 Subjects -> OCCUPATIONS AND CAREERS (Total: 33 journals)
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- Correction to: Pilot testing of the International Council
of Cardiovascular Prevention and Rehabilitation Registry-
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First page: mzad071
PubDate: Tue, 19 Sep 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad071
Issue No: Vol. 35, No. 3 (2023)
- The crisis of physician well-being in Nepal: a multifaceted dilemma
demanding urgent intervention-
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First page: mzad070
Abstract: AbstractThe healthcare system in Nepal faces challenges despite the establishment of numerous medical colleges and an increasing number of doctors. The distribution of medical colleges is disproportionately concentrated in urban areas, leaving rural populations without quality health care. The mental well-being of physicians is a growing concern, with studies indicating high levels of burnout, stress, and depression among healthcare workers, worsened by the Coronavirus Disease 2019 (COVID-19) pandemic. Rising suicide rates among medical professionals highlight the severity of burnout and depression in the healthcare sector. Factors contributing to this crisis include inadequate recruitment in government hospitals, a shortage of healthcare professionals, and inefficiencies in resource distribution. Attacks on physicians have become alarmingly frequent, necessitating comprehensive studies to understand the challenges faced by different specialties and the impact of rural versus urban settings. To address these issues, prompt filling of vacant positions in government hospitals and prioritizing physicians’ mental health is crucial. The government should offer competitive salaries, effective management, and supportive working environments to combat the brain drain. Initiatives inspiring professionals to stay in Nepal, along with maintaining the National Health Insurance Program and controlling healthcare privatization, are necessary. Resilience training, professional programs, and improved infrastructure in government medical colleges are vital. This crisis demands global attention and a national study to evaluate burnout, depression, and suicide among healthcare professionals. By addressing these challenges and supporting the well-being of healthcare workers, Nepal can work toward a sustainable healthcare system that provides quality care for all.
PubDate: Wed, 13 Sep 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad070
Issue No: Vol. 35, No. 3 (2023)
- Improving care safety by characterizing task interruptions during
interactions between healthcare professionals: an observational study-
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First page: mzad069
Abstract: AbstractFew studies have investigated interruptions to the work of professionals practicing in inpatient hospitals, and even fewer take account of the functions that make up the system. Safety of care can be improved by considering avoidable interruptions during interactions between managerial and care delivery functions. The present study describes the characteristics of interruptions to the work of professionals working in the inpatient hospital sector, with respect to their typology, frequency, duration, and avoidability in the context of interactions between functions. This direct observational study of interruptions in hospital care was performed in the Pays de la Loire (west coast) area of France. A total of 23 teams (17 institutions) working in medical or surgical specialties (excluding intensive care) were included. Observations were performed between May and September 2019, and lasted seven consecutive hours per team. A pair of observers simultaneously observed the same professional for ∼30 min. Each occupational category was examined. Reported characteristics were: (i) the method and duration of the request, (ii) the location of interrupted and interrupting persons, (iii) the reaction of the interrupted person, (iv) the characteristics of the interrupting person, and (v) the classification of interrupted and interrupting tasks according to their function. An avoidable interruption was defined. Interruptions during interactions between professionals were categorised in terms of their function and avoidability. Descriptive statistical analyses (mean, standard deviation, and distribution) were run. In particular, cross-comparisons were run to highlight avoidability interruptions and interactions between managerial and care delivery functions during the working day, for different professional categories, and for the location of the request. Overall, 286 interrupted professionals were observed and 1929 interruptions were characterised. The majority of interruptions were due to a face-to-face request (58.7%), lasting ≤30 s (72.5%). Professionals engaged in the response in 49.3% of cases. A total of 57.4% of interruptions were avoidable. The average number of interruptions was 10.5 (SD = 3.2) per hour per professional. An analysis of avoidability and interactions between managerial and care delivery functions found that the period between 12:00 and 13:00 was the riskiest in terms of care safety. This study highlighted the characteristics of interruptions to the activity of professionals working in inpatient hospitals. Care teams could focus on making medical and nursing professionals much more aware of the importance of interruptions, and each team could decide how to best-manage interruptions, in the context of their specific working environment.
