International Journal for Quality in Health Care最新文献

{"title":"Dying in hospital - A retrospective medical record analysis on care in the dying phase in intensive care units and general wards.","authors":"Sophie Meesters, Aneta Schieferdecker, Sukhvir Kaur, Nikolas Oubaid, Anneke Ullrich, Karin Oechsle, Holger Schulz, Raymond Voltz, Kerstin Kremeike","doi":"10.1093/intqhc/mzaf025","DOIUrl":"https://doi.org/10.1093/intqhc/mzaf025","url":null,"abstract":"<p><p>Background Care in the dying phase is often suboptimal in hospitals outside specialised palliative care. Studies of the implementation of recommendations for care in the dying phase are rare. Medical records can provide information in this regard. Methods Retrospective medical record analysis of n=400 patients who died on six intensive care units and four general wards of two German medical centres. To evaluate the care in the dying phase, we descriptively analysed 37 variables reflecting recommendations of the German Palliative Care Guideline. To identify factors associated with important aspects of care, seven of these variables were determined as appropriate for multiple logistic regression. Results In 299/400 (74.8%) patients, recognition of the dying phase was documented. Patients with ability to communicate were informed about the impending death in 46/121 (38.0%) and informal caregivers in 282/390 (72.3%). Patients' wishes regarding care were documented in 33/122 (27.1%). Monitoring was rarely stopped before death, with significantly lower percentages on intensive care units: e.g. vital signs in 30% (14.9% in intensive care units vs. 52.9% in general wards; confidence interval [28.4; 47.6]). Validated symptom assessment tools were used in 272/400 (68.0%), mainly for pain (66.3%). Logistic regression analysis identified setting (intensive care units vs. general ward), recognition of the dying phase, patient age, communication ability, and malignant neoplasm as factors significantly associated with aspects of care. Conclusion The dying phase was not consistently documented, many presumably non-beneficial interventions continued until death, systematic symptom assessment beyond pain was lacking, and communication with patients and informal caregivers was poorly documented. Findings suggest a need for setting-specific strengthening of healthcare professionals in these settings.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic recording and discussion of intraoperative adverse events using ClassIntra: Results of a qualitative context analysis before implementation.","authors":"Monika Finsterwald, Zuzanna Kita, Salome Dell-Kuster, Katrin Burri-Winkler, Anne Auderset, Judith Winkens, Christoph S Burkhart, Amanda van Vegten, Lauren Clack","doi":"10.1093/intqhc/mzaf023","DOIUrl":"https://doi.org/10.1093/intqhc/mzaf023","url":null,"abstract":"<p><strong>Background: </strong>Intra- and postoperative adverse events are devastating to patients and costly for healthcare systems. In 2008, the World Health Organization Surgical Safety Checklist was introduced to minimise morbidity and mortality and to enhance team performance. It consists of three parts whereof the third part, the sign-out at the end of surgery, is generally performed poorly. Addressing intraoperative adverse events and discussion of the consecutive postoperative management should take place during this often-omitted sign-out. To address this issue, a national, multicentre quality improvement project (CIBOSurg - ClassIntra® for Better Outcomes in Surgery) is currently being conducted in Switzerland. This project evaluates the effectiveness and implementation of systematic recording of intraoperative adverse events using ClassIntra® (a generic classification system for intraoperative adverse events) and an interdisciplinary discussion during the sign-outThe current study, conducted in the pre-implementation phase of CIBOSurg, aims to assess existing practices and determinants concerning the future implementation of systematic recording of intraoperative adverse events, perceptions surrounding ClassIntra®, and its implementation during sign-out.</p><p><strong>Methods: </strong>A qualitative context analysis was conducted across eight hospitals in Switzerland and one in the Netherlands. Nearly 100 semi-structured interviews were conducted with interdisciplinary staff from different surgical disciplines. Data were analysed using rapid analysis and concept-structuring qualitative content analysis guided by the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change.