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Am J Med Qual 2020 Jun 2:1062860620929423. Epub 2020 Jun 2.

Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

Annual influenza epidemics are associated with high morbidity and mortality worldwide, with vaccinations being the main preventive intervention; however, the compliance rate of health care employees remains low. Study aims were to examine vaccination rates among physicians and nurses in surgical and medicine wards, compare between medium and large tertiary hospitals, and identify factors associated with increased vaccination rates. Structured questionnaires were distributed. Read More

Am J Med Qual 2020 Jun 2:1062860620929306. Epub 2020 Jun 2.

Massachusetts General Hospital, Boston, MA.

Patient tracers and leadership WalkRounds proactively identify quality and safety issues. However, these programs have been inconsistent in application, results, and sustainability. The goal was to identify a more consistent and efficient approach to survey health care facilities. Read More

Am J Med Qual 2020 May 31:1062860620929419. Epub 2020 May 31.

Maine Medical Center, Portland, ME.

The 2016 Accreditation Council for Graduate Medical Education Clinical Learning Environment Review report identified knowledge gaps for quality in the clinical environment. It suggested quality improvement (QI) training is necessary to develop skills to improve health care quality. However, at the authors' institution, there is limited department-level QI mentorship and engagement, thus limiting QI experiences for residents and fellows. Read More

Am J Med Qual 2020 May 31:1062860620931934. Epub 2020 May 31.

Am J Med Qual 2020 May 31:1062860620929643. Epub 2020 May 31.

University of Calgary, Calgary, Alberta, Canada.

Am J Med Qual 2020 May 31:1062860620929642. Epub 2020 May 31.

East Carolina University, Greenville, NC.

Am J Med Qual 2020 May 31:1062860620928282. Epub 2020 May 31.

East Carolina University, Greenville, NC.

Am J Med Qual 2020 May 26:1062860620926710. Epub 2020 May 26.

Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.

Performance on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey can affect up to 33% of a physician's reimbursement from the Centers for Medicare & Medicaid Services. At this pseudo-private orthopedic practice, the authors characterized how physicians often achieve drastically different scores between HCAHPS and an Internal Patient Satisfaction Questionnaire (IPSQ). Eighteen physicians were ranked separately according to percentage of top-box scores on HCAHPS and IPSQ. Read More

Am J Med Qual 2020 May 26:1062860620928281. Epub 2020 May 26.

East Carolina University, Greenville, NC.

Am J Med Qual 2020 May 26:1062860620928002. Epub 2020 May 26.

Thomas Jefferson University Hospital, Philadelphia, PA.

Am J Med Qual 2020 May 22:1062860620925538. Epub 2020 May 22.

Am J Med Qual 2020 May 20:1062860620925536. Epub 2020 May 20.

Am J Med Qual 2020 May 20:1062860620925545. Epub 2020 May 20.

Am J Med Qual 2020 May 20:1062860620925537. Epub 2020 May 20.

Am J Med Qual 2020 May 16:1062860620920712. Epub 2020 May 16.

Cleveland Clinic, Abu Dhabi, UAE.

Transfer is a vulnerable setting that increases the risk of medication errors. Medication reconciliation (MedRec) ensures accurate medication transfer at interfaces of care. It is addressed as a key performance indicator (KPI) in a tertiary hospital. Read More

Am J Med Qual 2020 May 16:1062860620926271. Epub 2020 May 16.

Division of Hematology/Oncology/Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital IL.

Am J Med Qual 2020 May 11:1062860620920352. Epub 2020 May 11.

Am J Med Qual 2020 May 8:1062860620917206. Epub 2020 May 8.

Oregon Health & Science University, Portland, OR.

Inpatient falls are common, but little is known about hospitalist perceptions regarding their exact role in fall prevention. The authors conducted a cross-sectional analysis of hospitalists' attitudes and perceived barriers to fall prevention practices in 2 different hospital systems in Portland, Oregon. A total of 42 responses were collected. Read More

Am J Med Qual 2020 May 8:1062860620920364. Epub 2020 May 8.

Am J Med Qual 2020 May 8:1062860620918292. Epub 2020 May 8.

Am J Med Qual 2020 May 5:1062860620918295. Epub 2020 May 5.

MedStar National Rehabilitation Hospital, Washington, DC.

The Merit-based Incentive Payment System (MIPS) is a requirement for all physicians for value-based reporting. Medicare has approved registries as a mechanism for MIPS reporting. Concurrently, residencies continue to abide by the Accreditation Council for Graduate Medical Education's (ACGME's) curriculum requirement of utilizing/practicing quality improvement (QI). Read More

Am J Med Qual 2020 May 5:1062860620917205. Epub 2020 May 5.