PubDate: Sat, 09 Sep 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad069
Issue No: Vol. 35, No. 3 (2023)
- Reducing the risks of nuclear war: the role of health
professionals-
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First page: mzad059
PubDate: Thu, 07 Sep 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad059
Issue No: Vol. 35, No. 3 (2023)
- The development of indicators to measure the quality of care
in geriatric rehabilitation-
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First page: mzad044
Abstract: AbstractQuality of care is an essential aspect of geriatric rehabilitation. Usually, there are national standards for the quality of care or indicators to measure the quality of care. However, this is not the case for geriatric rehabilitation. Therefore, the aim of this study was to develop structure, process, and outcome indicators to measure the quality of geriatric rehabilitation.To develop quality indicators for geriatric rehabilitation, a literature search was performed to identify indicators for all types of rehabilitation that can also be suitable for geriatric rehabilitation. Thereafter, in the qualitative phase, different stakeholders were inte. Indicators from the literature and indicators developed based on the interviews were merged and processed in a questionnaire. Through this questionnaire, elderly care physicians and managers of geriatric rehabilitation facilities were asked to rate the indicators on relevance and feasibility. Indicators that were considered relevant and feasible by the respondents were included in the final quality indicator set for geriatric rehabilitation.Thirty-six indicators suitable for geriatric rehabilitation were identified from the literature. Additionally, 55 quality indicators were developed based on the interviews. Merging the indicators and omitting duplicates resulted in 69 quality indicators. Analysis of the data from the questionnaires resulted in a final set of 27 quality indicators for geriatric rehabilitation that consists of 17 structure, 8 process, and 2 outcome indicators.This study contributes to the quality of geriatric rehabilitation by providing a first set of quality indicators ready to use in practice. Follow-up research is recommended and may include an assessment of the applicability, reliability, and validity of the developed indicator set.
PubDate: Fri, 01 Sep 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad044
Issue No: Vol. 35, No. 3 (2023)
- Suicide and stigma: connections and challenges
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First page: mzad066
PubDate: Sat, 26 Aug 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad066
Issue No: Vol. 35, No. 3 (2023)
- Leveraging collaborative learning for improved heart failure care:
insights from Argentina-
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First page: mzad067
PubDate: Thu, 24 Aug 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad067
Issue No: Vol. 35, No. 3 (2023)
- A scoping review of clinical handover mnemonic devices
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First page: mzad065
Abstract: AbstractSince the Institute of Medicine (IOM) published To Err is Human: Building a Safer Health System in 1999, clinical handovers (or handoffs) and their relationship with the communication of patient safety have raised concerns from the public, regulatory bodies, and medical practitioners. Protocols, guidelines, forms, and mnemonic devices have been created to ensure safer clinical handovers. An initial literature search did not find a framework to describe the clinical processes and functions of each mnemonic device and its elements. The absence of a systematic framework could hinder the study across and the reusability of the established clinical handover mnemonic devices. This study aims to develop a universal framework to describe the clinical processes and functions essential for patient safety during handover. We queried PubMed.gov and obtained 98 articles related to clinical handovers. We examined the citing sources of the mnemonics mentioned in these articles. A total of 42 handover mnemonics with 238 elements were identified. Our review noted that there was no taxonomy to describe the clinical functions and process associated with the clinical handover mnemonic devices. We used grounded theory to address this gap and built a new taxonomy from the 42 mnemonics. A researcher read all mnemonics, developed a taxonomy for tagging clinical handover mnemonics, and categorized all mnemonic elements into correct processes and functions. After that, the second researcher, a medical practitioner, examined the taxonomy and made suggested corrections for the labelled functions of all mnemonic elements. Both researchers agreed on the taxonomy and the labelled processes and functions of different mnemonic elements. The taxonomy contains three processes and twenty functions in clinical handovers. Clinical processes like ‘medical condition’, ‘medical history’, ‘medical evaluation’, ‘care plan’, ‘outstanding care/tasks/results’, and ‘patient information’, as an administrative process, were widely adopted in clinical handover mnemonics. Moreover, mnemonic elements on communication manner and information validation had been identified in the list of clinical handover mnemonics. Although we recognize challenges because of both the vast number of clinical handover scenarios and the task of placing them under a few predefined groups, our findings suggest that such a taxonomy, as developed for this study, could assist medical practitioners to devise a clinical handover mnemonic to best fit their workplace.
