American journal of medical quality : the official journal of the American College of Medical Quality最新文献_第5页

Disproportionate Use of Security Response Codes on Black Patients in a Quaternary Academic Center. 第四纪学术中心黑人患者安全响应码使用不当。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-07-01 Epub Date: 2026-04-13 DOI: 10.1097/JMQ.0000000000000305

Emily Mitchell, Ravneet K Waraich, Sophie Goldman, Jacob T Luty, Jeff Gold, Andrea Smeraglio

{"title":"Disproportionate Use of Security Response Codes on Black Patients in a Quaternary Academic Center.","authors":"Emily Mitchell, Ravneet K Waraich, Sophie Goldman, Jacob T Luty, Jeff Gold, Andrea Smeraglio","doi":"10.1097/JMQ.0000000000000305","DOIUrl":"10.1097/JMQ.0000000000000305","url":null,"abstract":"Hospitals use security emergency response codes (SERCs) to manage security threats. This study explored the demographics of SERCs in an academic hospital setting in the Pacific Northwest. A retrospective chart review of all adult emergency department and inpatient encounters between January 2022 and July 2023 was performed. Age-adjusted standardized event ratios were calculated for each racial category and compared using a standardized rate ratio (SRR). Among the 60 957 eligible encounters over the study period, 411 SERCs occurred across 273 (0.45%) encounters. Compared with the demographics of all hospital encounters, SERCs occurred more frequently with patients who were male (n = 2313, 76.2%), English-speaking (n = 402, 97.8%), and younger (18-70 years old, n = 331, 80.6%). A total of 348 SERCs occurred among white individuals, 34 among Black individuals, and 29 among individuals of other racial groups. The age-adjusted standardized event ratio was 1.66 for Black individuals, 0.98 for white individuals, and 0.82 for individuals of other racial groups. The SRR (Black vs white) was 1.70 (95% CI, 1.20-2.40; P = 0.003), indicating a 70% higher standardized event rate among Black individuals compared with White individuals. The SRR (Black vs other racial groups) was 2.02, indicating a 202% higher standardized event rate among Black individuals compared with individuals of other racial groups. This study demonstrates disparities in the frequency of SERC utilization against Black patients. Further investigation into the etiologies leading to SERCs and improved mechanisms of SERC tracking should be undertaken.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"173-177"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648221","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

Reframing "No-Show": Patient-Reported Barriers for Missed Post-Hospital Discharge Primary Care Follow-Up Visits. 重新定义“缺席”：患者报告的错过出院后初级保健随访的障碍。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-07-01 Epub Date: 2026-05-15 DOI: 10.1097/JMQ.0000000000000309

Jessica J Zhang, Brian Le, Erin Dowling, Rosie Brown, Antonio Villarama, Sharon Ramirez, Wendy Simon

{"title":"Reframing \"No-Show\": Patient-Reported Barriers for Missed Post-Hospital Discharge Primary Care Follow-Up Visits.","authors":"Jessica J Zhang, Brian Le, Erin Dowling, Rosie Brown, Antonio Villarama, Sharon Ramirez, Wendy Simon","doi":"10.1097/JMQ.0000000000000309","DOIUrl":"10.1097/JMQ.0000000000000309","url":null,"abstract":"Post-hospital discharge primary care follow-up may reduce readmissions. Missed appointments without cancellation, \"no-show\" visits, may cause missed patient care and system inefficiencies. There is limited research on patient perspectives of barriers to successful completion of post-discharge primary care follow-up visits. In a quality improvement process over 6 weeks, care coordinators called adult patients (N = 36) who had a missed post-discharge primary care follow-up visit with a primary care physician in an academic health system. Of 22 (61%) patients reached, categories of patient-reported barriers were: (1) missed communication opportunities (n = 15) (eg, patient did not know visit was scheduled, did not feel the need to see primary care physician, or forgot); (2) access difficulties (n = 7); and (3) family or work-related issues (n = 2). Most patients completed the rescheduled visit. Continued quality improvement efforts to improve post-discharge primary care follow-up should consider reframing \"no-show\" visits to address communication and access barriers at the health system level.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"186-190"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936793","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

Quality Improvement and Patient Safety in Graduate Medical Education. 研究生医学教育的质量提高与患者安全。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-07-01 Epub Date: 2026-05-25 DOI: 10.1097/JMQ.0000000000000313

