LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 27

Search options

  1. Book ; Online ; E-Book: Patient safety and quality improvement in healthcare

    Shah, Rahul K. / Godambe, Sandip A.

    a case-based approach

    2021  

    Abstract: This text uses a case-based approach to share knowledge and techniques on how to operationalize much of the theoretical underpinnings of hospital quality and safety. Written and edited by leaders in healthcare, education, and engineering, these 22 ... ...

    Author's details Rahul K. Shah, Sandip A. Godambe, editors
    Abstract This text uses a case-based approach to share knowledge and techniques on how to operationalize much of the theoretical underpinnings of hospital quality and safety. Written and edited by leaders in healthcare, education, and engineering, these 22 chapters provide insights as to where the field of improvement and safety science is with regards to the views and aspirations of healthcare advocates and patients. Each chapter also includes vignettes to further solidify the theoretical underpinnings and drive home learning. End of chapter commentary by the editors highlight important concepts and connections between various chapters in the text. Patient Safety and Quality Improvement in Healthcare: A Case-Based Approach presents a novel approach towards hospital safety and quality with the goal to help healthcare providers reach zero harm within their organizations.
    Keywords Patients/Safety measures ; Medical care/Quality control ; Medicine/Practice
    Subject code 610.289
    Language English
    Size 1 online resource (XIX, 383 p. 129 illus., 118 illus. in color.)
    Publisher Springer
    Publishing place Cham, Switzerland
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    ISBN 3-030-55829-0 ; 3-030-55828-2 ; 978-3-030-55829-1 ; 978-3-030-55828-4
    DOI 10.1007/978-3-030-55829-1
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

    Full text online

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  2. Book ; Online: Fleisher & Ludwig's 5-minute pediatric emergency medicine consult

    Hoffman, Robert J., 1968- / Wang, Vincent J. / Scarfone, Richard / Godambe, Sandip A. / Pitetti, Raymond

    2012  

    Title variant 5-minute pediatric emergency medicine consult ; Fleisher and Ludwig's 5-minute pediatric emergency medicine consult
    Author's details editors, Robert J. Hoffman, Vincent J. Wang, Richard Scarfone ; associate editors, Sandip A. Godambe, Raymond Pitetti
    Keywords Emergency medicine ; Pediatrics ; Emergency medical services ; Emergency treatment ; Infant ; Child ; Adolescent ; Handbooks
    Language English
    Size 1 Online-Ressource (1120 Seiten)
    Publisher Lippincott Williams & Wilkins
    Publishing place Philadelphia, Pa
    Document type Book ; Online
    Note Includes bibliographical references
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    ISBN 978-1-605-47749-7 ; 1-605-47749-4
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

    Full text online

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  3. Article ; Online: Leveraging a Safety Event Management System to Improve Organizational Learning and Safety Culture.

    Dawson, Regina / Saulnier, Teresa / Campbell, Adam / Godambe, Sandip A

    Hospital pediatrics

    2022  Volume 12, Issue 4, Page(s) 407–417

    Abstract: Background and objectives: Safety event management systems (SEMS) are rich sources of patient safety information, which can be used to improve organizational safety culture. An ideal SEMS can accomplish this when the system is improved with the ... ...

    Abstract Background and objectives: Safety event management systems (SEMS) are rich sources of patient safety information, which can be used to improve organizational safety culture. An ideal SEMS can accomplish this when the system is improved with the intention of increasing learning and engagement across the organization. To support a global aim of improving overall patient safety and becoming a highly reliable learning health system, focus was directed toward increasing event review and follow-up completion and using this information to drive resource allocation and improvement efforts.
    Methods: A new integrated SEMS was customized, tested, and implemented based on identified organizational need. Revised policies were developed to define expectations for event review and follow-up. The new SEMS incorporated a closed-loop communication process which ensured information from events was shared with the event submitters and facilitated shared learning. The expected impacts, improved event reporting, and follow-up were studied and guided ongoing improvements.
    Results: After transitioning to a new SEMS, we experienced increased overall reporting by 8.6% and improved event follow-up, demonstrated by documentation on specified system forms, by 53.7%.
    Conclusions: By implementing a new, efficient, and standardized SEMS, which decentralized event management processes, the organization saw increased reporting and better engagement with patient safety event review and follow-up. Overall, these results demonstrated a stronger reporting culture, which allowed for local problem solving and improved learning from every event reported. A robust reporting culture positively impacted the overall organizational culture of safety.
    MeSH term(s) Humans ; Medical Errors ; Organizational Culture ; Patient Safety ; Safety Management/methods
    Language English
    Publishing date 2022-03-07
    Publishing country United States
    Document type Journal Article
    ISSN 2154-1671
    ISSN (online) 2154-1671
    DOI 10.1542/hpeds.2021-006266
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  4. Article ; Online: Identifying children at high risk for infection-related decompensation using a predictive emergency department-based electronic assessment tool.

