Quality Management in Health Care最新文献

{"title":"Potential Reinforcement of Health Misconceptions in YouTube Videos: Example of Elbow Enthesopathy (Tennis Elbow).","authors":"Zohair Zaidi, Ria Goyal, David Ring, Amirreza Fatehi","doi":"10.1097/QMH.0000000000000478","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000478","url":null,"abstract":"<p><strong>Background and objectives: </strong>We evaluated the prevalence of potential reinforcement of common unhealthy misinterpretations of bodily sensations in social media (YouTube videos) addressing elbow enthesopathy (eECRB, enthesopathy of the extensor carpi radialis brevis, tennis elbow).</p><p><strong>Methods: </strong>We recorded video metric data on 139 unique YouTube videos when searching \"lateral epicondylitis\" and \"tennis elbow.\" We designed a rubric to assess the level of potential reinforcement of unhelpful thinking in videos about eECRB. Informational quality was scored with an adapted version of the DISCERN instrument. We then assessed the factors associated with these scores.</p><p><strong>Results: </strong>Sixty-five percent (91 of 139) of videos contained information reinforcing at least one common misconception regarding eECRB. Potential reinforcement of misconceptions was associated with longer video duration, higher likes per day, and higher likes per view. No factors were associated with information quality scores.</p><p><strong>Conclusions: </strong>These findings of a high prevalence of potential reinforcement of misconceptions in YouTube videos, in combination with the known associations of misconceptions with greater discomfort and incapability, point to the potential of such videos to harm health. Producers of patient facing health material can add avoidance of reinforcement of unhelpful thinking along with readability, accuracy, and relevance as a guiding principle.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522843","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":"Use of Audit and Feedback to Improve the Quality of Consultation Notes.","authors":"","doi":"10.1097/QMH.0000000000000473","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000473","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547103","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 Effect of Hospital-to-Home Discharge Interventions on Reducing Unplanned Hospital Readmissions: A Systematic Review and Meta-analysis.","authors":"Yasemin Demir Avcı, Sebahat Gözüm, Engin Karadag","doi":"10.1097/QMH.0000000000000454","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000454","url":null,"abstract":"<p><strong>Background and objectives: </strong>Unplanned hospital readmissions (UHRs) constitute a persistent health concern worldwide. A high level of UHRs imposes a burden on individuals, their families, and health care system budgets. This systematic review and meta-analysis aimed to evaluate the effectiveness of discharge interventions in the transition from hospital to home in the context of reducing UHRs.</p><p><strong>Methods: </strong>The study design was a meta-analysis of randomized and nonrandomized controlled trials. Eight databases were searched. The effect on UHR rates (odds ratio [OR]) of discharge interventions in the transition from hospital to home was calculated at a 95% confidence interval (95% CI) based on meta-regression and meta-analysis of random-effects models.</p><p><strong>Results: </strong>Results showed that discharge interventions were effective in reducing rehospitalizations (effectiveness/OR =1.39; 95% CI, 1.24-1.55). It was furthermore determined that the studies showed heterogeneous characteristics (P ≤ .001, Q = 50.083, I2 = 44.093; df = 28). According to Duval and Tweedie's trim and fill results, there was no publication bias. Interventions in which telephone communications and hospital visits (OR = 1.64; 95% CI, 1.25-2.16; P < .001) were applied together were effective among patients with cardiovascular diseases (OR = 1.54; 95% CI, 1.28-2.09; P < .001), and it was found that UHRs were reduced within a period of 90 days (OR = 1.68; 95% CI, 1.16-2.42; P < .001). It was also found that discharge interventions applied to transitions from hospital to home had a diminishing effect on UHRs as the publication dates of the reviewed studies advanced from the past to the present (OR = 0.015; 95% CI, 0.002-0.003; P < .001).</p><p><strong>Conclusion: </strong>Supporting and facilitating cooperation between health care professionals and families should be a key focus of discharge interventions.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473467","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":"Effectiveness of a Hands-on Group Activity in Quality Improvement Education.","authors":"","doi":"10.1097/QMH.0000000000000485","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000485","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381516","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 Human-Technology Continuum.","authors":"Gordon C Shen, Deborah M Mullen, Matthew J DePuccio, Michaela Kerrissey","doi":"10.1097/QMH.0000000000000490","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000490","url":null,"abstract":"<p><strong>Background and objectives: </strong>Managers in health care today face an array of digital technologies that assist or augment certain human tasks. But these technologies are often fraught and present challenges to managers, whose competencies must evolve to keep pace with technological advancements.</p><p><strong>Methods: </strong>Drawing on theory about technology, work, and organizations, we present a human-technology continuum to facilitate this discussion for managers. Furthermore, we illustrate how managerial competencies are linked to the entire human-technology continuum, rather than to specific technologies, using diabetes management examples.