Subjects -> OCCUPATIONS AND CAREERS (Total: 33 journals)
Showing 1 - 23 of 23 Journals sorted alphabetically
American Journal of Pastoral Counseling     Hybrid Journal  
BMC Palliative Care     Open Access   (Followers: 31)
British Journal of Guidance & Counselling     Hybrid Journal   (Followers: 14)
Career Development International     Hybrid Journal   (Followers: 17)
Career Development Quarterly     Hybrid Journal   (Followers: 5)
Community Development     Hybrid Journal   (Followers: 21)
Education + Training     Hybrid Journal   (Followers: 23)
Equality, Diversity and Inclusion : An International Journal     Hybrid Journal   (Followers: 19)
Field Actions Science Reports     Open Access  
Formation emploi     Open Access  
Health Care Analysis     Hybrid Journal   (Followers: 13)
Industrial and Organizational Psychology     Hybrid Journal   (Followers: 24)
International Journal for Educational and Vocational Guidance     Hybrid Journal   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 39)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 13)
International Journal of Work Innovation     Hybrid Journal   (Followers: 2)
Journal of Human Capital     Full-text available via subscription   (Followers: 11)
Journal of Human Development and Capabilities : A Multi-Disciplinary Journal for People-Centered Development     Hybrid Journal   (Followers: 21)
Journal of Multicultural Counseling and Development     Hybrid Journal   (Followers: 7)
Journal of Psychological Issues in Organizational Culture     Hybrid Journal   (Followers: 8)
Journal of Vocational Behavior     Hybrid Journal   (Followers: 27)
Neurocritical Care     Hybrid Journal   (Followers: 17)
Palliative & Supportive Care     Hybrid Journal   (Followers: 32)
Performance Improvement Quarterly     Hybrid Journal   (Followers: 3)
Recherches & √©ducations     Open Access  
Research on Economic Inequality     Hybrid Journal   (Followers: 9)
Trabajo : Revista de la Asociaci√≥n Estatal de Centros Universitarios de Relaciones Laborales y Ciencias del Trabajo     Open Access  
Vocations and Learning     Hybrid Journal   (Followers: 7)
Similar Journals
Journal Cover
International Journal for Quality in Health Care
Journal Prestige (SJR): 1.348
Citation Impact (citeScore): 2
Number of Followers: 39  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1353-4505 - ISSN (Online) 1464-3677
Published by Oxford University Press Homepage  [419 journals]
  • The glaring omission in hospital ranking and quality grading programs:
           emergency department boarding

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      Authors: Weiner S; Salmasian H, Mendu M.
      Abstract: Hospitals in the United States are assessed and ranked by several agencies and services, including U.S. News & World Report. Frequently, though, the key hospital throughput metric of inpatient boarding time in the emergency department (ED) is not considered when ranking hospitals. As a result, there is a discordance in which highly ranking hospitals may be poor performers in boarding of patients, a practice with known adverse safety effects. This article outlines the rationale for considering ED boarding in hospital ranking and quality assessments.
      PubDate: Sat, 27 Nov 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab156
      Issue No: Vol. 33, No. 4 (2021)
       
  • Advancing the accreditation economy: a critical reflection

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      Authors: Hinchcliff R.
      PubDate: Fri, 19 Nov 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab154
      Issue No: Vol. 33, No. 4 (2021)
       
