Objectives: The quality of integrated diabetes care is important for reducing the burden of diabetes. Therefore, we have evaluated the effect of a supervision program on the quality of integrated diabetes care in the Netherlands in the 2011-2012 period.
Methods: In this cluster RCT, the supervision program was assigned to randomly selected care groups providing care to diabetes patients. The supervision program included announcements of inspections, site visits, and sending individualized reports. Indicators of effectiveness were derived from the structures, processes, and outcomes of care. These indicators were collected from patients' files, before and after the supervision program. Hierarchical linear and logistic regression models were used to analyze data from 356 patients of 10 intervention and 8 control care groups.
Results: Structures and processes of care did not improve more in the intervention groups than in the control care groups. Moreover, health outcomes did not improve more in the intervention groups than in the control care groups. Although structures of care improved over time in the total population of intervention and control care groups, there were no changes in process of care or health outcomes.
Conclusions: In this cluster RCT, we could not demonstrate improvements in quality of integrated diabetes care resulting from the supervision program. Although structures of care did improve over time, other quality-improvement initiatives are necessary to substantially strengthen integrated care for diabetes patients.
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http://dx.doi.org/10.1097/MLR.0000000000000399 | DOI Listing |
J Am Acad Orthop Surg
January 2025
From the Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Boyer, Burns, Razmjou, Renteria, Sheth, Richards, and Whyne), the Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada (Burns, Sheth, Richards, and Whyne), the Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada (Boyer, Burns, and Whyne), the Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada (Razmjou), and the Sunnybrook Orthopaedic Upper Limb (SOUL), Sunnybrook Health Science Centre, Toronto, Ontario, Canada (Sheth, Richards, and Whyne).
Introduction: Exercise-based physiotherapy is an established treatment of rotator cuff injury. Objective assessment of at-home exercise is critical to understand its relationship with clinical outcomes. This study uses the Smart Physiotherapy Activity Recognition System to measure at-home physiotherapy participation in patients with rotator cuff injury based on inertial sensor data captured from smart watches.
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January 2025
Department of Clinical Microbiology, Children's Health Ireland at Temple Street Children's University Hospital, Dublin 1, Ireland.
Background: Lab users should display an understanding of microbiology tests and avoid inappropriate requests which may yield negative clinical consequences. Our research addressed diagnostic stewardship education and the perspectives of paediatric hospital doctors on their (1) self-perceived knowledge, (2) motivators for test ordering, (3) proposed educational interventions and (4) preferred teaching modalities.
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Health Expect
February 2025
School of Health Sciences, University of Surrey, Guildford, UK.
Introduction: A multi-stakeholder conference was held in 2023, celebrating the achievements of the Burdett National Transition Nursing Network (BNTNN). The BNTNN had been implemented across England in 2020 to map the current state of young people's healthcare transition into adult services across England, and work with key stakeholders to coach them through making sustainable quality improvements to young people's transition services. This work was funded by the Burdett Trust for Nursing, following the success of an exemplar Model for Quality Improvement (QI) for Transition, which had been developed at a Teaching Hospital in England.
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June 2024
Centre for Rehab Innovations, University of Newcastle, Callaghan, New South Wales, Australia.
Introduction: Globally, there is an increasing demand for quality medical rehabilitation services. This is the first article of a two-part series showing the findings from the Rehabilitation Choices study in which the main aim was to understand the current landscape of decision-making, enablers and barriers to access appropriate rehabilitation services in the Australian setting. In Part 1, these insights were sought from a healthcare professionals' perspective.
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January 2025
Department of Pharmacology-Physiology-Toxicology, Institute of Pharmaceutical and Biological Sciences of Lyon, University Claude Bernard Lyon 1, France.
Non-small cell lung cancer (NSCLC) affects 10-50% of patients with epidermal growth factor receptor (EGFR) mutations. Osimertinib is a third-generation EGFR tyrosine kinase inhibitor (TKI) that radically changes the outcome of patients with tumors bearing EGFR sensitizing or EGFR T790M resistance mutations. However, resistance usually occurs, and new therapeutic combinations need to be explored.
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