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  Subjects -> HEALTH AND SAFETY (Total: 1277 journals)
    - CIVIL DEFENSE (18 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (506 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (381 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (106 journals)
    - PHYSICAL FITNESS AND HYGIENE (100 journals)
    - WOMEN'S HEALTH (80 journals)

HEALTH AND SAFETY (506 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 19)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 4)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 2)
AJOB Primary Research     Partially Free   (Followers: 2)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 12)
American Journal of Health Education     Hybrid Journal   (Followers: 24)
American Journal of Health Promotion     Hybrid Journal   (Followers: 24)
American Journal of Health Studies     Full-text available via subscription   (Followers: 8)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 170)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 7)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 2)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 1)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 5)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 2)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access  
Behavioral Healthcare     Full-text available via subscription   (Followers: 4)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 9)
BMC Oral Health     Open Access   (Followers: 4)
BMC Pregnancy and Childbirth     Open Access   (Followers: 19)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 15)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 10)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 11)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 9)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 2)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 4)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription  
Ethiopian Journal of Health Development     Open Access   (Followers: 9)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 1)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 8)
Evidence-based Medicine & Public Health     Open Access   (Followers: 4)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 9)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 12)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 4)
Global Health Promotion     Hybrid Journal   (Followers: 14)
Global Journal of Health Science     Open Access   (Followers: 3)
Global Journal of Public Health     Open Access   (Followers: 9)
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 7)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 14)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 9)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 46)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 11)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 9)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 34)
Health Policy and Technology     Hybrid Journal  
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 19)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 9)
Health Promotion Practice     Hybrid Journal   (Followers: 14)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 46)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 9)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Sciences and Disease     Open Access   (Followers: 1)
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 10)
Health, Risk & Society     Hybrid Journal   (Followers: 9)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
Heart Insight     Full-text available via subscription  
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 9)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 2)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 2)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 4)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 4)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 20)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 13)
International Journal of Health & Allied Sciences     Open Access   (Followers: 1)
International Journal of Health and Rehabilitation Sciences     Open Access   (Followers: 13)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 6)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services     Full-text available via subscription   (Followers: 9)
International Journal of Health Studies     Open Access   (Followers: 3)
International Journal of Health System and Disaster Management     Open Access   (Followers: 2)
International Journal of Healthcare Delivery Reform Initiatives     Full-text available via subscription   (Followers: 1)
International Journal of Healthcare Information Systems and Informatics     Hybrid Journal   (Followers: 10)
International Journal of Healthcare Management     Hybrid Journal   (Followers: 16)

        1 2 3 | Last

Journal Cover International Journal of Health Care Quality Assurance
  [SJR: 0.352]   [H-I: 32]   [6 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0952-6862
   Published by Emerald Homepage  [335 journals]
  • Failure mode and effect analysis: improving intensive care unit risk
           management processes
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. This study aimed to apply FMEA technique to examine the hazards associated with the process of service delivery in Intensive Care Unit of a tertiary hospital in Yazd, Iran. Design/methodology/approach This was a before-after study conducted between March 2013 to December 2014. By forming a FMEA team, all potential hazards associated with ICU services - their frequency and severity - were identified. Then risk priority number (RPN) was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation. Findings Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures. Practical implications Application of FMEA in Intensive Care Units proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function. Originality/value Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:39Z
      DOI: 10.1108/IJHCQA-04-2016-0053
       
  • Healthcare seeking behaviour among Chinese elderly
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose The Chinese population is rapidly ageing before they are rich. This study aimed to describe healthcare seeking behaviour and the critical factors associated with healthcare seeking behaviour. Design/methodology/approach Using a purposive sampling method, we recruited 44 adults age 60 years or older from three provinces, representing the developed (Shanghai), undeveloped (Ningxia) regions and the regions between (Hubei). From July to September 2008, using a semi-structured guide, we interviewed participants in focus group discussions. Findings The healthcare needs for chronic and catastrophic diseases were high; however, the healthcare demands were low and healthcare utilizations were even lower owing to the limited accessibility to healthcare services, particularly, in underdeveloped rural areas. “Too expensive to see a doctor” was a prime complaint, explaining substantial discrepancies between healthcare needs, demands and use. Care seeking behaviour varied, depending on insurance availability, perceived performance - particularly hospital services and prescription medications. Participants consistently rated increasing the healthcare accessibility as a high priority, including offering financial aid, and improving service convenience. Improving social security fairness was as the first on the elderly’s wish list. Originality/value Healthcare demand and use were lower than needs, and influenced by multiple factors, primarily, service affordability and efficiency, perceived performance and hospital service quality.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:36Z
      DOI: 10.1108/IJHCQA-10-2015-0132
       
