Joint Commission journal on quality and patient safety最新文献

{"title":"Frailty Screening Using the Risk Analysis Index: A User Guide","authors":"Daniel E. Hall MD, MDiv, MHSc, FACS (is Professor of Surgery and Anesthesiology & Perioperative Medicine, University of Pittsburgh, and Core Investigator, Center for Health Equity Research and Promotion, US Department of Veterans Affairs (VA) Pittsburgh Healthcare System.),&nbsp;Carly A. Jacobs MPH (is Health Science Specialist, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System.),&nbsp;Katherine M. Reitz MD, MSc (is Assistant Professor of Surgery, University of Pittsburgh, and Vascular Surgeon, University of Pittsburgh Medical Center.),&nbsp;Shipra Arya MD, SM, FACS (is Professor, Department of Surgery, Stanford University School of Medicine, and Section Chief, Vascular Surgery, VA Palo Alto Healthcare System, Palo Alto, California.),&nbsp;Michael A. Jacobs MS (is Research Health Science Specialist, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System.),&nbsp;John Cashy PhD (is Core Investigator, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System.),&nbsp;Jason M. Johanning MD, MS, FACS (is Professor, University of Nebraska Medical Center, and Chief Surgical Consultant, Nebraska-Western Iowa VA Medical Center. Please address correspondence to Daniel E. Hall.)","doi":"10.1016/j.jcjq.2024.12.005","DOIUrl":"10.1016/j.jcjq.2024.12.005","url":null,"abstract":"<div><div>The Risk Analysis Index (RAI) has emerged as the most thoroughly validated and flexible assessment of surgical frailty, proven feasible for at-scale bedside screening and available in a suite of tools, that effectively risk stratifies patients across a wide variety of clinical contexts and data sources. This user guide provides a definitive summary of the RAI's theoretical model, historical development, validation, statistical performance, and clinical interpretation, placing the RAI in context with other frailty assessments and emphasizing some of its advantages. Detailed instructions are provided for each RAI variant, along with a systematic review of existing RAI–related literature.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 178-191"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038980","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 Time to Diagnosis and Management of Pediatric Patients with Acute Neurologic Dysfunction","authors":"Sandra P. Spencer MD (is Associate Professor, Section of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado.),&nbsp;Nathaniel H. Forman MD (formerly Pediatric Emergency Medicine Fellow, Nationwide Children's Hospital, Columbus, Ohio, is Attending Physician, Pediatric Emergency Medicine, Joe DiMaggio Children's Hospital, Hollywood, Florida.),&nbsp;Melissa G. Chung MD (is Attending Pediatric Neurologist and Critical Care Physician, Nationwide Children's Hospital, and Associate Professor of Clinical Pediatrics, Ohio State University College of Medicine.),&nbsp;Terri Dachenhaus RN, BSN, CPEN (is Nurse Supervisor, Division of Emergency Medicine, Nationwide Children's Hospital.),&nbsp;Annie I. Drapeau MD, MSc, FRCSC (formerly Pediatric Neurosurgeon, Nationwide Children's Hospital, is Pediatric Neurosurgeon and Assistant Professor, Section of Neurosurgery, University of Manitoba.),&nbsp;Christopher Gerity MPH, RT, MRSO (is Clinical Manager of MRI, Nationwide Children's Hospital.),&nbsp;Rodrigo Iglesias MS (is Quality Improvement Specialist, Center for Clinical Excellence, Nationwide Children's Hospital.),&nbsp;Jeremy Y. Jones MD (is Neuroradiology Section Chief, Department of Pediatric Radiology, Nationwide Children's Hospital.),&nbsp;Marlina E. Lovett MD (is Attending Physician, Division of Critical Care Medicine, Nationwide Children's Hospital, and Assistant Professor, Ohio State University College of Medicine.),&nbsp;Julie C. Leonard MD, MPH (is Associate Division Chief for Research in Emergency Medicine, Nationwide Children's Hospital, and Professor, Department of Pediatrics, Ohio State University College of Medicine. Please address correspondence to Sandra P. Spencer)","doi":"10.1016/j.jcjq.2024.12.001","DOIUrl":"10.1016/j.jcjq.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Children presenting to the pediatric emergency department (PED) with neurologic dysfunction require prompt evaluation. Many PEDs successfully implement stroke alerts. However, most pediatric patients presenting with neurologic dysfunction have a non-stroke diagnosis better evaluated using magnetic resonance imaging (MRI). Therefore, we created a Neuro Deterioration clinical pathway using fast MRI to reduce time from PED arrival to completion of radiologic report by 25% in all PED patients presenting with new neurologic dysfunction.