Des'ree Garvin, William Hart, Nayda Parisio-Poldiak

引用次数: 0

Increasing Advance Care Planning in a Community Internal Medicine Clinic. 在社区内科诊所增加预先护理计划。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-07-01 Epub Date: 2026-06-30 DOI: 10.1097/JMQ.0000000000000322

Asrita Vattikonda, Mohamed Ibrahim, Dylan Scott, Emily Gansert, Jordan Phillipps, R Christopher Chase, Catherine Madaffari, Jose Raul Valery

{"title":"Increasing Advance Care Planning in a Community Internal Medicine Clinic.","authors":"Asrita Vattikonda, Mohamed Ibrahim, Dylan Scott, Emily Gansert, Jordan Phillipps, R Christopher Chase, Catherine Madaffari, Jose Raul Valery","doi":"10.1097/JMQ.0000000000000322","DOIUrl":"10.1097/JMQ.0000000000000322","url":null,"abstract":"Introduction: Advance care planning (ACP) supports goal-concordant care but remains underused nationally. In resident clinics, limited continuity, short visits, and lack of standardized workflows create barriers to ACP integration. In our Community Internal Medicine resident clinic, ACP discussion was documented in 2.5% of annual physicals, and 19.6% of paneled patients had an advance directive (AD) on file. We aimed to increase ACP documentation from 2.5% to 12.5% within 1 year without increasing perceived resident workflow burden.Methods: We conducted a resident-led quality improvement project using Lean Six Sigma methodology. Three interventions were implemented sequentially: nursing distribution of ACP brochures, an electronic medical record DotPhrase to prompt and document ACP discussions, and targeted patient portal outreach to patients without an AD before annual visits. The primary outcome was documented ACP discussion during annual physicals. Secondary outcomes included AD uploads and ACP consult referrals. The balancing measure was resident-perceived workflow burden. Charts were reviewed over 5-week periods at baseline (n = 118) and after each implementation phase (n = 132, 158, 129).Results: ACP documentation increased from 2.5% at baseline to 12.2%, 17.1%, and 24.0% across sequential phases (χ2(3) = 24.74, P < 0.0001). Pairwise comparisons versus baseline were significant (all P ≤ 0.005). AD upload rate increased from 1.7 to 6.0 per month, and ACP consult referrals increased from 0.0% to 10.9%. Mean perceived workflow burden decreased from 4.9 to 3.0.Conclusion: Workflow-embedded interventions improved ACP documentation, AD uploads, and ACP referrals without increasing perceived resident burden.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":"41 4","pages":"199-205"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335354","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

Improvement in Huddle Participation Among the Child Health Patient Safety Organization. 改善儿童健康患者安全组织的会议参与。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-07-01 Epub Date: 2026-06-09 DOI: 10.1097/JMQ.0000000000000315

Anne Dykes, Matthew Hall, Emily Tooley, Stephanie Burrus, Kelly Johnson, Autumne Harding, Sandip A Godambe

{"title":"Improvement in Huddle Participation Among the Child Health Patient Safety Organization.","authors":"Anne Dykes, Matthew Hall, Emily Tooley, Stephanie Burrus, Kelly Johnson, Autumne Harding, Sandip A Godambe","doi":"10.1097/JMQ.0000000000000315","DOIUrl":"10.1097/JMQ.0000000000000315","url":null,"abstract":"Preventable harm in pediatric care requires coordinated, cross-institutional learning. The Child Health Patient Safety Organization established weekly safety huddles to enhance situational awareness and strengthen a protected learning network under the Patient Safety and Quality Improvement Act. This iterative time-series quality improvement study examined weekly huddle content, assessed targeted interventions to increase participation, and evaluated engagement trends over time. The primary outcome was composite engagement, defined as ≥80% annual attendance and ≥5 submitted reports. Secondary measures included attendance, quarterly reporting, and categorization of reported safety events. Frequently reported events involved medication issues, diagnostic errors, and device malfunctions. Targeted interventions increased composite engagement from 21% to 71.4%, alongside improvements in weekly attendance and quarterly reporting. Organizations also reported using huddle insights to guide internal risk assessments and escalate concerns. Child Health Patient Safety Organization safety huddles improved participation, supported shared learning, and strengthened safety culture consistent with learning-organization and high-reliability principles.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"178-185"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148202033","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

The 2025 Vizient Connections Summit Report: Erratum. 2025年智能连接峰会报告：勘误。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-06-11 DOI: 10.1097/JMQ.0000000000000319

