Pub Date : 2024-11-20DOI: 10.1016/j.jcjq.2024.11.008
Maria Esteli Garcia MD, MPH, MAS (is Assistant Professor, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, and Senior Scholar, Department of Epidemiology and Biostatistics, University of California, San Francisco (UCSF)), Lisa C. Diamond MD, MPH (is Hospitalist and Research Faculty Member, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York), Mia Williams MD, MS (Associate Professor, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, UCSF), Sunita Mutha MD (is Professor, Department of Medicine, and Director, Healthforce Center, UCSF), Jane Jih MD, MPH, MAS (is Associate Professor, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, UCSF, and Co-Director, Asian American Research Center on Health, San Francisco), Sarita Pathak MPH (is Research Coordinator and PhD Student, Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University), Leah S. Karliner MD, MAS (is Professor and Director, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, UCSF. Please address correspondence to Maria Esteli Garcia)
Background
Communication barriers are known to adversely affect patient safety. Yet few health systems assess and track physician non-English language proficiency for use in clinical settings. Barriers to current assessments (usually simulated clinician oral proficiency interviews) include time constraints and lack of interactivity. This study's objective was to investigate physician perspectives on using direct clinical observation as an alternative form of assessment of their non-English language skills.
Methods
The authors conducted semistructured interviews with 11 fully and partially bilingual primary care physicians (general internists) from a large academic health system to understand physician perspectives on using direct observation as an alternative form of assessing non-English proficiency for use in clinical practice. Two researchers independently and iteratively coded transcripts using thematic analysis with constant comparison to identify themes.
Results
Participants, mostly women (n = 9; 81.8%), reported varying levels of proficiency in Cantonese, Mandarin, Russian, or Spanish. Participants expressed three main themes: (1) benefits of direct observation, including familiar setting, relevant content, and convenience; (2) disadvantages, including discomfort, potential embarrassment, and limitations of observing a single encounter; and (3) suggestions to enhance use of direct observation tools, such as observing multiple encounters, and use of remote observation.
Conclusion
To ensure high-quality language-concordant care, health systems must assess physicians’ non-English language proficiency. If validated tools can be developed and disseminated in clinical practice, direct observation may be an acceptable option.
{"title":"Physicians’ Perspectives on Using Direct Observation to Assess Non-English Language Proficiency for Clinical Practice: A Qualitative Study","authors":"Maria Esteli Garcia MD, MPH, MAS (is Assistant Professor, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, and Senior Scholar, Department of Epidemiology and Biostatistics, University of California, San Francisco (UCSF)), Lisa C. Diamond MD, MPH (is Hospitalist and Research Faculty Member, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York), Mia Williams MD, MS (Associate Professor, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, UCSF), Sunita Mutha MD (is Professor, Department of Medicine, and Director, Healthforce Center, UCSF), Jane Jih MD, MPH, MAS (is Associate Professor, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, UCSF, and Co-Director, Asian American Research Center on Health, San Francisco), Sarita Pathak MPH (is Research Coordinator and PhD Student, Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University), Leah S. Karliner MD, MAS (is Professor and Director, Multiethnic Health Equity Research Center, Division of General Internal Medicine, Department of Medicine, UCSF. Please address correspondence to Maria Esteli Garcia)","doi":"10.1016/j.jcjq.2024.11.008","DOIUrl":"10.1016/j.jcjq.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Communication barriers are known to adversely affect patient safety. Yet few health systems assess and track physician non-English language proficiency for use in clinical settings. Barriers to current assessments (usually simulated clinician oral proficiency interviews) include time constraints and lack of interactivity. This study's objective was to investigate physician perspectives on using direct clinical observation as an alternative form of assessment of their non-English language skills.