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被引量: 589
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期刊描述简介:
The Journal for Healthcare Quality (JHQ), a peer-reviewed journal, is an official publication of the National Association for Healthcare Quality. JHQ is a professional forum that continuously advances healthcare quality practice in diverse and changing environments, and is the first choice for creative and scientific solutions in the pursuit of healthcare quality. It has been selected for coverage in Thomson Reuter’s Science Citation Index Expanded, Social Sciences Citation Index®, and Current Contents®.
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Factors Associated With Nasogastric Tube Placement-Related Complications in a Single Academic Medical Center.
At our 710-bed academic medical center, nine (9) patients sustained injuries during nasogastric (NG) tube insertion attempts over a 16-month period (March 2021-July 2022). No injuries were reported during the comparable period before these events. This increase in reported events prompted an in-depth analysis to determine the root causes and implement a process improvement plan. Root cause analysis (RCA) of these events failed to identify risk factors or actionable themes. The RCAs demonstrated wide variation in the number of insertion attempts and techniques. A standard process was created to provide team members with guidance for escalation when NG tube placement was difficult. Although the complication rate for NG tube insertion was comparable with the criterion standard for large tertiary care institutions, we focused on minimizing risk and improving outcomes by creating a standard process for NG tube placement.
被引量：- 发表：2024
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Challenges Meeting 21st Century Cures Act Patient Identity Interoperability and Information Blocking Rules.
Gather insights into healthcare organization (HCO) preparedness for new 21st Century Cures Act information blocking disincentives and challenges in achieving greater accuracy /interoperability of patient identity/data. Survey of 197 U.S. healthcare executives (54.7% response rate), included 46 health systems (23.4%), 141 hospitals (71.6%), and 10 payer organizations (5.1%), evaluated organizational gaps in patient identity data management/interoperability and preparation for information deblocking. Healthcare organizations are unprepared to meet information deblocking requirements and manage increased data influx/exchange. Although 61% have invested in meeting requirements, only 36% have capabilities in place. Majorities reported inability to comply with information blocking rules (59%), communicate electronic patient activity notifications to other organizations (56%), or share/receive patient-level information with patients and other HCOs (57%). Across 12 critical functionalities, 57% lacked key capabilities; 97% reported inadequate patient data/identity management/interoperability as data volume expands, adversely affecting care quality/safety and outcomes; and 57% envision patient data-matching errors precipitating a healthcare crisis in 5-10 years. Many HCOs are unprepared to meet new Cures Act information blocking requirements and resultant increase of internal/external patient data volumes. Next generation master data management, enterprise master patient index, and referential matching technologies can improve HCO patient identity and data management, and information interoperability.
被引量：- 发表：2024
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Eradicating the Loneliness Epidemic: One Phone Call at a Time.
Loneliness and social isolation are serious problems that can impose negative consequences on individual well-being. Research suggests that loneliness can lead to an increased risk of depression, anxiety, and other health issues. Meritus Health, recognizing that loneliness is an issue within its community, has set a goal to comprehensively eradicate loneliness. As part of this effort, Meritus implemented the Care Caller program in November of 2021 through which a volunteer is paired up with a patient from our institution who has indicated that they are lonely. Each duo then finds a weekly cadence to share in 15- to 30-minute phone calls to facilitate meaningful social interaction. As of July 2023, the program has 500 participants enrolled with 47 volunteers and 2 full-time employees, and over 350 people are called weekly. In the last fiscal year, over 75,000 minutes have been spent on the phone between care callers and participants with promising results. Of the 172 participants who have been in the program for 4+ months, 166 have indicated that they felt less lonely, yielding a success rate of 97%. Meritus Health continues to further this program by increasing the number of care callers and utilization of Plan-Do-Study-Act rapid improvement.
被引量：- 发表：1970
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Improving Lung Cancer Screening at an Academic Medical Center.
Lung cancer ranks as the third most prevalent cancer in the United States. The use of low-dose computed tomography (LDCT) screening significantly reduces mortality from this disease. Unfortunately, Texas lags in completing lung cancer screening (LCS) for high-risk patients, ranking 48th among all states. It is crucial to implement quality improvement (QI) initiatives in Texas. In collaboration with the American Cancer Society, the primary care center (PCC) at our institution led a multidisciplinary QI project aimed at enhancing LCS through LDCT for eligible PCC patients. The study included patients eligible for screening and who fall into the following categories: established patients with Medicaid, low-income or uninsured established patients, and established patients with either Medicare or commercial insurance. Enhancements to electronic medical records, education for clinical staff and patients, and a coordinated, multidisciplinary effort were implemented. The study revealed a substantial 40.2% improvement in LCS rates. The US Preventive Services Task Force guidelines rely on an accurate history of patient's tobacco use to identify patients eligible for LCS. This QI project achieved success in improving the thoroughness of tobacco use history documentation and surpassed our target for increasing LCS by more than 10%.
被引量：- 发表：2024
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EHR Smart Phrases Used as Enrollment Mechanism in Diabetes Self-Management Support Programs: Preliminary Outcomes.
Diabetes in the United States is increasing rapidly. Innovative strategies are needed for diabetes prevention and self-management. This study assessed the usability, acceptability, and awareness of an electronic health record (EHR) tool for referring patients to a community-based diabetes self-management support program. Mixed-methods approaches were used, using EHR data and key informant interviews to assess the implementation of this quality improvement (QI) process intervention. The implementation of a smart phrase tool within the EHR led to a substantial increase in referrals (773) to the Health Extension for Diabetes (HED) program. Clinical health care professionals have actively used the referral mechanism; they reported using smart phrases to increase efficiency in patient care. Lack of training and program awareness was identified as a barrier to adoption. Awareness of the HED program and .HEDREF smart phrase was limited, but improved with targeted QI and training interventions. The .HEDREF smart phrase demonstrated effectiveness in increasing patient referrals to the HED program, highlighting the potential of EHR tools to streamline documentation and promote patient engagement in diabetes self-management. Future research should focus on broader health care contexts, patient perspectives, and integration of technology for optimal patient outcomes.
被引量：- 发表：1970