  • Hospital staff to death ratios – a sound performance measure?
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.

      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:34Z
      DOI: 10.1108/IJHCQA-01-2017-0011
       
  • Potential facilitators and barriers to adopting standard treatment
           guidelines in clinical practice: an Indian context
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose To assess medicines information sources accessed by clinicians if sources differed in theory and practice and to find out barriers and facilitators to effective guideline adoption. Design/methodology/approach One hundred and eighty-three doctors were surveyed.Barriers and facilitators were classified as: communication; potential adopters: innovation; organization characteristics and environmental/social/economic context Findings Most accessed multiple information sources including standard treatment guidelines (STGs), but consulted seniors/colleagues in practice. Top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in following areas: concerns about flexibility offered by the guideline; denying patients’ individuality; professional autonomy; insights into gaps in current practice and evidence based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance company) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors’ control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality/value This survey among clinicians, despite limitations, gives helpful insights. While favorable attitudes may be helpful, clinical adoption could be improved more effectively by targeting barriers.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:32Z
      DOI: 10.1108/IJHCQA-10-2016-0148
       
  • Patient non-adherence: an interpretative phenomenological analysis
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose While Interpretative Phenomenological Analysis (IPA) has been employed in health psychology research, it has so far not been applied to seek deeper insights into the patients’ experiences about treatment. This paper addresses this gap by employing Interpretative Phenomenological Analysis to understand patient non-adherence. Design/methodology/approach Eighteen patients with chronic conditions seeking health care services in Goa and Karnataka, India, were selected by employing snowball sampling method. In-depth interviews were conducted face to face. Semi-structured questionnaire developed by the researchers was used to collect the data. Interpretative Phenomenological Analysis was employed to explore the themes to predict patient non-adherence. Findings The study results indicate that economic factors, health system related factors, social factors and psychological factors impact patient non-adherence. Patient non-adherence includes medication non-adherence and lifestyle modification non-adherence. Research limitations/implications Being cross sectional in design, the results may not be as appropriate as the results derived from a longitudinal study given that non-adherence occurs over time. Practical implications Patient non-adherence is a global health issue. Multidisciplinary approach to enhance patient adherence to treatment should form the part of public health care policy. Originality/value Although there is extensive quantitative research on the prevalence of non-adherence, qualitative research is limited. This paper addresses this gap by employing Interpretative Phenomenological Analysis to understand patient non adherence and its factors and dimensions.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:31Z
      DOI: 10.1108/IJHCQA-03-2016-0033
       
  • Nurse staffing levels and outcomes - mining the UK national datasets for
           insight.
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose Purpose of this paper Despite the generation of mass data by the nursing workforce, determining the impact of the contribution to patient safety remains challenging. Several cross sectional studies have indicated a relationship between staffing and safety. The aim of this paper was to uncover possible associations and explore if a deeper understanding of relationships between staffing and other factors such as safety could be revealed within nationally routinely collected datasets. Design/methodology/approach Methods Two longitudinal routinely collected datasets consisting of thirty years of UK nurse staffing data and seven years of National Health Service benchmark data such as survey results, safety and other indicators were used. A correlation matrix was built and a linear correlation operation was applied (Pearson Product moment Correlation coefficient). Findings Findings A number of associations were revealed within both the UK Staffing dataset and the NHS benchmarking dataset. However the challenges of using these datasets soon became apparent. Practical implications Practical implications Staff time and effort is required to collect these data. The limitations of these datasets include inconsistent data collection & quality. The mode of data collection and the itemset collected should be reviewed to generate a dataset with robust clinical application. Originality/value What this paper adds This paper revealed that relationships are likely to be complex & non-linear however the main contribution of the paper is the identification of the limitations of routinely collected data. Much time and effort is expended collecting this data however its validity, usefulness & method of routine national data collection appear to require re-examination.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:29Z
      DOI: 10.1108/IJHCQA-08-2016-0118
       
