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Background: Chronic obstructive pulmonary disease (COPD) are managed predominantly in primary care. However, key opportunities to optimize treatment are often not realized due to unrecognized disease and delayed implementation of appropriate interventions for both diagnosed and undiagnosed individuals. The COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST) is the first-of-its-kind, collaborative, interventional COPD registry. It comprises an integrated quality improvement program focusing on patients (diagnosed and undiagnosed) at a modifiable and higher risk of COPD exacerbations. The first step in CONQUEST was the development of quality standards (QS). The QS will be imbedded in routine primary and secondary care, and are designed to drive patient-centered, targeted, risk-based assessment and management optimization. Our aim is to provide an overview of the CONQUEST QS, including how they were developed, as well as the rationale for, and evidence to support, their inclusion in healthcare systems.
Methods: The QS were developed (between November 2019 and December 2020) by the CONQUEST Global Steering Committee, including 11 internationally recognized experts with a specialty and research focus in COPD. The process included an extensive literature review, generation of QS draft wording, three iterative rounds of review, and consensus.
Results: Four QS were developed: 1) identification of COPD target population, 2) assessment of disease and quantification of future risk, 3) non-pharmacological and pharmacological intervention, and 4) appropriate follow-up. Each QS is followed by a rationale statement and a summary of current guidelines and research evidence relating to the standard and its components.
Conclusion: The CONQUEST QS represent an important step in our aim to improve care for patients with COPD in primary and secondary care. They will help to transform the patient journey, by encouraging early intervention to identify, assess, optimally manage and followup COPD patients with modifiable high risk of future exacerbations.
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http://dx.doi.org/10.2147/COPD.S313498 | DOI Listing |
Am J Emerg Med
September 2025
Department of Surgical Education, Orlando Regional Medical Center, Orlando, FL, USA; Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, FL, USA. Electronic address:
Background: There is conflicting literature regarding mortality outcomes associated with REBOA usage in patients with severe thoracic or abdominal trauma. Our study aims to assess the benefits and negative implications of REBOA use in adult trauma patients in hemorrhagic shock with severe thoracic or abdominal injuries.
Methods: This retrospective cohort analysis utilized the American College of Surgeons Trauma Quality Improvement Program Participant Use File (ACS-TQIP-PUF) database from 2017 to 2023 to evaluate adult patients with severe isolated thoracic or abdominal trauma undergoing REBOA placement.
Am J Emerg Med
September 2025
University of Toronto, Rotman School of Management, Canada.
Study Objective: Accurately predicting which Emergency Department (ED) patients are at high risk of leaving without being seen (LWBS) could enable targeted interventions aimed at reducing LWBS rates. Machine Learning (ML) models that dynamically update these risk predictions as patients experience more time waiting were developed and validated, in order to improve the prediction accuracy and correctly identify more patients who LWBS.
Methods: The study was deemed quality improvement by the institutional review board, and collected all patient visits to the ED of a large academic medical campus over 24 months.
Turk J Pediatr
September 2025
Department of Child and Adolescent Psychiatry, Ankara Bilkent City Hospital, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Türkiye.
Background: Intractable paroxysmal sneezing is a rare and diagnostically challenging condition in children, often mimicking organic diseases. While it is often addressed as psychogenic in the literature, our case presented findings suggestive of a tic disorder, highlighting the need for a broader diagnostic perspective.
Case Presentation: An 11-year-old girl was referred to the child and adolescent psychiatry clinic with a one-year history of persistent and fluctuating sneezing episodes.
Am J Clin Hypn
September 2025
Higher Institute of Nursing and Health Technology, Rabat, Morocco.
Gestational trophoblastic tumors (GTTs) encompass a spectrum of neoplastic conditions, including invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. Invasive mole, which frequently develops following a complete hydatidiform mole, represents the most common form. A cancer diagnosis constitutes a profoundly destabilizing experience, often resulting in considerable psychological distress.
View Article and Find Full Text PDFJ Nurses Prof Dev
September 2025
Brooke L. Ferris, MSN, RN, TCRN, NPD-BC, Brooke L. Ferris, Improvement Practitioner, The Guthrie Clinic.
Operational improvement serves to attain organizational goals through standardization and responsible resource management. The nursing professional development (NPD) practitioner is well suited for this work due to their clinical knowledge, ability to educate others, and skills in collaboration. By assisting individual departments or the organization on a wider scale, the NPD practitioner serves to increase cost savings, maximize resource utilization, and decrease variances in patient care.
View Article and Find Full Text PDF