I propose that for most healthcare improvement case reports, the context is the news. Such reflection on the interaction between a strategy for improvement and a unique setting14 builds the scholarship of healthcare improvement, one report at a time. The most important contribution that a healthcare improvement case report will offer-the news-will be found most often in the authors deep exploration of that interaction.. Readers have come to expect that clinical case reports will adhere to an explicit format.1-3 Similarly, authors of healthcare improvement case reports should craft their reports mindful of similar readers expectations. One could argue that the Quality Improvement Report (QIR) format comes close.15 The format was advanced in Quality and Safety in Health Care by Moss and Thomson in 1991-explicit guidelines in a checklist-like format. As of this publication, over 100 such reports have been published by QSHC and BMJ, but certainly nowhere near the thousands of clinical case ...
BACKGROUND The diversity of quality improvement interventions (QIIs) has impeded the use of evidence review to advance quality improvement activities. An agreed-upon framework for identifying QII articles would facilitate evidence review and consensus around best practices. AIM To adapt and test evidence review methods for identifying empirical QII evaluations that would be suitable for assessing QII effectiveness, impact or success. DESIGN Literature search with measurement of multilevel inter-rater agreement and review of disagreement. METHODS Ten journals (2005-2007) were searched electronically and the output was screened based on title and abstract. Three pairs of reviewers then independently rated 22 articles, randomly selected from the screened list. Kappa statistics and percentage agreement were assessed. 12 stakeholders in quality improvement, including QII experts and journal editors, rated and discussed publications about which reviewers disagreed. RESULTS The level of agreement among
TY - JOUR. T1 - Patterns of care among patients undergoing hepatic resection. T2 - A query of the National Surgical Quality Improvement Program-targeted hepatectomy database. AU - Spolverato, Gaya. AU - Ejaz, Aslam. AU - Kim, Yuhree. AU - Hall, Bruce L.. AU - Bilimoria, Karl. AU - Cohen, Mark. AU - Ko, Clifford. AU - Pitt, Henry. AU - Pawlik, Timothy M.. PY - 2015/6/15. Y1 - 2015/6/15. N2 - Background The American College of Surgeons recently added liver-specific variables to the National Surgical Quality Improvement Program (NSQIP). We sought to use these variables to define patterns of care, as well as characterize perioperative outcomes among patients undergoing hepatic resection. Methods The American College of Surgeons-NSQIP database was queried for all patients undergoing hepatic resection between January 1, 2013 and December 31, 2013 (n = 2448). Liver-specific variables were summarized. Results Preoperatively, 11.3% of patients had hepatitis B or C or both, whereas 9.2% had cirrhosis. The ...
This study collected long-term retrospective data and considered a time lag in exploring whether Taiwanese hospitals external environment and characteristics were associated with the scope and intensity of their implementation of QI activities, and whether those QI activities could improve hospitals performance. In this study, we found the scope and intensity of QI activities adopted in a hospital were associated with the external environment and the hospitals performance in the previous period. We also found that the intensity of QI activities in the previous period was associated with hospital operation performance, but the scope of QI activities was not. Two of our findings merit further discussions.. Firstly, why did hospital adopt QI activities? The medical environment had changed dramatically since the late 1990s in Taiwan. The findings of a previous study [24] conducted in Taiwan indicated that this increasing trend of QI activities adoption was associated with several major events: ...
Press Release Date: November 23, 1999 The Agency for Health Care Policy and Research (AHCPR) today announced funding for five new research projects which are aimed at assessing quality improvement strategies. These strategies include: education; the use of information systems; continuous quality improvement; behavioral interventions; academic detailing and use of regulations. These grants are funded under AHCPRs Request for Applications (RFA) entitled "Assessment of Quality Improvement Strategies in Health Care," which was released on January 22, 1999. The goal of the RFA, part of a series of three new calls for research on quality of health care, was to rigorously evaluate strategies for improving health care quality which are currently in widespread use by organized quality improvement systems.. The funding for these new projects is anticipated to total $8.42 million over a 3-year period. The newly funded projects are: ...
