American journal of medical quality : the official journal of the American College of Medical Quality
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Surgeon providers and billing professionals use Current Procedural Terminology (CPT) codes to specify patient treatment and associated charges. In the present study, coding discrepancies between surgeons' first pass coding and employed coders' final codes were investigated. A total of 500 patients over 3 months were retrospectively analyzed for coding discrepancies. ⋯ The most common source of change between the surgeon and coder was the addition of distinct codes by the billing professional (270 patients, 54.51%). These results demonstrate the existence of coding discrepancies. Future investigation will evaluate the communication between surgeons and billing professionals.
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The aim of this article is to summarize and interpret the current literature on patient quality and safety measures in the ambulatory setting. The authors reviewed the MEDLINE database from 2016 to the present for articles on patient quality and safety measures in the ambulatory setting. ⋯ This review shows that since 2016, very modest progress has been made in this critical area. Effective change in ambulatory quality and safety will require a prioritization and redoubling of efforts.
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Routine outpatient epilepsy care has shifted from in-person to telemedicine visits in response to safety concerns posed by the coronavirus disease 2019 (COVID-19) pandemic. But whether telemedicine can support and maintain standardized documentation of high-quality epilepsy care remains unknown. In response, the authors conducted a quality improvement study at a level 4 epilepsy center between January 20, 2019, and May 31, 2020. ⋯ By December 15, 2019, a 94% average weekly completion proportion of standardized epilepsy care documentation was achieved that was maintained through May 31, 2020. Moreover, during the period of predominately telemedicine encounters in response to the pandemic, the completion proportion was 90%. This study indicates that high completion of standardized documentation of seizure-related information can be sustained during telemedicine appointments for routine outpatient epilepsy care at a level 4 epilepsy center.
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The authors developed a process to produce a reliably fitting face mask from materials that were immediately available to health care workers, to reduce the risk of infection. Multiple materials and designs were developed to produce face masks that focused on ease of production, the ability to generate a reliable facial seal, and the ability to tailor the mask for those who did not fit commercially available N95 masks. Two final designs were selected. ⋯ Plan-Do-Study-Act cycles were developed for quality improvement. A process was successfully developed to produce 5000 face masks in a period of 3 weeks that fit almost all (95%) health care workers who did not fit in a commercially available mask. The process was able to produce quality face masks with specific attention paid to developing masks that would pass qualitative fit testing.