Journal for Healthcare Quality最新文献_第5页

Self-Measured Blood Pressure Monitoring During the COVID-19 Pandemic: Perspectives From Community Health Center Clinicians. COVID-19 大流行期间的自测血压监测：社区卫生中心临床医生的观点。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2024-03-01 Epub Date: 2023-12-27 DOI: 10.1097/JHQ.0000000000000417

Margaret Meador, Neha Sachdev, Eboni Anderson, Debosree Roy, R Curtis Bay, Lauren H Becker, Joy H Lewis

{"title":"Self-Measured Blood Pressure Monitoring During the COVID-19 Pandemic: Perspectives From Community Health Center Clinicians.","authors":"Margaret Meador, Neha Sachdev, Eboni Anderson, Debosree Roy, R Curtis Bay, Lauren H Becker, Joy H Lewis","doi":"10.1097/JHQ.0000000000000417","DOIUrl":"10.1097/JHQ.0000000000000417","url":null,"abstract":"Abstract: The early period of the COVID-19 pandemic necessitated a rapid increase in out-of-office care. To capture the impact from COVID-19 on care for patients with hypertension, a questionnaire was disseminated to community health center clinicians. The extent, types, and causes of care delays and disruptions were assessed along with adaptations and innovations used to address them. Clinician attitudinal changes and perspectives on future hypertension care were also assessed. Of the 65 respondents, most (90.8%) reported their patients with hypertension experienced care delays or disruptions, including lack of follow-up, lack of blood pressure assessment, and missed medication refills or orders. To address care delays and disruptions for patients with hypertension, respondents indicated that their health center increased the use of telehealth or other technology, made home blood pressure devices available to patients, expanded outreach and care coordination, provided medication refills for longer periods of time, and used new care delivery options. The use of self-measured blood pressure monitoring (58.5%) and telehealth (43.1%) was identified as the top adaptations that should be sustained to increase access to and patient engagement with hypertension care; however, barriers to both remain. Policy and system level changes are needed to support value-based care models that include self-measured blood pressure and telehealth.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"109-118"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049624","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

Quality Improvement Interventions to Enhance Vaccine Uptake in Cancer Patients: A Systematic Review. 提高癌症患者疫苗接种率的质量改进干预措施：系统回顾。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2024-03-01 DOI: 10.1097/JHQ.0000000000000422

Basil Kazi, Zain Talukdar, Jan Schriefer

{"title":"Quality Improvement Interventions to Enhance Vaccine Uptake in Cancer Patients: A Systematic Review.","authors":"Basil Kazi, Zain Talukdar, Jan Schriefer","doi":"10.1097/JHQ.0000000000000422","DOIUrl":"10.1097/JHQ.0000000000000422","url":null,"abstract":"Introduction: Cancer patients, because of their compromised immune responses, face a higher risk of preventable infections, leading to increased morbidity and mortality. Despite this, vaccination rates among these patients are suboptimal, and research on effective interventions to improve vaccination rates is limited.Methods: We conducted a comprehensive search in PubMed and Cochrane Library for studies investigating quality improvement (QI) interventions targeting vaccine uptake in cancer patients. Two authors independently screened, extracted data, and analyzed studies, resolving any discrepancies through consensus.Results: Thirteen studies met the inclusion criteria, published between 2014 and 2022. Seven studies focused on the influenza vaccine, five on the pneumococcal vaccine, and one on both. Twelve studies used multiple interventions, whereas one used a single intervention. Most interventions aimed to enhance patient and family knowledge and identify eligible patients before their appointments. All studies demonstrated improved vaccine uptake after implementing the interventions.Conclusions: A variety of QI interventions have effectively increased pneumococcal and influenza vaccine uptake among cancer patients. Future research should address roadblocks to implementation and explore the effect of these interventions on other vaccines.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"46 2","pages":"81-94"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997992","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

Improving Interdisciplinary Communication on an Academic Hospitalist Service: A Quality Improvement Project. 改善学术住院服务的跨学科交流：一个质量改进项目。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2024-03-01 Epub Date: 2023-10-10 DOI: 10.1097/JHQ.0000000000000411

