Three Pillars of Clinical Process Improvement and Control

The following is a guest blog post by Brita Hansen, MD, Chief Medical Officer at LogicStream Health. In a value-based care environment, achieving quality and safety measures is a priority. Health systems must have the capabilities to measure a process following its initial implementation. The reality, however, is that traditional improvement methods are often plagued with lagging indicators that provide little (if any) insight into areas requiring corrective actions. Health systems have an opportunity to make a significant impact on patient care by focusing on three pillars of clinical process improvement and control: quality and safety, appropriate utilization and clinician engagement. Quality and Safety Data in a health system’s electronic health record (EHR) typically is not easily accessible. Providers struggle to aggregate the data they need in a timely manner, often with limited resources, thereby hindering efforts to measure process efficacy and consistency. To achieve sustainable quality improvements, clinical leaders must equip their teams with advanced software solutions capable of delivering highly-actionable insights in near-real-time, thereby allowing them to gain a true understanding of clinical processes and how to avoid clinical errors and care variations. Clinicians need instant insights into what clinical content in their EHR is being used; by whom; and how it affects patient care. This data empowers providers with the ability to continuously analyze a...
Source: EMR and HIPAA - Category: Information Technology Authors: Tags: Care Management System Health Care Healthcare Analytics Healthcare CIO HealthCare IT Brita Hansen LogicStream Health Source Type: blogs

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Introduction: Hospitalized patients with urinary tract infections (UTIs) often present with comorbid illnesses and are subsequently prescribed multiple medications, which increases the likelihood of drug-drug interactions. Therefore, this study aimed to explore the prevalence, levels, risk factors, and clinical relevance of potential drug-drug interactions (pDDIs) in hospitalized patients with UTIs. Secondly, we aimed to develop management guidelines and identify monitoring parameters for the most frequent interactions.Methods: A retrospective cross-sectional study was conducted in internal medicine wards of two tertiary c...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
This study of Medicare-defined avoidable hospital stays for conditions such as urinary tract infection and complications of diabetes uses Medicare Fee-for-Service Inpatient and Outpatient Claim Files to investigate whether a decrease in inpatient admissions from 2011 to 2015 represented real gains in ambulatory care.
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research
Given increasing antimicrobial resistance, we aimed to determine antibiotic susceptibility and presence of resistance genes in uropathogens in primary care, factors associated with resistance to commonly prescribed antibiotics, and effect of treatment on early symptom resolution. We conducted a prospective study of primary care patients with urinary tract infection (UTI) symptoms and culture-confirmed UTI in Singapore from 2015 to 2016. Cohort characteristics and antimicrobial susceptibility of cultured isolates were analyzed. Among Enterobacteriaceae isolates, early symptom resolution (within 3 days) according to antibiot...
Source: Journal of Clinical Microbiology - Category: Microbiology Authors: Tags: Bacteriology Source Type: research
Over 2.6 million ED visits across the United States result in a primary diagnosis of urinary tract infection.1 While much attention has been paid to reducing blood culture contamination rates in the emergency department,2-9 a substantial gap remains in projects aimed at reducing contamination in clean-catch urine specimens obtained in the ED setting. Obtaining an adequate urine culture is clinically important to the care of several vulnerable patient groups, including patients with diabetes or compromised immune responses, those with high risk for subsequent urosepsis, previous antibiotic resistant infections, multiple ant...
Source: Journal of Emergency Nursing: JEN - Category: Nursing Authors: Tags: Editorial Source Type: research
An 82-year-old male, with a history of bowel cancer with partial colectomy, gastroesophageal reflux disease, remote partial gastrectomy for peptic ulcer disease, and no documented prior kidney disease, presents with several months of fatigue and subacute decline in kidney function. He had no history of diabetes, hypertension, kidney stones, or prior urinary tract infections. He denied use of nonsteroidal anti-inflammatory agents, herbal medications, and recent antibiotics. There was no family history of renal disease.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Make Your Diagnosis Source Type: research
CONCLUSIONS: In kidney transplant recipients, urinary tract infections are common complications and have negative outcomes on graft function. These infections remain an important disease that requires frequent investigations andnewwaysof approachforprevention. PMID: 31424358 [PubMed - as supplied by publisher]
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
ConclusionsIn this retrospective analysis of our clinical experience treating CRE infections in an LTACH setting, we documented that CRE infections occur in patients with substantial comorbidities. Although clinical outcome remains of great concern, the 28-day mortality and rate of eradication of CRE in this study were comparatively better than other national estimates. Inappropriate empiric treatment may be one of many factors leading to overall poor treatment outcomes.
Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research
ConclusionsAlthough few baseline comorbidities have a direct impact on hospitalization costs, most previous diagnoses increase the risk of in-hospital adverse events, which ultimately influence the hospitalization cost.
Source: Archives of Orthopaedic and Trauma Surgery - Category: Orthopaedics Source Type: research
Authors: Ze Ondo C, Pescheloche P, Bessede T, Parier B, Lebacle C, Irani J Abstract OBJECTIVE: To assess the value of systematic urine culture before ureteric double j removal. MATERIAL AND METHODS: This prospective audit was performed to assess the validity of our current clinical practice. A cohort of informed patients without clinical signs of urinary tract infection and without predefined risk factors were programmed for ureteral double j stent removal in an outpatient setting. Urine was sampled for culture immediately before the procedure. Patients had to complete a self-questionnaire 15 days following ste...
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
Introduction: Sub-Saharan Africa (SSA) has the highest stroke prevalence along with a case fatality that amounts to 40%. We aimed to assess the effect of a minimal setting stroke unit in SSA Public hospital on stroke mortality and main medical complications. Materials and Methods: The study was set in Conakry, Guinea, Ignace Deen public referral hospital. Clinical characteristics, hospital mortality and main medical stroke complications rates (pneumonia, urinary tract infections, sores and venous thromboembolism) of admitted stroke patients after the installation of a minimal stroke unit equipped with heart rate, bloo...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
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