Quality Management in Health Care最新文献

{"title":"Support for the Kids Online Safety Act (KOSA), With Caution.","authors":"Farrokh Alemi, Suzanne Carmack, David Gustafson, Judith Jacobson, Gary L Kreps, Priya Nambisan, Niloofar Remezani, Jack Simons, 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":" ","pages":"278-280"},"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":"32 4","pages":"286"},"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":" ","pages":"281-282"},"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":" ","pages":"217-221"},"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}

{"title":"Integrative Medicine: An Opportunity for Improving Quality of Care in the Inpatient Setting.","authors":"Arlene R Maheu, Soussan Ayubcha, Nathan R Handley","doi":"10.1097/QMH.0000000000000432","DOIUrl":"10.1097/QMH.0000000000000432","url":null,"abstract":"<p><p>As medicine shifts to a value-based focus, health care providers in inpatient settings are actively seeking approaches to providing high-quality patient care without exacerbating prevailing cost burden. Complementary and integrative medicine may offer one potential solution for this challenge. Although the benefits of utilizing integrative practices in the inpatient setting have not been explored extensively thus far, early evidence demonstrates great promise of using integrative modalities to improve symptom burden in the inpatient setting while increasing patient pain satisfaction and reducing overall costs of care. Currently, social, educational, and financial barriers exist, limiting the widespread incorporation of complementary and integrative medicine into the inpatient setting. Nonetheless, a more robust body of literature demonstrating the effectiveness of complementary and integrative medicine in reducing costs of care and improving patient outcomes may help address these limitations and lead to the acceptance of integrative practices as the standard of high-value inpatient care.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"257-262"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10119248","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":"Building Cultural and Clinical Bridges: Post-Merger Strategies to Create Synergy, Increase Quality, and Reduce Costs.","authors":"Timothy Fowles, Andrew Knighton, Natalie Soria, Doug Wolfe, Rajendu Srivastava","doi":"10.1097/QMH.0000000000000441","DOIUrl":"10.1097/QMH.0000000000000441","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":"32 4","pages":"283-285"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41127265","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":"Evaluating Outcomes and Time Delays of a Non-Trainee-Driven Hospitalist Procedure Service.","authors":"Gregory N Orewa, Sue S Feldman, Nicole Redmond, Allyson G Hall, Kierstin Cates Kennedy","doi":"10.1097/QMH.0000000000000413","DOIUrl":"10.1097/QMH.0000000000000413","url":null,"abstract":"<p><strong>Background and objectives: </strong>Ultrasound guidance has become standard of care in hospital medicine for invasive bedside procedures, especially central venous catheter placement. Despite ultrasound-guided bedside procedures having a high degree of success, only a few hospitalists perform them. This is because these are usually performed by radiologists or in the setting of trainee-run procedure teams. We sought to determine the impact of a non-trainee driven , hospitalist-run procedure service relative to time from consult to procedure.</p><p><strong>Methods: </strong>The University of Alabama at Birmingham Hospital (UAB), Department of Hospital Medicine, trained 8 non-trainee hospitalist physicians (from existing staff) to implement the ultrasound-guided procedure service. This study examines consult to procedure completion time since the implementation of the procedure service (2014 to 2020). Univariate analyses are used to analyze pre-implementation (2012-2014), pilot (2014-2016), and post-implementation data (2016-2018 initial, and 2018-2020 sustained).</p><p><strong>Results: </strong>Results suggest a 50% reduction in time from consult to procedure completion when compared with the period before implementation of the nontrainee hospitalist procedure service.</p><p><strong>Conclusions: </strong>A hospitalist procedure service, which does not include trainees, results in less time lag from consult to procedure completion time, which could increase patient satisfaction and improve throughput. As such, this study has wide generalizability to community hospitals and other nonacademic medical centers that may not have trainees.