scholarly journals Infectious Disease Providers’ Knowledge of and Engagement in Quality Improvement

2021 ◽  
Author(s):  
Kathleen R Sheridan ◽  
Michael A Lane ◽  
Thomas J Kim ◽  
Joshua C Eby
Keyword(s):  
Infectious Disease ◽  
Quality Improvement ◽  
Response Rate ◽  
Medical Center ◽  
Professional Activity ◽  
Limited Participation ◽  
Web Based ◽  
Measurement Systems ◽  
Disease States ◽  
Physician Engagement

Abstract Background Although engagement of infectious disease physicians has been demonstrated to improve clinical outcomes in a variety of disease states, the extent of ID physician engagement in quality improvement or their knowledge of QI has not been assessed. Methods A 12 question, web-based survey was distributed to members of the Infectious Disease Society of America between August and October 2019 to assess knowledge of and engagement in QI. The survey link was sent to IDSA members that self-identified patient care as their primary professional activity. Results Responses were received from 200 individuals (5.4% response rate which is just below standard IDSA survey response rate of 6%) consisting of 175 adult IDP. Most respondents were employed in a hospital or clinic (41%), private or group practice (25%), or university/medical center (24%). 58% of respondents currently participate in QI projects while 38% serve on QI oversight committees. Among respondents, 27% reported not being engaged in QI. Infection Prevention/Hospital Epidemiology (77%), stewardship (72%), and antimicrobial resistance (56%) were the most commonly reported measure types. Respondents reported barriers that limited participation in QI including cost (61%), lack of time (56%), lack of data collection resources (48%), and lack of an ID-specific registry (46%). IDPs report significant interest in additional training in QI and new quality measures. Conclusion Although IDPs participate in QI, there are gaps in QI knowledge and measurement systems. The low response rate of our survey also suggests a lack of engagement in QI amongst IDPs. Closing these gaps will benefit ID in a value-driven healthcare economy.

Establishing essential metrics for antifungal stewardship in hospitals: the results of an international Delphi survey

2020 ◽  
Vol 76 (1) ◽  
pp. 253-262 ◽  
Author(s):  
A Khanina ◽  
K F Urbancic ◽  
G M Haeusler ◽  
D C M Kong ◽  
A P Douglas ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Response Rate ◽  
Treatment Guidelines ◽  
Antifungal Stewardship ◽  
Web Based ◽  
Structure Quality ◽  
Core Set ◽  
Antifungal Consumption ◽  
International Experts

Abstract Background Guidance on assessment of the quantity and appropriateness of antifungal prescribing is required to assist hospitals to interpret data effectively and structure quality improvement programmes. Objectives To achieve expert consensus on a core set of antifungal stewardship (AFS) metrics and to determine their feasibility for implementation. Methods A literature review was undertaken to develop a list of candidate metrics. International experts were invited to participate in sequential web-based surveys to evaluate the importance and feasibility of metrics in the area of AFS using Delphi methodology. Three surveys were completed. Consensus was predefined as ≥80% agreement on the importance of each metric. Results Eighty-two experts consented to participate from 17 different countries. Response rate for each survey was >80%. The panel included adult and paediatric physicians, microbiologists and pharmacists with diverse content expertise. Consensus was achieved for 38 metrics considered important to routinely include in AFS programmes, and related to antifungal consumption (n = 5), quality of antifungal prescribing and management of invasive fungal infection (IFI) (n = 24), and clinical outcomes (n = 9). Twenty-one consensus metrics were considered to have moderate to high feasibility for routine collection. Conclusions The identified core AFS metrics will provide a framework to comprehensively assess the quantity and quality of antifungal prescribing within hospitals to develop quality improvement programmes aimed at improving IFI prevention, management and patient-centred outcomes. A standardized approach will support collaboration and benchmarking to monitor the efficacy of current prophylaxis and treatment guidelines, and will provide important feedback to guideline developers.

