Journal for Healthcare Quality最新文献_第8页

Interventions to Reduce Inappropriate Physical Therapy Consultation in the Inpatient Setting: A Quality Improvement Initiative. 减少住院患者不适当物理治疗咨询的干预措施：一项质量改进举措。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-11-01 DOI: 10.1097/JHQ.0000000000000407

Moksha Patel, Tiffany A Gardner, Christopher White, Angela Keniston, Becky Maassen, Emily Gottenborg

{"title":"Interventions to Reduce Inappropriate Physical Therapy Consultation in the Inpatient Setting: A Quality Improvement Initiative.","authors":"Moksha Patel, Tiffany A Gardner, Christopher White, Angela Keniston, Becky Maassen, Emily Gottenborg","doi":"10.1097/JHQ.0000000000000407","DOIUrl":"10.1097/JHQ.0000000000000407","url":null,"abstract":"Abstract: Physical therapy (PT) in inpatient settings is a limited and valuable resource. Inappropriate PT consultation is costly and can lead to delays in care and discharge planning. Baseline data at an academic hospital revealed that approximately one in four PT consults were inappropriate (n = 29,230) across all services, as defined by an activity measure post-acute care \"6-Clicks\" basic mobility score of >22. Our interdisciplinary quality improvement team used the Six Sigma methodology to address this problem. We performed a root-cause analysis that identified high-impact root causes and implemented two targeted interventions: (1) A modified electronic health record PT order with clinical-decision support, and (2) nursing role change to assume PT-ordering responsibility. The rate of inappropriate PT consults decreased from 23.9% to <10% postintervention across all inpatient units, with the nursing role change reaching statistical significance (p < .0019). Our multifaceted intervention contributed to a significant reduction in unnecessary PT consults, expediting evaluation of patients qualifying for skilled inpatient therapy.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 6","pages":"332-339"},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428152","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

Applying the Urgent Maternal Warning Signs Initiative in a Novel Setting. 在一个新颖的环境中应用紧急产妇警告信号倡议。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-11-01 Epub Date: 2023-10-03 DOI: 10.1097/JHQ.0000000000000401

Katherine Jenkins, Evelyn Quarshie, Crystal Phommasathit, Michelle Menegay, Allison Lorenz, Patrick Schneider, Reena Oza-Frank, Breanne Haviland, Heather Kristofzski-Raizor, Dyane Gogan Turner

{"title":"Applying the Urgent Maternal Warning Signs Initiative in a Novel Setting.","authors":"Katherine Jenkins, Evelyn Quarshie, Crystal Phommasathit, Michelle Menegay, Allison Lorenz, Patrick Schneider, Reena Oza-Frank, Breanne Haviland, Heather Kristofzski-Raizor, Dyane Gogan Turner","doi":"10.1097/JHQ.0000000000000401","DOIUrl":"10.1097/JHQ.0000000000000401","url":null,"abstract":"Abstract: Symptoms of urgent maternal warning signs (UMWS) may occur during pregnancy or after delivery and may have lasting effects or indicate a life-threatening situation if left untreated. The state department of health sponsored a quality improvement project (QIP) to broaden the reach of UMWS education beyond traditional clinical settings, to public health settings where prenatal and postpartum women are seen. Specifically, the QIP implemented process changes to provide education (written and verbal) and resources to individuals receiving services from Women, Infants, and Children clinics during pregnancy and up to 12 weeks postpartum. Clinics submitted participant-level data although the Research Electronic Data Capture secure data portal. The key results indicated an increase in both written and verbal education. In addition, the project monitored referrals made specific to conditions identified through project-specific data collection and the provision of UMWS education.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"324-331"},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172112","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

Should Penicillin Allergy Testing Be Included as Part of Preoperative Testing? 是否应将青霉素过敏测试作为术前测试的一部分？

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-09-01 Epub Date: 2023-06-29 DOI: 10.1097/JHQ.0000000000000395

Svjetlana Lozo, Daniel Wagner, Nirav Shah, Roger Goldberg, Adam Gafni-Kane, Anthony Solomonides