</div></div><div><h3>Methods</h3><div>The authors conducted semistructured interviews with 11 fully and partially bilingual primary care physicians (general internists) from a large academic health system to understand physician perspectives on using direct observation as an alternative form of assessing non-English proficiency for use in clinical practice. Two researchers independently and iteratively coded transcripts using thematic analysis with constant comparison to identify themes.</div></div><div><h3>Results</h3><div>Participants, mostly women (<em>n</em> = 9; 81.8%), reported varying levels of proficiency in Cantonese, Mandarin, Russian, or Spanish. Participants expressed three main themes: (1) benefits of direct observation, including familiar setting, relevant content, and convenience; (2) disadvantages, including discomfort<em>,</em> potential embarrassment, and limitations of observing a single encounter; and (3) suggestions to enhance use of direct observation tools, such as observing multiple encounters, and use of remote observation.</div></div><div><h3>Conclusion</h3><div>To ensure high-quality language-concordant care, health systems must assess physicians’ non-English language proficiency. If validated tools can be developed and disseminated in clinical practice, direct observation may be an acceptable option.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 211-215"},"PeriodicalIF":2.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18DOI: 10.1016/j.jcjq.2024.08.004
Peter Pronovost MD, PhD, FCCM (is Chief Quality and Transformation Officer, University Hospitals Cleveland Medical Center, Cleveland, Ohio), Hooman Azmi MD (is Director, Division of Functional and Restorative Neurosurgery and Trauma Liaison, Hackensack University Medical Center, Hackensack, New Jersey), Michael S. Okun MD (is Executive Director, Norman Fixel Institute for Neurological Diseases, and Adelaide Lackner Professor of Neurology, University of Florida Health, Gainesville, Florida), Benjamin Walter MD, MBA (is Section Head, Movement Disorders, and Medical Director, Deep Brain Stimulation Program, Cleveland Clinic, Cleveland, Ohio), Annie Brooks MSW (is Senior Director, Strategic Initiatives, Parkinson's Foundation, Miami, Florida), Sheera Rosenfeld MHS (is Vice President and Chief Strategic Initiatives Officer, Parkinson's Foundation, Miami, Florida. Please address correspondence to Sheera Rosenfeld)
{"title":"Protecting Parkinson's Patients: Hospital Care Standards to Avoid Preventable Harm","authors":"Peter Pronovost MD, PhD, FCCM (is Chief Quality and Transformation Officer, University Hospitals Cleveland Medical Center, Cleveland, Ohio), Hooman Azmi MD (is Director, Division of Functional and Restorative Neurosurgery and Trauma Liaison, Hackensack University Medical Center, Hackensack, New Jersey), Michael S. Okun MD (is Executive Director, Norman Fixel Institute for Neurological Diseases, and Adelaide Lackner Professor of Neurology, University of Florida Health, Gainesville, Florida), Benjamin Walter MD, MBA (is Section Head, Movement Disorders, and Medical Director, Deep Brain Stimulation Program, Cleveland Clinic, Cleveland, Ohio), Annie Brooks MSW (is Senior Director, Strategic Initiatives, Parkinson's Foundation, Miami, Florida), Sheera Rosenfeld MHS (is Vice President and Chief Strategic Initiatives Officer, Parkinson's Foundation, Miami, Florida. Please address correspondence to Sheera Rosenfeld)","doi":"10.1016/j.jcjq.2024.08.004","DOIUrl":"10.1016/j.jcjq.2024.08.004","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"50 12","pages":"Pages 890-892"},"PeriodicalIF":2.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Health care-associated infections are frequent complications for hospitalized patients, and the COVID-19 pandemic exacerbated this issue. This study aimed to explore stakeholders' viewpoints on how patients and families should engage in preventing health care-associated infections in hospital settings.
Methods: The authors employed Q-methodology, a mixed methods approach combining by-person factor analysis with in-depth interviews to capture shared viewpoints among participants. The research was conducted in a university-affiliated adult transplant unit using a purposive sample of staff members, patients, and family members. Participants ranked 40 preselected statements on a tablet using the Q-sorTouch Web application (for example, "Staff members should check that patients and family members wash their hands at key moments") on a continuum from "most agree" (+2) to "most disagree" (-2). Participants then took part in in-depth interviews to elaborate on their rankings. Data analysis included factor extraction and thematic interpretation.
