American Journal of Medical QualityThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader, such as GoogleReader, or to display this data on your own website or blog. Subscribe to this data using MyMedWorm.Subscribe to this data using GoogleReader.Subscribe to this data using Bloglines.Subscribe to this data using MyYahoo.

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Instructions for AuthorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Tags: Articles Source Type: journals

Book Review: Governance for Healthcare Providers: The Call to Leadership (New York: CRC Press; 2009), edited by David B. Nash, William J. Oetgen, and Valerie P. PracilioEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Benjamin, E. M. Tags: Articles Source Type: journals

Literature ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Toner, R., Goldfarb, N. I. Tags: Articles Source Type: journals

Ten Years After To Err Is HumanEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Clancy, C. M. Tags: Articles Source Type: journals

Injury and Death Associated With Incidents Reported to the Patient Safety NetEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The authors retrospectively evaluated anonymously submitted inpatient medical error reports from 8 institutions participating in the University HealthSystem Consortium Patient Safety Net (PSN) in 2004 in an attempt to focus patient safety efforts on problems that were most commonly associated with harm. Of the 25 300 incidents reported, 3381 (13.3%) were associated with adverse events (AEs), and 109 (0.4%) were associated with death. Although the most commonly reported categories of incidents associated with AEs were complications of procedure/treatment/test (29%), falls (17%), and medication errors (10%), the taxonomy of ...
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Reid, M., Estacio, R., Albert, R. Tags: Articles Source Type: journals

{beta}-Blocker Compliance, Mortality, and Reinfarction: Validation of Clinical Trial Association Using Insurer Claims DataEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although randomized controlled trials show that long-term β-blocker use post acute myocardial infarction (AMI) reduces mortality and subsequent cardiovascular events, and that increased compliance lowers mortality, there is limited published research on the effects of long-term β-blocker compliance in observational community settings. The authors retrospectively study the effect of β -blocker compliance on mortality and repeat reinfarction using claims records from a major health insurer of all patients who were discharged alive after AMI between January 2003 and June 2004, covered by that health insurer&rsq...
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Kleiner, S. A., Vogt, W. B., Gladowski, P., DeVries, A., Levin, G., Antonucci, C., Fong, J. Tags: Articles Source Type: journals

Improving Diabetes Care Using a Multitiered Quality Improvement ModelEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective was to increase the annual rate of recommended tests and examinations for patients with diabetes and to reduce levels of glycosylated hemoglobin, blood pressure, and low-density lipoprotein cholesterol. A process change for type 2 diabetes mellitus was implemented that included changes in office visit structure, protocol-driven electronic prompts for nursing and physician staffs, clinical decision support built into a new electronic medical record form, and audit with feedback. Twelve primary care physicians treated a total of 1592 patients with diabetes between January 2007 and January 2008. There were promp...
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Guzek, J., Guzek, S., Murphy, K., Gallacher, P., Lesneski, C. Tags: Articles Source Type: journals

Patient Satisfaction and Physician Productivity: Complementary or Mutually Exclusive?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Motivating physicians to increase productivity and maximize patient satisfaction may result in conflicted behavior, raising questions about whether one must be sacrificed for the other. To determine if high satisfaction (measured by Press Ganey patient satisfaction survey) can be achieved while maintaining high productivity (measured in McGladrey relative value units, MRVU), longitudinal data collected from January 2002 to July 2004 were modeled using repeated measures regression. A total of 136 000 patient-completed satisfaction questionnaires evaluating 417 physicians were collected for analysis. Patient confidence (posi...
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Wood, G. C., Spahr, R., Gerdes, J., Daar, Z. S., Hutchison, R., Stewart, W. F. Tags: Articles Source Type: journals

Glycemic Control and Insulin Safety: The Impact of Computerized Intravenous Insulin DosingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The aim of this work was to evaluate our Glycemic Control Initiative that was put in place to improve blood glucose control in hyperglycemic intensive care patients and improve insulin safety by minimizing the risk of hypoglycemia. A computerized decision-support tool was developed for intravenous insulin dosing that provided an automated and standardized approach across the organization’s intensive care units (ICUs). As a result of this, at 3 years post implementation, ICU patients are 2.28 times more likely to have blood glucose levels <150 mg/dL (odds ratio = 2.28; 95% confidence interval = 2.25-2.30; P < .0...
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Flanders, S. J., Juneja, R., Roudebush, C. P., Carroll, J., Golas, A., Elias, B. L. Tags: Articles Source Type: journals