  • A hybrid Shewhart chart for visualizing and learning from epidemic data

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      Authors: Parry G; Provost L, Provost S, et al.
      Abstract: ObjectiveAs the globe endures the coronavirus disease 2019 (COVID-19) pandemic, we developed a hybrid Shewhart chart to visualize and learn from day-to-day variation in a variety of epidemic measures over time.ContextCountries and localities have reported daily data representing the progression of COVID-19 conditions and measures, with trajectories mapping along the classic epidemiological curve. Settings have experienced different patterns over time within the epidemic: pre-exponential growth, exponential growth, plateau or descent and/ or low counts after descent. Decision-makers need a reliable method for rapidly detecting transitions in epidemic measures, informing curtailment strategies and learning from actions taken.MethodsWe designed a hybrid Shewhart chart describing four ‘epochs’ ((i) pre-exponential growth, (ii) exponential growth, (iii) plateau or descent and (iv) stability after descent) of the COVID-19 epidemic that emerged by incorporating a C-chart and I-chart with a log-regression slope. We developed and tested the hybrid chart using international data at the country, regional and local levels with measures including cases, hospitalizations and deaths with guidance from local subject-matter experts.ResultsThe hybrid chart effectively and rapidly signaled the occurrence of each of the four epochs. In the UK, a signal that COVID-19 deaths moved into exponential growth occurred on 17 September, 44 days prior to the announcement of a large-scale lockdown. In California, USA, signals detecting increases in COVID-19 cases at the county level were detected in December 2020 prior to statewide stay-at-home orders, with declines detected in the weeks following. In Ireland, in December 2020, the hybrid chart detected increases in COVID-19 cases, followed by hospitalizations, intensive care unit admissions and deaths. Following national restrictions in late December, a similar sequence of reductions in the measures was detected in January and February 2021.ConclusionsThe Shewhart hybrid chart is a valuable tool for rapidly generating learning from data in close to real time. When used by subject-matter experts, the chart can guide actionable policy and local decision-making earlier than when action is likely to be taken without it.
      PubDate: Fri, 19 Nov 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab151
      Issue No: Vol. 33, No. 4 (2021)
       
  • Safety climate, leadership and patient views associated with hip fracture
           care quality and clinician perceptions of hip fracture care performance

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      Authors: Do V; Mitchell R, Clay-Williams R, et al.
      Abstract: BackgroundHip fracture is a major public health concern for older adults, requiring surgical treatment for patients presenting at hospitals across Australia. Although guidelines have been developed to drive appropriate care of hip fracture patients in hospitals, data on health outcomes suggest these are not well-followed.ObjectiveThis study aims to examine whether clinician measures of safety, teamwork and leadership, and patient perceptions of care are associated with key indicators of hip fracture care and the extent to which there is agreement between clinician perceptions of hip fracture care performance and actual hospital performance of hip fracture care.MethodsRetrospective analysis was performed on a series of questionnaires used to assess hospital department- and patient-level measures from the Deepening our Understanding of Quality in Australia study. Data were analysed from 32 public hospitals that encompassed 23 leading hip fracture clinicians, 716 patient medical records and 857 patients from orthopaedic public hospital wards.ResultsAggregated across all hospitals, only 5 of 12 of the key hip fracture indicators had ≥50% adherence. Adherence to indicators requiring actions to be performed within a recommended time period was poor (7.2–25.6%). No Patient Measure of Safety or clinician-based measures of teamwork, safety climate or leadership were associated with adherence to key indicators of hip fracture care. Simple proportionate agreement between clinician perceptions and actual hospital performance was generally strong, but few agreement coefficients were compelling.ConclusionThe development of strong quality management processes requires ongoing effort. The findings of this study provide important insights into the relationship between hospital care and outcomes for hip fracture patients and could drive the design of targeted interventions for improved quality assurance of hip fracture care.
      PubDate: Fri, 19 Nov 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab152
      Issue No: Vol. 33, No. 4 (2021)
       
  • Feedback of ATP measurement as a tool for reducing environmental
           contamination in hospitals in the Dutch/Belgian border area

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      Authors: Van Arkel A; Willemsen I, Kilsdonk-Bode L, et al.
      Abstract: DesignA two-phase prospective intervention study.ObjectiveThe objective of this study was to determine if feedback of adenosine triphosphate (ATP) measurements decreases environmental contamination within hospitals in the Dutch/Belgian border area.MethodsStandardized ATP measurements were conducted in nine hospitals on pre-defined fomites. Four different fomite groups were defined: medical devices, patient-bound materials, ward-bound materials and sanitary items. ATP results were reported in relative light unit (RLU), RLU >1000 was considered as ‘not clean.’ Two rounds of ATP measurements were conducted. After the first round of ATP measurements, results were provided to the wards and cleaning staff. The second round of ATP measurements was performed one year later. The amount of surface contamination before and after the feedback was compared.ResultsIn total 1923 ATP measurements were performed. Before feedback 960 ATP measurements were conducted and after feedback 963 were conducted. The overall median reduction in RLU was 381 (P < 0.001), from 568 before feedback to 187 afterward. In each hospital there was a reduction of the median RLU after feedback.ConclusionsSubstantial reductions in RLU values were found after feedback of ATP measurements. Feedback of ATP measurement in itself was associated with a major reduction of surface contamination in hospitals.
      PubDate: Thu, 18 Nov 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab153
      Issue No: Vol. 33, No. 4 (2021)
       