Results: Nineteen participants completed the study. Analysis revealed three distinct viewpoints on patient and family engagement in infection prevention and control: (1) a controlling approach in which health care professionals ensure patient and family compliance, (2) an enabling approach that supports shared responsibility and emphasizes autonomy, and (3) a view of patients and family members as vigilant partners. Seven consensus statements emerged, indicating agreement on strategies in which patients and families are passive rather than proactive.
Conclusion: Although a paternalistic model emphasizing health care professional oversight prevailed, alternative perspectives emerged advocating for greater autonomy and responsibility among patients and families. These differing opinions indicate ongoing debate about how best to involve patients and their families in infection control, particularly during periods of heightened risk.
{"title":"Patient and Family Engagement in Infection Prevention During the COVID-19 Pandemic: A Q-Methodology Study with Stakeholders from a Canadian University Health Care Center.","authors":"Nathalie Clavel, Jesseca Paquette, Anaïck Briand, Alain Biron, Laurence Bernard, Céline Gélinas, Mélanie Lavoie-Tremblay","doi":"10.1016/j.jcjq.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.jcjq.2024.11.005","url":null,"abstract":"<p><strong>Background: </strong>Health care-associated infections are frequent complications for hospitalized patients, and the COVID-19 pandemic exacerbated this issue. This study aimed to explore stakeholders' viewpoints on how patients and families should engage in preventing health care-associated infections in hospital settings.</p><p><strong>Methods: </strong>The authors employed Q-methodology, a mixed methods approach combining by-person factor analysis with in-depth interviews to capture shared viewpoints among participants. The research was conducted in a university-affiliated adult transplant unit using a purposive sample of staff members, patients, and family members. Participants ranked 40 preselected statements on a tablet using the Q-sorTouch Web application (for example, \"Staff members should check that patients and family members wash their hands at key moments\") on a continuum from \"most agree\" (+2) to \"most disagree\" (-2). Participants then took part in in-depth interviews to elaborate on their rankings. Data analysis included factor extraction and thematic interpretation.</p><p><strong>Results: </strong>Nineteen participants completed the study. Analysis revealed three distinct viewpoints on patient and family engagement in infection prevention and control: (1) a controlling approach in which health care professionals ensure patient and family compliance, (2) an enabling approach that supports shared responsibility and emphasizes autonomy, and (3) a view of patients and family members as vigilant partners. Seven consensus statements emerged, indicating agreement on strategies in which patients and families are passive rather than proactive.</p><p><strong>Conclusion: </strong>Although a paternalistic model emphasizing health care professional oversight prevailed, alternative perspectives emerged advocating for greater autonomy and responsibility among patients and families. These differing opinions indicate ongoing debate about how best to involve patients and their families in infection control, particularly during periods of heightened risk.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-16DOI: 10.1016/j.jcjq.2024.11.006
Christopher Ayeni MD (Formerly Medical Student, Boston University Chobanian & Avedisian School of Medicine, is Resident, Morehouse School of Medicine), Westyn Branch-Elliman MD, MMSc (Clinician Scientist, Center for Health Optimization and Implementation Research (CHOIR), US Department of Veterans Affairs (VA) Boston Healthcare System, and Associate Professor of Medicine, Harvard Medical School), Marva Foster PhD, RN (Assistant Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine, and Investigator, CHOIR, VA Boston Healthcare System), Mikhail C.S.S. Higgins MD, MPH (Formerly Assistant Professor, Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, is Medical Director and Founder, Bahamas Fibroid & Interventional Clinic, Nassau, Bahamas), Kierstin Hederstedt (Formerly Junior Project Manager, CHOIR, VA Boston Healthcare System, is Neuroimmunology Project Manager, Boston Children's Hospital), Nina Bart (Formerly Research Assistant, CHOIR, VA Boston Healthcare System, is MPH/MBA Candidate, Johns Hopkins Bloomberg School of Public Health), Hillary J. Mull PhD, MPP (Associate Professor, Department of Surgery, Boston University Chobanian & Avedisian School of Medicine, and Research Investigator, CHOIR, VA Boston Healthcare System. Please address correspondence to Hillary J. Mull)