University of Washington School of Medicine, Seattle, WA.

Quality metrics are fundamental to value-based payment reforms. Because metrics are key components used to drive performance, health care organizations participating in payment reforms should consider metric reliability-a measure of true performance versus statistical "noise." This cross-sectional study examined reliability, variation from patient and clinician characteristics, and volume thresholds for 9 ambulatory quality metrics in a health system engaged in value-based payment reforms. Read More

Am J Med Qual 2020 Apr 24:1062860619900791. Epub 2020 Apr 24.

Thomas Jefferson University, Philadelphia, PA.

Pain is a common problem for patients undergoing radiation therapy, exacerbated by inconsistent pain documentation. Free-form templates, pain score prompts, and forcing functions are a hierarchy of constraint systems that can be applied to data entry. This study assessed the impact of incorporating these models into electronic health records on pain documentation rates during 450 on-treatment visits and pain severity of 258 patients with bone metastases and breast and thoracic cancer during radiation therapy. Read More

Am J Med Qual 2020 Apr 20:1062860620915280. Epub 2020 Apr 20.

Beth Israel Deaconess Medical Center, Boston, MA.

All adults should complete a health care proxy (HCP), especially those who are seriously ill or otherwise at increased risk of losing capacity. This study describes the implementation of an interdisciplinary process for helping patients complete HCPs during nonurgent visits at a large urban academic primary care practice between July 2014 and May 2017. The process was mapped using direct observations. Read More

Am J Med Qual 2020 Apr 20:1062860620915274. Epub 2020 Apr 20.

Am J Med Qual 2020 Mar 30:1062860620914026. Epub 2020 Mar 30.

National Quality Forum, Washington, DC.

In the summer of 2017, the National Quality Forum (NQF) announced the formation of a Scientific Methods Panel (hereafter referred to as "the Panel") as part of a redesign of its endorsement process. NQF created the Panel in response to stakeholder request during a Kaizen improvement event held in May 2017. Given the Panel's role in the endorsement of performance measures used in national payment programs, the objective of this article is to describe the work of the Panel, and to describe its function in the larger context of the NQF measure endorsement process and in the measurement enterprise writ large. Read More

Am J Med Qual 2020 Mar 30:1062860620914540. Epub 2020 Mar 30.

University of North Carolina Hospitals, Chapel Hill, NC.

Am J Med Qual 2020 Mar 23:1062860620912480. Epub 2020 Mar 23.

Nemours/Alfred I. du Pont Hospital for Children, Wilmington, DE.

Closed-loop communication (CLC) promotes a shared understanding of information. The authors hypothesized that simulation-based CLC training would improve staff perceptions of CLC ability and decrease medical errors. Participants experienced 2 hands-on CLC simulations one month apart. Read More

Am J Med Qual 2020 Mar/Apr;35(2):186

The University of Tennessee Health Science Center, Memphis, TN.

Am J Med Qual 2020 Mar/Apr;35(2):190-191

Am J Med Qual 2020 Mar 6:1062860620910200. Epub 2020 Mar 6.

Discern Health, Baltimore, MD.

The Garden Practice Transformation Network in Maryland brought together primary and specialty practices working toward value-based models and efficient care delivery. Practices were provided with coaching and live and multimedia education regarding practice transformation and quality improvement. Coaches supported practices in multipronged approaches to quality improvement. Read More

Am J Med Qual 2020 Mar 3:1062860620907685. Epub 2020 Mar 3.

Am J Med Qual 2020 Mar 3:1062860620908060. Epub 2020 Mar 3.

Am J Med Qual 2020 Mar 3:1062860620908059. Epub 2020 Mar 3.

Am J Med Qual 2020 Mar 3:1062860620908058. Epub 2020 Mar 3.

Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.

Interdisciplinary rounding has been shown to improve patient safety and provider engagement. Many models for interdisciplinary rounding have been proposed but few focus on preserving bedside medical education. The authors changed the interdisciplinary bedside rounding model to accommodate more time for medical education. Read More

Am J Med Qual 2020 Mar 1:1062860620907154. Epub 2020 Mar 1.

Thomas Jefferson University, Philadelphia, PA.

