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Quality training, quality board examinations, quality nephrologists.
Berns JS, Ikizler TA
(2015) Am J Kidney Dis 66: 7-8
MeSH Terms: Educational Measurement, Humans, Nephrology, Quality Assurance, Health Care, Specialty Boards
Added August 5, 2015
0 Communities
1 Members
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5 MeSH Terms
Improving the quality of cancer staging.
Asare EA, Washington MK, Gress DM, Gershenwald JE, Greene FL
(2015) CA Cancer J Clin 65: 261-3
MeSH Terms: Guideline Adherence, Humans, Neoplasm Staging, Practice Guidelines as Topic, Quality Assurance, Health Care, Quality Indicators, Health Care, Registries, United States
Added April 12, 2016
0 Communities
1 Members
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8 MeSH Terms
Improving diagnostic capability for HPV disease internationally within the NIH-NIAID Division of AIDS Clinical Trial Networks.
Godfrey CC, Michelow PM, Godard M, Sahasrabuddhe VV, Darden J, Firnhaber CS, Wetherall NT, Bremer J, Coombs RW, Wilkin T, A5282 Study Team
(2013) Am J Clin Pathol 140: 881-9
MeSH Terms: Acquired Immunodeficiency Syndrome, Clinical Trials, Phase II as Topic, Female, Human Papillomavirus DNA Tests, Humans, Laboratories, Mass Screening, National Institutes of Health (U.S.), Papillomavirus Infections, Pathology, Quality Assurance, Health Care, Randomized Controlled Trials as Topic, United States, Uterine Cervical Neoplasms
Show Abstract · Added March 5, 2014
OBJECTIVES - To evaluate an external quality assurance (EQA) program for the laboratory diagnosis of human papillomavirus (HPV) disease that was established to improve international research capability within the Division of AIDS at the National Institute of Allergy and Infectious Disease-supported Adult AIDS Clinical Trials Group network.
METHODS - A three-component EQA scheme was devised comprising assessments of diagnostic accuracy of cytotechnologists and pathologists using available EQA panels, review of quality and accuracy of clinical slides from local sites by an outside expert, and HPV DNA detection using a commercially available HPV test kit.
RESULTS - Seven laboratories and 17 pathologists in Africa, India, and South America participated. EQA scores were suboptimal for EQA proficiency testing panels in three of seven laboratories. There was good agreement between the local laboratory and the central reader 70% of the time (90% confidence interval, 42%-98%). Performance on the College of American Pathologists' HPV DNA testing panel was successful in all laboratories tested.
CONCLUSIONS - The prequalifying EQA round identified correctable issues that will improve the laboratory diagnosis of HPV-related cervical disease at the participating international study sites and will provide a mechanism for ongoing education and continuous quality improvement.
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1 Members
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14 MeSH Terms
The future state of clinical data capture and documentation: a report from AMIA's 2011 Policy Meeting.
Cusack CM, Hripcsak G, Bloomrosen M, Rosenbloom ST, Weaver CA, Wright A, Vawdrey DK, Walker J, Mamykina L
(2013) J Am Med Inform Assoc 20: 134-40
MeSH Terms: Continuity of Patient Care, Documentation, Efficiency, Organizational, Electronic Health Records, Guidelines as Topic, Humans, Information Dissemination, Information Storage and Retrieval, Public Policy, Quality Assurance, Health Care, Research, United States, Workflow
Show Abstract · Added December 10, 2013
Much of what is currently documented in the electronic health record is in response toincreasingly complex and prescriptive medicolegal, reimbursement, and regulatory requirements. These requirements often result in redundant data capture and cumbersome documentation processes. AMIA's 2011 Health Policy Meeting examined key issues in this arena and envisioned changes to help move toward an ideal future state of clinical data capture and documentation. The consensus of the meeting was that, in the move to a technology-enabled healthcare environment, the main purpose of documentation should be to support patient care and improved outcomes for individuals and populations and that documentation for other purposes should be generated as a byproduct of care delivery. This paper summarizes meeting deliberations, and highlights policy recommendations and research priorities. The authors recommend development of a national strategy to review and amend public policies to better support technology-enabled data capture and documentation practices.
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13 MeSH Terms
Antiretroviral therapy for prevention of tuberculosis in adults with HIV: a systematic review and meta-analysis.