{"title":"Potentially Preventable Adverse Events in Ambulatory Interventional Radiology: Results from a National Multisite Retrospective Medical Record Review","authors":"Christopher Ayeni MD (Formerly Medical Student, Boston University Chobanian & Avedisian School of Medicine, is Resident, Morehouse School of Medicine), Westyn Branch-Elliman MD, MMSc (Clinician Scientist, Center for Health Optimization and Implementation Research (CHOIR), US Department of Veterans Affairs (VA) Boston Healthcare System, and Associate Professor of Medicine, Harvard Medical School), Marva Foster PhD, RN (Assistant Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine, and Investigator, CHOIR, VA Boston Healthcare System), Mikhail C.S.S. Higgins MD, MPH (Formerly Assistant Professor, Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, is Medical Director and Founder, Bahamas Fibroid & Interventional Clinic, Nassau, Bahamas), Kierstin Hederstedt (Formerly Junior Project Manager, CHOIR, VA Boston Healthcare System, is Neuroimmunology Project Manager, Boston Children's Hospital), Nina Bart (Formerly Research Assistant, CHOIR, VA Boston Healthcare System, is MPH/MBA Candidate, Johns Hopkins Bloomberg School of Public Health), Hillary J. Mull PhD, MPP (Associate Professor, Department of Surgery, Boston University Chobanian & Avedisian School of Medicine, and Research Investigator, CHOIR, VA Boston Healthcare System. Please address correspondence to Hillary J. Mull)","doi":"10.1016/j.jcjq.2024.11.006","DOIUrl":"10.1016/j.jcjq.2024.11.006","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 223-228"},"PeriodicalIF":2.3,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.jcjq.2024.11.007
{"title":"Sentinel Event Alert 69: Environmental Disasters: Preparing to Safely Evacuate or Shelter in Place","authors":"","doi":"10.1016/j.jcjq.2024.11.007","DOIUrl":"10.1016/j.jcjq.2024.11.007","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 232-236"},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-12DOI: 10.1016/j.jcjq.2024.11.004
Amy K. Rosen PhD (is VA Senior Research Career Scientist, VA Center for Healthcare Organization and Implementation Research (CHOIR), US Department of Veterans Affairs (VA) Boston Healthcare System, and Professor of Surgery, Boston University Chobanian & Avedisian School of Medicine.), Peter E. Rivard PhD (is Emeritus Associate Professor of Healthcare Administration, Suffolk University, Boston. Please address correspondence to Amy K. Rosen)
{"title":"Moving the Needle on Measurement of Patient Safety: The Evolving Role of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators","authors":"Amy K. Rosen PhD (is VA Senior Research Career Scientist, VA Center for Healthcare Organization and Implementation Research (CHOIR), US Department of Veterans Affairs (VA) Boston Healthcare System, and Professor of Surgery, Boston University Chobanian & Avedisian School of Medicine.), Peter E. Rivard PhD (is Emeritus Associate Professor of Healthcare Administration, Suffolk University, Boston. Please address correspondence to Amy K. Rosen)","doi":"10.1016/j.jcjq.2024.11.004","DOIUrl":"10.1016/j.jcjq.2024.11.004","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 229-231"},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08DOI: 10.1016/j.jcjq.2024.11.002
Roma A. Vasa MD (is Director, Psychiatric Services, Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, and Professor of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine.), Vamsi K. Kalari MD, MS (was Child and Adolescent Psychiatrist, Kennedy Krieger Institute, and Instructor, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Christopher A. Kitchen MS (is Senior Programmer Analyst, Johns Hopkins Bloomberg School of Public Health.), Hadi Kharrazi MD, PhD (is Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.), John V. Campo MD (is Vice President, Psychiatric Services, Kennedy Krieger Institute, and Professor and Director, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Holly C. Wilcox PhD, MS (is Professor, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health and Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine. Please address correspondence to Holly C. Wilcox)
Background
Youth with autism spectrum disorder (ASD) are over three times more likely to experience suicidal thoughts and behaviors (STB) than children in the general population. Screening to detect suicide risk is therefore critical for youth with ASD. This study examines the capacity of the Ask Suicide-Screening Questions (ASQ), a standard suicide screening tool, to detect suicide risk in children and adolescents with ASD who present to the pediatric emergency department (PED).
