Clinical performance and quality health care
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Clin Perform Qual Health Care · Oct 1998
A quality management approach to optimizing delivery and administration of preoperative antibiotics.
To optimize the process for delivering and administering preoperative antibiotics in order to prevent potential adverse patient outcomes. ⋯ A continuous quality-improvement approach that engages all departments involved in patient care is necessary to achieve meaningful change in complicated hospital processes.
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Clin Perform Qual Health Care · Jul 1998
Overutilization of indwelling urinary catheters and the development of nosocomial urinary tract infections.
To assess the impact of the overutilization of indwelling urinary catheters in the emergency department on the development of nosocomial urinary tract infection. ⋯ Many nosocomial urinary tract infections are due to the inappropriate placement of indwelling urinary catheters in the emergency department. The prevention of these infections should begin with restricting catheterization to those patients for whom it is appropriate.
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Clin Perform Qual Health Care · Jan 1998
A clinical decision process model for evaluating vancomycin use with modified HICPAC guidelines. Hospital Infection Control Practice Advisory Committee.
The objective of this study was to evaluate a clinical decision process model for the appropriateness of vancomycin use, using modified Hospital Infection Control Practice Advisory Committee (HICPAC) guidelines. ⋯ Comprehensive evaluation of vancomycin use with HICPAC guidelines should include a modification to encompass initial and 3-day reevaluation, because most initial use is for suspected, and not documented, infections. HICPAC guidelines do not address the issues of differentiating suspected from documented infection indications or ongoing empirical use. The clinical decision process model is a framework for documentation and data collection for use evaluation and addresses issues not covered in HICPAC vancomycin guidelines. This model could be used by other medical centers for evaluation of vancomycin or other antibiotics.
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Evidence-based health care (EBHC) is a growing movement to integrate healthcare research with healthcare practice. A key element to EBHC is convenient access to relevant high-quality evidence. The Cochrane Collaboration is an international consortium of persons dedicated to producing and maintaining systematic reviews of healthcare practice and is an invaluable resource to the EBHC movement. This article will describe EBHC briefly and will highlight how the Cochrane Collaboration supports the EBHC perspective to create an efficient and effective healthcare system.
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Clin Perform Qual Health Care · Jul 1997
Informatics, imaging, and healthcare quality management: imaging quality improvement opportunities and lessons learned form HCFA's Health Care Quality Improvement Program.
This article examines the use of population-based healthcare data at the interface among radiology, healthcare informatics, and health services research for the purposes of healthcare quality management. To illustrate these concepts, we draw on experience with Health Care Financing Administration's Medicare Health Care Quality Improvement Program (HCQIP). ⋯ The examples demonstrate from a population-level perspective that there are opportunities to enhance the quality of imaging practice by reducing the magnitude of imaging practice variability, implementing evidence-based guidelines, and optimizing the communication of imaging study findings to physicians who are responsible for subsequent diagnostic and therapeutic decisions. Additional research is required in specific clinical domains of radiology to determine if implementation of evidence-based imaging guidelines and enhanced clarity in the interpretation and communication of diagnostic imaging will improve health outcomes.