</div></div><div><h3>Methods</h3><div>After creating an algorithm and allocating resources, the team used quality improvement methodology to implement a Neuro Deterioration clinical pathway. Interventions focused on patient identification, patient flow, and electronic decision support. Statistical process control charting assessed interventions. The primary outcome measure was time from PED arrival to completion of radiologic report. Additional measures included time from arrival to image finish and percentage of patients on pathway.</div></div><div><h3>Results</h3><div>From 2018 to 2021, time from PED arrival to completion of radiologic report reduced by 32.2%. The average time decrease from a baseline of 211 (<em>n</em> = 287, January 2018–August 2019) to 143 minutes (<em>n</em> = 162, October 2020–December 2021), as noted by a centerline shift on the statistical process control chart. Average time from PED arrival to image finish decreased from 179 to 131 minutes. Percentage of patients on pathway increased. The average age of patients on pathway was 11.5 years, 63.8% were admitted, and 87.5% had a fast MRI for initial imaging. Of the 30.4% of patients with abnormal findings on initial imaging, 85.8% had non-stroke etiologies.</div></div><div><h3>Conclusion</h3><div>The authors created a sustainable Neuro Deterioration clinical pathway to improve time to diagnosis of all pediatric patients with neurologic findings in the PED.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 4","pages":"Pages 252-260"},"PeriodicalIF":2.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005623","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":"Voices of Frontline Leaders: Challenges and Opportunities from Frontline Primary Care Clinic Leaders in a Safety-Net Health Care System","authors":"Jessica Wallace DrPH, MPH, MSHS, PA-C (is Lead Advanced Practice Provider for Family Medicine, Denver Health and Hospital Authority, Denver),&nbsp;Read Pierce MD (is Chief Quality, Safety, and Transformation Officer, Denver Health and Hospital Authority),&nbsp;Thomas J Staff MD, MPH (is Chief Medical Officer, STRIDE Community Health Center, Denver),&nbsp;Rebecca Allyn MD (is Internist, Denver Health and Hospital Authority. Please address correspondence to Rebecca Allyn)","doi":"10.1016/j.jcjq.2024.11.012","DOIUrl":"10.1016/j.jcjq.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>Burnout, disengagement, and turnover among clinicians is a major challenge for the US health care industry. Research has shown that higher direct supervisor leadership scores correlate with decreased provider burnout and increased professional fulfillment. Safety-net health systems such as Federally Qualified Health Centers (FQHCs) face increased challenges due to limited financial resources, more complex social determinants of health among patients, and often fewer physician leaders who can serve as mentors compared to large, integrated health systems.</div></div><div><h3>Methods</h3><div>The authors interviewed frontline physician leaders of primary care clinics in a large, urban FQHC network regarding their approach to leadership, prior training and support, opinions related to provider burnout, and ideas for improvement. Qualitative data analysis was completed using the Immersion–Crystallization method, reaching theme saturation.</div></div><div><h3>Results</h3><div>Key themes were structure of leaders’ roles, challenges in daily leadership that outstripped time set aside for leadership activities, and the nature of and response to team members’ burnout. Leaders found their roles meaningful and viewed themselves as a bridge between institutional decisions and frontline providers. Longer duration in leadership roles, formal and informal mentoring, and networks of support were related to increased confidence. Variation existed in the amount and perceived value of leadership training, development, and support. Physician leaders emphasized the importance of a high-functioning clinic leadership team and expressed frustration with a lack of connection to institutional decision-making. Leaders were empathetic to the drivers of burnout among their teams and strove to assist individual providers while facing challenges from structural causes of burnout.