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Am J Med Qual 2021 May-Jun 01;36(3):208

Broward Health, Boca Raton, FL.

Am J Med Qual 2021 May-Jun 01;36(3):203

Department of Family and Community Medicine, Division of Geriatric and Palliative Care, Thomas Jefferson University, Philadelphia, PA Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA.

Am J Med Qual 2021 May-Jun 01;36(3):180-184

Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI.

Payors hold hospitals accountable for patient experience using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The objective was to determine if hospital unit (medicine versus nonmedicine [ie, cardiology, oncology, urology, physical medicine and rehabilitation, and surgery]) influences HCAHPS scores when care is given by the same providers on different units. This retrospective analysis of adult inpatient data (n = 845), included overall hospital satisfaction, staff communication, care and communication from physicians, and discharge communication. Read More

Am J Med Qual 2021 May-Jun 01;36(3):139-144

Clinical Medicine and Population Health Sciences, Weill Cornell Medical College, Adjunct Professor Columbia University, NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY Population Health, NewYork-Presbyterian Healthcare System Inc., New York, NY NewYork-Presbyterian Healthcare System Inc., Digital Health, New York, NY Harvard Medical School, Boston, MA IS & Telehealth, NewYork-Presbyterian Heatlhcare System, Inc., New York, NY Center for Behavioral Cardiovascular Health. Columbia University Irving Medical Center. New York, NY Columbia University Irving Medical Center, New York, NY Weill Cornell Medicine. New York, NY Clinical Emergency Medicine, Weill Cornell Medicine. New York, NY.

The coronavirus pandemic catalyzed a digital health transformation, placing renewed focus on using remote monitoring technologies to care for patients outside of hospitals. At NewYork-Presbyterian, the authors expanded remote monitoring infrastructure and developed a COVID-19 Hypoxia Monitoring program-a critical means through which discharged COVID-19 patients were followed and assessed, enabling the organization to maximize inpatient capacity at a time of acute bed shortage. The pandemic tested existing remote monitoring efforts, revealing numerous operating challenges including device management, centralized escalation protocols, and health equity concerns. Read More

Am J Med Qual 2021 Apr 22. Epub 2021 Apr 22.

Department of Performance Excellence, Duke University Health System, One Renaissance Centre, Raleigh, NC Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC Department of Public Health Leadership, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC.

Health care is at a critical moment. High rates of medical errors and decreasing quality of health care make it crucial that organizations focus on quality improvement (QI). For this work to be successful, it is essential to engage physicians, as they are key decision-makers, leaders, and influencers of care. Read More

Am J Med Qual 2021 Apr 20. Epub 2021 Apr 20.

Stanford University, School of Medicine, Stanford, CA Patient Care Services, Stanford Health Care, Stanford, CA Healthcare AI Applied Research Team, Division of Primary Care and Population Health, Stanford Health Care, Stanford, CA.

Following the adoption of an acuity-adaptable unit model in an academic medical center, a $13M increase in cost of intermediate intensive care unit (IICU) accommodations was observed. The authors followed A3 methodology to determine the root cause of this increase and developed a 3-prong intervention centered on physician engagement, given that physicians have the ability to order a patient's level of care. This intervention consisted of: (1) identifying physician champions to promote appropriate IICU use, (2) visual changes to essential electronic medical record tools, and (3) data-driven feedback to physician champions. Read More

Am J Med Qual 2021 Mar-Apr 01;36(2):136-137

Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA.

Am J Med Qual 2021 Mar-Apr 01;36(2):129

Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI Division of Hospital Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI Division of General Internal Medicine and Clinical Innovation, Department of Medicine, NYU Langone Health, New York, NY Emergency Department, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.

Am J Med Qual 2021 Mar-Apr 01;36(2):122-124

Jefferson College of Population Health, Thomas Jefferson University, Walnut Street, Philadelphia, PA Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.

Am J Med Qual 2021 Mar-Apr 01;36(2):84-89

Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO UCHealth, Aurora, CO Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.