Awareness of the preventive measures against Covid -19 spread among small shop owners

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1144-1150
Author(s):  
Muralidharan V A ◽  
Gheena S
Keyword(s):  
Infectious Disease ◽  
Data Analysis ◽  
Preventive Measures ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Positive Perception ◽  
Cross Sectional ◽  
Web Based ◽  
Small Shop ◽  
Structured Questionnaire

Covid -19 is an infectious disease caused by the newly discovered strain of coronavirus. As there is no vaccine discovered, the only way to prevent the spread is through following the practice of social isolation. But prolonged isolation may also lead to psychological stress and problems. The objective of the survey was to assess the knowledge and awareness of preventive measures against Covid 19 amongst small shop owners. A web-based cross-sectional study was conducted amongst the small shop owners.  A structured questionnaire comprising 15-17 questions had been put forth to assess the Covid 19 related knowledge and perception. The shopkeepers were contacted telephonically and responses recorded. The data analysis was performed using IBM SPSS statistics. Although the majority of the population had a positive perception about the preventive measures against the Covid spread, 36% of the shopkeepers were not aware of the preventive measures against the Covid spread. This study found optimal knowledge and perception of the preventive measures against Covid spread among the shopkeepers but misinformation and misunderstanding still prevailing. The shopkeepers are crucial in the prevention of the spread of Covid 19 and educating them might aid us in the fight against Covid- 19. 

Quality Improvement Pilot Study of the Living Your Best Weight Program: A Health at Every Size Approach

2020 ◽  
Vol 81 (2) ◽  
pp. 91-93
Author(s):  
Anna Angelinas ◽  
Roseann Nasser ◽  
Amanda Geradts ◽  
Justine Herle ◽  
Kristen Schott ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pilot Study ◽  
Response Rate ◽  
Participant Satisfaction ◽  
Health At Every Size ◽  
Outpatient Program ◽  
To Receive

Purpose: Living Your Best Weight (LYBW) is an outpatient program based on Health at Every Size (HAES) principles for adults interested in managing their weight. The purpose of this pilot study was to determine perceptions of participants and their satisfaction with the LYBW program. Methods: A survey was developed to determine participant satisfaction of the LYBW program. Fifty-six participants who completed the LYBW program from June 2017 to February 2018 were contacted via telephone and invited to participate in the study. Forty-five participants agreed to receive the survey by mail or email. Results: Thirty-four participants completed the survey for a response rate of 61%. The average age of respondents was 52 years. Seventy-nine percent of respondents agreed that the program helped them to focus on health instead of weight. Eighty-two percent agreed that the program helped them respond to internal cues of hunger and fullness, and 94% were satisfied with the program. Conclusion: Participants reported that they were satisfied with the LYBW program and perceived improvements in their health. Future programming may benefit from using a HAES-based approach with adults.

Estimating the number of cases during COVID-19 pandemics using a web-based tool: first week results of “COVID-19 TRENDS” social media project in the Araba-Alava province in Basque country, Spain. (Preprint)

2020 ◽  
Author(s):  
Ignacio Garitano ◽  
Manuel Linares ◽  
Laura Santos ◽  
Ruth Gil ◽  
Elena Lapuente ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Response Rate ◽  
Basque Country ◽  
Case Definition ◽  
Public Health Action ◽  
Web Based ◽  
Health Action ◽  
Estimate Number ◽  
Media Project

UNSTRUCTURED On 28th February a case of COVID-19 was declared in Araba-Álava province, Spain. In Spain, a confinement and movement restrictions were established by Spanish Government at 14th March 2020. We implemented a web-based tool to estimate number of cases during the pandemic. We present the results in Áraba-Álava province. We reached a response rate of 10,3% out a 331.549 population. We found that 22,4 % fulfilled the case definition. This tool rendered useful to inform public health action.

scholarly journals Creation of a dedicated line team for critically ill patients with COVID-19: A multidisciplinary approach to maximize resource utilization during the COVID-19 pandemic

2021 ◽  
pp. 112972982199175
Author(s):  
Pooja Nawathe ◽  
Robert Wong ◽  
Gabriel Pollock ◽  
Jack Green ◽  
Michael Kissen ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Resource Utilization ◽  
Vascular Access ◽  
Medical Center ◽  
Academic Medical Center ◽  
Target Population ◽  
Primary Data ◽  
Arterial Line ◽  
Central Venous ◽  
Development Organization