</div></div><div><h3>Conclusion</h3><div>Frontline leaders in safety-net clinics play a powerful role in the well-being and resilience of their provider care teams and typically are highly engaged despite facing significant barriers to success. Investing in development and formal support for frontline physician leaders in primary care safety-net settings is important to ensure their longevity and a resilient provider workforce.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 4","pages":"Pages 261-269"},"PeriodicalIF":2.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005597","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":"Simulation-Based Clinical System Testing of Neonatal Resuscitation Readiness Across a Rural Health System Identifies Common Latent Safety Threats","authors":"Jeffrey Holmes MD (is Attending Physician, Department of Emergency Medicine, Maine Medical Center, Portland, Maine),&nbsp;Micheline Chipman RN (is Clinical Educator, Hannaford Center for Safety, Innovation and Simulation),&nbsp;Beth Gray (is Program Manager, Hannaford Center for Safety, Innovation and Simulation),&nbsp;Timothy Pollick (is Simulation Specialist, Hannaford Center for Safety, Innovation and Simulation),&nbsp;Samantha Piro MBA (is Program Manager, Department of Pediatrics, Barbara Bush Children's Hospital at MaineHealth),&nbsp;Leah Seften (is Children's Health Research Navigator, Department of Pediatrics, Barbara Bush Children's Hospital),&nbsp;Alexa Craig MD, MSc, MS (is Neonatal and Pediatric Neurologist, Department of Pediatrics, Barbara Bush Children's Hospital),&nbsp;Allison Zanno MD (is Neonatologist and Clinical Faculty, Department of Pediatrics, Barbara Bush Children's Hospital),&nbsp;Misty Melendi MD (is Neonatologist and Clinical Faculty, Department of Pediatrics, Barbara Bush Children's Hospital),&nbsp;Leah Mallory MD (is Medical Director, Hannaford Center for Safety, Innovation and Simulation, and Pediatric Hospitalist Department of Pediatrics, Barbara Bush Children's Hospital. Please address correspondence to Leah Mallory)","doi":"10.1016/j.jcjq.2024.11.009","DOIUrl":"10.1016/j.jcjq.2024.11.009","url":null,"abstract":"<div><h3>Background</h3><div>Simulation offers an opportunity to practice neonatal resuscitation and test clinical systems to improve safety. The authors used simulation-based clinical systems testing (SbCST) with a Healthcare Failure Mode and Effect Analysis (HFMEA) rubric to categorize and quantify latent safety threats (LSTs) during in situ training in eight rural delivery hospitals. The research team hypothesized that most LSTs would be common across hospitals. LST themes were identified across sites.</div></div><div><h3>Methods</h3><div>Between May 2019 and May 2023, the neonatal simulation team conducted half-day training sessions including a total of 177 interprofessional delivery room team members. Teams participated in skills stations, followed by in situ simulations with facilitated debriefs. Facilitators included neonatologists and simulation faculty trained in HFMEA. HFMEA rubrics were completed for each site with mitigation strategies captured on follow-up. LSTs were compared across sites.</div></div><div><h3>Results</h3><div>A total of 67 distinct LSTs were identified. Forty-one of 67 (61.2%) were shared by more than one hospital, and 26 (38.8%) were unique to individual hospitals. LSTs were distributed across five systems categories and three teams categories. The 4 LSTs detected at 75% or more of hospitals were lack of clear newborn blood transfusion protocols, inconsistent use of closed-loop communication, inconsistent processes for accessing additional resources, and inconsistent use of a recorder.</div></div><div><h3>Conclusion</h3><div>Use of SbCST across a health system allows for comparison of LSTs at each site and identification of common opportunities to mitigate safety threats. Systemwide analysis provides leaders with data needed to guide resource allocation to track and ensure effective implementation of solutions for prioritized LSTs. Identification of themes may allow other hospitals that have not participated in simulation testing to engage in prospective readiness efforts.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 199-210"},"PeriodicalIF":2.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970926","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":"The Joint Commission Journal on Quality and Patient Safety 50th Anniversary Article Collections: Patient Communication","authors":"","doi":"10.1016/j.jcjq.2024.11.003","DOIUrl":"10.1016/j.jcjq.2024.11.003","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"50 12","pages":"Pages 897-898"},"PeriodicalIF":2.