International Journal for Quality in Health Care最新文献

{"title":"Exploring the development of safety culture among physicians with text mining of patient safety reports: a retrospective study.","authors":"Daisuke Koike, Masahiro Ito, Akihiko Horiguchi, Hiroshi Yatsuya, Atsuhiko Ota","doi":"10.1093/intqhc/mzae108","DOIUrl":"10.1093/intqhc/mzae108","url":null,"abstract":"<p><strong>Background: </strong>Safety culture development is essential for patient safety in healthcare institution. Perceptions of patient safety and cultural changes are reflected in patient safety reports; however, they were rarely investigated. The aim of this study was to investigate the perception of physicians and to explore the development of safety culture using quantitative content analysis for patient safety reports.</p><p><strong>Methods: </strong>A retrospective analysis of free descriptions of harmful patient safety reports submitted by physicians was performed. Natural language processing and text analysis were conducted using the \"KH Coder.\" A co-occurrence analysis was performed in each period to identify and analyze the safety concepts. The study period was grouped into three for comparison.</p><p><strong>Results: </strong>The patient safety reports from physicians were collected between April 2004 and March 2020. Of these, 3351 reports were harmful: 839 reports were included in period 1, 1016 reports in period 2, and 1496 reports in period 3. Natural language processing identified 316 307 words in the free descriptions of 3351 reports. We identified seven concepts from the cluster in co-occurrence analysis as follows: \"explanation of adverse event to patients and families,\" \"central venous catheter,\" \"intraoperative procedure and injury,\" \"minimally invasive surgery,\" \"life-threatening events,\" \"blood loss,\" and \"medical emergency team and critical care.\" These seven concepts showed significant differences among the three periods, except for \"blood loss.\" The \"explanation of adverse event to patients and families\" decreased in proportion from 11.3% to 8.8% (P < .05). The \"central venous catheter\" decreased from 17.3% to 11.3% (P < .01). Meanwhile, \"minimally invasive surgeries\" and \"intraoperative procedures\" increased from 3.9% to 12.9% (P < .01) and from 10.8% to 14.6% (P < .05), respectively. Focusing on patients' events, \"life-threatening events\" decreased from 13.0% to 8.1% (P < .01); however, \"medical emergency teams and critical care\" increased from 3.3% to 10.6% (P < .01).</p><p><strong>Conclusion: </strong>Free description in patient safety reports is useful for evaluating the safety culture. Co-occurrence analysis revealed multiple concepts of physicians' perceptions. Quantitative content analysis revealed changes in perceptions and attitudes, and a disclosure policy of adverse events and the priority of patient care appeared with the development of safety culture.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675058","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":"Improvements to safety and quality: mastery of tools and techniques is not enough, people and culture matter.","authors":"Alessandro Laureani","doi":"10.1093/intqhc/mzae121","DOIUrl":"10.1093/intqhc/mzae121","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909627","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":"Safeguarding quality of care in active conflict: priority issues and interventions in Sudan.","authors":"Sheila Leatherman, Aparna Ghosh Kachoria, Mohammed Idriss, Omer Ali, Christina Christopher, Ezequiel Garcia Elorrio","doi":"10.1093/intqhc/mzae112","DOIUrl":"10.1093/intqhc/mzae112","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854062","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":"Exploring the development of safety culture among physicians with text mining of patient safety reports: a retrospective study.","authors":"Daisuke Koike, Masahiro Ito, Akihiko Horiguchi, Hiroshi Yatsuya, Atsuhiko Ota","doi":"10.1093/intqhc/mzae108","DOIUrl":"https://doi.org/10.1093/intqhc/mzae108","url":null,"abstract":"<p><strong>Background: </strong>Safety culture development is essential for patient safety in healthcare institution. Perceptions of patient safety and cultural changes are reflected in patient safety reports; however, they were rarely investigated. The aim of this study was to investigate the perception of physicians and to explore the development of safety culture using quantitative content analysis for patient safety reports.</p><p><strong>Methods: </strong>A retrospective analysis of free descriptions of harmful patient safety reports submitted by physicians was performed. Natural language processing and text analysis were conducted using the \"KH Coder.