American Journal of Medical Quality最新文献_第3页

Convocation Valedictory for Quality and Safety. 质量与安全评议会评议会。

IF 1 4区医学

American Journal of Medical Quality Pub Date : 2023-09-01 Epub Date: 2023-09-07 DOI: 10.1097/JMQ.0000000000000141

David B Nash

引用次数: 0

Assessment and Optimization of Practices with Patients with Limited English Proficiency in an Urban Emergency Department. 城市急诊科英语能力有限患者实践的评估和优化。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2023-09-01 Epub Date: 2023-09-07 DOI: 10.1097/JMQ.0000000000000142

Zachary Bopp, Alexander Kleinmann

引用次数: 0

Comparative Perspectives on Diagnostic Error Discussions Between Inpatient and Outpatient Pediatric Providers. 住院和门诊儿科提供者之间诊断错误讨论的比较视角。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2023-09-01 Epub Date: 2023-09-07 DOI: 10.1097/JMQ.0000000000000148

Meagan M Ladell, Grant Shafer, Sonja I Ziniel, Joseph A Grubenhoff

{"title":"Comparative Perspectives on Diagnostic Error Discussions Between Inpatient and Outpatient Pediatric Providers.","authors":"Meagan M Ladell, Grant Shafer, Sonja I Ziniel, Joseph A Grubenhoff","doi":"10.1097/JMQ.0000000000000148","DOIUrl":"10.1097/JMQ.0000000000000148","url":null,"abstract":"Diagnostic error remains understudied and underaddressed despite causing significant morbidity and mortality. One barrier to addressing this issue remains provider discomfort. Survey studies have shown significantly more discomfort among providers in discussing diagnostic error compared with other forms of error. Whether the comfort in discussing diagnostic error differs depending on practice setting has not been previously studied. The objective of this study was to assess differences in provider willingness to discuss diagnostic error in the inpatient versus outpatient setting. A multicenter survey was sent out to 3881 providers between May and June 2018. This survey was designed to assess comfort level of discussing diagnostic error and looking at barriers to discussing diagnostic error. Forty-three percent versus 22% of inpatient versus outpatient providers (P = 0.004) were comfortable discussing short-term diagnostic error publicly. Similarly, 76% versus 60% of inpatient versus outpatient providers (P = 0.010) were comfortable discussing short-term diagnostic error privately. A higher percentage of inpatient (64%) compared with outpatient providers (46%) (P = 0.043) were comfortable discussing long-term diagnostic error privately. Forty percent versus 24% of inpatient versus outpatient providers (P = 0.018) were comfortable discussing long-term error publicly. No difference in barriers cited depending on practice setting. Inpatient providers are more comfortable discussing diagnostic error than their outpatient counterparts. More study is needed to determine the etiology of this discrepancy and to develop strategies to increase outpatient provider comfort.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"38 5","pages":"245-254"},"PeriodicalIF":1.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/d9/jmq-38-245.PMC10484186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10189834","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

Efficacy of Interventions Based on WHO Multimodal Hand Hygiene Improvement Strategy in a Tertiary Care Hospital in Eastern India: A Quasi-Experimental Study. 基于世界卫生组织多模式手卫生改善策略的干预措施在印度东部一家三级护理医院的疗效：一项准实验研究。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2023-09-01 Epub Date: 2023-09-07 DOI: 10.1097/JMQ.0000000000000145

Ratnadeep Biswas, Ravi Kirti, Vishnu Shankar Ojha, Yash Jaiswal, Gurleen Kaur

{"title":"Efficacy of Interventions Based on WHO Multimodal Hand Hygiene Improvement Strategy in a Tertiary Care Hospital in Eastern India: A Quasi-Experimental Study.","authors":"Ratnadeep Biswas, Ravi Kirti, Vishnu Shankar Ojha, Yash Jaiswal, Gurleen Kaur","doi":"10.1097/JMQ.0000000000000145","DOIUrl":"10.1097/JMQ.0000000000000145","url":null,"abstract":"The study aimed to evaluate the efficacy of the World Health Organization (WHO) multimodal hand hygiene improvement (WHO-5) strategy in enhancing hand hygiene compliance among health care workers at a tertiary care hospital. The interrupted time series study included preintervention, intervention, and postintervention phases, with 2 points of observation each during the pre- and postintervention phases. The baseline hand hygiene compliance was 16%, which improved to 43.9% after the intervention. Health care workers were 4 times more likely to adhere to proper hand hygiene postintervention (odds ratio [OR], 4.117). Independent predictors of hand hygiene compliance included the week of observation (week 3: adjusted odds ratio [AOR], 0.872; week 5: AOR, 3.427; and week 7: AOR, 4.713), health care worker type (consultants: AOR, 0.964; residents: AOR, 2.187; and interns: AOR, 6.684), daytime (AOR, 1.232), and \"after\" type of hand hygiene opportunity (AOR, 1.577). No significant differences were found in knowledge, attitude, and practices pre- and postintervention, and the interventions' effect was sustained and increased over time, supporting implementation in hospitals across India.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"38 5","pages":"255-263"},"PeriodicalIF":1.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10182833","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

