scholarly journals PMH86 THE STANDARDS FOR BIPOLAR EXCELLENCE (STABLE) PROJECT: A BIPOLAR DISORDER QUALITY IMPROVEMENT INITIATIVE TO DEVELOP ANDVALIDATE EVIDENCE-BASED PERFORMANCE MEASURES FOR ENDORSEMENT BY THE NATIONAL QUALITY FORUM (NQF)

2008 ◽  
Vol 11 (3) ◽  
pp. A135-A136
Author(s):  
M Jewell ◽  
W Golden ◽  
P Keck ◽  
Q Harshaw ◽  
A Shillington ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Quality Improvement ◽  
Performance Measures ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
National Quality Forum ◽  
National Quality

scholarly journals Sustained quality improvement in outcomes of preterm neonates with a gestational age less than 29 weeks: results from the Evidence-based Practice for Improving Quality Phase 3

2019 ◽  
Vol 97 (3) ◽  
pp. 213-221 ◽  
Author(s):  
Prakesh S. Shah ◽  
Michael Dunn ◽  
Khalid Aziz ◽  
Vibhuti Shah ◽  
Akhil Deshpandey ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Necrotizing Enterocolitis ◽  
Gestational Age ◽  
Evidence Based Practice ◽  
Preterm Neonates ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
Composite Outcome ◽  
Phase 3 ◽  
National Quality

Quality improvement initiatives in neonatology have yielded positive results; however, few programs have demonstrated sustainability. We evaluated an ongoing, national quality improvement initiative (Evidence-based Practice for Improving Quality Phase 3 (EPIQ-3)) on outcomes of preterm neonates with a gestational age (GA) of 220–286 weeks (i.e., from 22 weeks and 0 days of gestation to 28 weeks and 6 days of gestation). Data from 7459 neonates admitted to 25 Canadian centers between 2013 and 2017 were studied. Trends in mortality and major morbidities were evaluated. The number of neonates with a GA of 220–236 weeks increased from 90 in 2013 to 139 in 2017 without a significant change in any other GA categories. In the entire cohort, the odds of composite outcome of mortality or any major morbidity (adjusted odds ratio (AOR) 0.72, 95% confidence interval (CI) 0.61–0.84) and of necrotizing enterocolitis (AOR 0.66, 95% CI 0.49–0.89) were lower in 2017 than in 2013. When calculated per year, the odds of composite outcome (AOR 0.93, 95% CI 0.89–0.97) and odds of necrotizing enterocolitis (AOR 0.89, 95% CI 0.82–0.96) decreased significantly. Among the subgroup of neonates with a GA of 260–286 weeks, the odds of composite outcome (AOR 0.63, 95% CI 0.51–0.79), necrotizing enterocolitis (AOR 0.44, 95% CI 0.26–0.73), and nosocomial infection (AOR 0.64, 95% CI 0.49–0.84) were reduced. The collaborative, multidisciplinary, nationwide EPIQ-3 program improved outcomes of preterm neonates, and the improvement was sustainable over 5 years.

scholarly journals Performance measures for endoscopy services: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative

Endoscopy ◽  
2018 ◽  
Vol 50 (12) ◽  
pp. 1186-1204 ◽  
Author(s):  
Roland Valori ◽  
George Cortas ◽  
Thomas de Lange ◽  
Omer Balfaqih ◽  
Marjon de Pater ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Performance Measures ◽  
European Society ◽  
Gastrointestinal Endoscopy ◽  
Quality Improvement Initiative ◽  
Advocacy Groups ◽  
Patient Journey ◽  
Professional Societies ◽  
Adoption And Implementation ◽  
Key Performance Measures

AbstractThe European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a list of key performance measures for endoscopy services. We recommend that these performance measures be adopted by all endoscopy services across Europe. The measures include those related to the leadership, organization, and delivery of the service, as well as those associated with the patient journey. Each measure includes a recommendation for a minimum and target standard for endoscopy services to achieve. We recommend that all stakeholders in endoscopy take note of these ESGE endoscopy services performance measures to accelerate their adoption and implementation. Stakeholders include patients and their advocacy groups; service leaders; staff, including endoscopists; professional societies; payers; and regulators.

