Subjects -> OCCUPATIONS AND CAREERS (Total: 33 journals)
Showing 1 - 23 of 23 Journals sorted alphabetically
Advances in Developing Human Resources     Hybrid Journal   (Followers: 33)
American Journal of Pastoral Counseling     Hybrid Journal  
BMC Palliative Care     Open Access   (Followers: 39)
British Journal of Guidance & Counselling     Hybrid Journal   (Followers: 22)
Career Development and Transition for Exceptional Individuals     Hybrid Journal   (Followers: 10)
Career Development International     Hybrid Journal   (Followers: 19)
Career Development Quarterly     Hybrid Journal   (Followers: 5)
Community Development     Hybrid Journal   (Followers: 26)
Education + Training     Hybrid Journal   (Followers: 28)
Entrepreneurship Research Journal     Hybrid Journal   (Followers: 16)
Equality, Diversity and Inclusion : An International Journal     Hybrid Journal   (Followers: 21)
Field Actions Science Reports     Open Access  
Formation emploi     Open Access  
Health Care Analysis     Hybrid Journal   (Followers: 17)
Human Resource Development Review     Hybrid Journal   (Followers: 33)
Industrial and Organizational Psychology     Hybrid Journal   (Followers: 27)
International Journal for Educational and Vocational Guidance     Hybrid Journal   (Followers: 9)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 41)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 15)
International Journal of Work Innovation     Hybrid Journal   (Followers: 2)
Journal of Career Assessment     Hybrid Journal   (Followers: 9)
Journal of Career Development     Hybrid Journal   (Followers: 12)
Journal of Human Capital     Full-text available via subscription   (Followers: 13)
Journal of Human Development and Capabilities : A Multi-Disciplinary Journal for People-Centered Development     Hybrid Journal   (Followers: 24)
Journal of Multicultural Counseling and Development     Hybrid Journal   (Followers: 8)
Journal of Psychological Issues in Organizational Culture     Hybrid Journal   (Followers: 8)
Journal of Vocational Behavior     Hybrid Journal   (Followers: 28)
Neurocritical Care     Hybrid Journal   (Followers: 17)
Palliative & Supportive Care     Hybrid Journal   (Followers: 37)
Performance Improvement Quarterly     Hybrid Journal   (Followers: 3)
Professions and Professionalism     Open Access   (Followers: 9)
Recherches & éducations     Open Access  
Rehabilitation Counseling Bulletin     Hybrid Journal   (Followers: 3)
Research on Economic Inequality     Hybrid Journal   (Followers: 11)
Trabajo : Revista de la Asociación Estatal de Centros Universitarios de Relaciones Laborales y Ciencias del Trabajo     Open Access  
Vocations and Learning     Hybrid Journal   (Followers: 9)
Work and Occupations     Hybrid Journal   (Followers: 56)
Work, Employment & Society     Hybrid Journal   (Followers: 52)
Similar Journals
Journal Cover
International Journal for Quality in Health Care
Journal Prestige (SJR): 1.348
Citation Impact (citeScore): 2
Number of Followers: 41  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1353-4505 - ISSN (Online) 1464-3677
Published by Oxford University Press Homepage  [416 journals]
  • Discrepancy between patient-reported and clinician-documented symptoms for
           myocardial perfusion imaging: initial findings from a prospective registry
           