Paying for Quality and Coordination: Aligning Provider Payments With Global GoalsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article argues that incentives can be created for increasing coordination by specifying accountability for the 4 basic types of health care encounter defined in this article. Payment design can be used to identify units of service that are sufficiently narrow to give a transparent understanding of the type of care rendered but with the capacity for aggregation to describe the process as a whole. Transparency is defined as the use of categorical or rules-based models such as Diagnosis Related Groups. Payment systems can use a building block approach for each of the 4 types of health care encounter so as to encourage im...
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Goldfield, N. I., Fuller, R. L., Averill, R. F. Tags: Articles Source Type: journals

Implementation of the National Surgical Quality Improvement Program: Critical Steps to Success for Surgeons and HospitalsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The National Surgical Quality Improvement Program (NSQIP), as administered by the American College of Surgeons, became available to private sector hospitals across the United States in 2004. The program works to improve surgical outcomes by providing high-quality, risk-adjusted data to surgeons at a given hospital to stimulate discussion and define target areas for improvement. Although the NSQIP began in the early 1990s with Veterans Administration hospitals and expanded to private sector hospitals nearly 5 years ago, the "how to" process for NSQIP implementation has been left to individual institutions to manage on their...
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Velanovich, V., Rubinfeld, I., Patton, J. H., Ritz, J., Jordan, J., Dulchavsky, S. Tags: Articles Source Type: journals

"Canary Measures" Among the AHRQ Patient Safety IndicatorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study aims to identify 1 or more measures among the PSIs best suited for a quick index of general patient safety status. The 1997-2002 Nationwide Inpatient Sample was used to calculate the hospital-level risk-adjusted rates of the PSIs. Both pairwise correlation analyses and multivariate analyses showed that PSI #7 (Selected infections due to medical care) is significantly correlated with most of the other PSIs. The results are robust even when (1) the pairwise and multivariate analyses are rerun on a reduced data set that excludes admissions with multiple patient safety events, and (2) Bonferroni-adjusted P values ar...
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Yu, H., Greenberg, M. D., Haviland, A. M., Farley, D. O. Tags: Articles Source Type: journals

The Canary's Warning: Why Infections MatterEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - November 4, 2009 Category: Health Management Authors: Clancy, C. M. Tags: Articles Source Type: journals

Literature ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: McAna, J., Goldfarb, N. I. Tags: Article Source Type: journals

The Open School: A Framework for InnovationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Pracilio, V. P. Tags: Article Source Type: journals

Database Duels Do Not Advance Quality ImprovementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Keroack, M. A., Meurer, S. J. Tags: Article Source Type: journals

New Patient Safety Culture Survey Helps Medical Offices Assess AwarenessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Clancy, C. M. Tags: Article Source Type: journals

Quality: The Mayo Clinic ApproachEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Developing highly reliable care for patients requires changes in some traditional beliefs of medical practice, an evolution toward a "system" of health care, the disciplined application of scientific principles, modifications in the way all future providers are trained, and a fundamental understanding by leadership that quality must become a business strategy and core work, not an expense or regulatory requirement. Quality at Mayo is defined as a composite of outcomes, safety, and service. A 4-part strategic construct focusing on Culture, Infrastructure, Engineering, and Execution has been developed to guide improvement ac...
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Swensen, S. J., Dilling, J. A., Milliner, D. S., Zimmerman, R. S., Maples, W. J., Lindsay, M. E., Bartley, G. B. Tags: Article Source Type: journals

Assessing Quality Indicators for Pediatric Community-Acquired PneumoniaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
To assess applicability of adult quality indicators in the management of pediatric community-acquired pneumonia (CAP), a retrospective cohort study of children admitted with CAP was conducted. The primary outcome was achievement of recommended adult quality indicators. Associations between quality indicators and clinical outcomes were assessed. Most children had rapid oxygenation assessment (97%) and blood culture before antibiotics (98%). Antibiotic timing and selection indicators were met less frequently. The only quality indicator associated with time to stability or length of stay was antibiotic timing; each additional...
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Sandora, T. J., Desai, R., Miko, B. A., Harper, M. B. Tags: Article Source Type: journals