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701719","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":"The Surgical Pause: The Importance of Measuring Frailty and Taking Action to Address Identified Frailty","authors":"Daniel E. Hall MD, MDiv, MHSc, FACS (is Professor of Surgery and Anesthesiology & Perioperative Medicine, University of Pittsburgh, and Medical Director, High Risk Populations and Outcomes, University of Pittsburgh Medical Center (UPMC), and Core Investigator, Center for Health Equity Research and Promotion, US Department of Veterans Affairs (VA) Pittsburgh Healthcare System.),&nbsp;Danielle Hagan MSA (is Management and Program Analyst and Diffusion Specialist, US Department of Veterans Affairs.),&nbsp;LauraEllen Ashcraft PhD, MSW (is Assistant Professor, Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, and Implementation Scientist, US Department of Veterans Affairs.),&nbsp;Mark Wilson MD, PhD (is Executive Director, National Surgery Office, Veterans Health Administration.),&nbsp;Shipra Arya MD (is Professor, Department of Surgery, Stanford University School of Medicine, and Section Chief of Vascular Surgery, VA Palo Alto Healthcare System.),&nbsp;Jason M. Johanning MD, MS, FACS (is Professor, Department of Surgery, University of Nebraska Medical Center, and Chief Surgical Consultant, Nebraska-Western Iowa VA Medical Center. Please address correspondence to Daniel E. Hall)","doi":"10.1016/j.jcjq.2024.11.011","DOIUrl":"10.1016/j.jcjq.2024.11.011","url":null,"abstract":"<div><h3>Conceptual Framework</h3><div>The Surgical Pause is a rapid, scalable strategy for health care systems to optimize perioperative outcomes for high-risk, frail patients considering elective surgery. The first and most important step is to screen for frailty, thereby identifying the 5% to 10% of patients at most risk for postoperative complications, loss of independence, institutionalization, and mortality. The second step is to take action to improve outcomes. Action may include clarifying perioperative goals, optimizing perioperative decision-making, and mitigating frailty-associated risks through prehabilitation.</div></div><div><h3>History of Dissemination</h3><div>Initially implemented at the Omaha Veterans Affairs (VA) Medical Center in 2012, the Surgical Pause was associated with a nearly three-fold survival advantage among the frail. The program was subsequently replicated at more than 50 VA and private sector hospitals with similarly robust results, leading the Veterans Health Administration (VHA) National Surgery Office to formally adopt the program in January 2024. The Joint Commission and the National Quality Forum recognized the program with the Eisenberg Award for Patient Safety and Quality at the National Level.</div></div><div><h3>Lessons Learned</h3><div>Successful dissemination grew from simultaneous real-world quality projects paralleled by rigorous, high-quality, peer reviewed publications demonstrating the need for and impact of the Surgical Pause. Adoption was facilitated in an iterative process to streamline feasibility and leverage existing resources. Success was accelerated by national infrastructure catalyzing a community of practice.</div></div><div><h3>Conclusion</h3><div>The Surgical Pause is changing surgical culture by proactively identifying frail patients, aligning treatment plans with patient-defined goals, optimizing perioperative decisions, and mitigating frailty-associated risks to deliver both quality and value.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 167-177"},"PeriodicalIF":2.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970974","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":"Physicians’ Perspectives on Using Direct Observation to Assess Non-English Language Proficiency for Clinical Practice: A Qualitative Study","authors":"Maria Esteli Garcia MD, MPH, MAS (is Assistant Professor, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, and Senior Scholar, Department of Epidemiology and Biostatistics, University of California, San Francisco (UCSF)),&nbsp;Lisa C. Diamond MD, MPH (is Hospitalist and Research Faculty Member, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York),&nbsp;Mia Williams MD, MS (Associate Professor, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, UCSF),&nbsp;Sunita Mutha MD (is Professor, Department of Medicine, and Director, Healthforce Center, UCSF),&nbsp;Jane Jih MD, MPH, MAS (is Associate Professor, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, UCSF, and Co-Director, Asian American Research Center on Health, San Francisco),&nbsp;Sarita Pathak MPH (is Research Coordinator and PhD Student, Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University),&nbsp;Leah S. Karliner MD, MAS (is Professor and Director, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, UCSF. Please address correspondence to Maria Esteli Garcia)","doi":"10.1016/j.jcjq.2024.11.008","DOIUrl":"10.1016/j.jcjq.