    Sepanski, Robert J / Zaritsky, Arno L / Godambe, Sandip A

    Diagnosis (Berlin, Germany)

    2020  Volume 8, Issue 4, Page(s) 458–468

    Abstract: Objectives: Electronic alert systems to identify potential sepsis in children presenting to the emergency department (ED) often either alert too frequently or fail to detect earlier stages of decompensation where timely treatment might prevent serious ... ...

    Abstract Objectives: Electronic alert systems to identify potential sepsis in children presenting to the emergency department (ED) often either alert too frequently or fail to detect earlier stages of decompensation where timely treatment might prevent serious outcomes.
    Methods: We created a predictive tool that continuously monitors our hospital's electronic health record during ED visits. The tool incorporates new standards for normal/abnormal vital signs based on data from ∼1.2 million children at 169 hospitals. Eighty-two gold standard (GS) sepsis cases arising within 48 h were identified through retrospective chart review of cases sampled from 35,586 ED visits during 2012 and 2014-2015. An additional 1,027 cases with high severity of illness (SOI) based on 3 M's All Patient Refined - Diagnosis-Related Groups (APR-DRG) were identified from these and 26,026 additional visits during 2017. An iterative process assigned weights to main factors and interactions significantly associated with GS cases, creating an overall "score" that maximized the sensitivity for GS cases and positive predictive value for high SOI outcomes.
    Results: Tool implementation began August 2017; subsequent improvements resulted in 77% sensitivity for identifying GS sepsis within 48 h, 22.5% positive predictive value for major/extreme SOI outcomes, and 2% overall firing rate of ED patients. The incidence of high-severity outcomes increased rapidly with tool score. Admitted alert positive patients were hospitalized nearly twice as long as alert negative patients.
    Conclusions: Our ED-based electronic tool combines high sensitivity in predicting GS sepsis, high predictive value for physiologic decompensation, and a low firing rate. The tool can help optimize critical treatments for these high-risk children.
    MeSH term(s) Electronics ; Emergency Service, Hospital ; Hospitalization ; Humans ; Retrospective Studies ; Sepsis/diagnosis ; Sepsis/epidemiology
    Language English
    Publishing date 2020-08-17
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2194-802X
    ISSN (online) 2194-802X
    DOI 10.1515/dx-2020-0030
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  5. Article: Pediatric Vital Sign Distribution Derived From a Multi-Centered Emergency Department Database.

    Sepanski, Robert J / Godambe, Sandip A / Zaritsky, Arno L

    Frontiers in pediatrics

    2018  Volume 6, Page(s) 66

    Abstract: Background: We hypothesized that current vital sign thresholds used in pediatric emergency department (ED) screening tools do not reflect observed vital signs in this population. We analyzed a large multi-centered database to develop heart rate (HR) and ...

    Abstract Background: We hypothesized that current vital sign thresholds used in pediatric emergency department (ED) screening tools do not reflect observed vital signs in this population. We analyzed a large multi-centered database to develop heart rate (HR) and respiratory rate centile rankings and
    Methods: Initial HR and respiratory rate data entered into the Cerner™ electronic health record at 169 participating hospitals' ED over 5 years (2009 through 2013) as part of routine care were analyzed. Analysis was restricted to non-admitted children (0 to <18 years). Centile curves and
    Results: HR and RR centiles and
    Conclusion: Heart and respiratory rate centiles derived from a large real-world non-hospitalized ED pediatric population can inform the modification of electronic and paper-based screening tools to stratify children by the degree of deviation from normal for age rather than dichotomizing children into groups having "normal" versus "abnormal" vital signs. Furthermore, these centiles also may be useful in paper-based screening tools and bedside alarm limits for children in areas other than the ED and may establish improved alarm limits for bedside monitors.
    Language English
    Publishing date 2018-03-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2018.00066
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Article ; Online: Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care.

