scholarly journals The impact of language and ethnicity on preparation for endoscopy: A prospective audit of an East London Hospital Ward

2020 ◽  
Author(s):  
Ryan Essex ◽  
Mihaela Cucos ◽  
Lesley Dibley
Keyword(s):  
Hospital Ward ◽  
Prospective Audit ◽  
London Hospital ◽  
Language And Ethnicity ◽  
The Impact

Assessing the impact of antibiotic stewardship program elements on antibiotic use across acute-care hospitals: an observational study

2018 ◽  
Vol 39 (8) ◽  
pp. 941-946 ◽  
Author(s):  
Bradley J. Langford ◽  
Julie Hui-Chih Wu ◽  
Kevin A. Brown ◽  
Xuesong Wang ◽  
Valerie Leung ◽  
...  
Keyword(s):  
Observational Study ◽  
Acute Care ◽  
Antimicrobial Stewardship ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Audit And Feedback ◽  
Prospective Audit ◽  
Defined Daily Doses ◽  
Prospective Audit And Feedback ◽  
The Impact

AbstractObjectivesAntibiotic use varies widely between hospitals, but the influence of antimicrobial stewardship programs (ASPs) on this variability is not known. We aimed to determine the key structural and strategic aspects of ASPs associated with differences in risk-adjusted antibiotic utilization across facilities.DesignObservational study of acute-care hospitals in Ontario, CanadaMethodsA survey was sent to hospitals asking about both structural (8 elements) and strategic (32 elements) components of their ASP. Antibiotic use from hospital purchasing data was acquired for January 1 to December 31, 2014. Crude and adjusted defined daily doses per 1,000 patient days, accounting for hospital and aggregate patient characteristics, were calculated across facilities. Rate ratios (RR) of defined daily doses per 1,000 patient days were compared for hospitals with and without each antimicrobial stewardship element of interest.ResultsOf 127 eligible hospitals, 73 (57%) participated in the study. There was a 7-fold range in antibiotic use across these facilities (min, 253 defined daily doses per 1,000 patient days; max, 1,872 defined daily doses per 1,000 patient days). The presence of designated funding or resources for the ASP (RRadjusted, 0·87; 95% CI, 0·75–0·99), prospective audit and feedback (RRadjusted, 0·80; 95% CI, 0·67–0·96), and intravenous-to-oral conversion policies (RRadjusted, 0·79; 95% CI, 0·64–0·99) were associated with lower risk-adjusted antibiotic use.ConclusionsWide variability in antibiotic use across hospitals may be partially explained by both structural and strategic ASP elements. The presence of funding and resources, prospective audit and feedback, and intravenous-to-oral conversion should be considered priority elements of a robust ASP.

Accommodating ethnic minority consumers during service encounters: the fine line

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sarah Mady ◽  
John B. Ford ◽  
Tarek Mady
Keyword(s):  
Service Quality ◽  
Ethnic Minority ◽  
Service Providers ◽  
Service Encounter ◽  
Service Encounters ◽  
Service Firms ◽  
Content Type ◽  
Quality Perceptions ◽  
Language And Ethnicity ◽  
The Impact

Purpose This paper aims to examine the effect of intercultural accommodation efforts on service quality perceptions among ethnic minority consumers. Specifically, the paper postulates that during an intercultural service encounter, the impact of the service provider’s language and ethnicity on the consumer’s service quality perceptions is moderated by the level of service involvement, consumer acculturation and perceived discrimination, which, in turn, influence purchase intent. Design/methodology/approach A 2 × 2 between-subjects experimental design with an online nationwide consumer panel of Hispanic consumers was conducted where 377 participants were randomly assigned to a series of service encounter scenarios in the banking service context to manipulate accommodation efforts (yes vs no) and the level of involvement with the service (high vs low). Findings When such language and ethnicity accommodations were offered, highly acculturated minority consumers regarded the service encounter less favorably than low acculturated minority consumers. Moreover, during low-involvement service encounters, intercultural accommodations positively impacted consumer’s service quality perceptions compared to situations involving high-involvement services. Also, minority consumers with perceptions of past discrimination had less favorable evaluations of the service quality than when such perceptions were nonexistent when intercultural accommodation efforts were made by the service provider. Research limitations/implications The findings add to the sparse literature that examines the effectiveness of intercultural accommodation and focuses on the combined use of service provider’s language and ethnicity as a means to enhance service quality. Practical implications The study delivers cautions for service firms not to generalize the receptivity of intercultural accommodation efforts. Given the increasingly sizable segments of minority customers, this study offers insights for service providers to develop suitable recruitment strategies and training programs when devising effective ethnic targeting strategies. Originality/value This research is among the first to explain why the effect of target marketing is not homogenous by expanding the research on intercultural accommodations toward a new context considering service involvement levels among varied minority consumer groups.

