Quality Management in Health Care最新文献

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Implementation of Intrahospital Transfer Strategy During COVID-19 and Identify Success Factors Based on DEMATEL Technique. 在 COVID-19 期间实施院内转运策略并基于 DEMATEL 技术识别成功因素。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-18 DOI: 10.1097/QMH.0000000000000433
Bahareh Ahmadinejad, Alireza Jalali, Fatemeh Bahramian, Amir Shabani, Mohammadali Sherafati
{"title":"Implementation of Intrahospital Transfer Strategy During COVID-19 and Identify Success Factors Based on DEMATEL Technique.","authors":"Bahareh Ahmadinejad, Alireza Jalali, Fatemeh Bahramian, Amir Shabani, Mohammadali Sherafati","doi":"10.1097/QMH.0000000000000433","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000433","url":null,"abstract":"<p><strong>Background and objectives: </strong>The COVID-19 pandemic caused a significant strain on world health care systems. The lack of trained and experienced staff was a complicated issue during the pandemic. To overcome insufficient staffing problems, the intrahospital transfer (IHT) strategy was implemented at Milad Hospital in Tehran during COVID-19. We evaluated the effectiveness of the IHT strategy in order to determine whether the strategy should be continued post-COVID.</p><p><strong>Methods: </strong>Six supervisors with experience in COVID-19 wards and the IHT strategy were consulted to identify the advantages of continuing the IHT strategy and to evaluate the success and continuation of IHT factors. Then, the decision-making trial and evaluation laboratory (DEMATEL) method was used to establish a network of influence relationships among IHT strategy factors' success.</p><p><strong>Results: </strong>The result showed that all criteria except increasing patient satisfaction (C1) and reducing waste of time (C8) are cause-and-effect criteria that affected other criteria.</p><p><strong>Conclusion: </strong>The research findings have implications for improving the day-to-day experience of staff navigating transfers of patients between wards and paraclinic units. This study also highlights the theoretical value of the cross-disciplinary integration of medical decision issues and multiple-attribute decision-making methodologies.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748997","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}
引用次数: 0
COVID-19 Inpatient Caseloads in General Hospitals Did Not Affect Quality Indicator Compliance Rates in Israel. COVID-19 以色列综合医院的住院病人数量并未影响质量指标达标率。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-18 DOI: 10.1097/QMH.0000000000000458
Olga Bronshtein, Alexander Konson, Michael Kuniavsky, Nethanel Goldschmidt, Shuli Hanhart, Hannah Mahalla-Garashi, Shir Peri, Chana Rosenfelder, Yaron Niv, Shaul Dollberg
{"title":"COVID-19 Inpatient Caseloads in General Hospitals Did Not Affect Quality Indicator Compliance Rates in Israel.","authors":"Olga Bronshtein, Alexander Konson, Michael Kuniavsky, Nethanel Goldschmidt, Shuli Hanhart, Hannah Mahalla-Garashi, Shir Peri, Chana Rosenfelder, Yaron Niv, Shaul Dollberg","doi":"10.1097/QMH.0000000000000458","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000458","url":null,"abstract":"<p><strong>Background and objectives: </strong>Early in the global COVID-19 pandemic, a concern was raised that potentially high volumes of COVID-19 inpatients in general hospitals might compromise the hospitals' capabilities to maintain high-quality care for routine patients and, thereby, to comply with indicators specifying quality of care. The objective of this study is to evaluate the impact of the surges of COVID-19 inpatients into general hospitals in Israel on the compliance rates for selected quality indicators reported by these hospitals within the Israeli National Program for Quality Indicators (NPQI).</p><p><strong>Methods: </strong>Compliance rate data were collected from the quality indicators reports made to the NPQI by participating hospitals. COVID-19 inpatient volume data were obtained from the Ministry of Health Digital Technologies and Data Division. Both datasets were analyzed on a week-by-week basis and plotted one alongside the other on a time scale. Association of each quality indicator's compliance rate with the number of COVID-19 inpatients was tested by Pearson's correlation analysis. The study included data from July 1, 2019 through June 30, 2022, spanning the duration of the COVID-19 pandemic in Israel. Five quality indicators included in the study were: Surgical repair of femoral neck fracture within 48 h of admission; Assessment of cerebral ischemic event risk for patients with atrial fibrillation; Duplex carotid ultrasound within 72 h of emergency department admission for patients with suspected transient ischemic attack; Antibiotic prophylaxis for caesarean sections; and Percutaneous coronary intervention within 90 min for patients presenting with ST-elevation myocardial infarction.