\" A co-occurrence analysis was performed in each period to identify and analyze the safety concepts. The study period was grouped into three for comparison.</p><p><strong>Results: </strong>The patient safety reports from physicians were collected between April 2004 and March 2020. Of these, 3351 reports were harmful: 839 reports were included in period 1, 1016 reports in period 2, and 1496 reports in period 3. Natural language processing identified 316 307 words in the free descriptions of 3351 reports. We identified seven concepts from the cluster in co-occurrence analysis as follows: \"explanation of adverse event to patients and families,\" \"central venous catheter,\" \"intraoperative procedure and injury,\" \"minimally invasive surgery,\" \"life-threatening events,\" \"blood loss,\" and \"medical emergency team and critical care.\" These seven concepts showed significant differences among the three periods, except for \"blood loss.\" The \"explanation of adverse event to patients and families\" decreased in proportion from 11.3% to 8.8% (P < .05). The \"central venous catheter\" decreased from 17.3% to 11.3% (P < .01). Meanwhile, \"minimally invasive surgeries\" and \"intraoperative procedures\" increased from 3.9% to 12.9% (P < .01) and from 10.8% to 14.6% (P < .05), respectively. Focusing on patients' events, \"life-threatening events\" decreased from 13.0% to 8.1% (P < .01); however, \"medical emergency teams and critical care\" increased from 3.3% to 10.6% (P < .01).</p><p><strong>Conclusion: </strong>Free description in patient safety reports is useful for evaluating the safety culture. Co-occurrence analysis revealed multiple concepts of physicians' perceptions. Quantitative content analysis revealed changes in perceptions and attitudes, and a disclosure policy of adverse events and the priority of patient care appeared with the development of safety culture.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"37 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052487","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":"Improvements to safety and quality: mastery of tools and techniques is not enough, people and culture matter.","authors":"Alessandro Laureani","doi":"10.1093/intqhc/mzae121","DOIUrl":"https://doi.org/10.1093/intqhc/mzae121","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"37 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052502","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":"Adverse medication reactions: raising a red flag locally, sharing lessons globally, and improving safety and quality in health care.","authors":"Linda Velta Graudins","doi":"10.1093/intqhc/mzae117","DOIUrl":"10.1093/intqhc/mzae117","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909625","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":"Safeguarding quality of care in active conflict: priority issues and interventions in Sudan.","authors":"Sheila Leatherman, Aparna Ghosh Kachoria, Mohammed Idriss, Omer Ali, Christina Christopher, Ezequiel Garcia Elorrio","doi":"10.1093/intqhc/mzae112","DOIUrl":"https://doi.org/10.1093/intqhc/mzae112","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"37 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052507","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":"Adverse medication reactions: raising a red flag locally, sharing lessons globally, and improving safety and quality in health care.","authors":"Linda Velta Graudins","doi":"10.1093/intqhc/mzae117","DOIUrl":"https://doi.org/10.1093/intqhc/mzae117","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"37 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052447","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":"Effects of early palliative care intervention on medical resource use among end-of-life patients.","authors":"Chia-Chia Lin, Tsing-Fen Ho, Chang-Hung Lin, Nu-Man Tsai, Yu-Hung Kuo, Ju-Huei Chien","doi":"10.1093/intqhc/mzae119","DOIUrl":"https://doi.org/10.1093/intqhc/mzae119","url":null,"abstract":"<p><strong>Background: </strong>In Taiwan, as the population ages, palliative care services (PCS) have expanded significantly to include comprehensive benefit plans for critically ill individuals, supported by reimbursements from the National Health Insurance program. However, incorporating palliative care into the medical management of these patients presents several challenges. We aim to evaluate the effects of palliative care interventions on medical resources in end-of-life scenarios, to promote earlier palliative care access and provide high-quality healthcare services for patients.