scholarly journals Every antibiotic, every day: Maximizing the impact of prospective audit and feedback on total antibiotic use

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0178434 ◽  
Author(s):  
Tonya J. Campbell ◽  
Melissa Decloe ◽  
Suzanne Gill ◽  
Grace Ho ◽  
Janine McCready ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Audit And Feedback ◽  
Prospective Audit ◽  
Prospective Audit And Feedback ◽  
The Impact

scholarly journals 222. The Impact of Education and Prospective Audit and Feedback on Reducing Ciprofloxacin Utilization at a Small Community Academic Hospital

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S96-S96
Author(s):  
Alyssa M Thompson ◽  
Jason G Newland ◽  
Helen Newland ◽  
Jennifer Feldmann ◽  
Stephen Y Liang
Keyword(s):  
Audit And Feedback ◽  
Small Community ◽  
Prospective Audit ◽  
Academic Hospital ◽  
Prospective Audit And Feedback ◽  
The Impact

Vancomycin Use: Room for Improvement Among Hospitalized Children

2016 ◽  
Vol 30 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Jessica Gillon ◽  
Meng Xu ◽  
James Slaughter ◽  
M. Cecilia Di Pentima
Keyword(s):  
Real Time ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Hospitalized Children ◽  
Interrupted Time Series Analysis ◽  
Prospective Audit ◽  
Children's Hospitals ◽  
Children’S Hospitals ◽  
Before And After ◽  
The Impact

Introduction: The use of vancomycin is common among hospitalized children. We sought to evaluate the impact of prospective audit with real-time feedback on vancomycin use and pharmacy costs. Methods: Vancomycin use was evaluated at Monroe Carell Jr Children’s Hospital at Vanderbilt (MCJCHV) before and after the implementation of prospective audit with intervention and feedback to providers in 2012. Antibiotic use was compared to academic children’s hospitals with established antimicrobial stewardship programs (ASPs). Two similar pediatric academic institutions without an ASP were used as nonintervention controls. Analysis of monthly days of antibiotic therapy (DoT) per 1000 patient-days was performed by interrupted time series analysis. Results: Monthly vancomycin use decreased from 114 DoTs/1000 patient-days to 89 DoTs/1000 patient-days ( P < .0001). We did not find significant differences in the slope of change in vancomycin use between MCJCHV and institutions with ASPs either before or after the intervention ( P = .86 and P = .71, respectively). When compared to children’s hospitals without ASPs, the use of vancomycin was significantly lower at MCJCHV ( P < .001). Conclusion: The use of vancomycin at academic children’s hospitals with an ASP is declining. In our experience, prospective audit with real-time intervention and feedback to providers significantly reduced the use and costs associated with vancomycin.

scholarly journals Influenza vaccination: a cross-sectional prospective audit of influenza vaccination in patients admitted to a London hospital

2009 ◽  
Vol 9 (5) ◽  
pp. 506-507 ◽  
Author(s):  
Katherine Styles ◽  
Anshul Rastogi ◽  
Sufyan Hussain ◽  
Sonya Abraham
Keyword(s):  
Influenza Vaccination ◽  
Prospective Audit ◽  
Cross Sectional ◽  
London Hospital

scholarly journals Use of portable air cleaners to reduce aerosol transmission on a hospital COVID-19 ward