Methods
This is a retrospective chart review of 393 (2.1%) youth with ASD and 17,964 (97.9%) youth without ASD, aged 8 to 21 years, who presented to the PED of a large urban academic medical center between 2017 and 2020. During the study period, the ASQ was universally administered to children and adolescents who presented to the PED for any reason. Data extracted from the electronic health record included demographic information, presenting concerns, ASD diagnosis, and ASQ results.
Results
Autistic children and adolescents were more likely to present to the PED with STB at the first PED visit compared to non-autistic children (12.7% vs. 4.4%, p < 0.001). In both autistic and non-autistic groups, presenting concerns about STB were significantly associated with a positive ASQ screen. More autistic youth were found to have a positive ASQ without STB as their chief presenting complaint as compared to non-autistic youth (22.6% vs. 11.6%, p < 0.001). Youth with ASD endorsed each item of the ASQ at roughly twice the rate of those without ASD.
Conclusion
This preliminary descriptive study indicates that the ASQ may be a promising screening tool to assess suicide risk in autistic individuals. Further research on the predictive validity and overall reliability of the ASQ in youth with ASD is recommended.
{"title":"Suicide Risk Screening in Children and Adolescents with Autism Spectrum Disorder Presenting to the Emergency Department","authors":"Roma A. Vasa MD (is Director, Psychiatric Services, Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, and Professor of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine.), Vamsi K. Kalari MD, MS (was Child and Adolescent Psychiatrist, Kennedy Krieger Institute, and Instructor, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Christopher A. Kitchen MS (is Senior Programmer Analyst, Johns Hopkins Bloomberg School of Public Health.), Hadi Kharrazi MD, PhD (is Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.), John V. Campo MD (is Vice President, Psychiatric Services, Kennedy Krieger Institute, and Professor and Director, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine.), Holly C. Wilcox PhD, MS (is Professor, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health and Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine. Please address correspondence to Holly C. Wilcox)","doi":"10.1016/j.jcjq.2024.11.002","DOIUrl":"10.1016/j.jcjq.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Youth with autism spectrum disorder (ASD) are over three times more likely to experience suicidal thoughts and behaviors (STB) than children in the general population. Screening to detect suicide risk is therefore critical for youth with ASD. This study examines the capacity of the Ask Suicide-Screening Questions (ASQ), a standard suicide screening tool, to detect suicide risk in children and adolescents with ASD who present to the pediatric emergency department (PED).</div></div><div><h3>Methods</h3><div>This is a retrospective chart review of 393 (2.1%) youth with ASD and 17,964 (97.9%) youth without ASD, aged 8 to 21 years, who presented to the PED of a large urban academic medical center between 2017 and 2020. During the study period, the ASQ was universally administered to children and adolescents who presented to the PED for any reason. Data extracted from the electronic health record included demographic information, presenting concerns, ASD diagnosis, and ASQ results.</div></div><div><h3>Results</h3><div>Autistic children and adolescents were more likely to present to the PED with STB at the first PED visit compared to non-autistic children (12.7% vs. 4.4%, <em>p</em> < 0.001). In both autistic and non-autistic groups, presenting concerns about STB were significantly associated with a positive ASQ screen. More autistic youth were found to have a positive ASQ without STB as their chief presenting complaint as compared to non-autistic youth (22.6% vs. 11.6%, <em>p</em> < 0.001). Youth with ASD endorsed each item of the ASQ at roughly twice the rate of those without ASD.</div></div><div><h3>Conclusion</h3><div>This preliminary descriptive study indicates that the ASQ may be a promising screening tool to assess suicide risk in autistic individuals. Further research on the predictive validity and overall reliability of the ASQ in youth with ASD is recommended.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 192-198"},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08DOI: 10.1016/j.jcjq.2024.10.011