A Qualitative Study of Consumers' Views on Public Reporting of Health Care-Associated InfectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Recent interest in publicly reporting health care–associated infections (HAIs) makes it important to develop reports that consumers can understand and evaluate. In-depth qualitative interviews were conducted with 59 consumers. Interviews focused on responses to existing and prototypical reports and on recommendations for improvements. Many interviewees were unfamiliar with HAIs and were distressed to learn HAIs occur and can result in death. Public reporting was seen as unlikely to affect hospital choice; other factors were considered more influential. Interviewees recommended that reports be brief and include inform...
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Mazor, K. M., Dodd, K. S. Tags: Article Source Type: journals

Institutional Variability of Intraoperative Red Blood Cell Utilization in Coronary Artery Bypass Graft SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The variability in frequency of allogeneic blood transfusion during coronary artery bypass surgery (CABG) is a concern. Evidence-based guidelines support minimizing the use of blood during open heart surgery. The Hospital Clinical Services Group quality indicator database was queried for intraoperative red blood cell (RBC) transfusions in 17 252 isolated CABG surgery cases during 2007. Institutional variability was observed in the frequency of intraoperative RBC transfusion rates, which ranged from 0% to 85.7%. The institution mean RBC transfusion rate was 40.8%. Regional geographic and cardiac program size variations were...
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Maddux, F. W., Dickinson, T. A., Rilla, D., Kamienski, R. W., Saha, S. P., Eales, F., Rego, A., Donias, H. W., Crutchfield, S. L., Hardin, R. A. Tags: Article Source Type: journals

Assessing Surgical Quality Using Administrative and Clinical Data Sets: A Direct Comparison of the University HealthSystem Consortium Clinical Database and the National Surgical Quality Improvement Program Data SetEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study directly compares the University HealthSystem Consortium Clinical Database (UHC CDB) and the National Surgical Quality Improvement Program (NSQIP) in terms of their assessment of complications and death for 26 322 surgery patients using analyses of variance, correlation, and multivariable logistic regression. The NSQIP had more variables with significant correlation with outcomes. The NSQIP was better at predicting death (c-index 0.94 vs 0.90, P < .05) and complications (c-index 0.78 vs 0.76, P = .07), especially for higher risk patients. The UHC CDB missed and misclassified several major complications. The d...
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Davenport, D. L., Holsapple, C. W., Conigliaro, J. Tags: Article Source Type: journals

The Challenge of Measuring Quality of Care From the Electronic Health RecordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The electronic health record (EHR) is seen by many as an ideal vehicle for measuring quality of health care and monitoring ongoing provider performance. It is anticipated that the availability of EHR-extracted data will allow quality assessment without the expensive and time-consuming process of medical record abstraction. A review of the data requirements for the indicators in the Quality Assessment Tools system suggests that only about a third of the indicators would be readily accessible from EHR data. Other factors involving complexity of required data elements, provider documentation habits, and EHR variability make t...
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Roth, C. P., Lim, Y.-W., Pevnick, J. M., Asch, S. M., McGlynn, E. A. Tags: Article Source Type: journals

Examination of How a Survey Can Spur Culture Changes Using a Quality Improvement Approach: A Region-Wide Approach to Determining a Patient Safety CultureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of this study was to investigate safety climates within a cohort of regional hospitals to assess health care workers’ perceptions of their hospitals’ safety reporting, feedback, and problem-solving systems, and to examine how regional initiatives and health care organizations use safety climate information to improve patient safety outcomes. A purposive sample of staff at 25 western Pennsylvania hospitals was surveyed using Likert scale questions. The instrument studied provided foci on which regional efforts and hospitals could base interventions to improve patient safety culture. Significant dif...
Source: American Journal of Medical Quality - September 8, 2009 Category: Health Management Authors: Pringle, J., Weber, R. J., Rice, K., Kirisci, L., Sirio, C. Tags: Article Source Type: journals