Exploring the sustainability of quality improvement interventions in healthcare organisations: a multiple methods study of the 10-year impact of the Productive Ward: Releasing Time to Care programme in English acute hospitals ...
This quality improvement project revealed a serious and large discrepancy in the care of acute stroke patients at baseline, when reviewed against evidence-based recommendations. Specifically, only 6% of patients admitted to the unit had their swallow ability examined. A systematic approach to develop a change strategy, tailored to local barriers and largely founded in implementation science, led to a significant improvement where this percentage increased to 61%. Other substantial improvements gained were the documentation of timing of screening, which increased from 7 to 76% and the time from admission to screening for dysphagia, which was reduced by nearly four hours.. Our project had several noteworthy strengths. First, we invested efforts in developing the audit tool, and later in testing it for validity. Also, we made sure that recommendations used to set the criteria, explicitly came from evidence based guidelines that we systematically searched for, which in turn were appraised for ...
The core mission of the Center for Healthcare Improvement & Patient Safety at the University of Pennsylvania is to improve the quality of healthcare utilizing a comprehensive approach integrating health services research and quality improvement and patient safety training.
This is the third in a series of papers using identical methodology to evaluate adherence to AUC for SPECT imaging in a single institution. The first publication dealt with patients from 2005 and demonstrated a substantial (14.4%) prevalence of inappropriate studies and furthermore identified four separate indications accounting for 88% of inappropriate studies including asymptomatic low-risk patients, which accounted for almost 50% of the inappropriate studies. A follow-up after publication of the AUC in 2006 demonstrated a significant decrease to 7.0% of inappropriate studies. The authors, at that time, engaged in a quality improvement project including grand rounds, publication of one page synopses of these studies, and other intramural educational activities designed to educate the referring physician base, and presumably further decrease the incidence of inappropriate studies. These educational and information sessions occurred predominantly in January 2008, and a third cohort of patients ...
We identified several limitations in the literature included in our analysis. First, similar to other studies of complex interventions,77 studies included in our meta-analysis reported few details about the intensity and "dose" of quality improvement strategies, as well as further details regarding delivery. The Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines have been developed to improve the reporting of quality improvement strategies,78 which will be of benefit to future meta-analyses such as ours. Second, in some studies, the duration of intervention may have been too short (e.g., 1 mo) to show any significant impact. Third, the duration of follow-up (as little as 3 mo) was also short in some studies. Fourth, the definition of a frequent user was inconsistent across the studies. Finally, most of the included studies had unclear or inadequate concealment of the allocation sequence and a high risk of bias owing to incomplete outcome data.. Our systematic review ...
Improvement Skills and a Record of Successful Improvement: To succeed in this work, strong improvement capabilities are required. Successful participants will commit to learning quality improvement methods or already be skilled and agile in using the Model for Improvement or other improvement methods. These include iterative learning through running small tests of change, testing new designs at ever-increasing scale, and implementing change throughout the system or community. IHI has a wide array of programming that can help bolster the improvement skills of team members and community partners ...
Context Hospitals in European countries apply a wide range of quality improvement strategies; however, knowledge on the effectiveness of these strategies is limited. Objectives We propose to study the effectiveness of quality improvement systems in European hospitals. Specific research objectives are: a) to develop a maturity classification model for the assessment of organizational quality improvement systems in EU hospitals; b) to investigate associations between the maturity of quality improvement systems and measures of organizational culture, professional involvement and patient empowerment (at hospital level); c) to investigate associations between the maturity of quality improvement systems and measures of clinical effectiveness, patient safety and patient involvement (at patient and departmental level); d) to identify factors influencing the uptake of quality improvement activities by hospitals including external pressure as enforced by accreditation, certification or external assessment ...
