International Journal for Quality in Health Care最新文献

{"title":"A scoping review of the methodological approaches used in retrospective chart reviews to validate adverse event rates in administrative data","authors":"Anna Connolly, Marcia Kirwan, Anne Matthews","doi":"10.1093/intqhc/mzae037","DOIUrl":"https://doi.org/10.1093/intqhc/mzae037","url":null,"abstract":"Background Patient safety is a key quality issue for health systems. Healthcare acquired adverse events (AEs) compromise safety and quality; therefore, their reporting and monitoring is a patient safety priority. Although administrative datasets are potentially efficient tools for monitoring rates of adverse events, concerns remain over the accuracy of their data. Chart review validation studies are required to explore the potential of administrative data to inform research and health policy. This review aims to present an overview of the methodological approaches and strategies used to validate rates of adverse events in administrative data through chart review. Methodology This review was conducted in line with the Joanna Briggs Institute methodological framework for scoping reviews. Through database searches, 1054 sources were identified, imported into Covidence, and screened against the inclusion criteria. Articles that validated rates of AEs in administrative data through chart review were included. Data were extracted, exported to Microsoft Excel, arranged into a charting table, and presented in a tabular and descriptive format. Results Fifty-six studies were included. Most sources reported on surgical adverse events however, other medical specialties were also explored. Chart reviews were used in all studies, however few agreed on terminology for the study design. Various methodological approaches and sampling strategies were used. Some studies used the Global Trigger Tool, a two-stage chart review method, whilst others used alternative single-, two-stage or unclear approaches. The sources used samples of flagged charts (n=24), flagged and random charts (n=11) and random charts (n=21). Most studies reported poor or moderate accuracy of adverse event rates. Some studies reported good accuracy of adverse event recording which highlights the potential of using administrative data for research purposes. Conclusions This review highlights the potential for administrative data to provide information on adverse event rates and improve patient safety and healthcare quality. Nonetheless, further work is warranted to ensure that administrative data are accurate. The variation of methodological approaches taken, and sampling techniques used demonstrate a lack of consensus on best practice, therefore, further clarity and consensus are necessary to develop a more systematic approach to chart reviewing.","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"14 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140803355","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":"Primum non nocere: first, do no harm-determining the current, ongoing, and future contribution of smart healthcare.","authors":"Daniel Wu, David Greenfield, Pa-Chun Wang","doi":"10.1093/intqhc/mzae025","DOIUrl":"10.1093/intqhc/mzae025","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"36 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852554","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":"Cost-effectiveness evaluations should be based on trials, not models.","authors":"Robert M Kaplan","doi":"10.1093/intqhc/mzae024","DOIUrl":"10.1093/intqhc/mzae024","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"36 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849486","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":"Implementation remains the biggest challenge to the effective use of PROMs and PREMs, so what can we do about it?","authors":"Claudia Bull, Jason D Pole","doi":"10.1093/intqhc/mzae029","DOIUrl":"10.1093/intqhc/mzae029","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"36 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849487","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":"Integration of persistence in the 5P-medicine approach for age-related chronic diseases.","authors":"Joaquín Borrás-Blasco, Esther Ramírez-Herráiz, Andrés Navarro-Ruiz","doi":"10.1093/intqhc/mzae026","DOIUrl":"https://doi.org/10.1093/intqhc/mzae026","url":null,"abstract":"<p><p>5P medicine is defined as Personalized, Predictive, Preventive, Participatory, and Population-based. 5P medicine may be improved by including a factor that could provide information about the therapeutic value of a particular drug treatment and measure its effectiveness in clinical practice. We propose that this factor may be treatment persistence, and that its addition to 5P medicine would allow to define a new improved 6P medicine. Persistence is the length of time between initiation and the last dose, which immediately precedes discontinuation, that is, a definitive suspension of the treatment. By including this sixth P, the persistence, we would be able to present the value of a treatment for each individual patient with its own characteristics, state of the disease, with more than one age-related diseases and patient journey. Persistence is a concept of the value of a treatment that includes the three main stakeholders of the pharmacotherapeutic process: Patient, Physician, and Pharmacist. Persistence is becoming a useful measure to evaluate the long-term effectiveness of therapies in real-world setting in chronic diseases. Drug treatments with longer persistence are more likely to provide better disease control and to be amenable to dose adjustment in order to optimize treatment cost in age-related chronic diseases. Long-term persistence could be a measure of a drug´s real-world performance and has been shown to aid in clinical decision-making.