</p><p><strong>Results: </strong>Findings indicate that the sign-out is not yet implemented consistently at every participating hospital. Currently, intraoperative adverse events are not being systematically recorded and discussed, despite recognition of their importance. Most interviewees considered the application and implementation of ClassIntra® to be feasible and were convinced that a systematic recording of intraoperative adverse events and interdisciplinary discussion amongst the operative team during sign-out is particularly useful for learning and postoperative patient care. Several barriers and facilitators to the successful recording and discussion of intraoperative adverse events were identified.</p><p><strong>Conclusion: </strong>The study results provide important information about current practices, while also generating insights on how to better discuss and systematically record intraoperative adverse events and improve sign-out performance. Future implementation of ClassIntra® is generally perceived positively. The findings address a critical gap in surgical safety practice and provide a basis for developing multifaceted implementation strategies.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HemeTEAM India: together everyone achieves more.","authors":"Rahul Bhargava, Nathany Shrinidhi, Vikas Dua, Ritu Garg, Arun Danewa, Sohini Chakraborty, Neha Panda Rastogi, Aastha Gupta, Madhur Arora, Chitresh Yadav, Nikhil M Kumar, Anusha Swaminathan, Akash Jaiswal, Richa Soni, Swati Bhayana, Sunisha Arora, Surbhi Singh, Prerna Mahajan, Karthika Rudrakumar, Garg Paritosh, Aakriti Kothari, Kanika Verma, Manish Saini, Haristuti Varma, Shikha Singh, Sukhdeep Singh, Poonam Saxena, Veronica Dorothy, Kiran Sharma","doi":"10.1093/intqhc/mzaf016","DOIUrl":"10.1093/intqhc/mzaf016","url":null,"abstract":"<p><strong>Background: </strong>Interprofessional team-based care has been known to aid in better patient-focused care and outcomes. However, the same concept in the space of bone marrow transplant (BMT) especially in this part of the world is currently elusive. This single-center experience from a BMT unit of India depicts the effectiveness of interdisciplinary care.</p><p><strong>Methods: </strong>An interdisciplinary team was built, and experts from different medical and allied specialties were onboarded along with establishment of state-of-the-art laboratories. Conceptualization of an integrative approach and development of HemeTEAM India began in 2020, and implementation in 2021. The evaluation of outcomes was performed on 31 December 2020 and on 31 July 2024 to compare the differences in outcomes after implementation of HemeTEAM India.</p><p><strong>Results: </strong>A total of 550 transplants were conducted before 2021. From 2021 to 2024, 500 more transplants were done. The day 100 mortality, hospital acquired infection rate, and antibiotic stewardship reduced by ∼70% after 2021. The uptake of genomics-based testing increased to 95%, with genetically informed treatment in 65%. The average length of hospital stay reduced from 21 to 19 days and intensive care unit stay from 7 to 3 days. The net profit increased from 12% to 16%, with a cost benefit of ∼$10 000 to the patient.</p><p><strong>Conclusion: </strong>This is a single-center experience, depicting the effect of an integrative team base approach in a BMT unit providing holistic interdisciplinary care in India. This is the largest and the first of its kind hematology team in the country and South East Asia, where all aspects for a hematology/transplant patient are available in a single consultation.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sustainability of hospital accreditation models: a cross-sectional study.","authors":"Mohammed Hussein, Milena Pavlova, Wim Groot","doi":"10.1093/intqhc/mzaf017","DOIUrl":"10.1093/intqhc/mzaf017","url":null,"abstract":"<p><strong>Background: </strong>Despite the importance of hospital accreditation, its sustainability is jeopardized. This is due to the disparity between the rapid changes in the health sector and the accreditation standards that remain unchanged. This study aims to examine what improvements are important in enhancing the sustainability of the hospital accreditation model in Saudi Arabia.</p><p><strong>Methods: </strong>All quality managers in accredited Saudi Arabian hospitals were invited to participate in a cross-sectional questionnaire-based study in July-August 2022. A structured questionnaire was developed, tested, piloted, and factorially validated using exploratory factor analysis. On a 5-point Likert scale, respondents were asked to rate the importance of recommended changes that are proposed to enhance the sustainability of accreditation policies, standards development, evaluation methods, and the evaluation team. The importance of the recommendations, according to the respondents, was described using the relative importance index, while multivariate linear regression was used to analyse the association with independent variables.