The posthospital discharge period is vulnerable for patients with coronavirus disease 2019 (COVID-19). The authors implemented a COVID-19 discharge pathway in the electronic medical record for UCHealth, a 12-hospital health care system, including an academic medical center (University of Colorado Hospital [UCH]), to improve patient safety by standardizing discharge processes for COVID-19 patients. There were 3 key elements: (1) building consensus on discharge readiness criteria, (2) summarizing discharge criteria for disposition locations, and (3) establishing primary care follow-up protocols. Read More

Am J Med Qual 2021 Mar-Apr 01;36(2):73-83

Department of Emergency Medicine, Yale School of Medicine, New Haven, CT Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN Department of Internal Medicine, Central Michigan University College of Medicine, Mount Pleasant, MI Department of Emergency Medicine, Florida Atlantic University College of Medicine, Boca Raton, FL Department of Emergency Medicine, University of California, Irvine, Irvine, CA Department of Pediatrics, Yale School of Medicine, New Haven, CT Department of Emergency Medicine, Yale School of Medicine, New Haven, CT Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI College of Population Health, Thomas Jefferson University, Philadelphia, PA.

The health care sector has made radical changes to hospital operations and care delivery in response to the coronavirus disease (COVID-19) pandemic. This article examines pragmatic applications of simulation and human factors to support the Quadruple Aim of health system performance during the COVID-19 era. First, patient safety is enhanced through development and testing of new technologies, equipment, and protocols using laboratory-based and in situ simulation. Read More

Am J Med Qual 2021 Apr 2. Epub 2021 Apr 2.

Faculty of Health, University of Plymouth, Plymouth, UK University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.

Am J Med Qual 2021 May-Jun 01;36(3):197-199

Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, NY.

Am J Med Qual 2021 Apr 2. Epub 2021 Apr 2.

Thomas Jefferson University Hospital, Philadelphia, PA.

Am J Med Qual 2021 Jan-Feb 01;36(1):69-71

Chief Clinical Product Officer, Medical Home Network: Faculty, University of Illinois, Chicago School of Public Health, Chicago, IL University of Arizona College of Medicine, Phoenix, AZ President & Board Chair: BeWell Orange County, Irvine, CA Chief Medical Officer, Norwegian American Hospital, Chicago, IL Jefferson College of Population Health, Philadelphia, PA Rush University, Chicago, IL.

Am J Med Qual 2021 Jan-Feb 01;36(1):66

Wayne State University School of Medicine, Detroit, MI Department of Internal Medicine and Pediatrics, Wayne State University School of Medicine, Detroit, MI, Detroit Medical Center, Detroit, MI.

Am J Med Qual 2021 Jan-Feb 01;36(1):64-65

University of Oklahoma Health Sciences Center, Department of Medicine, Cardiovascular Diseases Section, Oklahoma City, OK, Veterans Affair Medical Center, Department of Internal Medicine, Oklahoma City, OK Veterans Affair Medical Center, Department of Internal Medicine, Oklahoma City, OK, University of Oklahoma Health Sciences Center, Department of Internal Medicine, Oklahoma City, OK University of Oklahoma Health Sciences Center, Department of Medicine, Cardiovascular Diseases Section, Oklahoma City, OK, Veterans Affair Medical Center, Department of Internal Medicine, Oklahoma City, OK University of Oklahoma Health Sciences Center, Department of Pediatrics, Oklahoma City, OK Veterans Affair Medical Center, Department of Internal Medicine, Oklahoma City, OK, University of Oklahoma Health Sciences Center, Department of Internal Medicine, Oklahoma City, OK.

Am J Med Qual 2021 Jan-Feb 01;36(1):63

School of Medicine, University of California, San Francisco, CA Department of Medicine, University of California, San Francisco, CA Division of General Internal Medicine and Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA.