  • Defining value in health care: a scoping review of the literature

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      Authors: Landon S; Padikkala J, Horwitz L.
      Abstract: BackgroundAs health-care spending rises internationally, policymakers have increasingly begun to look to improve health-care value. However, the precise definition of health-care value remains ambiguous.MethodsWe conducted a scoping review of the literature to understand how value has been defined in the context of health care. We searched PubMed, Embase, Google Scholar, PolicyFile and Scopus between February and March 2020 to identify articles eligible for inclusion. Publications that defined value (including high or low value) using an element of cost and an element of outcomes were included in this review. No restrictions were placed on the date of publication. Articles were limited to those published in English.ResultsOut of 1750 publications screened, 46 met inclusion criteria. Among the 46 included articles, 22 focused on overall value, 19 on low value and 5 on high value. We developed a framework to categorize definitions based on three core domains: components, perspective and scope. Differences across these three domains contributed to significant variations in definitions of value.ConclusionsHow value is defined has the potential to influence measurement and intervention strategies in meaningful ways. To effectively improve value in health-care systems, we must understand what is meant by value and the merits of different definitions.
      PubDate: Thu, 11 Nov 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab140
      Issue No: Vol. 33, No. 4 (2021)
       
  • Interruption of initial patient assessment in the emergency department and
           its effect on patient perception of care quality

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      Authors: Johnson K; Lindsell C, Froehle C, et al.
      Abstract: BackgroundTriage is a critical first step in appropriately caring for patients in the emergency department (ED). Patients’ assumptions of the care they will receive can be established in triage. Interruptions to this process can disrupt patient flow, cause errors and lead to patient dissatisfaction.ObjectiveThe purpose of this study was to determine how the frequency and duration of interruptions during triage are associated with errors, patient satisfaction and patient’s perception of the care they received.MethodsProspective, observational, cohort study conducted in the ED of a Level 1 trauma center. Interruptions were measured using time-and-motion observations of triage interviews performed by nurses and physicians. Patients were surveyed immediately after triage interviews were complete.ResultsSurveys were completed for 178 observations. In total, 62.9% of the observations were interrupted between 1 and 5 times. While interruptions did not significantly influence patient satisfaction directly, interruptions positively influenced triage duration, which was negatively associated with patient satisfaction. Increased errors were associated with increasing frequency of triage interruptions. Triage interruptions were not associated with either patient satisfaction or perceived caregiver competence. Overall, the majority (76.6%) of patients were satisfied with their care; patient satisfaction was associated with the perceived competency of caregivers but was not associated with errors.ConclusionInterruptions are associated with increased errors and delays in patient care. Although increased triage duration adversely affected patient satisfaction, patients’ perceptions were not influenced by interruptions. While patient satisfaction is essential, a lack of association between patient satisfaction and errors suggests that using patient satisfaction as a measure of care quality may omit important safety information.
      PubDate: Tue, 09 Nov 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab146
      Issue No: Vol. 33, No. 4 (2021)
       
  • Organizational capacity for patient and family engagement in hospital
           planning and improvement: interviews with patient/family advisors,
           managers and clinicians