Background: Pandemics create challenges for medical centers, which call for innovative adaptations to care for patients during the unusually high census, to distribute stress and work hours among providers, to reduce the likelihood of transmission to health care workers, and to maximize resource utilization. Methods: We describe a multidisciplinary vascular access team’s development to improve frontline providers’ workflow by placing central venous and arterial catheters. Herein we describe the development, organization, and processes resulting in the rapid formation and deployment of this team, reporting on notable clinical issues encountered, which might serve as a basis for future quality improvement and investigation. We describe a retrospective, single-center descriptive study in a large, quaternary academic medical center in a major city. The COVID-19 vascular access team included physicians with specialized experience in placing invasive catheters and whose usual clinical schedule had been lessened through deferment of elective cases. The target population included patients with confirmed or suspected COVID-19 in the medical ICU (MICU) needing invasive catheter placement. The line team placed all invasive catheters on patients in the MICU with suspected or confirmed COVID-19. Results and conclusions: Primary data collected were the number and type of catheters placed, time of team member exposure to potentially infected patients, and any complications over the first three weeks. Secondary outcomes pertained to workflow enhancement and quality improvement. 145 invasive catheters were placed on 67 patients. Of these 67 patients, 90% received arterial catheters, 64% central venous catheters, and 25% hemodialysis catheters. None of the central venous catheterizations or hemodialysis catheters were associated with early complications. Arterial line malfunction due to thrombosis was the most frequent complication. Division of labor through specialized expert procedural teams is feasible during a pandemic and offloads frontline providers while potentially conferring safety benefits.

Extrapulmonary Small Cell Cancer: A New Insight into a Rare Disease

Oncology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Leora Brazg Ferro ◽  
Ido Wolf ◽  
Shira Peleg Hasson ◽  
Inbal Golomb ◽  
Ester Osher ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Response Rate ◽  
Medical Center ◽  
Cell Cancer ◽  
Small Cell ◽  
Ki 67 ◽  
Small Cell Cancer ◽  
Pathological Characteristics ◽  
Results Of Treatment

<b><i>Introduction:</i></b> Extrapulmonary small-cell cancer (EPSCC) is a relatively rare malignancy. The management of EPSCC is usually extrapolated from small-cell lung cancer (SCLC). In spite of the morphological similarity of the 2 malignancies, there are many differences in clinical features, prognosis, and recommendations of treatment of these disorders. The data on the correlation of clinical-pathological characteristics of EPSCC and treatment results is scarce. <b><i>Materials and Methods:</i></b> This retrospective analysis of 41 consecutively treated patients diagnosed with EPSCC in 2015–2018 was performed in a tertiary medical center. The correlation between the clinical and pathological characteristics and the treatment outcome (response rate, disease-free interval, and overall medial survival) was done using the standard statistics, Kaplan-Meier method, and multivariate analyses. The stratification was done on the stage of the disease, Ki-67 proliferative index, the location of the tumor, and smoking. <b><i>Results:</i></b> Forty-one patients were included with a median age of 66.3 years. The most common primary site was the gastrointestinal tract (28, 68.3%) including the pancreas. The most common distant metastasis site was the liver (23, 56.1%). Only 2 patients (4.9%) had brain metastases. Unlike in SCLC, most patients did not have any history of smoking (23, 56.1%). Nineteen patients with metastatic disease received systemic treatment, mostly cisplatin-based chemotherapy, with a response rate of 57.9%. The results of treatment were significantly better in patients with disseminated EPSCC with Ki-67 &#x3c;55%, while its role in limited disease was nonsignificant. <b><i>Discussion:</i></b> The results of our study show the unique entity of EPSCC. The rarity of brain metastases proves that prophylactic brain irradiation should not be recommended in practice. The provocative idea of prophylactic liver irradiation in limited-stage EPSCC of gastrointestinal origin can be evaluated in future studies. The predictive role of Ki-67 is important in metastatic EPSCC. There is probably no role of smoking in developing EPSCC.

scholarly journals Physical Therapist–Established Intensive Care Unit Early Mobilization Program: Quality Improvement Project for Critical Care at the University of California San Francisco Medical Center

