American journal of medical quality : the official journal of the American College of Medical Quality最新文献_第8页

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

Physician Practices Promoting Effective Communication with Nurses: A Qualitative Study. 促进与护士有效沟通的医师实践：一项定性研究。

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.0000000000000279

Claire Howlett, Esther Y Hsiang, Molly A Kantor, Sarah J Flynn

{"title":"Physician Practices Promoting Effective Communication with Nurses: A Qualitative Study.","authors":"Claire Howlett, Esther Y Hsiang, Molly A Kantor, Sarah J Flynn","doi":"10.1097/JMQ.0000000000000279","DOIUrl":"10.1097/JMQ.0000000000000279","url":null,"abstract":"Although effective physician-nurse communication has been associated with improved healthcare quality and patient safety outcomes, few studies have explored physician practices that foster high-quality communication. In this study, we aimed to identify physician behaviors that promote effective communication with bedside nurses in the inpatient setting. Using purposeful sampling, we recruited physicians who were identified as excellent communicators by bedside nurses to participate in semi-structured interviews exploring workflows, communication methods, and attitudes toward interprofessional collaboration. Data were analyzed using inductive content analysis. Interviews identified that physicians prioritized communication with bedside nurses in their daily workflows and employed specific techniques to enhance communication quality. Three key themes emerged: (1) consistent daily communication workflows; (2) intentional communication; and (3) deliberate relationship-building. Results highlight opportunities to improve communication through physician- and system-level interventions to integrate structured communication practices into daily workflows and promote relationship-building between physicians and nurses.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954826","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

Utilizing a Stakeholder Driven Approach in Developing a Regional Perinatal Psychiatry Access Program. 利用利益相关者驱动的方法在发展区域围产期精神病学访问计划。

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.0000000000000282

Meredith Spada, Colleen Gianneski, Shivali Hariharan, Chiamaka Ejinaka, Shinnyi Chou, Elizabeth Krans, Abigail Schlesinger, Heather M Joseph, Jody B Glance, Belinda Sirianni, Alison Boast, Robert Ferguson, Priya Gopalan

{"title":"Utilizing a Stakeholder Driven Approach in Developing a Regional Perinatal Psychiatry Access Program.","authors":"Meredith Spada, Colleen Gianneski, Shivali Hariharan, Chiamaka Ejinaka, Shinnyi Chou, Elizabeth Krans, Abigail Schlesinger, Heather M Joseph, Jody B Glance, Belinda Sirianni, Alison Boast, Robert Ferguson, Priya Gopalan","doi":"10.1097/JMQ.0000000000000282","DOIUrl":"10.1097/JMQ.0000000000000282","url":null,"abstract":"The authors conducted a stakeholder survey to inform the development of a regional perinatal access program. Sixty-one (22.4%) stakeholders in total completed the survey. Ninety-two percent agreed that their perinatal patients would benefit from the availability of a perinatal access program, and 90% agreed or strongly agreed that they would utilize a perinatal access program if available. The survey also showed that stakeholders indicated relative comfort with anxiety and depression and its management, and low comfort with more complex psychiatric topics. When the program opened services to the region, after the first 100 calls, 21 satisfaction surveys were completed (21%) following telephone consultation with a perinatal psychiatrist. The program was universally rated as 5/5 stars, suggesting that stakeholder needs are being met.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"50-57"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286805","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

Optimizing Organizational Safety: The Role of Tier 4 Huddles in Escalation Management. 优化组织安全：四级会议在升级管理中的作用。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-01-01 Epub Date: 2025-12-12 DOI: 10.1097/JMQ.0000000000000277

Mallory A Koshiol, William Kirven, Akua B Osei-Bonsu, Juliana Aadland, Venkateshwaran K Iyer, Ganesh Asaithambi

{"title":"Optimizing Organizational Safety: The Role of Tier 4 Huddles in Escalation Management.","authors":"Mallory A Koshiol, William Kirven, Akua B Osei-Bonsu, Juliana Aadland, Venkateshwaran K Iyer, Ganesh Asaithambi","doi":"10.1097/JMQ.0000000000000277","DOIUrl":"10.1097/JMQ.0000000000000277","url":null,"abstract":"In high-reliability organizations, early detection and escalation of safety risks are critical to averting harm. Tiered safety huddles are forums for surfacing weak signals and escalating risk concerns from the frontline unit to executive leadership. We assessed the effect of a tier 4 safety huddle format redesign on reporting within a multihospital system. We conducted a retrospective observational study using 120 paired tier 4 huddle reports (60 pre-redesign and 60 postredesign). Huddle reports were evaluated using a red/green framework, where items were tagged red when they signaled an urgent safety concern. The tier 4 huddle format was redesigned in April 2024 to include: high-reliability organization principles, standardized electronic reporting, and leader accountability. Red look-back (retrospective) and red look-ahead (prospective) items were compared. Red items were identified in 100% of reports. After the redesign, red look-back reports more than doubled (mean 9.02 versus 4.15; P < 0.001), and red look-ahead reports significantly increased (mean 5.40 versus 4.12; P < 0.001). In conclusion, a structured, system-wide tier 4 safety huddle format resulted in increased reporting of urgent safety concerns. Findings suggest improved escalation of both retrospective and prospective concerns, supporting situational awareness and proactive risk management in complex health care systems, and strengthening safety culture.","PeriodicalId":101338,"journal":{"name":"American journal of medical quality : the official journal of the American College of Medical Quality","volume":" ","pages":"22-26"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728055","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