{"title":"Should Penicillin Allergy Testing Be Included as Part of Preoperative Testing?","authors":"Svjetlana Lozo, Daniel Wagner, Nirav Shah, Roger Goldberg, Adam Gafni-Kane, Anthony Solomonides","doi":"10.1097/JHQ.0000000000000395","DOIUrl":"10.1097/JHQ.0000000000000395","url":null,"abstract":"Introduction: Penicillin allergy is the most commonly reported drug allergy in the United States. Patients labeled with penicillin allergy are at risk of receiving broad-spectrum antibiotics for surgical site infection prophylaxis, which can lead to increased antibiotic resistance, higher morbidity, suboptimal antibiotic therapy, and higher medical costs. This study aimed to determine the true prevalence of penicillin allergy among surgical patients and to decrease the unnecessary use of broad-spectrum antibiotics.Methods: A retrospective chart review was performed of patients who underwent urogynecologic surgery in 2017. In 2018, a quality initiative was started, and all patients reporting penicillin allergies were offered antibiotic allergy testing as part of their preoperative testing.Results: In 2017, 15% of patients reported penicillin allergy and 52% of them received surgical prophylaxis with broad-spectrum antibiotics. In 2018, 463 patients underwent surgery, 55 of whom reported penicillin allergy and were offered penicillin allergy testing. 35 (64%) agreed to proceed with testing, and of those tested, 33 (94%) tested negative for penicillin allergy.Conclusions: 94% of patients with stated penicillin allergy who consented to allergy testing proved to have negative test. Penicillin allergy testing should be considered as part of preoperative management.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 5","pages":"255-260"},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10206858","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

Development of Quality Measures for Inpatient Diabetes Care and Education Specialists: A Call to Action. 制定住院糖尿病护理和教育专家的质量措施：行动呼吁。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-09-01 Epub Date: 2023-07-10 DOI: 10.1097/JHQ.0000000000000397

Gwen Klinkner, Leigh Bak, Jennifer N Clements, Eva H Gonzales

引用次数: 0

Clinical Pharmacist Transition of Care Model Improves Hospital System Practice by Reducing Readmissions. 临床药剂师护理模式的转变通过减少重复来改善医院系统实践。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-09-01 Epub Date: 2023-05-02 DOI: 10.1097/JHQ.0000000000000384

Nha Uyen Tuong Ngo, Soodtida Tangpraphaphorn, Deborah Kahaku, Catherine P Canamar, Andrew Young

{"title":"Clinical Pharmacist Transition of Care Model Improves Hospital System Practice by Reducing Readmissions.","authors":"Nha Uyen Tuong Ngo, Soodtida Tangpraphaphorn, Deborah Kahaku, Catherine P Canamar, Andrew Young","doi":"10.1097/JHQ.0000000000000384","DOIUrl":"10.1097/JHQ.0000000000000384","url":null,"abstract":"Purpose: A primary cause of hospital readmission is medication-related problems (MRPs). Polypharmacy patients taking multiple medications concurrently experience an increased likelihood of MRPs and high occurrence of readmissions to the hospital within 30 days. This study assessed the ability of a pharmacist-led transition of care program to decrease readmissions in polypharmacy patients by evaluating and rectifying MRPs.Methods: Over 16 months, patients admitted onto the medicine ward service with ≥10 home medications ( n = 536) received medication management interventions from a clinical pharmacist including admission interview, medication reconciliation and consultation, and postdischarge phone follow-up. Admitted patients taking fewer than 10 home medications during the same time served as the control group and received routine standard of care ( n = 2317).Results: The polypharmacy group who received the pharmacist-led intervention had a statistically significantly lower 30-day readmission rate (8.8%) compared with patients in the control group (12.4%; X 2 = 5.63, p = .01). Patients receiving pharmacist intervention were 33% less likely to be readmitted within 30 days of discharge compared with the control group (odds ratio = 0.67, 95% CI = 0.49-0.94). All patients had at least one medication-related discrepancy.Conclusion: This pharmacy-led transition of care program can effectively reduce readmission rates through resolution of medication-related problems.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 5","pages":"272-279"},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10197040","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 Operating Room Efficiency Through Reducing First Start Delays in an Academic Center. 通过减少学术中心的首次启动延迟来提高手术室的效率。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-09-01 Epub Date: 2023-07-13 DOI: 10.1097/JHQ.0000000000000398

