{"title":"Thank You to Reviewers.","authors":"Cathy E Duquette","doi":"10.1097/JHQ.0000000000000459","DOIUrl":"https://doi.org/10.1097/JHQ.0000000000000459","url":null,"abstract":"","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"46 6","pages":"380"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584607","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":"A Note from the Editor-in-Chief.","authors":"Cathy E Duquette","doi":"10.1097/JHQ.0000000000000458","DOIUrl":"10.1097/JHQ.0000000000000458","url":null,"abstract":"","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"46 6","pages":"325"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584595","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}
Erwin Wang, Aditya Samaroo, Joseph Weisstuch, Bret Rudy
{"title":"The Use of a Single Risk Assessment Tool for Mortality and Numerous Hospital-Acquired Conditions.","authors":"Erwin Wang, Aditya Samaroo, Joseph Weisstuch, Bret Rudy","doi":"10.1097/JHQ.0000000000000456","DOIUrl":"10.1097/JHQ.0000000000000456","url":null,"abstract":"<p><strong>Abstract: </strong>Quality assessment organizations leverage numerous patient safety measures to evaluate hospital performance, resulting in significant financial, administrative, and operational burdens on health systems. Low-intensity approaches that allow for reliable risk stratification of patients can reduce the required investment. The Braden score is a routinely performed bedside nursing evaluation validated to assess risk for hospital-acquired pressure injury. We hypothesized that the tool can be used to evaluate risk for other hospital-related adverse outcomes, including mortality, catheter-associated urinary tract infection (CAUTI), and central line-associated bloodstream infection (CLABSI). We found that abnormal Braden scores have significant association with numerous adverse outcome measures, including mortality, CLABSI, CAUTI, and iatrogenic hypoglycemia. Because of its frequency of reevaluation, we have found preliminary evidence that leveraging this tool can reduce harm by quickly identifying the most at-risk patients for various types of iatrogenic harm. We conclude that in the face of increasing automation and technical applications, for example, artificial intelligence-driven tools, highly reliable clinician bedside physical examination and evaluation can still have significant, low-cost, and high-value impact in improving patient safety.</p>","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"370-379"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478390","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}
Celeste R Romp, Lori Ross, Sabrina Baucom, Breanna K Dalmolin, Catherine Chang
{"title":"Collaboration to Remove Barriers to Pump Integration With the Electronic Health Record.","authors":"Celeste R Romp, Lori Ross, Sabrina Baucom, Breanna K Dalmolin, Catherine Chang","doi":"10.1097/JHQ.0000000000000454","DOIUrl":"10.1097/JHQ.0000000000000454","url":null,"abstract":"<p><strong>Background: </strong>The Institute for Safe Medication Practices and The Joint Commission recommend the implementation of bidirectional smart infusion pump interoperability with the electronic health record (EHR) to improve medication safety. However, there are barriers associated with implementation of this process.</p><p><strong>Purpose: </strong>The purpose of this process improvement project was to identify, evaluate, and implement improvements in pump integration with the EHR to decrease manual programming and increase the use of the smart pump functions (the dose error reduction system or infusion guardrails).</p><p><strong>Methods: </strong>A medication safety task force was formed, and end users were surveyed for barriers. The task force found and implemented solutions to improve the process.</p><p><strong>Results: </strong>Infusion pump integration rates for seven hospitals improved from 79.4% to 91.8% ( p < .001), and the use of smart pump programming increased from 84.7% to 93.6%.</p><p><strong>Conclusions: </strong>Including all stakeholders in the project allowed barriers to be identified and solutions to be implemented. As more healthcare systems implement technology-related processes to improve patient safety, this work can guide medication safety teams on how to optimize technology use by removing barriers to the use of pump integration with the EHR.</p>","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"359-364"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478389","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}
Jianling Tao, Sara May, Mingyi Li, Marianne Monahan, Donna Phanumas, Charles Seelig