    • Authors: Schwartz C; Winchester D.
      Abstract: BackgroundOccasionally, the symptoms reported by patients disagree with those documented in the medical record. We designed the Patient Centered Assessment of Symptoms (PCAS) registry to measure discrepancies between patient-reported and clinician-documented symptoms.ObjectiveUse patient-derived symptoms data to measure discrepancies with clinical documentation.MethodsThe PCAS registry captured data from a prospective cohort of patients undergoing myocardial perfusion imaging (MPI) and includes free response and structured questions to gauge symptoms. Clinician-documented symptoms were extracted from the patients’ medical records. The appropriateness of testing was determined twice: once using the patient-reported symptoms and once using the clinician-documented symptoms.ResultsA total of 90 subjects were enrolled, among whom diabetes (36.7%), prior coronary disease (28.9%), hypertension (80.0%) and hyperlipidemia (85.6%) were common. Percentage of patient-reported symptoms compared to clinician-documented symptoms and agreement were as follows: chest pain (patient 29.0%, clinician 36.6%, moderate [kappa = 0.54]), chest pressure (patient 18.3%, clinician 10.8%, fair [kappa = 0.27]), dyspnea (patient 41.0%, clinician 36.6%, fair [kappa = 0.28]), onset with exertion (patient 61.7%, clinician 59.6%, slight [kappa = 0.17]), symptoms same as prior coronary artery disease (patient 46.2%, clinician 15.3%, slight [kappa = 0.01]). As a result of these inconsistencies, appropriateness ratings were different for 13.3% (n = 12) subjects.ConclusionIn this prospective registry of patients undergoing MPI, we observed substantial disagreements between patient-reported and clinician-documented symptoms. Disagreement resulted in a considerable proportion of MPI appropriateness ratings also being incongruous.
      PubDate: Thu, 29 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab076
      Issue No: Vol. 33, No. 2 (2021)
       
  • Effect of COVID-19 on hospital visits in Ningbo, China: an interrupted
           time-series analysis
    • Authors: Yang Z; Wu M, Lu J, et al.
      Abstract: ObjectiveUnprecedented rigorous public health measures were implemented during the coronavirus disease 2019 (COVID-19) epidemic, but it is still unclear how the intervention influenced hospital visits for different types of diseases. We aimed to evaluate the impact of the intervention on hospital visits in Yinzhou District, Ningbo, Zhejiang province, China.MethodsWe conducted an interrupted time-series analysis from 1 January 2017 to 6 September 2020 based on the Yinzhou Health Information System in Ningbo, Zhejiang province. The beginning of the intervention was on 23 January 2020, and thus, there were 160 weeks before the intervention and 32 weeks after the implementation of the intervention. Level changes between expected and observed hospital visits in the post-intervention period were estimated using quasi-Poisson regression models.ResultsCompared with the expected level, there was an estimated decrease of −22.60% (95% confidence interval (CI): −27.53%, −17.36%) in the observed total hospital visits following the intervention. Observed hospital visits for diseases of the respiratory system were found to be decreased dramatically (−62.25%; 95% CI: −65.62%, −58.60%). However, observed hospital visits for certain diseases were estimated to be increased, including diseases of the nervous system (+11.17%; 95% CI: +3.21%, +19.74%); diseases of pregnancy, childbirth and the puerperium (+27.01%; 95% CI: +17.89%, +36.85%); certain conditions originating in the perinatal period (+45.05%; 95% CI: +30.24%, +61.56%); and congenital malformation deformations and chromosomal abnormalities (+35.50%; 95% CI: +21.24%, +51.45%).ConclusionsOur findings provided scientific evidence that cause-specific hospital visits evolve differently following the intervention during the COVID-19 epidemic.
      PubDate: Wed, 28 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab078
      Issue No: Vol. 33, No. 2 (2021)
       
  • Masked and distanced: a qualitative study of how personal protective
           equipment and distancing affect teamwork in emergency care
    • Authors: Hayirli T; Stark N, Bhanja A, et al.
      Abstract: BackgroundNewly intensified use of personal protective equipment (PPE) in emergency departments presents teamwork challenges affecting the quality and safety of care at the frontlines.ObjectiveWe conducted a qualitative study to categorize and describe barriers to teamwork posed by PPE and distancing in the emergency setting.MethodsWe conducted 55 semi-structured interviews between June 2020 and August 2020 with personnel from two emergency departments serving in a variety of roles. We then performed a thematic analysis to identify and construct patterns of teamwork challenges into themes.ResultsWe discovered two types of challenges to teamwork: material barriers related to wearing masks, gowns and powered air-purifying respirators, and spatial barriers implemented to conserve PPE and limit coronavirus exposure. Both material and spatial barriers resulted in disrupted communication, roles and interpersonal relationships, but they did so in unique ways. Material barriers muffled information flow, impeded team member recognition and role/task division, and reduced belonging and cohesion while increasing interpersonal strain. Spatial barriers resulted in mediated communication and added physical and emotional distance between teammates and patients.ConclusionOur findings identify specific aspects of how intensified PPE use disrupts teamwork and can inform efforts to ensure care quality and safety in emergency settings as PPE use continues during and, potentially beyond, the coronavirus disease-2019 pandemic.
      PubDate: Sat, 17 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab069
      Issue No: Vol. 33, No. 2 (2021)
       