Dylan Singh, Lawrence Cai, Dominique Watt, Elise Scoggins, Samuel Wald, Rahim Nazerali

{"title":"Improving Operating Room Efficiency Through Reducing First Start Delays in an Academic Center.","authors":"Dylan Singh, Lawrence Cai, Dominique Watt, Elise Scoggins, Samuel Wald, Rahim Nazerali","doi":"10.1097/JHQ.0000000000000398","DOIUrl":"10.1097/JHQ.0000000000000398","url":null,"abstract":"Background: Delays in operating room (OR) first-case start times can cause additional costs for hospitals, healthcare team frustration and delay in patient care. Here, a novel process improvement strategy to improving first-case start times is presented.Methods: First case in room start times were recorded for ORs at an academic medical center. Three interventions-automatic preoperative orders, dot phrases to permit re-creation of unavailable consent forms, and improved H&P linking to the surgical encounter-were implemented to target documentation-related delays. Monthly percentages of first-case on-time starts (FCOTS) and time saved were compared with the \"preintervention\" time period, and total cost savings were estimated.Results: During the first 3-months after implementation of the interventions, the percentage of FCOTS improved from an average of 36.7%-52.7%. Total time savings across all ORs over the same time period was found to be 55.63 hours, which is estimated to have saved a total of $121,834.52 over the 3-month interventional period.Conclusions: By implementing multiple quality improvement interventions, delays to first start in room OR cases can be meaningfully reduced. Quality improvement protocols targeted toward root causes of OR delays can be a significant driver to reduce healthcare costs.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 5","pages":"308-313"},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10576200","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

The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review. 质量改进在物理治疗文献中的应用：范围界定综述。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2023-09-01 Epub Date: 2023-06-14 DOI: 10.1097/JHQ.0000000000000394

James P Crick, Timothy J Rethorn, Tyler A Beauregard, Riley Summers, Zachary D Rethorn, Catherine C Quatman-Yates

{"title":"The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review.","authors":"James P Crick, Timothy J Rethorn, Tyler A Beauregard, Riley Summers, Zachary D Rethorn, Catherine C Quatman-Yates","doi":"10.1097/JHQ.0000000000000394","DOIUrl":"10.1097/JHQ.0000000000000394","url":null,"abstract":"Introduction: Quality improvement (QI) is a useful methodology for improving healthcare, often through iterative changes. There is no prior review on the application of QI in physical therapy (PT).Purpose and relevance: To characterize and evaluate the quality of the QI literature in PT.Methods: We searched four electronic databases from inception through September 1, 2022. Included publications focused on QI and included the practice of PT. Quality was assessed using the 16-point QI Minimum Quality Criteria Set (QI-MQCS) appraisal tool.Results: Seventy studies were included in the review, 60 of which were published since 2014 with most ( n = 47) from the United States. Acute care ( n = 41) was the most prevalent practice setting. Twenty-two studies (31%) did not use QI models or approaches and only nine studies referenced Revised Standards for QI Reporting Excellence guidelines. The median QI-MQCS score was 12 (range 7-15).Conclusions/implications: Quality improvement publications in the PT literature are increasing, yet there is a paucity of QI studies pertaining to most practice settings and a lack of rigor in project design and reporting. Many studies were of low-to-moderate quality and did not meet minimum reporting standards. We recommend use of models, frameworks, and reporting guidelines to improve methodologic rigor and reporting.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 5","pages":"280-296"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10206861","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

What are Effective Strategies to Reduce Low-Value Care? An Analysis of 121 Randomized Deimplementation Studies. 减少低价值护理的有效策略是什么？121项随机脱实研究的分析。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-09-01 Epub Date: 2023-06-29 DOI: 10.1097/JHQ.0000000000000392

Pauline Heus, Simone A van Dulmen, Jan-Willem Weenink, Christiana A Naaktgeboren, Toshihiko Takada, Eva W Verkerk, Isabelle Kamm, Maarten J van der Laan, Lotty Hooft, Rudolf B Kool