</p><p><strong>Results: </strong>A total of 158 valid questionnaires (64% response rate) were included in the analysis. On average, participants had 6.9 (SD 2.1) years of experience in quality management. The overall mean importance attached to improving standards development, accreditation policies, evaluation team, and evaluation methods were 3.55, 3.43, 3.41, and 3.21, on a 5-point scale, respectively. Shifting the focus of accreditation standards from structure and compliance to outcomes and improvement (mean importance = 4.47), updating standards periodically to reflect current best practices and research (mean importance = 4.41), and integrating consumer perspectives in all aspects of accreditation (mean importance = 4.37) were the most important perceived recommendations. Multivariate regression analysis yielded that managers with more years of experience had significantly higher mean scores on the importance of improving accreditation policies (β = 0.120, P = .037), standards development (β = 0.246, P < .001), evaluation methods (β = 0.268, P < .001), and the evaluation team (β = 0.369, P < .001).</p><p><strong>Conclusions: </strong>Improving accreditation policies, standards development, evaluation methods, and the evaluation team are important in enhancing the sustainability of hospital accreditation programmes. This study offers insights to assist policymakers and other stakeholders in redesigning traditional accreditation models to make them more sustainable and that can supplement other performance improvement tools in improving the quality of healthcare services.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the Human Factors Analysis and Classification System within root cause analysis to prevent medical errors and enhancing patient safety culture: insights from a medical center.","authors":"Jiun-Yih Lee, Chien-Hsien Huang, Yi-An Sie, Pei-Ching Yang, Chun-Cheng Su, Jui-Ting Chang","doi":"10.1093/intqhc/mzaf009","DOIUrl":"10.1093/intqhc/mzaf009","url":null,"abstract":"<p><strong>Introduction: </strong>Enhancing patient safety and minimizing medical errors are crucial in healthcare. While root cause analysis (RCA) is commonly used to investigate adverse events, its lack of human factor integration limits its effectiveness. The Human Factors Analysis and Classification System (HFACS), adapted from aviation to healthcare, systematically identifies human and organizational factors. However, the integration of HFACS into RCA and the impact of HFACS-RCA implementation remain underexplored. Therefore, this study aims to provide a practical case of HFACS integration into RCA and explore the effects of HFACS-RCA implementation.</p><p><strong>Methods: </strong>This study integrates HFACS into the RCA process at a medical center in Taiwan, examining an incident involving unsterilized instruments distributed from the Central Sterile Supply Room (CSR) to the Intensive Care Unit (ICU). This study employed a before-and-after study design to examine the impact of the HFACS-RCA intervention. The primary outcome measures were the changes in scores across the eight dimensions of the Taiwan Patient Safety Culture Survey (TPSC) before and after the intervention.</p><p><strong>Results: </strong>A 1-year follow-up of the CSR case showed no similar incidents. HFACS-RCA significantly improved TPSC scores in unit safety climate (P = .05), feelings toward management (P = .05), and job satisfaction (P = 0.05), while the other dimensions showed no significant changes.</p><p><strong>Conclusion: </strong>HFACS-RCA application offers a comprehensive framework for identifying and mitigating factors contributing to medical errors, improving patient safety, and setting a precedent for future healthcare safety management research and practice.