Quality Management in Health Care最新文献

{"title":"Re: Watson H. The Center for Nursing Inquiry: Developing Nurse-Led Inquiry. Qual Manag Health Care . 2022;31(3):149-150.","authors":"Lisa Di Prospero, Sara Morassaei","doi":"10.1097/QMH.0000000000000403","DOIUrl":"10.1097/QMH.0000000000000403","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9966884","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":"Interprofessional Team Collaboration as a Mediator Between Workplace Social Capital and Patient Safety Climate: A Cross-Sectional Study.","authors":"Ryohei Kida, Risa Suzuki, Katsumi Fujitani, Kaori Ichikawa, Hironobu Matsushita","doi":"10.1097/QMH.0000000000000421","DOIUrl":"10.1097/QMH.0000000000000421","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patient-safety climate is one of the most important organizational factors contributing to health care quality. We hypothesized that a patient safety climate is fostered by the willingness to collaborate and trust among members as well as by daily collaborative practices. This study aimed to clarify the effect of workplace social capital on patient safety climate. We also sought to investigate the mediating effect of interprofessional team collaboration on the relationship between workplace social capital and patient safety climate.</p><p><strong>Methods: </strong>This cross-sectional survey was conducted from November 2021 to January 2022 using anonymous web-based questionnaires. The survey was distributed to 1495 employees working in a hospital in Tokyo, Japan. The questionnaire included the patient safety climate scale, workplace social capital scale, Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II-J), and demographic items. Structural equation modeling was performed to verify the associations among the 3 variables. In addition, a significance test for indirect effects was conducted using the bootstrap method to confirm the mediating effect of AITCS-II-J.</p><p><strong>Results: </strong>A total of 725 employees participated in this survey, and 632 data items were analyzed. Nurses were the highest number of respondents (68.2%), followed by physicians (13.3%). Workplace social capital and patient safety were directly and significantly associated (β = .309, P < .01). Furthermore, the partially indirect effect of the AITCS-II-J on the association between workplace social capital and patient safety climate was also significant (β = .430, P < .01).</p><p><strong>Conclusions: </strong>Workplace social capital was significantly and directly related to patient safety climate and was also significantly related to patient safety climate partially mediated by interprofessional team collaboration. Our findings suggest the importance of workplace social capital and routine multidisciplinary collaboration for a patient safety climate to manage health care quality.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10119244","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 Speed to Bedside: Standardized Tools to Inform High-Quality, Timely Clinical Implementations.","authors":"Ashley Krueger, Andrew Knighton, Timothy R Fowles, Griffin Olsen, Rajendu Srivastava","doi":"10.1097/QMH.0000000000000448","DOIUrl":"10.1097/QMH.0000000000000448","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139074879","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 an Integrated Ambulatory Care Program in Health Care and Medication Use in Patients With Multimorbidity and Polypharmacy.","authors":"Yu-Tai Lo, Mei-Hua Chen, Pin-Hao Chen, Feng-Hwa Lu, Chia-Ming Chang, Yi-Ching Yang","doi":"10.1097/QMH.0000000000000434","DOIUrl":"10.1097/QMH.0000000000000434","url":null,"abstract":"<p><strong>Background and objectives: </strong>Multimorbidity increases risks, such as polypharmacy, inappropriate prescription, and functional decline. It also increases medical care utilization by older adults, placing a burden on health care systems. This study evaluated the effectiveness of an integrated ambulatory care program for health care and medication use in patients with multimorbidity and polypharmacy.</p><p><strong>Methods: </strong>We conducted a retrospective clinical review of adults with multimorbidity and polypharmacy who attended an integrated ambulatory care program at a 1193-bed university hospital between July 1 and September 30, 2019. This program involves multidisciplinary teamwork, comprehensive assessments, medication reviews, and case management. Outcomes, including the frequency of outpatient visits, emergency department visits, hospitalizations, chronic prescription medications, potentially inappropriate medications (PIMs), health care costs, and total medical expenditure, were compared before and after the program.