Impact of a Hospital Evidence-Based Practice Center (EPC) on Nursing Policy and Practice.

Background: In 2006, our healthcare system created a hospital Evidence-based Practice Center (EPC) to support the local delivery of high-quality, safe and high value patient care. Since then, the importance of healthcare staff work life has also been highlighted, and together these four elements form the Quadruple Aim framework. Synergistic to this Aim, the Magnet program promotes and recognizes organizational nursing excellence.

Using a 10-step framework to support the implementation of an evidence-based clinical pathways programme.

Background: Integration of evidence into practice is suboptimal. Clinical pathways, defined as multidisciplinary care plans, are a method for translating evidence into local settings and have been shown to improve the value of patient care.

Objective: To describe the development of a clinical pathways programme across a large academic healthcare system.

Effectiveness of indoor allergen reduction in asthma management: A systematic review.

Background: This review will inform updated National Asthma Education and Prevention Program clinical practice guidelines.

Objective: We sought to evaluate the effectiveness of allergen reduction interventions on asthma outcomes.

Methods: We systematically searched the "gray literature" and 5 bibliographic databases.

Neonatal Herpes Simplex Virus Type 1 Infection and Jewish Ritual Circumcision With Oral Suction: A Systematic Review.

Jewish ritual circumcision rarely but occasionally includes a procedure involving direct oral suction of the wound, which can expose an infant to infection with herpes simplex virus type 1 (HSV-1). This practice has provoked international controversy in recent years, but no systematic review of the clinical literature has previously been published. We designed this review to identify and synthesize all published studies examining the association between circumcision with direct oral suction and HSV-1 infection.

Cleaning Hospital Room Surfaces to Prevent Health Care-Associated Infections: A Technical Brief.

The cleaning of hard surfaces in hospital rooms is critical for reducing health care-associated infections. This review describes the evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness. Key informants were interviewed, and a systematic search for publications since 1990 was done with the use of several bibliographic and gray literature resources.

Quality measurement in diabetes care.

This study aimed to evaluate diabetes quality measurement efforts, assess their strengths and areas for improvement, and identify gaps not adequately addressed by these measures. We conducted an environmental scan of diabetes quality measures, focusing on metrics included in the National Quality Measures Clearinghouse or promulgated by leading measurement organizations. Key informant interviews were also completed with thought leaders who develop, promote, and use quality measures.

Ambulatory quality improvement in academic medical centers: a changing landscape.

Efforts to improve the quality of ambulatory care have received tremendous attention as bold new initiatives aimed at influencing the environment of care through financial incentives, public transparency, and information technology rapidly spread. Academic medical centers, which represent a long tradition of excellence and innovation in medical care, might be expected to lead the charge in these new arenas, but motivation for change may be mitigated by the unique complexity and multiple goals of these institutions. A survey conducted in the fall of 2006 examined the early impact of these major new influences on faculty practice plans.

Assessing quality of care for migraineurs: a model health plan measurement set.

Quality of care measures are increasingly important to health plans, purchasers, physicians, and patients. Appropriate measures can be used to assess quality and evaluate improvement and are necessary components of pay-for-performance programs. Despite the broad scope of activity in the development of quality measures, migraine headache has received little attention.

In chronic disease, nationwide data show poor adherence by patients to medication and by physicians to guidelines.

Purpose: It is widely acknowledged in small studies that provider variation from evidence-based care guidelines and patient medication nonadherence lead to less than optimal health outcomes, increasing costs, and higher utilization. The research presented here aims to determine the prevalence of patient adherence to a medication regimen and provider adherence to guidelines for a variety of chronic conditions, using nationally representative data.

Design: A retrospective analysis of administrative claims data from a large national insurer was conducted.