{"title":"What are Effective Strategies to Reduce Low-Value Care? An Analysis of 121 Randomized Deimplementation Studies.","authors":"Pauline Heus, Simone A van Dulmen, Jan-Willem Weenink, Christiana A Naaktgeboren, Toshihiko Takada, Eva W Verkerk, Isabelle Kamm, Maarten J van der Laan, Lotty Hooft, Rudolf B Kool","doi":"10.1097/JHQ.0000000000000392","DOIUrl":"10.1097/JHQ.0000000000000392","url":null,"abstract":"Background: Low-value care is healthcare leading to no or little clinical benefit for the patient. The best (combinations of) interventions to reduce low-value care are unclear.Purpose: To provide an overview of randomized controlled trials (RCTs) evaluating deimplementation strategies, to quantify the effectiveness and describe different combinations of strategies.Methods: Analysis of 121 RCTs (1990-2019) evaluating a strategy to reduce low-value care, identified by a systematic review. Deimplementation strategies were described and associations between strategy characteristics and effectiveness explored.Results: Of 109 trials comparing deimplementation to usual care, 75 (69%) reported a significant reduction of low-value healthcare practices. Seventy-three trials included in a quantitative analysis showed a median relative reduction of 17% (IQR 7%-42%). The effectiveness of deimplementation strategies was not associated with the number and types of interventions applied.Conclusions and implications: Most deimplementation strategies achieved a considerable reduction of low-value care. We found no signs that a particular type or number of interventions works best for deimplementation. Future deimplementation studies should map relevant contextual factors, such as the workplace culture or economic factors. Interventions should be tailored to these factors and provide details regarding sustainability of the effect.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 5","pages":"261-271"},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10461725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10206859","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

Assessing Factors Influencing Commitment to a Disparities Reduction Intervention: Social Justice Attitudes and Organizational Mission. 评估影响对减少差异干预措施的承诺的因素：社会正义态度和组织使命。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2023-07-01 DOI: 10.1097/JHQ.0000000000000385

Jill A Marsteller, Yea-Jen Hsu, Kristina Weeks, Modupe Oduwole, Romsai T Boonyasai, Gideon D Avornu, Katherine B Dietz, Zehui Zhou, Deven Brown, Anika Hines, Suna Chung, Lisa Lubomski, Kathryn A Carson, Chidinma Ibe, Lisa A Cooper

{"title":"Assessing Factors Influencing Commitment to a Disparities Reduction Intervention: Social Justice Attitudes and Organizational Mission.","authors":"Jill A Marsteller, Yea-Jen Hsu, Kristina Weeks, Modupe Oduwole, Romsai T Boonyasai, Gideon D Avornu, Katherine B Dietz, Zehui Zhou, Deven Brown, Anika Hines, Suna Chung, Lisa Lubomski, Kathryn A Carson, Chidinma Ibe, Lisa A Cooper","doi":"10.1097/JHQ.0000000000000385","DOIUrl":"10.1097/JHQ.0000000000000385","url":null,"abstract":"Abstract: This mixed-methods study aims to understand what the perceptions of leaders and healthcare professionals are regarding causes of disparities, cultural competence, and motivation before launching a disparity reduction project in hypertension care, contrasting perceptions in Federally Qualified Health Centers (FQHCs), and in a non-FQHC system. We interviewed leaders of six participating primary care systems and surveyed providers and staff. FQHC respondents reported more positive cultural competence attitudes and behavior, higher motivation to implement the project, and less concern about barriers to caring for disadvantaged patients than those in the non-FQHC practices; however, egalitarian beliefs were similar among all. Qualitative analysis suggested that the organizational missions of the FQHCs reflect their critical role in serving vulnerable populations. All system leaders were aware of the challenges of provider care to underserved groups, but comprehensive initiatives to address social determinants of health and improve cultural competence were still needed in both system types. The study provides insights into the perceptions and motivations of primary care organizational leaders and providers who are interested in improving chronic care. It also offers an example for care disparity programs to understand commitment and values of the participants for tailoring interventions and setting baseline for progress.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 4","pages":"209-219"},"PeriodicalIF":0.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10228306","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

Meta-Analysis of Medication Administration Errors in African Hospitals. 非洲医院用药错误的 Meta 分析。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-07-01 Epub Date: 2023-06-05 DOI: 10.1097/JHQ.0000000000000396

Wudma Alemu, Jeannie P Cimiotti

引用次数: 0