Rand Ballard, Simrit Sandhu, Julie Cerese, John Grande, Juli Hermanson

引用次数: 0

The Linear Illusion: Misdiagnosis in Health Care Improvement. 线性错觉：医疗保健改善中的误诊。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-15 DOI: 10.1097/JMQ.0000000000000316

S Jason Moore

引用次数: 0

Cultivating a Quality Improvement Culture With Mayo Clinic Quality Academy. 与梅奥诊所质量学院一起培养质量改进文化。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 Epub Date: 2026-04-13 DOI: 10.1097/JMQ.0000000000000298

Nelly Tan, Vriddhi Rohila, Chloe Reyes, Ashley Lawrence, Hiliary Phan, Matthew D Cox, April M Gomes, Chendong Ma, Pablo Moreno Franco

{"title":"Cultivating a Quality Improvement Culture With Mayo Clinic Quality Academy.","authors":"Nelly Tan, Vriddhi Rohila, Chloe Reyes, Ashley Lawrence, Hiliary Phan, Matthew D Cox, April M Gomes, Chendong Ma, Pablo Moreno Franco","doi":"10.1097/JMQ.0000000000000298","DOIUrl":"10.1097/JMQ.0000000000000298","url":null,"abstract":"We examined outcomes of a quality improvement (QI) culture implemented through Mayo Clinic Quality Academy by retrospectively reviewing data from QI projects credited from 2019 to 2024. Data analyzed included roles, member count, region, project details, priorities, financial outcomes, methodologies, and lessons learned. During the study period, Mayo Clinic Quality Academy credited 1106 projects involving 10 063 members (median, 8 members per project). Physicians participated in 52.4% of projects, allied health professionals in 83.6%, and nurses in 55.2%. Among all projects, teamwork (54.0%) and efficiency (52.8%) were the most common organizational priorities; among National Academy of Medicine priorities, efficiency was the most common (32.2%), followed by safety (20.7%) and patient-centeredness (18.9%). Model for improvement was the most prevalent QI methodology (29.2%). Most participants (93%) believed the QI project changed the way they work. Cultivating a QI culture influences health care delivery by emphasizing efficiency, teamwork, operational performance, patient outcomes, satisfaction, and financial benefits.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"133-138"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648278","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

"Better Safe Than Sorry?": Reconsidering ADAMTS13 Testing and Plasma Exchange for Suspected aTTP as a High‑Value Care Priority. “安全总比后悔好？”重新考虑ADAMTS13检测和血浆置换对疑似aTTP的高价值护理优先。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 Epub Date: 2026-04-13 DOI: 10.1097/JMQ.0000000000000304

Anil Ananthaneni, Francesca Weis, Gaelen Shimkus

引用次数: 0

Healing the Divide: Bridging Physicians and Healthcare Administrators for Value-Based Care. 弥合鸿沟：为基于价值的护理架起医生和医疗保健管理人员的桥梁。

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.0000000000000299

Tauseef Ali, Adam McConnell, Charles R Gill, Tammy Powell, Kayla A Stangl

{"title":"Healing the Divide: Bridging Physicians and Healthcare Administrators for Value-Based Care.","authors":"Tauseef Ali, Adam McConnell, Charles R Gill, Tammy Powell, Kayla A Stangl","doi":"10.1097/JMQ.0000000000000299","DOIUrl":"10.1097/JMQ.0000000000000299","url":null,"abstract":"Misalignment between physicians and hospital administrators has long challenged US healthcare systems. The COVID-19 pandemic magnified these tensions, with physicians reporting increased burnout and administrators grappling with severe financial pressures. This narrative review synthesizes findings from peer-reviewed studies, national surveys, organizational case examples, and policy reports to evaluate physician-administrator relationships. The analysis identifies 6 thematic areas: shared vision and transparency, governance engagement, incentive alignment, administrative burden, physician well-being, technology and innovation, and organizational trust and culture. The literature consistently documents the persistence of misalignment: physicians cite loss of autonomy and administrative overload, while administrators must manage costs and ensure compliance. Evidence from health systems such as Mayo Clinic, Cleveland Clinic, and rural hospitals demonstrates that structured engagement strategies can mitigate these divides. Bridging the physician-administrator divide is critical for value-based care. In rural areas where hospital closures and workforce shortages are acute, collaborative models are urgently needed. The proposed framework highlights actionable strategies to reduce burnout, enhance retention, and strengthen patient-centered outcomes.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"151-159"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504639","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