Journal for Healthcare Quality最新文献_第2页

From Improvement to Effect: Advancing Quality Through Innovation, Reliability, and Operational Excellence. 从改进到效果：通过创新、可靠性和卓越运营提高质量。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-07-01 Epub Date: 2026-07-27 DOI: 10.1097/JHQ.0000000000000535

Cathy E Duquette

引用次数: 0

Improving Nursing Home Vaccination Rates: A Collaboration Between Community Pharmacies and a Quality Improvement Organization. 提高养老院疫苗接种率：社区药房与质量改进组织的合作。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-07-01 Epub Date: 2026-02-09 DOI: 10.1097/JHQ.0000000000000516

Sydney Stawarz, Stephanie McGrath, Kim Coley

{"title":"Improving Nursing Home Vaccination Rates: A Collaboration Between Community Pharmacies and a Quality Improvement Organization.","authors":"Sydney Stawarz, Stephanie McGrath, Kim Coley","doi":"10.1097/JHQ.0000000000000516","DOIUrl":"10.1097/JHQ.0000000000000516","url":null,"abstract":"Background: The Centers for Medicare and Medicaid Services developed Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) with the priority of increasing nursing home residents' vaccine rates to prevent respiratory diseases including COVID-19, pneumonia, and influenza. The Pennsylvania Pharmacists Care Network (PPCN) partnered with Pennsylvania's QIN-QIO to increase the rate of immunizations of nursing home residents across the state.Purpose: To evaluate vaccination improvement rates in Pennsylvania nursing home residents after community pharmacist-led vaccination clinics.Method: A retrospective analysis was conducted of data from pharmacist-led vaccination clinics conducted at Pennsylvania nursing homes between March 1, 2024, and February 28, 2025. Outcomes were analyzed using descriptive statistics.Results: There were 68 vaccination clinics across 33 Pennsylvania nursing homes. Nineteen pharmacies administered 4,938 vaccines to nursing home residents including 2,193 COVID-19 vaccines, 1,193 pneumococcal, and 853 influenza vaccines. The average relative improvement rates among nursing home residents after the pharmacist-led clinics were 46.3% for influenza vaccines, 41.4% for COVID-19 vaccines, and 26.3% for pneumococcal vaccines.Conclusions/implications: A partnership between a QIN-QIO and PPCN community pharmacies improved respiratory vaccination rates among nursing home residents in Pennsylvania. This study demonstrates that community pharmacists are well positioned to conduct vaccination clinics at nursing homes to improve vaccination rates.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126642","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}

引用次数: 0

Present on Admission Checklist to Complement a CLABSI Reduction Plan in a Quaternary Care Center. 在第四期护理中心补充CLABSI减少计划的入院检查表。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-07-01 Epub Date: 2026-03-11 DOI: 10.1097/JHQ.0000000000000520

Gregory Glauser, Shaarada Srivatsa, Abby Gross, Mokshal Shah, Kelly Nimylowycz, Tonya Moyse, Shannon Pengel, Myra King, Meaghanne Caraballo, Toms Augustin

{"title":"Present on Admission Checklist to Complement a CLABSI Reduction Plan in a Quaternary Care Center.","authors":"Gregory Glauser, Shaarada Srivatsa, Abby Gross, Mokshal Shah, Kelly Nimylowycz, Tonya Moyse, Shannon Pengel, Myra King, Meaghanne Caraballo, Toms Augustin","doi":"10.1097/JHQ.0000000000000520","DOIUrl":"10.1097/JHQ.0000000000000520","url":null,"abstract":"Background: There are no standardized methods to assess central lines that are present on admission (POA) for risk of central line-associated bloodstream infections (CLABSI). This pilot study validated a tool to identify patients at risk of CLABSI-POA.Methods: A questionnaire to assess patients' risk of CLABSI-POA was developed based on four criteria. If any criteria were positive, two sets of blood cultures were obtained. From November 2023 to September 2025 (Phase 1), all patients admitted to general & colorectal surgery, liver & intestinal transplant, or hepatology with a central line POA were screened. Phase 2 of the pilot study began in June 2024, which included screening of patients admitted to the oncology units.Resultsintotal,: 366 patients were screened for CLABSI POA, with 56% (n = 204) screening positive. Blood cultures were drawn for 97% (n = 198) of at-risk patients. In total, 15% (n = 30) of cultures were positive. After the pilot study, CLABSI counts across all nursing units in the pilot study decreased, and the time to CLABSI diagnosis shifted (median 6.5 days prepilot study vs. 15 days postpilot study) ( p = .038) likely denoting true hospital-acquired CLABSIs, without a corresponding increase in resources for testing ( p = .06).Conclusions: Implementation of a screening questionnaire for patients with central line POA can lead to early identification of patients presenting with blood stream infections.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436789","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}

