American Journal of Medical Quality最新文献_第9页

Is Patient Geography a Risk Factor for Chronic Opioid Use After ACDF? 患者地理是ACDF后慢性阿片类药物使用的危险因素吗?

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000077

Hannah A Levy, Brian A Karamian, Joseph Larwa, Jeffrey Henstenburg, Jose A Canseco, Brett Haislup, Michael Chang, Parthik Patel, Barrett I Woods, Alan S Hilibrand, Christopher K Kepler, Alexander R Vaccaro, Gregory D Schroeder

{"title":"Is Patient Geography a Risk Factor for Chronic Opioid Use After ACDF?","authors":"Hannah A Levy, Brian A Karamian, Joseph Larwa, Jeffrey Henstenburg, Jose A Canseco, Brett Haislup, Michael Chang, Parthik Patel, Barrett I Woods, Alan S Hilibrand, Christopher K Kepler, Alexander R Vaccaro, Gregory D Schroeder","doi":"10.1097/JMQ.0000000000000077","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000077","url":null,"abstract":"The social and medical implications intrinsic to patient zip codes with high opioid fatality may reveal residence in these locations to be a risk factor predicting chronic opioid use after anterior cervical discectomy and fusion (ACDF). The purpose of this study is to determine if residence in Pennsylvania zip codes with high incidence of opioid overdose deaths is a risk factor for chronic postoperative opioid use after ACDF. Preoperative opioid usage did not vary meaningfully between high- and low-risk zip code groups. Patients in high-risk opioid overdose zip codes were significantly more likely to exhibit chronic postoperative opioid use. The Kaplan-Meier curve demonstrated that opioid discontinuation was less probable at any postoperative time for patients residing in high opioid fatality zip codes. Logistic regression found opioid tolerance, smoking, and depression to predict extended opioid use.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"37 5","pages":"464-471"},"PeriodicalIF":1.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10018766","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

Building High-Performance Team Dynamics for Rapid Response Events in a US Tertiary Hospital: A Quality Improvement Model for Sustainable Process Change. 在美国三级医院为快速反应事件建立高绩效团队动力:可持续过程变更的质量改进模型。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000057

Lauren Raff, Kelly Reilly, Shana Ratner, Carlton Moore, Evan Raff

引用次数: 0

Navigating the Code-How Revolutionary Technology Transforms the Patient-Physician Journey by Barry P. Chaiken. 巴里·p·查肯的《驾驭代码——革命性技术如何改变医患之旅》。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000073

Ravi Patel

引用次数: 0

Frequency of Statin Prescription Among Individuals with Coronary Artery Calcifications Detected Through Lung Cancer Screening. 通过肺癌筛查发现冠状动脉钙化个体的他汀类药物处方频率

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000053

Amry Majeed, Brooke Ruane, Christine S Shusted, Melissa Austin, Khulkar Mirzozoda, Marcella Pimpinelli, Jetmir Vojnika, Lawrence Ward, Baskaran Sundaram, Paras Lakhani, Gregory Kane, Yair Lev, Julie A Barta

{"title":"Frequency of Statin Prescription Among Individuals with Coronary Artery Calcifications Detected Through Lung Cancer Screening.","authors":"Amry Majeed, Brooke Ruane, Christine S Shusted, Melissa Austin, Khulkar Mirzozoda, Marcella Pimpinelli, Jetmir Vojnika, Lawrence Ward, Baskaran Sundaram, Paras Lakhani, Gregory Kane, Yair Lev, Julie A Barta","doi":"10.1097/JMQ.0000000000000053","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000053","url":null,"abstract":"Individuals eligible for lung cancer screening (LCS) are at risk for atherosclerotic cardiovascular disease (ASCVD) due to smoking history. Coronary artery calcifications (CAC), a common incidental finding on low-dose CT (LDCT) for LCS, is a predictor of cardiovascular events. Despite findings of high ASCVD risk and CAC, a substantial proportion of LCS patients are not prescribed primary preventive statin therapy for ASCVD. We assessed the frequency of statin prescription in LCS patients with moderate levels of CAC. Among 259 individuals with moderate CAC, 95% had ASCVD risk ≥ 7.5%. Despite this, 27% of patients were statin-free prior to LDCT and 21.2% remained statin-free after LDCT showing moderate CAC. Illustratively, while a substantial proportion of LCS patients are statin-eligible, many lack a statin prescription, even after findings of CAC burden. CAC reporting should be standardized, and interdisciplinary communication should be optimized to ensure that LCS patients are placed on appropriate preventive therapy.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"37 5","pages":"388-395"},"PeriodicalIF":1.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10013369","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