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      Authors: Anderson N; Baker G, Moody L, et al.
      Abstract: BackgroundPatient and family engagement (PE) in healthcare planning and improvement achieves beneficial outcomes and is widely advocated, but a lack of resources is a critical barrier. Little prior research studied how organizations support engagement specifically in hospitals.ObjectiveWe explored what constitutes hospital capacity for engagement.MethodsWe conducted descriptive qualitative interviews and complied with criteria for rigour and reporting in qualitative research. We interviewed patient/family advisors, engagement managers, clinicians and executives at hospitals with high engagement activity, asking them to describe essential resources or processes. We used content analysis and constant comparison to identify themes and corresponding quotes and interpreted findings by mapping themes to two existing frameworks of PE capacity not specific to hospitals.ResultsWe interviewed 40 patient/family advisors, patient engagement managers, clinicians and corporate executives from nine hospitals (two < 100 beds, four 100 + beds, three teaching). Four over-arching themes about capacity considered essential included resources, training, organizational commitment and staff support. Views were similar across participant and hospital groups. Resources included funding and people dedicated to PE and technology to enable communication and collaboration. Training encompassed initial orientation and project-specific training for patient/family advisors and orientation for new staff and training for existing staff on how to engage with patient/family advisors. Organizational commitment included endorsement from the CEO and Board, commitment from staff and continuous evaluation and improvement. Staff support included words and actions that conveyed value for the role and input of patient/family advisors. The blended, non-hospital-specific framework captured all themes. Hospitals of all types varied in the availability of funding dedicated to PE. In particular, reimbursement of expenses and compensation for time and contributions were not provided to patient/family advisors. In addition to skilled engagement managers, the role of clinician or staff champions was viewed as essential.ConclusionThe findings build on prior research that largely focused on PE in individual clinical care or research or in primary care planning and improvement. The findings closely aligned with existing frameworks of organizational capacity for PE not specific to hospital settings, which suggests that hospitals could use the blended framework to plan, evaluate and improve their PE programs. Further research is needed to yield greater insight into how to promote and enable compensation for patient/family advisors and the role of clinician or staff champions in supporting PE.
      PubDate: Fri, 29 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab147
      Issue No: Vol. 33, No. 4 (2021)
       
  • An appraisal of healthcare accreditation agencies and programs:
           similarities, differences, challenges and opportunities

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      Authors: Greenfield D; Iqbal U, O’connor E, et al.
      Abstract: BackgroundThe study, following similar reviews in 2000 and 2010, presents an update of knowledge about external evaluation agencies and accreditation programs.ObjectiveThe study aim was to investigate the current profile of external evaluation agencies identifying their program features, and significant changes and challenges.
      PubDate: Wed, 27 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab150
      Issue No: Vol. 33, No. 4 (2021)
       
  • Patients experience more support, information and involvement after
           first-time hospital accreditation: a before and after study in the Faroe
           Islands

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      Authors: Bergholt M; Falstie-jensen A, Brink valentin J, et al.
      Abstract: BackgroundThe impact of hospital accreditation on the experiences of patients remains a weak point in quality improvement research. This is surprising given the time and cost of accreditation and the fact that patient experiences influence outcomes. We investigated the impact of first-time hospital accreditation on patients’ experience of support from health-care professionals, information and involvement in decisions.ObjectiveWe aimed to examine the association between first-time hospital accreditation and patient experiences.MethodsWe conducted a longitudinal study in the three Faroese hospitals that, unlike hospitals on the Danish mainland and elsewhere internationally, had no prior exposure to systematic quality improvement. The hospitals were accredited in 2017 according to a modified second version of the Danish Healthcare Quality program. Study participants were 18 years or older and hospitalized for at least 24 h in 2016 before or 2018 after accreditation. We administered the National Danish Survey of Patient Experiences for acute and scheduled hospitalization. Patients rated their experiences of support, information and involvement in decision-making on a 5-point Likert scale. We calculated individual and grouped mean item scores, the percentages of scores ≥4, the mean score difference, the relative risk (RR) for high/very high scores (≥4) using Poisson regression and the risk difference. Patient experience ratings were compared using mixed effects linear regression.ResultsIn total, 400 patients before and 400 after accreditation completed the survey. After accreditation patients reported increased support from health professionals; adjusted mean score difference (adj. mean diff.) = 1.99 (95% confidence interval (CI): 1.89, 2.10), feeling better informed before and during the hospitalization; adj. mean diff. = 1.14 (95% CI: 1.07; 1.20) and more involved in decision-making; adj. mean diff. = 1.79 (95% CI: 1.76; 1.82). Additionally, the RR for a high/very high score (≥4) was significantly greater on 15 of the 16 questionnaire items. The greatest RR for a high/very high score (≥4) after accreditation, was found for the item ‘Have you had a dialogue with the staff about the advantages and disadvantages of the examination/treatment options available'’; RR= 5.73 (95% CI: 4.51, 7.27).ConclusionHospitalized patients experienced significantly more support from health professionals, information and involvement in decision-making after accreditation. Future research on accreditation should include the patients’ perspective.
      PubDate: Tue, 26 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab149
      Issue No: Vol. 33, No. 4 (2021)
       