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Communication barriers are known to adversely affect patient safety. Yet few health systems assess and track physician non-English language proficiency for use in clinical settings. Barriers to current assessments (usually simulated clinician oral proficiency interviews) include time constraints and lack of interactivity. This study's objective was to investigate physician perspectives on using direct clinical observation as an alternative form of assessment of their non-English language skills.</div></div><div><h3>Methods</h3><div>The authors conducted semistructured interviews with 11 fully and partially bilingual primary care physicians (general internists) from a large academic health system to understand physician perspectives on using direct observation as an alternative form of assessing non-English proficiency for use in clinical practice. Two researchers independently and iteratively coded transcripts using thematic analysis with constant comparison to identify themes.</div></div><div><h3>Results</h3><div>Participants, mostly women (<em>n</em> = 9; 81.8%), reported varying levels of proficiency in Cantonese, Mandarin, Russian, or Spanish. Participants expressed three main themes: (1) benefits of direct observation, including familiar setting, relevant content, and convenience; (2) disadvantages, including discomfort<em>,</em> potential embarrassment, and limitations of observing a single encounter; and (3) suggestions to enhance use of direct observation tools, such as observing multiple encounters, and use of remote observation.</div></div><div><h3>Conclusion</h3><div>To ensure high-quality language-concordant care, health systems must assess physicians’ non-English language proficiency. If validated tools can be developed and disseminated in clinical practice, direct observation may be an acceptable option.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 211-215"},"PeriodicalIF":2.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970947","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":"Protecting Parkinson's Patients: Hospital Care Standards to Avoid Preventable Harm","authors":"Peter Pronovost MD, PhD, FCCM (is Chief Quality and Transformation Officer, University Hospitals Cleveland Medical Center, Cleveland, Ohio),&nbsp;Hooman Azmi MD (is Director, Division of Functional and Restorative Neurosurgery and Trauma Liaison, Hackensack University Medical Center, Hackensack, New Jersey),&nbsp;Michael S. Okun MD (is Executive Director, Norman Fixel Institute for Neurological Diseases, and Adelaide Lackner Professor of Neurology, University of Florida Health, Gainesville, Florida),&nbsp;Benjamin Walter MD, MBA (is Section Head, Movement Disorders, and Medical Director, Deep Brain Stimulation Program, Cleveland Clinic, Cleveland, Ohio),&nbsp;Annie Brooks MSW (is Senior Director, Strategic Initiatives, Parkinson's Foundation, Miami, Florida),&nbsp;Sheera Rosenfeld MHS (is Vice President and Chief Strategic Initiatives Officer, Parkinson's Foundation, Miami, Florida. Please address correspondence to Sheera Rosenfeld)","doi":"10.1016/j.jcjq.2024.08.004","DOIUrl":"10.1016/j.jcjq.2024.08.004","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"50 12","pages":"Pages 890-892"},"PeriodicalIF":2.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675875","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":"Patient and Family Engagement in Infection Prevention During the COVID-19 Pandemic: A Q-Methodology Study with Stakeholders from a Canadian University Health Care Center","authors":"Nathalie Clavel PhD (Assistant Professor, Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal),&nbsp;Jesseca Paquette MSc (Research Professional, Institut de la Statistique du Québec),&nbsp;Anaïck Briand MSc (Nursing Practice Consultant, Department of Nursing, McGill University Health Centre),&nbsp;Alain Biron PhD (Director of Nursing, McGill University Health Centre),&nbsp;Laurence Bernard PhD (Professor, Faculty of Science, Technology and Medicine, University of Luxembourg),&nbsp;Céline Gélinas PhD (Professor, Ingram School of Nursing, McGill University),&nbsp;Mélanie Lavoie-Tremblay PhD (Professor, Department of Nursing, University of Montreal. Please address correspondence to Nathalie Clavel)","doi":"10.1016/j.jcjq.2024.11.005","DOIUrl":"10.1016/j.jcjq.