PubDate: Thu, 24 Aug 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad065
Issue No: Vol. 35, No. 3 (2023)
- Barcode and radio frequency identification utilization varied across
Korean hospitals-
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First page: mzad063
Abstract: AbstractBarcodes and radio frequency identification (RFID) are increasingly used in health care to improve patient safety. However, studies on their utilization in clinical settings are limited. This study aimed to comprehensively examine the utilization status of barcodes and RFID in Korean hospitals, recognize the effects and obstacles associated with utilization, and explore the measures to expand the applications of barcodes and RFID. A self-reported online survey was conducted in tertiary hospitals, general hospitals, hospitals, and nursing hospitals in the Republic of Korea. The survey questionnaire comprised questions on barcodes and RFID utilization status, the effect of barcodes and RFID utilization, measures to expand the utilization of barcodes and RFID, and information on respondents’ demographics and hospitals. A representative from each of 23 tertiary hospitals, 101 general hospitals, 232 hospitals, and 214 nursing hospitals completed the survey (total response rate 17%). The data were analysed using the chi-square test or Fisher's exact test to determine the differences in responses based on the type and characteristics of hospitals. The tertiary hospitals had the highest utilizations of both RFID and barcodes (n = 10, 43.5%), whereas the nursing hospitals had the lowest (n = 96, 55.1%). Barcodes and RFID were most commonly used in the visits and security management domains. However, the use of barcodes and RFID in medication dispensing and administration safety was low, despite its value in improving patient safety. The hospitals recognized the positive effect of utilization of barcodes and RFID, reporting the highest frequency for the prevention of patient safety incidents (n = 79, 85.9%). Nevertheless, the cost of barcodes and RFID facility investments (n = 128, 90.3%) appeared to be the greatest obstacle to the introduction of barcodes and RFID. Hence, barcodes and RFID facility investment support (n = 133, 95.5%) were given the highest priority among the measures to expand barcode and RFID utilization in health care. The utilization of barcodes and RFID varied across the type and domain of hospitals in the Republic of Korea. Hospitals recognized the positive effects of barcode and RFID utilization. Nonetheless, all hospitals were concerned about the cost of investment and maintenance of barcode and RFID facilities as the main obstacles to utilization. Therefore, a support plan must be developed for the cost of barcodes and RFID facility investments to expand barcode and RFID utilization in health care.
