BACKGROUND Pediatric subspecialists can participate in the care of obese children. OBJECTIVE To describe steps to help subspecialty providers initiate quality improvement efforts in obesity care. METHODS An anonymous patient data download, provider surveys and interviews assessed subspecialty providers' identification and perspectives of childhood obesity and gathered information on perceiv...

To achieve the diverse health care goals of the United States, health care value must increase. The capacity to create value through innovation is facilitated by an integrated delivery system focused on creating value, measuring innovation returns, and receiving market rewards. This paper describes the Geisinger Health System's innovation strategy for care model redesign. Geisinger's clinical l...

BACKGROUND Pain is common in older people, particularly those in residential aged care facilities (RACF) and those with dementia. However, despite 20 years of discourse on pain and dementia, pain is still undetected or misinterpreted in people with dementia in residential aged care facilities, particularly those with communication difficulties. METHODS A topical survey typology with semistruc...

1 Abstract Operational protocols are a valuable means for quality control. However, developing operational protocols is a highly complex and costly task. We present an integrated approach involving both intelligent data analysis and knowledge acquisition from experts that supports the development of operational protocols. The aim is to ensure high quality standards for the protocol through empi...

AIMS Good end-of-life communication and decision-making are important to patients with advanced heart failure (HF) and their families, but their needs remain unmet. In this pilot study, we describe the feasibility and performance of a novel questionnaire aimed at identifying barriers and solutions to improve communication and decision-making about goals of care for hospitalized patients with ad...

IMPORTANCE Seriously ill hospitalized patients have identified communication and decision making about goals of care as high priorities for quality improvement in end-of-life care. Interventions to improve care are more likely to succeed if tailored to existing barriers. OBJECTIVE To determine, from the perspective of hospital-based clinicians, (1) barriers impeding communication and decision...

Restructured health care reimbursement systems and new requirements for nonprofit hospitals are transforming the U.S. health system, creating opportunities for enhanced integration of public health and health care goals. This article explores the role of public health practitioners and lawyers in this moment of transformation. We argue that the population perspective and structural strategies t...

BACKGROUND Isolation-based practices in nursing homes (NHs) differ from those in acute care. NHs must promote quality of life while preventing infection transmission. Practices used in NHs to reconcile these goals of care have not been characterised. PURPOSE To explore decision-making in isolation-based infection prevention and control practices in NHs. METHODS A qualitative study was condu...