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"36 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860731","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":"Process management program to prevent falls in hospitalized patients with neuropsychiatric disorders: a quality improvement program","authors":"Hua XU, Zhao-hong CHEN, Juan SHE, Yan-hong ZHANG","doi":"10.1093/intqhc/mzae034","DOIUrl":"https://doi.org/10.1093/intqhc/mzae034","url":null,"abstract":"Background: Falls were among the most common adverse nursing events. The incidence of falls in patients with neuropsychiatric disorders was high, and the occurrence of falls not only caused physical and psychological harm to patients but also led to medical disputes. Therefore, interventions for falls prevention were essential, but evaluations of the intervention process were lacking. Methods: In this study, a process management program to prevent falls based on the “structure-process-outcome” quality evaluation model was designed and applied to the clinical practice of falls prevention in hospitalized patients with neuropsychiatric disorders. The process quality evaluation checklist to prevent falls was used to supervise the implementation effect of intervention measures to prevent falls, identify the problems in the intervention measures, and make continuous improvements, to reduce the incidence of falls in such hospitalized patients as the final index. Results: The incidence of inpatient falls decreased from 0.199‰ (0.199 per 1000 patient-days) to 0.101‰ (0.101 per 1000 patient-days) before and after the implementation of the process management program for 12 months, 24 months, and 36 months, respectively, and the difference was statistically significant (P&amp;lt;0.05). The probability of falls was reduced by 49% after 36 months of monitoring. Furthermore, the proportion of patients at high risk of falls exhibited a downward trend. Conclusion: This quality improvement program was feasible and effective at reducing falls in hospitalized patients with neuropsychiatric disorders. Therefore, attention should be given to monitoring process quality in the management of falls.","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"57 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140596110","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":"A multi-phase, multi-centre development and validation of two maturity tools assessing the implementation of the FlaQuM co-creation roadmap","authors":"Fien Claessens, Charlotte Van der Auwera, Deborah Seys, Dirk De Ridder, Astrid Van Wilder, Kris Vanhaecht","doi":"10.1093/intqhc/mzae035","DOIUrl":"https://doi.org/10.1093/intqhc/mzae035","url":null,"abstract":"Background: As part of the new Flanders Quality Model (FlaQuM) towards sustainable quality management systems, a co-creation roadmap with six primary drivers and 19 building blocks that guides healthcare organisations has been developed. Currently, no assessment tool is available to monitor hospitals’ quality management systems implementation according to this co-creation roadmap. Therefore, we aimed to measure the maturity of the implementation of the FlaQuM co-creation roadmap in hospitals. Methods: A three-phase approach in co-design with 19 hospitals started with defining the scope, followed by establishing content validity through a literature review, involvement of content experts (n=47), 20 focus groups with content experts (n=79) and a Delphi round with healthcare quality managers (n=19) to test the content validity index (CVI). Construct validity was assessed by confirmatory factor analyses and convergent validity by Spearman’s ρ correlation coefficients. Results: Based on 17 included existing maturity instruments and sub-components of content experts, two maturity tools were developed according to the implementation of the FlaQuM co-creation roadmap: 1) a maturity matrix with 52 sub-components and 2) a co-creation scan with 19 statements. The overall scale-CVI varied between 93.3% and 90.0% in terms of relevance and clarity, respectively. In a sample of 119 healthcare professionals, factor analyses revealed a 6-factor structure and 16 (84.2%) of the 19 hypothesis for testing convergent validity between both maturity tools were statistically significant. Conclusion: Measuring the implementation of the FlaQuM co-creation roadmap and monitoring its maturity over time should be feasible by using these comprehensive maturity tools in hospitals. Results of both tools should be able to describe the current state of hospitals’ implementation of the co-creation roadmap as basis for strategic improvement plans and next steps.","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"94 