American journal of medical quality : the official journal of the American College of Medical Quality最新文献

{"title":"Creating a Pediatric Cardio-Oncology Clinic for Childhood Cancer Survivors.","authors":"Kimberly Davidow, Emi H Caywood, Takeshi Tsuda, Alison Hong","doi":"10.1097/JMQ.0000000000000210","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000210","url":null,"abstract":"","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":"40 1","pages":"26-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030663","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}

{"title":"Depression and Distress Screening in Oncology Patients: A Descriptive Analysis.","authors":"Chelsey R Ali, Alexander M Litvintchouk, Patrick Moeller, Raegan Davis, Emma Hannan, Vittorio Maio, Valerie P Csik","doi":"10.1097/JMQ.0000000000000212","DOIUrl":"10.1097/JMQ.0000000000000212","url":null,"abstract":"<p><p>This retrospective study aimed to describe the characteristics of cancer patients undergoing depression and distress screening at the Sidney Kimmel Cancer Center and to assess factors associated with their screening results. Data were retrieved from electronic medical records of adult Sidney Kimmel Cancer Center patients with at least one oncology encounter between January 2021 and June 2022, who underwent both depression and distress screening using the Patient Health Questionnaire-2/9 for depression and the National Comprehensive Cancer Network distress thermometer for distress during the encounter. Demographics, clinical factors, and screening results were analyzed using descriptive statistics and binary logistic regression. A total of 1954 cancer patients were screened for psychological needs. Of these, 110 (5.6%) screened positive for depression and 830 (42.5%) screened positive for distress. About 69.1% of patients who screened positive for depression also screened positive for distress. Conversely, 9.2% of patients who screened positive for distress also screened positive for depression. Cancer patients >65 years old were found significantly less likely to screen positive for both distress and depression, while males were found significantly less likely to screen positive for distress. African American patients were found to be significantly more likely than White patients to screen positive for both distress and depression (odds ratio: 2.58; confidence interval: 1:53-4.34). In this study, a higher proportion of cancer patients were found to be distressed than depressed, suggesting that the National Comprehensive Cancer Network distress thermometer may be a more useful tool in identifying psychosocial concerns in this population. Differences in depression and distress scores were significantly associated with age, sex, and race. These findings highlight the need for the implementation of effective screening strategies to better address the psychosocial needs of cancer patients. Further research is warranted to validate these findings and assess the impact of distress screening on patient outcomes across various oncology settings.</p>","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960945","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}

{"title":"Why We Still Kill Patients.","authors":"Michael L Millenson","doi":"10.1097/JMQ.0000000000000213","DOIUrl":"10.1097/JMQ.0000000000000213","url":null,"abstract":"","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"24-25"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960948","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}

{"title":"Implementing Self-Measured Blood Pressure in Primary Care: A Feasible and Systematic Approach.","authors":"Stavros Tsipas, Laken Barkowski, Neha Sachdev, Afnan Ammar, Carissa Huff, Christina Harsant, Gregory Wozniak","doi":"10.1097/JMQ.0000000000000218","DOIUrl":"10.1097/JMQ.0000000000000218","url":null,"abstract":"<p><p>Randomized clinical trials and clinical practice guidelines recommend the use of self-measured blood pressure (SMBP) to help improve the treatment of patients with hypertension. Many clinicians use SMBP in their practices, but there is significant variability in how SMBP is implemented in their day-to-day practice. This quality improvement study details the pragmatic and real-world approach clinicians and administrators used at 3 sites of the IHA Medical Group, a part of Trinity Healthcare, to implement the American Medical Association (AMA) 7-Step SMBP framework as part of the larger AMA hypertension quality improvement program AMA MAP BP. The SMBP program included distributing SMBP devices, training patients on SMBP use, capturing and recording SMBP values in the electronic health record, using SMBP readings in treatment decisions, and receiving reimbursement for patient training and education. Of 331 patients enrolled, 98% of patients had at least 1 return visit within a year. Average systolic blood pressure was reduced by 8 mm Hg between the first and last office visit, and blood pressure control rates increased from 33.5% to 63.5% in these patients. Among patients with one return visit, 46% had documented SMBP readings and 71% were treated with medications. Payors reimbursed 95% of claims submitted for patient training.</p>","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":"40 1","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030665","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}