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"230-237"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9790542","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":"Preventing Postoperative Urinary Retention (POUR) in Patients Undergoing Elective Lumbar Surgery: A Quality Improvement Project.","authors":"Jacob Jasinski, Doris Tong, Elise Yoon, Chad Claus, Evan Lytle, Clifford Houseman, Peter Bono, Teck M Soo","doi":"10.1097/QMH.0000000000000394","DOIUrl":"10.1097/QMH.0000000000000394","url":null,"abstract":"<p><strong>Background and objectives: </strong>Postoperative urinary retention (POUR) is associated with significant morbidity. Our institution's POUR rate was elevated among patients undergoing elective lumbar spinal surgery. We sought to demonstrate that our quality improvement (QI) intervention would significantly lower our POUR rate and length of stay (LOS).</p><p><strong>Methods: </strong>A resident-led QI intervention was implemented from October 2017 to 2018 on 422 patients in an academically affiliated community teaching hospital. This consisted of standardized intraoperative indwelling catheter utilization, postoperative catheterization protocol, prophylactic tamsulosin, and early ambulation after surgery. Baseline data on 277 patients were collected retrospectively from October 2015 to September 2016. Primary outcomes were POUR and LOS. The focus, analyze, develop, execute, and evaluate (FADE) model was used. Multivariable analyses were used. P value <.05 was considered significant.</p><p><strong>Results: </strong>We analyzed 699 patients (277 pre-intervention vs 422 post-intervention). The POUR rate (6.9% vs 2.6%, Δ confidence interval [CI] 1.15-8.08, P = .007) and mean LOS (2.94 ± 1.87 days vs 2.56 ± 2.2 days, Δ CI 0.066-0.68, P = .017) were significantly improved following our intervention. Logistic regression demonstrated that the intervention was independently associated with significantly decreased odds for developing POUR (odds ratio [OR] = 0.38, CI 0.17-0.83, P = .015). Diabetes (OR = 2.25, CI 1.03-4.92, P = .04) and longer surgery duration (OR = 1.006, CI 1.002-1.01, P = .002) were independently associated with increased odds of developing POUR.</p><p><strong>Conclusions: </strong>After implementing our POUR QI project for patients undergoing elective lumbar spine surgery, the institutional POUR rate significantly decreased by 4.3% (62% reduction) and LOS, by 0.37 days. We demonstrated that a standardized POUR care bundle was independently associated with a significant decrease in the odds of developing POUR.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"270-277"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9103560","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":"Perception of Health Care Professionals Toward Hospital Accreditation at Johns Hopkins Aramco Healthcare.","authors":"Huda Al-Sayedahmed, Ayman Al-Qaaneh, Jaffar Al-Tawfiq, Basmah Al-Dossary, Saeed Al-Yami","doi":"10.1097/QMH.0000000000000405","DOIUrl":"10.1097/QMH.0000000000000405","url":null,"abstract":"<p><strong>Background and objectives: </strong>The quality of health care relies on achieving the best quality and patient safety goals, and accreditation plays a fundamental role in achieving these goals through compliance with standards that guide excellence. Accreditation also helps streamline operations and supports evidence-based quality improvement plans. This study aims to evaluate the perception of health care professionals on the accreditation process and its impact on the quality of health care and patient safety.</p><p><strong>Methods: </strong>This is a cross-sectional questionnaire survey distributed via the SuccessFactors website and made accessible to all hospital staff.</p><p><strong>Results: </strong>The online questionnaire was completed by 2047 participants, representing 51% of the entire hospital staff at Johns Hopkins Aramco Healthcare (JHAH). Overall analysis indicated a positive perception of accreditation benefits among health care employees (as indicated by participation in accreditation activities and/or preparation for the survey visits) and reflected on patient health care quality and safety dimensions, with an overall Likert median score of 4.0 (interquartile range = 3.7-5.0; P < .05).</p><p><strong>Conclusion: </strong>The outcomes of our study confirm that JHAH employees perceived a positive impact of accreditation on health care quality improvement and patient safety. Also, the study supports considering accreditation as a fundamental requirement to improve health care system processes. However, it is critical to sustain quality of services over time during accreditation cycles.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"238-246"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128036","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":"Call for Reviewers.","authors":"","doi":"10.1097/01.QMH.0000991268.57972.a6","DOIUrl":"https://doi.org/10.1097/01.QMH.0000991268.57972.a6","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":"32 4","pages":"286"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161781","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}