  • Embedding learning from adverse incidents: a UK case study
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose This paper reports on a regionally based UK study uncovering what has worked well in learning from adverse incidents in hospitals. It reviews the incident investigation methodology used, identifying strengths or weaknesses and explores the use of a database as a tool to embed learning Design/methodology/approach Documentary examination was conducted of all adverse incidents reported between 1st June 2011 and 30th June 2012 by three UK National Health Service hospitals. One Root Cause Analysis report per adverse incident for each individual hospital was sent an advisory group for review. Using terms of reference supplied, the advisory group feedback was analysed using an inductive thematic approach. The emergent themes led to the generation of questions which informed seven in-depth semi-structured interviews Findings ‘Time’ and ‘Work Pressures’ were identified as barriers to using adverse incident investigations as tools for quality enhancement. Methodologically, a weakness in approach was that no criteria influenced the techniques which were used in investigating adverse incidents. Regarding the sharing of learning, the use of a database as a tool to embed learning across the region was not supported Practical implications Softer intelligence from adverse incident investigations could be usefully shared between hospitals through a regional forum Originality/value The use of a database as a tool to facilitate the sharing of learning from adverse incidents across the health economy is not supported
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:26Z
      DOI: 10.1108/IJHCQA-05-2016-0060
       
  • Improving throughput in a youth mental health service
    • Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 3, April 2017.
      Purpose The discrepancy between increasing demand and limited resources in public mental health is putting pressure on services to continuously review their practices and develop innovative models of care that redress this discrepancy. To ensure the service models continue to meet the needs of all stakeholders, Children and Young People’s Mental Health (CYPMH) conducts regular reviews of its service models. Accordingly, the Youth Mental Health (YMH) model at CYPMH has evolved significantly over time in response to the needs of young people and service demand. This paper outlines the findings of a recent review of the YMH service, and the subsequent changes to the service model. Design/methodology/approach Informed by a participatory action philosophy, feedback was sought from staff on the service model through a range of methods including a questionnaire, staff consultations through a working party and interviews. This feedback was used to redesign the model, which was then evaluated again. Findings Staff identified a number of challenges with the service model and a range of service improvement solutions. The key issues included exceedingly high caseloads, workplace tensions, and fragmentation of the client journey. This paper outlines the primary solution to these key concerns, namely the introduction of brief intervention as the entry point to the service. Originality/value Brief intervention approaches provide a solution to overly high caseloads as the direct and focussed approach of brief intervention generally reduces the number of sessions people need. Brief intervention is an important addition to other treatment options and should be seen as a valid component of the continuum of mental health care.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-03-06T11:04:25Z
      DOI: 10.1108/IJHCQA-05-2016-0062
       
