Quality Management in Health Care最新文献

{"title":"Improving the Screening and Treatment of Hepatitis C in a Rural Primary Care Clinic.","authors":"Neil Langer, Pam LaBorde","doi":"10.1097/QMH.0000000000000532","DOIUrl":"10.1097/QMH.0000000000000532","url":null,"abstract":"<p><strong>Background and objectives: </strong>With the potential to lead to liver failure, cirrhosis, and death and the availability of hepatitis C Virus (HCV) treatment with direct-acting antiviral medications, primary care clinicians need to take action to improve screening and treatment of HCV. Current literature demonstrates gaps in knowledge contribute to low HCV screening and treatment rates. The project's purpose is to use a multidisciplinary approach to patient and clinician education to improve HCV care in a rural primary care clinic.</p><p><strong>Methods: </strong>This quality improvement project involved 1225 adult patients aged 18-79 seen at a rural Federally Qualified Health Center (FQHC) in Arkansas, from February 15 to April 1, 2024. The project applied the Chronic Care Model to promote change in decision support and clinical information systems by educating patients and clinicians, reinforcing care accuracy, and monitoring practice. Project interventions included provider, clinical staff, and patient education and improving the visibility of the patient's HCV screening status in the electronic medical record (EMR). The clinic manager and marketing director assisted the project leader with educational training. The laboratory director designated an area for HCV screening history in the EMR, and the quality director evaluated the program's efficacy. A manual retrospective chart review was performed to evaluate the program's effectiveness. The collected data were analyzed using descriptive statistics to demonstrate the efficacy of the quality improvement project.</p><p><strong>Results: </strong>Following the implementation of this project, providers at the clinic demonstrated an improved understanding of current HCV screening and treatment guidelines. Additionally, the HCV screening rates for eligible adults increased from the baseline screening rate of 42% to 44.8% with 549 of 1225 eligible patients screened for HCV during the project implementation period. Additionally, 100% (n = 4) of adult patients diagnosed with HCV from February 15, 2024, to April 1, 2024, initiated HCV treatment ordered by their primary care provider.</p><p><strong>Conclusions: </strong>While the short duration of the project poses a limitation, implications from this project to current practice point to the importance of innovative changes in information technologies as well as patient, staff, and clinician education to improve access to HCV screening and care in rural primary care clinics. Further, to improve the quality of care and the screening and treatment of HCV, rural health clinics and organizations should consider updating policies and procedures to standardize HCV screening for adults aged 18-79.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"104-109"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplifying Measurement and Reporting to Drive High Adherence and Sustainment of Best Practices.","authors":"R Lynae Roberts, Crystal Nielson, Tom Belnap, Jonathan Anderson, Douglas Wolfe, Rajendu Srivastava","doi":"10.1097/QMH.0000000000000571","DOIUrl":"10.1097/QMH.0000000000000571","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"136-137"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned From Provider Minder: A Provider Tracking Application for Improving Stroke Risk Screening in Sickle Cell Anemia.","authors":"Alyssa M Schlenz, Shannon M Phillips, Judson Stevens, Logan P Williams, Margaret T Lee, Robert Nickel, Beng Fuh, Lily Dolatshahi, Julie Kanter","doi":"10.1097/QMH.0000000000000515","DOIUrl":"10.1097/QMH.0000000000000515","url":null,"abstract":"<p><strong>Background and objectives: </strong>We developed a novel web-based application, Provider Minder, for providers to track and monitor stroke risk screening in children with sickle cell anemia. Here, we describe the development of the application, the process evaluation during implementation, and our lessons learned.</p><p><strong>Methods: </strong>An iterative development process was used to develop the Provider Minder application and its functionalities. For our process evaluation, our team conducted surveys and interviews with study teams across 13 sites that used Provider Minder as part of a multi-intervention trial for the Dissemination and Implementation of Stroke Prevention Looking at the Care Environment study. Surveys and interviews were conducted with providers and coordinators at midpoint (1 year) and end point (2 years). Results were integrated and organized according to themes.</p><p><strong>Results: </strong>The process evaluation indicated factors critical for implementation success, such as coordination across stakeholders. Successes of the intervention included high adaptability for unique site needs, ease of use, low costs of implementation, and perceived effectiveness at capturing missed screenings. Key challenges were the time burden for use, redundancy of data capture, and lack of integration, as Provider Minder was distinct from the electronic medical record.</p><p><strong>Conclusions: </strong>While providers and coordinators described multiple barriers to implementing Provider Minder, results indicated that perceived successes outweighed barriers. Future efforts to reduce the burden associated with health care complexity and improvement in interoperability of electronic medical records will be important for improving the success of similar tracking applications for complex conditions.