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocols for ischaemic stroke in Flemish hospitals: correlation between availability and content versus adherence.","authors":"Charlotte Lens, Lotte Hermans, Caroline Weltens, Kris Vanhaecht, Robin Lemmens, Ellen Coeckelberghs","doi":"10.1093/intqhc/mzaf014","DOIUrl":"10.1093/intqhc/mzaf014","url":null,"abstract":"<p><strong>Background: </strong>Stroke is globally one of the leading causes of mortality and disability. Adhering to evidence-based guidelines and protocols can improve the quality of care for ischaemic stroke patients. We aimed to compare the availability and content of specific protocols versus adherence to these key interventions in clinical daily practice among Flemish hospitals. We selected five key interventions for managing ischaemic stroke patients. These key interventions encompassed the measurement of body temperature, glycaemia monitoring, screening of swallowing function according to the Fever, Sugar, and Swallowing protocol (FeSS protocol), depression screening, and activities of daily living (ADL) screening (FeSS+ key interventions).</p><p><strong>Methods: </strong>A systematic quantitative and qualitative approach was designed to analyse specific protocols from 24 hospitals. A predefined data extraction matrix for the five FeSS+ key interventions was utilized for data collection. Using this matrix, protocols were scored according to the completeness of content, regarding the FeSS+ interventions. These scores were used to calculate a total protocol content score, i.e. a total score for the five FeSS+ interventions and an individual score for each key intervention separately, ranging between 0 and 1, per hospital. A score of 0 indicates absence of the FeSS+ interventions in the protocols, while a score of 1 signifies complete coverage of these interventions. In addition, we assessed the correlation between the availability and content of these protocols in relation to the adherence to interventions documented for 30 patients per hospital.</p><p><strong>Results: </strong>The mean total protocol content score was 0.40 ± 0.20, ranging from 0.64 ± 0.25 for glycaemia management to 0.1 ± 0.28 for ADL screening. With regard to the individual FeSS+ key interventions, we identified a correlation between protocol characteristics and adherence for glycaemia (rs = 0.42, P = .04), depression screening (rs = 0.43, P = .04), and ADL screening (rs = 0.44, P = 0.03). Total FeSS+-protocol content also correlated with adherence (r = 0.6140, P = .0014).</p><p><strong>Conclusion: </strong>Protocol characteristics for the FeSS+ key interventions were variable and rather limited, especially for ADL and depression screening. The identified relationship between the content of protocols and adherence to interventions underscores the value of defining these activities in hospital documentation to improve stroke care.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological safety, job satisfaction, and the intention to leave among German early-career physicians.","authors":"Nicola Etti, Matthias Weigl, Nikoloz Gambashidze","doi":"10.1093/intqhc/mzaf002","DOIUrl":"10.1093/intqhc/mzaf002","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Healthcare systems worldwide experience shortages of healthcare professionals. Retention of physicians is becoming an increasing problem. The psychological safety among physicians affects not only performance but also their emotional well-being and job satisfaction. This study aims to evaluate early career physicians' perception of psychological safety and its influence on job satisfaction and intention to leave.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In a cross-sectional study, early career physicians, currently in fellowship programs in Germany were invited to fill in an electronic survey. The instrument consisted of demographic variables and sections from validated and well-established questionnaires. Psychological safety was evaluated on three levels-in relation to the team leader, team as a whole, and peers. Also, job satisfaction was assessed with standardized measures, and participants were asked if they were considering leaving their current employer. Participants were recruited via a nationwide learning platform-an online educational portal for medical students and early career physicians. Data analyses included descriptive, correlation analysis, and regression analyses to determine univariate and multivariate associations with job satisfaction and intention to leave.