    Venn, April M-R / Sotomayor, Cecilia A / Godambe, Sandip A / Vazifedan, Turaj / Jennings, Andrea D / Qureshi, Faiqa A / Mullan, Paul C

    Pediatric quality & safety

    2021  Volume 6, Issue 4, Page(s) e426

    Abstract: Introduction: Intrahospital transports (IHTs) are high-risk activities with the potential for adverse outcomes. Suboptimal care of a patient in our emergency department (ED) needing IHT to the pediatric intensive care unit (ICU) identified improvement ... ...

    Abstract Introduction: Intrahospital transports (IHTs) are high-risk activities with the potential for adverse outcomes. Suboptimal care of a patient in our emergency department (ED) needing IHT to the pediatric intensive care unit (ICU) identified improvement opportunities. We describe implementing a novel checklist (Briefing ED-to-ICU Transport To Exit Ready: BETTER) for improving the IHT safety of pediatric ED patients admitted to the pediatric ICU.
    Methods: A multidisciplinary team used the Model for Improvement to create a key driver diagram and process map. An evidence-based IHT checklist was implemented on July 23, 2019 after multiple plan-do-study-act checklist revisions. The specific aim was a ≥80% checklist completion rate for 6 months and maintaining that rate for 6 months. An anonymous, voluntary survey of ED nurses and physicians, 9 months postimplementation, evaluated perceived improvements in IHT safety. The outcome measure was the proportion of IHT-related incident reports, per ED-to-pediatric ICU admission, comparing baseline (2-year preimplementation) and intervention (1-year postimplementation) periods. Balancing measures included a quantitative assessment for any throughput measure delays and a survey question on perceived delays.
    Results: From July 23, 2019 to July 22, 2020, 335 (84%) of 400 ED-to-ICU admissions had completed IHT checklists. Ninety percent of survey respondents (84% response rate) agreed that the checklist improved IHT safety. The incident report rate was lower in the intervention period (0.5% versus 2.3%;
    Conclusions: This IHT checklist was feasible and associated with improvements in perceived safety and incident event reporting. Further studies are needed to assess generalizability.
    Language English
    Publishing date 2021-06-23
    Publishing country United States
    Document type Journal Article
    ISSN 2472-0054
    ISSN (online) 2472-0054
    DOI 10.1097/pq9.0000000000000426
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  7. Article ; Online: Optimizing Recognition and Management of Patients at Risk for Infection-Related Decompensation Through Team-Based Decision Making.

    Martinez, Elizabeth M / Sepanski, Robert J / Jennings, A Dawn / Schmidt, James M / Cholis, Thomas J / Dominy, Meaghan E / Devlin, Sanaz B / Eilers, Lindsay Floyd / Zaritsky, Arno L / Godambe, Sandip A

    Journal for healthcare quality : official publication of the National Association for Healthcare Quality

    2022  Volume 45, Issue 2, Page(s) 59–68

    Abstract: Introduction: Pediatric sepsis is a leading cause of death among children. Electronic alert systems may improve early recognition but do not consistently result in timely interventions given the multitude of clinical presentations, lack of treatment ... ...