</p><p><strong>Results: </strong>The mean age of participants (n = 134) at baseline was 74.22 ± 9.75 years. The mean number of chronic diagnoses was 9.45 ± 3.38. Participants included 72 (53.7%) women. At the 1-year follow-up, participants showed a significant decrease in the annual frequency of outpatient visits (19.78 ± 9.98 to 13.90 ± 10.22, P < .001), emergency department visits (1.04 ± 1.70 to 0.73 ± 1.40, P = .029), and chronic disease medications (10.71 ± 3.96 to 9.57 ± 3.67, P < .001) across all age groups. There was also a reduction in the annual number of PIMs (from 1.31 ± 1.01 to 1.12 ± 0.93, P = .002) among patients aged 65 years. However, no effects were observed on annual hospitalization, duration of hospital stay, or total health care expenditure, possibly due to the high disease-related treatment cost for certain participants.</p><p><strong>Conclusions: </strong>Expanding integrated ambulatory care programs in Taiwan may help patients with multimorbidity reduce their use of outpatient and emergency services, chronic prescriptions, and PIMs.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144639","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":"Burnout Among Family Physicians in the United States: A Review of the Literature.","authors":"Timothy Hoff, Kathryn Trovato, Aliya Kitsakos","doi":"10.1097/QMH.0000000000000439","DOIUrl":"10.1097/QMH.0000000000000439","url":null,"abstract":"<p><strong>Background and objectives: </strong>Burnout among physicians who work in primary care is an important problem that impacts health care quality, local communities, and the public's health. It can degrade the quality of primary care services in an area and exacerbate workforce shortages. This study conducted a review of the published research on burnout among family physicians working in the United States.</p><p><strong>Methods: </strong>We used a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided approach and several article databases to identify, filter, and analyze published research on US family physician burnout that uses data collected from 2015 onward.</p><p><strong>Results: </strong>Thirty-three empirical studies were identified with findings that included US family physician burnout prevalence and/or associations between burnout and specific personal and contextual drivers. Mean family physician burnout prevalence across studies that measured it was 35%. Almost half of the studies classified one-third or more of their family physician samples as burned out. Physician gender (being female), age (being younger), and job/work-related factors (workload, time pressures) were the most commonly identified correlates of family physician burnout. The vast majority of studies were cross-sectional and used secondary data.</p><p><strong>Conclusions: </strong>The extant research literature on family physician burnout in the United States shows that burnout is currently a meaningful problem. Several important correlates of the problem can be identified, some of which managers and health care organizations can proactively address. Other correlates require managers and health care organizations also viewing family physicians in differentiated ways. The collective literature can be improved through a more consistent focus on similar burnout correlates across studies; inclusion of interventions aimed at lessening the effects of key burnout correlates; employment of more robust longitudinal and quasi-experimental research designs; and additional pandemic-era data collection on burnout.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210938","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":"Estimated Costs of Drug-Related Problems Prevented by Pharmacist Prescription Reviews Among Hospitalized Internal Medicine Patients.","authors":"Xiaoying Zheng, Xuefeng Shan, Weichu Liu, Diansa Gao, Huiming Jiang, Lifen Xue, Lei Hu, Feng Qiu","doi":"10.1097/qmh.0000000000000425","DOIUrl":"https://doi.org/10.1097/qmh.0000000000000425","url":null,"abstract":"Data are lacking on the estimated costs of pharmacist prescription reviews (PPRs) for hospitalized internal medicine patients. This study investigates the estimated costs of drug-related problems (DRPs) prevented by PPRs among hospitalized internal medicine patients.","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138688935","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":"Support for the Kids Online Safety Act (KOSA), With Caution.","authors":"Farrokh Alemi,&nbsp;Suzanne Carmack,&nbsp;David Gustafson,&nbsp;Judith Jacobson,&nbsp;Gary L Kreps,&nbsp;Priya Nambisan,&nbsp;Niloofar Remezani,&nbsp;Jack Simons,&nbsp;Yunyu Xiao","doi":"10.1097/QMH.0000000000000424","DOIUrl":"10.1097/QMH.0000000000000424","url":null,"abstract":"T o the Editor: We are a group of health scientists working in diverse fields of study who have come together to conduct research addressing risks from suicide for transgender and non-binary teenagers and the potential role of social media in addressing these events. We are writing this letter to provide partial support for the Senate bill “Kids Online Safety Act” (KOSA). We applaud the spirit of the bill