Pay-for-Performance (of) Advance DirectivesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Manthous, C. A. Tags: Article Source Type: journals

Literature ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Jutkowitz, E., Goldfarb, N. I. Tags: Article Source Type: journals

Professions on the Edge: Can Physicians Learn About Leadership From the Military?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Bonadonna, R. R. Tags: Article Source Type: journals

Medicare's New Hospital Payment Rule: Limitations and Unintended ConsequencesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Bahl, V., Campbell, D. A. Tags: Article Source Type: journals

Reengineering Hospital Discharge: A Protocol to Improve Patient Safety, Reduce Costs, and Boost Patient SatisfactionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Clancy, C. M. Tags: Article Source Type: journals

Teaching Trainees the Tenets of Quality and Safety: An Annotated BibliographyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Moskowitz, E. J., Nash, D. B. Tags: Article Source Type: journals

Associated Factors and Cost of Inappropriate Hospital Admissions and Stays in a Second-Level HospitalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of this study was to analyze the variables related to inappropriate admissions and hospital stays and their financial repercussions. This was a descriptive retrospective study in which the Appropriateness Evaluation Protocol (AEP) was applied to a representative sample of 725 hospital admissions and 1350 hospital stays. The cost of inappropriate stays was calculated by cost accounting. The study found that 7.4% of admissions and 24.6% of stays were inappropriate. Inappropriate admissions were significantly related to medical specialties and younger patient age. Inappropriate stays were related to these factor...
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Soria-Aledo, V., Carrillo-Alcaraz, A., Campillo-Soto, A., Flores-Pastor, B., Leal-Llopis, J., Fernandez-Martin, M. P., Carrasco-Prats, M., Aguayo-Albasini, J. L. Tags: Article Source Type: journals

Evaluation of Glycemic Control Metrics for Intensive Care Unit PopulationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Glycemic control is an important quality indicator in the management of intensive care unit patients. Tight glycemic control and/or insulin infusion protocols may reduce complications and improve outcomes in certain intensive care unit patients. Unfortunately, a consistent method of describing glycemic control has not been used for this population. A standardized metric is needed to adequately evaluate quality performance as well as interpret and apply the literature. The current glycemic control metrics such as mean, median, mean morning, hyperglycemic index, and time-weighted averages will be analyzed. The complexities a...
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Badawi, O., Yeung, S. Y., Rosenfeld, B. A. Tags: Article Source Type: journals

Illinois Medical Home Project: Pilot Intervention and EvaluationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study implemented and evaluated the pilot phase of a pediatric practice-directed medical home quality improvement (QI) project focused on improving primary care for children and youth with special health care needs (CYSHCN). Six practices received training, QI team development and facilitation, and receipt of mini-grants for QI projects. Practice-level and parent-level evaluations were obtained at pre-intervention and post-intervention. The intervention was well-received. Many areas of improvement were found on practice-level evaluations, especially family-centered care and QI activities. Poor response rates limited t...
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Rankin, K. M., Cooper, A., Sanabria, K., Binns, H. J., Onufer, C. Tags: Article Source Type: journals

Physician Quality Officer: A New Model for Engaging Physicians in Quality ImprovementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The slow progress in health care quality improvement and patient safety in America can be attributed, in part, to the challenge of physician engagement. As multidisciplinary patient-centered care becomes the standard, it is essential to integrate physicians into this process. To this end, the UMass Memorial Medical Center redesigned its Physician Quality Officer (PQO) program in 2007. The PQOs of the UMass Memorial Medical Center, who are all practicing clinicians, are fully compensated for their time and effort, trained in safety science, and teamed with other members of the department of quality and patient safety. Over ...
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Walsh, K. E., Ettinger, W. H., Klugman, R. A. Tags: Article Source Type: journals

Ambulatory Quality Improvement in Academic Medical Centers: A Changing LandscapeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Efforts to improve the quality of ambulatory care have received tremendous attention as bold new initiatives aimed at influencing the environment of care through financial incentives, public transparency, and information technology rapidly spread. Academic medical centers, which represent a long tradition of excellence and innovation in medical care, might be expected to lead the charge in these new arenas, but motivation for change may be mitigated by the unique complexity and multiple goals of these institutions. A survey conducted in the fall of 2006 examined the early impact of these major new influences on faculty pra...
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Leas, B. F., Goldfarb, N. I., Browne, R. C., Keroack, M., Nash, D. B. Tags: Article Source Type: journals