Stephen Biederman, Nargiza Sadr, Rehan Qayyum

{"title":"Improving Interdisciplinary Communication on an Academic Hospitalist Service: A Quality Improvement Project.","authors":"Stephen Biederman, Nargiza Sadr, Rehan Qayyum","doi":"10.1097/JHQ.0000000000000411","DOIUrl":"10.1097/JHQ.0000000000000411","url":null,"abstract":"Abstract: Effective communication is essential for quality patient care, and paging remains among the most common forms of communication despite the introduction of secure texting platforms. The goal of this project was to use quantitative and qualitative analyses of paging to guide improvements in paging best practices. A retrospective analysis of pages sent over a 7-day period was completed, characterizing the volume, content, and effectiveness of pages both preintervention and 3-month postintervention. The content of each page was categorized into laboratories, medications, vital signs, diet, patient assessment/clinical change, pain, or miscellaneous/other. Effectiveness was based on the following five critical elements: (1) two patient identifiers, (2) the sender's name, (3) the sender's callback number, (4) priority or acuity of the page, and (5) patient-care concern. Pages were considered successful if they contained all the five essential elements. The preintervention results guided interventions. Of 3,483 included pages, 1,806 and 1,677 were sent during the preintervention and postintervention periods, respectively. Adherence to all essential paging elements increased from 15.2% to 40% ( p < .001). The largest deficiency was labeling the urgency of a page, which increased from 31.6% to 51.9% ( p < .001). Quantitative and qualitative analyses of pages effectively guided this project to increase the standardization of paging.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"65-71"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216856","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

Surgical Site Infection Prevention Using "Strike Teams": The Experience of an Academic Colorectal Surgical Department. 利用 "突击队 "预防手术部位感染：学术结直肠外科部门的经验。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2024-01-01 DOI: 10.1097/JHQ.0000000000000412

Buddhi Hatharaliyadda, Michelle Schmitz, Anne Mork, Fauzia Osman, Charles Heise, Nasia Safdar, Aurora Pop-Vicas

{"title":"Surgical Site Infection Prevention Using \"Strike Teams\": The Experience of an Academic Colorectal Surgical Department.","authors":"Buddhi Hatharaliyadda, Michelle Schmitz, Anne Mork, Fauzia Osman, Charles Heise, Nasia Safdar, Aurora Pop-Vicas","doi":"10.1097/JHQ.0000000000000412","DOIUrl":"10.1097/JHQ.0000000000000412","url":null,"abstract":"Abstract: Surgical site infections (SSIs) are healthcare-acquired infections with substantial morbidity. Surgical site infection persist because of low adherence to prevention bundles comprising multiple infection control elements. We propose the \"Strike Team\" as an implementation strategy to improve adherence and reduce SSI in colorectal surgery. At an academic medical center, a multidisciplinary Strike Team met monthly to review colorectal SSI cases, audit and discuss barriers to adherence to SSI prevention bundle, and propose actionable feedback. The latter was shared with frontline clinicians by the Strike Team's surgical leaders in everyday practice. Colorectal SSI rates and bundle adherence data were disseminated quarterly via the hospital intranet and reviewed with surgeons at departmental meetings. Trends in adherence and SSI rates were analyzed by regression analysis using a time series model. While the Strike Team was active, adherence to antibiotic prophylaxis, maintenance of normoglycemia, and standardized intraoperative skin preparation significantly increased (p < .05). There was a trend toward statistically significant reduction in SSI (p = .07), although it was not maintained once the Strike Team activity was disrupted by the COVID-19 pandemic. Colorectal SSI prevention requires a resource-intensive, multidisciplinary approach with numerous strategies to improve adherence to infection control bundles, as illustrated by our SSI Strike Team experience.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"46 1","pages":"22-30"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081017","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

Identifying Obstructive Sleep Apnea Risk Using the STOP-BANG Questionnaire in a Cardiology Clinic. 在心脏病学诊所使用STOP-BANG问卷确定阻塞性睡眠呼吸暂停的风险。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2024-01-01 Epub Date: 2023-10-09 DOI: 10.1097/JHQ.0000000000000408