    Abstract Introduction: Pediatric sepsis is a leading cause of death among children. Electronic alert systems may improve early recognition but do not consistently result in timely interventions given the multitude of clinical presentations, lack of treatment consensus, standardized order sets, and inadequate interdisciplinary team-based communication. We conducted a quality improvement project to improve timely critical treatment of patients at risk for infection-related decompensation (IRD) through team-based communication and standardized treatment workflow.
    Methods: We evaluated children at risk for IRD as evidenced by the activation of an electronic alert system (Children at High Risk Alert Tool [CAHR-AT]) in the emergency department. Outcomes were assessed after multiple improvements including CAHR-AT implementation, clinical coassessment, visual cues for situational awareness, huddles, and standardized order sets.
    Results: With visual cue activation, initial huddle compliance increased from 7.8% to 65.3% ( p < .001). Children receiving antibiotics by 3 hours postactivation increased from 37.9% pre-CAHR-AT to 50.7% posthuddle implementation ( p < .0001); patients who received a fluid bolus by 3 hours post-CAHR activation increased from 49.0% to 55.2% ( p = .001).
    Conclusions: Implementing a well-validated electronic alert tool did not improve quality measures of timely treatment for high-risk patients until combined with team-based communication, standardized reassessment, and treatment workflow.
    MeSH term(s) Humans ; Child ; Sepsis/therapy ; Patients ; Interdisciplinary Communication ; Communication ; Emergency Service, Hospital ; Decision Making
    Language English
    Publishing date 2022-08-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1472097-8
    ISSN 1945-1474 ; 1062-2551
    ISSN (online) 1945-1474
    ISSN 1062-2551
    DOI 10.1097/JHQ.0000000000000363
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 5029: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  8. Article ; Online: Improving Equity of Care for Patients with Limited English Proficiency Using Quality Improvement Methodology.

    Martinez, Elizabeth M / Carr, Daniel Timothy / Mullan, Paul C / Rogers, Lakisha E / Howlett-Holley, Wendy L / McGehee, Coleman A / Mangum, Christopher D / Godambe, Sandip A

    Pediatric quality & safety

    2021  Volume 6, Issue 6, Page(s) e486

    Abstract: Disparate clinical outcomes have been reported for patients with Limited English Proficiency (LEP) in the emergency department setting, including increased length of stay, diagnostic error rates, readmission rates, and dissatisfaction. Our emergency ... ...

    Abstract Disparate clinical outcomes have been reported for patients with Limited English Proficiency (LEP) in the emergency department setting, including increased length of stay, diagnostic error rates, readmission rates, and dissatisfaction. Our emergency department had no standard processes for LEP patient identification or interpreter encounter documentation and a higher rate of 48-hour LEP return visits (RV) than English proficient patients. The aim was to eliminate gaps by increasing appropriate interpreter use and documentation (AIUD) for Spanish-speaking LEP (LEP-SS) patients from 35.7% baseline (10/17-05/18) to 100% by October 2020.
    Methods: LEP-SS patient data were reviewed in the electronic medical record to determine the AIUD and RV rates. Using the Model for Improvement and multiple Plan-Do-Study-Act (PDSA) cycles, a multi-disciplinary team encouraged stakeholder engagement and identified improvement opportunities, implemented an electronic tracking board LEP icon (PDSA1), standardized documentation using an LEP Form linked to the icon (PDSA2), and included color changes to the icon for team situational awareness (PDSA3).
    Results: The mean of LEP-SS patients with AIUD improved from 35.7% to 64.5% without significant changes in balancing measures. During the postintervention period (6/1/2018-10/31/2020), no special cause variation was noted from the baseline 48-hour emergency department RV rates for LEP patients (3.1%) or English proficient patients (2.6%).
    Conclusions: While the RV rate was not affected, this project is part of a multi-faceted approach aiming to positively impact this outcome measure. Significant improvements in AIUD were achieved without affecting balancing measures.
    Language English
    Publishing date 2021-12-15
    Publishing country United States
    Document type Journal Article
    ISSN 2472-0054
    ISSN (online) 2472-0054
    DOI 10.1097/pq9.0000000000000486
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  9. Article ; Online: Use of the Lean Manufacturing Principles to Improve Total Parenteral Nutrition Logistics and Clinical Outcomes in the Neonatal Patient Population.

    Mangum, Christopher D / Stanley, Andrew J / Peterson, Catherine C / Biava, Laura / Dice, James / Khan, Jamil / Godambe, Sandip A

    Pediatric quality & safety

    2019  Volume 4, Issue 6, Page(s) e233

    Abstract: Total parenteral nutrition (TPN) is one of the most frequently used pharmaceuticals administered to patients in our Neonatal Intensive Care Unit (NICU). Initially, the total interdepartmental processing time (ordering, manufacturing, and delivery between ...