This study is the first to comprehensively evaluate quality improvement initiatives aimed at reducing the amount of inappropriate tests performed across common cardiac imaging modalities. First, we have identified components of these interventions that may provide the most consistent benefits in reducing inappropriate testing. Second, we have identified important limitations in the literature to inform further studies, which is directly relevant to determining the most effective methods of designing and evaluating initiatives aimed at reducing unnecessary cardiac testing.. Determining the optimal strategies to reduce inappropriate cardiac testing is important for both improving the quality of cardiac testing and reducing unwarranted health expenditures. Although quality improvement initiatives were associated with an overall reduction in inappropriate cardiac testing, the significant heterogeneity observed between studies in our meta-analysis signifies that the effects of these interventions ...
TY - JOUR. T1 - Association between statin use and lipid status in quality improvement initiatives. T2 - Statin use, a potential surrogate?. AU - Bojadzievski, Trajko. AU - Schaefer, Eric. AU - Hollenbeak, Chris S.. AU - Gabbay, Robert A.. PY - 2012/12/1. Y1 - 2012/12/1. N2 - Objective To test the association between statin use and low-density-lipoprotein (LDL)-cholesterol control in outpatient community practices undergoing quality improvement efforts in diabetes care. Design A retrospective observational study of primary care practices that underwent efforts at improving the quality of diabetes care. Each practice provided an electronic registry-based monthly report of the percentage of patients with LDL ,130 mg/dl (3.4 mmol/1), LDL ,100 mg/dl (2.6 mmol/1) and statin use. Setting Primary care practices in Pennsylvania focused on improving diabetes care by implementing the Chronic Care Model in urban, suburban and rural regions. Participants Consisted of 109 primary care practices, academic ...
The Quality Improvement Coordinator and Quality Committee oversee the Quality Improvement Program. Quality Committees role is to act in an advisory capacity to the Board of Directors regarding quality improvement activities and utilization, in support of the strategic direction and goals of Riverside Health Care and is the Quality Committee for the purposes of the Excellent Care For All Act, 2010 ("ECFAA ...
In the Johns Hopkins Hospital medical ICU, a multidisciplinary quality improvement project targeting early rehabilitation was planned over an 8-month period and then executed over 4 months.51 The quality improvement project, conducted using the Translating Research into Practice model, focused on all medical ICU patients, with detailed data collection and evaluation completed for patients requiring ≥4 d of mechanical ventilation, without any preexisting cognitive or neuromuscular problems. Among the steps included in executing the quality improvement project were modifying the default activity level in the medical ICU admission order set from "bed rest" to "activity as tolerated," changing sedation practice from continuous infusions to "as needed" boluses, providing guidelines for both physical therapy and occupational therapy consultations, and implementing safety screening guidelines for rehabilitation in ICU patients.. Compared with the 3-month period immediately preceding the quality ...
Through a series of five short lessons, youll learn how to use the Model for Improvement to improve everything from your clinics sealant rates to you own tennis game. Because, as youll learn, the basic steps for any improvement project are the same: Set an aim, select measures, develop ideas for changes, and test changes using Plan-Do-Study-Act (PDSA) cycles ...
iv) mixed methods evaluation of quality improvement initiatives implementing evidence-based interventions.. Findings from previous analyses of patient safety incidents in primary care have been used to empirically inform the design of quality improvement initiatives and projects to improve patient safety in healthcare organisations. Lessons learnt from our primary care studies are being used by the 1000 Lives Improvement service in Wales to design their national-level improvement strategy for primary care patient safety. At a local level, one health board in Wales, used our analysis of reports about anticoagulation-related errors to highlight risks to patients being initiated on Warfarin in hospital. The subsequent quality improvement project led to a national Directed Enhanced Service for anticoagulation services to be delivered to patients in community settings instead (for more detail, watch a short video on YouTube).. We conceptualise, investigate and support teams to improve patient safety ...