  • From accreditation to quality improvement—The Danish National
           Quality Programme
    • Authors: Uggerby C; Kristensen S, Mackenhauer J, et al.
      Abstract: The Danish government launched a new National Quality Programme (NQP) in healthcare in 2015. It has changed the focus from old public management in terms of accreditation, regulation, rules and standards to new public governance focusing on delivering high quality healthcare and outcomes of value for the patients, health professionals and the Danish healthcare system. The NQP aims to strengthen the focus on continuous quality improvement and the launch of the programme was accompanied by a decision to phase out accreditation of public hospitals. The NQP includes 1) eight specific national quality goals, 2) a national educational programme for quality management, and 3) establishment of quality improvement collaboratives. Since the establishment of the NQP the indicator results have improved in several important clinical areas. However, causal conclusions related to the effect of the NQP cannot yet be made. This perspective on quality paper aims to give a short introduction to the NQP and documented outcomes.
      PubDate: Fri, 16 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab071
      Issue No: Vol. 33, No. 2 (2021)
       
  • Medication adherence as mandatory indicator in healthcare safety
    • Authors: Amir M; Feroz Z, Beg A.
      PubDate: Thu, 15 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab070
      Issue No: Vol. 33, No. 2 (2021)
       
  • A cost-effectiveness analysis of the Chronic Disease Management Program in
           patients with hypertension in Korea
    • Authors: Kim W; Lee S, Chun S.
      Abstract: BackgroundThe Chronic Disease Management Program (CDMP) of Korea has been introduced to improve care continuity in patients with hypertension and diabetes.ObjectiveThis study evaluated the cost effectiveness of the CDMP in patients with hypertension from the perspective of the healthcare payer.MethodsA cost-effectiveness analysis was performed based on a Markov simulation model. The cost and effect of the CDMP versus usual care was compared in individuals aged 40 years or above. The two strategies were presumed to result in a difference in the incidence of myocardial infarction, stroke, and chronic kidney disease. The model was analyzed over the lifetime of the cohort. Incremental cost-effectiveness ratio (ICER) was calculated by dividing the difference in lifetime costs by the difference in lifetime effects (quality adjusted life years, QALYs) between the two strategies. Costs were expressed in Korean Won (KRW).ResultsThe ICER value of the CDMP participation strategy was −5 761 088 KRW/QALY compared to usual care. Similar tendencies were found when limiting the population to only clinic users (−3 843 355 KRW/QALY) and national health examination participants (−5 595 185 KRW/QALY).ConclusionThe CDMP was highly cost-effective in patients with hypertension aged 40 years or above. Implementing efficient policies that enhance care coordination and improve outcomes in patients with hypertension is important.
      PubDate: Thu, 15 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab073
      Issue No: Vol. 33, No. 2 (2021)
       
  • Are operating room distractions, interruptions and disruptions associated
           with performance and patient safety' A systematic review and
           meta-analysis
    • Authors: Mcmullan R; Urwin R, Gates P, et al.
      Abstract: ObjectiveThe operating room is a complex environment in which distractions, interruptions and disruptions (DIDs) are frequent. Our aim was to synthesize research on the relationships between DIDs and (i) operative duration, (ii) team performance, (iii) individual performance and (iv) patient safety outcomes in order to better understand how interventions can be designed to mitigate the negative effects of DIDs.MethodsElectronic databases (MEDLINE, Embase, CINAHL and PsycINFO) and reference lists were systematically searched. Included studies were required to report the quantitative outcomes of the association between DIDs and team performance, individual performance and patient safety. Two reviewers independently screened articles for inclusion, assessed study quality and extracted data. A random-effects meta-analysis was performed on a subset of studies reporting total operative time and DIDs.ResultsTwenty-seven studies were identified. The majority were prospective observational studies (n = 15) of moderate quality. DIDs were often defined, measured and interpreted differently in studies. DIDs were significantly associated with extended operative duration (n = 8), impaired team performance (n = 6), self-reported errors by colleagues (n = 1), surgical errors (n = 1), increased risk and incidence of surgical site infection (n = 4) and fewer patient safety checks (n = 1). A random-effects meta-analysis showed that the proportion of total operative time due to DIDs was 22.0% (95% confidence interval 15.7–29.9).ConclusionDIDs in surgery are associated with a range of negative outcomes. However, significant knowledge gaps exist about the mechanisms that underlie these relationships, as well as the potential clinical and non-clinical benefits that DIDs may deliver. Available evidence indicates that interventions to reduce the negative effects of DIDs are warranted, but current evidence is not sufficient to make recommendations about potentially useful interventions.
      PubDate: Thu, 15 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab068
      Issue No: Vol. 33, No. 2 (2021)
       