    Abstract Total parenteral nutrition (TPN) is one of the most frequently used pharmaceuticals administered to patients in our Neonatal Intensive Care Unit (NICU). Initially, the total interdepartmental processing time (ordering, manufacturing, and delivery between NICU and Pharmacy) averaged 15.2 hours. Inefficiencies in this process only allowed TPN to infuse 8.8 hours on average before labs were collected the next morning. Given the short administration-to-laboratory collection time, we hypothesized that laboratory samples would not adequately reflect the effect of the current TPN infusion. Furthermore, clinicians would be making decisions based on suboptimal data and ultimately nourish this patient population inadequately.
    Methods: The project team and the frontline staff created an efficient process for the manufacture and delivery of TPN. They removed waste in the process associated with manufacturing TPN and created capacity for change upstream (ordering process) and downstream (TPN infusion process) of the internal pharmacy process. The use of selection criteria and new standard operating procedures allowed for controlled PDSA testing of changes on a subset of patients. After we attained proven, sustainable results, we scaled the improvement efforts to the entire NICU patient population.
    Results: After 4 cycles of change, patients now receive TPN on average 14.2 hours before new labs are collected. The interventions over the continuum of this project yielded statistically significant results, increased infusion times to our patients by 61.4% (
    Conclusions: In conclusion, creating process capacity from incremental changes and iterative PDSA cycles has yielded sustained results.
    Language English
    Publishing date 2019-11-26
    Publishing country United States
    Document type Journal Article
    ISSN 2472-0054
    ISSN (online) 2472-0054
    DOI 10.1097/pq9.0000000000000233
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  10. Article ; Online: Use of Lean Healthcare to Improve Hospital Throughput and Reduce LOS.

    Mangum, Christopher D / Andam-Mejia, Rachel L / Hale, Leslie R / Mananquil, Ana / Fulcher, Kyle R / Hall, Jason L / McDonald, Laura Anne C / Sjogren, Karl N / Villalon, Felicita D / Mehta, Ami / Shomaker, Kyrie / Johnson, Edward A / Godambe, Sandip A

    Pediatric quality & safety

    2021  Volume 6, Issue 5, Page(s) e473

    Abstract: Improving the discharge process is an area of focus throughout healthcare organizations. Capacity constraints, efficiency improvement, patient safety, and quality care are driving forces for many discharge process workgroups.: Methods: Following the ... ...

    Abstract Improving the discharge process is an area of focus throughout healthcare organizations. Capacity constraints, efficiency improvement, patient safety, and quality care are driving forces for many discharge process workgroups.
    Methods: Following the Pareto principle, we focused on improving the discharge process on the medical-surgical units that received the most patients admitted from the emergency department. Increased demand for medical-surgical beds, renovations, and diminished bed capacity made it imperative to improve efficiency using quality improvement techniques. A core team of frontline staff decreased the time between computer entry of discharge orders and patient's departure from the unit to less than 60 minutes, with 80% compliance. The team developed a daily dashboard that detailed the process and outcome measures to create situational awareness and daily visual management. Additional observations of staff workflow uncovered excessive walking for printer use. Printers were placed at the point of use to reduce transport times. Next, using survey results provided by patients on discharge quality, a Treasure Map that aided with teach-back and Team Discharge were implemented to level the staff's workload. Finally, physicians discharged patients earlier in the day. They standardized their discharge criteria to remove subjectivity from the discharge process and enable better team involvement.
    Results: After implementing 4 interventions, the average time between computer entry of discharge orders and patient's departure from the unit decreased (94.26 versus 65.98 minutes;
    Conclusions: In conclusion, hardwiring proven interventions and complementing them with daily visual management led to significant, sustained results.
    Language English
    Publishing date 2021-09-24
    Publishing country United States
    Document type Journal Article
    ISSN 2472-0054
    ISSN (online) 2472-0054
    DOI 10.1097/pq9.0000000000000473
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

To top