2021 ◽  
Author(s):  
Kirsty Lee Buising ◽  
Robyn Schofield ◽  
Louis Irving ◽  
Melita Keywood ◽  
Ashley Stevens ◽  
...  
Keyword(s):  
Observational Study ◽  
Public Hospital ◽  
Respiratory Viruses ◽  
Hospital Ward ◽  
Single Patient ◽  
Patient Room ◽  
Air Cleaners ◽  
The Impact ◽  
Study Setting ◽  
Over Time

Objective To study the airflow, transmission and clearance of aerosols in the clinical spaces of a hospital ward that had been used to care for patients with COVID-19, and to examine the impact of portable air cleaners on aerosol clearance. Design Observational study Setting A single ward of a tertiary public hospital in Melbourne Australia Intervention Glycerine-based aerosol was used as a surrogate for respiratory aerosols. The transmission of aerosols from a single patient room into corridors and a nurses station in the ward was measured. The rate of clearance of aerosols was measured over time from the patient room, nurses station and ward corridors with and without air cleaners (also called portable HEPA filters). Results Aerosols rapidly travelled from the single patient room into other parts of the ward. Air cleaners were effective in increasing the clearance of aerosols from the air in clinical spaces and reducing their spread to other areas. Conclusion Air cleaners may be useful in clinical spaces to help reduce the risk of healthcare acquired acquisition of respiratory viruses that are transmitted via aerosols.

scholarly journals 1071. Implementation and Impact of an Antimicrobial Tier Structure Along with Prospective Audit and Feedback at a Large Health System: Collaborations for Care Transformation

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S379-S380
Author(s):  
Sarah Brooks Minor ◽  
Kelly D Rafferty ◽  
Julia Rutkowski ◽  
Steven Allison ◽  
Victor Herrera
Keyword(s):  
Cost Savings ◽  
Audit And Feedback ◽  
Prospective Audit ◽  
Antibiotic Overuse ◽  
Antimicrobial Utilization ◽  
Days Of Therapy ◽  
Tier System ◽  
Implementation Period ◽  
Hospital Acquired ◽  
The Impact

Abstract Background Antibiotic overuse continues to be a challenge in the acute care setting. At AdventHealth Orlando (AHO), pharmacy-led prospective audit with feedback (PAAF) has been the primary stewardship tool. Despite PAAF and criteria for use, overall utilization of high-cost, broad-spectrum agents continues to increase. Recently, the Antimicrobial Stewardship Awareness Program (ASAP) employed transformation medical directors (TMDs) and, along with the pharmacy team, developed a novel concept using an antimicrobial tier structure, in addition to historical PAAF. The purpose was to assess the impact of the tier structure, along with PAAF performed by the pharmacists and TMDs, compared with PAAF alone. Methods This retrospective pre (March–August 2018)- and post (October 2018–March 2019) implementation study was conducted at AHO. The ASAP team developed a hospital-wide policy listing antimicrobials based on a tier system (Figure 1), with higher priority agents falling in tiers 3 (T3) and 4 (T4). Education was completed in September 2018 and the process was implemented in October 2018. Criteria for use was evaluated at the point of order entry, followed by PAAF by the pharmacist and TMD. The primary outcome was impact on T3 and T4 antimicrobial utilization, measured in days of therapy (DOT) per 1,000 days present (DP). Secondary outcomes included T3 and T4 antimicrobial cost/adjusted patient-days and rates of hospital-acquired C. difficile infections (CDI). Results During the post-implementation period, the average DOT per 1,000 DP for T3 and T4 agents decreased by 21.3% (89 vs. 70, P = 0.001) compared with the pre-implementation period (Figure 2). Average T3 and T4 antimicrobial costs decreased by 26% during the post-implementation period ($9.83 vs. $7.27, P < 0.001). Additionally, rates of hospital-acquired CDI decreased by 14% (P = 0.41) during the post-implementation period. Conclusion The tier concept, along with PAAF collaborations between the pharmacists and TMD, allowed for a greater impact on antimicrobial utilization, compared with pharmacist-led PAAF alone. In addition to significant decrease in antimicrobial utilization, substantial cost-savings were demonstrated. A nonsignificant declining trend in the incidence of hospital-acquired CDI was also noted during the post-implementation period. Disclosures All authors: No reported disclosures.

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