A Statewide Program to Improve Management of Suspected Urinary Tract Infection in Long-Term Care.

Background/objectives: Suspected urinary tract infection (UTI) is the most common indication for antibiotic use in long-term care (LTC). Due to the high prevalence of asymptomatic bacteriuria, for which antibiotics are not warranted, these antibiotics are frequently unnecessary. We implemented a collaborative quality improvement program to improve the management of suspected UTI in LTC residents by increasing awareness of current guidelines, with a focus on decreasing treatment in the absence of symptoms.

Randomized Trial of Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project.

Objective: Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas.

Study Setting: In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts.

Study Design: Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools.

Evaluating ambulatory practice safety: the PROMISES project administrators and practice staff surveys.

Background: Ambulatory practices deliver most health care services and contribute to malpractice risk. Yet, policymakers and practitioners often lack information about safety and malpractice risk needed to guide improvement.

Objective: To assess staff and administrator perceptions of safety and malpractice risk in ambulatory settings.