  • A method for evaluating treatment quality using in-vivo EPID dosimetry and
           statistical process control in radiation therapy
    • First page: 90
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 2, March 2017.
      Purpose Due to increasing complexity, modern radiotherapy techniques require comprehensive quality assurance (QA) program, that to date generally focus on the pre-treatment stage. Here, we aim to provide a method for: 1) individual patient treatment quality assurance evaluation; and 2) identification of a “quality gap” for continuous quality improvement. Design/methodology/approach A statistical process control (SPC) was applied to evaluate treatment delivery using in-vivo electronic portal imaging device (EPID) dosimetry. A moving range control chart was constructed to monitor the individual patient treatment performance based on a control limit generated from initial data of 90 IMRT and 10 VMAT patient deliveries. A process capability index was used to evaluate continuing treatment quality based on three quality classes; treatment type-specific, treatment linac-specific, and body site-specific. Findings The determined control limits were 62.5 and 70.0 % of the chi pass-rate for IMRT and VMAT deliveries, respectively. Fourteen patients were selected for a pilot study the results of which showed that about 1% of all treatments contained errors relating to unexpected anatomical changes between treatment fractions. Both rectum and pelvis cancer treatments demonstrated process capability indices were less than 1, indicating the potential for quality improvement and hence may benefit from further assessment. Research limitations/implications Our study relied on the application of in-vivo EPID dosimetry for patients treated at our center. Sampling patients for generating the control limits were limited to 100 patients. Whilst the quantitative results are specific to the clinical techniques and equipment used, the described method is generally applicable to IMRT and VMAT treatment quality assurance. Whilst more work is required to determine the level of clinical significance, we have demonstrated the capability of the method for both treatment specific quality assurance and continuing quality improvement. Practical implications Our proposed method is a valuable tool for assessing the accuracy of treatment delivery whilst also improving treatment quality and patient safety. Originality/value Assessing in-vivo EPID dosimetry with SPC can be used to improve the quality of radiation treatment for cancer patients.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-01-27T11:14:31Z
      DOI: 10.1108/IJHCQA-03-2016-0028
       
  • The effects of a lean transition on process times, patients and employees
    • First page: 103
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 2, March 2017.
      Purpose Treatment delays must be avoided, especially in oncology, to assure sustainable high quality health care and increase the odds of survival. We hypothesized that waiting times would decrease and patients and employees would benefit when specific lean interventions are incorporated in an organizational improvement approach. Design/methodology/approach In 2013, 15 lean interventions were initiated to improve flow in a single radiotherapy institute. Process/waiting times, patient satisfaction, safety, employee satisfaction, and absenteeism were evaluated using a mixed methods methodology (2010-2014). Data from databases, surveys, and interviews were analyzed by time series analysis, chi-squares, multi-level regression, and t-tests. Findings Median waiting/process times improved from 20.2 days in 2012 to 16.3 in 2014 (P<0.001). The percentage of palliative patients for which waiting times had exceeded Dutch national norms (10 days) improved from 35% (six months in 2012: pre-intervention) to 16% (six months in 2013-2014: post-intervention; P<0.01), and the percentage exceeding national objectives (7 days) from 22% to 17% (P:0.44). For curative patients, exceeding of norms (28 days) improved from 17% (2012) to 8% (2013-2014: P:0.05), and for the objectives (21 days) from 18% to 10% (P<0.01). Reported safety incidents decreased with 47% from 2009 to 2014, whereas safety culture, awareness and intention to solve problems improved. Employee satisfaction improved slightly, and absenteeism decreased from 4.6% (2010) to 2.7% (2014; P<0.001). Originality/value Combining specific lean interventions with an organizational improvement approach improved waiting times, patient safety, employee satisfaction and absenteeism on the short term. Continuing evaluation of effects should study the improvements sustainability.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-01-27T11:14:19Z
      DOI: 10.1108/IJHCQA-08-2015-0106
       
  • Understanding the working relationships between National Health Service
           clinicians and finance staff
    • First page: 119
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 2, March 2017.
      Purpose The Department of Health and the National Health Service (NHS) Future Focused Finance programme promotes effective engagement between clinical and finance staff. Surveys undertaken by the Department of Health between 2013 and 2015 found few NHS Trusts reported high levels of engagement. The purpose of the present study was to gain a better understanding of current working relationships between NHS clinical and finance professionals and how they might be supported to become more effective. Design/methodology/approach Ipsos MORI were commissioned by the NHS Future Focused Finance programme to undertake an on-line survey of NHS clinical and finance staff between June and August 2015. Findings The majority of clinicians had a member of a finance team linked to their speciality or directorate. Clinical and finance professionals have a positive view of joint working preferring face to face contact. Clinician’s confidence in their understanding of finance was generally good and finance staff felt they had a good understanding of clinical issues. Effective working relationships were facilitated by face to face contact, a professional relationship, and the availability of clear, well presented finance and activity data. Research limitations/implications Data protection issues limited the accessibility of the survey team to NHS staff resulting in a relatively low response rate. Other forms of communication, including social media, were utilised to increase access to the survey. Originality/value The Future Focused Finance programme is a unique programme aimed at making the NHS finance profession fit for the future. The Close Partnering work stream brings together the finance and clinical perspective to share knowledge, evidence, training, and to develop good practice and engagement.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-01-27T11:14:32Z
      DOI: 10.1108/IJHCQA-01-2016-0006
       
