Accurate clinical documentation is necessary for healthcare organizations to achieve quality improvement and accurate payment. Physician buy-in is essential to a successful clinical documentation improvement program. The program should not focus on revenue enhancement or a particular tool, but ...

Dynamic healthcare market forces impel educators to search for innovative methods of academic assessment to measure learning outcomes. The clinical achievement portfolio is a creative and systematic tool for documenting continuous improvement of student clinical learning. The authors describe the use of the ...

Clinical performance measures are instruments that estimate the extent to which a health care provider (1) delivers appropriate clinical services in a safe, competent, and timely manner; and (2) achieves desired outcomes in terms of patient health and sat...

Clinical performance measures are instruments that estimate the extent to which a health care provider (1) delivers appropriate clinical services in a safe, competent, and timely manner; and (2) achieves desired outcomes in terms of patient health and sat...

The aim of IHI's Idealized Design of Clinical Office initiative (IDCOP) is to demonstrate that clinical office practices, with appropriate redesign, can achieve significant improvement in performance relevant to today's urgent social needs. From its incep...

A major step toward improving and speeding up transatlantic cancer clinical research has been achieved through an agreement between the U.S. Office for Protection from Research Risks (OPRR) and the European Organization for Research and Treatment of Cancer (EORTC), Brussels.

... criteria to use in clinical trials for rheumatoid arthritis that report the percentage of study participants who achieve improvement in tender or swollen ...

To achieve this end, NCI is spearheading an innovative platform of activities to enhance the full spectrum of cancer research and accelerate the translation of scientific discoveries in the laboratory into better treatments in the clinic.

In 1994, the Federal Government of Brazil enacted legislation to share the costs with municipalities of establishing or remodelling up to 20 000 health clinics, covering a population of 69 million people. S�o Jos� clinic was established with family physicians in 1993 in a community of 3000 in the City of Curitiba. The clinic was ...

The opportunity to mobilize linkages between quality improvement (QI) and research is at an early stage. This article describes some of the opportunities for and challenges of integrating QI and more traditional forms of clinical research to achieve broad improvements in medical care. The authors suggest that such ...

... IMPROVING CLINICAL EFFICIENCY OF MILITARY TREATMENT FACILITIES ... clinics which in turn will improve the efficiency of the whole hospital. ...

With the advent of quality improvement and outcome measurement imperatives, providers of healthcare services must fully understand the importance of the human and clinical processes that lead to positive patient encounters. To that end, this article proposes that parallel qualities exist between behavioral need theory and the clinical ...

A study was made of child health clinics run from three centres in Enga Province. Clinic management, statistical reporting, immunisation adequacy, and attitudes of attending mothers were examined. The accuracy of statistical reporting and the immunisation coverage achieved were found to be poor and many clinics ...

Clinical nurse specialist practice is essential in providing the clinical expertise, leadership, and organizational influence necessary for attaining the excellence in care reflected by the American Nurses Credentialing Center's Magnet designation. Clinical nurse specialists, prepared as advanced practice nurses, bring ...

We are investigating the development, implementation and evaluation of clinical decision support (CDS) projects to advance our understanding of how best to incorporate these interventions into the delivery of healthcare. Our overall goal is to explore how the translation of clinical knowledge into CDS and its incorporation into practice can be routinely ...

The authors describe their experience in developing a strategy-focused organization using the balanced scorecard methodology. They achieved this at Duke Children's Hospital by aligning the clinicians and administrators around a single integrated platform that linked improving business processes with achieving quality ...

This clinical paper presents the evolution of a Point of Care Scholars (POCS) program, which embodies three components of the Magnet model: exemplary professional practice, new knowledge, innovations, and improvements, and empirical outcomes. The drive to achieve Magnet designation and redesignation provides a focused approach on ...

Clinical laboratory members, composed of medical doctors, laboratory technologists and office staff from 8 public university or college hospitals and one medical center, have an annual meeting, in which achievements including tested numbers, income, outsourcing ratio, and so on were reported and various agendas from each institution were discussed. The ...

Vancomycin is a commonly used antimicrobial in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections. Increasing vancomycin MIC values in MRSA clinical isolates makes the optimization of vancomycin dosing pivotal to its continued use. Unfortunately, limited data exist regarding the optimal pharmacokinetic�pharmacodynamic (PK�PD) goal to ...