to protect youth from harmful social media content, as well as to facilitate enhanced research of social media risks for youth. We also believe the bill should have provisions that prevent its abuse, in particular prevent censoring critical content important for the well-being of LGBTQ+ (lesbian, gay, bisexual, transgender, and queer) young people, who extensively rely on social media. The KOSA is a bipartisan bill introduced by Sens. Richard Blumenthal (D-Conn.) and Marsha Blackburn (R-Tenn.) earlier this year. It holds social media platforms accountable for risks posed to children and adolescents younger than 17 years. The overall intention of the bill is to protect youth from content that could be harmful to them, indicating that those online platforms have a duty to prevent the promotion of harmful behaviors, including suicide, self-harm, eating disorders, and substance abuse. The KOSA allows parents and users to opt out of algorithmic recommendations installed on any platforms, prevents third parties from viewing a minor’s data, and limits the amount of time kids could spend on the platform. It also includes provisions regarding online platform disclosure policies and advertising systems. Importantly, the bill requires the National Telecommunications and Information Administration to enable researchers to apply for data sets that platform companies would have to provide to allow them to study potential online communication harms to minors. However, this does not mean that this bill would make social media platforms fully safe for transgender youth. Bullying, discrimination, and harassment of transgender youth and other minority groups have become rampant in social media platforms. These negative factors could lead to depression, anxiety disorders, and even suicide. We know that the teen suicide rate has increased significantly, and some sub-","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675984","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 for Authors.","authors":"","doi":"10.1097/01.QMH.0000991260.82863.89","DOIUrl":"https://doi.org/10.1097/01.QMH.0000991260.82863.89","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144640","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":"Prevention of Hospital-Associated Venous Thromboembolism: A Road Map to Defect-Free Care.","authors":"Brandyn D Lau, Dauryne L Shaffer, Peggy S Kraus, Oluwafemi P Owodunni, Mujan Varasteh Kia, Sara J Chiochetti, Michael B Streiff, Elliott R Haut","doi":"10.1097/QMH.0000000000000436","DOIUrl":"10.1097/QMH.0000000000000436","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196436","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":"Decreased Length of Stay and Opioid Usage After Liver Cancer Surgery With Enhanced Recovery Pathway Implementation.","authors":"Yvonne Nguyen, Leopoldo Fernandez, Brooke Trainer, Marilyn McNulty, Michael R Kazior","doi":"10.1097/QMH.0000000000000389","DOIUrl":"10.1097/QMH.0000000000000389","url":null,"abstract":"<p><strong>Background and objectives: </strong>Enhanced recovery after surgery (ERAS) pathways are associated with better postoperative recovery; however, evidence is lacking in liver cancer surgery. This study aimed to evaluate the impact of an ERAS pathway in US veterans undergoing liver cancer surgery.</p><p><strong>Methods: </strong>We initiated an ERAS pathway for liver cancer surgery with preoperative, intraoperative, and postoperative interventions, which included a novel regional anesthesia technique, erector spinae plane block, for multimodal analgesia management. A retrospective quality improvement study was conducted with patients undergoing elective open hepatectomy or microwave ablation of liver tumors before and after ERAS pathway implementation.</p><p><strong>Results: </strong>With 24 patients in the post-ERAS group and 23 patients in the pre-ERAS group, we found a significant decreased length of stay in the ERAS group (4.1 days ± 3.9) compared with traditional care (8.6 days ± 7.1, P = .01) and decreased perioperative opioid consumption including intraoperative opioids (post-ERAS 49.8 mg ± 28.5 vs pre-ERAS 98 mg ± 42.3, P = 4.1E-5), postoperative opioids (post-ERAS 65.3 mg ± 59.9 vs pre-ERAS 175.7 mg ± 210.6, P = .018), and patient-controlled analgesia requirements (post-ERAS 0% vs pre-ERAS 50%, P < .001).</p><p><strong>Conclusion: </strong>The implementation of ERAS for liver cancer surgery in our veteran population translates into decreased length of stay and perioperative opioid consumption. Although this study is limited as a quality improvement project implemented at one institution with a small sample size, our results are clinically and statistically significant and sufficient to warrant further investigation into the efficacy of ERAS as the surgical needs of the US veteran population increase.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9110670","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}