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The Official Journal of the
National Association for Healthcare Quality
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March/April 2008
Contents
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Abstract:
Since 2002, the Centers for Medicare and Medicaid Services have
reported quality measures on the Nursing Home Compare Web site. In this
study researchers examined nursing homes to see whether they have
improved their quality scores, after accounting for regression to the
mean. Researchers also examined whether gains varied according to
market competition or market occupancy rates. The greatest improvements
occurred in the most competitive markets and in those with the lowest
average occupancy rates.
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The $6 Million Question: Can Process Improvement Ensure Appropriate Hospitalizations?
Yishih J. Chang, Rita Ketterlin, Gregg Laiben
Abstract:
Short, unnecessary hospitalizations are the largest contributor to
erroneous Medicare payment. A team of medical, nursing, case
management, and coding and billing professionals used process
improvement techniques to reduce inappropriate 1-day admissions among
20 hospitals with high 1-day-stay utilization. Interventions included
performance feedback, root cause analyses, process redesign, monthly
progress monitoring, and quarterly pattern analyses. An estimated 1,396
1-day stays were prevented or denied payment, resulting in an annual
savings of $6 million for Medicare’s Hospital Insurance Trust Fund.
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Providing Reliable Care for Patients with Emergent Acute Myocardial Infarction
Susan Hendrickson
Abstract:
Reducing inconsistency and variability in emergency care processes
increases chances for survival. Development of consistent processes for
early risk stratification of patients with acute coronary syndrome and
provision of evidence-based therapy will reduce variability. A
reproducible system of care for patients with acute coronary syndrome
was developed. Mortality for patients experiencing an acute myocardial
infarction decreased 30% from fiscal year 2003 to fiscal year 2007. |
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Pediatric Healthcare Quality: A Novel Approach to Lifelong Child Health Research
Kim Nagel, Sarah J. Robinson, Peter Rosenbaum
Abstract:
Medical science historically focuses on biomedical research about
causes and treatment of disease. McMaster Child Health Research
Institute, in Hamilton, Ontario, Canada, takes a noncategorical
approach to research about lifelong health in children with varied
chronic conditions to help them meet the challenges of growing up and
reaching their full potential.
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| 37 |
Factors Affecting Electronic Health Record Adoption in Long-Term Care Facilities
Barbara Cherry, Michael Carter, Donna Owen, Carol Lockhart
Abstract:
This study was conducted among long-term care (LTC) nurses,
administrators, and corporate executives to identify factors that
hinder and facilitate electronic health record (EHR) adoption in LTC
facilities and offer a framework of action for policy makers, LTC
leaders, and researchers. Primary barriers identified were costs, the
need for training, and the culture change required to embrace
technology. Primary facilitators were training programs, well-defined
implementation plans, government assistance with implementation costs,
evidence that EHRs will improve care outcomes, and support from state
regulatory agencies.
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| 48 |
Spreading Improvement Strategies Within a Large Home Healthcare Organization
Miriam Ryvicker, Joan Marren, Sally Sobolewski, Terese Acampora, Marki
Flannery, Elizabeth Buff, Ann Marie R. Hess, Robert J. Rosati, Theresa
Schwartz, Penny Hollander Feldman
Abstract:
This article describes the process of the spread of improvement
strategies to improve relationships between professional and
paraprofessional service providers within a large home healthcare
organization and its partnering home health aide vendors. Two case
studies show how the attributes of innovations and the methods for
spreading them can influence the effectiveness of an improvement
effort.
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JHQ Web Exclusives
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q&a: Nancy Pratt on Sharp HealthCare’s Journey to Receiving the 2007 Baldrige National Quality Award
Luc R. Pelletier
Media Reviews
Quality NETwork
Quality Resources
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Editorial: Writing for Publication—Getting Started
Joann Genovich-Richards
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