 门诊手术的并发症：患病率和医院门诊的变化。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-03-01 Epub Date: 2025-02-06 DOI: 10.1097/JMQ.0000000000000224

Richard L Fuller, John S Hughes, Samuel D Young, Robert Fogerty, Sandeep Wadhwa, Dana Casey, Miki Patterson, Yonghong Chen

{"title":"Complications of Ambulatory Procedures: Prevalence and Hospital Outpatient Department Variation.","authors":"Richard L Fuller, John S Hughes, Samuel D Young, Robert Fogerty, Sandeep Wadhwa, Dana Casey, Miki Patterson, Yonghong Chen","doi":"10.1097/JMQ.0000000000000224","DOIUrl":"10.1097/JMQ.0000000000000224","url":null,"abstract":"Ambulatory procedures performed electively in hospital outpatient departments are of increasing complexity and constitute a growing share of total procedure volume. Despite their importance, little is known of the prevalence of complications from routine procedures once patients are discharged. This study utilizes a 100% Medicare Fee-for-Service claims data file for the years 2019-2022 to assess the relative frequency of hospital-based ambulatory procedures and 30-day patient postprocedure emergency room and hospitalization complication rates utilizing the Ambulatory Potentially Preventable Complication (AM-PPC) classification method. AM-PPC is a claims-based method designed to calculate comparative provider rates of complication exclusively for elective ambulatory procedures excluding procedures performed in hospital emergency departments. The authors calculated the mean rate of ambulatory complications by procedure across hospitals and then compared them for variation in hospital-specific procedure complication rates to the mean rate. About 2.1% of patients receiving a procedure performed in a hospital outpatient department had an emergency room or inpatient hospitalization visit within 30 days. Complication event rates varied widely across hospital outpatient departments and within specific procedures. Hip arthroplasty complication rates varied from 0.0% to 7.6% while those for upper genitourinary procedures varied from 1.7% to 14.2%. In conclusion, the complication rate for ambulatory procedures is seen to vary substantially across hospital outpatient departments for well-established, routine procedures. This study provides a baseline of complication rates for ambulatory procedures, which will be essential for future efforts to improve patient safety.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"44-52"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Data to Improvement: Social Mechanisms as a Key to Understanding Dashboard Adoption. 从数据到改进：社会机制是理解仪表板采用的关键。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-03-01 Epub Date: 2025-02-06 DOI: 10.1097/JMQ.0000000000000225

Tamara Broughton, Anne Marie Weggelaar-Jansen, Sandra Sülz

{"title":"From Data to Improvement: Social Mechanisms as a Key to Understanding Dashboard Adoption.","authors":"Tamara Broughton, Anne Marie Weggelaar-Jansen, Sandra Sülz","doi":"10.1097/JMQ.0000000000000225","DOIUrl":"10.1097/JMQ.0000000000000225","url":null,"abstract":"Research on dashboard adoption has focused on technical and design requirements. Evidence on social mechanisms for successful dashboard adoption is scarce. This study examined 2 quality dashboards in a similar organizational context with different outcomes. The research question was: How do social mechanisms influence the adoption of dashboards in practice? This embedded case study within one Dutch hospital in 2 phases: (1) interviews and observations to identify social mechanisms in the end-user's team and (2) expert focus groups to validate identified mechanisms. Data were transcribed verbatim and analyzed thematically, resulting in the identification of 3 social mechanisms within the team of end-users influencing dashboard adoption: cultivating a supportive team climate, trust, and leadership behavior in end-users' teams. These mechanisms stimulate a learning environment for discussing and improving care quality. They require action from individuals and teams, so dashboards can be used for collective understanding, learning, and improving. Without these social mechanisms, dashboards remain an unadopted \"materiality.\"","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"31-37"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementation of a Trauma Zone Improves Disposition Times for Patients With Intracerebral Hemorrhage or Hip Fracture. 实施创伤区可改善脑出血或髋部骨折患者的处置时间。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-03-01 Epub Date: 2025-02-28 DOI: 10.1097/JMQ.0000000000000220

Tenzin Oshoe, Adam Billig, Darshak Vekaria, Jia Jian Li, Henry Thode, Samita M Heslin

引用次数: 0

Six-Year Retrospective Look at the Effects of Institutional Quality Improvement Efforts to Reduce CAUTIs. 机构质量改进工作对减少 CAUTIs 影响的六年回顾性观察。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-03-01 Epub Date: 2025-02-11 DOI: 10.1097/JMQ.0000000000000216

Jeong Min Kim, Heba Aboshihata, Lee Moldowsky, Stephanie DiGiovanni

引用次数: 0

A Checklist to Improve Acute Stroke Evaluation and Treatment in the Emergency Department. 改进急诊科急性脑卒中评估和治疗的检查表

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-03-01 Epub Date: 2025-02-03 DOI: 10.1097/JMQ.0000000000000217

Meagan Elam, Rachel Moyal-Smith, Madison Canfora, Wendy Cohen, Ki-Do Eum, Christopher Fischer, Judy Margo, Marie McCune, Omer Moin, Magdy Selim, Linda Wendell, Sandeep Kumar