{"title":"Measuring Improvement Capabilities in a Health System: Findings From a Content Validity Study.","authors":"Steve Meurer, Suzy Escalante","doi":"10.1097/JMQ.0000000000000208","DOIUrl":"10.1097/JMQ.0000000000000208","url":null,"abstract":"<p><p>Measurable improvements in the American Healthcare System have been elusive. To understand why, a survey measuring improvement capabilities in a health system was developed from a 2002 tool that measured an outdated quality improvement methodology. That survey was tested for content validity and achieved an overall representativeness content validity index of 87.5%. From the responses and discussions with the subject matter experts, 3 reasons emerged as to why a lack of improvement occurs in key metrics on a balanced scorecard. These 3 were the decentralization of improvement efforts, waning leadership attention, and presenting information rather than insights.</p>","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":"39 6","pages":"261-266"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960944","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}

{"title":"Improving Provider Compliance with Recommended Lab Monitoring for Patients on Mood Stabilizers and Atypical Antipsychotics.","authors":"Alisha Agrawal, Benjamin H Shapiro, Joshua D Prickel","doi":"10.1097/JMQ.0000000000000184","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000184","url":null,"abstract":"","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":"39 6","pages":"295-296"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960938","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}

{"title":"Clinical Staff Perceptions of Pay-for-Performance Financial Incentives for HPV Vaccine Promotion.","authors":"Vanessa Rodriguez, Kathryn Brignole, Tara Licciardello Queen, Justin G Trogdon","doi":"10.1097/JMQ.0000000000000207","DOIUrl":"10.1097/JMQ.0000000000000207","url":null,"abstract":"<p><p>The purpose was to investigate clinical staff perceptions of pay-for-performance human papillomavirus (HPV) vaccination financial incentives. In 2022, the authors conducted a national survey of clinical staff (N = 2527; response rate = 57%). Respondents were (1) certified to practice in the United States; (2) practiced as a physician, physician assistant, nurse practitioner, advanced practice nurse, registered nurse, licensed practical/vocational nurse, medical assistant, or certified nursing assistant; (3) worked in pediatrics, family medicine, or general medicine specialties; and (4) had a role in HPV vaccination for children ages 9 through 12 years. The team used ordered regressions to model whether respondents agreed with (ie, \"Strongly agreed\" or \"Agreed\" on a 5-point Likert scale) each of the 9 statements. The statements were mapped to domains based on the theory of planned behavior: attitudes (5 statements), perceived behavioral control (2), and norms (2). Favorable responses to 9 statements ranged from 32% to 85%; 5/9 items had more than 50% favorable responses. The following example odds ratios (ORs) are for \"agree\" versus \"neutral\" or \"disagree\" to change their behavior to obtain the incentive. Clinical staff with prior experience with incentives were more likely to agree with 8/9 positive statements about incentives (eg, OR = 1.32 [95% confidence interval {CI}: 1.12-1.57]). Family medicine clinics were more likely than pediatric clinics to agree with 5/9 statements (eg, OR = 1.42 [95% CI: 1.18-1.70]). Clinical staff with more years of experience were less likely to agree with 6/9 statements (eg, OR = 0.97 [95% CI: 0.97-0.98]). Clinical staff's perceptions of pay-for-performance HPV vaccination financial incentives were generally favorable.</p>","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"267-274"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550015","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}