  • Telemedicine usage via WeChat for children with congenital heart disease
           preoperatively during COVID-19 pandemic: a retrospective analysis
    • Authors: Zhang Q; Xie W, Lei Y, et al.
      Abstract: ObjectiveDuring the COVID-19 pandemic, parents of infants having medical problem face challenges of insufficient medical resources at home. The purpose of this study was to investigate the effect of WeChat-based telehealth services on the preoperative follow-up of infants with congenital heart disease (CHD) during the COVID-19 pandemic.MethodsThis study retrospectively analyzed the medical records of 190 infants with CHD who underwent remote follow-up via WeChat from December 2019 to May 2020 in Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University. In addition, the psychological benefits of WeChat on the parents of these infants were analyzed.ResultsIn total, 190 infants were involved in this study, including 72 cases of ventricular septal defects, 42 cases of patent ductus arteriosus, 55 cases of atrial septal defects, 3 cases of tetralogy of Fallot, 2 cases of endocardial cushion defects, 12 cases of pulmonary stenosis, 2 cases of total anomalous pulmonary venous connection and 2 cases of aortic arch constriction. During the follow-up period, 48 infants who received surgical indications were hospitalized in time for surgical treatment. It was recommended that 10 infants with respiratory tract infections be treated in local hospitals through the WeChat platform. We provided feeding guidance to 28 infants with dysplasia through the WeChat platform. The psychological evaluation results of parents showed that the median score and range of Self-Rating Depression Scale scores were 42 and 32–58, respectively. Nine parents (4.7%) were clinically depressed, while the majority had mild depression. The median score and range of Self-Rating Anxiety Scale scores were 44 and 31–59, respectively. Twenty parents (10.5%) had clinical anxiety, while the rest had mild anxiety.ConclusionDuring the COVID-19 pandemic, follow-up management and health services for infants with CHD prior to surgery through the WeChat platform were useful in identifying the state of an infant’s condition as well as in identifying and relieving care pressure, anxiety and depression in the parents.
      PubDate: Fri, 09 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab066
      Issue No: Vol. 33, No. 2 (2021)
       
  • Implementing structured handoffs to verify operating room blood delivery
           using a quality academy training program: an interrupted time-series
           analysis
    • Authors: Amon C; Paley A, Forbes J, et al.
      Abstract: BackgroundBlood transfusion is a complex process at risk for error.ObjectiveTo implement a structured handoff during the blood transfusion process to improve delivery verification.MethodsA multidisciplinary team participated in the quality academy training program at an academic medical center and implemented a structured handoff of blood delivery to the operating room (OR) using Plan-Do-Study-Act cycles between 28 October 2019 and 1 December 2019. An interrupted time-series analysis was performed to investigate the proportions of verified deliveries (primary outcome) and of verified deliveries among those without a handoff (secondary outcome). Delivery duration was also assessed.ResultsA total of 2606 deliveries occurred from 1 July 2019 to 19 April 2020. The baseline trend for verified deliveries was unchanging [parameter coefficient −0.0004; 95% confidence interval (CI) −0.002 to 0.001; P = 0.623]. Following intervention, there was an immediate level change (parameter coefficient 0.115; 95% CI 0.053 to 0.176; P = 0.001) without slope change (parameter coefficient 0.002; 95% CI −0.004 to 0.007; P = 0.559). For the secondary outcome, there was no immediate level change (parameter coefficient −0.039; 95% CI −0.159 to 0.081; P = 0.503) or slope change (parameter coefficient 0.002; 95% CI −0.022 to 0.025; P = 0.866). The mean (SD) delivery duration during the intervention was 12.4 (2.8) min and during the post-intervention period was 9.6 (1.6) min (mean difference 2.8; 95% CI 0.9 to 4.8; P = 0.008).ConclusionUsing the quality academy framework supported the implementation of a structured handoff during blood delivery to the OR, resulting in a significant increase in verified deliveries.
      PubDate: Wed, 07 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab061
      Issue No: Vol. 33, No. 2 (2021)
       