  • Mapping the quality of basic and comprehensive emergency obstetric care
           services in Haiti

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      Authors: Adegbosin A; Warnken J, Sun J.
      Abstract: ObjectiveTo investigate geographical inequalities and changes in the quality of emergency obstetric care services available in Haiti over time.MethodsWe utilized data from the Service Provision Assessment survey of all health facilities in Haiti in 2013 and 2017.We developed a quality index for basic emergency obstetric care (BEmOC) and comprehensive emergency obstetric care (CEmOC) based on the items in the signal functions of an emergency obstetric care framework, using a structure, process and outcome framework. We measured the quality index of all facilities in 2013 and 2017. We also assessed geographical trends and changes in quality between 2013 and 2017 using geospatial analysis.ResultOur analysis showed that basic structure items such as connection to electricity grid, manual vacuum extractors, vacuum aspirators and dilation and curettage kits were widely unavailable at healthcare facilities. There was a significant improvement in indicators of structure (P < 0.001) and BEmOC (P = 0.03) in primary facilities; however, there was no significant change in the quality of CEmOC in primary facilities (P = 0.18). Similarly, there was no significant change in any of the structure or process indicators at secondary care facilities.ConclusionThe availability of BEmOC at several Haitian facilities remains poor; however, there was significant improvement at primary care facilities, with little to no change in overall quality at secondary health facilities.
      PubDate: Wed, 20 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab143
      Issue No: Vol. 33, No. 4 (2021)
       
  • Ensuring medication safety for consumers from ethnic minority backgrounds:
           The need to address unconscious bias within health systems

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      Authors: Chauhan A; Walpola R.
      Abstract: Medication safety remains a pertinent issue for health systems internationally, with patients from ethnic minority backgrounds recognized at increased risk of exposure to harm resulting from unsafe medication practices. While language and communication barriers remain a central issue for medication safety for patients from ethnic minority backgrounds, increasing evidence suggests that unconscious bias can alter practitioner behaviours, attitudes and decision-making leading to unsafe medication practices for this population. Systemwide, service and individual level approaches such as cultural competency training and self-reflections are used to address this issue, however, the effectiveness of these strategies is not known. While engagement is proposed to improve patient safety, the strategies currently used to address unconscious bias seem tokenistic. We propose that including consumers from ethnic minority backgrounds in design and delivery of the education programs for health professionals, allocating extra time to understand their needs and preferences in care, and co-designing engagement strategies to improve medication related harm with diverse ethnic minority groups are key to mitigating medication related harm arising as a result of unconscious bias.
      PubDate: Tue, 19 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab145
      Issue No: Vol. 33, No. 4 (2021)
       
  • Effect of automated unit dose dispensing with barcode scanning on
           medication administration errors: an uncontrolled before-and-after study