</p><p><strong>Results: </strong>The human-technology continuum indicates that augmentative technologies are layered onto assistive ones in health care settings. This suggests that technological advancements not only enhance but alter managerial competencies.</p><p><strong>Conclusions: </strong>Digital technology stretches the boundaries of managers' day-to-day work in health care. Therefore, we make the following suggestions so the managers can be responsive to ongoing digital transformations: restructuring work, training the workforce, neutralizing threats, establishing ethical boundaries, and building partnerships.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988717","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 Linkages Between Sexual and Reproductive Health and Substance Use Providers: The Partnership to Advance Integrated Referrals.","authors":"Sonya Dublin, Dayana Bermudez, Christina Ortiz, Natalie Tobier, Joslyn Levy, Leah Hargarten","doi":"10.1097/QMH.0000000000000469","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000469","url":null,"abstract":"<p><strong>Background and objectives: </strong>Women of reproductive age with substance use (SU) disorders have lower rates of contraceptive use and higher rates of unintended pregnancy than women without SU disorders and are less likely to access treatment than men. Integration of SU and sexual and reproductive health (SRH) services, using a model known as Screening, Brief Intervention, and Referral to Treatment (SBIRT), has been proven effective in reducing SU and improving health care equity. The SBIRT model includes screening, brief intervention (a short client-centered conversation providing an opportunity to identify/discuss concerns), and referral to treatment. The purpose of this study was to test whether an established quality improvement (QI) learning collaborative model could be used to support SU and SRH sites in implementing an SBIRT/SBIRT-like model to improve health outcomes for women. Five SRH sites and 4 SU sites across New York State participated in the Partnership to Advance Integrated Referrals (PAIR), an 18-month QI learning collaborative designed and implemented by Public Health Solutions.</p><p><strong>Methods: </strong>Six standardized mixed-methods data collection tools were used over 18 months to gather process and outcome data from over 130 QI team members and site staff and over 5000 clients.</p><p><strong>Results: </strong>By the end of PAIR, QI team members and site staff showed a reduction in bias, increased knowledge and comfort, increased rating of organizational practices related to client-centered care, and increased access to peer learning, information about best practices, and training and technical assistance. SU sites increased SRH screening from 47.9% in the first quarter of data collection to 67.4% in the final quarter and increased brief interventions from 92.5% in the first quarter to 100.0% in the final quarter. Similarly, SRH sites increased SU screening from 51.6% to 75.6% and increased brief interventions from 81.3% to 85.1%. The processes and outcomes were very different for the SU and SRH sites, and their varying successes and challenges are discussed. Making and verifying referrals remained challenging.</p><p><strong>Conclusions: </strong>The results of PAIR demonstrated the feasibility of SU and SRH sites implementing an SBIRT/SBIRT-like model when supported by a QI learning collaborative. Larger community and organizational challenges (COVID-19, staff turnover) still present barriers to improved reproductive health and SU outcomes for women.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988715","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":"Information Overload-Do We Read All the Posters Displayed Across the Walls on Hospital Wards?","authors":"Amunpreet Sahota, Pramudi Wijayasiri, Htet Than, Mohsin Munir, Opinder Sahota","doi":"10.1097/QMH.0000000000000467","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000467","url":null,"abstract":"<p><strong>Background and objectives: </strong>To establish whether posters displayed across the walls on hospital wards are read, what information is important, and how the information should be received.</p><p><strong>Methods: </strong>Sixty-eight staff and 32 patients' relatives were interviewed across 3 older people's medical wards followed by 20 follow-up secondary questionnaires postintervention.</p><p><strong>Results: </strong>Only 23% of those interviewed were able to recall any of the posters displayed, and of those, 34% did not find the information useful. Those interviewed were enthusiastic about utilizing alternative media. A quarter felt the walls across the hospitals wards should be for artwork. Among patients' relatives interviewed, common information requests were \"the discharge pathway,\" \"delirium,\" and \"falls.\" Based on the initial findings, a targeted information board was installed and a mural was painted across the wall in one of the wards. Further post-intervention interviews with patients' relatives showed that the board was well received, but further unmet information needs were uncovered. Despite the new mural, 45% called for more paintings.</p><p><strong>Conclusion: </strong>Most people ignore the posters displayed across the walls of hospital wards, and unmet information needs are rife. An appetite exists for alternative media. Paintings were earnestly called for, highlighting how a comforting environment could be part of the holistic care we offer patients in hospital.