DiseasesAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPsychiatry and PsychologyPhenomena and ProcessesDisciplines and OccupationsAnthropology, Education, Sociology and Social PhenomenaTechnology, Industry, AgricultureHumanitiesInformation ScienceNamed GroupsHealth CareGeographicals
Quality ImprovementTotal Quality ManagementQuality Assurance, Health CareQuality of LifeQuality of Health CareQuality Indicators, Health CareQuality ControlManagement Quality CirclesBenchmarkingUnited StatesInstitutional Management TeamsHealth Services ResearchHospital AdministratorsOrganizational CultureOrganizational InnovationOutcome and Process Assessment (Health Care)Program EvaluationHospital AdministrationGuideline AdherenceHospitalsTreatment OutcomeMedical AuditProcess Assessment (Health Care)Outcome Assessment (Health Care)Safety ManagementPrimary Health CareAccreditationQuestionnairesDelivery of Health CarePractice Guidelines as TopicHealth Plan ImplementationCooperative BehaviorPatient Care TeamPeer Review, Health CareModels, OrganizationalHospitals, VeteransProgram DevelopmentEfficiency, OrganizationalPatient SatisfactionEvidence-Based MedicineProfessional Review OrganizationsPatient SafetyManagement AuditLeadershipUnited States Department of Veterans AffairsPatient-Centered CareHealth Care SurveysMedical ErrorsSystems AnalysisReimbursement, IncentiveTime FactorsInservice TrainingPilot ProjectsClinical AuditDocumentationManaged Care ProgramsData CollectionOrganizational Case StudiesProspective StudiesPhysician's Practice PatternsDiffusion of InnovationReproducibility of ResultsNursing HomesConsumer SatisfactionGroup PracticeHospital Bed Capacity, 300 to 499Hospitals, PublicElectronic Health RecordsRetrospective StudiesWater QualityCross-Sectional StudiesClinical CompetenceCommunity Health CentersResearch DesignCenters for Medicare and Medicaid Services (U.S.)Family PracticeSocieties, MedicalUnited States Agency for Healthcare Research and QualityDatabases as TopicAttitude of Health PersonnelFollow-Up StudiesJoint Commission on Accreditation of Healthcare OrganizationsGuidelines as TopicHospitals, PediatricNetherlandsInterinstitutional RelationsEvidence-Based Emergency MedicineFeedbackPhysician Incentive PlansEducation, Medical, ContinuingMulti-Institutional SystemsAmbulatory CareAcademic Medical CentersPractice Management, MedicalDisease ManagementChronic DiseasePatient Care ManagementGreat BritainInterviews as TopicInterprofessional Relations

Targeting primary care referrals to smoking cessation clinics does not improve quit rates: implementing evidence-based interventions into practice. (1/941)

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Do physicians within the same practice setting manage osteoporosis patients similarly? Implications for implementation research. (2/941)

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Professional quality improvement project in vaccination services: results of a 5-year survey. (3/941)

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Elderly hispanics more likely to reside in poor-quality nursing homes. (4/941)

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Helping States enhance health care quality through technical assistance. (5/941)

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Developing targets for public health initiatives to improve palliative care. (6/941)

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Current yardsticks may be inadequate for measuring quality improvements from the medical home. (7/941)

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Closing the gap "Disparity in Native Hawaiian cardiac care". (8/941)

PURPOSE: Queen's Heart, the cardiac service line at the Queen's Medical Center (QMC), Honolulu, Hawaii, recognizes the importance of closing the health disparity gap that affects the Native Hawaiian population. The purpose of this study was to examine the process and outcomes of health care among Native Hawaiians with heart disease, and to evaluate the impact of a multidisciplinary, culturally sensitive effort to improve quality of care. An inpatient program was created by assembling a team of practitioners who have an affinity for Native Hawaiian culture to address the health care of the Native Hawaiian people. METHODS: All Native Hawaiian patients who were admitted to The Queen's Medical Center from January 2007 to December 2008 became participants of the program. Baseline outcomes data for cardiac core measures, length of stay, 30 day readmission rates, and adverse events were reviewed by the team before the study was initiated. Educational materials were developed to provide culturally specific disease management information to patients and family members. The patient educators and discharge counselors provided patients with the education and tools they needed to engage in self care management. Heart failure disease management ensured that all Native Hawaiian patients receive appropriate quality care, individualized heart failure education, and a definitive plan for out patient follow up. The Integrative Care Program provided a holistic perspective of healing. RESULTS: All quality indicators for Native Hawaiian patients with cardiac disease have improved. Patient satisfaction rates have remained at the 99th percentile. There has been a marked improvement in adverse events following percutaneous coronary interventions (PCI) for Native Hawaiian patients. Readmissions that occurred in less than 30 days for patients admitted with myocardial infarctions and heart failure have improved and are now essentially the same as all other patient populations. CONCLUSIONS: Culturally sensitive and patient centered care, delivered by the team of specialists from Queen's Heart, has allowed patients to incorporate cultural preferences into their care and recovery. Readmission rates have decreased, mortality rates have improved, and patient and family satisfaction is enhanced.  (+info)