American journal of medical quality : the official journal of the American College of Medical Quality最新文献_第7页

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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

Best Practices for Diagnostic Evaluation of Unintentional Weight Loss. 非故意体重减轻诊断评估的最佳实践。

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.0000000000000281

Goutham Rao, Kelsey Ufholz, Sarah Koopman-Gonzalez, Harry Menegay, Sunah Song, Beverly Koepf, Mark Beno

{"title":"Best Practices for Diagnostic Evaluation of Unintentional Weight Loss.","authors":"Goutham Rao, Kelsey Ufholz, Sarah Koopman-Gonzalez, Harry Menegay, Sunah Song, Beverly Koepf, Mark Beno","doi":"10.1097/JMQ.0000000000000281","DOIUrl":"10.1097/JMQ.0000000000000281","url":null,"abstract":"Evidence-based guidance for the evaluation of unintentional weight loss (UWL) is lacking. Using electronic health record data, common diagnostic tests ordered among patients with UWL were identified, as well as their usefulness, by comparing rates of abnormalities to patients without UWL and reviewing reports. Only 38% of cases of UWL were recognized by physicians. Among 1471 patients with recognized UWL, a wide variety of laboratory tests (eg, thyroid-stimulating hormone, complete blood count, prostate specific antigen) potentially related to UWL evaluation were ordered. None of these was more likely to be abnormal in patients with recognized UWL compared with patients without UWL. Neither upper or lower endoscopy nor imaging was found to be useful in identifying a cause. With a stakeholder panel, we developed a conservative approach to UWL. Routine diagnostic evaluation of patients with UWL is not recommended. Patients should monitor their weight weekly as a useful indicator of overall health and undergo recommended routine cancer screening.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"58-68"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954702","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

Implementing High-Value Care with Daily Labs in Internal Medicine Resident Driven Hospital Medicine: A Quality Improvement Project. 在内科住院医师驱动的医院医学中实施高价值的日常实验室护理：一个质量改进项目。

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.0000000000000286

Nudar Bhuiya, Olivera Drobac, Kaynat Khalid, Maidah Raja, Madeline Stull, David Sullivan, Nagaraju Sarabu, William Cook

引用次数: 0

Bridging the Methodological Gap: Integrating Implementation Science With HFACS to Move From Diagnosis to Intervention Design. 弥合方法差距：将实施科学与HFACS整合，从诊断转向干预设计。

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.0000000000000284

Daren Zhao

引用次数: 0