Journal for Healthcare Quality最新文献_第3页

Intervention Bundle to Reduce Hospital Length of Stay in a Quaternary Academic Department of Surgery. 综合干预减少第四学术外科住院时间。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2026-06-09 DOI: 10.1097/JHQ.0000000000000529

Joseph D Forrester, Joshua A Villarreal, Elijah Suh, Tara Lahiji-Neary, Amin Etemad, William J Frederick, Dale Beatty, Samuel H Wald, Neera Ahuja, Ronald L Dalman, Mary T Hawn

{"title":"Intervention Bundle to Reduce Hospital Length of Stay in a Quaternary Academic Department of Surgery.","authors":"Joseph D Forrester, Joshua A Villarreal, Elijah Suh, Tara Lahiji-Neary, Amin Etemad, William J Frederick, Dale Beatty, Samuel H Wald, Neera Ahuja, Ronald L Dalman, Mary T Hawn","doi":"10.1097/JHQ.0000000000000529","DOIUrl":"https://doi.org/10.1097/JHQ.0000000000000529","url":null,"abstract":"Background: Length of stay (LOS) is a process metric for optimizing hospital resource planning.Purpose: To identify an intervention bundle that would reduce Vizient LOS index for a quaternary, academic medical center department of surgery.Methods: We applied three interventions: (1) multidisciplinary discharge rounds; (2) quarterly data sharing of surgeon- and procedure-specific LOS data; (3) electronic health record (EHR)-based summary capable of capturing patient complexity. We performed a running prospective analysis of Vizient LOS index, assessing impact of interventions implemented in a pragmatic, bundled fashion. Pre- and postintervention LOS data were analyzed using a two-sample t-test to assess statistical significance at a 95% confidence interval for difference in means.Results: From 6/2022 to 6/2025, 14,754 patients were discharged from the Department of Surgery. When comparing pre- and postintervention data, our bundled efforts led to a decline in observed average LOS (aLOS) from 6.208 to 5.777 days (difference = -0.431; [0.153, 0.709]; t[34] = 3.150, p = .003). This reduction contributed to an improvement in the LOS index (ratio of observed to expected LOS), from 0.950 to 0.857 days (difference = 0.093; [0.053, 0.134]; t[34] = 4.718, p = .000). This reduction in observed aLOS by 0.43 days resulted in an annual estimated cost savings of >$5.1 million.Conclusions: Implementing bundled LOS interventions helped our quaternary, academic department of surgery reduce LOS and improve throughput while reducing cost.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259895","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

Burnout and Well-Being Among Nurses in an Integrated Healthcare System. 综合医疗保健系统中护士的职业倦怠和幸福感。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-04-22 DOI: 10.1097/NAQ.0000000000000738

Hannah Jang Kim, Leslie Owen Pole, Carolina Perez Ramirez, Benjamin Simons, Michelle Mancuso, Nicole VanderHorst, Randa Merizian, Tanya B Moore, Maria Dee, Phyllis Doulaveris, Lina Najib Kawar

{"title":"Burnout and Well-Being Among Nurses in an Integrated Healthcare System.","authors":"Hannah Jang Kim, Leslie Owen Pole, Carolina Perez Ramirez, Benjamin Simons, Michelle Mancuso, Nicole VanderHorst, Randa Merizian, Tanya B Moore, Maria Dee, Phyllis Doulaveris, Lina Najib Kawar","doi":"10.1097/NAQ.0000000000000738","DOIUrl":"10.1097/NAQ.0000000000000738","url":null,"abstract":"Background/local problem : An integrated healthcare system conducted surveys to assess overall well-being to describe perceptions of work environment and to inform meaningful intervention. Burnout and high turnover are compromising workplace safety and quality of care.Methods: Surveys were sent to all eligible employees in the organization and participation was voluntary and confidential. The 2022 surveys were conducted, and 6,913 nurses participated.Interventions: Statistical testing was conducted to identify demographic differences in burnout for tenure, age, manager/non-manager, and care setting. Regressions were conducted to determine top predictors of burnout.Results: Significant differences were found in tenure ( P < .001), age ( P < .001), and manager/ non-manager ( P = .009). Mental health, retention, and workload significantly predicted burnout, F (3,4609) = 1028.33, P < .001, R2 adj = 0.40.Conclusion: Nursing burnout ultimately affects turnover and retention in a healthcare system. Monitoring by age, tenure, manager status, and care setting are vital for addressing burnout for nurses.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786517","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

