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Donnelly C, Janssen A, Vinod S, Stone E, Harnett P, Shaw T. A Systematic Review of Electronic Medical Record Driven Quality Measurement and Feedback Systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010200. [PMID: 36612522 PMCID: PMC9819986 DOI: 10.3390/ijerph20010200] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 06/09/2023]
Abstract
Historically, quality measurement analyses utilize manual chart abstraction from data collected primarily for administrative purposes. These methods are resource-intensive, time-delayed, and often lack clinical relevance. Electronic Medical Records (EMRs) have increased data availability and opportunities for quality measurement. However, little is known about the effectiveness of Measurement Feedback Systems (MFSs) in utilizing EMR data. This study explores the effectiveness and characteristics of EMR-enabled MFSs in tertiary care. The search strategy guided by the PICO Framework was executed in four databases. Two reviewers screened abstracts and manuscripts. Data on effect and intervention characteristics were extracted using a tailored version of the Cochrane EPOC abstraction tool. Due to study heterogeneity, a narrative synthesis was conducted and reported according to PRISMA guidelines. A total of 14 unique MFS studies were extracted and synthesized, of which 12 had positive effects on outcomes. Findings indicate that quality measurement using EMR data is feasible in certain contexts and successful MFSs often incorporated electronic feedback methods, supported by clinical leadership and action planning. EMR-enabled MFSs have the potential to reduce the burden of data collection for quality measurement but further research is needed to evaluate EMR-enabled MFSs to translate and scale findings to broader implementation contexts.
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Affiliation(s)
- Candice Donnelly
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
| | - Anna Janssen
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
| | - Shalini Vinod
- Liverpool Cancer Therapy Centre, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia
- South West Sydney Clinical Campuses, University of New South Wales, Liverpool, NSW 2170, Australia
| | - Emily Stone
- Department of Thoracic Medicine and Lung Transplantation, St Vincent’s Hospital, Darlinghurst, NSW 2010, Australia
- School of Clinical Medicine, University of New South Wales, Randwick, NSW 2031, Australia
| | - Paul Harnett
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
- Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead, NSW 2145, Australia
| | - Tim Shaw
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
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The Clinical Value of High-Quality Nursing in Concurrent Radiotherapy and Chemotherapy after Glioma Surgery and Its Influence on the Stress Indicators Cor, ACTH, and CRP. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:8335400. [PMID: 35126950 PMCID: PMC8808127 DOI: 10.1155/2022/8335400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/31/2021] [Indexed: 12/30/2022]
Abstract
Objective The purpose of this study is to explore the clinical value of high-quality nursing in concurrent radiotherapy and chemotherapy after glioma surgery and its influence on the stress indicators such as cortisol (Cor), adrenocorticotrophic hormone (ACTH), and C-reactive protein (CRP). Methods A total of 94 glioma patients diagnosed and treated in our hospital were randomly divided into a research group and a control group, with 47 cases in each group. Both groups of patients were given concurrent radiotherapy and chemotherapy. On this basis, patients in the control group were given basic care, while patients in the research group were given a combination of basic care and high-quality care. The nursing satisfaction and adverse reactions of the two groups were compared. The pain degree and the levels of stress indicators Cor, ACTH, and CRP at different time points were compared between the two groups. The sleep quality, bad mood, and quality of life before and after nursing were compared between the two groups. Results After nursing, the nursing satisfaction of the research group (95.74%) was higher than that of the control group (80.85%), and the difference between the two groups was statistically significant (X2 = 11.678, P < 0.05). There was no significant difference between patients in the Visual Analogue Scale (VAS) score and the levels of stress indicators Cor, ACTH, and CRP at the T1 time point between the two groups (P > 0.05). With the passage of time, the levels of Cor and ACTH of the two groups showed an upward trend. At T4, the increased levels of Cor and ACTH in the research group were less than those in the control group, and the difference was statistically significant (P < 0.05). The VAS scores and CRP levels of the two groups showed an upward trend at T1 and T2 and a downward trend at T3 and T4. And, at T4, the decrease in CRP level of the research group was greater than that in the control group, and the difference was statistically significant (P < 0.05). Before nursing, there was no statistically significant difference between two groups of patients in the time to fall asleep, sleep time, number of awakenings, SAS score, self-rating depression scale (SDS) score, quality of life index scores, and total scores (P > 0.05). After nursing, the time to fall asleep and the number of awakenings in the two groups of patients showed an upward trend, and the increase in the control group was higher (P < 0.05). The sleep time of the two groups showed a downward trend, and the degree of decline in the control group was higher (P < 0.05). After nursing, the SAS score and SDS score of the two groups of patients decreased (∗P < 0.05), and the decrease in the research group was more obvious (#P < 0.05). After nursing, the scores of all indicators of the quality of life and the total score of the two groups increased and the score of the research group increased more significantly (P < 0.05). After nursing, the control group had 5 cases of gastrointestinal reactions, 7 cases of bone marrow suppression, 6 cases of leukopenia, 6 cases of thrombocytopenia, and 10 cases of dizziness and nausea. In the research group, there were 1 case of gastrointestinal reaction, 2 cases of bone marrow suppression, 1 case of leukopenia, 1 case of thrombocytopenia, and 2 cases of dizziness and nausea. The difference between the two groups was statistically significant (P < 0.05). Conclusion Glioma patients are given high-quality care during the course of concurrent radiotherapy and chemotherapy, which can reduce the pain and bad mood of the patient, reduce the stress response of the patient, and improve the quality of sleep and the quality of life of the patient, thereby improving nursing satisfaction and patients compliance, reducing adverse reactions, and having a good prognosis.
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Jordan JT, Sanders AE, Armstrong T, Asher T, Bennett A, Dunbar E, Mohile N, Nghiemphu PL, Smith TR, Ney DE. Quality improvement in neurology: Neuro-oncology quality measurement set. Neurology 2018; 90:652-658. [PMID: 29500290 PMCID: PMC10681057 DOI: 10.1212/wnl.0000000000005251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 12/04/2017] [Indexed: 12/18/2022] Open
Affiliation(s)
- Justin T Jordan
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
| | - Amy E Sanders
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
| | - Terri Armstrong
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
| | - Tony Asher
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
| | - Amy Bennett
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
| | - Erin Dunbar
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
| | - Nimish Mohile
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
| | - P Leia Nghiemphu
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
| | - Timothy R Smith
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
| | - Douglas E Ney
- From the Pappas Center for Neuro-Oncology (J.T.J.), Massachusetts General Hospital, Boston; Department of Neurology (A.E.S.), SUNY Upstate Medical University, Syracuse, NY; Neuro-Oncology Branch, Center for Clinical Research (T. Armstrong), National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Neurological Surgery (T. Asher), Carolinas Medical Center Carolina Neurosurgery and Spine Associates, Charlotte, NC; American Academy of Neurology (A.B.), Minneapolis, MN; Department of Neuro-Oncology (E.D.), Piedmont Brain Tumor Center, Atlanta, GA; Department of Neurology (N.M.), University of Rochester, NY; Department of Neurology (P.L.N.), UCLA, Los Angeles, CA; Cushing Neurosurgical Outcomes Center (T.R.S.), Brigham & Women's Hospital, Harvard Medical School, Boston, MA; and Departments of Neurology and Neurosurgery (D.E.N.), University of Colorado School of Medicine, Aurora
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