{"title":"A Survey for Charting Intake, Output, and Body Weight in the Electronic Medical Record.","authors":"Jianling Tao, Sara May, Mingyi Li, Marianne Monahan, Donna Phanumas, Charles Seelig","doi":"10.1097/JHQ.0000000000000437","DOIUrl":"10.1097/JHQ.0000000000000437","url":null,"abstract":"<p><strong>Background: </strong>The accuracy of documentation of body weight and fluid balance in hospitalized patients is frequently questioned.</p><p><strong>Methods: </strong>We conducted a survey to understand provider perceptions of the accuracy of intake, output, and weight charting in the electronic medical record. We sent a six-item questionnaire to nurses and physicians who provide inpatient service in a community-based teaching hospital of the Northeastern United States. We compared the response difference between nurses and physicians by Fisher exact test.</p><p><strong>Results: </strong>One hundred eight nurses and 39 physicians participated in the survey. Both nurses and physicians responded that the accuracy of documentation is crucial. However, only 25.7% of participating physicians and 38.3% of participating nurses considered that documentation in the electronic medical record is reliable. Both physicians and nurses assumed that the nurses are too busy to collect and document the data, and the variability of non-patient weight and variations in body weight measurement under different conditions account for inaccuracies in the documented body weight.</p><p><strong>Conclusions: </strong>Assessing the accuracy of documenting intake, output, and body weight in the electronic medical record is warranted. Providers believe that educating patients about fluid balance and volume assessment help to improve the accuracy in charting intake, output, and body weight in the electronic medical record.</p>","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"293-299"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921753","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":"Optimizing the Team Approach: Designing a Clinical Care Pathway for Functional Neurological Disorder.","authors":"Laurey Brown, Meredith Norwood, Laurie G Thompson","doi":"10.1097/JHQ.0000000000000445","DOIUrl":"10.1097/JHQ.0000000000000445","url":null,"abstract":"<p><strong>Abstract: </strong>Functional neurological disorder (FND) sits at the intersection of neurology and psychology and has a variety of presentations, severity, and symptomatology. It affects a considerable number of pediatric patients and overwhelmingly influences healthcare spending. Diagnosis, treatment, and outcomes are varied, challenging, and lack standardization, often leading to frustration from patients, caregivers, and providers. Multidisciplinary care is essential though communication is often complex and disjunct. Using quality improvement tools and experiences from one institution, a team was established to ameliorate these concerns. A clinical care pathway was designed for the diagnosis and treatment of FND in the pediatric inpatient setting. This pathway was the result of the multidisciplinary team effort and an outcome, highlighting the need for early and intentional diagnosis with diagnosing provider specified, provider education and consistent language, patient and caregiver education, and clear and thorough discharge planning. Through the implementation of this pathway, it is anticipated that patient and provider satisfaction will improve as will the outcomes and care given to affected individuals. This work can be applied to the global treatment of FND and raise awareness to effectively managed care as well as the opportunity for clinicians to drive institutional change.</p>","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"276-280"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421504","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":"Impact of Collaborative Leadership, Workplace Social Capital, and Interprofessional Collaboration Practice on Patient Safety Climate.","authors":"Ryohei Kida, Katsumi Fujitani, Hironobu Matsushita","doi":"10.1097/JHQ.0000000000000443","DOIUrl":"10.1097/JHQ.0000000000000443","url":null,"abstract":"<p><strong>Purpose: </strong>Patient safety climate is an important factor in promoting patient safety for healthcare organizations. This study investigated the relationship between collaborative leadership and patient safety climate, the mediation effect of workplace social capital, or interprofessional collaboration practice.</p><p><strong>Methods: </strong>A web-based cross-sectional questionnaire survey was administered between May 2021 and May 2022, to employees of three acute care hospitals in Japan. The relationship between variables was verified by structural equation modeling.</p><p><strong>Results: </strong>A total of 1,276 staff members participated in the study. Collaborative leadership affected the workplace social capital (β = .734) and interprofessional collaboration (β = .561), which were positively associated with patient safety climate (β = .403 and .405, respectively), verifying the mediating relationship of workplace social capital and interprofessional collaboration between collaborative leadership and patient safety climate.</p><p><strong>Conclusions: </strong>Collaborative leadership enhances the reciprocity and interprofessional practices of the healthcare team. The interaction among interprofessional team members fosters a patient safety climate. The results of this survey suggest that the development of collaborative leadership, which encourages interprofessional collaboration and fosters workplace social capital, is inherently crucial for cultivating a patient safety climate.</p>","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"268-275"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960489","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}
Cynthia Cantu, Rebecca Jones, Dolores Garcia, Arlene Reyes, Ramon S Cancino
