scholarly journals ReCAP: Feasibility and Effectiveness of a Pilot Program to Facilitate Quality Improvement Learning in Oncology: Experience of the American Society of Clinical Oncology Quality Training Program

2016 ◽  
Vol 12 (2) ◽  
pp. 177-177 ◽  
Author(s):  
Arif H. Kamal ◽  
Doris Quinn ◽  
Timothy D. Gilligan ◽  
Barbara Corning Davis ◽  
Carole K. Dalby ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Real Life ◽  
Pilot Project ◽  
Early Adopters ◽  
High Participation ◽  
American Society ◽  
Structured Program

CONTEXT AND QUESTION ASKED: Improving quality of oncology delivery is an important responsibility for busy oncology practices. Is it feasible to construct a training program for oncology professionals to teach quality improvement that is applicable to practice? SUMMARY ANSWER: Using a longitudinal, project-based program with a mix of in-person and distance-learning components, the ASCO Quality Training Program is a highly feasible method to facilitate quality improvement learning in oncology. METHODS: The ASCO Quality Training Program (QTP) consisted of three in-person Learning Sessions and four phases: pre-work, planning, implementation, and sustain and spread. We measured two primary outcomes: program feasibility and effectiveness. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: Although we observed high participation, satisfaction, and applicability of content to the needs of the oncology learners, it should be noted that this represents a small, pilot project. REAL-LIFE IMPLICATIONS: Even busy oncology clinicians find a structured program to learn and practice quality improvement skills valuable. Conclusions regarding long-term applicability effectiveness and feasibility among non-early adopters require further study.

Organizational partnership to expand the ASCO Quality Training Program to oncology pharmacists.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 198-198
Author(s):  
Emily R. Mackler ◽  
Amy Morris ◽  
George W. Carro ◽  
Vedner Guerrier ◽  
Gene Cunningham ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Response Rate ◽  
Medication Management ◽  
Interdisciplinary Team ◽  
Training And Education ◽  
American Society ◽  
Oncology Practice

198 Background: Pharmacists have a recognized role in optimizing medication management and enhancing patient quality of care. In an effort to enhance knowledge related to oncology quality improvement (QI), the Hematology/Oncology Pharmacy Association (HOPA) partnered with the American Society of Clinical Oncology (ASCO) Quality Training Program (QTP) to provide a 1-day HOPA-ASCO QTP Workshop. Methods: HOPA’s Quality Oversight Committee identified several areas of priority focus, including identifying and developing opportunities for members to participate in education focused on oncology value and quality-based patient care. The ASCO QTP program most closely met HOPA goals for training due to the practical outcomes associated with the program, the interdisciplinary focus, the successful experience of prior HOPA-member participants, and expertise of the faculty. In addition, both organizations have a unified goal in improving the care of cancer patients. Surveys were formulated to assess knowledge pre- and post-participation and actionable efforts participants made given knowledge gained from the workshop. Results: A total of 24 HOPA members participated in the 1-day workshop with 40% having been in oncology practice for 15+ years and 70% involved in some aspect of QI within their role. Primary reasons for participation were – to help lead oncology multidisciplinary initiatives in my organization (44%), to increase skills to complete QI projects (28%), and to help lead oncology pharmacy practitioners in my organization (20%). Measures of knowledge and competence increased after participation. Knowledge increased by an average of 3 points from 4.57 to 7.55 (0-10 scale) and competence increased an average of 2.8 points from 4.48 to 7.32. In a 3-month follow-up survey (67% response rate), the majority (93%) of participants indicated they were very likely or extremely likely to use the skills gained from the workshop in practice and 88% of respondents indicated they used the skills gained from the program somewhat often, very often or extremely often. Since the 9 months from the workshop, 2 pharmacists who participated have enrolled in the ASCO QTP 6-month course. Conclusions: The 1-day HOPA-ASCO QTP Workshop proved to be a successful partnership between the two organizations, providing excellent training and education to HOPA members. Next steps of this collaboration include additional 1-day workshops available to more members and a modified 6-month ASCO QTP program for HOPA members with oncology pharmacists serving as the interdisciplinary team leader.