PubDate: Thu, 24 Aug 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad063
Issue No: Vol. 35, No. 3 (2023)
- A comparison of end-of-shift reports to an incident reporting system
for reporting incidents in the intensive care unit-
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First page: mzad064
PubDate: Thu, 24 Aug 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad064
Issue No: Vol. 35, No. 3 (2023)
- Quality improvement collaborative to optimize heart failure care
in patients from a network of clinics in Argentina during the COVID-19
pandemic-
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First page: mzad060
Abstract: Heart failure (HF) is a major clinical and public health problem associated with significant mortality, morbidity, and health-care costs. Despite the existence of evidence-based guidelines for the optimal treatment of HF, the quality of care remains suboptimal. Our aim was to increase the use a care bundle in 50% of enrolled subjects during their hospitalization and discharge and to reduce their readmission for HF causes by 10%. We conducted an uncontrolled before–after study in eight hospitals in Argentina to evaluate the effect of a quality improvement intervention on the use of an HF care bundle in patients with HF New York Heart Association (NYHA) Class II–III. The HF bundle of care included medication, continuum of care, lifestyle habits, and predischarge examinations. Training and follow-up of multidisciplinary teams in each center were performed through learning sessions and plan-do-study-act improvement cycles. Data collectors reviewed bundle compliance in the health records of recruited patients after their hospital discharge and verified readmissions through phone calls to patients within 30–40 days after discharge. We recruited 200 patients (83 before and 127 during the intervention phase), and bundle compliance increased from 9.6% to 28.3% [odds ratio 3.71, 95% confidence interval (8.46; 1.63); P = .002]. Despite a slow improvement during the first months, bundle compliance gained momentum near the end of the intervention surpassing 80%. We observed a non-significant decreased readmission rate within 30 days of discharge due to HF in the postintervention period [8.4% vs. 5.5%, odds ratio 0.63, 95% CI (1.88; 0.21); P = .410]. Qualitative analysis showed that members of the intervention teams acknowledged the improvement of work organization and standardization of care, teamwork, shared mental model, and health record completeness as well as the utility of training fellows. Despite the challenges related to the pandemic, better care of patients with HF NYHA Class II–III was possible through simple interventions and collaborative work.Graphical abstract
PubDate: Sat, 12 Aug 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad060
Issue No: Vol. 35, No. 3 (2023)
- Harnessing patient complaints to systematically monitoring healthcare
concerns through disproportionality analysis-
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First page: mzad062
Abstract: AbstractStaff observations are the most common source of data for driving improvements in care. However, the patient perspective should also be considered, and healthcare complaints offer concrete details that health organizations might otherwise overlook and that can highlight areas for learning and improvement in the healthcare system. However, because of the diverse nature of patient complaints, systematic analyses can be challenging. This study aimed to identify and prioritize areas for improvement using a data-driven approach to analysing patient complaints. The Danish version of the Healthcare Complaints Analysis Tool was used to categorize the content of complaint letters. All complaints managed by the national complaints authority, compensation claims to the Patient Compensation Association, and locally managed complaints that were filed directly at Odense University Hospital from 2017 to 2021 were included. Proportional reporting ratios (PRRs) were used to measure and display the top five signals of disproportionality and rank them by excess complaints at the hospital level and when divided into department types. The study included 6366 complaints containing 13 156 problems (on average, 2.1 problems mentioned per complaint letter). Surgical departments had the highest number of complaints (3818), followed by medical (1059), service (439), and emergency departments (239). Signal 1 of disproportionality, relating to quality problems during ward procedures, had the highest excess reporting of 1043 complaints at the hospital level and a PRR of 1.61 and was present in all department types. Signal 2, relating to safety problems during the examination and diagnosis stage, had an excess reporting of 699 problems and a PRR of 1.86 and was also present in all department types. Signal 3, relating to institutional problems during admission, had the highest PRR of 3.54 and was found in most department types. Signals 4 and 5, relating to environmental problems during ward procedures and care on the ward, respectively, had PRRs of 1.5 and 1.84 and were present in most department types. The study found that analysing patient complaints can identify potential areas for hospital improvement. The study identified recurring issues in multiple departments, including quality problems during ward procedures, safety problems during the examination, institutional problems during admission, and environmental problems on the ward. The study highlights disproportionality analysis of complaints as a valuable tool to monitor patient concerns systematically.