Quality Control for Spine Registries: Development and Application of a New Protocol. 脊柱登记的质量控制:新方案的发展和应用。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2023-07-01 DOI: 10.1097/JMQ.0000000000000128

Alice Baroncini, Francesco Langella, Paolo Barletta, Riccardo Cecchinato, Daniele Vanni, Fabrizio Giudici, Laura Scaramuzzo, Roberto Bassani, Carlotta Morselli, Marco Brayda-Bruno, Andrea Luca, Claudio Lamartina, Pedro Berjano

{"title":"Quality Control for Spine Registries: Development and Application of a New Protocol.","authors":"Alice Baroncini, Francesco Langella, Paolo Barletta, Riccardo Cecchinato, Daniele Vanni, Fabrizio Giudici, Laura Scaramuzzo, Roberto Bassani, Carlotta Morselli, Marco Brayda-Bruno, Andrea Luca, Claudio Lamartina, Pedro Berjano","doi":"10.1097/JMQ.0000000000000128","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000128","url":null,"abstract":"Registries are gaining importance both in clinical practice and for research purposes. However, quality control is paramount to ensure that data are consistent and reliable. Quality control protocols have been proposed for arthroplasty registries, but these are not directly applicable to the spine setting. This study aims to develop a new quality control protocol for spine registries. Based on the available protocols for arthroplasty registries, a new protocol for spine registries was developed. The items included in the protocol were completeness (yearly enrollment rate and rate of assessment completion), consistency, and internal validity (coherence between registry data and medical records for blood loss, body mass index, and treated levels). All aspects were then applied to the spine registry of the Institution to verify its quality for each of the 5 years in which the registry has been used (2016-2020). Regarding completeness, the yearly enrollment rate ranged from 78 to 86%; the completion of preoperative assessment from 79% to 100%. The yearly consistency rate varied from 83% to 86%. Considering internal validity, the interclass correlation coefficient ranged from 0.1 to 0.8 for blood loss and from 0.3 to 0.9 for body mass index. The coherency for treated levels ranged from 25% to 82%. Overall, all 3 items showed an improvement over time. All 3 analyzed domains showed good to excellent results. The overall quality of the registered data improved over time.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"38 4","pages":"181-187"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371866","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

Quality and Safety Practices Among Academic Obstetrics and Gynecology Departments. 学术妇产科的质量与安全实践。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2023-07-01 DOI: 10.1097/JMQ.0000000000000129

Diane Christopher, William M Leininger, Laurel Beaty, Jaclyn D Nunziato, Mallory E Kremer, Juan J Diaz Quinones, Sara Rutz, Todd R Griffin, Timothy E Klatt

{"title":"Quality and Safety Practices Among Academic Obstetrics and Gynecology Departments.","authors":"Diane Christopher, William M Leininger, Laurel Beaty, Jaclyn D Nunziato, Mallory E Kremer, Juan J Diaz Quinones, Sara Rutz, Todd R Griffin, Timothy E Klatt","doi":"10.1097/JMQ.0000000000000129","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000129","url":null,"abstract":"The objective was to quantify resources devoted to quality and patient safety initiatives, to document the development and use of key performance indicator reports regarding patient outcomes and patient feedback, and to assess the culture of safety within academic obstetrics and gynecology departments. Chairs of academic obstetrics and gynecology departments were asked to complete a quality and safety assessment survey. Surveys were distributed to 138 departments, yielding 52 completed responses (37.7%). Five percent of departments reported including a patient representative on a quality committee. Most committee leaders (60.5%) and members (67.4%) received no compensation. Formal training was required in 28.8% of responding departments. Most departments monitored key performance metrics for inpatient outcomes (95.9%). Leaders scored their departments' culture of safety highly. Most departments provided no protected time to faculty devoted to quality efforts, generation of key performance indicators for inpatient activities was prevalent and integrating patient and community input remain unrealized opportunities.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"38 4","pages":"165-173"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10020379","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

Population Health Management Approach to Depression Symptom Monitoring in Primary Care via Patient Portal: A Randomized Controlled Trial. 通过患者门户进行初级保健抑郁症状监测的人群健康管理方法:一项随机对照试验。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2023-07-01 DOI: 10.1097/JMQ.0000000000000126

Erin M Staab, Melissa I Franco, Mengqi Zhu, Wen Wan, Robert D Gibbons, Lisa M Vinci, Nancy Beckman, Daniel Yohanna, Neda Laiteerapong

