The official journal of the National Association for Healthcare Quality

JHQ 160 - A Real-Time Medical Event Reporting and Prevention System in Long-Term Care
Pamela A. Carroll-Solomon, Diane S. Denny
Catholic Health East developed a knowledge-transfer process focused on improving resident safety in the skilled nursing or long-term care setting.

JHQ 161 - Changing Unit Culture: An Interdisciplinary Commitment to Improve Pain Outcomes
Heather Chung, Phuong H. Nguyen
An acute-care unit developed an interdisciplinary team to individualize pain management through daily rounds and improvements in nursing assessment.

JHQ 162 - Quality Improvement Initiatives to Minimize Seclusion and Restraint
Margaret M. Knight
A retrospective study using the medical record and the database of seclusion and restraint episodes was initiated to examine clinical symptoms at the point of admission of individuals who later experienced an S&R and to evaluate S&R practices across treatment areas.

Interview with a Quality Leader: Helen Darling on Healthcare Business Coalitions, Purchasing, and Health Policy
Joann Genovich-Richards, Jill Flateland
Abstract: Helen Darling is president of the National Business Group on Health, a national nonprofit membership organization devoted exclusively to providing practical solutions to its employermembers’ most important healthcare problems and representing large-employer perspectives on national health policy issues. Its 233 members purchase health and disability benefits for over 50 million employees, retirees, and dependents. Darling also heads NBGH’s Institute on Health Care Costs and Solutions, which is devoted to finding practical solutions to the nation’s growing crisis of rapidly rising costs and decreasing affordability of care, in addition to addressing continuing issues of patient safety and quality. As president of NBGH, she was named in 2003 and 2004 one of the “100 Most Powerful People in Health Care” in the United States by Modern Healthcare magazine. Darling currently serves as co-chair of the Committee on Performance Measurement of the National Committee for Quality Assurance. She is a member of the Medical Advisory Panel’s Technology Evaluation Center (run by the Blue Cross Blue Shield Association), the Institute of Medicine’s Board on Health Promotion and Disease Prevention, and the Board of the Veterans Health Administration Health Foundation. Earlier in her career, she was an advisor to Senator David Durenberger, the ranking Republican on the Health Subcommittee of the Senate Finance Committee. She directed three studies at the Institute of Medicine for the National Academy of Sciences.

Interview with a Quality Leader: Michael Cohen on Medication Error Reporting and Patient Safety
Pamela K. Scarrow, Cherrie Routon
Abstract: Michael R. Cohen, RPh MS ScD, is president of the Institute for Safe Medication Practices (ISMP), an independent nonprofit agency that reviews medication-error reports submitted by practitioners to the national medication errors reporting programs operated by the United States Pharmacopeia and the U.S. Food and Drug Administration (FDA). ISMP also provides expert analysis of medication-related events for the Patient Safety Authority of the Commonwealth of Pennsylvania, which operates the Pennsylvania Patient Safety Reporting System. Through various professional journals, newsletters, Web sites, and four ISMP Medication Safety Alert! publications tailored for consumers, acute care nurses, and community and ambulatory care providers, ISMP regularly provides drug-safety alerts to an estimated 3.5 million readers in the United States and around the world. Dr. Cohen serves as associate editor of the journal Hospital Pharmacy and is on the editorial boards of the Joint Commission Journal on Quality and Patient Safety, Journal of Patient Safety, Journal of Intravenous Nurse Society, Nursing 2005, and Healthcare Risk Control (ECRI, Plymouth Meeting, PA). He is a member of the Sentinel Event Advisory Group for the Joint Commission on Accreditation of Healthcare Organizations, the FDA Drug Safety and Risk Management Advisory Panel, and the Institute of Medicine Committee on Drug Safety. He is also author of the book Medication Errors.

JHQ 163 - Financial Reporting Practices: A Comprehensive Evaluation
Norman H. Godwin, Jennifer M. Mueller
Public companies are now required by law to document controls over financial reporting, in order to fully address exposures and the effectiveness of current controls. Regulatory agencies could follow suit and require similar compliance from healthcare organizations. This article provides a guide for organizations desiring to stay ahead of the curve.

Improving the Management of Chronic Obstructive Pulmonary Disease
Ross M. Miller, Dorothy George, R. J. Halbert
Abstract: As the fourth leading cause of death in the United States, chronic obstructive pulmonary disease (COPD) represents a major burden to the healthcare system and society at large. Underdiagnosis and undertreatment lead to an increased economic burden, with exacerbations being a key driver of costs. COPD symptoms compromise quality of life (QOL), which affects both patients and caregivers. Appropriate management decreases healthcare utilization and improves QOL. This article provides an overview of COPD and promotes understanding of opportunities to optimize patient health and outcomes for those with the disease. Specific interventions that have been demonstrated to improve clinical and economic outcomes for COPD include improved implementation of guidelines, optimized pharmacologic treatment, and risk-factor reduction.

Quality Toolbox: Using Diffusion of Innovations and Academic Detailing to Spread Evidence-based Practices
Clark Carboneau
This article explains the theory and research associated with how change spreads across human systems, as described in E. Rogers’s Diffusion of Innovations, and provides a communication strategy for applying the theory to healthcare.

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