Initial Specimen Diversion Device Utilization Mitigates Blood Culture Contamination Across Regional Community Hospital and Acute Care Facility. 初步标本转移装置的使用减轻了地区社区医院和急症护理机构的血液培养污染。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000055

Mark D Povroznik

{"title":"Initial Specimen Diversion Device Utilization Mitigates Blood Culture Contamination Across Regional Community Hospital and Acute Care Facility.","authors":"Mark D Povroznik","doi":"10.1097/JMQ.0000000000000055","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000055","url":null,"abstract":"A West Virginia regional community hospital incorporated an initial specimen diversion device (ISDD) into conventional blood culture protocol with the objective to bring the hospital-wide blood culture contamination (BCC) rate from a 3.06% preintervention rate to a target performance level below 1%. Emergency department staff, laboratory phlebotomists, and nursing staff on acute-critical care floors were trained on ISDD (Steripath Gen2, Magnolia Medical Technologies, Inc., Seattle, WA) operating procedure and utilized the device for blood culture sample collection with adult patients from September 2020 through April 2021. Of 5642 blood culture sets collected hospital-wide, 4631 were collected with the ISDD, whereas the remaining sets were collected via the conventional method. The ISDD BCC rate of 0.78% differed from the conventional method BCC rate of 4.06% observed during the intervention period (chi-squared test P < 0.00001). The ISDD group attained a sub-1% BCC rate to satisfy the intervention objective.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"37 5","pages":"405-412"},"PeriodicalIF":1.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/9a/jmq-37-405.PMC9426727.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10007094","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: 7

A Customized Electronic Health Record-Based Tool Highlights and Addresses Gaps in Patient Safety. 定制的基于电子健康记录的工具突出并解决了患者安全方面的差距。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000066

Joanna S Cavalier, Brian Griffith, Noppon Setji, Krishna Vanam, Myung Woo, Govind Krishnan, Sunny Chung, Anisha Chandiramani

{"title":"A Customized Electronic Health Record-Based Tool Highlights and Addresses Gaps in Patient Safety.","authors":"Joanna S Cavalier, Brian Griffith, Noppon Setji, Krishna Vanam, Myung Woo, Govind Krishnan, Sunny Chung, Anisha Chandiramani","doi":"10.1097/JMQ.0000000000000066","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000066","url":null,"abstract":"The authors present a tool to improve gaps in patient safety using the electronic health record. The tool integrates gap identification, passive alerts, and actions into a single interface embedded within clinicians' workflow. The tool was developed to address venous thromboembolism prophylaxis, prevention of hypo- and hyperglycemia, code status documentation, bowel movement frequency, and skilled nursing facility transitions. Alerts and actions during silent and live periods were retrospectively analyzed. The most prevalent safety gaps were lack of venous thromboembolism prophylaxis (40.4% of alerts), constipation (19.3%), and lack of code status (18.4%). Disparities in safety gaps were present by patient race, sex, and socioeconomic status. Usability testing showed positive feedback without significant alert burden. Thus, a safety gap tool was successfully built to study and address patient safety issues. The tool's strengths are its integration within the electronic health record, ease of use, customizability, and scalability.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"37 5","pages":"434-443"},"PeriodicalIF":1.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10013387","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 National Practitioner Database Malpractice Study of Severity of Alleged Malpractice Injuries Trends 2008-2018. 2008-2018年涉嫌医疗事故伤害趋势严重程度的国家从业者数据库医疗事故研究。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000060

