Journal for Healthcare Quality最新文献_第9页

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

Experience and Hospital Context Influence Fall Prevention Practice by Physical Therapists: A Survey Study. 经验和医院环境对物理治疗师预防跌倒实践的影响：一项调查研究。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-07-01 Epub Date: 2023-03-31 DOI: 10.1097/JHQ.0000000000000382

James P Crick, Lisa Juckett, Marka Salsberry, Carmen Quatman, Catherine C Quatman-Yates

{"title":"Experience and Hospital Context Influence Fall Prevention Practice by Physical Therapists: A Survey Study.","authors":"James P Crick, Lisa Juckett, Marka Salsberry, Carmen Quatman, Catherine C Quatman-Yates","doi":"10.1097/JHQ.0000000000000382","DOIUrl":"10.1097/JHQ.0000000000000382","url":null,"abstract":"Background: Falls in and following hospitalization are common and problematic. Little is understood about the factors that impede or promote effective implementation of fall prevention practices.Purpose and relevance: Physical therapists are commonly consulted for acute care patients at risk for falling. The purpose of this study is to understand therapist perceptions of their effectiveness in fall prevention and to explore the impact of contextual factors on practice patterns to prevent falls surrounding hospitalization.Methods: Survey questions were tailored to the constructs of hospital culture, structural characteristics, networks and communications, and implementation climate, in addition to inquiries regarding practice patterns and attitudes/beliefs.Results: Overall, 179 surveys were analyzed. Most therapists (n = 135, 75.4%) affirmed their hospital prioritizes best practices for fall prevention, although fewer agreed that therapists other than themselves provide optimal fall prevention intervention (n = 105, 58.7%). Less practice experience was associated with greater odds of affirming that contextual factors influence fall prevention practice (odds ratio 3.90, p < .001). Respondents who agreed that their hospital system prioritizes best practices for fall prevention had 14 times the odds of believing that their system prioritizes making improvements ( p = .002).Conclusions/implications: As experience influences fall prevention practice, quality assurance and improvement initiatives should be used to ensure minimum specifications of practice.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 4","pages":"191-199"},"PeriodicalIF":1.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9753041","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

A Cross-Sectional Study of the Characteristics Associated With Chronic Pain Documentation on the Problem List. 问题清单中记录慢性疼痛相关特征的横断面研究。

IF 1.3 4区医学

Journal for Healthcare Quality Pub Date : 2023-07-01 Epub Date: 2023-03-17 DOI: 10.1097/JHQ.0000000000000381

Tina L Rylee, David Copenhaver, Christiana Drake, Jill Joseph

{"title":"A Cross-Sectional Study of the Characteristics Associated With Chronic Pain Documentation on the Problem List.","authors":"Tina L Rylee, David Copenhaver, Christiana Drake, Jill Joseph","doi":"10.1097/JHQ.0000000000000381","DOIUrl":"10.1097/JHQ.0000000000000381","url":null,"abstract":"Abstract: Chronic pain is often elusive because of its specific diagnosis and complex presentation, making it challenging for healthcare providers to develop safe and effective treatment plans. Experts recommend a multifaceted approach to managing chronic pain that requires interdisciplinary communication and coordination. Studies have found that patients with a complete problem list receive better follow-up care. This study aimed to determine the factors associated with chronic pain documentation in the problem list. This study included 126 clinics and 12,803 patients 18 years or older with a chronic pain diagnosis within 6 months before or during the study period. The findings revealed that 46.4% of the participants were older than 60 years, 68.3% were female, and 52.1% had chronic pain documented on their problem list. Chi-square tests revealed significant differences in demographics between those who did and did not have chronic pain documented on their problem list, with 55.2% of individuals younger than 60 years having chronic pain documented on their problem list, 55.0% of female patients, 60.3% of Black non-Hispanic people, and 64.8% of migraine sufferers. Logistic regression analysis revealed that age, sex, race/ethnicity, diagnosis type, and opioid prescriptions were significant predictors of chronic pain documentation on the problem list.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"45 4","pages":"200-208"},"PeriodicalIF":1.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9753038","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