PubDate: Wed, 09 Aug 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad062
Issue No: Vol. 35, No. 3 (2023)
- Patient-centered care: the North Star to guide us during uncertainty into
a better day-
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First page: mzad061
PubDate: Wed, 09 Aug 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad061
Issue No: Vol. 35, No. 3 (2023)
- The optimal control chart selection for monitoring COVID-19 phases: a
case study of daily deaths in the USA-
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First page: mzad058
Abstract: AbstractEpidemiologists frequently adopt statistical process control tools, like control charts, to detect changes in the incidence or prevalence of a specific disease in real time, thereby protecting against outbreaks and emergent health concerns. Control charts have proven essential in instantly identifying fluctuations in infection rates, spotting emerging patterns, and enabling timely reaction measures in the context of COVID-19 monitoring. This study aims to review and select an optimal control chart in epidemiology to monitor variations in COVID-19 deaths and understand pandemic mortality patterns. An essential aspect of the present study is selecting an appropriate monitoring technique for distinct deaths in the USA in seven phases, including pre-growth, growth, and post-growth phases. Stage-1 evaluated control chart applications in epidemiology departments of 12 countries between 2000 and 2022. The study assessed various control charts and identified the optimal one based on maximum shift detection using sample data. This study considered at Shewhart ($\bar X$, $R$, $C$) control charts and exponentially weighted moving average (EWMA) control chart with smoothing parameters λ = 0.25, 0.5, 0.75, and 1 were all investigated in this study. In Stage-2, we applied the EWMA control chart for monitoring because of its outstanding shift detection capabilities and compatibility with the present data. Daily deaths have been monitored from March 2020 to February 2023. Control charts in epidemiology show growing use, with the USA leading at 42% applications among top countries. During the application on COVID-19 deaths, the EWMA chart accurately depicted mortality dynamics from March 2020 to February 2022, indicating six distinct stages of death. The third and fifth waves were extremely catastrophic, resulting in a considerable loss of life. Significantly, a persistent sixth wave appeared from March 2022 to February 2023. The EWMA map effectively determined the peaks associated with each wave by thoroughly examining the time and amount of deaths, providing vital insights into the pandemic’s progression. The severity of each wave was measured by the average number of deaths $W5(1899)\,\gt\,W3(1881)\,\gt\,W4(1393)\,\gt\,W1(1036)\,\gt\,W2(853)\,\gt\,(W6(473)$. The USA entered a seventh phase (6th wave) from March 2022 to February 2023, marked by fewer deaths. While reassuring, it remains crucial to maintain vaccinations and pandemic control measures. Control charts enable early detection of daily COVID-19 deaths, providing a systematic strategy for government and medical staff. Incorporating the EWMA chart for monitoring immunizations, cases, and deaths is recommended.
PubDate: Tue, 08 Aug 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad058
Issue No: Vol. 35, No. 3 (2023)
- Addressing wounded healers’ burnout and moral distress: starts
and ends with integrity-
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First page: mzad057
Abstract: Moral DistressIntegrityHealthcare professionals
PubDate: Thu, 13 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad057
Issue No: Vol. 35, No. 3 (2023)
- Advancing quality in low human development index scoring countries; the
need for standardized and shared quality measurement and reporting-
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First page: mzad055
PubDate: Thu, 13 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad055
Issue No: Vol. 35, No. 3 (2023)
- Comparing rates of adverse events detected in incident reporting
and the Global Trigger Tool: a systematic review-
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First page: mzad056
Abstract: AbstractMany hospitals continue to use incident reporting systems (IRSs) as their primary patient safety data source. The information IRSs collect on the frequency of harm to patients [adverse events (AEs)] is generally of poor quality, and some incident types (e.g. diagnostic errors) are under-reported. Other methods of collecting patient safety information using medical record review, such as the Global Trigger Tool (GTT), have been developed. The aim of this study was to undertake a systematic review to empirically quantify the gap between the percentage of AEs detected using the GTT to those that are also detected via IRSs. The review was conducted in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies published in English, which collected AE data using the GTT and IRSs, were included. In total, 14 studies met the inclusion criteria. All studies were undertaken in hospitals and were published between 2006 and 2022. The studies were conducted in six countries, mainly in the USA (nine studies). Studies reviewed 22 589 medical records using the GTT across 107 institutions finding 7166 AEs. The percentage of AEs detected using the GTT that were also detected in corresponding IRSs ranged from 0% to 37.4% with an average of 7.0% (SD 9.1; median 3.9 and IQR 5.2). Twelve of the fourteen studies found <10% of the AEs detected using the GTT were also found in corresponding IRSs. The >10-fold gap between the detection rates of the GTT and IRSs is strong evidence that the rate of AEs collected in IRSs in hospitals should not be used to measure or as a proxy for the level of safety of a hospital. IRSs should be recognized for their strengths which are to detect rare, serious, and new incident types and to enable analysis of contributing and contextual factors to develop preventive and corrective strategies. Health systems should use multiple patient safety data sources to prioritize interventions and promote a cycle of action and improvement based on data rather than merely just collecting and analysing information.