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"110-118"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Collaborative Specialist Panel Deployment to Address Health Disparities in the RICH LIFE Project.","authors":"Lena Mathews, Edgar R Miller, Lisa A Cooper, Jill A Marsteller, Chiadi E Ndumele, Denis G Antoine, Kathryn A Carson, Rexford Ahima, Gail L Daumit, Modupe Oduwole, Chioma Onuoha, Deven Brown, Katherine Dietz, Gideon D Avornu, Suna Chung, Deidra C Crews","doi":"10.1097/QMH.0000000000000500","DOIUrl":"10.1097/QMH.0000000000000500","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objectives: &lt;/strong&gt;Individuals with low income or from minoritized racial or ethnic groups experience a high burden of hypertension and other chronic conditions (eg, diabetes, chronic kidney disease, and mental health conditions) and often lack access to specialist care when compared to their more socially advantaged counterparts. We used a mixed-methods approach to describe the deployment of a Remote Collaborative Specialist Panel intervention aimed at the comprehensive and coordinated management of patients with hypertension and comorbid conditions to address health disparities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants of the collaborative care/stepped care arm of the Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone ( RICH LIFE ) Project, a cluster-randomized trial comparing the effectiveness of enhanced standard of care to a multilevel intervention (collaborative care/stepped care) for improving blood pressure control and reducing disparities, were included. Participants were eligible for referral by their care manager to the Specialist Panel if they continued to have poorly controlled hypertension or had uncontrolled comorbid conditions (eg, diabetes, hyperlipidemia, depression) after 3 months in the RICH LIFE trial. Referred participant cases were discussed remotely with a panel of specialists in internal medicine, cardiology, nephrology, endocrinology, and psychiatry. Qualitative data on the Specialist Panel recommendations and interviews with care managers to understand barriers and facilitators to the intervention were collected. We used available components of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to examine the impact of the intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 302 participants in the relevant RICH LIFE arm who were potentially eligible for the Specialist Panel, 19 (6.3%) were referred. The majority were women (53%) and of Black race (84%). Referral reasons included uncontrolled blood pressure, diabetes, and other concerns (eg, chronic kidney disease, life-stressors, medication side effects, and medication nonadherence). Panel recommendations centered on guideline-recommended diagnostic and management algorithms, minimizing intolerable medication side effects and costs, and recommendations for additional referrals. Panel utilization was limited. Barriers reported by care managers were lack of perceived need by clinicians due to redundant specialists, a cumbersome referral process, the remote nature of the panel, and the sensitivity of relaying recommendations back to the primary care physician. Care managers who made panel referrals reported it was overwhelmingly valuable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The use of a Remote Collaborative Specialist Panel was limited but well-received by referring clinicians. With modifications to enhance uptake, the Remote Collaborative Specialist Panel may be a practical care m","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"73-84"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Soft and Hard Total Quality Management at Shahroud University of Medical Sciences.","authors":"Mohammad Amiri, Zahra Mehmannavaz Mikal, Hasan Bagheri, Elham Sadeghi, Ahmad Khosravi","doi":"10.1097/QMH.0000000000000499","DOIUrl":"10.1097/QMH.0000000000000499","url":null,"abstract":"<p><strong>Background and objectives: </strong>This research aims to examine the current level of soft and hard Total Quality Management (TQM) at Shahroud University of Medical Sciences and explore the factors contributing to its success.</p><p><strong>Methods: </strong>The present cross-sectional study included 462 university managers and employees selected by stratified random sampling method in 2022. The participants were asked to answer TQM, soft TQM, and hard TQM questionnaires. The data were analyzed using ANOVA and chi-square tests, Pearson's correlation coefficient, and structural equation modeling.</p><p><strong>Results: </strong>Managers made up 73 of the participants (15.8%). The average score for TQM was 143.02 ± 11.56, soft TQM 52.47 ± 9.35, and hard TQM 36.49 ± 9.54. There was no statistically significant variation in the mean score of hard TQM, soft TQM, and TQM based on gender or course completion. There was a strong and positive link between the scores of soft TQM, hard TQM, and TQM. Leadership commitment, employee suggestion systems, problem-solving groups, information quality, and preventive maintenance were strongly associated with quality management in the structural equation model.</p><p><strong>Conclusion: </strong>Given the university's average level of TQM implementation, it appears that steps should be taken to improve the evaluation process and provide feedback to employees. Steps should also be taken toward improving the commitment of senior management to implementing and enhancing the system of employee suggestions, establishing problem-solving groups, and training job duties. TQM can assist employees and increase the quality of the information to improve the university's rank in quality management.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"126-133"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential of Patient Stories to Advance Birth Equity.","authors":"Anjali Walia, Fiona Miller, Linda Jones, Julie Harris-Taylor, Breezy Powell, Sarah B Garrett","doi":"10.1097/QMH.0000000000000504","DOIUrl":"10.1097/QMH.0000000000000504","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"134-135"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing Evidence-Based Quality Improvement in Health Care Quality and Patient Safety and Clinical Research Programs.","authors":"Evelyn O'Shea, Anita O'Donovan, Sharon Sheehan, Mary Coffey, Sinead Brennan, Maureen Flynn, Mary Browne, Petar Popivanov, Charles Gillham, Patricia Daly, Sarah Bergin","doi":"10.1097/QMH.0000000000000520","DOIUrl":"10.1097/QMH.0000000000000520","url":null,"abstract":"<p><strong>Background and objectives: </strong>This paper defines quality improvement (QI), describes the differences and connections among QI, clinical audit/quality assurance, and clinical research, highlights the importance of strong organizational governance for QI, and provides a simplified, evidence-based QI methodology that can be readily used by health care staff.