引用次数: 0

Lessons Learned From the COVID-19 Pandemic: Preparing for Emerging Threats. 2019冠状病毒病大流行的经验教训：为新出现的威胁做好准备。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-07-01 Epub Date: 2026-05-07 DOI: 10.1097/JHQ.0000000000000527

Pauline A Swiger, Christopher H Stucky, Judy A Orina, Jennifer H Miley, Peng Li, Patrician A Patrician

{"title":"Lessons Learned From the COVID-19 Pandemic: Preparing for Emerging Threats.","authors":"Pauline A Swiger, Christopher H Stucky, Judy A Orina, Jennifer H Miley, Peng Li, Patrician A Patrician","doi":"10.1097/JHQ.0000000000000527","DOIUrl":"10.1097/JHQ.0000000000000527","url":null,"abstract":"Purpose: The COVID-19 pandemic placed an unprecedented strain on the healthcare system, including military hospitals. Military hospitals leveraged a rigorous response plan, creating additional demands on military healthcare staff. The purpose of this project was to determine the levels of burnout, job satisfaction, intent to leave, potentially preventable loss, and healthcare quality, and identify lessons learned from the COVID-19 pandemic to support future organizational preparedness.Methods: A cross-sectional survey was administered from October 2021 to April 2022 ( n = 1814) to military healthcare staff in various roles at four military hospitals. Analyses were conducted using descriptive statistics, t-tests, and generalized linear mixed modeling.Results: Burnout was moderate to high across all healthcare staff, with the highest score among nurse practitioners (39.5) and the lowest among case managers and care coordinators (21.8). Higher care quality was significantly associated with potentially preventable loss ( p < .0001), lower burnout ( p < .0001), higher job satisfaction ( p < .0001), reduced intent to leave ( p < .0001), and improved pandemic preparedness ( p < .0001).Conclusions: Focus on traditional workforce improvement and leadership skills, as well as preparedness, is likely to strengthen the Military Health System's capacity to deliver high-quality care before, during, and after a global healthcare crisis.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844945","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}

引用次数: 0

Determinants of Patient-Reported Experience After Interhospital Transfer Within an Integrated Health System. 综合医疗系统内医院间转院后患者报告经历的决定因素。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-07-01 Epub Date: 2026-06-01 DOI: 10.1097/JHQ.0000000000000525

James F Howick V, Nahyr S Lugo-Fagundo, Goyal Umadat, Xiaoxi Yao, Kelly E Viola, Camille A Knepper, Kenneth K Ackerman, Gurpreet Singh

{"title":"Determinants of Patient-Reported Experience After Interhospital Transfer Within an Integrated Health System.","authors":"James F Howick V, Nahyr S Lugo-Fagundo, Goyal Umadat, Xiaoxi Yao, Kelly E Viola, Camille A Knepper, Kenneth K Ackerman, Gurpreet Singh","doi":"10.1097/JHQ.0000000000000525","DOIUrl":"10.1097/JHQ.0000000000000525","url":null,"abstract":"Objective: To evaluate patient-reported experiences after interhospital transfer (IHT) within an integrated health system and identify communication and coordination domains associated with overall satisfaction.Methods: This retrospective study included adults admitted to Mayo Clinic Health System hospitals between July 1, 2024, and June 12, 2025. Patients were categorized as transferred or nontransferred during their index admission. Propensity score matching (1:1) using demographic, clinical, and hospital characteristics compared patient experience survey responses. Logistic regression identified factors associated with a \"very good\" overall hospital rating. Open-ended comments from transferred patients were summarized by Copilot for recurring themes.Results: Among 3,138 nontransfer and 163 transfer patients, 3,301 provided experience data. After matching, 163 pairs were analyzed. Overall hospital ratings did not differ significantly between groups ( p = .40). No individual communication or coordination domain differed after matching. Environmental cleanliness was independently associated with higher odds of a \"very good\" rating (odds ratio 1.76; 95% confidence intervals: 1.04-2.98; p = .036). Qualitative feedback emphasized clear communication and coordinated care as key drivers of satisfaction, whereas discharge instructions and intersite communication remained areas for improvement.Conclusion: Within an integrated health system, IHT did not adversely affect patient satisfaction. Cleanliness, communication, and coordination most strongly influenced overall experience.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139421","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}