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study sample consisted of 432 early career physicians. Most were fulltime employed (85.6%), female (78.2%), and in first 3 years of their postgraduate education (77.5%). A total of 47.2% indicated intention to leave their current employment. On a Likert-10 agreement scale, with high scores indicating greater psychological safety, the mean scores for leader-related, team-related, and peer-related psychological safety were 6.01 [95% confidence interval = 5.81-6.21), 7.30 (7.11-7.49), and 7.95 (7.78-8.12), respectively. In correlation analysis, all dimensions of psychological safety showed significant associations with job satisfaction and the intention to leave. In the multiple regression analyses, female gender (B = -0.10; P = .04) and age group (B = -0.08; P &lt; .01) were associated with lower job satisfaction. High leader and team-related psychological safety were significantly associated with higher job satisfaction (B = 0.18, P &lt; .01; B = 0.10, P &lt; .01), and negatively related to intention to leave (OR = 0.53, P &lt; 0.01; OR = 0.77, P &lt; .01).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This survey enhances our understanding of the nuances of psychological safety among early career physicians. In Germany, they reported low-to-medium levels of psychological safety related to the leader and low job satisfaction. Almost every second participant indicated intention to leave the organization. Leader-related psychological safety had highest effect on job satisfaction and intention to leave. Our findings corroborate the eminent role of leadership, workplace, and safety culture for job satisfaction and retention of early career phys","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with harm in reported patient safety incidents and characteristics during health screenings in Korea: a secondary data analysis.","authors":"Jeongin Choe, Kyungmi Woo","doi":"10.1093/intqhc/mzaf011","DOIUrl":"10.1093/intqhc/mzaf011","url":null,"abstract":"<p><strong>Background: </strong>Various health screenings are conducted in South Korea, including state-supported national health screenings, privately funded comprehensive health screenings, and employment-related or industry-specific screenings. Given the various risks of patient safety incidents during the health screening process and the lack of studies of incidents in this environment, this study aimed to analyse the types and characteristics of reported patient safety incidents during health screenings, the distribution of harm, and the impact of the incident types on harm.</p><p><strong>Methods: </strong>We analysed patient safety incidents reported to the Korean Institute for Healthcare Accreditation (2017-22) using the World Health Organization's framework for patient safety. We performed frequency analysis, chi-square tests, and binomial logistic regression analysis to identify the types and characteristics of reported patient safety incidents, the differences in the distribution of harm, and the impact of patient safety incident types on harm during health screenings.</p><p><strong>Results: </strong>A total of 213 cases were included in the analysis. Over half of the patient safety incidents during health screenings resulted in harm to the patient, and examination-related incidents were the most frequent type of incident. Furthermore, reported patient safety incidents were more likely to occur during regular working hours, in the examination room, in hospitals with over 500 beds, and amongst patients in their 50s, with no significant differences in sex distribution. Significant differences were observed in the distribution of harm according to incident types (P <.001) and patient age (P =.023). Controlling for patient and incident characteristics, the incident type was a determinant of harm. Amongst the incident types, medication/drug administration [adjusted odds ratio (aOR) = 29.730, 95% confidence interval (CI) = 6.081, 145.368], anaesthesia/sedation/treatments and procedures (aOR = 5.121, 95% CI = 1.002, 26.178), falls (aOR = 4.903, 95% CI = 2.022, 11.890), infections/injuries (aOR = 11.898, 95% CI = 1.082, 130.839), and other types of incidents (aOR = 8.719, 95% CI = 2.602, 29.212) increased the probability of harm compared to examination-related incidents.</p><p><strong>Conclusion: </strong>This study underscores the critical need to manage high-risk patient safety incidents and implement systemic harm reduction strategies during health screenings. Encouraging the reporting of incidents, including near misses, alongside developing targeted interventions, is essential for enhancing patient safety. Future research should leverage larger datasets, consistent classification systems, and standardized data collection to generalize findings and advance prevention strategies, thereby improving the quality and safety of health screening services.