{"title":"Population Health Management Approach to Depression Symptom Monitoring in Primary Care via Patient Portal: A Randomized Controlled Trial.","authors":"Erin M Staab, Melissa I Franco, Mengqi Zhu, Wen Wan, Robert D Gibbons, Lisa M Vinci, Nancy Beckman, Daniel Yohanna, Neda Laiteerapong","doi":"10.1097/JMQ.0000000000000126","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000126","url":null,"abstract":"Depression is undertreated in primary care. Using patient portals to administer regular symptom assessments could facilitate more timely care. At an urban academic medical center outpatient clinic, patients with active portal accounts and depression on their problem list or a positive screen in the past year were randomized to assessment during triage at visits (usual care) versus usual care plus assessment via portal (population health care). Portal invitations were sent regardless of whether patients had scheduled appointments. More patients completed assessments in the population health care arm than usual care: 59% versus 18%, P < 0.001. Depression symptoms were more common among patients who completed their initial assessment via the portal versus in the clinic. In the population health care arm, 57% (N = 80/140) of patients with moderate-to-severe symptoms completed at least 1 follow-up assessment versus 37% (N = 13/35) in usual care. A portal-based population health approach could improve depression monitoring in primary care.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"38 4","pages":"188-195"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371865","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

Physician Burnout and Medical Errors: Exploring the Relationship, Cost, and Solutions. 医生职业倦怠和医疗差错:探讨关系、成本和解决方案。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2023-07-01 DOI: 10.1097/JMQ.0000000000000131

Chris J Li, Yash B Shah, Erika D Harness, Zachary N Goldberg, David B Nash

{"title":"Physician Burnout and Medical Errors: Exploring the Relationship, Cost, and Solutions.","authors":"Chris J Li, Yash B Shah, Erika D Harness, Zachary N Goldberg, David B Nash","doi":"10.1097/JMQ.0000000000000131","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000131","url":null,"abstract":"Physician burnout has demonstrated risks to providers and patients through medical errors. This review aims to synthesize current data surrounding burnout and its impacts on quality to inform targeted interventions that benefit providers and patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping review methodology was utilized to identify studies of quantitative metrics for burnout and medical errors. Three independent reviewers conducted screening, study selection, and data extraction. Of 1096 identified articles, 21 were analyzed. Overall, 80.9% used the Maslach Burnout Inventory to evaluate for burnout. Moreover, 71.4% used self-reported medical errors as their primary outcome measure. Other outcome measures included observed/identified clinical practice errors and medication errors. Ultimately, 14 of 21 studies found links between burnout and clinically significant errors. Significant associations exist between burnout and medical errors. Physician demographics, including psychological factors, well-being, and training level, modulate this relationship. Better metrics are necessary to quantify errors and their impacts on outcomes. These findings may inform novel interventions that target burnout and improve experiences.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"38 4","pages":"196-202"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10117018","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: 1

Hematologic Malignancy Episodes Exceed Target Price in Oncology Care Model. 肿瘤治疗模式中的恶性血液病发作超过目标价格。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2023-07-01 DOI: 10.1097/JMQ.0000000000000127

Jennifer Nguyen, Vittorio Maio, Karen Walsh, Nathan Handley, Shivangi Patel, Scott W Keith, Valerie P Csik

{"title":"Hematologic Malignancy Episodes Exceed Target Price in Oncology Care Model.","authors":"Jennifer Nguyen, Vittorio Maio, Karen Walsh, Nathan Handley, Shivangi Patel, Scott W Keith, Valerie P Csik","doi":"10.1097/JMQ.0000000000000127","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000127","url":null,"abstract":"The current study evaluated whether total cost of care (TCOC) and target price were aligned in Oncology Care Model (OCM) hematologic malignancy episodes and identified factors associated with episodes exceeding target price. Hematologic malignancy episodes from OCM performance period 1-4 reconciliation reports were identified from a large academic medical center. Of the 516 hematologic malignancies episodes included in the analysis, 283 (54.8%) exceeded the target price. Episode characteristics found to be statistically significantly associated with exceeding target price were Medicare Part B drug use and Part D drug use, novel therapy use, home health agency, and >730 days from last chemotherapy. The mean TCOC was $85 374 (± $26 342) for the episodes that exceeded target price while the mean target price was $56 106 (±$16 309). The results found a substantial misalignment between the TCOC and target price for hematologic malignancy episodes, adding to the existing evidence on the lack of adequate adjustment to the OCM target price.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"38 4","pages":"174-180"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371864","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

Changing the Calculus of Self-Interest in Health Care. 改变医疗保健中的自我利益计算。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2023-07-01 DOI: 10.1097/JMQ.0000000000000125

Eric Weaver, Craig Solid, Andrew Kopolow

引用次数: 0