{"title":"Expanding Naloxone Coprescribing at a Regional VA Medical Center.","authors":"Jeremy Zhang, Kathie Zhang, Joseph Phillips, Michael C Sauer, Sarah Van Dorin, Patrick Watson, Lauren Zabel, Emily Peters, Yvonne De Sloover Koch, Ethan F Kuperman, Matthew D Soltys","doi":"10.1097/JMQ.0000000000000209","DOIUrl":"10.1097/JMQ.0000000000000209","url":null,"abstract":"<p><p>Veterans are disproportionately affected by chronic pain and are more likely to be prescribed opioids. As a means of risk mitigation, the Centers for Disease Control and Prevention and Department of Defense recommend naloxone for patients on opioids with risk factors, including use of ≥50 morphine milligram equivalents daily, concurrent benzodiazepine/sedative use, and pulmonary or liver disease. An interprofessional quality improvement team consisting of 6 residents, a pharmacist, a nurse educator, and a faculty mentor was formed to increase naloxone coprescriptions at a regional VA medical center Continuity of Care Clinic. Primary intervention identified eligible patients via the VA Primary Care Almanac's Opioid Therapy Risk Report and alerted providers by email and secure messaging. Naloxone coprescription rates increased from 42% initially in June 2022 to 82% by June 2023 (29/69 to 41/50 patients, P < 0.0001). This project demonstrates that notifying providers of high-risk patients can significantly increase naloxone coprescriptions.</p>","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"275-279"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592449","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}

{"title":"Improved Cardiac Rehabilitation Referral Rates following Coronary Artery Bypass Graft and Heart Valve Replacement in an Inner-City Veteran Population.","authors":"Akash Gopal, Ian Detroyer, Neiberg de Alcantara Lima, Preeti Ramappa","doi":"10.1097/JMQ.0000000000000206","DOIUrl":"10.1097/JMQ.0000000000000206","url":null,"abstract":"<p><p>Cardiac rehabilitation (CR) is underutilized due to various barriers, despite its known benefits in decreasing 5-year mortality after cardiac surgery. The authors initiated a quality improvement project to identify barriers and enhance CR referral rates and participation. The team conducted a retrospective review of cardiac surgery patients from 2015 to 2022 at the Detroit Veterans Affairs. Phase 1 covered 2015-2017 (preintervention), phase 2 was the intervention period, and phase 3 covered 2018-2022 (postintervention). Appropriate CR referral was defined as within 6 months postevent. Referral rates and 1-year post-op hospitalization were assessed. Group 1 (2015-2017) had 54 male patients, 44% Black, 89% hypertensive, with a 22% CR referral rate. Group 2 (2018-2022) had 98 male patients, 64% Caucasian, mean age 73 years, with a 36% CR referral rate postintervention ( P = 0.0018). One-year hospitalization decreased from 26% to 13% ( P = 0.20). CR is still an underutilized tool. Provider education and complete funding of CR can improve referral rates and participation.</p>","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"280-284"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550016","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}

{"title":"A Century of Surgical Quality: Origins, Evolution, and Future Directions.","authors":"David B Hoyt, Clifford Y Ko, Frank G Opelka","doi":"10.1097/JMQ.0000000000000205","DOIUrl":"10.1097/JMQ.0000000000000205","url":null,"abstract":"<p><p>Over a century has passed since Ernst A. Codman's pioneering call for surgeons to take open responsibility for patient care, a concept integral to the emergence and leadership of the American College of Surgeons (ACS). Codman's End Result Idea, originating in the early 20th century, laid the groundwork for professional responsibility and accountability in surgical practice, catalyzing the formation of the ACS. His innovative use of the \"end result\" technique at Massachusetts General Hospital highlighted significant variability in surgical outcomes, spurring debates on specialization and accountability. The ACS, under John Bowman's leadership, aimed to ensure optimal care through defined standards and verification mechanisms. Codman's Bone Sarcoma Registry, initiated in 1920, marked an early attempt at quality assessment and improvement through data collection. Despite facing resistance, Codman's vision laid the foundation for modern quality initiatives in surgical care. ACS programs, spanning trauma care to cancer treatment and beyond, have significantly enhanced patient outcomes while reducing costs. Looking forward, advancing surgical quality requires measuring quality, leveraging trusted data, embracing change management, fostering collaboration, and empowering specialists. The future of surgical care depends on collective efforts to uphold standards that ensure optimal care for all.</p>","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"285-289"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550014","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}