scholarly journals The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures

Endoscopy ◽  
2015 ◽  
Vol 48 (01) ◽  
pp. 81-89 ◽  
Author(s):  
Matthew Rutter ◽  
Carlo Senore ◽  
Raf Bisschops ◽  
Dirk Domagk ◽  
Roland Valori ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Performance Measures ◽  
European Society ◽  
Gastrointestinal Endoscopy ◽  
Quality Improvement Initiative

Abstract WP237: Improved Thrombolysis Rates and Quality of Care for Stroke Patients Through a Provincial Emergency Department Quality Improvement Initiative

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Devin R Harris ◽  
Robert Stenstrom ◽  
Eric Grafstein ◽  
Mark Collison ◽  
Grant Innes ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Performance Measures ◽  
Large Scale ◽  
Primary Outcome ◽  
Baseline Data ◽  
Quality Improvement Initiative ◽  
Stroke Patients

Background: The care of stroke patients in the emergency department (ED) is time sensitive and complex. We sought to improve quality of care for stroke patients in British Columbia (B.C.), Canada, emergency departments. Objectives: To measure the outcomes of a large-scale quality improvement initiative on thrombolysis rates and other ED performance measures. Methods: This was an evaluation of a large-scale stroke quality improvement initiative, within ED’s in B.C., Canada, in a before-after design. Baseline data was derived from a medical records review study performed between December 1, 2005 to January 31, 2007. Adherence to best practice was determined by measuring selected performance indicators. The quality improvement initiative was a collaboration between multidisciplinary clinical leaders within ED’s throughout B.C. in 2007, with a focus on implementing clinical practice guidelines and pre-printed order sets. The post data was derived through an identical methodology as baseline, from March to December 2008. The primary outcome was the thrombolysis rate; secondary outcomes consisted of other ED stroke performance measures. Results: 48 / 81 (59%) eligible hospitals in B.C. were selected for audit in the baseline data; 1258 TIA and stroke charts were audited. For the post data, 46 / 81 (57%) acute care hospitals were selected: 1199 charts were audited. The primary outcome of the thrombolysis rate was 3.9% (23 / 564) before and 9.3% (63 / 676) after, an absolute difference of 5.4% (95% CI: 2.3% - 7.6%; p=0.0005). Other measures showed changes: administration of aspirin to stroke patients in the ED improved from 23.7% (127 / 535) to 77.1% (553 / 717), difference = 53.4% (95% CI: 48.3% - 58.1%; p=0.0005); and, door to imaging time improved from 2.25 hours (IQR = 3.81 hours) to 1.57 hours (IQR 3.0), difference = 0.68 hours (p=0.03). Differences were found in improvements between large and small institutions, and between health regions. Conclusions: Implementation of a provincial emergency department quality improvement initiative showed significant improvement in thrombolysis rates and adherence to other best practices for stroke patients. The specific factors that influenced improvement need to be further explored.

A quality improvement project to reduce restrictive interventions in a mental health service

2021 ◽  
pp. 1-12
Author(s):  
Darren Savarimuthu ◽  
Katja Jung
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Positive Impact ◽  
Essential Elements ◽  
Quality Improvement Project ◽  
Psychiatric Ward ◽  
Quality Improvement Initiative ◽  
Successful Implementation ◽  
Evidence Based ◽  
Improvement Project

Background/aims This article describes a quality improvement project that aimed to reduce restrictive interventions on an acute psychiatric ward. In light of a service level agreement and based on a trust-wide target, the purpose of the project was to reduce restrictive interventions by 20% within a period of 6 months. It was also anticipated that a least restrictive environment could have a positive impact on patient experience. Methods Three evidence-based interventions were introduced to the ward during the quality improvement project. These included positive behaviour support, the Safewards model and the productive ward initiative. Results There was a 63% reduction in restrictive interventions over a 6-month period through the successful implementation of a series of evidence-based interventions to manage behaviours that challenge on the mental health ward. Conclusions The project identified collaborative team working, staff training and adequate resources as essential elements in the success of the quality improvement initiative. However, co-production was found to be crucially significant in bringing sustainable changes in ward environment and in addressing restrictive practices.