  • Monitoring of three-phase variations in the mortality of COVID-19 pandemic
           using control charts: where does Pakistan stand'
    • Authors: Mahmood Y; Ishtiaq S, Khoo M, et al.
      Abstract: BackgroundAt the end of December 2019, the world in general and Wuhan, the industrial hub of China, in particular, experienced the COVID-19 pandemic. Massive increment of cases and deaths occurred in China and 209 countries in Europe, America, Australia, Asia and Pakistan. Pakistan was first hit by COVID-19 when a case was reported in Karachi on 26 February 2020. Several methods were presented to model the death rate due to the COVID-19 pandemic and to forecast the pinnacle of reported deaths. Still, these methods were not used in identifying the first day when Pakistan enters or exits the early exponential growth phase.ObjectiveThe present study intends to monitor variations in deaths and identify the growth phases such as pre-growth, growth, and post-growth phases in Pakistan due to the COVID-19 pandemic.MethodsNew approaches are needed that display the death patterns and signal an alarming situation so that corrective actions can be taken before the condition worsens. To meet this purpose, secondary data on daily reported deaths in Pakistan due to the COVID-19 pandemic have been considered. The $ c$ and exponentially weighted moving average (EWMA) control charts have been used for monitoring variations.ResultsThe $ c$-chart shows that Pakistan switches from the pre-growth to the growth phase on 31 March 2020. The EWMA chart demonstrates that Pakistan remains in the growth phase from 31 March 2020 to 17 August 2020, with some indications signaling a decrease in deaths. It is found that Pakistan moved to a post-growth phase for a brief period from 27 July 2020 to 28 July 2020. Pakistan switches to re-growth phase with an alarm on 31/7/2020, right after the short-term post-growth phase. The number of deaths starts decreasing in August in that Pakistan may approach the post-growth phase shortly.ConclusionThis amalgamation of control charts illustrates a systematic implementation of the charts for government leaders and forefront medical teams to facilitate the rapid detection of daily reported deaths due to COVID-19. Besides government and public health officials, it is also the public’s responsibility to follow the enforced standard operating procedures as a temporary remedy of this pandemic in ensuring public safety while awaiting a suitable vaccine to be discovered.
      PubDate: Mon, 05 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab062
      Issue No: Vol. 33, No. 2 (2021)
       
  • Development of the perceptions of preventable adverse events assessment
           tool (PPAEAT): measurement properties and patients’ mental health status
           
    • Authors: Keller F; Derksen C, Kötting L, et al.
      Abstract: BackgroundPatient-centered care and patient involvement have been increasingly recognized as crucial elements of patient safety. However, patient safety has rarely been evaluated from the patient perspective with a quantitative approach aiming at making patient safety and preventable adverse events measurable.ObjectivesThe objectives of this study were to develop and evaluate the psychometric properties of a questionnaire assessing patient safety by perceived triggers of preventableadverse events among patients in primary health-care settings while considering mental health.MethodsTwo hundred and ten participants were recruited through various digital and print channels and asked to complete an online survey between November 2019 and April 2020. Exploratory factor analysis was performed to identify domains of triggers of preventable adverse events affecting patient safety. Furthermore, a multi-trait scaling analysis was performed to evaluate internal reliability as well as item-scale convergent–discriminant validity. A multivariate analysis of covariance evaluated whether individuals below and above the symptom threshold for depression and generalized anxiety perceive triggers of preventable adverse events differently.ResultsThe five factors determined were information and communication with patients, time constraints of health-care professionals, diagnosis and treatment, hygiene and communication among health-care professionals, and knowledge and operational procedures. The questionnaire demonstrated a good total and subscale internal consistency (α = 0.90, range = 0.75–0.88), good item-scale convergent validity with significant correlations between 0.57 and 0.78 (P < 0.05; P < 0.01) for all items with their associated subscales, and satisfactory item-scale discriminant validity between 0.14 and 0.55 (P > 0.05) with no significant correlations between the items and their competing subscales. The questionnaire further revealed to be a generic measure irrespective of patients’ mental health status. Patients older than 50 years of age perceived a significantly greater threat to their own safety compared to patients below that age.ConclusionThe developed Perceptions of Preventable Adverse Events Assessment Tool (PPAEAT) exhibits good psychometric properties, which supports its use in future research and primary health-care practice. Further validation of the PPAEAT in different settings, languages and larger samples is needed. The results of this study need to be considered when assessing patient safety in the context of health-care research.
      PubDate: Sat, 03 Apr 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab063
      Issue No: Vol. 33, No. 2 (2021)
       