Clinical Decision Support (CDS) is viewed as a means to improve safety and efficiency in health care. Yet the lack of a consensus around what is meant by CDS represents a barrier to effective design, use, and utilization of CDS tools. We conducted a multi-site qualitative inquiry to understand how different people define and describe CDS. Using subjects� ...

Clinical Decision Support (CDS) is viewed as a means to improve safety and efficiency in health care. Yet the lack of consensus about what is meant by CDS represents a barrier to effective design, implementation, and utilization of CDS tools. We conducted a multi-site qualitative inquiry to understand how different people define and describe CDS. Using ...

We compared the rate of prescription of low-dose spironolactone among patients with heart failure in a general medical inpatient setting and in a specialist left ventricular (LV) dysfunction clinic. 38% of general medical patients and 72% of patients attending the specialist clinic had been prescribed spironolactone. When contraindications were considered, ...

Outpatient services are increasingly recognised as an important component of health care provision and may be improved through the application of modern management techniques. We have performed a time and role audit of consultation and waiting times in two medical clinics using different queuing systems: namely, a serial processing ...

Community-based clinical teaching programmes are now an established feature of most UK dental school training programmes. Appropriately implemented, they enhance the educational achievements and competences achieved by dental students within the earlier part of their developing careers, while helping students to traverse the ...

The question of pathologic roots of achievement patterns in girls and boys suffering from anorectic disorders is investigated by empirical and theoretical means. Records of 59 inpatients were reviewed with special emphasis on premorbid school achievement and its development during therapy. 44 completed a catamnestic questionnaire or interview. 10 students ...

Good communication and advanced planning were two keys used in this case to provide the patient with a predictable, clinically acceptable outcome of improved esthetics while preserving tooth structure. Demonstrating the successful integration of various dental specialists, the case utilized new technology that included chairside optical scanning and ...

The overarching goal of this study is to assess and improve interval adherence to mammography screening. Interventions to improve adherence to regular mammography screening have had conflicting results. Many studies have depended on women's self-report rather than clinical evidence of a mammography encounter. This study will take ...

This study investigated depressive symptom and interpersonal relatedness outcomes from eight sessions of manualized narrative therapy for 47 adults with major depressive disorder. Post-therapy, depressive symptom improvement (d=1.36) and proportions of clients achieving reliable improvement (74%), movement to the functional population ...

Although strict glucose control can prevent or delay the onset of complications in patients with diabetes, optimal control frequently is not achieved. A partial explanation for this phenomenon can be attributed to so-called clinical inertia of physicians, defined as "recognition of the problem but failure to act". Such therapeutic inertia may result from ...

Important progress has been achieved in recent years in simulating the fluid-structure interaction around cardiac valves. An important step in making these computational tools useful to clinical practice is the development of postprocessing techniques to extract clinically relevant information from these simulations. This work focuses ...

This paper aims to update the therapeutical strategies in liver metastasis with complete clinical response (CCR) after chemotherapy and to determine if surgery is always necessary after CCR. The aim of chemotherapy is to achieve a good clinical response rather than CCR of liver metastasis. The CCR of liver metastasis after chemotherapy ...

In 2005, the U.S. Department of Education awarded eight Striving Readers grants to projects around the country. The goal of Striving Readers is to improve literacy skills and achievement for struggling readers in middle and high school and to increase the research base using randomized clinical research to address ...

Diffuse lymphangiomatosis is a very rare congenital disease, characterized by diffuse or multifocal lymphangioma in the skeletal tissue, spleen, liver, mediastinum, and/or lung. The prognosis is usually poor, especially for children with thoracic lesion, and treatments for the disease are controversial. The authors report a 9-year-old boy with diffuse lymphangiomatosis involving the thorax with ...

There are many changes occurring within the healthcare system today, bringing forth multiple challenges for nurses. Changes in reimbursement for hospitals and staffing shortages are impacting the ways that nurses are delivering care. During these changing times, it is essential that healthcare providers strive to maintain high-quality care and patient safety. Utilizing evidence-based practice ...

BackgroundSmall general practices are often perceived to provide worse care than larger practices.AimTo describe the comparative performance of small practices on the UK's pay-for-performance scheme, the Quality and Outcomes Framework.Design of studyLongitudinal analysis (2004�2005 to 2006�2007) of quality scores for 48 clinical activities.SettingFamily practices in ...

Integration of research findings into clinical practice is essential for achieving cost-effective, quality patient outcomes. Data confirm that nursing care in most settings is "empiric" and is based largely on untested assumptions, as opposed to being evidence-based. Process improvement efforts must engage clinicians in initiatives ...