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140596319","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":"Assessing quality of critical care during an ongoing health emergency in a resource-limited setting: A novel approach to evaluate the quality of care in Lebanese public ICUs during the COVID-19 pandemic.","authors":"Karim AbouNader","doi":"10.1093/intqhc/mzae028","DOIUrl":"https://doi.org/10.1093/intqhc/mzae028","url":null,"abstract":"Background Quality of care has been systematically monitored in hospitals in high-income countries to ensure adequate care. However, in low- and middle-income countries, quality indicators are not readily measured. The primary aim of this study was to assess to what extent it was feasible to monitor the quality of Intensive care in an ongoing health emergency, and the secondary aim was to assess a quality of care intervention (twinning project) focused on Intensive Care Unit (ICU) quality of care in public hospitals in Lebanon. Methods We conducted a retrospective cohort study nested within an intervention implemented by the World Health Organization (WHO) together with partners. To assess the quality of care throughout the project, a monitoring system framed in the Donabedian model and included structure, process, and outcome indicators was developed and implemented. Data collection consisted of a checklist performed by external healthcare workers (HCWs) as well as collection of data from all admitted patients performed by each unit. The association between the number of activities within the interventional project and ICU mortality was evaluated. Results . A total of 1 679 patients were admitted to five COVID-19 ICUs during the study period. The project was conducted fully across 4 out of 5 hospitals. In these hospitals, a significant reduction in ICU mortality was found (OR: 0.83, p&amp;lt;0.05, CI: 0.72–0.96). Conclusion We present a feasible way to assess quality of care in ICUs and how it can be used in assessing a quality improvement project during ongoing crises in resource-limited settings. By implementing a quality of care intervention in Lebanon’s public hospitals, we have shown that such initiatives might contribute to improvement of ICU care. The observed association between increased numbers of project activities and reduced ICU mortality underscores the potential of quality assurance interventions to improve outcomes for critically ill patients in resource-limited settings. Future research is needed to expand this model to be applicable in similar settings.","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"61 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140596115","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 impact of elective surgery postponement during COVID-19 on emergency bellwether procedures in a large tertiary centre in Singapore.","authors":"Sze Ling Chan, Alwin Yaoxian Zhang, Sean Shao Wei Lam, Vijaya Rao, Devendra Kanagalingam, Hiang Khoon Tan, Pierce Kah Hoe Chow, Sachin Mathur","doi":"10.1093/intqhc/mzae022","DOIUrl":"10.1093/intqhc/mzae022","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic drove many healthcare systems worldwide to postpone elective surgery to increase healthcare capacity, manpower, and reduce infection risk to staff. The aim of this study was to assess the impact of an elective surgery postponement policy in response to the COVID-19 pandemic on surgical volumes and patient outcomes for three emergency bellwether procedures. A retrospective cohort study of patients who underwent any of the three emergency procedures [Caesarean section (CS), emergency laparotomy (EL), and open fracture (OF) fixation] between 1 January 2018 and 31 December 2021 was conducted using clinical and surgical data from electronic medical records. The volumes and outcomes of each surgery were compared across four time periods: pre-COVID (January 2018-January 2020), elective postponement (February-May 2020), recovery (June-November 2020), and postrecovery (December 2020-December 2021) using Kruskal-Wallis test and segmented negative binomial regression. There was a total of 3886, 1396, and 299 EL, CS, and OF, respectively. There was no change in weekly volumes of CS and OF fixations across the four time periods. However, the volume of EL increased by 47% [95% confidence interval: 26-71%, P = 9.13 × 10-7) and 52% (95% confidence interval: 25-85%, P = 3.80 × 10-5) in the recovery and postrecovery period, respectively. Outcomes did not worsen throughout the four time periods for all three procedures and some actually improved for EL from elective postponement onwards. Elective surgery postponement in the early COVID-19 pandemic did not affect volumes of emergency CS and OF fixations but led to an increase in volume for EL after the postponement without any worsening of outcomes.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174483","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":"Making remote healthcare safer.","authors":"Trisha Greenhalgh, Rebecca Payne, Flora McCabe","doi":"10.1093/intqhc/mzae023","DOIUrl":"10.1093/intqhc/mzae023","url":null,"abstract":"","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":"36 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140184372","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}