Healthcare delivery is complex and constantly changing. A primary mission of leading healthcare organizations is to advance the quality of patient care by striving to deliver care that is safe, effective, efficient, timely, cost-effective, and patient-centered (Institute of Medicine). The goal of this interprofessional course is to provide students with a broad overview of the principles and tools of quality improvement and patient safety in healthcare as well address the knowledge, skills and attitudes as defined by the Quality and Safety Education for Nurses (QSEN) guidelines. It will provide a foundation for students or practicing clinicians who are interested in quality improvement and patient safety research, administration, or clinical applications.Content will address the history of the quality improvement process in healthcare, quality databases and improvement process tools and programs. Through the use of case studies and exercises students will be become familiar with the use of ...
Scheer, S. et al. Critical Care Medicine. Published online: September 22 2016 Objective: To investigate the impact of a quality improvement initiative for severe sepsis and septic shock focused on the resuscitation bundle on 90-day mortality. Furthermore, effects on compliance rates for antiinfective therapy within the recommended 1-hour interval are evaluated. Design: Prospective observational before-after cohort study.…
Sepsis is the number one-cause of hospital admissions and readmissions for people with Medicare. This Telligen presentation recorded in July 2019 offers insights into the problem of sepsis-related admissions and readmissions, an overview of sepsis data and quality improvement tools to target causes of sepsis and alert caregivers, patients and families to warning signs of sepsis.. ...
When recommending a quality improvement strategy, how do you present the recommendations and what data and tools do you use during the presentation and why? What key elements should be included in a process improvement.
Pharmaceutical care has been playing an increasingly critical role in Chinese hospitals. However, evidence about the most recent development of pharmaceutical care in China is limited. This study analyzed the current situation of pharmaceutical care and the capacities of pharmacists in Chinese public tertiary hospitals. All on-duty pharmacists of 143 public tertiary hospitals responded to the Likert-5 pre-set online questionnaire about their pharmaceutical care capacities in eight aspects, and their respective hospitals valued pharmaceutical care in clinical practice from March 18 to 31, 2019. This study measured the appraisals of the responding pharmacists as positive (
Results 102 patients were enrolled pre-intervention, 113 post-intervention. Median time from intravenous cannula insertion to antibiotic administration decreased from 55 min (IQR 27-90 min) pre-intervention to 19 min (IQR 10-32 min) post-intervention (p≤0.01). Venous blood gas at time of first intravenous cannula insertion was performed in 60% of patients pre-intervention vs 79% post-intervention (p≤0.01). Fluids were administered using manual push-pull or pressure-bag methods in 31% of patients pre-intervention and 84% of patients post-intervention (p≤0.01). Median hospital length of stay decreased from 96 h (IQR 64-198 h) pre-intervention to 80 h (IQR 53-167 h) post-intervention (p=0.02). This effect persisted when corrected for unequally distributed confounders between pre-intervention and post-intervention groups (uncorrected HR: 1.36, 95% CI 1.04 to 1.80, p=0.02; corrected HR: 1.34, 95% CI 1.01 to 1.80, p=0.04). ...
BACKGROUND: Despite evidence supporting the effectiveness of diabetic retinopathy screening (DRS) in reducing the risk of sight loss, attendance for screening is consistently below recommended levels. OBJECTIVES: The primary objective of the review was to assess the effectiveness of quality improvement (QI) interventions that seek to increase attendance for DRS in people with type 1 and type 2 diabetes.Secondary objectives were:To use validated taxonomies of QI intervention strategies and behaviour change techniques (BCTs) to code the description of interventions in the included studies and determine whether interventions that include particular QI strategies or component BCTs are more effective in increasing screening attendance;To explore heterogeneity in effect size within and between studies to identify potential explanatory factors for variability in effect size;To explore differential effects in subgroups to provide information on how equity of screening attendance could be improved;To ...