Full Implementation of Computerized Physician Order Entry and Medication-Related Quality Outcomes: A Study of 3364 HospitalsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study compares quality of care measures for hospitals with fully implemented computerized physician order entry (CPOE) systems with hospitals that have not fully implemented such a system. Using a cross-sectional design, this study linked hospital quality data from the Centers for Medicare and Medicaid Services to the Health Information Management Systems Society Analytics database, which contains hospital CPOE adoption information. Performance on quality measures was assessed using univariate and multivariate methods. In all, 8% of hospitals have fully implemented CPOE systems; CPOE hospitals were more frequently lar...
Source: American Journal of Medical Quality - July 6, 2009 Category: Health Management Authors: Yu, F. B., Menachemi, N., Berner, E. S., Allison, J. J., Weissman, N. W., Houston, T. K. Tags: Article Source Type: journals

Literature ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Royo, M. B., Goldfarb, N. I. Tags: Article Source Type: journals

Pie in the Sky--or a Grassroots Call to Action?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Callan, C. M. Tags: Article Source Type: journals

More Work Is Needed to Protect Medical Residents From Fatigue and Potential Errors, IOM Report FindsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Clancy, C. M. Tags: Article Source Type: journals

Medicare's Value-Based Payment Initiatives: Impact on and Implications for Improving Physician Documentation and CodingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Medicare has introduced a number of new payment initiatives that will have a profound effect on hospital reimbursement and quality and safety ratings. The new medical severity diagnosis—related group (MS-DRG) payment system adds a number of new DRG categories to more adequately account for patient severity. The new present-on-admission (POA) initiative is designed to withhold additional reimbursement for selected complications that were not recorded as being POA but that occurred during the course of the hospitalization. The recovery audit contract requires hospitals to repay Medicare for services deemed not clinical...
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Rosenstein, A. H., O'Daniel, M., White, S., Taylor, K. Tags: Article Source Type: journals

Effect of Smoking Cessation Advice on Cardiovascular DiseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article analyzes the effects of offering smoking cessation advice in the US population. The Archimedes model is used to simulate several clinical trials in which basic advice and medication advice are offered and to calculate the rates of myocardial infarctions, congestive heart disease deaths, strokes, life years, quality-adjusted life years (QALYs), costs, and cost/ QALY. The simulated population is a representative sample of the US population drawn from the Third National Health and Nutrition Survey conducted just before the performance measures and guidelines were introduced. The results show that offering basic a...
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Eddy, D. M., Peskin, B., Shcheprov, A., Pawlson, G., Shih, S., Schaaf, D. Tags: Article Source Type: journals

Resident, Nursing Home, and State Factors Affecting the Reliability of Minimum Data Set Quality MeasuresEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Nursing home quality measures impact policy decisions such as reimbursement or consumer choice. Quality indicators in the United States are collected through the federally mandated Minimum Data Set (MDS). Bias in MDS data collection or coding can thus have a negative impact on policy applications. To understand whether bias was present in coding, the authors studied 5174 pairs of MDS assessments that were independently collected by nursing home staff and study nurses from 206 nursing homes. The authors developed multivariate multilevel models to identify nursing home and resident characteristics that were significantly ass...
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Wu, N., Mor, V., Roy, J. Tags: Article Source Type: journals

End-of-Life Decision Making in the Intensive Care Unit: Physician and Nurse PerspectivesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
End-of-life decision making, including consideration of advance directives and code status, is taking place more frequently in critical care units. There is a need to identify how nurses and physicians perceive end-of-life care so that nurse-physician understanding and communication can be improved. A total of 96 physicians and nurses completed a survey about their general beliefs and practices related to end-of-life care in the intensive care unit. Nurses were more likely to ask if there was a living will and to read it. Only 53% of physicians read living wills; however 90% of physicians consider the wishes in the living ...
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Westphal, D. M., McKee, S. A. Tags: Article Source Type: journals

