Joint Commission journal on quality and patient safety / Joint Commission Resources
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Jt Comm J Qual Patient Saf · Nov 2008
An intensive care unit quality improvement collaborative in nine Department of Veterans Affairs hospitals: reducing ventilator-associated pneumonia and catheter-related bloodstream infection rates.
Measured adherence to evidence-based best practice in the intensive care unit (ICU) setting, as in all of health care, remains unacceptably low. In 2005 to 2006, the VA Midwest Health Care Network used a quality improvement collaborative (QIC) model to improve adherence with ICU best practices in widely varying ICU and hospital settings in nine Department of Veterans Affairs (VA) hospitals. ⋯ Implementing the ventilator and central line bundles was associated with a reduction in rates of VAPs and CRBSIs.
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Jt Comm J Qual Patient Saf · Nov 2008
Positive predictive value of ICD-9-CM codes to detect acute exacerbation of COPD in the emergency department.
Accurate identification of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) visits by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes will help organizations monitor quality of care for this common condition. A study was undertaken to validate ICD-9-CM coding for accurate identification of AECOPD visits. ⋯ In the first known chart validation of ICD-9-CM codes for identification of AECOPD visits, the proposed ICD-9-CM codes accurately identified cases of AECOPD in the ED. The study contributed to the use of these codes in the National Committee for Quality Assurance's new quality indicator for management of AECOPD.
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Jt Comm J Qual Patient Saf · Nov 2008
The business case for preventing ventilator-associated pneumonia in pediatric intensive care unit patients.
A retrospective matched (1:1) case-control study was conducted to compare the financial impact and costs attributable to ventilator-associated pneumonia (VAP) in a 25-bed pediatric intensive care unit (PICU) in a 475-bed quaternary-care pediatric hospital from the perspective of multiple stakeholders, including the hospital and payors. ⋯ This study provides the first demonstration of significant, sustained reductions in pediatric VAP rates following the implementation of the VAP prevention bundle and the first business case analysis of this pediatric-specific intervention as described from the perspective of multiple stakeholders. A return on investment may speed health care organizations' investment in patient safety and quality improvement.