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Health care–associated infections are frequent complications for hospitalized patients, and the COVID-19 pandemic exacerbated this issue. This study aimed to explore stakeholders’ viewpoints on how patients and families should engage in preventing health care–associated infections in hospital settings.</div></div><div><h3>Methods</h3><div>The authors employed Q-methodology, a mixed methods approach combining by-person factor analysis with in-depth interviews to capture shared viewpoints among participants. The research was conducted in a university-affiliated adult transplant unit using a purposive sample of staff members, patients, and family members. Participants ranked 40 preselected statements on a tablet using the Q-sorTouch Web application (for example, “Staff members should check that patients and family members wash their hands at key moments”) on a continuum from “most agree” (+2) to “most disagree” (-2). Participants then took part in in-depth interviews to elaborate on their rankings. Data analysis included factor extraction and thematic interpretation.</div></div><div><h3>Results</h3><div>Nineteen participants completed the study. Analysis revealed three distinct viewpoints on patient and family engagement in infection prevention and control: (1) a controlling approach in which health care professionals ensure patient and family compliance, (2) an enabling approach that supports shared responsibility and emphasizes autonomy, and (3) a view of patients and family members as vigilant partners. Seven consensus statements emerged, indicating agreement on strategies in which patients and families are passive rather than proactive.</div></div><div><h3>Conclusion</h3><div>Although a paternalistic model emphasizing health care professional oversight prevailed, alternative perspectives emerged advocating for greater autonomy and responsibility among patients and families. These differing opinions indicate ongoing debate about how best to involve patients and their families in infection control, particularly during periods of heightened risk.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 4","pages":"Pages 270-278"},"PeriodicalIF":2.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046834","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":"Potentially Preventable Adverse Events in Ambulatory Interventional Radiology: Results from a National Multisite Retrospective Medical Record Review","authors":"Christopher Ayeni MD (Formerly Medical Student, Boston University Chobanian & Avedisian School of Medicine, is Resident, Morehouse School of Medicine),&nbsp;Westyn Branch-Elliman MD, MMSc (Clinician Scientist, Center for Health Optimization and Implementation Research (CHOIR), US Department of Veterans Affairs (VA) Boston Healthcare System, and Associate Professor of Medicine, Harvard Medical School),&nbsp;Marva Foster PhD, RN (Assistant Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine, and Investigator, CHOIR, VA Boston Healthcare System),&nbsp;Mikhail C.S.S. Higgins MD, MPH (Formerly Assistant Professor, Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, is Medical Director and Founder, Bahamas Fibroid & Interventional Clinic, Nassau, Bahamas),&nbsp;Kierstin Hederstedt (Formerly Junior Project Manager, CHOIR, VA Boston Healthcare System, is Neuroimmunology Project Manager, Boston Children's Hospital),&nbsp;Nina Bart (Formerly Research Assistant, CHOIR, VA Boston Healthcare System, is MPH/MBA Candidate, Johns Hopkins Bloomberg School of Public Health),&nbsp;Hillary J. Mull PhD, MPP (Associate Professor, Department of Surgery, Boston University Chobanian & Avedisian School of Medicine, and Research Investigator, CHOIR, VA Boston Healthcare System. Please address correspondence to Hillary J. Mull)","doi":"10.1016/j.jcjq.2024.11.006","DOIUrl":"10.1016/j.jcjq.2024.11.006","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 223-228"},"PeriodicalIF":2.3,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970948","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}