Journal for Healthcare Quality最新文献_第9页

Comparison of Clinical, Economic, and Humanistic Outcomes Between Blood Collection Approaches: A Systematic Literature Review. 血液采集方法的临床、经济和人文结果比较：系统文献综述。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-11-01 Epub Date: 2023-09-27 DOI: 10.1097/JHQ.0000000000000399

Cathy Perry, Kimberly Alsbrooks, Alicia Mares, Klaus Hoerauf

{"title":"Comparison of Clinical, Economic, and Humanistic Outcomes Between Blood Collection Approaches: A Systematic Literature Review.","authors":"Cathy Perry, Kimberly Alsbrooks, Alicia Mares, Klaus Hoerauf","doi":"10.1097/JHQ.0000000000000399","DOIUrl":"10.1097/JHQ.0000000000000399","url":null,"abstract":"Background: A systematic literature review was performed to understand the prevalence, advantages, and disadvantages of blood collection using different approaches (direct venipuncture or vascular access devices), and interventions used to mitigate the disadvantages.Methods: The review included a broad range of study designs and outcomes. Database searches (Embase, MEDLINE, Cochrane library, and Centre for Reviews and Dissemination) were conducted in March 2021 and supplemented by hand searching.Results: One hundred forty-one publications were included. The data indicate that blood sampling from vascular access devices is common in emergency departments, trauma centers, and intensive care units. Studies showed that hemolysis and sample contamination place a considerable economic burden on hospitals. Significant cost savings could be made through enforcing strict aseptic technique, or using the initial specimen diversion technique.Conclusions: Hemolysis and sample contamination are far from inevitable in vascular access device-collected or venipuncture samples; both can be reduced through adherence to strict blood sampling protocols and utilization of the initial specimen diversion technique. Needle-free blood collection devices offer further hope for reducing hemolysis. No publication focused on the difficult venous access population; insertion success rates are likely to be lower (and the benefits of vascular access devices higher) in these patients.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"359-370"},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174197","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

Diagnostic Accuracy of a Trauma Risk Assessment Tool Among Geriatric Patients With Crash Injuries. 创伤风险评估工具在老年车祸患者中的诊断准确性。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2023-11-01 Epub Date: 2023-08-18 DOI: 10.1097/JHQ.0000000000000402

Oluwaseun John Adeyemi, Kester Gibbons, Luke B Schwartz, Ariana T Meltzer-Bruhn, Garrett W Esper, Corita Grudzen, Charles DiMaggio, Joshua Chodosh, Kenneth A Egol, Sanjit R Konda

{"title":"Diagnostic Accuracy of a Trauma Risk Assessment Tool Among Geriatric Patients With Crash Injuries.","authors":"Oluwaseun John Adeyemi, Kester Gibbons, Luke B Schwartz, Ariana T Meltzer-Bruhn, Garrett W Esper, Corita Grudzen, Charles DiMaggio, Joshua Chodosh, Kenneth A Egol, Sanjit R Konda","doi":"10.1097/JHQ.0000000000000402","DOIUrl":"10.1097/JHQ.0000000000000402","url":null,"abstract":"Abstract: The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a risk stratification tool. We evaluated the STTGMA's accuracy in predicting 30-day mortality and the odds of unfavorable clinical trajectories among crash-related trauma patients. This retrospective cohort study (n = 912) pooled adults aged 55 years and older from a single institutional trauma database. The data were split into training and test data sets (70:30 ratio) for the receiver operating curve analysis and internal validation, respectively. The outcome variables were 30-day mortality and measures of clinical trajectory. The predictor variable was the high-energy STTGMA score (STTGMAHE). We adjusted for the American Society of Anesthesiologists Physical Status. Using the training and test data sets, STTGMAHE exhibited 82% (95% CI: 65.5-98.3) and 96% (90.7-100.0) accuracies in predicting 30-day mortality, respectively. The STTGMA risk categories significantly stratified the proportions of orthopedic trauma patients who required intensive care unit (ICU) admissions, major and minor complications, and the length of stay (LOS). The odds of ICU admissions, major and minor complications, and the median difference in the LOS increased across the risk categories in a dose-response pattern. STTGMAHE exhibited an excellent level of accuracy in identifying middle-aged and geriatric trauma patients at risk of 30-day mortality and unfavorable clinical trajectories.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 6","pages":"340-351"},"PeriodicalIF":0.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428151","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

An Initiative to Stop Antibiotics Prescribed for Urinary Symptoms When Urine Culture Is Negative. 当尿液培养呈阴性时，停止使用针对尿液症状的抗生素。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-11-01 DOI: 10.1097/JHQ.0000000000000403

Benjamin Kofoed, Jacob Morris, Jennifer Rich

引用次数: 0

Barriers to Health Information Exchange Among Ambulatory Physicians: Results From a Nationally Representative Sample. 门诊医师之间健康信息交流的障碍：来自全国代表性样本的结果。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-11-01 DOI: 10.1097/JHQ.0000000000000404

Elizabeth B Matthews, Victoria Stanhope, Yuanyuan Hu

引用次数: 0

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