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      Authors: Jessurun J; Hunfeld N, Van Rosmalen J, et al.
      Abstract: BackgroundMedication administration errors (MAEs) occur frequently in hospitals and may compromise patient safety. Preventive strategies are needed to reduce the risk of MAEs.ObjectiveThe primary aim of this study was to assess the effect of central automated unit dose dispensing with barcode-assisted medication administration on the prevalence of MAEs. Secondary aims were to assess the effect on the type and potential severity of MAEs. Furthermore, compliance with procedures regarding scanning of patient and medication barcodes and nursing staff satisfaction with the medication administration system were assessed.MethodsWe performed a prospective uncontrolled before-and-after study in six clinical wards in a Dutch university hospital from 2018 to 2020. MAE data were collected by observation. The primary outcome was the proportion of medication administrations with one or more MAEs. Secondary outcomes were the type and potential severity of MAEs, rates of compliance with patient identification and signing of administered medication by scanning and nursing staff satisfaction with the medication administration system. Multivariable mixed-effects logistic regression analyses were used for the primary outcome to adjust for confounding and for clustering on nurse and patient level.ResultsOne or more MAEs occurred in 291 of 1490 administrations (19.5%) pre-intervention and in 258 of 1630 administrations (15.8%) post-intervention (adjusted odds ratio 0.70, 95% confidence interval 0.51–0.96). The rate of omission fell from 4.6% to 2.0% and of wrong dose from 3.8% to 2.1%, whereas rates of other MAE types were similar. The rate of potentially harmful MAEs fell from 3.0% (n = 44) to 0.3% (n = 5). The rates of compliance with scanning of patient and medication barcode post-intervention were 13.6% and 55.9%, respectively.The median overall satisfaction score of the nurses with the medication administration system on a 100-point scale was 70 (interquartile range 63–75, n = 193) pre-intervention and 70 (interquartile range 60–78, n = 145) post-intervention (P = 0.626, Mann–Whitney U test).ConclusionThe implementation of central automated unit dose dispensing with barcode-assisted medication administration was associated with a lower probability of MAEs, including potentially harmful errors, but more compliance with scanning procedures is needed. Nurses were moderately satisfied with the medication administration system, both before and after implementation. In conclusion, despite low compliance with scanning procedures, this study shows that this intervention contributes to the improvement of medication safety in hospitals.
      PubDate: Mon, 18 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab142
      Issue No: Vol. 33, No. 4 (2021)
       
  • Effect of a waiting room communication strategy on imaging rates and
           awareness of public health messages for low back pain

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      Authors: Sharma S; Traeger A, Tcharkhedian E, et al.
      Abstract: BackgroundFew studies have investigated the effects of waiting room communication strategies on health-care behavior.ObjectiveWe aimed to determine the effect of a waiting room communication strategy, designed to raise awareness of potential harms of unnecessary imaging, on lumbar imaging rates in the emergency department (ED).MethodsWe conducted a controlled experimental study with a replicated time series design. The design included a 6-week run-in time. Following this there were alternating 1-week intervention and control periods. The intervention group received a communication strategy describing the potential harms of unnecessary imaging for low back pain, shown on a 55” LCD screen positioned in the ED waiting room. The communication strategy was designed by a creative innovation agency and included five digital posters and a patient leaflet. The control group received standard messaging for the waiting room at the time, shown on the same 55” LCD screen, and access to the patient leaflet. The primary outcome was the number and proportion of people presenting to ED with low back pain who received at least one lumbar imaging test, measured using routinely collected ED data. Secondary patient-reported outcomes (patient satisfaction and awareness of campaign messages) were collected from a sample of people presenting for any condition who responded to a text-message-based survey.ResultsFor the imaging outcome, 337 people presenting to ED with low back pain were included over a 4-month period (intervention n = 99; control n = 238). All had available data on lumbar imaging. Use of lumbar imaging was 25% in those exposed to the communication strategy [95% confidence interval (CI) = 18% to 35%] compared with 29% in those exposed to the standard waiting room messaging [95% CI = 23% to 35%; odds ratio (OR) = 0.83, 95% CI = 0.49 to 1.41]. For the patient-reported outcomes, 349 patients presenting to ED for any condition responded to the survey (intervention n = 170; control n = 179; response rate = 33%). There was uncertain evidence that the intervention increased awareness of the communication strategy leaflet (OR = 2.00, 95% CI = 0.90 to 4.47). Other measures did not suggest between-group differences in patient satisfaction or awareness of the campaign messages.ConclusionA communication strategy displayed in the ED waiting room may slightly reduce the proportion of patients with low back pain who receive lumbar imaging, although there is uncertainty due to imprecision. The campaign did not appear to increase awareness of campaign messages or affect patient satisfaction in a sample of patients presenting to the ED for any reason. Larger studies should investigate whether simple, low-cost waiting room communication strategies can raise awareness of unnecessary healthcare and influence health-care quality.Trial registrationACTRN12620000300976, 05/03/2020
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab129
      Issue No: Vol. 33, No. 4 (2021)
       