Megan Rogel, Lindsay Iverson, Alex Hall

{"title":"Identifying Obstructive Sleep Apnea Risk Using the STOP-BANG Questionnaire in a Cardiology Clinic.","authors":"Megan Rogel, Lindsay Iverson, Alex Hall","doi":"10.1097/JHQ.0000000000000408","DOIUrl":"10.1097/JHQ.0000000000000408","url":null,"abstract":"Abstract: Untreated obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality, warranting enhanced awareness, screening, and action among healthcare providers to optimize patient outcomes. Attempting to address the potential under detection of OSA, this quality improvement project implemented the STOP-Bang Sleep Apnea Questionnaire at a cardiology clinic, with the goals to stratify risk for OSA in 100% of patients and increase provider referral of high risk patients for sleep studies. The setting was an outpatient cardiology clinic in Pensacola, Florida. The sample included new and existing patients 18 years or older who had one or more of the following diagnoses: hypertension, heart failure, coronary artery disease, atrial fibrillation, or arrhythmia. Methods involved collecting and comparing preintervention sleep study referral rate data with 6-week STOP-Bang questionnaire implementation data. Results demonstrated a 65% (279 of 428 patients seen) screening implementation rate and a modest but statistically significant increase in the overall referral rate from 2.6% preintervention to 5.1% postintervention ( p = .040). Overall, standard use of the STOP-Bang questionnaire may enable higher detection and referral of OSA.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"51-57"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216855","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

Hospital Adaptions to Mitigate the COVID-19 Pandemic Effects on MARQUIS Toolkit Implementation and Sustainability. 缓解新冠肺炎大流行病对MARQUIS工具包实施和可持续性影响的医院适应。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2024-01-01 Epub Date: 2023-10-03 DOI: 10.1097/JHQ.0000000000000406

Bethany Rhoten, Abigail C Jones, Cathy Maxwell, Deonni P Stolldorf

{"title":"Hospital Adaptions to Mitigate the COVID-19 Pandemic Effects on MARQUIS Toolkit Implementation and Sustainability.","authors":"Bethany Rhoten, Abigail C Jones, Cathy Maxwell, Deonni P Stolldorf","doi":"10.1097/JHQ.0000000000000406","DOIUrl":"10.1097/JHQ.0000000000000406","url":null,"abstract":"Objective: To explore the perceived effects of COVID-19 on MARQUIS toolkit implementation and sustainability, challenges faced by hospitals in sustaining medication reconciliation efforts, and the strategies used to mitigate the negative effects of the pandemic.Data sources and study settings: Primary qualitative data were extracted from a Web-based survey. Data were collected from hospitals that participated in MARQUIS2 ( n = 18) and the MARQUIS Collaborative ( n = 5).Study design: A qualitative, cross-sectional study was conducted.Data collection/data extraction: Qualitative data were extracted from a Research Electronic Data Capture survey databased and uploaded into an Excel data analysis template. Two coders independently coded the data with a third coder resolving discrepancies.Principal findings: Thirty-one team members participated, including pharmacists ( n = 20; 65%), physicians ( n = 9; 29%), or quality-improvement (QI) specialists ( n = 2; 6%) with expertise in medication reconciliation (MedRec) (14; 45%) or QI (10; 32%). Organizational resources were limited, including funding, staffing, and access to pharmacy students. To support program continuation, hospitals reallocated staff and used new MedRec order sets. Telemedicine, workflow adaptations, leadership support, QI team involvement, and ongoing audits and feedback promoted toolkit sustainability.Conclusions: COVID-19 affected the capacity of hospitals to sustain the MARQUIS toolkit. However, hospitals adapted various strategies to sustain the toolkit.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10840884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41177289","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

Development of Diagnostic Quality Metrics for Prosthetic Joint Infection. 制定假体关节感染的诊断质量标准。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-01-01 Epub Date: 2023-12-06 DOI: 10.1097/JHQ.0000000000000405