{"title":"A Checklist to Improve Acute Stroke Evaluation and Treatment in the Emergency Department.","authors":"Meagan Elam, Rachel Moyal-Smith, Madison Canfora, Wendy Cohen, Ki-Do Eum, Christopher Fischer, Judy Margo, Marie McCune, Omer Moin, Magdy Selim, Linda Wendell, Sandeep Kumar","doi":"10.1097/JMQ.0000000000000217","DOIUrl":"10.1097/JMQ.0000000000000217","url":null,"abstract":"Narrow therapeutic time windows and delays in assessing acute ischemic stroke patients limit the access to and effectiveness of reperfusion therapies. A 2-year quality improvement project codesigned and tested a checklist for quicker evaluation of suspected stroke cases in 2 emergency departments (EDs). Utility, feasibility, and implementation barriers were assessed through semistructured interviews. The impact on stroke quality metrics was analyzed using bivariate and multivariate regression models with data from the American Heart Association's Get With the Guidelines registry. Implementing the checklist was significantly associated with higher odds of receiving intravenous thrombolytics within 60 minutes of ED arrival (odds ratio: 6.4, 95% confidence interval: 1.1-68.7, P = 0.03). Users felt the checklist improved the standardization of stroke care and promoted teamwork, especially in a time of higher staff turnover. An ED-based stroke checklist resulted in timelier stroke care for acute ischemic stroke patients, meriting further testing in larger, more diverse settings.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"53-63"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082434","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

Clinician Views of an Opioid Prescribing Report with Peer Comparisons and Patient-Reported Outcomes. 临床医生对阿片类药物处方报告的看法与同行比较和患者报告的结果。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-02-18 DOI: 10.1097/JMQ.0000000000000228

Jeffrey P Ebert, E Madeline Grenader, Rachel E Gonzales, Evan A Spencer, Devon M Schroeder, Lauren Southwick, Frances S Shofer, M Kit Delgado, Anish K Agarwal

{"title":"Clinician Views of an Opioid Prescribing Report with Peer Comparisons and Patient-Reported Outcomes.","authors":"Jeffrey P Ebert, E Madeline Grenader, Rachel E Gonzales, Evan A Spencer, Devon M Schroeder, Lauren Southwick, Frances S Shofer, M Kit Delgado, Anish K Agarwal","doi":"10.1097/JMQ.0000000000000228","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000228","url":null,"abstract":"Providing feedback to clinicians on their prescribing is a promising approach to right-sizing opioid prescriptions. The present research investigated the perceived acceptability, appropriateness, helpfulness, and areas for improvement of a monthly report providing surgical clinicians feedback on their postoperative opioid prescribing relative to guidelines, peer prescribing, and patient-reported pills taken, as well as on patient-reported ability to manage pain. Between January and May 2023, surgeons, advanced practice providers, and residents who recently received these reports as part of a health system quality improvement intervention completed a survey (n = 38) or interview (n = 8). Mean (SD) acceptability of the prescribing report was 4.2 (0.8), and appropriateness was 4.2 (0.8); appropriateness varied by clinical role. All features of the report were rated as \"very\" or \"extremely\" helpful by a majority of respondents. Interviewees wished for fuller explanations, real-time updates, and improved accuracy. These findings can inform the design of clinician feedback in learning health systems.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472990","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

Resident-Driven Guideline to Reduce Iatrogenic Pneumothoraxes From Small-Bore Feeding Tubes: A Quality and Safety Improvement Project. 减少由小口径饲管引起的医源性气胸：一项质量和安全改进项目。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-01-01 Epub Date: 2025-01-10 DOI: 10.1097/JMQ.0000000000000215

Sourav Podder, Scott Cowan, Scott Koeneman, Elizabeth Pavis, Doo Park, Christine Schleider, Kathleen Shindle, Matthew Bowen, Adam Johnson

{"title":"Resident-Driven Guideline to Reduce Iatrogenic Pneumothoraxes From Small-Bore Feeding Tubes: A Quality and Safety Improvement Project.","authors":"Sourav Podder, Scott Cowan, Scott Koeneman, Elizabeth Pavis, Doo Park, Christine Schleider, Kathleen Shindle, Matthew Bowen, Adam Johnson","doi":"10.1097/JMQ.0000000000000215","DOIUrl":"10.1097/JMQ.0000000000000215","url":null,"abstract":"Small-bore feeding tubes (SBFT) in vulnerable patients carry a risk of iatrogenic pneumothorax by misplacement into the lung. This institution noted a series of iatrogenic pneumothoraxes caused by the placement of these devices. A resident-led, multidisciplinary team developed a hospital guideline through a consensus-driven process. The guideline mandated SBFT placement by approved \"super-users\" via the CORTRAK Enteral Access System or via non-CORTRAK Methods, including the 2-step X-ray Method, fluoroscopy, or direct visualization techniques. A \"super-user\" Program for the CORTRAK Enteral Access System was developed to assure competency and consistency. With the development of the guideline and \"super-user\" program, the authors observed a decrease in the number of SBFT-related iatrogenic pneumothoraxes. Following a brief period of adoption, the three-hospital organization has had no SBFT-related iatrogenic pneumothoraxes. This project demonstrates the effectiveness of developing a resident-driven, evidence-based hospital guideline for the safe passage of SBFTs.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"8-14"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960947","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

Leveraging Informative Phone Calls by Student Volunteers to Improve Colorectal Cancer Screening Compliance: A Case Study From the Veterans Health Administration. 利用学生志愿者的信息电话提高结直肠癌筛查依从性：来自退伍军人健康管理局的案例研究。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-01-01 Epub Date: 2025-01-24 DOI: 10.1097/JMQ.0000000000000211

Lauren R Hamilton, Benjamin Hewlett, Sepehr Sajadi, Steve T Flynn, Mayan Bomsztyk, Nazima Allaudeen

引用次数: 0

Is Pathogen Molecular Testing Reshaping Outpatient Antibiotic Prescribing? 病原体分子检测正在重塑门诊抗生素处方吗？

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2025-01-01 Epub Date: 2025-01-10 DOI: 10.1097/JMQ.0000000000000214

Barbara D Alexander, William D Irish, Adriana E Rosato, Barry I Eisenstein, Maren S Fragala, Steven E Goldberg, David B Nash

引用次数: 0