If the study will have positive results, it will benefit the health of children in the study area, and indirectly, their communities. The study will inform, with a robust design, about the efficacy and cost-efficacy of a quality improvement intervention for ameliorating the health of children suffering from malnutrition in Uganda. Currently no other study with RCT design explored the efficacy of supportive supervision as a quality improvement intervention at health center level. This study will therefore fill an important knowledge gap. Findings of the study will be useful to develop policies at local level, and in other countries with similar setting ...
A common complaint amongst programme managers is the large amount of data they have to collect and process. The development of a comprehensive health systems framework, key tracer indicators and relatively simple data collection tools in this intervention enabled middle level managers to feasibly collect relevant data rapidly and to identify possible bottle necks to optimal programme performance.. The results of the assessment showed that the district is clearly performing well in terms of HIV testing within antenatal care and this has been achieved through adequate human resource provision in terms of lay counsellors and a philosophy of making HIV testing a routine component of antenatal care. Areas of weakness identified include inadequate coverage of training amongst clinical staff, inadequate infrastructure in terms of counselling rooms, infrequent supervision by district supervisors, low coverage of CD4 testing, nevirapine to mother and infant and infant PCR testing. These weaknesses are ...
Chronic kidney disease (CKD) is a common long-term condition, affecting 5 to 10% of the population. CKD is an independent risk factor for cardiovascular disease, established renal failure (ERF) and all cause mortality [1-3]. Patients with CKD are far more likely to die prematurely from cardiovascular disease than progress to ERF requiring dialysis or transplantation. The presence of proteinuria confers additional cardiovascular risk.. CKD is classified into five stages based upon a measurement of kidney function and the estimated glomerular filtration rate (eGFR) determines the class of CKD for the more severe stages (Stage three to five). Stage one and two are the mildest of the five stages of CKD and require evidence of kidney damage, usually the presence of proteinuria, to confirm the diagnosis. Stages three to five CKD can be diagnosed by eGFR alone; and stage three is now often split into stages 3a and 3b, as there are far higher rates of cardiovascular co-morbidity in stage 3b disease. ...
Intervention An NHSLA audit was carried out in July 2012 to assess the care of neonates at risk of hypoglycaemia. This showed multiple problem areas including neonates not being managed as per the guideline and "at risk" neonates being monitored using incorrect proformas or not being monitored at all. The audit also revealed unnecessary glucose monitoring of some neonates who no longer required it. A survey of all staff involved in newborn care was carried out and factors contributing to the problem were identified at all levels. At an organisational level, there were obsolete proformas on the ward with different thresholds for referral and three differing guidelines available on the intranet. At team level, the survey revealed that midwifes felt it was difficult to contact a neonatal SHO for referral and that there was lack of consistency in advice provided. At an individual level, staff indicated a lack of education regarding the guideline and testing revealed a lack of familiarity, especially ...
Background Gaps in breast cancer (BC) surgical care have been identified. We have completed a surgeon-directed, iterative project to improve the quality of BC surgery in South-Central Ontario.
Health care quality and patient safety are not dependent upon a singular factor. Rather than addressing the system and its processes in a methodical, incremental fashion, the current model focuses improvement in a single area, rather than addressing the system as a whole-this is where the industry is failing. Organizations are seeing functions such as patient safety, provider safety, patient experience and satisfaction, utilization and others, rather than an intricate web with the patient and direct care providers at the center.. In health care, quality improvement is seen as the domain of clinical staff. Look at the profiles of people in quality improvement roles, and you will see most are RNs, MDs, or DOs, thus sending the message that the onus of quality improvement is on the clinical staff alone. This prevailing attitude is sabotaging the ongoing efforts to improve quality and ultimately impacting patient safety and experience.. What the typical health care approach to quality improvement ...
Xcendas quality improvement programs differentiate products and provide value to manufacturers, payers, providers, and patients.
Mitsubishi Electric Corporation is committed to a better, cleaner planet with our technological innovations, to manufacturing processes to product recycling activities.
Mitsubishi Electric Corporation is committed to a better, cleaner planet with our technological innovations, to manufacturing processes to product recycling activities.
BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden.. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQRs criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis.. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from ...
This is a recorded version of the AACC webinar Delta Checks in Action: An Essential Quality Improvement Tool which was originally held March 21, 2012. Delta checks play a pivotal role in the quality improvement process by comparing current laboratory results to previous results. If there is a discrepancy between the results it could be due to either sample error, analytical error or a change in the patients condition
I earned a MS in Health Education through Utah State University and became a certified as a Quality Improvement Advisor by the Institute for Healthcare Improvement in 2015. For the past 15 years, my career efforts have demonstrated my commitment to improving public health through health promotion, education, research, policy development, evaluation, and grant development from the community to national levels. My professional positions and interests provide me with broad and valuable experiences in public health. Early on, I worked in tobacco cessation, injury prevention, and employee wellness. Currently, I am engaged in learning systems development (e.g., coalitions, learning communities, and collaboratives) and childrens health research (e.g., environmental, viral, and genetic factors) as the Director of Quality Improvement at the National Center for Hearing Assessment and Management, an MCHB-funded technical assistance center. I am also the project director of the CMV (cytomegalovirus) Public ...
Quality Improvement Reports (submitted as article type "Original Article") Abstract length: 250 words or fewer Article length: 3,000 words or fewer. Figures/tables: 5 or fewer. Quality reports pertaining to inpatient care will be considered. Authors are expected to generally follow the Standard for Quality Improvement Reporting Excellence (SQUIRE) Guidelines for reporting their quality improvement projects. These guidelines are described in detail on the SQUIRE website at www.squire-statement.org. Authors should note that the basic structure of a quality report will mirror the rest of the journal, using the IMRaD (Introduction, Methods, Results, Discussion) format. The following is a brief description of the sections of a quality report:. Introduction: Why did you start? Summarizes background, local problem/setting, and specific aim(s) of project.. Methods: What did you do? Describes contextual issues, the intervention itself, implementation and evaluation/measurement plan.. Results: What did ...
A 2014 analysis in Patient Safety in Surgery estimated that 46 percent to 65 percent of adverse events at hospitals occur during operations, largely due to human error. Given these numbers, the effort to reduce risk is becoming ever important. One approach finds hospitals increasingly monitoring their own performance. About 600 sites are using the National Surgical Quality Improvement Project to report complications, with the goal of closing safety gaps and developing best practices. In anesthesiology, meanwhile, a new voluntary registry lets providers enter the details of adverse events and compare their data against their peers data. Other strategies involve hospitals using big data to screen patients for individual risk and better prepare them for the operating room, such as with preoperative antiseptic baths. For those most at risk for complications from surgery or anesthesia, that might mean postponing elective procedures until the patient boosts nutritional intake or stops smoking, for ...
It was important to use Sr. Clinicians who were confident making decisions on the spot, speaking to judges, etc. Sr. Clinicians had a 30% appointment rate vs. 60% appointment rate for less experienced staff ...
PubMed comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
Pragmatic and adaptive trial designs are increasingly used in quality improvement (QI) interventions to provide the strongest evidence for effective implementation and impact prior to broader scale-up. We previously showed that an on-site coaching intervention focused on the World Health Organization Safe Childbirth Checklist (SCC) improved performance of essential birth practices (EBPs) in one facility in Karnataka, India. We report on the process and outcomes of adapting the intervention prior to larger-scale implementation in a randomized controlled trial in Uttar Pradesh (UP), India. Initially, we trained a local team of physicians and nurses to coach birth attendants in SCC use at two public facilities for 4-6 weeks. Trained observers evaluated adherence to EBPs before and after coaching. Using mixed methods and a systematic adaptation process, we modified and strengthened the intervention. The modified intervention was implemented in three additional facilities. Pre/post-change in EBP prevalence
BACKGROUND: Despite evidence supporting the effectiveness of diabetic retinopathy screening (DRS) in reducing the risk of sight loss, attendance for screening is consistently below recommended levels. OBJECTIVES: The primary objective of the review was to assess the effectiveness of quality improvement (QI) interventions that seek to increase attendance for DRS in people with type 1 and type 2 diabetes.Secondary objectives were:To use validated taxonomies of QI intervention strategies and behaviour change techniques (BCTs) to code the description of interventions in the included studies and determine whether interventions that include particular QI strategies or component BCTs are more effective in increasing screening attendance;To explore heterogeneity in effect size within and between studies to identify potential explanatory factors for variability in effect size;To explore differential effects in subgroups to provide information on how equity of screening attendance could be improved;To ...