  • Conversion of a colorectal cancer guideline into clinical decision trees
           with assessment of validity
    • Authors: Keikes L; Kos M, Verbeek X, et al.
      Abstract: ObjectiveThe interpretation and clinical application of guidelines can be challenging and time-consuming, which may result in noncompliance to guidelines. The aim of this study was to convert the Dutch guideline for colorectal cancer (CRC) into decision trees and subsequently implement decision trees in an online decision support environment to facilitate guideline application.MethodsThe recommendations of the Dutch CRC guidelines (published in 2014) were translated into decision trees consisting of decision nodes, branches and leaves that represent data items, data item values and recommendations, respectively. Decision trees were discussed with experts in the field and published as interactive open access decision support software (available at www.oncoguide.nl). Decision tree validation and a concordance analysis were performed using consecutive reports (January 2016–January 2017) from CRC multidisciplinary tumour boards (MTBs) at Amsterdam University Medical Centers, location AMC.ResultsIn total, we developed 34 decision trees driven by 101 decision nodes based on the guideline recommendations. Decision trees represented recommendations for diagnostics (n = 1), staging (n = 10), primary treatment (colon: n = 1, rectum: n = 5, colorectal: n = 9), pathology (n = 4) and follow-up (n = 3) and included one overview decision tree for optimal navigation. We identified several guideline information gaps and areas of inconclusive evidence. A total of 158 patients’ MTB reports were eligible for decision tree validation and resulted in treatment recommendations in 80% of cases. The concordance rate between decision tree treatment recommendations and MTB advices was 81%. Decision trees reported in 22 out of 24 non-concordant cases (92%) that no guideline recommendation was available.ConclusionsWe successfully converted the Dutch CRC guideline into decision trees and identified several information gaps and areas of inconclusive evidence, the latter being the main cause of the observed disagreement between decision tree recommendations and MTB advices. Decision trees may contribute to future strategies to optimize quality of care for CRC patients.
      PubDate: Wed, 24 Mar 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab051
      Issue No: Vol. 33, No. 2 (2021)
       
  • Second victim support structures in anaesthesia: a cross-sectional survey
           in Belgian anaesthesiologists
    • Authors: Nijs K; Seys D, Coppens S, et al.
      Abstract: BackgroundAnaesthesiologists are prone to patient safety situations after which second victim symptoms can occur. In international literature, a majority of these second victims indicated that they were emotionally affected in the aftermath of a patient safety incident (PSI) and received little institutional support after these events.ObjectiveTo study the current second victim support structures in anaesthesia departments in Belgium.MethodsAn observational cross-sectional survey. Belgian anaesthesiologists and anaesthesiologists in training were contacted through e-mail from May 27th until 15 July 2020.ResultsIn total, 456 participants completed the online survey. 73.7% (n = 336) of the participants encountered a PSI during the last year of their medical practice. 80.9% (n = 368) of respondents answered that they do discuss incidents with their colleagues. 18.0% (n = 82) discussed all incidents. 19.3% (n = 88) admitted that these incidents are never discussed in their department. 15.4% of participants (n = 70) experienced or thought that the culture is negative during these PSI discussions. 17.3% (n = 79) scored the culture neutral. Anaesthesiologists who encountered a PSI in the last years scored the support of their anaesthesia department a mean score of 1.59 (ranging from −10 to +10). A significant correlation (P < 0.05) was found between the culture during the morbidity and mortality meetings, the support after the incidents and the perceived quality of the anaesthesia department.ConclusionOf the participating anaesthesiologist in Belgium, 80.9% discussed some PSIs and 18.0% discussed all PSIs as a normal part of their staff functioning with an experienced positive or neutral culture during these meetings in 84.6%. Psychological safety within the anaesthesiology departments is globally good; however, it could and should be optimized. This optimization process warrants further investigations in the future.
      PubDate: Wed, 24 Mar 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab058
      Issue No: Vol. 33, No. 2 (2021)
       