Victoria Goode, Christian Douglas, Elizabeth Merwin

{"title":"The National Practitioner Database Malpractice Study of Severity of Alleged Malpractice Injuries Trends 2008-2018.","authors":"Victoria Goode, Christian Douglas, Elizabeth Merwin","doi":"10.1097/JMQ.0000000000000060","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000060","url":null,"abstract":"This research examined trends and severity of alleged injury in malpractice over a 10-year period. An understanding of the severity of patient outcomes is important to gauge improvements in care delivery. Analysis of the National Practitioner Database (NPDB) investigated malpractice payments from 2008 to 2018 by physicians, advanced nurse practitioners, and registered nurses and assessed the relationship of years of practice on the severity of alleged malpractice injury. Malpractice payments over the study period, primarily represented payments for significant permanent or major permanent injuries (25.97%) or death (32.74%). Claims overall have shown a decline, including claims by the severity of malpractice injury, for most outcomes. The clinicians represented in the NPDB with >15 years of practice have greater odds for severity of malpractice injuries classified as minor permanent injury and significant permanent injury than those clinicians represented in the NPDB with fewer years of practice. Top allegation categorizations for malpractice payment were diagnostics, treatment, and surgery related for 4 of the severities of alleged injury.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"37 5","pages":"396-404"},"PeriodicalIF":1.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10018728","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

Challenges and Strategies for Patient Safety in Primary Care: A Qualitative Study. 初级保健患者安全的挑战和策略:一项定性研究。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000054

Christina T Yuan, Sydney M Dy, Alden Yuanhong Lai, Tyler Oberlander, Susan M Hannum, Elyse C Lasser, JaAlah-Ai Heughan, Vadim Dukhanin, Hadi Kharrazi, Julia M Kim, Ayse P Gurses, Mark Bittle, Sarah H Scholle, Jill A Marsteller

{"title":"Challenges and Strategies for Patient Safety in Primary Care: A Qualitative Study.","authors":"Christina T Yuan, Sydney M Dy, Alden Yuanhong Lai, Tyler Oberlander, Susan M Hannum, Elyse C Lasser, JaAlah-Ai Heughan, Vadim Dukhanin, Hadi Kharrazi, Julia M Kim, Ayse P Gurses, Mark Bittle, Sarah H Scholle, Jill A Marsteller","doi":"10.1097/JMQ.0000000000000054","DOIUrl":"https://doi.org/10.1097/JMQ.0000000000000054","url":null,"abstract":"Although most health care occurs in the ambulatory setting, limited research examines how providers and patients think about and enact ambulatory patient safety. This multimethod qualitative study seeks to identify perceived challenges and strategies to improve ambulatory safety from the perspectives of clinicians, staff, and patients. Data included interviews (N = 101), focus groups (N = 65), and observations of safety processes (N = 79) collected from 10 patient-centered medical homes. Key safety issues included the lack of interoperability among health information systems, clinician-patient communication failures, and challenges with medication reconciliation. Commonly cited safety strategies leveraged health information systems or involved dedicated resources (eg, providing access to social workers). Patients also identified strategies not mentioned by clinicians, emphasizing the need for their involvement in developing safety solutions. This work provides insight into safety issues of greatest concern to clinicians, staff, and patients and strategies to improve safety in the ambulatory setting.","PeriodicalId":7539,"journal":{"name":"American Journal of Medical Quality","volume":"37 5","pages":"379-387"},"PeriodicalIF":1.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9700196/pdf/nihms-1851889.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10370336","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

"Gaps In Care" Fall Short. “医疗缺口”不足。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000075

Robert E Matthews

引用次数: 0

Improving Documentation and Adherence to United States Preventive Services Taskforce Cancer Screening Recommendations at a Safety Net Clinic. 改善文件和遵守美国预防服务工作组癌症筛查建议在安全网诊所。

IF 1.4 4区医学

American Journal of Medical Quality Pub Date : 2022-09-01 DOI: 10.1097/JMQ.0000000000000068

Siddharth Suresh Madapoosi, Kevin Karlic, Ryan Townshend, Aliya Moreira, Jennifer Riske, Hari Conjeevaram

引用次数: 0