PubDate: Thu, 13 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad056
Issue No: Vol. 35, No. 3 (2023)
- Spanish Abstracts for Volume 34, Issue 1, 2022
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First page: mzad052
PubDate: Mon, 10 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad052
Issue No: Vol. 35, No. 3 (2023)
- Effect of China’s long-term care insurance on health outcomes
of older disabled people: role of institutional care-
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First page: mzad054
Abstract: AbstractSince the public long-term care insurance (LTCI) system was piloted in Chengdu, China, in October 2017, there has been considerable growth of LTC institutions in China. This study aimed to evaluate the health value effect of LTCI in older patients with severe disabilities in an LTC institution. This prospective study was based on data from 985 severe disability patients with or without LTCI from October 2017 to May 2021 in the Eighth People’s Hospital, Chengdu, China. The Cox proportional hazard model estimated LTCI’s health value, including survival probability and risk of pneumonia/pressure ulcers. Subgroup analysis was performed for sex, age, Charlson Comorbidity Index (CCI), and the number of drugs. In the analysis, 519 and 466 patients in LTCI and non-LTCI groups were included, respectively. In adjusted Cox analyses, the LTCI group had a significantly elevated survival rate compared with the non-LTCI groups at 12 months (P < .001, hazard ratio (HR) = 1.758, 95% confidence interval (CI) 1.300–2.376). At 40 months, the adjusted survival rate was 62.6% in the LTCI group, which was significantly higher (53.7%; P = .003, HR = 1.438, 95% CI 1.131–1.831). The subgroups of patients aged 60 to 79 years (interaction P = .007) and with CCI ≥ 3 (interaction P = .026) were more significantly associated with survival improvement than those aged >80 years and with CCI< 3. The LTCI group was also at lower risk for hospital-acquired pneumonia (P = .016, HR 0.622, 95% CI 0.422–0.917) and pressure ulcers (P = .008, HR 0.695, 95% CI 0.376–0.862). The improved survival of LTCI remained stable in sensitivity analyses. For older patients with severe disabilities, in a LTC institution, LTCI significantly improved their health profile and longevity after a year, suggesting the large role and development potentiality of institution care in the LTCI system of China.
PubDate: Fri, 07 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad054
Issue No: Vol. 35, No. 3 (2023)
- Spanish Abstracts for Volume 34, Issue 2, 2022
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First page: mzad051
PubDate: Fri, 07 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad051
Issue No: Vol. 35, No. 3 (2023)
- Development and validation of a patient satisfaction survey
for pharmaceutical service at primary care settings-
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First page: mzad053
Abstract: AbstractPatient satisfaction is a key quality indicator of pharmacy service. However, there are few studies that develop and validate patient satisfaction surveys applied to pharmaceutical services in primary care settings. It is imperative to establish a well-validated multidimensional instrument for evaluating the viability and sustainability of pharmacy service across geographically diverse regions in low- and middle-income countries.To develop and validate a patient satisfaction instrument for community pharmaceutical services, we carried out a cross-sectional survey in seven provinces across China. The study was conducted in four phases: (i) literature review–based item generation, (ii) expert panel–endorsed questionnaire refinement, (iii) pilot questionnaire development, and (iv) psychometric validation. Survey respondents were standard patients recruited locally and trained to conduct unannounced visits to preselected primary care centers.Between December 2020 and November 2021, the pilot survey comprised a total of 166 unannounced standard patient visits from 125 health-care facilities. The final 24-item Likert-type instrument encompassed five domains: relationship, medication counseling, empathy, accessibility, and overall satisfaction. The satisfactory survey revealed excellent internal consistency. Factor analyses resulted in a 4-factor solution that accounted for 70.7% variance.The results suggest that the questionnaire is a valid and reliable instrument, which has been taken an important step to evaluate patient satisfaction with pharmaceutical services in Chinese primary care settings. Further research on its cross-culture adaptation and applicability in urban retail pharmacy settings is warranted.