引用次数: 0

A Cross-Sectional Analysis of Inappropriate Sharps Container Utilization at a Level 1 Trauma Center. 一级创伤中心利器容器使用不当的横断面分析。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-07-01 Epub Date: 2026-02-05 DOI: 10.1097/JHQ.0000000000000517

Suraj Modi, Melanie Jones, Ryan Langston, Ishika Samantarai, Stephen Cave, Evani Patel, Robert Younan, Jack Yu

{"title":"A Cross-Sectional Analysis of Inappropriate Sharps Container Utilization at a Level 1 Trauma Center.","authors":"Suraj Modi, Melanie Jones, Ryan Langston, Ishika Samantarai, Stephen Cave, Evani Patel, Robert Younan, Jack Yu","doi":"10.1097/JHQ.0000000000000517","DOIUrl":"10.1097/JHQ.0000000000000517","url":null,"abstract":"Background: U.S. hospitals generate ∼6 billion tons of medical waste annually. Disposal costs exceed $4 billion. High-temperature incineration, required for sharp wastes, is the most costly and carbon-intensive disposal. Inappropriate waste contributes significantly to health care's financial and environmental burdens.Methods: This single-blinded cross-sectional study involved a one-time audit of 176 sharps containers from operating rooms, procedure rooms, and clinics across a Level 1 trauma center, conducted on a single day in 2023. Containers were photographed before disposal. Metadata, such as specialty and room type, were recorded separately. Independent reviewers who analyzed the images were masked to the containers' origins. The proportion of image area occupied by nonsharp items was calculated using ImageJ. Statistical comparisons were performed using independent-samples t-tests and ANOVAs.Results: Overall, 24.74% of sharps container contents were inappropriate. Emergency services had the highest rate (40.22%), followed by surgical (22.37%) and medical services (9.79%) ( p < .001). Specialties differed significantly ( p < .001); orthopedics, otolaryngology, and plastic surgery had lower inappropriate disposal, while emergency medicine and general surgery had higher rates.Conclusions: Our findings highlight an opportunity for targeted interventions to reduce medical waste misclassification. Standardized protocols and specialty-specific education may reduce costs and support environmental sustainability.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126601","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}

引用次数: 0

Intravenous Fluid Conservation in Endoscopic Procedures and Its Effects on the Outcomes of Patients Undergoing Nurse-Administered Moderate Sedation. 内窥镜手术中静脉液体保存及其对护士给予适度镇静患者预后的影响。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-07-01 Epub Date: 2026-04-28 DOI: 10.1097/JHQ.0000000000000528

Katie Kropf, Brandon W Qualls

{"title":"Intravenous Fluid Conservation in Endoscopic Procedures and Its Effects on the Outcomes of Patients Undergoing Nurse-Administered Moderate Sedation.","authors":"Katie Kropf, Brandon W Qualls","doi":"10.1097/JHQ.0000000000000528","DOIUrl":"10.1097/JHQ.0000000000000528","url":null,"abstract":"Background: After Hurricane Helene, which caused flooding and led to the shutdown of Baxter International, a major supplier of intravenous (IV) fluids, healthcare systems nationwide faced significant disruptions to their supply chains. In response, one health system implemented IV fluid conservation policies across its campuses to prioritize patients with critical needs.Purpose: This study evaluated the impact of withholding IV fluids during outpatient endoscopic procedures on patient blood pressure, heart rate, nausea, vomiting, and recovery time.Methods: A retrospective chart review was conducted at an ambulatory gastroenterology center. Adults aged 18-85 who underwent specific endoscopic procedures with moderate sedation were included.Results: Of the 1,535 cases reviewed, 56.9% occurred before IV fluid restrictions, and 96% of those received IV fluids. After the restriction, only 3.8% of patients received IV fluids. The lowest systolic and diastolic blood pressures, as well as the lowest heart rate, exhibited little variability between the pre- and post-restriction periods. Post-procedure recovery time was equal in both groups.Conclusions: Patients tolerated endoscopy and moderate sedation without significant hemodynamic changes during the IV fluid shortage.Implications: This clinic successfully adapted its practices during a critical supply shortage, maintaining safe and effective care despite limited access to IV fluids.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786533","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}

引用次数: 0

Financial Stewardship and CLABSI Elimination: A Blueprint for Reliable Outcomes. 财务管理和CLABSI消除：可靠结果的蓝图。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-07-01 Epub Date: 2025-12-26 DOI: 10.1097/NAQ.0000000000000743