Browse resources from AF4Q, a community-based quality improvement initiative that supported 16 alliances located throughout the United States.
This is the third consecutive year that Christiana Care has been recognized through the organizations National Surgical Quality Improvement Program
Hearings leading to the reauth. of the Agency for Health Care Policy & Research (AHCPR). This hearing focuses on the current activities & recent products of this agency as they relate to health care quality improvement. Witnesses: John Eisenberg, AHCPR; Sherrie Kaplan, NE Med. Cntr; Fiona McTavish, Center for Health Syst. Res. & Analysis, Univ. of WI; David Knouse, Rand Corp.; David Edwards, Eastman Kodak Co.; Cary Sennett, Nat. Comm. for Quality Assurance; Barry Greene, Med. Group Mgt. Assoc.; Stuart Butler, Heritage Fdn.; Paul Clayton, Amer. Med. Informatics Assoc.; William Tierney, Soc. of General Internal Med.First, Bill is the author of Agency for Health Care Policy and Research Role in Health Care Quality Improvement Hearing Before the Committee on Labor and Human Resources, U.S. Senate with ISBN 9780788184116 and ISBN 0788184113. [read more] ...
ACOs help address the quality improvement goals of the Triple Aim, which were described by Berwick and colleagues from the Institute of Healthcare Improvement. In a seminal article, Berwick and colleagues argued that reform of the US healthcare system requires simultaneous pursuit of improving the overall care experience, improving population health, and reducing the cost of care for populations on a per-capita level. This is the so-called Triple Aim concept. These authors suggest that 3 inescapable design constraints underlie effective accomplishment of the Triple Aim: 1) recognition of the unit of concern as a patient population; 2) policy constraints in a given organization, such as budgetary limitations, or a requirement for equitable treatment of all patient subgroups; and 3) existence of a single authority, or integrator, that coordinates services, enabling implementation of all 3 aspects of the Triple Aim simultaneously. One method of implementation would be establishment of a registry to ...
Africas first summit on quality improvement and innovation in health care was hosted by the Best Care...Always! Campaign in conjunction with the Institute for Healthcare Improvement at the Hospital Association South Africa (HASA) Conference from 28-30 October 2013 at the Cape Town International Convention Centre ...
Now, lets put it all together. A single center study from a Spanish academic hospital, among respiratory and medical ICU patients, with a minuscule sample size, yet halted early for efficacy, an exceedingly high baseline rate of VAP, a substantial number of patients excluded for a nebulous reason, unblinded and therefore prone to biased diagnosis, reporting an inflated reduction in VAP development in the intervention group. It would be very easy to write this off as a flawed study (like all studies tend to be in one way or another) in need of confirmatory evidence, if it were not so critical in the current punitive environment of quality improvement. (By the way, to the best of my knowledge, there is no study that replicates these results). The ATS/IDSA guideline includes semi-recumbent positioning as a level I (highest possible level of evidence) recommendation for VAP prevention, and it is one of the elements of the MV bundle, as promoted by the Institute for Healthcare Improvement, which ...
Primary clinical activities include attending in the Surgical Intensive Care Unit (SICU), Post Anesthesia Care Unit (PACU) and the general surgical service. My administrative activities are focused on directing the Anesthesia-Critical Care Fellowship. Research interests include medical education, outcome and quality improvement studies in the critically ill.. ...