  • Barriers to discharge from inpatient rehabilitation: a teamwork approach
    • First page: 137
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 2, March 2017.
      Purpose In order to prevent adverse events during the discharge process, coordinating appropriate community resources, medication reconciliation, and patient education needs to be implemented before the patient leaves the hospital. This coordination requires communication and effective teamwork amongst staff members. In order to address these concerns, the authors incorporated the TeamSTEPPS principles to develop a discharge plan that would best meet the needs of the patients as they return to the community. Design/methodology/approach Through a gap analysis, barriers to discharge were identified from the following disciplines; nursing, social work, physical and occupational therapy, psychology, and rehabilitation physician. To improve communication, weekly meetings and twice-weekly huddles were implemented so that concerns regarding discharge obstacles could be identified and resolved. Visibility of discharge dates were improved by use of graduation certificates in patient rooms and green ribbons on patient wheelchairs. Findings After implementation of this discharge intervention, length of stay was reduced providing cost savings to the hospital, patient satisfaction on HCAHP surveys improved and demonstrated patient satisfaction with the discharge process, and readmission rates improved. Originality/value This study demonstrated that effective teamwork and communication can improve patient safety and satisfaction during the discharge period.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-01-27T11:14:23Z
      DOI: 10.1108/IJHCQA-07-2016-0102
       
  • ‘When I am with my husband, I do not feel mosquito bite’:
           insecticide-treated net usage among pregnant women, Accra, Ghana
    • First page: 148
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 2, March 2017.
      Purpose To explore how socio-cultural beliefs and practices could influence the knowledge, attitude and perception of ITN use in the control of malaria amongst pregnant women attending ante natal clinic. Design/methodology/approach Data were gathered using interviews and documentary review. Framework analysis was applied to classify emerging themes and the findings interpreted using the health belief model. Findings The findings showed that the pregnant women had appreciable knowledge, both positive and negative attitudes and perceptions of insecticide treated nets. To most of them, sleeping under an ITN would not affect pregnancy/cause abortion, but rather prevent mosquito bites and associated malaria. Research limitations/implications The limitations include the sample size of participants and health facilities used. Lack of application of quantitative research method meant that we could not quantify the findings to ensure generalisation to the entire population. Practical implications The findings suggest that health policy makers, implementers and health professionals need to appreciate the perception and attitude of pregnant women when designing policy guidelines for the malaria control programme. Originality/value This paper suggests that health policy makers, implementers and health professionals have to devise strategies to address socio-cultural beliefs and practices in the scaling up of malaria control programmes.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-01-27T11:14:20Z
      DOI: 10.1108/IJHCQA-03-2016-0032
       
  • Performance assessment of human resource by integration of HSE and
           ergonomics and EFQM management system: a fuzzy-based approach
    • First page: 160
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 2, March 2017.
      Purpose The aim of this study is to present an integrated framework for performance evaluation and analysis of human resource with respect to the factors of health, safety, environment and ergonomics (HSEE) management system and European federation for quality management (EFQM) as one of the well-known business excellence (BE) models. Performance evaluation of human resource (HR) based on integrated management systems (IMSs) raised from different aspects is conducted in various companies. Because HR is ultimately responsible to ensure the safety and success of system. Design/methodology/approach In this study, an intelligent algorithm based on adaptive neuro-fuzzy inference system (ANFIS) along with fuzzy data envelopment analysis (FDEA) are developed and employed to assess the performance of the company. Furthermore, the impact of the factors on the company’s performance as well as their strengths and weaknesses are identified by conducting a sensitivity analysis on the results. Similarly, a design of experiment is performed to prioritize the factors in the order of importance. Findings The results show that EFQM model has a far greater impact upon the company's performance than HESS management system. According to the obtained results, it can be argued that integration of HSEE and EFQM leads to the performance improvement in the company. Practical implications In current study, the required data for executing the proposed framework, are collected via valid questionnaires which are filled in by the staff of an aviation industry located in Tehran, Iran. Originality/value Managing HR performance results in improving usability, maintainability, and reliability and finally in a significant reduction in the commercial aviation accident rate. Also, study of factors affecting HR performance authorities participate in developing systems in order to help operators better manage human error. This paper for the first time, presents an intelligent framework based on ANFIS, FDEA and statistical tests for HR performance assessment and analysis with the ability of handling uncertainty and vagueness existing in real world environment
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-01-27T11:14:25Z
      DOI: 10.1108/IJHCQA-06-2016-0089
       