</p><p><strong>Methods: </strong>The authors draw on their diverse QI experiences, encompassing a university maternity hospital, a radiation oncology specialist center, an acute general hospital, senior health care management, and academia. This demonstrates the feasibility of implementing QI in diverse health care settings and by all members of the multidisciplinary team.</p><p><strong>Results: </strong>Embedding QI in clinical audit, incident, and service user feedback management enables learning from Quality and Patient Safety activities, driving evidence-based improvements by frontline staff. Strong governance and accountability are essential to ensure QI efforts are sustained and impactful. QI also supports and enhances clinical research activities, improving patient outcomes and care.</p><p><strong>Conclusion: </strong>QI is most effective when it is kept simple, includes frontline multidisciplinary teams and patients/service users, and is supported by staff with QI expertise. This paper demonstrates the successful application of a QI methodology across varied health care specialties, emphasizing its broad applicability and significant benefits for health care delivery.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"94-103"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiating the Conversation: Prioritizing Women's Reproductive Health in Primary Care.","authors":"Katherine H Endres, Grace Thapa, Cheryl Oetjen","doi":"10.1097/QMH.0000000000000509","DOIUrl":"10.1097/QMH.0000000000000509","url":null,"abstract":"<p><strong>Background and objectives: </strong>The United States continues to have the highest rates of maternal mortality and morbidity of all high-income countries. Added to this is the high rate of unintended pregnancy, making it clear that reproductive health services in this country are still deficient. National health care organizations recommend prioritizing reproductive health in primary care.</p><p><strong>Methods: </strong>Using the knowledge-to-action framework, this quality improvement project applied evidence-based practice regarding preconception and contraceptive services to primary care. King's Goal Attainment Theory was used to disrupt the usual routine and create a culture promoting reproductive health conversations with patients. Staff received education on reproductive health in the primary care setting, leading to the development of a new process to screen for pregnancy intent. Providers were guided on the use of shared decision-making tools to discuss reproductive services and to provide preconception care and the full range of contraceptive methods.</p><p><strong>Results: </strong>Over 40% of female patients seen received unexpected yet desired reproductive health services. Providers and staff reported that the implementation of the process was feasible and sustainable. A new culture emerged in which reproductive health inquiry became usual care.</p><p><strong>Conclusions: </strong>Including reproductive health inquiry as part of the primary care visit was an easy intervention to implement that led to success in bridging the gap to reproductive health in primary care without placing undue burden on providers or staff.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"119-125"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Quality in Chronic Diseases in the Outpatient Setting Using a CNS-Led Care Management Program.","authors":"Molly L McClelland, Douglas A MacDonald, Kacie Garver, Nancy Pattyn","doi":"10.1097/QMH.0000000000000531","DOIUrl":"10.1097/QMH.0000000000000531","url":null,"abstract":"<p><strong>Background and objectives: </strong>The magnitude of chronic disease management is a daunting health care problem at the same time when there is a reduction in primary care physicians, making achieving high-quality standards and goals extremely challenging for health care professionals. The research objective for this project was to provide evidence to support the use of clinical nurse specialist (CNS)-led multidisciplinary teams in the outpatient setting to improve quality measures in chronic conditions.</p><p><strong>Methods: </strong>Patient data were collected from 2019 to 2023 for patients engaging in a multidisciplinary care management program in an outpatient internal medicine office. Pre-post data were collected for weight, body mass index, blood pressure, glucose levels, A1C levels, cholesterol levels, and medical diagnosis. Data were recorded for the first care management patient visit and compared to the most recent care management visit. Four hundred five patient records were included in the study.</p><p><strong>Results: </strong>Ten of the 11  t -tests evaluated were statistically significant in improving health measures. The only variable that did not emerge significant was HDL.</p><p><strong>Conclusions: </strong>Because of their education and training, CNSs are the best-suited health professionals to lead a team-based collaborative approach to chronic disease care management and improve quality health outcomes in primary care environments. Patients choosing to participate in care management programs demonstrated significant improvement in their health, therefore reducing risk for health, complications.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"65-72"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haddon Matrix: An Applied Analytical Framework for Patient Safety.","authors":"Marissa Leff, Jonathan Walsh, Rahul Koka, Lori-Ann Edwards","doi":"10.1097/QMH.0000000000000573","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000573","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":"35 2","pages":"138-140"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}