Suthar AB, Lawn SD, del Amo J, Getahun H, Dye C, Sculier D, Sterling TR, Chaisson RE, Williams BG, Harries AD, Granich RM
(2012) PLoS Med 9: e1001270
MeSH Terms: Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, HIV Infections, Humans, Quality Assurance, Health Care, Randomized Controlled Trials as Topic, Tuberculosis
Show Abstract · Added May 29, 2014
BACKGROUND - Human immunodeficiency virus (HIV) infection is the strongest risk factor for developing tuberculosis and has fuelled its resurgence, especially in sub-Saharan Africa. In 2010, there were an estimated 1.1 million incident cases of tuberculosis among the 34 million people living with HIV worldwide. Antiretroviral therapy has substantial potential to prevent HIV-associated tuberculosis. We conducted a systematic review of studies that analysed the impact of antiretroviral therapy on the incidence of tuberculosis in adults with HIV infection.
METHODS AND FINDINGS - PubMed, Embase, African Index Medicus, LILACS, and clinical trial registries were systematically searched. Randomised controlled trials, prospective cohort studies, and retrospective cohort studies were included if they compared tuberculosis incidence by antiretroviral therapy status in HIV-infected adults for a median of over 6 mo in developing countries. For the meta-analyses there were four categories based on CD4 counts at antiretroviral therapy initiation: (1) less than 200 cells/µl, (2) 200 to 350 cells/µl, (3) greater than 350 cells/µl, and (4) any CD4 count. Eleven studies met the inclusion criteria. Antiretroviral therapy is strongly associated with a reduction in the incidence of tuberculosis in all baseline CD4 count categories: (1) less than 200 cells/µl (hazard ratio [HR] 0.16, 95% confidence interval [CI] 0.07 to 0.36), (2) 200 to 350 cells/µl (HR 0.34, 95% CI 0.19 to 0.60), (3) greater than 350 cells/µl (HR 0.43, 95% CI 0.30 to 0.63), and (4) any CD4 count (HR 0.35, 95% CI 0.28 to 0.44). There was no evidence of hazard ratio modification with respect to baseline CD4 count category (p = 0.20).
CONCLUSIONS - Antiretroviral therapy is strongly associated with a reduction in the incidence of tuberculosis across all CD4 count strata. Earlier initiation of antiretroviral therapy may be a key component of global and national strategies to control the HIV-associated tuberculosis syndemic.
REVIEW REGISTRATION - International Prospective Register of Systematic Reviews CRD42011001209 Please see later in the article for the Editors' Summary.
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1 Members
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9 MeSH Terms
A surveillance tool to support quality assurance and research in personalized medicine.
Khan NA, Peterson JF
(2011) AMIA Annu Symp Proc 2011: 701-8
MeSH Terms: Aryl Hydrocarbon Hydroxylases, Biomedical Research, Clopidogrel, Cytochrome P-450 CYP2C19, Drug Therapy, Computer-Assisted, Drug-Eluting Stents, Genotype, Humans, Pharmacogenetics, Pilot Projects, Platelet Aggregation Inhibitors, Precision Medicine, Quality Assurance, Health Care, Ticlopidine, User-Computer Interface
Show Abstract · Added May 19, 2014
Developing effective methods to enable the practice of personalized medicine is a national priority for translational science. By leveraging modern genotyping technology and health information technologies, prescribing therapies based on genotype becomes an achievable goal. Within this manuscript, we describe the development, implementation, and piloting of a surveillance tool to assure the quality of clinical decision making in the context of new pharmacogenetic information. The surveillance tool allows a quality assurance (QA) team to review significant genotyping results and deliver focused educational interventions to providers. We report on the first eight patients undergoing genotyping to support antiplatelet therapy selection after drug-eluting stent placement. The collected pilot data supports an informatics approach to QA process management, as our tool delivered actionable patient information. It also enabled providers to tailor antiplatelet therapy to individual patients' genotypes. Our expectation is to continue collecting surveillance reports to perform an in-depth analysis of our tool.
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1 Members
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15 MeSH Terms
A computerized provider order entry intervention for medication safety during acute kidney injury: a quality improvement report.
McCoy AB, Waitman LR, Gadd CS, Danciu I, Smith JP, Lewis JB, Schildcrout JS, Peterson JF
(2010) Am J Kidney Dis 56: 832-41
MeSH Terms: Acute Kidney Injury, Decision Support Systems, Clinical, Drug Therapy, Computer-Assisted, Female, Humans, Male, Medical Order Entry Systems, Medication Systems, Hospital, Middle Aged, Prospective Studies, Quality Assurance, Health Care, User-Computer Interface
Show Abstract · Added December 10, 2013
BACKGROUND - Frequently, prescribers fail to account for changing kidney function when prescribing medications. We evaluated the use of a computerized provider order entry intervention to improve medication management during acute kidney injury.
STUDY DESIGN - Quality improvement report with time series analyses.
SETTING & PARTICIPANTS - 1,598 adult inpatients with a minimum 0.5-mg/dL increase in serum creatinine level over 48 hours after an order for at least one of 122 nephrotoxic or renally cleared medications.