Long-Term Effectiveness of Fingolimod for Multiple Sclerosis in a Real-World Clinical Setting

2021 ◽  
pp. 1-6
Author(s):  
Cihat Uzunköprü ◽  
Yesim Beckmann ◽  
Sabiha Türe
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Real Life ◽  
Life Assessment ◽  
Health Related Quality ◽  
Serious Adverse Events ◽  
Related Quality ◽  
Health Related

<b><i>Introduction:</i></b> The primary aim of the present study was to evaluate the long-term efficacy of fingolimod in patients with multiple sclerosis (MS); secondary aims were to describe the safety of fingolimod with the evaluation of treatment satisfaction and impact on the quality of life in real life. <b><i>Methods:</i></b> We collected clinical, demographical, neuroradiological, and treatment data, including pre- and posttreatment status health-related quality of life from 286 MS patients consecutively treated with fingolimod. Clinical assessment was based on the Expanded Disability Status Scale (EDSS), and quality of life assessment was performed with MS-related quality of life inventory (MSQOLI). The data were recorded at baseline and every 6 months for 2 years. <b><i>Results:</i></b> One hundred and fourteen males and 172 females were enrolled. The annualized relapse rate and EDSS showed a statistically significant reduction during the observation period (<i>p</i> &#x3c; 0.001). The patients also demonstrated substantial improvements in magnetic resonance imaging (MRI) outcomes (<i>p</i> &#x3c; 0.001). Health-related quality of life scores improved significantly between baseline and 24-month visit (<i>p</i> &#x3c; 0.001). No serious adverse events occurred. <b><i>Conclusion:</i></b> In our cohort, fingolimod treatment was associated with reduced relapse, MRI activity, and improved EDSS and MSQOLI scores. Additionally, fingolimod has been able to maintain its effectiveness over a considerable long period of treatment.

scholarly journals Poverty Alleviation Through the Program Slums in the City of Kendari, Indonesia

2019 ◽  
Vol 9 (2) ◽  
pp. 35
Author(s):  
Joko Tri Brata ◽  
La Ode Bariun ◽  
Asri Djauhar ◽  
Andi Gusti Tantu
Keyword(s):  
Quality Improvement ◽  
Focus Group ◽  
Poverty Alleviation ◽  
Poverty Reduction ◽  
Group Discussion ◽  
Governance Model ◽  
The Subject ◽  
The City

The long-term goal of the concept of poverty reduction is to give the same level of welfare for the Indonesian people, and in this research is the development of innovative Models of Poverty Reduction, with the subject on (1) How the application design model of the institutional prevention of poverty through interface Program Quality Improvement of Slums and (2) how the efforts in governance of slum through simulation integration with poverty alleviation. The method used is the description by sharpening the Focus Group Discussion (FGD) about the handling of the slums in the city of Kendari and intervention efforts Increase the quality of housing and slums, so that the governance model can be used in other areas in Southeast Sulawesi.

scholarly journals Changes of Insulation Properties of Photovoltaic Cables Caused by Ageing Treatment

2020 ◽  
Vol 6 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Juraj Packa ◽  
Vladimir Kujan ◽  
Daniel Štrkula ◽  
Vladimír Šály ◽  
Milan Perný
Keyword(s):  
Power Plants ◽  
Real Life ◽  
Life Time ◽  
Operating Conditions ◽  
Solar Panels ◽  
Font Size ◽  
Long Term Stability ◽  
Cable Systems

<span style="font-family: 'Times New Roman',serif; font-size: 10pt; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;" lang="EN-US">An important part of the photovoltaic power plants are cable systems. The dielectric properties of cables, reliability and durability depend on quality of production processes, operating conditions and degradation factors, as well. Expected lifetime of cable systems is more than 20-30 years in general. Their failure free operation and long-term stability of properties has a direct impact on the economic return of the investments. According to our experiences the tests in compliance with valid standards are not adequate to verify real life time during operation. Photovoltaic cables intended for use in outdoor applications for the connection between the solar panels and possible connection between panels and inverter were chosen for our experiments. <span style="-ms-layout-grid-mode: line;">The changes </span>of insulation resistance and breakdown voltage caused by some degradation factors, mainly water, are presented. This research was inspired by real failure in operation.</span>

