Quality Improvement: An ACQIP Exercise on the Management of Acute Asthma—Part 2

1995 ◽  
Vol 16 (8) ◽  
pp. 311-315
Author(s):  
Shannon Smith-Ross ◽  
Lisa Honigfeld ◽  
Keyword(s):  
Quality Improvement ◽  
Quality Care ◽  
Normal Activity ◽  
Forced Expiratory Volume ◽  
Care Quality ◽  
Activity Levels ◽  
Improvement Program ◽  
Office Management ◽  
Acute Exacerbations ◽  
Asthma In Children

Last month's issue of Pediatrics in Review contains the questions asked of participants in the Ambulatory Care Quality Improvement Program (ACQIP) exercise on the management of acute exacerbations of asthma in children. The answers of those who completed that exercise, which was part of the 1993-1994 program, are summarized in this article. In addition, pointers for clinicians are presented as well as practical "pearls of wisdom" from subscribers. Readers who wish to evaluate their own practices may use this exercise and should consider enrollment in the ongoing ACQIP program. Further information may be obtained through the Division of Quality Care of the American Academy of Pediatrics. [See table in the PDF file] Quality Pointers for the Office Management of Acute Exacerbations of Asthma in Children TREATMENT Goals of Treatment: General treatment goals include helping patients to maintain "normal" pulmonary function rates, maintain normal activity levels, prevent chronic and troublesome symptoms (eg, nocturnal coughing or dyspnea), prevent recurrent exacerbations of asthma, and avoid adverse effects from asthma medications. The principal goal of management for the acute exacerbation is the recognition of early indicators, such as a worsening peak expiratory flow rate or forced expiratory volume over 1 second or an increase in symptoms, and early treatment to reverse these symptoms.

Quality Improvement: An ACQIP Exercise on the Management of Otitis Media

1996 ◽  
Vol 17 (7) ◽  
pp. 251-256
Author(s):  
Robert H. Sebring ◽  
Keyword(s):  
Quality Improvement ◽  
American Academy ◽  
Otitis Media ◽  
Quality Care ◽  
Care Quality ◽  
Self Assessment ◽  
Improvement Program ◽  
Additional Information ◽  
American Academy Of Pediatrics

As part of Pediatrics in Review's ongoing focus on quality improvement, we present a self-assessment exercise taken from the American Academy of Pediatrics' Ambulatory Care Quality Improvement Program (ACQIP). Tabulated responses of pediatricians who completed this exercise as part of the ACQIP program are presented on pages 253 to 254, allowing readers to see how their own answers compare and providing material for thought and discussion. Readers are encouraged to participate in the ACQIP program. Additional information can be obtained by calling or writing the Division of Quality Care, American Academy of Pediatrics, Box 927, Elk Grove Village, IL 60009-0927. Monitoring Otitis Media EDUCATIONAL OBJECTIVES This exercise and the follow-up materials should help you identify areas of improvement in how your practice monitors and documents information for children with acute or chronic otitis. INSTRUCTIONS Beginning with tomorrow's appointments, answer the questions below for the most recent, but not the current episode of otitis media in the first 10 patients you see who are younger than 4 years of age and experiencing at least their second episode of otitis. You will need to review charts to answer the questions. Put a check in each box in which you find the information in your medical record listed.

scholarly journals Evidence-Based Practice Implementation: Case Report of the Evolution of a Quality Improvement Program in a Multicenter Physical Therapy Organization

2015 ◽  
Vol 95 (4) ◽  
pp. 588-599 ◽  
Author(s):  
Joel M. Stevans ◽  
Christopher G. Bise ◽  
John C. McGee ◽  
Debora L. Miller ◽  
Paul Rockar ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Case Report ◽  
Physical Therapy ◽  
Care Quality ◽  
Routine Practice ◽  
Evidence Based ◽  
Implementation Barriers ◽  
Improvement Program ◽  
Improvement Project ◽  
Systems Perspective