PubDate: Thu, 06 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad053
Issue No: Vol. 35, No. 3 (2023)
- Revolutionizing patient safety with artificial intelligence: the potential
of natural language processing and large language models-
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First page: mzad049
PubDate: Tue, 04 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad049
Issue No: Vol. 35, No. 3 (2023)
- Breast cancer care amidst a pandemic: a scoping review to understand the
impact of coronavirus disease 2019 on health services and health
outcomes-
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First page: mzad048
Abstract: AbstractSince the onset of the coronavirus disease 2019 (COVID-19) pandemic, health services for breast cancer (BC) have been disrupted. Our scoping review examines the impact of the COVID-19 pandemic on BC services, health outcomes, and well-being for women. Additionally, this review identifies social inequalities specific to BC during the pandemic. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines, the literature search was conducted using scientific databases starting from March 2020 through November 2021. Studies were identified and selected by two researchers based on inclusion criteria, and the relevant data were extracted and charted to summarize the findings. Ninety-three articles were included in this review. Main themes included are as follows: (i) the impact of COVID-19 on BC services; (ii) the impact of COVID-19 on health outcomes and well-being in women with BC; and (iii) any variation in the impact of COVID-19 on BC by social determinants of health. There were apparent disruptions to BC services across the cancer continuum, especially screening services. Clinical repercussions were a result of such disruptions, and women with BC experienced worsened quality of life and psychosocial well-being. Finally, there were social inequalities dependent on social determinants of health such as age, race, insurance status, and region. Due to the disruption of BC services during the COVID-19 pandemic, women were impacted on their health and overall well-being. The variation in impact demonstrates how health inequities have been exacerbated during the pandemic. This comprehensive review will inform timely health-care changes to minimize long-term impacts of the pandemic and improve evidence-based multidisciplinary needs.
PubDate: Mon, 03 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad048
Issue No: Vol. 35, No. 3 (2023)
- Pilot testing of the International Council of Cardiovascular Prevention
and Rehabilitation Registry-
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First page: mzad050
Abstract: AbstractThe International Council of Cardiovascular Prevention and Rehabilitation developed an International Cardiac Rehabilitation (CR) Registry (ICRR) to support CR programs in low-resource settings to optimize care provision and patient outcomes. This study assessed implementation of the ICRR, site data steward experience with on-boarding and data entry, and patient acceptability. Multimethod observational pilot involves (I) analysis of ICRR data from three centers (Iran, Pakistan, and Qatar) from inception to May 2022, (II) focus group with on-boarded site data stewards (also from Mexico and India), and (III) semistructured interviews with participating patients. Five hundred sixty-seven patients were entered. Based on volumes at each program, 85.6% of patients were entered in ICRR. 99.3% patients approached consented to participate. The average time to enter data at pre- and follow-up assessments by source was 6.8–12.6 min. Of 22 variables preprogram, completion was 89.5%. Among patients with any follow-up data, of four program-reported variables, completion was 99.0% in program completers and 51.5% in none; of 10 patient-reported variables, completion was 97.0% in program completers and 84.8% in none. The proportion of patients with any follow-up data was 84.8% in program completers, with 43.6% of noncompleters having any data entered other than completion status. Twelve data stewards participated in the focus group. Main themes were valuable on-boarding process, data entry, process of engaging patients, and benefits of participation. Thirteen patients were interviewed. Themes were good understanding of the registry, positive experience providing data, and value of lay summary and eagerness for annual assessment. Feasibility and data quality of ICRR were demonstrated.