Implementation of 5:10:15:20 Minute Model With Improvement in First-Case On-Time Starts. 实施5:10:15:20分钟模式，提高首件准时开工率。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-04-01 Epub Date: 2026-01-26 DOI: 10.1097/JHQ.0000000000000515

Shruti Parikh, Thomas Corrado, Joseph Gnolfo, Ayesha Khan, Samuel Stanely, Arlene Arrigo, Christopher DiRusso, Donna Hoffman, Cynthia Jorgensen, Michelle Knipe, Jill Setaro, Paul F Murphy, Elliott Bennett-Guerrero

{"title":"Implementation of 5:10:15:20 Minute Model With Improvement in First-Case On-Time Starts.","authors":"Shruti Parikh, Thomas Corrado, Joseph Gnolfo, Ayesha Khan, Samuel Stanely, Arlene Arrigo, Christopher DiRusso, Donna Hoffman, Cynthia Jorgensen, Michelle Knipe, Jill Setaro, Paul F Murphy, Elliott Bennett-Guerrero","doi":"10.1097/JHQ.0000000000000515","DOIUrl":"10.1097/JHQ.0000000000000515","url":null,"abstract":"Background: The operating room (OR) is a dynamic environment requiring close communication between surgeons, anesthesiologists, and clinicians. First-case on-time starts (FCOTS) is a common metric of OR efficiency. OR delays are multifactorial and can increase hospital expenditures.Purpose: We sought to determine whether implementing explicit deadlines, in conjunction with feedback to late individuals, would improve our institution's FCOTS.Methods: After obtaining approval from quality board at our tertiary care, Level 1 trauma institution, a \"pre versus post\" quality improvement project implemented a multicomponent initiative with explicit deadlines for perioperative tasks, feedback to late surgeons, and OR tracking boards. We included American Society of Anesthesiologists (ASA) classification score ≤4 patients, undergoing elective or urgent surgery.Results: A total of 14,609 patients were included (6,635 preimplementation and 7,974 postimplementation). Both groups were well balanced regarding most potential confounders, for example, age, sex, and ASA score. We observed a significant difference ( p < .0001) in FCOTS between the preimplementation (39.0%) and postimplementation (74.0%) phases. Using a 5-minute grace period, the monthly average FCOTS percentage increased from 54.8% preimplementation to 83.2% postimplementation ( p < .0001).Conclusions: Implementation of a central OR tracking board, clinician feedback, and explicit 5:10:15:20-minute goals was associated with significant improvement of our hospital's FCOTS.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054641","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

Empowering Excellence: The Evolution of the NAHQ ® Healthcare Quality Competency Framework ™. 授权卓越：NAHQ®医疗质量能力框架™的演变。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-04-01 DOI: 10.1097/JHQ.0000000000000523

Carole S Guinane, Jaclyn Hunter, Stephanie Mercado, Aleese Eckenrode

{"title":"Empowering Excellence: The Evolution of the NAHQ ® Healthcare Quality Competency Framework ™.","authors":"Carole S Guinane, Jaclyn Hunter, Stephanie Mercado, Aleese Eckenrode","doi":"10.1097/JHQ.0000000000000523","DOIUrl":"10.1097/JHQ.0000000000000523","url":null,"abstract":"Introduction: The National Association for Healthcare Quality (NAHQ ® ) has refreshed its Healthcare Quality Competency Framework ™ , ensuring health care professionals are equipped with essential skills to navigate the complexities of modern health care systems. Originally introduced in 2016, these competencies have served as the industry standard for defining the knowledge and capabilities required to advance quality and safety across health care environments.Purpose: The framework emphasizes the necessity of competencies that enhance quality, safety, and strategic objectives within health care organizations.Methods: Through collaborative efforts involving subject matter experts and leadership interviews, the process addressed the present-day challenges faced by practitioners and health care entities.Results: The framework revisions further defined each domain, consolidated overlapping competencies, and strengthened the integration of patient experience and engagement throughout all domains. The changes were implemented to support broader application of quality and safety competencies across all health care professions. The update emphasizes the importance of continuously refining competencies to adapt to the evolving demands of health care, which may help promote an environment that enhances patient outcomes.Conclusions: The framework serves as a central reference for health care professionals at all levels, nurturing effective collaboration across multidisciplinary teams, and promoting a culture of continuous learning and improvement. This article explores the evolution of the framework, the historical context of health care quality, and the importance of aligning standard competencies to elevate patient care standards in an increasingly complex environment.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786520","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