Background and Purpose Our nation's suboptimal health care quality and unsustainable costs can be linked to the failure to implement evidence-based interventions. Implementation is the bridge between the decision to adopt a strategy and its sustained use in practice. The purpose of this case report is threefold: (1) to outline the historical implementation of an evidence-based quality improvement project, (2) to describe the program's future direction using a systems perspective to identify implementation barriers, and (3) to provide implications for the profession as it works toward closing the evidence-to-practice gap. Case Description The University of Pittsburgh Medical Center (UPMC) Centers for Rehab Services is a large, multicenter physical therapy organization. In 2005, they implemented a Low Back Initiative utilizing evidence-based protocols to guide clinical decision making. Outcomes The initial implementation strategy used a multifaceted approach. Formative evaluations were used repeatedly to identify barriers to implementation. Barriers may exist outside the organization, they can be created internally, they may result from personnel, or they may be a direct function of the research evidence. Since the program launch, 3 distinct improvement cycles have been utilized to address identified implementation barriers. Discussion Implementation is an iterative process requiring evaluation, measurement, and refinement. During this period, behavior change is actualized as clinicians become increasingly proficient and committed to their use of new evidence. Successfully incorporating evidence into routine practice requires a systems perspective to account for the complexity of the clinical setting. The value the profession provides can be enhanced by improving the implementation of evidence-based strategies. Achieving this outcome will require a concerted effort in all areas of the profession. New skills will be needed by leaders, researchers, managers, and clinicians.

Effect of angiotensin-converting inhibitor or angiotensin receptor blocker on one-year survival in patients ≥65 years hospitalized with a left ventricular ejection fraction ≥50%**The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. The investigator assumes full responsibility for the accuracy and completeness of the ideas presented. This study is a direct result of the Health Care Quality Improvement Program initiated by the Centers for Medicare & Medicaid Services, which has encouraged identification of quality improvement projects derived from analysis of patterns of care, and therefore required no special funding on the part of this contractor. Ideas and contributions to the investigator concerning experience in engaging with issues presented are welcomed.

2003 ◽  
Vol 91 (3) ◽  
pp. 363-365 ◽  
Author(s):  
Carla A Sueta ◽  
Allison Russo ◽  
Anna Schenck ◽  
David W Brown ◽  
Ross J Simpson
Keyword(s):  
Quality Improvement ◽  
Health Care Quality ◽  
Left Ventricular ◽  
Care Quality ◽  
Left Ventricular Ejection ◽  
Direct Result ◽  
Improvement Program ◽  
Ventricular Ejection Fraction ◽  
Us Government ◽  
Health Care Quality Improvement

scholarly journals Patient Outcomes and Cost-Effectiveness of a Sepsis Care Quality Improvement Program in a Health System*

2019 ◽  
Vol 47 (10) ◽  
pp. 1371-1379 ◽  
Author(s):  
Majid Afshar ◽  
Erum Arain ◽  
Chen Ye ◽  
Emily Gilbert ◽  
Meng Xie ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cost Effectiveness ◽  
Health System ◽  
Patient Outcomes ◽  
Care Quality ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Sepsis Care

scholarly journals Translational Effect of Provider-Focused, Multi-State, Multi-Clinic Asthma Care Quality Improvement Program on Patient-Level Health Care Costs

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Sirikan Rojanasarot ◽  
Angeline M. Carlson ◽  
Wendy L. St. Peter ◽  
Pinar Karaca-Mandic ◽  
Julian Wolfson ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care Costs ◽  
Health Care Expenditures ◽  
Economic Benefits ◽  
Care Quality ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Implementation Period ◽  
Care Costs

Introduction/Objectives: Enhancing Care for Patients with Asthma (ECPA), a year-long provider-focused, multi-state, multi-clinic quality improvement program, decreased avoidable utilizations among patients with asthma, but its effects on health care expenditures were not determined. This study examined the translational and sustainable effects of improved care through ECPA on individual-level total health care costs due to asthma. Methods: We conducted a retrospective pretest-posttest quasi-experimental study in which attributed 1683 patients in a 12-month pre-ECPA implementation period served as their own control. We constructed the total annual asthma-related health care costs per patient occurred during pre-ECPA implementation, ECPA implementation, and post-ECPA completion. We used 3-level generalized linear mixed models (GLMMs) to estimate the ECPA effect on the annual health care costs and account for correlation between the repeated outcome measures for each patient and nested clinic. All costs were adjusted for inflation to 2014 U.S. dollars, the last year of program observation. Results: Total asthma-related health care costs among the 1683 included patients decreased from an average of $7033 to $3237 per person-year (pre-ECPA implementation vs implementation). Using the cost data from the 12-month pre-ECPA implementation period as a reference, GLMMs found that the ECPA implementation was associated with a reduction in total annual asthma-related health care costs by 56.4% (95% CI −60.7%, −51.8%). During the 12-months after ECPA completion period, health care costs were also found to be significantly lower, experiencing a 57.3% reduction. Conclusions: The economic benefits of ECPA provide a justification to adopt this quality improvement initiative to more primary care clinics at a national level.

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