Am J Med Qual 2021 Jan-Feb 01;36(1):57-59

Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD Departments of Surgery, Anesthesiology and Critical Care Medicine, Emergency Medicine, Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Am J Med Qual 2021 Jan-Feb 01;36(1):5-16

Department of Neurology, Massachusetts General Hospital, Boston, MA Department of Neurology, Harvard Medical School, Boston, MA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.

Routine outpatient epilepsy care has shifted from in-person to telemedicine visits in response to safety concerns posed by the coronavirus disease 2019 (COVID-19) pandemic. But whether telemedicine can support and maintain standardized documentation of high-quality epilepsy care remains unknown. In response, the authors conducted a quality improvement study at a level 4 epilepsy center between January 20, 2019, and May 31, 2020. Read More

Am J Med Qual 2020 12;35(6):509-510

Am J Med Qual 2020 Oct 8:1062860620961168. Epub 2020 Oct 8.

University of Colorado, Aurora, CO.

Training in leadership and health system transformation is increasingly important in undergraduate medical education in order to develop a pipeline of engaged physicians dedicated to transforming health care. Despite this growing need, it is unclear whether current leadership training methods have long-term impact on students' career trajectory. The authors analyzed career outcomes from 6 years of the Health Innovations Scholars Program (HISP) to better understand how the program affected the 46 graduates' future involvement in health system transformation and leadership. Read More

Am J Med Qual 2021 Jan-Feb 01;36(1):67

Lady Hardinge Medical College, New Delhi, India.

Am J Med Qual 2020 Oct 7:1062860620962572. Epub 2020 Oct 7.

University of Minnesota, Minneapolis, MN.

Performance improvement on clinical quality outcomes typically requires significant effort by personnel in health care organizations. Understanding the cost of quality improvement is important given diffusion of value-based contracting. This study investigates the organizational costs and benefits associated with planning and implementing the Ask about Aspirin intervention to increase use of low-dose aspirin in clinically recommended patient populations. Read More

Am J Med Qual 2021 Jan-Feb 01;36(1):60-62

University of Massachusetts-Baystate, Springfield, MA Baystate Health, Springfield, MA.

Am J Med Qual 2020 Sep 23:1062860620959450. Epub 2020 Sep 23.

New York University, New York, NY.

Few studies have assessed the fidelity of practice facilitation (PF) as an implementation strategy, and none have used an a priori definition or conceptual framework of fidelity to guide fidelity assessment. The authors adapted the Conceptual Framework for Implementation Fidelity to guide fidelity assessment in HealthyHearts NYC, an intervention that used PF to improve adoption of cardiovascular disease evidence-based guidelines in primary care practices. Data from a web-based tracking system of 257 practices measured fidelity using 4 categories: frequency, duration, content, and coverage. Read More

Am J Med Qual 2020 Sep 22:1062860620959440. Epub 2020 Sep 22.

University of Pennsylvania, Philadelphia, PA.

Surgeon providers and billing professionals use Current Procedural Terminology (CPT) codes to specify patient treatment and associated charges. In the present study, coding discrepancies between surgeons' first pass coding and employed coders' final codes were investigated. A total of 500 patients over 3 months were retrospectively analyzed for coding discrepancies. Read More

Am J Med Qual 2020 Sep/Oct;35(5):437-438

Am J Med Qual 2021 May-Jun 01;36(3):200-202

Thomas Jefferson University, Philadelphia, PA.

Am J Med Qual 2020 Sep 13:1062860620953214. Epub 2020 Sep 13.

New York University School of Medicine, New York, NY.

HealthyHearts New York City (HHNYC), one of 7 cooperatives funded through the Agency for Healthcare Research and Quality's EvidenceNOW initiative, evaluated the impact of practice facilitation on implementation of the Million Hearts guidelines for cardiovascular disease prevention and treatment. Tracking the intervention required a system to facilitate process data collection that was also user-friendly and flexible. Coupled with protocols and training, a strategically planned and customizable customer relationship management system (CRMS) was implemented to support the quality improvement intervention with 257 small independent practices. Read More