Melissa H. Chouinard MD (is Medical Director, Medication Safety, Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, Virginia.), Natalie L. Nguyen PharmD, MSHA (MSHA, is Medication Safety Manager, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Joshua A. Young CPhT (is Lead Pharmacy Buyer, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Benjamin M. Hester PharmD, MBA (is Compounding Manager, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Denise M. Reilly PharmD (is Pharmacy Informatics Manager, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Michael C. Kontos MD (is Medical Director, Coronary Intensive Care Unit, Department of Internal Medicine, Virginia Commonwealth University Health System.), William D. Cahoon Jr. PharmD (is Clinical Pharmacist, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Cassandra R. Baker PharmD (is Clinical Pharmacist, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Kylie M. Weigel PharmD (is Clinical Pharmacist, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Gonzalo M. Bearman MD, MPH (is Associate Chief Quality and Safety Officer, Department of Internal Medicine, Virginia Commonwealth University Health System. Please address correspondence to Melissa H. Chouinard)
In a landscape of increasingly frequent and severe drug shortages, this article describes an interdisciplinary strategy for managing a nationwide shortage of dobutamine in an academic health system. The authors outline an approach that centers on leveraging information technology resources, minimizing waste, conserving supply, and centralizing supply. These efforts, which enabled the organization to consistently supply dobutamine to those patients who needed it most, could form a model for health systems to follow during future drug shortages.
{"title":"Reflections on a Dobutamine Shortage in an Academic Health System: A Roadmap for Risk Reduction","authors":"Melissa H. Chouinard MD (is Medical Director, Medication Safety, Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, Virginia.), Natalie L. Nguyen PharmD, MSHA (MSHA, is Medication Safety Manager, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Joshua A. Young CPhT (is Lead Pharmacy Buyer, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Benjamin M. Hester PharmD, MBA (is Compounding Manager, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Denise M. Reilly PharmD (is Pharmacy Informatics Manager, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Michael C. Kontos MD (is Medical Director, Coronary Intensive Care Unit, Department of Internal Medicine, Virginia Commonwealth University Health System.), William D. Cahoon Jr. PharmD (is Clinical Pharmacist, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Cassandra R. Baker PharmD (is Clinical Pharmacist, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Kylie M. Weigel PharmD (is Clinical Pharmacist, Department of Pharmacy Services, Virginia Commonwealth University Health System.), Gonzalo M. Bearman MD, MPH (is Associate Chief Quality and Safety Officer, Department of Internal Medicine, Virginia Commonwealth University Health System. Please address correspondence to Melissa H. Chouinard)","doi":"10.1016/j.jcjq.2024.10.011","DOIUrl":"10.1016/j.jcjq.2024.10.011","url":null,"abstract":"<div><div>In a landscape of increasingly frequent and severe drug shortages, this article describes an interdisciplinary strategy for managing a nationwide shortage of dobutamine in an academic health system. The authors outline an approach that centers on leveraging information technology resources, minimizing waste, conserving supply, and centralizing supply. These efforts, which enabled the organization to consistently supply dobutamine to those patients who needed it most, could form a model for health systems to follow during future drug shortages.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"51 3","pages":"Pages 216-222"},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1016/j.jcjq.2024.10.007
Gerald B. Hickson MD (is Joseph C. Ross Chair in Medical Education and Administration and| Professor of Pediatrics, Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville. Please address correspondence to Gerald B. Hickson)
{"title":"Supporting Professionalism in a Crisis Requires Leadership and a Well-Developed Plan","authors":"Gerald B. Hickson MD (is Joseph C. Ross Chair in Medical Education and Administration and| Professor of Pediatrics, Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville. Please address correspondence to Gerald B. Hickson)","doi":"10.1016/j.jcjq.2024.10.007","DOIUrl":"10.1016/j.jcjq.2024.10.007","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"50 12","pages":"Pages 823-826"},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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