  • Benefits and risks of non-slip socks in hospitals: a rapid review
    • Authors: Jazayeri D; Heng H, Slade S, et al.
      Abstract: BackgroundNon-slip socks are sometimes used in an attempt to prevent falls in hospitals despite limited evidence of benefit. We critique the current literature on their risks, benefits and effects.MethodsA rapid review was conducted following the Cochrane Rapid Review Methods Group Guidelines. To be included, studies needed to have data on single or multifactorial interventions that used non-slip socks in hospitals or their safety, risks or effects in a laboratory setting. Six electronic databases were searched: Medline, Embase, Cinahl, Cochrane, Allied and Medical Health Database (AMED) and Proquest Central.ResultsFourteen articles met the inclusion criteria. Nine used non-slip socks as an intervention in hospitals. Three assessed their effects in laboratory settings. Two reported risks in relation to bacterial transfer. Most studies that used non-slip socks to prevent hospital falls had negative or equivocal results and were of comparatively low method quality, with a high risk of bias. Two of the laboratory tests reported traction socks to be no safer than walking barefoot and to have similar slip resistance. The laboratory studies had a low risk of bias and showed that bacteria can sometimes be acquired from socks.ConclusionNon-slip socks have the potential to carry an infection control risk that requires careful management. There was no strong or conclusive evidence that they prevent hospital falls.
      PubDate: Tue, 23 Mar 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab057
      Issue No: Vol. 33, No. 2 (2021)
       
  • Content of antenatal care and perception about services provided by
           primary hospitals in Nepal: a convergent mixed methods study
    • Authors: Acharya Y; James N, Thapa R, et al.
      Abstract: BackgroundNepal has made significant strides in maternal and neonatal mortality over the last three decades. However, poor quality of care can threaten the gains, as maternal and newborn services are particularly sensitive to quality of care. Our study aimed to understand current gaps in the process and the outcome dimensions of the quality of antenatal care (ANC), particularly at the sub-national level. We assessed these dimensions of the quality of ANC in 17 primary, public hospitals across Nepal. We also assessed the variation in the ANC process across the patients’ socio-economic gradient.MethodsWe used a convergent mixed methods approach, whereby we triangulated qualitative and quantitative data. In the quantitative component, we observed interactions between providers (17 hospitals from all 7 provinces) and 198 women seeking ANC and recorded the tasks the providers performed, using the Service Provision Assessments protocol available from the Demographic and Health Survey program. The main outcome variable was the number of tasks performed by the provider during an ANC consultation. The tasks ranged from identifying potential signs of danger to providing counseling. We analyzed the resulting data descriptively and assessed the relationship between the number of tasks performed and users’ characteristics. In the qualitative component, we synthesized users’ and providers’ narratives on perceptions of the overall quality of care obtained through focus group discussions and in-depth interviews.ResultsOut of the 59 tasks recommended by the World Health Organization, providers performed only 22 tasks (37.3%) on average. The number of tasks performed varied significantly across provinces, with users in province 3 receiving significantly higher quality care than those in other provinces. Educated women were treated better than those with no education. Users and providers agreed that the overall quality of care was inadequate, although providers mentioned that the current quality was the best they could provide given the constraints they faced.ConclusionThe quality of ANC in Nepal’s primary hospitals is poor and inequitable across education and geographic gradients. While current efforts, such as the provision of 24/7 birthing centers, can mitigate gaps in service availability, additional equipment, infrastructure and human resources will be needed to improve quality. Providers also need additional training focused on treating patients from different backgrounds equally. Our study also points to the need for additional research, both to document the quality of care more objectively and to establish key determinants of quality to inform policy.
      PubDate: Wed, 17 Mar 2021 00:00:00 GMT
      DOI: 10.1093/intqhc/mzab049
      Issue No: Vol. 33, No. 2 (2021)
       
 
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