  • How safe is prehospital care' A systematic review

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      Authors: O’connor P; O’malley R, Lambe K, et al.
      Abstract: BackgroundAs compared to other domains of healthcare, little is known about patient safety incidents (PSIs) in prehospital care. The aims of our systematic review were to identify how the prevalence and level of harm associated with PSIs in prehospital care are assessed; the frequency of PSIs in prehospital care; and the harm associated with PSIs in prehospital care.MethodSearches were conducted of Medline, Web of Science, PsycInfo, CINAHL, Academic Search Complete and the grey literature. Reference lists of included studies and existing related reviews were also screened. English-language, peer-reviewed studies reporting data on number/frequency of PSIs and/or harm associated with PSIs were included. Two researchers independently extracted data from the studies and carried out a critical appraisal using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).ResultsOf the 22 included papers, 16 (73%) used data from record reviews, and 6 (27%) from incident reports. The frequency of PSIs in prehospital care was found to be a median of 5.9 per 100 records/transports/patients. A higher prevalence of PSIs was identified within studies that used record review data (9.9 per 100 records/transports/patients) as compared to incident reports (0.3 per records/transports/patients). Across the studies that reported harm, a median of 15.6% of PSIs were found to result in harm. Studies that utilized record review data reported that a median of 6.5% of the PSIs resulted in harm. For data from incident reporting systems, a median of 54.6% of incidents were associated with harm. The mean QATSDD score was 25.6 (SD = 4.1, range = 16–34).ConclusionsThis systematic review gives direction as to how to advance methods for identifying PSIs in prehospital care and assessing the extent to which patients are harmed.
      PubDate: Fri, 08 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab138
      Issue No: Vol. 33, No. 4 (2021)
       
  • Are clinicians using routinely collected data to drive practice
           improvement' A cross-sectional survey

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      Authors: Gawthorne J; Fasugba O, Levi C, et al.
      Abstract: BackgroundClinical registry participation is a measure of healthcare quality. Limited knowledge exists on Australian hospitals’ participation in clinical registries and whether this registry data informs quality improvement initiatives.ObjectiveTo identify participation in clinical registries, determine if registry data inform quality improvement initiatives, and identify registry participation enablers and clinicians’ educational needs to improve use of registry data to drive practice change.MethodsA self-administered survey was distributed to staff coordinating registries in seven hospitals in New South Wales, Australia. Eligible registries were international-, national- and state-based clinical, condition-/disease-specific and device/product registries.ResultsResponse rate was 70% (97/139). Sixty-two (64%) respondents contributed data to 46 eligible registries. Registry reports were most often received by nurses (61%) and infrequently by hospital executives (8.4%). Less than half used registry data ‘always’ or ‘often’ to influence practice improvement (48%) and care pathways (49%). Protected time for data collection (87%) and benchmarking (79%) were ‘very likely’ or ‘likely’ to promote continued participation. Over half ‘strongly agreed’ or ‘agreed’ that clinical practice improvement training (79%) and evidence–practice gap identification (77%) would optimize use of registry data.ConclusionsRegistry data are generally only visible to local speciality units and not routinely used to inform quality improvement. Centralized on-going registry funding, accessible and transparent integrated information systems combined with data informed improvement science education could be first steps to promote quality data-driven clinical improvement initiatives.
      PubDate: Wed, 06 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab141
      Issue No: Vol. 33, No. 4 (2021)
       
  • Disparities in unmet health service needs among people with disabilities
           in China

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      Authors: Zhao X; Wang H.
      Abstract: BackgroundExtensive research has explored disparities in access to health care between people with and without disabilities, but much less is understood about disparities and associated factors within the disabled population.ObjectiveThe aim of this study was to examine differences in the prevalence of unmet health-care needs by residential status (hukou status) and disability type among people with disabilities.MethodsOur data were from the National Survey on Basic Public Service Delivery of Persons with Disabilities. The analysis sample included a nationally representative sample of 9 642 112 adults (aged 16+ years) with disabilities. Associated factors were obtained at both individual level and community level. Cross-sectional multivariable logistic regression analyses were conducted to compare unmet medical, care, rehabilitation and accessibility needs among people with different residential statuses and different types of disabilities.ResultsThe estimated prevalence of unmet medical, care, rehabilitation and accessibility needs is 15.4%, 10.2%, 45.6% and 13.7%, respectively. Rural hukou was associated with an important 13–40% increase in unmet health-care needs for people with disabilities in China. These rural–urban disparities in unmet health service needs can be partly explained by community-level factors, including access to facilities, social participation and health professionals. Disparities across the type of disability were smaller, but on average, people with multiple disabilities appeared to have the highest rates of unmet care, medical and accessibility needs, whereas those with physical disability had the highest unmet rehabilitation need.ConclusionsDifferences by residential status and impairment type were evident in all types of unmet health service needs. Targeted policy designs that meet the needs for justice and equality of people with disabilities are advisable. Public health and policy efforts are required to improve access to health service and meet the needs of people with disabilities, especially in rural practices and for particular disability groups.
      PubDate: Wed, 06 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab136
      Issue No: Vol. 33, No. 4 (2021)
       