scholarly journals Performance measures for small-bowel endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative

Endoscopy ◽  
2019 ◽  
Vol 51 (06) ◽  
pp. 574-598 ◽  
Author(s):  
Cristiano Spada ◽  
Deirdre McNamara ◽  
Edward J. Despott ◽  
Samuel Adler ◽  
Brooks D. Cash ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Small Bowel ◽  
Performance Measures ◽  
Capsule Endoscopy ◽  
European Society ◽  
Gastrointestinal Endoscopy ◽  
Quality Improvement Initiative ◽  
Upper Gastrointestinal Endoscopy ◽  
Small Bowel Endoscopy ◽  
First Time

AbstractThe European Society of Gastrointestinal Endoscopy (ESGE) together with the United European Gastroenterology (UEG) recently developed a short list of performance measures for small-bowel endoscopy (i. e. small-bowel capsule endoscopy and device-assisted enteroscopy) with the final goal of providing endoscopy services across Europe with a tool for quality improvement. Six key performance measures for both small-bowel capsule endoscopy and for device-assisted enteroscopy were selected for inclusion, with the intention being that practice at both a service and endoscopist level should be evaluated against them. Other performance measures were considered to be less relevant, based on an assessment of their overall importance, scientific acceptability, and feasibility. Unlike lower and upper gastrointestinal endoscopy, where performance measures had already been identified, this is the first time that small-bowel endoscopy quality measures have been proposed.

scholarly journals Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children

2019 ◽  
Vol 76 (22) ◽  
pp. 1869-1874 ◽  
Author(s):  
Elizabeth Goswami ◽  
Richard K Ogden ◽  
William E Bennett ◽  
Stuart L Goldstein ◽  
Richard Hackbarth ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Quality Improvement ◽  
Injury Risk ◽  
Kidney Injury ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
Hospitalized Children ◽  
Consensus Definition ◽  
Medication Exposure ◽  
Definition Of

Abstract Purpose Medications are commonly associated with acute kidney injury (AKI). However, in both clinical practice and research, consideration of specific medications as nephrotoxic varies widely. The Nephrotoxic Injury Negated by Just-in-time Action quality improvement collaborative was formed to focus on prevention or reduction of nephrotoxic medication-associated AKI in noncritically ill hospitalized children. However, there were discrepancies among institutions as to which medications should be considered nephrotoxic. The collaborative convened a Nephrotoxic Medication (NTMx) Subcommittee to develop a consensus for the classification of nephrotoxic medications. Summary The NTMx Subcommittee initially included pediatric nephrologists, a pharmacist, and a pediatric intensivist. The committee reviewed NTMx lists from the collaborative and identified changes from the initial NTMx list. The NTMx Subcommittee conducted a literature review of the disputed medications and assigned an evidence grade based on the reported association with nephrotoxicity and the quality of the data. The association between medication exposure and AKI was also determined using administrative data from the Pediatric Health Information Systems database. The NTMx Subcommittee then came to a majority consensus regarding which medications should be included on the list. The subcommittee’s recommendations were presented to the larger collaborative for approval, and consensus was achieved. The list continues to be reviewed and updated annually. Conclusion Formation of a multicenter quality-improvement initiative exposed current limitations as to which medications are considered nephrotoxic in clinical and research settings and presented an opportunity to approach this problem using an evidence-based process. A consensus definition of nephrotoxic-medication exposure was achieved.

The NQF Scientific Methods Panel: Enhancing the Review and Endorsement Process for Performance Measures

2020 ◽  
Vol 35 (6) ◽  
pp. 458-464
Author(s):  
David R. Nerenz ◽  
David Cella ◽  
Lacy Fabian ◽  
Eugene Nuccio ◽  
John Bott ◽  
...  
Keyword(s):  
Health Care ◽  
Performance Measurement ◽  
Performance Measures ◽  
National Quality Forum ◽  
Scientific Methods ◽  
National Quality ◽  
Technical Issues ◽  
Health Care Performance ◽  
Care Performance

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. This article also serves as an introduction to a series of planned white papers being authored by the panel on specific technical issues in the area of health care performance measurement.

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