Improving anti-emetics in chemotherapy induced nausea and vomiting.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 220-220 ◽  
Author(s):  
Sandra Toutounji ◽  
Ron Fung ◽  
Katherine Enright
Keyword(s):  
Quality Improvement ◽  
Target Duration ◽  
Nausea And Vomiting ◽  
Primary Driver ◽  
American Society ◽  
New Guidelines ◽  
Dose Modifications ◽  
Primary Measure ◽  
Over Time

220 Background: Chemotherapy induced nausea and vomiting (CINV) remains one of the most feared treatment-related toxicities in cancer patients. CINV has been shown to decrease quality of life and to increase dose modifications and unplanned hospital visits. Cancer Care Ontario (CCO) and the American Society of Clinical Oncology (ASCO) updated their CINV guidelines in 2013. These changes included a reclassification of many regimens from moderate (MEC) to highly emetogenic (HEC) and a decrease in the duration of serotonin inhibitors (5HT3i). Uptake of the new guidelines at Trillium Health Partners has been slow. We aimed to improve CINV by increasing the percentage of patients who received guideline concordant anti-emetics with their first cycle of HEC/MEC chemotherapy. Methods: The first 25 patients started on MEC/HEC chemotherapy during 3 time periods (pre-guidelines, 6 months post guidelines, 1.5 years post guidelines) were identified. The primary measure of interest was the percentage of patients receiving MEC/HEC who were treated in concordance with the updated CINV guidelines. Secondary measures included the percentage of MEC/HEC patients who experienced grade 2+ CINV. The collected data was used with quality improvement techniques to guide the development of interventions to improve guideline concordance. Results: The concordance of anti-emetics on the day of chemotherapy improved over time, but post-chemotherapy concordance remained at 0% (table). The primary driver for concordance was the use of NK1inhibitors on chemotherapy day, and the duration of 5HT3i post-chemotherapy. Using quality improvement methodology, the highest impact intervention was identified as changing the default settings in the computerized order entry system (CPOE) to reflect the updated guidelines. These changes are currently in progress and a test of this change will be presented. Conclusions: Concordance with CINV guidelines improved over time resulting in lower CINV and less need for reactive CINV interventions. Further work to target duration of 5HT3i is ongoing. [Table: see text]

Long-term treatment of chronic migraine with OnabotulinumtoxinA: efficacy, quality of life and tolerability in a real-life setting

2016 ◽  
Vol 123 (5) ◽  
pp. 533-540 ◽  
Author(s):  
Katja Kollewe ◽  
Claus M. Escher ◽  
Dirk U. Wulff ◽  
Davood Fathi ◽  
Lejla Paracka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Migraine ◽  
Real Life ◽  
Term Treatment ◽  
Real Life Setting ◽  
Long Term Treatment

Welfare of cats 5–29 months after perineal urethrostomy: 74 cases (2015–2017)

2019 ◽  
Vol 22 (6) ◽  
pp. 582-588 ◽  
Author(s):  
Margaret R Slater ◽  
Sharon Pailler ◽  
J’mai M Gayle ◽  
Illoneete Cohen ◽  
Erin L Galloway ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Case Series ◽  
Life Outcomes ◽  
Retrospective Case ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
Potential Factors ◽  
American Society

Objectives The objective of this study was to evaluate the long-term quality of life in cats following perineal urethrostomy. Methods This study comprised a retrospective case series of 74 cats with urinary obstructions that received perineal urethrostomies at the American Society for the Prevention of Cruelty to Animals (ASPCA) Animal Hospital between September 2015 and July 2017. Medical records were reviewed for information on the number of obstructions prior to surgery, urinary tract problems at the time of surgery and other potential factors influencing long-term welfare. Owners were surveyed by telephone and text 5–29 months after their cat’s surgery. Responses were compiled and analyzed to determine owner perception of welfare postsurgery, and to identify patterns in medical history and welfare outcomes. Results In total, 105 cat owners were eligible for the survey; 74 responded. Altogether, 100% of responding individuals reported at least the same quality of life postsurgery compared with the cat’s quality of life before demonstrating urinary problems (48% reported better). On a quality-of-life scale of 1–10 (10 = excellent), 100% of responding cat owners reported at least 7; 75% reported 10. Conclusions and relevance Quality-of-life outcomes for cats 5–29 months after receiving perineal urethrostomy surgery were reported to be very good. Given this finding, and that perineal urethrostomy surgery should mitigate future blockages, we suggest considering perineal urethrostomy surgery as a standard tool to manage urinary obstructions in cats. The needs of the specific client and patient, including risks, costs and welfare of the cats, should drive the options for management of urinary obstructions in male cats.