Structuring for Success: A Framework for Building a Cardiovascular Center of Excellence. 构建成功：构建卓越心血管中心的框架。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-01-01 Epub Date: 2025-09-19 DOI: 10.1097/JMQ.0000000000000268

Adam C Powell, Ronald C Whiting, Jacque J Sokolov

{"title":"Structuring for Success: A Framework for Building a Cardiovascular Center of Excellence.","authors":"Adam C Powell, Ronald C Whiting, Jacque J Sokolov","doi":"10.1097/JMQ.0000000000000268","DOIUrl":"10.1097/JMQ.0000000000000268","url":null,"abstract":"Cardiovascular programs are often high-cost, high-volume service lines plagued by fragmentation and inconsistent governance. This article presents a structured framework for developing a cardiovascular center of excellence (CVCOE) to enhance care quality and strategic integration. A CVCOE is a purpose-built program defined by three interdependent layers-foundational infrastructure, clinical pillars, and governance-unified through a physician-led clinical model that drives the business and operating models. Drawing on implementation experience across diverse hospital settings, the framework provides a roadmap for aligning structural investments with evidence-based care delivery and organizational capacity. It introduces a two-stage lifecycle: an initial implementation stage to achieve clinical and financial viability, followed by a maintenance stage focused on iterative quality improvement and potential scope expansion. By embedding leadership and quality systems at the structural level, this model offers hospitals and health systems a replicable approach to optimizing cardiovascular services and creating the conditions needed for better outcomes.","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":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082976","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

Protocolizing Natriuresis-Guided Inpatient Diuretic Therapy in Acute Decompensated Heart Failure. 急性失代偿性心力衰竭患者在钠疗指导下的住院利尿治疗方案。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-01-01 Epub Date: 2025-12-31 DOI: 10.1097/JMQ.0000000000000276

Pranav Puri, Ethan Kuperman, Chad M McPherson, Jonathan M Nizar, Ernesto Ruiz

引用次数: 0

Analyzing the Impact of the "Faculty Quality Collaborative": A Quality Improvement Training Experience for Physicians. “教师素质协作”对医师素质提升培训的影响分析。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-01-01 Epub Date: 2025-10-23 DOI: 10.1097/JMQ.0000000000000270

Mitchell J Gitkind, Meghna C Trivedi, Joann L Wagner, Allan J Walkey, Kimberly A Fisher, Penelope Iannelli

{"title":"Analyzing the Impact of the \"Faculty Quality Collaborative\": A Quality Improvement Training Experience for Physicians.","authors":"Mitchell J Gitkind, Meghna C Trivedi, Joann L Wagner, Allan J Walkey, Kimberly A Fisher, Penelope Iannelli","doi":"10.1097/JMQ.0000000000000270","DOIUrl":"10.1097/JMQ.0000000000000270","url":null,"abstract":"Despite a longstanding connection of quality improvement methodology to health care, challenges related to training physicians in this area continue, and knowledge about downstream results is limited. To address these gaps, a team of local educators, including physicians, began by developing a novel quality improvement training experience, the Faculty Quality Collaborative. Content was delivered over a full day, book-ended by a total of 3 hours of independent study. The training was delivered to over 100 physicians between 2021 and 2024, and this group was then surveyed about the effects on their professional roles. The survey aimed to capture overall experience, subsequent participation in quality improvement efforts, dissemination of learnings, and enhancement of educational, clinical, and administrative responsibilities. Survey respondents cited impacts in all these areas. The findings suggest this type of physician-targeted training can lead to meaningful engagement in related activities and help support broader educational and clinical goals.","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":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350865","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

Trauma-Informed Care Through the Lens of Immigration-Related Trauma: A Medical Education Intervention. 透过移民相关创伤的镜头了解创伤护理：医学教育干预。

American journal of medical quality : the official journal of the American College of Medical Quality Pub Date : 2026-01-01 Epub Date: 2025-12-31 DOI: 10.1097/JMQ.0000000000000274

Julia Gillan, Betsy Mathew, Jessica Occhiogrosso, Nathalia Arias-Alzate, Kristen M Coppola, Karen W Lin

引用次数: 0