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of routine clinical debriefings and incident reports: insights for patient safety and teamwork enhancement.","authors":"Méryl Paquay, Michaela Kolbe, Sophie Klenkenberg, Clément Buléon, Audrey Bertrand, Robert Simon, Alexandre Ghuysen","doi":"10.1093/intqhc/mzaf010","DOIUrl":"10.1093/intqhc/mzaf010","url":null,"abstract":"<p><strong>Background: </strong>Routine clinical debriefings (RCDs) have been shown to improve communication, team reflexivity, and safety in clinical settings. When combined with incident reports (IRs), RCDs offer a potential tool for enhancing quality improvement frameworks. This study aimed to identify and compare healthcare safety-related information captured through RCDs and IRs in a Belgian emergency department operating across two distinct facilities.</p><p><strong>Methods: </strong>This study employed a quasi-mixed-method design with a monostrand conversion approach. Information was collected from 90 RCDs and 263 IRs. Data were analyzed using two frameworks: the World Health Organization's Incident Report Classification Grid and the Debriefing and Organizational Lessons Learned Grid.</p><p><strong>Results: </strong>The findings revealed significant differences in the types of information captured by RCDs and IRs. RCDs predominantly highlighted teamwork, internal organization, and procedural issues, while IRs focused more on care processes, patient concerns, and patient flow. These complementary insights demonstrate the value of integrating RCDs and IRs to create a comprehensive understanding of patient and clinician safety.</p><p><strong>Conclusions: </strong>This study highlights the complementary nature of RCDs and IRs in addressing healthcare safety. RCDs foster team reflexivity and promote open discussions about systemic challenges, directly improving team cohesion, resilience, and learning. Combining RCDs and IRs provides actionable insights for enhancing safety and driving organizational improvements.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect effects of the COVID-19 pandemic on healthcare contacts, quality of care, and social disparities across essential healthcare domains.","authors":"Søren Valgreen Knudsen, Henry Jensen, Jan Mainz, Lone Baandrup, Ismail Gögenur, Jens Winther Jensen, Søren Paaske Johnsen, Jens Flensted Lassen, Anders Løkke, Julie Mackenhauer, Laust Hvas Mortensen, Henrik Møller, Tina Bech Olesen","doi":"10.1093/intqhc/mzaf013","DOIUrl":"10.1093/intqhc/mzaf013","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic significantly affected global healthcare systems, revealing their resilience to crises. Despite this, national-level research on its impact across key healthcare domains-such as acute and chronic disease management, cancer screening and care, mental health, and palliative care-is scarce. This study examines the pandemic's impact on contacts, quality of care, and social disparity in these healthcare domains to guide better preparedness for future health emergencies.</p><p><strong>Methods: </strong>The study utilized data from the Danish National Clinical Quality Registries, covering January 2015 to June 2022, to create a nationwide cohort for comparing healthcare metrics across the pandemic's phases and the prepandemic period. Healthcare contacts were assessed through descriptive analyses, while the quality of care and social disparities were analysed using multivariable regression models, providing estimated prevalence ratios and 95% confidence intervals.</p><p><strong>Results: </strong>The first wave of the COVID-19 pandemic in Denmark led to community and healthcare lockdowns, which were associated with fewer hospital contacts and reduced participation in national cancer screening programs. However, a gradual recovery towards prepandemic levels was found, with the exceptions of chronic obstructive pulmonary disease contacts and colorectal cancer incidence. Overall, the quality of care across various healthcare domains in Denmark remained largely unchanged or improved slightly during the pandemic. However, social disparities in contacts were increased across all examined healthcare domains, with patients who were immigrants, living alone, had limited educational level or low income experiencing reduced contact compared to the prepandemic period.</p><p><strong>Conclusions: </strong>Overall, the Danish healthcare system appeared to be resilient and largely unaffected throughout the pandemic, and the quality of care in several healthcare domains remained high. Nevertheless, the increasing social disparities in healthcare contacts during the pandemic demands attention. In preparing for future health crises, it is important to address and mitigate potential social inequalities, focusing on achieving equity in healthcare.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}