In this article, we describe the use of an information-gathering tool, the Delphi technique, to overcome issues encountered when conducting a failure modes effects analysis as part of a define, measure, analyze, implement, control study to improve the processes of a clinical medical laboratory. The study was conducted with the goals of reducing medical ...

Translational research can be conceptualized within several blocks or spheres of knowledge transfer and focused on closing the gap between new discoveries and their endpoint application to clinical practice, health decision-making, and health policy. Although support for type 1 translational research (the classical bench-to-bedside paradigm) is common, it is types 2 and 3 that ...

A review was made of 219 transcatheter vessel occlusion procedures performed over a ten-year period for control of hemorrhage, tumor palliation, or blood supply redistribution prior to intra-arterial chemotherapy. Complete angiographic success was obtained in 85% of the procedures, with partial success in 8%; complete clinical success was achieved in 53% ...

The European Paediatric Regulation (EUPR) calls for the fostering of high quality ethical research and medicinal products to be used in children. The EUPR provides the background, goals, and requirements for paediatric clinical trials. Paediatric clinical trials in children are mandatory to generate data on new drugs as well as on drugs used off-label or ...

LDL cholesterol is the primary target of treatment for lowering the risk of cardiovascular events in both primary and secondary prevention. The usual drug to achieve this goal is HMG-CoA reductase inhibitors (statins), which constitute the most potent and effective class to reduce LDL cholesterol. Statins have been shown to be associated with good patient compliance, lower ...

Clinical experience is recognised as the core of nursing education. Quality clinical placements across a variety of venues are vital to the development of capable and competent professionals. However there is evidence, both anecdotal and empirical, suggesting that students' clinical placement experiences are fraught with problems. The ...

Objective: While preference elicitation techniques have been effective in helping patients make decisions consistent with their preferences, little is known about whether information about patient preferences affects clinicians in clinical decision making and improves patient outcomes. The purpose of this study was to evaluate a decision support ...

PRACTICAL RELEVANCE: Optimising the clinical outcome for the cases we treat has to be of primary importance to every practitioner wherever they are working and whatever their sphere of practice, yet it requires much more than just clinical knowledge. This review discusses how a system of good clinical governance can help to ...

This study evaluated the efficacy of intra-arterial nimodipine infusion for symptomatic vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH). Clinical data collected from 42 consecutive patients with symptomatic vasospasm after aSAH were retrospectively reviewed. Forty-two patients underwent 101 sessions of intra-arterial nimodipine infusion. Angiographic ...

A systems analysis of healthcare organizations demonstrates that methods for improving quality involve the effective feedback regulation of key organizational performance parameters. Information flow is impaired in dysfunctional healthcare organizations, which often disregard significant clinical problems while preferentially tracking nonclinical ...

While preference elicitation techniques have been effective in supporting patients in their abilities to make decisions consistent with their preferences, little is known about whether information about patient preferences affects clinicians in clinical decision making and improves patient outcomes. This paper presents a study that tested the effect of ...

Pregnancy represents an ideal time for health promotion activities. Many women, including adolescents, are interested and willing to change health behaviors to improve the chance that they will deliver a healthy infant. This paper focuses on improving nutrition in pregnant adolescents. Seven recommendations are presented to help ...

Canadian hospitals struggle to balance the need to increase and improve operational services and quality with diminishing resources. Many realize that sustaining their organization depends on how well they focus their resources and talents on their core business, clinical care delivery. Outsourcing of non-core, non-clinical support ...

The enactment of the Patient Protection and Affordable Care Act is a signal achievement on the road to reform, which arguably began with the passage of the American Recovery and Reinvestment Act of 2009. That statute's Health Information Technology for Economic and Clinical Health (HITECH) provisions created an essential foundation for restructuring health ...

This review describes the most commonly used rodent models and outcome measures in pre-clinical stroke research and discusses their strengths and limitations. Most models involve permanent or transient middle cerebral artery occlusion with therapeutic agents tested for their ability to reduce stroke-induced infarcts and improve neurological deficits. Many ...

Environmental contamination of high-touch surfaces in patient rooms can lead to the transmission of clinically significant pathogens; thus, such surfaces should be cleaned routinely and thoroughly. Fluorescent targeting can be used to provide feedback to frontline cleaning staff on the thoroughness of room cleaning, which can result in substantial ...