Implementing Guidelines for NICU Parent Presence: Effects on Parent and Infant Stress. 新生儿重症监护病房父母在场的实施指南：对父母和婴儿压力的影响。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2026-04-01 DOI: 10.1097/JPN.0000000000000992

引用次数: 0

Strengthening Healthcare Quality: The Essential Role of Frameworks and Measurement Criteria. 加强医疗保健质量：框架和衡量标准的重要作用。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-04-01 Epub Date: 2026-04-13 DOI: 10.1097/JHQ.0000000000000521

Allyson G Hall

引用次数: 0

Criteria to Prioritize Measures of Healthcare Quality: A Scoping Review. 优先衡量医疗质量的标准：范围审查。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-04-01 Epub Date: 2025-12-02 DOI: 10.1097/JHQ.0000000000000509

Diana Zhang, Feifei Ye, Sachi Yagyu, Aneesa Motala, Danica Tolentino, Susanne Hempel

{"title":"Criteria to Prioritize Measures of Healthcare Quality: A Scoping Review.","authors":"Diana Zhang, Feifei Ye, Sachi Yagyu, Aneesa Motala, Danica Tolentino, Susanne Hempel","doi":"10.1097/JHQ.0000000000000509","DOIUrl":"10.1097/JHQ.0000000000000509","url":null,"abstract":"Background: National and international agencies charged with assuring quality of healthcare need to select quality indicators. This study aimed to identify criteria used to prioritize healthcare quality measures, with particular focus on healthcare disparities.Methods: A scoping review (osf.io/e5duc) combined comprehensive scientific literature review searches in seven databases with detailed reviews of gray literature sources in December 2024. We mapped the criteria across various identified approaches, documenting similarities and differences.Results: We identified 103 criteria sets; sets were intended for population/public health and general or specific healthcare settings. The use of formal consensus methods and involvement of interest -holders varied. Commonly used criteria included importance, validity, reliability, feasibility, scientific soundness, improvability, and usability of measures, but operationalizations varied. The need for parsimony and minimizing measurement burden was a recurring theme, along with calls for alignment with broader health system goals.Conclusions: Selecting criteria for quality-of-care and healthcare disparities has implications for how the quality-of-care is scored, healthcare organizations are evaluated, and healthcare is delivered. This review documents the process and relative frequency of proposed criteria. Many different criteria have been suggested, and approaches vary considerably across agencies, highlighting the complexity and diversity of the process.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"48 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822533","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

Facility Acquisition and Care Quality in the U.S. Dialysis Industry. 美国透析行业的设备收购和护理质量。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-04-01 Epub Date: 2025-10-29 DOI: 10.1097/JHQ.0000000000000502

Ilana Segal, Truc Bui, Yu Liu, Kevin Callison

{"title":"Facility Acquisition and Care Quality in the U.S. Dialysis Industry.","authors":"Ilana Segal, Truc Bui, Yu Liu, Kevin Callison","doi":"10.1097/JHQ.0000000000000502","DOIUrl":"10.1097/JHQ.0000000000000502","url":null,"abstract":"Purpose: To evaluate whether acquisition of independent dialysis facilities by large chains is associated with changes in clinical quality metrics and patient-reported experiences of care.Methods: We conducted a longitudinal cohort study using 2016-2020 data from Medicare Dialysis Facility Care Compare (DFC) and In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS). Facility acquisition was defined as the transition of a nonchain-owned facility to chain ownership. We estimated within-facility changes in clinical and patient-reported outcomes after acquisition using linear regression with facility and year fixed effects, adjusting for ownership type and facility size.Results: Among 4,627 facilities in the DFC sample and 1,377 in the ICH-CAHPS sample, acquisition was associated with a 3.0% relative increase in hospitalization rates, a 9.4% increase in infection rates, and a 0.5% decline in dialysis adequacy. Patient-reported experiences showed a statistically significant 1.0% decline in reported information sharing while other experience metrics trended negatively but were not statistically significant.Conclusions: Facility acquisition was associated with worsening clinical performance and small declines in patient experience. These findings suggest consolidation may negatively affect dialysis care quality, underscoring the need for closer oversight of industry mergers.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606771","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