</p><p><strong>Methods: </strong>A total of 2202 patients were included in this study. Primary diagnosis and referral for PCS were assessed using ICD-10 and HNI code. All study subjects were divided into three groups: patients who did not receive PCS (no-PCS), patients who received PCS before their final hospital admission (PCS-before), and patients who received PCS after their final admission (PCS-after). We evaluated (i) the effects of PCS on eight medical resource utilization outcomes within the 30 days preceding death and (ii) the effects of early intervention on two major diseases.</p><p><strong>Results: </strong>Initiating PCS before a patient's last hospital admission was associated with less aggressive medical interventions in the 30 days before death, including reduced length of intensive care unit (ICU) [odds ratio (OR) = 0.25], and rates of endotracheal intubation (OR = 0.12), respiratory ventilator support (OR = 0.20), cardiopulmonary resuscitation (OR = 0.18), and blood transfusion (OR = 0.65). Among patients with cancer and lung diseases, those who received PCS prior to their final hospitalization of over 14 days experienced reduced hospitalization duration (OR = 0.52 and 0.24, respectively). Patients with lung disease also had significantly lower odds of ICU stays (OR = 0.44) and respiratory ventilation (OR = 0.33).</p><p><strong>Conclusion: </strong>The timing of palliative care intervention critically impacts on duration of hospitalization and ICU stay and the need for intubation procedures or cardiopulmonary resuscitation. The findings can help the government and medical providers in developing comprehensive palliative care policies and programs to improve care quality and patient rights.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"37 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052483","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":"Effects of early palliative care intervention on medical resource use among end-of-life patients.","authors":"Chia-Chia Lin, Tsing-Fen Ho, Chang-Hung Lin, Nu-Man Tsai, Yu-Hung Kuo, Ju-Huei Chien","doi":"10.1093/intqhc/mzae119","DOIUrl":"10.1093/intqhc/mzae119","url":null,"abstract":"<p><strong>Background: </strong>In Taiwan, as the population ages, palliative care services (PCS) have expanded significantly to include comprehensive benefit plans for critically ill individuals, supported by reimbursements from the National Health Insurance program. However, incorporating palliative care into the medical management of these patients presents several challenges. We aim to evaluate the effects of palliative care interventions on medical resources in end-of-life scenarios, to promote earlier palliative care access and provide high-quality healthcare services for patients.</p><p><strong>Methods: </strong>A total of 2202 patients were included in this study. Primary diagnosis and referral for PCS were assessed using ICD-10 and HNI code. All study subjects were divided into three groups: patients who did not receive PCS (no-PCS), patients who received PCS before their final hospital admission (PCS-before), and patients who received PCS after their final admission (PCS-after). We evaluated (i) the effects of PCS on eight medical resource utilization outcomes within the 30 days preceding death and (ii) the effects of early intervention on two major diseases.</p><p><strong>Results: </strong>Initiating PCS before a patient's last hospital admission was associated with less aggressive medical interventions in the 30 days before death, including reduced length of intensive care unit (ICU) [odds ratio (OR) = 0.25], and rates of endotracheal intubation (OR = 0.12), respiratory ventilator support (OR = 0.20), cardiopulmonary resuscitation (OR = 0.18), and blood transfusion (OR = 0.65). Among patients with cancer and lung diseases, those who received PCS prior to their final hospitalization of over 14 days experienced reduced hospitalization duration (OR = 0.52 and 0.24, respectively). Patients with lung disease also had significantly lower odds of ICU stays (OR = 0.44) and respiratory ventilation (OR = 0.33).</p><p><strong>Conclusion: </strong>The timing of palliative care intervention critically impacts on duration of hospitalization and ICU stay and the need for intubation procedures or cardiopulmonary resuscitation. The findings can help the government and medical providers in developing comprehensive palliative care policies and programs to improve care quality and patient rights.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909626","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}