A Patient Safety Curriculum for Graduate Medical Education: Results From a Needs Assessment of Educators and Patient Safety ExpertsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Graduate medical education (GME) has traditionally focused on the diagnosis and management of disease with little attention devoted to patient safety and systems thinking. In this article, we describe the results of a needs assessment conducted to develop a patient safety curriculum for GME. Eight program directors, 10 patient safety experts, and 9 experts in education technology were interviewed for this project. A total of 21 patient safety topics were identified in the categories of cultural, cognitive, and technical content and included communications and handoffs, sentinel event reporting and management, calling for h...
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Varkey, P., Karlapudi, S., Rose, S., Swensen, S. Tags: Article Source Type: journals

Hand Hygiene Compliance Rates in the United States--A One-Year Multicenter Collaboration Using Product/Volume Usage Measurement and FeedbackEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article presents the results of a 12-month multicenter collaboration assessing HH compliance rates at US health care facilities by measuring product usage and providing feedback about HH compliance. Our results show that HH compliance at baseline was 26% for intensive care units (ICUs) and 36% for non-ICUs. After 12 months of measuring product usage and providing feedback, compliance increased to 37% for ICUs and 51% for non-ICUs. (ICU, P = .0119; non-ICU, P < .001). HH compliance in the United States can increase when monitoring is combined with feedback. However, HH still occurs at or below 50% compli- ance for b...
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: McGuckin, M., Waterman, R., Govednik, J. Tags: Article Source Type: journals

Systematic Review of Handoff Mnemonics LiteratureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A systematic review of published English-language articles on handoffs is conducted (1987 to June 4, 2008). Forty-six articles describing 24 handoff mnemonics are identified by trained reviewers. The majority (82.6%) have been published in the last 3 years (2006-2008), and SBAR (Situation, Background, Assessment, Recommendation) is the most frequently cited mnemonic (69.6%). Of 7 handoff research articles, only 4 study mnemonics. All 4 of these studies have relatively small sample sizes (10-100) and lack validated instruments. Only 1 study has obtained IRB approval. Scientifically rigorous research studies are needed to as...
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Riesenberg, L. A., Leitzsch, J., Little, B. W. Tags: Article Source Type: journals

Learning From Defects to Enhance Morbidity and Mortality ConferencesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
While required by the Accreditation Council for Graduate Medical Education (ACGME) and recommended by the Institute of Medicine, there are few published studies demonstrating that morbidity and mortality conferences (MMCs) are an effective strategy to improve patient care. To learn from medical incidents and improve patient care, care-givers need to: (1) elicit input from all staff involved in the incident, (2) use a structured framework to investigate all underlying contributing factors, and (3) assign responsibility for management and follow-up on recommendations. Many MMCs lack these key elements. The specific aims of t...
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Berenholtz, S. M., Hartsell, T. L., Pronovost, P. J. Tags: Article Source Type: journals

A Novel Method to Link and Validate Routinely Collected Emergency Department Clinical Data to Measure Quality of CareEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective was to develop and validate a method to link routinely captured electronic data for the measurement of emergency department (ED) quality indicators. Electronic ED data were linked to calculate time to antibiotics and time to electrocardiogram (ECG) for pneumonia and chest pain patients, respectively; validation was by comparison with chart data. Linked electronic data correctly identified 40/40 pneumonia and 65/65 chest pain patients. The median difference in time to antibiotics calculated from linked electronic data versus chart data was 6 minutes (standard deviation [SD] = 14.0); for time to ECG it was 0 mi...
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Yip, A., Leduc, M., Teo, V., Timmons, M., Schull, M. J. Tags: Article Source Type: journals

The Inequality in Health Care QualityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - May 20, 2009 Category: Health Management Authors: Abouzaid, S., Maio, V. Tags: Article Source Type: journals

The Accountability Conundrum: Staying Focused, Delivering Results: A Report on the UHC 2008 Quality and Safety Fall ForumEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: American Journal of Medical Quality)
Source: American Journal of Medical Quality - March 17, 2009 Category: Health Management Authors: Clarke, J. L. Tags: Article Source Type: journals