{"title":"Improving Lung Cancer Screening at an Academic Medical Center.","authors":"Cynthia Cantu, Rebecca Jones, Dolores Garcia, Arlene Reyes, Ramon S Cancino","doi":"10.1097/JHQ.0000000000000449","DOIUrl":"10.1097/JHQ.0000000000000449","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer ranks as the third most prevalent cancer in the United States. The use of low-dose computed tomography (LDCT) screening significantly reduces mortality from this disease. Unfortunately, Texas lags in completing lung cancer screening (LCS) for high-risk patients, ranking 48th among all states. It is crucial to implement quality improvement (QI) initiatives in Texas. In collaboration with the American Cancer Society, the primary care center (PCC) at our institution led a multidisciplinary QI project aimed at enhancing LCS through LDCT for eligible PCC patients.</p><p><strong>Methods: </strong>The study included patients eligible for screening and who fall into the following categories: established patients with Medicaid, low-income or uninsured established patients, and established patients with either Medicare or commercial insurance. Enhancements to electronic medical records, education for clinical staff and patients, and a coordinated, multidisciplinary effort were implemented.</p><p><strong>Results: </strong>The study revealed a substantial 40.2% improvement in LCS rates.</p><p><strong>Conclusion: </strong>The US Preventive Services Task Force guidelines rely on an accurate history of patient's tobacco use to identify patients eligible for LCS. This QI project achieved success in improving the thoroughness of tobacco use history documentation and surpassed our target for increasing LCS by more than 10%.</p>","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"46 5","pages":"286-292"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093999","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}
Johanna Greenberg, Andrew Curtin, Eliza Taylor, Katherine Fortenberry
{"title":"Fall Risk Screening in Older Adult Patients on Chronic Opioid Therapy: A Quality Improvement Project.","authors":"Johanna Greenberg, Andrew Curtin, Eliza Taylor, Katherine Fortenberry","doi":"10.1097/JHQ.0000000000000442","DOIUrl":"10.1097/JHQ.0000000000000442","url":null,"abstract":"<p><strong>Abstract: </strong>Many older adults prescribed opioid pain medications may be at increased risk of falls. As a quality improvement (QI) initiative, the University of Utah Sugar House clinic initiated a 9-month fall risk screening pilot for older adult patients on chronic opioids. This QI project sought to determine the feasibility of adding screening to a busy clinical practice, examine risk of falls in this patient cohort, and examine whether there were significant clinical and demographic differences between the patients who did or did not receive screening. We observed whether conventionally understood fall risk factors, including higher opioid doses, concurrent benzodiazepine prescription, and age, correlate with high fall risk. After the screening initiative, we determined that it was possible to significantly increase fall risk screening rates with prompts in Electronic Health Record (EHR). This cohort's fall risk screening increased from 18% to 33%. In the patients who were screened, 43% were found to be at high risk of falls. We did not see a correlation with high fall risk and patients taking higher doses of opioids or concurrent benzodiazepine prescriptions. These findings emphasize the need for consistent screening in primary care because review of the medication list alone is not a reliable predictor of fall risk.</p>","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"259-267"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560147","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":"Eradicating the Loneliness Epidemic: One Phone Call at a Time.","authors":"Ethan Feldmiller, Lynnae Messner, Sridhar Rao Gona, Maulik Joshi","doi":"10.1097/JHQ.0000000000000441","DOIUrl":"10.1097/JHQ.0000000000000441","url":null,"abstract":"<p><strong>Abstract: </strong>Loneliness and social isolation are serious problems that can impose negative consequences on individual well-being. Research suggests that loneliness can lead to an increased risk of depression, anxiety, and other health issues. Meritus Health, recognizing that loneliness is an issue within its community, has set a goal to comprehensively eradicate loneliness. As part of this effort, Meritus implemented the Care Caller program in November of 2021 through which a volunteer is paired up with a patient from our institution who has indicated that they are lonely. Each duo then finds a weekly cadence to share in 15- to 30-minute phone calls to facilitate meaningful social interaction. As of July 2023, the program has 500 participants enrolled with 47 volunteers and 2 full-time employees, and over 350 people are called weekly. In the last fiscal year, over 75,000 minutes have been spent on the phone between care callers and participants with promising results. Of the 172 participants who have been in the program for 4+ months, 166 have indicated that they felt less lonely, yielding a success rate of 97%. Meritus Health continues to further this program by increasing the number of care callers and utilization of Plan-Do-Study-Act rapid improvement.</p>","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"46 5","pages":"300-305"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093997","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}