Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management最新文献_第10页

Initial distribution of COVID-19 vaccines to front-line hospital workers and community first responders—A prospective descriptive study 向一线医院工作人员和社区第一响应者初始分发COVID-19疫苗:一项前瞻性描述性研究

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-08-27 DOI: 10.1002/jhrm.21485

Julie M. Stausmire MSN, APRN, CNS, Deidre J. Rohaley PharmD, MBA, BCPS, James A. Tita DO, FCCP, Nancy M. Buderer MS, Tamela Nuesmeyer DNP, RN, EBP-C, David L. Faulkner BS, ACSM CCEP, Matthew Sapara JD

{"title":"Initial distribution of COVID-19 vaccines to front-line hospital workers and community first responders—A prospective descriptive study","authors":"Julie M. Stausmire MSN, APRN, CNS, Deidre J. Rohaley PharmD, MBA, BCPS, James A. Tita DO, FCCP, Nancy M. Buderer MS, Tamela Nuesmeyer DNP, RN, EBP-C, David L. Faulkner BS, ACSM CCEP, Matthew Sapara JD","doi":"10.1002/jhrm.21485","DOIUrl":"10.1002/jhrm.21485","url":null,"abstract":"As one of the initial ten sites in Ohio designated to receive and distribute the first COVID-19 vaccines in December 2020, we initiated a self-reported IRB-approved research survey to describe the demographics, side-effects, and missed work time experienced by front-line health care workers in an urban tertiary care center and a rural regional hospital. First responders from both the urban and rural surrounding communities were also included in the initial Tier 1A vaccine distribution. The primary outcome measure was to identify the most frequently experienced side effects from the Pfizer and Moderna vaccines, based on type of vaccine, first or second dose, age, gender, race and occupation. The secondary outcome measure was to document the total number of work shifts missed after receiving the vaccine. Of interest to health care risk managers, the survey identified the most common side effects and resulting missed time from work broken down by type of vaccine and first or second dose. This information will be helpful for those institutions who have not yet vaccinated a majority of their work force, employees who still need their second dose, and for strategic scheduling of employees when booster doses become available later in the year.","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"41 2","pages":"46-55"},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jhrm.21485","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39361142","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}

引用次数: 0

Issue Information - Editorial Review Board 发行信息-编辑审查委员会

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-07-17 DOI: 10.1002/jhrm.21418

引用次数: 0

Issue Information - Board of Directors 发行信息-董事会

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-07-17 DOI: 10.1002/jhrm.21417

引用次数: 0

Implementing a human factors approach to RCA² : Tools, processes and strategies. 在 RCA 中采用人为因素方法2 ：工具、流程和战略。

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-07-01 Epub Date: 2020-12-19 DOI: 10.1002/jhrm.21454

Douglas A Wiegmann, Laura J Wood, Demetrius B Solomon, Scott A Shappell

{"title":"Implementing a human factors approach to RCA2 : Tools, processes and strategies.","authors":"Douglas A Wiegmann, Laura J Wood, Demetrius B Solomon, Scott A Shappell","doi":"10.1002/jhrm.21454","DOIUrl":"10.1002/jhrm.21454","url":null,"abstract":"Root Cause Analysis and Action (RCA2 ) guidelines offer fundamental improvements to traditional RCA. Yet, these guidelines lack robust methods to support a human factors analysis of patient harm events and development of systems-level interventions. We recently integrated a complement of human factors tools into the RCA2 process to address this gap. These tools include the Human Factors Analysis and Classification System (HFACS), the Human Factors Intervention Matrix (HFIX), and a multiple-criterion decision tool called FACES, for selecting effective HFIX solutions. We describe each of these tools and illustrate how they can be integrated into RCA2 to create a robust human factors RCA process called HFACS-RCA2 . We also present qualitative results from an 18-month implementation study within a large academic health center. Results demonstrate how HFACS-RCA2 can foster a more comprehensive, human factors analysis of serious patient harm events and the identification of broader system interventions. Following HFACS-RCA2 implementation, RCA team members (risk managers and quality improvement advisors) also experienced greater satisfaction in their work, leadership gained more trust in RCA findings and recommendations, and the transparency of the RCA process increased. Effective strategies for overcoming implementation barriers, including changes in roles, responsibilities and workload will also be presented.","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"41 1","pages":"31-46"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213862/pdf/nihms-1647261.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38727984","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}

引用次数: 0

Presidents letter. 总统的信。

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-07-01 DOI: 10.1002/jhrm.21483

Margaret Garrett

引用次数: 0

Case Law Update. 判例法更新。

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-07-01 Epub Date: 2021-06-28 DOI: 10.1002/jhrm.21482

John C West, Christopher J Allman

引用次数: 1

Characteristics of medical malpractice claims involving emergency medicine physicians. 涉及急诊医师的医疗事故索赔特征。

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-07-01 Epub Date: 2020-10-19 DOI: 10.1002/jhrm.21450