Nicole M Brown, Grady Williams

引用次数: 0

Streamlining Care: Effective Approaches to Decreasing Observation Status Length of Stay in Community Medical Centers. 简化护理：减少社区医疗中心观察状态停留时间的有效方法。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-07-01 Epub Date: 2026-06-01 DOI: 10.1097/JHQ.0000000000000526

G Xavier, T Arora, J M Rosengrant, I Agaronin, N Parikh, S Thompson-Aurelien

{"title":"Streamlining Care: Effective Approaches to Decreasing Observation Status Length of Stay in Community Medical Centers.","authors":"G Xavier, T Arora, J M Rosengrant, I Agaronin, N Parikh, S Thompson-Aurelien","doi":"10.1097/JHQ.0000000000000526","DOIUrl":"10.1097/JHQ.0000000000000526","url":null,"abstract":"Introduction: To identify areas of opportunity and gaps and develop and test strategies to improve patient treatment in the observation units of two regional community medical centers.Methods: The Plan-Do-Study-Act (PDSA) approach identified the two common emergency department complaints (syncope and collapse; unspecified atrial fibrillation) with the longest patient length of stay (LOS) in observation. Fishbone exercises elucidated these gaps. Departmental meetings, group discussions, and 1:1 discussion of particular cases provided education to reduce LOS.Results: Plan-Do-Study-Act target goal for median LOS for these two complaints was 30 hours, which was approximately 12% less than the median LOS during the data collection stage. The PDSA process improved care efficiency, as demonstrated by reduced LOS for the atrial fibrillation cohort between the early and later months after launch and implementation. For the syncope cohort, the median LOS met or remained below the target threshold of 30 hours from the mid-point through the later stages of the implementation period.Conclusions: The reproducible PDSA-improved processes lowered the median LOS of patients with syncope or atrial fibrillation in observation status to the target goal of 30 hours or less in the past 5 and 8 months, respectively, of the launch and implementation stages.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139416","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}

引用次数: 0

Reduction of Blood Culture Contamination Through an Evidence-Based, Multidisciplinary Quality Improvement Initiative. 通过循证、多学科质量改进倡议减少血液培养污染。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2026-06-17 DOI: 10.1097/JHQ.0000000000000531

Pei-Chin Lin, Chia-Ling Chang, Shu-Wen Chang, Hui-Fei Tang, Chia-Ying Liu, Ya-Mei Yu, Yi-Hua Chung, Fang-Yeh Chu

{"title":"Reduction of Blood Culture Contamination Through an Evidence-Based, Multidisciplinary Quality Improvement Initiative.","authors":"Pei-Chin Lin, Chia-Ling Chang, Shu-Wen Chang, Hui-Fei Tang, Chia-Ying Liu, Ya-Mei Yu, Yi-Hua Chung, Fang-Yeh Chu","doi":"10.1097/JHQ.0000000000000531","DOIUrl":"https://doi.org/10.1097/JHQ.0000000000000531","url":null,"abstract":"Background: Contaminated blood cultures can lead to diagnostic errors, inappropriate antimicrobial use, and prolonged hospital stays. Although a contamination rate ≤3% is generally considered as an acceptable upper limit, the rate in our hospital exceeded this benchmark.Purpose: We aimed to reduce blood culture contamination rates by a hospital-wide, evidence-based quality improvement (QI) approach.Methods: A multidisciplinary team including clinical pathology, infectious diseases, nursing, and quality management implemented a QI initiative using Plan-Do-Study-Act (PDSA) cycles. Root cause analysis identified inconsistent disinfection practices, inadequate formal training, and lack of feedback. Interventions included standard operating procedures revision based on current best practices, development of standardized instruction and e-learning, monthly unit-level feedback, and device standardization.Results: The preintervention contamination rate was 4.74% (range: 4.08%-5.77%). After implementation, the rate decreased to 2.82% (2.71%-2.90%). Improvement was sustained over 1 year, with a rate of 2.42% (2.17%-2.65%). Additional outcomes included increased blood culture volume and reduced reporting time.Conclusions: A multidisciplinary collaboration and evidence-based QI initiative targeting all staff involved in blood culture collection was the key to effectively reducing and sustaining lower contamination rates.Implications: Blood culture contamination is a modifiable quality metric. Evidence-based, multidisciplinary QI programs using PDSA cycles are a replicable framework for improving patient safety, diagnostic accuracy, and antimicrobial stewardship.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259960","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}

引用次数: 0