QUALITY IMPROVEMENT PLAN - Passive noninteractive warnings about increasing serum creatinine level appeared within the computerized provider order entry interface and on printed rounding reports. For contraindicated or high-toxicity medications that should be avoided or adjusted, an interruptive alert within the system asked providers to modify or discontinue the targeted orders, mark the current dosing as correct and to remain unchanged, or defer the alert to reappear in the next session.
OUTCOMES & MEASUREMENTS - Intervention effect on drug modification or discontinuation, time to modification or discontinuation, and provider interactions with alerts.
RESULTS - The modification or discontinuation rate per 100 events for medications included in the interruptive alert within 24 hours of increasing creatinine level improved from 35.2 preintervention to 52.6 postintervention (P < 0.001); orders were modified or discontinued more quickly (P < 0.001). During the postintervention period, providers initially deferred 78.1% of interruptive alerts, although 54% of these eventually were modified or discontinued before patient death, discharge, or transfer. The response to passive alerts about medications requiring review did not significantly change compared with baseline.
LIMITATIONS - Single tertiary-care academic medical center; provider actions were not independently adjudicated for appropriateness.
CONCLUSIONS - A computerized provider order entry-based alerting system to support medication management after acute kidney injury significantly increased the rate and timeliness of modification or discontinuation of targeted medications.
Copyright © 2010 National Kidney Foundation, Inc. All rights reserved.
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12 MeSH Terms
Quality of radiotherapy reporting in randomized controlled trials of Hodgkin's lymphoma and non-Hodgkin's lymphoma: in regard to Bekelman and Yahalom (Int J Radiat Oncol Biol Phys 2009;73:492-498).
Fitzgerald TJ, Bishop-Jodoin M, Cicchetti MG, Hanusik R, Kessel S, Laurie F, McCarten KM, Moni J, Pieters RS, Rosen N, Ulin K, Urie M, Chauvenet AR, Constine LS, Deye J, Vikram B, Friedman D, Marcus RB, Mendenhall NP, Williams JL, Purdy J, Saltz J, Schwartz CL, White KS, Wolden S
(2010) Int J Radiat Oncol Biol Phys 77: 315-6
MeSH Terms: Child, Clinical Protocols, Guideline Adherence, Hodgkin Disease, Humans, Quality Assurance, Health Care, Radiation Oncology
Added March 27, 2014
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1 Members
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7 MeSH Terms
Health literacy and quality: focus on chronic illness care and patient safety.
Rothman RL, Yin HS, Mulvaney S, Co JP, Homer C, Lannon C
(2009) Pediatrics 124 Suppl 3: S315-26
MeSH Terms: Adult, Age Factors, Child, Chronic Disease, Communication Barriers, Comprehension, Educational Status, Health Education, Health Knowledge, Attitudes, Practice, Health Status Disparities, Humans, Medical Errors, Medication Errors, Patient Education as Topic, Patient Participation, Patient-Centered Care, Quality Assurance, Health Care, Treatment Outcome, United States
Show Abstract · Added December 10, 2013
Despite a heightened focus on improving quality, recent studies have suggested that children only receive half of the indicated preventive, acute, or chronic care. Two major areas in need of improvement are chronic illness care and prevention of medical errors. Recently, health literacy has been identified as an important and potentially ameliorable factor for improving quality of care. Studies of adults have documented that lower health literacy is independently associated with poorer understanding of prescriptions and other medical information and worse chronic disease knowledge, self-management behaviors, and clinical outcomes. There is also growing evidence to suggest that health literacy is important in pediatric safety and chronic illness care. Adult studies have suggested that addressing literacy can lead to improved patient knowledge, behaviors, and outcomes. Early studies in the field of pediatrics have shown similar promise. There are significant opportunities to evaluate and demonstrate the importance of health literacy in improving pediatric quality of care. Efforts to address health literacy should be made to apply the 6 Institute of Medicine aims for quality-care that is safe, effective, patient centered, timely, efficient, and equitable. Efforts should also be made to consider the distinct nature of pediatric care and address the "4 D's" unique to child health: the developmental change of children over time; dependency on parents or adults; differential epidemiology of child health; and the different demographic patterns of children and their families.
0 Communities
1 Members
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19 MeSH Terms
CKD classification: time to move beyond KDOQI.
Ikizler TA
(2009) J Am Soc Nephrol 20: 929-30
MeSH Terms: Albuminuria, Cohort Studies, Disease Progression, Foundations, Humans, Kidney Failure, Chronic, Prevalence, Quality Assurance, Health Care, Reagent Strips, Treatment Outcome, United States
Added September 29, 2014
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1 Members
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11 MeSH Terms