Frameworks for Health Care Quality and Disparities in Health Care Quality: A Scoping Review. 卫生保健质量框架和卫生保健质量差异：范围审查。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-04-01 Epub Date: 2026-04-13 DOI: 10.1097/JHQ.0000000000000513

Diana Zhang, Feifei Ye, Steven Martino, Emma Longo, Charlotte Ong, Katrina Ninh, Cecilia Paz, Sandra Tyler-Mills, Dean Madera, Brionna Yiggins, Sangita Baxi, Niranjan Bhatt, Sachi Yagyu, Aneesa Motala, Danica Tolentino, Susanne Hempel

{"title":"Frameworks for Health Care Quality and Disparities in Health Care Quality: A Scoping Review.","authors":"Diana Zhang, Feifei Ye, Steven Martino, Emma Longo, Charlotte Ong, Katrina Ninh, Cecilia Paz, Sandra Tyler-Mills, Dean Madera, Brionna Yiggins, Sangita Baxi, Niranjan Bhatt, Sachi Yagyu, Aneesa Motala, Danica Tolentino, Susanne Hempel","doi":"10.1097/JHQ.0000000000000513","DOIUrl":"10.1097/JHQ.0000000000000513","url":null,"abstract":"Background: Quality-of-care frameworks are essential for assessing health care system performance, addressing disparities, and guiding quality improvement. The aim of the project was to identify and appraise such frameworks for health care delivery settings.Methods: A scoping review (protocol: osf.io/cegq3) searched seven research databases for quality-of-care frameworks published through October 2024. We also reviewed websites of health services research organizations and agencies charged with monitoring quality of care and/or health care disparities. Eligible publications addressed quality-of-care measures, indicators, criteria, or benchmarks; included a visualization or structured description differentiating quality domains; and were applicable to health care.Results: We identified 154 frameworks proposed by national and international entities. Critical appraisal showed 49% of frameworks were constructed with input from interest holders, 29% described an evidence-based process, and 36% reported validity testing. Frameworks varied in complexity and scope, and inclusion of disparities as a framework component increased over time. The most frequent framework domains were access, structural capabilities, equity, and effectiveness; however, definitions and conceptualizations varied.Conclusions: Our findings show that there remains much work to be done to refine and operationalize health care quality frameworks to ensure they can be applied effectively across health care settings to drive real-world improvements in quality and equity of care.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718683","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

Reducing Community-Acquired CDIFF Admissions: Outpatient Antimicrobial Stewardship. 减少社区获得性CDIFF入院：门诊抗菌药物管理。

IF 1.1 4区医学

Journal for Healthcare Quality Pub Date : 2026-04-01 DOI: 10.1097/JHQ.0000000000000507

Taylor Trahan, Christopher Wexler

{"title":"Reducing Community-Acquired CDIFF Admissions: Outpatient Antimicrobial Stewardship.","authors":"Taylor Trahan, Christopher Wexler","doi":"10.1097/JHQ.0000000000000507","DOIUrl":"10.1097/JHQ.0000000000000507","url":null,"abstract":"Introduction: According to the CDC, approximately 80%-90% of antibiotic use occurs among outpatients and at least 30% of these prescriptions are unnecessary.Methods: In 2024, multidisciplinary team at our institution developed a program to monitor outpatient antibiotic use for high priority respiratory conditions. Best practice guidelines from the Agency for Healthcare Research and Quality Outpatient Antibiotic Stewardship Toolkit were used, and feedback was provided to providers in the program. Data were tracked using an electronic medical record to pull high priority respiratory conditions such as upper respiratory infection, acute bronchitis, sinusitis, otitis media, pharyngitis, and pneumonia by ICD-10.Results: Antibiotic Prescription rates decreased from 528.32 antibiotics per 1,000 persons in 2023 to 270.91 in 2024 ( p < .05). Overall community-acquired C. difficile admissions decreased from 21 in 2023 to 16 in 2024 ( p > .05). The percentage of C. difficile admissions with outpatient antibiotics within 90 days reduced from 8 (33%) in 2023 to 1 (6%) in 2024 ( p < .05).Conclusions: Outpatient Antibiotic Stewardship Programs can reduce the number of inappropriate prescriptions potentially leading to a reduced risk for patients developing C. difficile . A cost savings was established to promote key stakeholder buy in and program sustainability.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786471","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