Laura C Myers, Jonathan Einbinder, Carlos A Camargo, Emily L Aaronson

{"title":"Characteristics of medical malpractice claims involving emergency medicine physicians.","authors":"Laura C Myers, Jonathan Einbinder, Carlos A Camargo, Emily L Aaronson","doi":"10.1002/jhrm.21450","DOIUrl":"https://doi.org/10.1002/jhrm.21450","url":null,"abstract":"Background: Identifying characteristics of malpractice claims involving emergency medicine (EM) physicians allows leaders to develop patient safety initiatives to prevent future harm events.Methods: A retrospective study was performed of paid/unpaid claims closed 2007 to 2016 from Comparative Benchmarking System. Claims were identified by physician specialty involved (EM, internal medicine, general surgery). Various characteristics were compared by physician specialty. Multivariable regression was performed to identify factors associated with claim payment, in which (1) physician specialty was included as a predictor and (2) only the subset involving EM physicians was analyzed.Results: Of 54,772 claims, 2760 involved EM physicians, 5886 involved internists, and 3207 involved surgeons. Death was the most common severity among EM claims (34%). Diagnosis-related allegations accounted for 58%, higher than 42% and 11% of claims involving internists and surgeons, respectively (P < 0.0001). Thirty-one percent was paid. The median indemnity paid on behalf of any defendant was $206,261 (interquartile range $55,065-527,651). The most common final diagnoses were myocardial infarction (2%), pulmonary embolus (2%), and cardiac arrest (2%). Procedure-related claims were associated with increased payment likelihood (odds ratio 1.21, 95% confidence interval 1.10-1.34).Conclusion: Malpractice claims in EM are often diagnosis- or procedure related. Our findings suggest that diagnostic accuracy and procedural competency should shape future quality improvement work.","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"41 1","pages":"9-15"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jhrm.21450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38506972","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}

引用次数: 6

The influence of medical insurance on obstetrical care. 医疗保险对产科护理的影响。

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-07-01 Epub Date: 2020-10-22 DOI: 10.1002/jhrm.21451

Manuel C Vallejo, Robert E Shapiro, Christa L Lilly, Linda S Nield, Norman D Ferrari

{"title":"The influence of medical insurance on obstetrical care.","authors":"Manuel C Vallejo, Robert E Shapiro, Christa L Lilly, Linda S Nield, Norman D Ferrari","doi":"10.1002/jhrm.21451","DOIUrl":"10.1002/jhrm.21451","url":null,"abstract":"Maternal and obstetrical outcomes vary widely within the United States. The impact of insurance type on health care disparities and its influence on obstetrical care and maternal outcome is not clear. We report the impact of health care insurance on obstetrical and maternal outcomes in a tertiary care health care system. Our maternal quality care database (n = 4199) was queried comparing commercial insurance to government sponsored insurance from July 1, 2015 through June 30, 2018. Parturients with commercial insurance were older, weighed more, presented with less gravidity and parity, had more advanced gestation, and had a higher neonatal 5-minute Apgar score than government insured parturients. Additionally, government insured parturients were less likely to be admitted for induction with oxytocin, receive labor epidural analgesia, and have a primary caesarean delivery. Similarly, government insured parturients were more likely to be of African American descent, be a current known smoker, have a positive urine drug screen, and receive a general anesthetic. We conclude obstetrical and maternal health care disparities exist based on medical insurance type.","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"41 1","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jhrm.21451","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38521812","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}

引用次数: 6

Health care Inequity. 医疗保健不平等。

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-07-01 DOI: 10.1002/jhrm.21465

Sue Boisvert

引用次数: 0

TRIAD XI: Utilizing simulation to evaluate the living will and POLST ability to achieve goal concordant care when critically ill or at end-of-life-The Realistic Interpretation of Advance Directives.

Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management Pub Date : 2021-07-01 Epub Date: 2020-12-10 DOI: 10.1002/jhrm.21453

Ferdinando Mirarchi, Kristin Juhasz, Timothy Cooney, Daniel Desiderio

{"title":"TRIAD XI: Utilizing simulation to evaluate the living will and POLST ability to achieve goal concordant care when critically ill or at end-of-life-The Realistic Interpretation of Advance Directives.","authors":"Ferdinando Mirarchi, Kristin Juhasz, Timothy Cooney, Daniel Desiderio","doi":"10.1002/jhrm.21453","DOIUrl":"https://doi.org/10.1002/jhrm.21453","url":null,"abstract":"Objective: Utilize simulation to evaluate if living wills (LW) or POLST achieves goal concordant Care (GCC) in a medical crisis.Methods: Nurses and resident-physicians from a single center were randomized to a clinical scenario with a living will (LW), physician orders for life sustaining treatment (POLST) or no document. Primary outcomes were resuscitation decision and time to decision. Secondary outcome was the effect of education.Results: Total enrollment was 57 and less than 30% received prior training. Types of directives were linked to resuscitation decisions (P = .019). Participants randomized to \"No Document\" or POLST specifying \"CPR\" performed resuscitation. If a terminal condition presented with a POLST/ do not resuscitate-comfort measures only (DNR-CMO), 73% resuscitated. The LW or POLST specifying DNR combined with medical support resulted in resuscitations in 29% or more of the scenarios. Documents did not significantly affect median time-to-decision (P = .402) but decisions for \"No Document\" and POLST/CPR were at least 10 s less than other scenarios. Scenarios involving POLST DNR/Limited Treatment had the highest median time of 43 s. Prior training in LWs and POLST exerted a 10% improvement in decision making (P = .537).Conclusion: GCC was not always achieved with a LW or POLST. This conclusion supports prior research identifying problems with the interpretation and discordance with LW's and POLST.","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"41 1","pages":"22-30"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jhrm.21453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38694976","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}

引用次数: 2