Medicine

Discover expert assistance in medicine with our AI homework help platform. Get answers to your questions, explore detailed explanations, and enhance your understanding of complex medical topics. Perfect for students seeking reliable resources and support in their academic journey.

New Questions

AHRQ Quality Indicators (QIs) Case Study: Tampa General Hospital's Adoption of AHRQ Qis Yields Performance Improvements Key Findings - In 2014, Tampa General Hospital began tracking its performance across the full set of AHRQ Patient Safety Indicators, both as a means of improving the quality and safety of patient care, and in response to the incentives underlying CMS' value-based purchasing programs. - Tampa General Hospital substantially reduced its Pressure Ulcer Rate (PSI 03) after implementing a nutrition program aimed at patients whose poor nutrition impacted the healing of skin injuries. - Tampa General Hospital substantially reduced its Deep Vein Thrombosis Rate (PSI 12) after instituting an education campaign aimed at both nurses and patients. Tampa General Hospital: At a Glance - 1000+ bed single facility teaching hospital with an affiliated ambulatory surgery center - 1,500 medical staff members - Affiliated with University of South Florida medical school, and their residency program (750 residents) - Serves as the community hospital referral facility for the Tampa Bay area Urged by its Board of Directors, Tampa General Hospital leadership initially selected the AHRQ Patient Safety Indicators (PSIs) to monitor performance because leadership wanted to improve the hospital's standing under CMS' value-based purchasing and incentive programs. Starting in 2014, Tampa General Hospital analyzed its performance using the full set of AHRQ PSIs. Tampa General also established the position of Chief Quality Officer as a strong signal regarding the hospital's commitment to improving safety and quality of patient care. Laura Haubner, MD, Tampa General Hospital's inaugural and current Chief Quality Officer described the improvement of clinical care experienced by patients of Tampa General Hospital following implementation of the AHRQ PSIs. Focus on Nutrition Lowers Tampa General Hospital's Pressure Ulcer Rate (PSI 03) After comparing its Pressure Ulcer Rate (PSI 03) to that of peer facilities in other parts of the country, Tampa General Hospital committed to substantially reducing its rate of pressure ulcers. The hospital's research identified poor nutrition as a significant contributor to the incidence of pressure ulcers. As a result of this finding, Tampa General Hospital developed a nutrition program targeted to undernourished patients at high risk for pressure ulcers. After implementing the nutrition program, Tampa General Hospital's PSI 03 rate improved significantly, dropping from an observed rate of 518 per 1,000 discharges for the fourth quarter of FY 2015 to zero incidents in the third and fourth quarters of FY 2018. Beverly Hernandez, PhD, RD, LD/N, Director, Clinical Nutrition Services, explained that Tampa General Hospital took a three-pronged approach to addressing malnutrition in these patients. 1. Utilized technology to identify patients at risk for pressure sores, The hospital adopted a computerized malnutrition screen to assist nurses with early identification of patients suffering from malnutrition. 2. Standardized clinical protocols for at-risk patients. The hospital combined early identification of patients at risk for pressure sores with more aggressive protocols for clinical staff, including a requirement that staff must see patients flagged by the malnutrition screen within 24 hours, and an automatic referral to a nutritionist for a poor score on the Braden Scale for Predicting Pressure Ulcer Risk. In addition, at-risk patients are visited by a hospital social worker who helps identify community resources (food banks, meals on wheels) for when patients return home. 3. Increased interdisciplinary collaboration. Tampa General Hospital instituted a Medical Nutrition Committee comprised of physicians, pharmacists, and dietitians. This committee instituted changes that now allow nurses to write nutrition-based orders, instead of waiting for a physician to do so. A Wound Care Committee works aggressively to deter skin wounds during hospital stays, and the Nurse Nutrition Council meets regularly to review cases and identify opportunities for continuous improvement. "The AHRQ PSIs awakened in all of us an awareness that we need to improve the hospital's performance rate of pressure ulcers and that nutrition could be a key means of achieving that," said Ms. Hernandez.
In a test of the effects of eating a vegetarian diet on cholesterol, one group of 55 randomly selected subjects undergoes a treatment consisting of a vegetarian diet while another group of 58 randomly selected subjects eats a non-vegetarian diet. The researchers doing the measurements of cholesterol are aware of which participants receive the treatment and which do not receive it. Identify any problems that are likely to cause confounding and explain how the problems could be avoided. Identify any problems that are likely to cause confounding. Select all that apply. A. There is likely to be an experimenter effect in this study because the researcher making the cholesterol measurements will influence the subjects by knowing which participants eat a vegetarian diet and which participants do not. B. The groups are so small that confounding is likely to be introduced by the select of the group subjects. C. If there are differences in the measurements of cholesterol, there is no way to know if the differences are attributable to the treatment (eating a vegetarian diet) or to the height of the participant. D. There is likely to be a placebo effect in this study because the subjects know whether they are eating a vegetarian or non-vegetarian diet. E. There is no control group. Explain how the problems could be avoided. Select all that apply. A. The size of the groups should be increased to eliminate the possibility of a biasє sample. B. Differences in the measurements of cholesterol can be correctly attributed to eating vegetarian by giving the vegetarian diet treatment to half of the short subjects and half of the tall subjects and by not giving the vegetarian diet treatment to the other subjects. C. Unfortunately, there is no way to eliminate the placebo effect in this study. D. The study's subjects should not be aware whether they receive the vegetarian diet treatment or not. E. The researchers doing the cholesterol measurements should not be aware of which participants eat a vegetarian diet or do not eat a vegetarian diet.