Crossing the Quality Chasm

doi:10.17226/10027

Cited by 376 publications

(134 citation statements)

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“…In 2001, the Institute of Medicine published their landmark report Crossing the Quality Chasm in which they introduced the concept of shared decision making between patients and their physicians. 19 They recommended that when patients and clinicians are faced with complex medical decisions there are a multitude of factors at play including patient values, preferences, clinician opinion and evidence-based guidelines regarding their condition. 20 For these reasons our above recommendations should serve as an evidence-based advisement that should be considered as part of the discussion when an adult male presents with a previously unrecognized UDT.…”

Section: Cuaj -Original Research Shah Et Al Updated Mortality Risks Amentioning

confidence: 99%

An updated mortality risk analysis of the post-pubertal undescended testis

Shah

Feustel

Knuth

et al. 2018

CUAJ

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Shah et al Updated mortality risks analysis in men with cryptorchidismAn updated mortality risk analysis of the post-pubertal undescended testis The undescended testicle (UDT) presents a problem in post-pubertal (PP) men, as it carries an increased risk of developing a germ cell tumour (GCT). Management of the PP patient with an UDT must weigh the relative risk (RR) of perioperative mortality (POM) from orchiectomy against the lifetime risk of death from a GCT. Methods:The most recent data on GCT mortality were obtained from the National Centre for Health Statistics. Standard life tables were used to calculate the cumulative risk over a man's lifetime based on age. The increased RR of GCT in men with UDT was determined by weighing the observed and expected rates from literature review. Life table data was then multiplied by the RR to define the risk of GCT in men with UDT. Data from patients undergoing similar risk surgical procedures stratified by American Society of Anesthesiologists (ASA) class was used to determine POM. Results: Lifetime risk of dying from GCT decreases with increasing age. POM exceeded risks of death from GCT for men after age 50.2 for ASA class 1 and age 35.4 for ASA class 2. Men with an ASA class higher than 2 have a higher risk of POM compared to GCT for all ages. Conclusions:We found different ages from previous reports at which observation is advised. We consider prophylactic orchiectomy only in men who are under 50.2 years if ASA class 1 and under 35.4 years if ASA class 2. Men with an ASA class 3 or higher should always undergo observation.

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Section: Cuaj -Original Research Shah Et Al Updated Mortality Risks Amentioning

confidence: 99%

An updated mortality risk analysis of the post-pubertal undescended testis

Shah

Feustel

Knuth

et al. 2018

CUAJ

View full text Add to dashboard Cite

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“…In this category, the study identified 8 interventions of relevance including: 1) In-service training , a form of positive behavior support aimed at increasing the capabilities of individual primary care system actors 49 ; 2) Reminders , manual or computerized interventions that prompt individual providers to perform an action during a clinical exchange and can include, among others, job aids, paper reminders, checklists, and computer decision support systems 42 50 54 ; 3) Clinical practice guidelines , or systematically developed statements to assist healthcare providers and patients to decide on appropriate health care for specific circumstances 42 55 59 ; 4) Continuous education, referring to courses, workshops, or other educational meetings aimed at increasing the technical competencies of primary care providers; 5) Clinical incident reporting, or systems for reporting critical incidents and adverse or undesirable effects as a means to improving the safety of healthcare delivery 33 ; 6) Local opinion leaders , referring to the identification and use of identifiable local opinion leaders to promote good clinical practices 31 60 ; 7) Continuous quality improvement defined as the iterative process to review and improve care that includes involvement of healthcare teams, analysis of a process or system, a structured process improvement method or problem-solving approach, and use of data analysis to assess changes 42 . It will include lean management as one of the approaches used to improve efficiency and quality in service provider organizations 61 65 ; and, 8) Supervision , defined as routine control visits by senior primary care staff to providers and facilities 66 72 .…”

Section: Intervention and Outcomes Of Interestmentioning

confidence: 99%

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

et al. 2018

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Background . For the last two decades there has been growing interest in governmental and global health stakeholders about the role that performance measurement and management systems can play for the production of high-quality and safely delivered primary care services. Despite recognition and interest, the gaps in evidence in this field of research and practice in low- and middle-income countries remain poorly characterized. This study will develop an evidence gap map in the area of performance management in primary care delivery systems in low- and middle-income countries. Methods. The evidence gap map will follow the methodology developed by 3Ie, the International Initiative for Impact Evaluation, to systematically map evidence and research gaps. The process starts with the development of the scope by creating an evidence-informed framework that helps identify the interventions and outcomes of relevance as well as help define inclusion and exclusion criteria. A search strategy is then developed to guide the systematic search of the literature, covering the following databases: Medline (Ovid), Embase (Ovid), CAB Global Health (Ovid), CINAHL (Ebsco), Cochrane Library, Scopus (Elsevier), and Econlit (Ovid). Sources of grey literature are also searched. Studies that meet the inclusion criteria are systematically coded, extracting data on intervention, outcome, measures, context, geography, equity, and study design. Systematic reviews are also critically appraised using an existing standard checklist. Impact evaluations are not appraised but will be coded according to study design. The process of map-building ends with the creation of an evidence gap map graphic that displays the available evidence according to the intervention and outcome framework of interest. Discussion . Applications arising from the evidence map will be discussed in a separate paper that will summarize findings and make recommendations for the development of a prioritized research agenda.

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“…The dimension of quality is defined as the degree to which healthcare services for an individual or population increase the likelihood of desired health outcomes and is consistent with current professional knowledge [7]. The Institute of Medicine (IOM) describes attributes of the dimension of quality, the most important being appropriateness, timeliness and safety.…”

Section: Quality Of Care -A Continuum With Attributesmentioning

confidence: 99%

Quality trends in healthcare and their impact on anesthesiology

Nicolescu

2017

Rom J Anaesth Int Care

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The new approach of a patient-centred, appropriate and timely care that was at the heart of the Institute of Medicine (IOM) initiative is changing the face of the healthcare industry in general and, in particular, of anesthesiology as a speciality. The drivers of this change are better quality and decreased healthcare costs, since despite a large expenditure for healthcare, the quality of care has not changed tremendously. Metrics have been identified, derived from the cybernetic model first described by the quality "parent". Donabedian and each of those metrics have both advantages as well as disadvantages. Ultimately the outcome measures are the ones that CMS will hold hospitals accountable for financially as well as from a safety standpoint. The culture of safety and quality as well as methodologies to improve that culture will shape the future of quality of care and improve outcomes and patient satisfaction.

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Crossing the Quality Chasm

Cited by 376 publications

References 0 publications

An updated mortality risk analysis of the post-pubertal undescended testis

An updated mortality risk analysis of the post-pubertal undescended testis

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

Quality trends in healthcare and their impact on anesthesiology

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