  • Promoting systemic incident analysis in healthcare—key challenges
           and ways forwards

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      Authors: Waterson P.
      PubDate: Wed, 06 Oct 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab139
      Issue No: Vol. 33, No. 4 (2021)
       
  • The intersection of big data and epidemiology for epidemiologic research:
           The impact of the COVID-19 pandemic

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      Authors: Tang C; Plasek J, Zhang S, et al.
      Abstract: Big data epidemiology facilitates pandemic response by providing data-driven insights by utilizing big data tools that differ from traditional methods. Aspects regarding ‘garbage in, garbage out’, such as insufficient data, inaccessibility of data, missing data, uncertainty in handling data and bias in analysis or common findings are addressable by combining techniques across disciplines.
      PubDate: Sun, 12 Sep 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab134
      Issue No: Vol. 33, No. 4 (2021)
       
  • Adopting systems models for multiple incident analysis: utility and
           usability

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      Authors: Wheway J; Jun G.
      Abstract: BackgroundThis study aims to present two system models widely used in Human Factors and Ergonomics (HF/E) and evaluate whether the models are adoptable to England’s national patient safety team in improving the exploration and understanding of multiple incident reports of an active patient safety issue and the development of the remedial actions for a potential National Patient Safety Alert. The existing process of examining multiple incidents is based on inductive thematic analysis and forming the remedial actions is based on barrier analysis of intelligence on potential solutions. However, no formal systems models evaluated in this study have been used.MethodsAcciMap and Systems Engineering Initiative for Patient Safety (SEIPS) were selected, applied and evaluated to the analysis of two different sets of patient safety incidents: (i) incidents concerning ingestion of superabsorbent polymer granules and (ii) incidents concerning the interruption in use of High Nasal Flow Oxygen. The first set was analysed by the first author and the utility and usability were reflected. The second set was analysed collectively by a purposeful sample of patient safety team members, who create the National Patient Safety Alerts from incident-level data and information. All of them attended a 30-min video-based training and a 1.5 h case-based online workshop. Post-workshop individual interviews were conducted to evaluate their perceived utility and usability of each model.ResultsThe patient safety team showed overwhelming support for the utility of the system models as a ‘framework’ that provides a systematic, structured way of looking at an issue and examining the causes, whilst also sharing concerns regarding their usability. AcciMap was viewed useful particularly in providing a visual comprehensive overview of the issue but considered chaotic by some participants due to many arrows between factors. SEIPS was perceived easier to understand due to the familiarity of the structure (Donbedian’s model), but the non-hierarchical format of SEIPS was considered less useful.ConclusionsThe participants of the study agreed with the high level of utility of both models for their unique strengths, but shared some concern for the usability of them in terms of complexity and further training/coaching time would be required to adopt these models in their daily practices. It is recommended that the gap between HF/E practitioners and patient safety practitioners can be narrowed by strengthening education, and coaching and mentoring relationships between the two groups, led by the increasing number of healthcare practitioners who embrace their membership to HF/E practice.
      PubDate: Sat, 11 Sep 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab135
      Issue No: Vol. 33, No. 4 (2021)
       
  • Gender in the consolidated criteria for reporting qualitative research
           (COREQ) checklist

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      Authors: Albury C; Pope C, Shaw S, et al.
      PubDate: Tue, 24 Aug 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab123
      Issue No: Vol. 33, No. 4 (2021)
       
 
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