Journal of evaluation in clinical practice
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Routine clinical biochemistry tests are crucial for clinical diagnostics and play a key role in enhancing outpatient turnover efficiency and patient satisfaction. This study aimed to implement Lean Six Sigma in the biochemistry laboratory of a hospital in China to improve efficiency and quality by reducing turnaround time. ⋯ Lean Six Sigma aimed to reduce the turnaround time for biochemical tests have significant advantages. This study confirms the effectiveness of Lean Six Sigma in a Chinese clinical laboratory setting and provides guidance for optimizing efficiency in global clinical laboratories with limited implementation experience, constrained technical and equipment resources, and high demand for medical diagnostics.
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Objective Structured Clinical Examinations (OSCEs) are widely used for assessing clinical competence, especially in high-stakes environments such as medical licensure. However, the reuse of OSCE cases across multiple administrations raises concerns about parameter stability, known as item parameter drift (IPD). AIMS & OBJECTIVES: This study aims to investigate IPD in reused OSCE cases while accounting for examiner scoring effects using a Many-facet Rasch Measurement (MFRM) model. ⋯ These findings suggest that while OSCE cases demonstrate sufficient stability for reuse, continuous monitoring is essential to ensure the accuracy of score interpretations and decisions. The study provides an objective threshold for detecting concerning levels of IPD and underscores the importance of addressing examiner scoring effects in OSCE assessments. The MFRM model offers a robust framework for tracking and mitigating IPD, contributing to the validity and reliability of OSCEs in evaluating clinical competence.
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The increasing number of immigrants in the United States (U.S.) has resulted in more patients with limited English proficiency (LEP). LEP contributes to patient-provider language discordance, which may impact oncologic health outcomes. ⋯ Studies assessing the impact of LEP and EP on the health outcomes of cancer patients are sparse and inconsistent in the measurements of outcomes and data reporting. The inconclusiveness of our study indicates that further standardized research is needed to assess the impact of LEP on the outcomes of cancer patients in the United States.
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Understanding drivers of antibiotic use is key to limiting the development of antimicrobial resistance. Outpatient antibiotic prescribing rates vary substantially across and within states. Kentucky is one of the highest prescribing states, and the southeastern region has rates that are drastically higher than the national average and urban areas of the state. We sought to examine provider perceptions of antibiotic use in this rural area to more effectively guide future interventions and policy. ⋯ This study highlights unique challenges associated with antibiotic prescribing in rural areas. Findings will guide future interventions through adaptation of existing strategies to better serve this vulnerable population.