American journal of medical quality : the official journal of the American College of Medical Quality最新文献_第6页

Rethinking the Design of Adolescent Crisis Stabilization Units: A Mixed-Methods Study Using Physical Mock-Up Simulations and Artificial Intelligence. 重新思考青少年危机稳定单元的设计：使用实体模型模拟和人工智能的混合方法研究。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 Epub Date: 2026-04-13 DOI: 10.1097/JMQ.0000000000000300

Roxana Jafarifiroozabadi, Cheng Zhang, Stephen Parker, Virginia Pankey, Hani Patel, Neil Gautam, Chih-Chuan Hsu

{"title":"Rethinking the Design of Adolescent Crisis Stabilization Units: A Mixed-Methods Study Using Physical Mock-Up Simulations and Artificial Intelligence.","authors":"Roxana Jafarifiroozabadi, Cheng Zhang, Stephen Parker, Virginia Pankey, Hani Patel, Neil Gautam, Chih-Chuan Hsu","doi":"10.1097/JMQ.0000000000000300","DOIUrl":"10.1097/JMQ.0000000000000300","url":null,"abstract":"Limited research has examined safety features in nonhospital settings for adolescents experiencing behavioral health crises, including the crisis stabilization unit (CSU). This mixed-methods study investigated safety through design features (eg, open versus semi-enclosed nursing stations) in an adolescent CSU with experts (clinicians and health care designers) and design trainees (N = 17) using physical mock-up simulations and artificial intelligence (AI). Participants' feedback was obtained using questionnaires and focus groups. Simulations were video-recorded, manually coded, and an AI-driven tool was developed for automatic, real-time analysis of videos. Findings revealed that experts rated the semi-enclosed nursing station higher in visibility, whereas design trainees reported significantly higher perceived privacy in the open nursing station ( P = 0.036). AI-driven video analyses demonstrated high-accuracy performance in detecting and tracking participants (>80%) when compared with manual data. This study proposed a methodology to improve safety in future adolescent CSUs by integrating AI-driven tools and clinical mock-up simulations during the design process.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"139-150"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648248","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

Increasing Life Sustaining Treatment Note Completion in High-Risk Veterans at VA San Diego. 在退伍军人圣地亚哥增加高风险退伍军人的生命维持治疗记录完成。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 DOI: 10.1097/JMQ.0000000000000296

April Butler, John Temple

引用次数: 0

An Algorithmic Framework for Reducing Near-Fatal Aspiration Events: A Single-Institution Experience. 减少近乎致命的意外事件的算法框架：单一机构的经验。

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.0000000000000291

Shaarada Srivatsa, Gregory Glauser, Abby Gross, Kelly Nimylowycz, Corey Gentle, Tonya Moyse, Stacey Claus, Toms Augustin

{"title":"An Algorithmic Framework for Reducing Near-Fatal Aspiration Events: A Single-Institution Experience.","authors":"Shaarada Srivatsa, Gregory Glauser, Abby Gross, Kelly Nimylowycz, Corey Gentle, Tonya Moyse, Stacey Claus, Toms Augustin","doi":"10.1097/JMQ.0000000000000291","DOIUrl":"10.1097/JMQ.0000000000000291","url":null,"abstract":"Aspiration-related cardiopulmonary arrests (CPAs) in hospitalized patients have a survival rate under 10%, representing a serious preventable complication. In October 2023, a multidisciplinary group of physicians, nurses, and safety specialists was formed. Review of aspiration cases from 2020 to 2024 and root cause analysis identified 3 factors: unrecognized risk, refusal of nasogastric (NG) tubes, and inconsistent application of aspiration precautions. Targeted interventions included nurse and resident education, expanded swallow screens, revised NG tubes management, and new signage to flag high-risk patients. From 2020 to 2023, there were 72 aspiration-related CPAs. Following the implementation of the countermeasures, aspiration-related CPAs decreased by 52% between 2023 and 2024 (27 events vs 13 events). Statistical process control analysis using a c-chart demonstrated a significant shift below the median with 12 consecutive points under the centerline. A multipronged, multidisciplinary approach effectively reduced fatal aspiration events, suggesting comprehensive education, improved screening, and standardized precautions can lower the incidence of aspiration-related CPAs.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"126-132"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147506007","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

Documentation Is Care: Language, OpenNotes, and the Recorded Patient. 文档就是护理：语言、OpenNotes和记录的病人。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 DOI: 10.1097/JMQ.0000000000000302

Erin Rizor

引用次数: 0

Effective Physician-Nurse Communication: Foundation of Patient-Centered Care. 有效的医护沟通：以病人为中心护理的基础。

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.0000000000000303

Farzana Hoque

引用次数: 0

Reducing ED Boarding Time as the Key to Minimizing Admission Delays: A Quality Improvement Initiative. 减少急诊科登机时间是减少入院延误的关键：一项质量改进计划。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 DOI: 10.1097/JMQ.0000000000000294

Gina Moon, Muhammad Karim, Victoria Corbin, Jesse Davis, Heather Smith, George Kurdgelashvili

引用次数: 0

Quality Improvement Methods for Improving Diabetic Retinopathy Screening Rates at a Large Academic Medical Center and Affiliate Medical Group. 在大型学术医疗中心和附属医疗集团提高糖尿病视网膜病变筛查率的质量改进方法。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-05-01 Epub Date: 2026-02-25 DOI: 10.1097/JMQ.0000000000000287

John Brown, Mariam Eldeib, Barbara Scherbaum, Manjot K Gill

{"title":"Quality Improvement Methods for Improving Diabetic Retinopathy Screening Rates at a Large Academic Medical Center and Affiliate Medical Group.","authors":"John Brown, Mariam Eldeib, Barbara Scherbaum, Manjot K Gill","doi":"10.1097/JMQ.0000000000000287","DOIUrl":"10.1097/JMQ.0000000000000287","url":null,"abstract":"Diabetic eye exams are essential for the detection of diabetic retinopathy (DR); however, screening rates remain below the Healthy People 2030 target of 70%. At Northwestern Medicine, screening rates for DR were as low as 49.7%, highlighting care gaps in Chicagoland. A qualitative improvement initiative informed through Plan-Do-Study-Act cycles, root cause analysis, and data-driven decision-making was implemented. Key interventions included point-of-care retinal imaging, previsit questionnaires, practice advisory tools, clinical decision support updates, and community health worker integration. Screening rates of DR significantly increased from 49.7% to 57% within a 22-month period by improving patient access and care coordination. Same-day exam availability, seamless referrals, and targeted outreach addressed barriers to care while closing gaps effectively. This article offers interventions for elevating diabetic eye exam screening rates while sharing lessons learned and resources to adopt best practices that benefit patient outcomes and health care systems.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"110-118"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286808","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

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

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