1643: Long-Term Safety and Improvement on LUTS, Quality of Life and Sexual Function with Alfuzosin 10mg Once Daily: A 3-Year Experience in BPH Patients in Real Life Practice

2006 ◽  
Vol 175 (4S) ◽  
pp. 529-530 ◽  
Author(s):  
Mostafa M. Elhilali ◽  
Mark Emberton ◽  
Haim Matzkin ◽  
Niels Harving ◽  
Jeroen Van Moorselaar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Real Life ◽  
Once Daily

A feasible model for early intervention for high-risk substance use in the emergency department setting

2019 ◽  
Vol 43 (2) ◽  
pp. 188 ◽  
Author(s):  
Rebecca Howard ◽  
Stephanie Fry ◽  
Andrew Chan ◽  
Brigid Ryan ◽  
Yvonne Bonomo
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
High Risk ◽  
Patient Engagement ◽  
Real Life ◽  
Community Support ◽  
Pilot Project ◽  
Relative Contribution ◽  
Gamma Hydroxybutyrate ◽  
High Participation

Objective In response to escalating alcohol and other drug (AOD)-related emergency department (ED) presentations, a tertiary Melbourne hospital embedded experienced AOD clinical nurse consultants in the ED on weekends to trial a model for screening, assessment and brief intervention (BI). The aim of the present study was to evaluate the relative contributions of AOD to ED presentations and to pilot a BI model. Methods Using a customised AOD screening tool and a framework for proactive case finding, screened participants were offered a comprehensive AOD assessment and BI in the ED. Immediate effects of the intervention were evaluated via the engagement of eligible individuals and a self-administered ‘intention to change’ survey. Results Over the 32-month pilot, 1100 patients completed a comprehensive AOD assessment, and 95% of these patients received a BI. The most commonly misused substances were, in order, alcohol, tobacco, amphetamine-type stimulants, gamma-hydroxybutyrate and cannabis. Thirty-two per cent of patients were found to be at risk of dependence from alcohol and 25% were found to be at risk of dependence from other substances. Forty per cent of the people assessed reported no previous AOD support or intervention. On leaving the ED, 78% of participants reported an intention to contact community support services and 65% stated they would change the way they used AOD in the future. Conclusion This study of a pilot program quantifies the relative contribution of AOD to ED presentations and demonstrates that hospital EDs can implement a feasible, proactive BI model with high participation rates for people presenting with AOD-related health consequences. What is known about the topic? Clinician-led BI for high-risk consumption of alcohol has been demonstrated to be effective in primary care and ED settings. However, hospital EDs are increasingly receiving people with high-risk AOD-related harms. The relative contribution of other drugs in relation to ED presentations has not been widely documented. In addition, the optimal model and effects of AOD screening and BI programs in the Australian ED setting are unknown. What does this paper add? This paper describes a ‘real-life’ pilot project embedding AOD-specific staff in a metropolitan Melbourne ED at peak times to screen and provide BI to patients presenting with AOD-related risk and/or harms. The study quantifies the relative contribution of other drugs in addition to alcohol to ED presentations and reports on this model’s much higher levels of patient engagement in receiving BI than has been reported previously. What are the implications for practitioners? This study demonstrates the relative contribution of drugs, in addition to alcohol, to ED presentations at peak weekend times. Although BI has been well proven, the pilot project evaluated herein has demonstrated that by embedding AOD-specific staff in the ED, much higher rates of patient engagement, screening and BI can be achieved.

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