  • Use of failure mode effect analysis (FMEA) to improve medication
           management process
    • First page: 175
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 2, March 2017.
      Purpose Medication management is a complex process, at high risk of error with life threatening consequences. The focus should be on devising strategies to avoid errors and make the process self reliable by ensuring prevention of errors and/or error detection at subsequent stages. Failure mode Effect Analysis is a systematic proactive tool to identify the likelihood and the causes for the process to fail at various steps and prioritize them to devise risk reduction strategies to improve patient safety. Design/methodology/approach The study was designed as an observational analytical study of medication management process in the inpatient area of a multi-speciality hospital in Gurgaon, Haryana, India. A team was made to study the complex process of medication management in the hospital. Failure mode effect analysis (FMEA) tool was used. Corrective actions were developed based on the prioritized failure modes which were implemented and monitored. Findings The percentage distribution of medication errors as per the observation made by the team was found to be maximum of transcription errors (37%) followed by administration errors (29%) indicating the need to identify the causes and effects of their occurrence. Eleven failure modes were identified out of which major five were prioritized based on the risk priority number (RPN). The process was repeated after corrective actions were taken which resulted in about 40% (average) and around 60% reduction in the RPN of prioritised failure modes. Research limitations/implications Limitations FMEA is a time consuming process and requires a multidisciplinary team which has good understanding of the process being analysed. FMEA only helps in identifying the possibilities of a process to fail, it does not eliminate them, additional efforts are required to develop action plans and implement them. Frank discussion and agreement among the team members is required not only for successfully conducing FMEA but also for implementing the corrective actions. Practical implications FMEA is an effective proactive risk assessment tool and is a continuous process which can be continued in phases. The corrective actions taken resulted in reduction in RPN, subjected to further evaluation and usage by others depending on the facility type. Originality/value The application of the tool helped the hospital in identifying failures in medication management process, thereby prioritizing and correcting them leading to improvement.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-01-27T11:14:30Z
      DOI: 10.1108/IJHCQA-09-2015-0113
       
  • Markov chain decision model for urinary incontinence procedures
    • First page: 187
      Abstract: International Journal of Health Care Quality Assurance, Volume 30, Issue 2, March 2017.
      Purpose Urinary Incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch Colposuspension and Sling for UI which have high success rates. This study will analyze which of these popular surgical procedures for UI is effective. Design/methodology/approach This research employs randomized, prospective studies to obtain robust cost and utility data used in the Markov Chain decision model for examining which of these surgical interventions is more effective in treating women with stress urinary incontinence based on two measures: number of quality adjusted life years (QALY) and cost per QALY. Treeage Pro Healthcare software was employed in Markov decision analysis. Findings Results showed the Sling procedure is a more effective surgical intervention than the Burch. However, if a utility greater than certain utility value, for which both procedures are equally effective, is assigned to persistent incontinence, the Burch procedure is more effective than the Sling procedure. Originality/value This paper demonstrates the efficacy of a Markov Chain decision modeling approach to study the comparative effectiveness analysis of available treatments for patients with UI, an important public health issue, widely prevalent among elderly women in developed and developing countries. This research also improves upon other analyses using a Markov Chain decision modeling process to analyze various strategies for treating UI.
      Citation: International Journal of Health Care Quality Assurance
      PubDate: 2017-01-27T11:15:33Z
      DOI: 10.1108/IJHCQA-03-2016-0034
       
 
 
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