Diagnostic error and diagnostic delays in health care are widespread. This article outlines an improvement effort targeting weekday evening inpatient radiology delays through staffing changes replacing trainees with faculty-trainee team coverage, pushing faculty coverage from 4 pm to 8 pm. Order-report turnaround times (TATs), critical findings TATs for pneumothorax and intracranial hemorrhage (ICH), and percentage meeting target were compared pre and post implementation for the 4 to 8 pm time frame using the Mann-Whitney and χ tests, respectively. Read More

Am J Med Qual 2020 Feb 20:1062860620905310. Epub 2020 Feb 20.

Tel Aviv University, Tel Aviv, Israel.

In recent years, health care systems have undergone a consumer revolution-putting patients at the center. The study aim was to explore the association between -the new measure proposed by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)-and hospital patients' based on their experience, along with hospitals' internal characteristics and operational attributes. Using HCAHPS and American Hospital Association published databases, the authors examined the association between hospital characteristics and measures of patient experience, focusing on the care transition measure, in 2350 US hospitals. Read More

Am J Med Qual 2020 Mar/Apr;35(2):187. Epub 2020 Feb 11.

Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, NC.

Am J Med Qual 2020 Jan 24:1062860619900929. Epub 2020 Jan 24.

Am J Med Qual 2020 Jan/Feb;35(1):94-95

Am J Med Qual 2020 Jan 15:1062860619898534. Epub 2020 Jan 15.

Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.

Among children hospitalized for acute problems, comorbid obesity is commonly unaddressed. The objective was to improve identification and initial management of obesity among hospitalized children. In collaboration with nurses and dietitians, pediatric hospitalists of 2 children's hospitals conducted a quality improvement project to improve body mass index (BMI) documentation, obesity diagnosis, diet, and nutrition consultation through clinician education, development of computerized clinical decision-support system tools, and workflow modifications. Read More

Am J Med Qual 2020 Jan 15:1062860619897406. Epub 2020 Jan 15.

Wayne State University, Detroit, MI.

The nuts and bolts of planning and designing cancer care facilities-the physical space, the social systems, the clinical and nonclinical workflows, and all of the patient-facing services-directly influence the quality of clinical care and the overall patient experience. Cancer facilities should be conceived and constructed on the basis of evidence-based design thinking and implementation, complemented by input from key stakeholders such as patients, families, and clinicians. Specifically, facilities should be designed to improve the patient experience, offer options for urgent care, maximize infection control, support and streamline the work of multidisciplinary teams, integrate research and teaching, incorporate palliative care, and look beyond mere diagnosis and treatment to patient wellness-all tailored to each cancer center's patient population and logistical and financial constraints. Read More

Am J Med Qual 2020 Jan 15:1062860619897289. Epub 2020 Jan 15.

University of Washington, Seattle, WA.

Immunizations against , and type b are recommended for patients undergoing splenectomy to decrease the risk of developing overwhelming infections. The authors sought to determine adherence to these recommendations by providers at UW Medicine. Regional immunization records for patients who underwent splenectomy between October 2015 and January 2019 were analyzed to measure compliance with immunization guidelines from the US Centers for Disease Control and Prevention (CDC). Read More

Am J Med Qual 2019 Dec 24:1062860619892064. Epub 2019 Dec 24.

Am J Med Qual 2019 Dec 22:1062860619893422. Epub 2019 Dec 22.

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

Few studies have examined factors that facilitate recruitment of small independent practices (SIPs) (<5 full-time clinicians) to participate in research and methods for optimizing retention. The authors analyzed qualitative data (eg, recruiter's field notes and diary entries, provider interviews) to identify barriers and facilitators encountered in recruiting and retaining 257 practices in HealthyHearts New York City (NYC). This study was a stepped-wedge randomized controlled trial that took place 2015 through 2018 across 5 boroughs in NYC. Read More

Am J Med Qual 2019 Dec 20:1062860619892060. Epub 2019 Dec 20.

Am J Med Qual 2019 Dec 13:1062860619893454. Epub 2019 Dec 13.

Am J Med Qual 2019 Dec 4:1062860619891995. Epub 2019 Dec 4.

The George Washington University, Washington, DC.

Adverse event (AE) reporting is a key component of patient safety and physicians are known to underreport. The authors hypothesized that integrating AE reporting into a mobile application used in daily physician workflow would increase physician reporting of AEs. After integrating AE reporting into a free-text mobile application used for daily workflow, the change in AE reporting by physicians was analyzed using Mann-Whitney tests. Read More

Am J Med Qual 2020 Jan/Feb;35(1):91. Epub 2019 Dec 1.

St. Michael's Hospital, Toronto, Ontario, Canada.

Am J Med Qual 2020 Jan/Feb;35(1):92. Epub 2019 Nov 28.

Thomas Jefferson University, Philadelphia, PA.