PubDate: Mon, 03 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad050
Issue No: Vol. 35, No. 3 (2023)
- Association of patient experience and the quality
of hospital care-
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First page: mzad047
Abstract: AbstractThe association between patient experience and the quality of hospital care is controversial. We assess the association between clinical outcomes and patient-reported experience measures (PREMs) in hospitals in Saudi Arabia. Knowledge on this issue informs value-based health-care reforms. A retrospective observational study was conducted in 17 hospitals in Saudi Arabia during the period of 2019–22. Hospital data were collected on PREMs, mortality, readmission, length of stay (LOS), central line–associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and surgical site infection. Descriptive analysis was used to describe hospital characteristics. Spearman’s rho correlation tests were used to assess the correlation between these measures, and multivariate generalized linear mixed model regression analysis was used to study associations while controlling for hospital characteristics and year. Our analysis showed that PREMs were negatively correlated with hospital readmission rate (r = −0.332, P ≤ .01), LOS (r = −0.299, P ≤ .01), CLABSI (r = −0.297, P ≤ .01), CAUTI (r = −0.393, P ≤ .01), and surgical site infection (r = −0.298, P ≤ .01). The results indicated that CAUTI and LOS converged negatively with PREMs (β = −0.548, P = .005; β = −0.873, P = .008, respectively) and that larger hospitals tended to have better patient experience scores (β =0.009, P = .003). Our findings suggest that better performance in clinical outcomes is associated with higher PREM scores. PREMs are not a substitute or surrogate for clinical quality. Yet, PREMs are complementary to other objective measures of patient-reported outcomes, the process of care, and clinical outcomes.
PubDate: Mon, 03 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad047
Issue No: Vol. 35, No. 3 (2023)
- NEO-SAFE: a clinical model for patients and healthcare personnel safety
in primary level hospitals-
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First page: mzad045
Abstract: AbstractPatient safety is a major concern in medicine. Approximately, 4 million infants die each year worldwide and 23% of these deaths are caused by perinatal asphyxia. To prevent the long-term damage of asphyxia, the resuscitation flowchart must be perfectly and promptly performed. However, high effectiveness in performing resuscitation can only be achieved and maintained if the algorithm is frequently executed. Therefore, maintaining a high level of patient care is difficult in some remote centres. The aim of this study was to evaluate the effectiveness of a new organizational model of care-network between Hub & Spoke hospitals to improve both the safety of the newborns in hospitals with a low number of births and the well-being of operators. Our project, NEO-SAFE (NEOnatal SAFety and training Elba), began in 2017 and involved the neonatal intensive care unit and the NINA Center of the Pisa University Hospital (hub) and the Hospital of Elba Island (spoke). It consisted of a continuous training program, both with ‘classic’ training course and ‘on-job tutoring’ (on side and remotely), of the health workers at spoke (i.e. nurses, midwives, and paediatricians). All four milestones of the study design were achieved. During the project, NINA Center instructors organized training courses for the staff in Portoferraio. These courses were based on learning technical and non-technical skills in a training course of increasing difficulty. Staff training needs were also monitored during the project by means of periodic questionnaires, sentinel events, and specific requests. The curve described by the rate of newborns transfer to the Pisa neonatal intensive care unit (hub) shows a monotonous decreasing trend line. On the other hand, this project allowed operators to develop greater self-confidence and greater safety in managing emergency situations, reducing stress for them and improving patient safety. The project allowed the creation of a safe, effective, low-cost, and reproducible organizational model for centres with a low number of births. Moreover, the tele-medicine approach is an important improvement in the assistance and is a window on the future.
PubDate: Mon, 03 Jul 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad045
Issue No: Vol. 35, No. 3 (2023)
- Governance and management in healthcare organizations: their different
roles in driving safety and quality-
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First page: mzad046
PubDate: Thu, 29 Jun 2023 00:00:00 GMT
DOI: 10.1093/intqhc/mzad046
Issue No: Vol. 35, No. 3 (2023)
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