Andy O Miller, Alberto V Carli, Amy Chin, Diana Chee, Sam Simon, Catherine H MacLean

{"title":"Development of Diagnostic Quality Metrics for Prosthetic Joint Infection.","authors":"Andy O Miller, Alberto V Carli, Amy Chin, Diana Chee, Sam Simon, Catherine H MacLean","doi":"10.1097/JHQ.0000000000000405","DOIUrl":"10.1097/JHQ.0000000000000405","url":null,"abstract":"Abstract: Although well-accepted clinical practice guidelines exist for the diagnosis of prosthetic joint infection (PJI), little is known about the quality of diagnosis for PJI. The identification of quality gaps in the diagnosis of PJI would facilitate the development of care structures and processes to shorten time to diagnosis and reduce the significant morbidity, mortality, and economic burden associated with this condition. Hence, we sought to develop valid clinical quality measures to improve the timeliness and accuracy of PJI diagnosis. We convened a nine-member multidisciplinary national panel of PJI experts including orthopedic surgeons, infectious disease specialists, an emergency medicine physician, and a patient previously treated for PJI to review, discuss, and rate the validity of proposed measures using a modification of the RAND-UCLA appropriateness method. In total, 57 permutations of six proposed measures were rated. Populations considered to be at high enough risk for PJI that certain care processes should always be performed were identified by the panel. Among the proposed quality measures, the panel rated five as valid. These novel clinical quality measures could provide insight into care gaps in the diagnosis of PJI.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"46 1","pages":"31-39"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10802978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081015","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

Improving Utilization of a Nursing-Initiated Supportive Medication Order Panel in the Inpatient Setting. 在住院患者环境中提高护理启动的支持性药物医嘱小组的利用率。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2024-01-01 Epub Date: 2023-10-10 DOI: 10.1097/JHQ.0000000000000409

Alexandra W Tatara, Samuel D Lipten

{"title":"Improving Utilization of a Nursing-Initiated Supportive Medication Order Panel in the Inpatient Setting.","authors":"Alexandra W Tatara, Samuel D Lipten","doi":"10.1097/JHQ.0000000000000409","DOIUrl":"10.1097/JHQ.0000000000000409","url":null,"abstract":"Background: Many medications are low-risk but must undergo the same ordering process as high-risk medications in the inpatient setting. Nurses identify the need for supportive medications and notify providers. An order panel and policy were developed to allow nurses to order low-risk, supportive medications.Purpose: The aim of this study was to increase order panel utilization from a 6% to a goal of 15%.Methods: This was a quality improvement study at a 1000-bed academic medical center. Five plan-do-study-act (PDSA) cycles were implemented. The primary end point was order panel utilization, and secondary end points were individual nursing unit utilization and the number of orders for each medication on the panel.Results: After each PDSA cycle, order panel utilization improved to 7.8%, 13.2%, 7.5%, 10.2%, and 10.6%, respectively. The units using the order panel most often were general medicine (n = 95, 28%), medical intensive care (n = 71, 21%), and inpatient oncology (n = 40, 12%). The medication most frequently ordered was lanolin alcohols-mineral oil with petrolatum (Eucerin) cream (n = 220, 28%).Conclusions: Order panel utilization improved from a baseline of 6% to an average of 9.9%. Increasing awareness of the order panel and adding medications will contribute to improvement in order panel utilization in the long-term.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"58-63"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216857","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

Thank You to Reviewers. 感谢审稿人。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2024-01-01 DOI: 10.1097/JHQ.0000000000000427

引用次数: 0

Increasing Hospital at Home Enrollment Through Decentralization With Agile Science. 通过敏捷科学分散管理，提高居家医院的注册率。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2024-01-01 Epub Date: 2023-12-14 DOI: 10.1097/JHQ.0000000000000410

Erin Shadbolt, Margaret Paulson, Lorin T Divine, Julie Ellis, Lucas Myers, Karly Mucks, Malaz Boustani, Igor Dumic, Michael Maniaci, Heidi Lindroth

引用次数: 0