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988716","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":"Leadership Strategies to Increase Psychological Safety of Nurses: A Longitudinal Study.","authors":"Karen L Hessler, Gwen Anderson, Mary Scannell, Bryan McNair, Maude Becker","doi":"10.1097/QMH.0000000000000453","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000453","url":null,"abstract":"<p><strong>Background and objectives: </strong>A work environment where employees feel comfortable taking chances without fear and with sufficient protection from retaliation is psychologically safe. The objective of this study was to investigate the effects of leader training for nurse managers on psychological safety of clinical registered nurses.</p><p><strong>Methods: </strong>The study was designed a longitudinal outcomes approach to assess nurse leader intervention (classes on leadership methods and psychological safety) with pre- and post-intervention measurement of nurse psychological safety at each time point.</p><p><strong>Results: </strong>The intervention and nurse leader rounding were shown to increase individual psychological safety climate scores of clinical nurses.</p><p><strong>Conclusion: </strong>Psychological safety is an important component to consider in a nursing leadership role. Leadership interventions that focus on the tenets of psychological safety and include methods of being present, such as nurse leader rounding, can foster a sense of a psychologically safe environment for clinical registered nurses.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748972","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 Integration of Quality Improvement and Health Care Simulation: A Scoping Review.","authors":"Ashleigh Allgood, Susan Wiltrakis, Marjorie Lee White, Leslie W Hayes, Scott Buchalter, Allyson G Hall, Michelle R Brown","doi":"10.1097/QMH.0000000000000464","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000464","url":null,"abstract":"<p><strong>Background and objectives: </strong>Quality improvement (QI) and simulation employ complementary approaches to improve the care provided to patients. There is a significant opportunity to leverage these disciplines, yet little is known about how they are utilized in concert. The purpose of this study is to explore how QI and simulation have been used together in health care.</p><p><strong>Methods: </strong>This scoping review includes studies published between 2015 and 2021 in 4 databases: CINAHL, Embase, PubMed, and Scopus.</p><p><strong>Results: </strong>The search yielded 921 unique articles.18 articles met the inclusion criteria and specifically described QI and simulation collaborative projects. Of the 18 articles, 28% focused on improvements in patient care, 17% on educational interventions, 17% on the identification of latent safety threats (LSTs) that could have an impact on clinical care, 11% on the creation of new processes, 11% on checklist creation, and 6% on both LST identification and educational intervention. The review revealed that 61% of the included studies demonstrated a concurrent integration of simulation and QI activities, while 33% used a sequential approach.</p><p><strong>Conclusions: </strong>There is a paucity of studies detailing the robust and synergistic use of QI and simulation. The findings of this review suggest a positive impact on patient safety when QI and simulation are used in tandem. The systematic integration of these disciplines and the use of established reporting guidelines can promote patient safety in practice and in the literature.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748975","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":"Driving in the Wrong Direction: Exploring the Unintended Consequence of an Early Discharge Program on Length of Stay in Hospital Setting.","authors":"Paul Hodges, Christopher A Linke, Johannah D Bjorgaard, Megan E Edgerton","doi":"10.1097/QMH.0000000000000466","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000466","url":null,"abstract":"<p><strong>Importance: </strong>Early discharge of patients has become standard work in acute care settings to reduce inpatient length of stay (LOS), improve patient flow, and reduce boarding in the emergency department (ED).</p><p><strong>Objective: </strong>Retrospective analysis of outcomes from a discharge by 11 am program at an academic medical center from January 1, 2020, to June 30, 2022. The analysis addresses the effects of a discharge by 11 am goal on time from discharge order release to patient discharge, ED boarding, LOS, and observed-to-expected LOS.</p><p><strong>Design, setting, and participants: </strong>Patient-level electronic health record data included discharge order entry time, discharge time, LOS, and diagnosis-related group geometric LOS (GMLOS). Additional unit-level data for ED boarding volumes and hours were included. Analyses were conducted at the hospital and unit levels where indicated.</p><p><strong>Results: </strong>Patients with a discharge order by 9 am have longer mean hours from order to discharge than patients without a discharge order by 9 am (9.04 vs 2.48 hours, P < .001) ED boarding total (R2 = 46.2%, P ≤ .001), percentage (R2 = 50.4%, P ≤ .001), median minutes (R2 = 24.6%, P = .005), and total minutes (R2 = 40.8%, P ≤ .001) all increased as discharge by 11 am performance improved. The mean LOS is longer for the discharge by 11 am group than the non-discharge by 11 am group -1.67; 95% CI, -2.03 to -1.28, P < .001). Discharge by 11 am patients had a LOS/GMLOS ratio 21.9% higher than the non-discharge by 11 am cohort (difference -0.31; 95% CI, -0.36 to -0.26, P < .001).</p><p><strong>Conclusions: </strong>Discharge order entry and release by 9 am and patient physically discharged by 11 am initiatives demonstrate a statistical increase in time from discharge order to discharge time, ED boarding, LOS, and observed-to-expected LOS.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748995","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}