2013 ◽  
Vol 93 (7) ◽  
pp. 975-985 ◽  
Author(s):  
Heidi J. Engel ◽  
Shintaro Tatebe ◽  
Philip B. Alonzo ◽  
Rebecca L. Mustille ◽  
Monica J. Rivera
Keyword(s):  
Quality Improvement ◽  
Physical Therapy ◽  
San Francisco ◽  
Physical Therapist ◽  
Medical Center ◽  
Early Mobilization ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Icu Admission ◽  
Number Of Patients

Background Long-term weakness and disability are common after an intensive care unit (ICU) stay. Usual care in the ICU prevents most patients from receiving preventative early mobilization. Objective The study objective was to describe a quality improvement project established by a physical therapist at the University of California San Francisco Medical Center from 2009 to 2011. The goal of the program was to reduce patients' ICU length of stay by increasing the number of patients in the ICU receiving physical therapy and decreasing the time from ICU admission to physical therapy initiation. Design This study was a 9-month retrospective analysis of a quality improvement project. Methods An interprofessional ICU Early Mobilization Group established and promoted guidelines for mobilizing patients in the ICU. A physical therapist was dedicated to a 16-bed medical-surgical ICU to provide physical therapy to selected patients within 48 hours of ICU admission. Patients receiving early physical therapy intervention in the ICU in 2010 were compared with patients receiving physical therapy under usual care practice in the same ICU in 2009. Results From 2009 to 2010, the number of patients receiving physical therapy in the ICU increased from 179 to 294. The median times (interquartile ranges) from ICU admission to physical therapy evaluation were 3 days (9 days) in 2009 and 1 day (2 days) in 2010. The ICU length of stay decreased by 2 days, on average, and the percentage of ambulatory patients discharged to home increased from 55% to 77%. Limitations This study relied upon the retrospective analysis of data from 6 collectors, and the intervention lacked physical therapy coverage for 7 days per week. Conclusions The improvements in outcomes demonstrated the value and feasibility of a physical therapist–led early mobilization program.

Assessing early unplanned reoperations in neurosurgery: opportunities for quality improvement

2015 ◽  
Vol 123 (1) ◽  
pp. 198-205 ◽  
Author(s):  
Nancy McLaughlin ◽  
Peng Jin ◽  
Neil A. Martin
Keyword(s):  
Quality Improvement ◽  
Quality Indicator ◽  
Outpatient Surgery ◽  
Care Delivery ◽  
Average Length ◽  
Medical Center ◽  
Postoperative Bleeding ◽  
Time Interval ◽  
Neurosurgical Procedures ◽  
Neurosurgical Department

OBJECT Review of morbidities and mortality has been the primary method used to assess surgical quality by physicians, hospitals, and oversight agencies. The incidence of reoperation has been proposed as a candidate quality indicator for surgical care. The authors report a comprehensive assessment of reoperations within a neurosurgical department and discuss how such data can be integrated into quality improvement initiatives to optimize value of care delivery. METHODS All neurosurgical procedures performed in the main operating room or the outpatient surgery center at the Ronald Reagan UCLA Medical Center and UCLA Santa Monica Medical Center from July 2008 to December 2012 were considered for this study. Interventional radiology and stereotactic radiosurgery procedures were excluded. Early reoperations within 7 days of the index surgery were reviewed and their preventability status was evaluated. RESULTS The incidence of early unplanned reoperation was 2.6% (occurring after 183 of 6912 procedures). More than half of the patients who underwent early unplanned reoperation initially had surgery for shunt-related conditions (34.4%) or intracranial tumor (23.5%). Shunt failure was the most common indication for early unplanned reoperation (34.4%), followed by postoperative bleeding (20.8%) and postoperative elevated intracranial pressure (9.8%). The average time interval (± SD) between the index surgery and reoperation was 3.0 ± 1.9 days. The average length of stay following reoperation was 12.1 ± 14.4 days. CONCLUSIONS This study enabled an in-depth assessment of reoperations within an academic neurosurgical practice and identification of strategic opportunities for department-wide quality improvement initiatives. The authors provide a nuanced discussion regarding the use of absolute reoperations as a quality indicator for neurosurgical patient populations.

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