</p><p><strong>Results: </strong>Compliance rates for five quality indicators, representing different aspects of routine health care, remained steady - even at times with high volumes of COVID-19 inpatients in general hospitals. This lack of effect was prominent throughout the analyzed period, i.e., general hospitals maintained similar compliance rates for all quality indicators both during the surges of COVID-19 patients and between these periods. Statistical analysis showed no correlation between the quality indicators' compliance rates and the number of COVID-19 inpatients.</p><p><strong>Conclusions: </strong>Our findings indicate that high volumes of COVID-19 inpatients in general hospitals did not affect the hospitals' capability to comply with routine health care quality indicators. The results of our study imply that general hospitals in Israel were able to withstand the challenges associated with the care of COVID-19 inpatients while preserving high quality of care for routine patients.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748994","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}
引用次数: 0
Primary Care Quality Improvement Through Patient-Centered Medical Homes and the Impact on Emergency Department Utilization for Children With Autism and Mental Health Disorders. 通过 "以患者为中心的医疗之家 "提高初级保健质量,以及对自闭症和精神疾病儿童使用急诊室的影响》(Patient-Centered Medical Homes and the Impact on Emergency Department Utilization for Children with Autism and Mental Health Disorders)。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-18 DOI: 10.1097/QMH.0000000000000452
Li Huang, Jarron M Saint Onge
{"title":"Primary Care Quality Improvement Through Patient-Centered Medical Homes and the Impact on Emergency Department Utilization for Children With Autism and Mental Health Disorders.","authors":"Li Huang, Jarron M Saint Onge","doi":"10.1097/QMH.0000000000000452","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000452","url":null,"abstract":"<p><strong>Background and objectives: </strong>To address health care spending growth, coordinated care, and patient-centered primary care, most states in the United States have adopted value-based care coordination programs such as patient-centered medical homes (PCMHs). The objective of this study was to understand the relationship between having access to PCMHs and emergency department (ED) utilization for high cost/need children with autism and children with mental health disorders (MHDs).</p><p><strong>Methods: </strong>This cross-sectional study included 87 723 children between ages 3 and 17 years in the 2016-2018 National Survey for Children's Health. Multivariate-adjusted logistic regression analyses were used to assess the association between ED and PCMH utilization for children with autism, with MHDs without autism, and others without autism or MHDs. Marginal predictions were used to examine whether PCMH utilization was moderated by health conditions.</p><p><strong>Findings: </strong>The results showed that children with a PCMH had a 16% reduction in the odds to visit the ED (adjusted odds ratio [aOR] = 0.84; confidence interval [CI], 0.77-0.92; P < .001). When compared with the reference group of children without autism and without MHDs, children with MHDs but without autism had 93% higher odds to visit the ED (aOR = 1.93; CI, 1.75-2.13; P < .001) and children with autism had 35% higher odds to visit the ED (aOR = 1.35; CI, 1.04-1.75; P = .023). Marginal effects results suggested that PCMHs reduced the odds of ED visits the most for children with MHDs without autism and reduced the predicted ED visits from 30.1% to 23.7% (P < .001).</p><p><strong>Conclusions: </strong>Primary care quality improvement through access to a PCMH reduced ED visits for children, but the effect varied by autism and MHD conditions. Future PCMH efforts should continue to support children with autism and address unmet needs for children with MHDs with a focus on needed care coordination, family-centered care, and referrals.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748974","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}
引用次数: 0
Patient-Engagement Health Information Technology and Quality Process Outcomes in Federally Qualified Health Centers. 联邦合格医疗中心的患者参与医疗信息技术和质量流程成果。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-18 DOI: 10.1097/QMH.0000000000000428
Seongwon Choi, Thomas Powers
{"title":"Patient-Engagement Health Information Technology and Quality Process Outcomes in Federally Qualified Health Centers.","authors":"Seongwon Choi, Thomas Powers","doi":"10.1097/QMH.0000000000000428","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000428","url":null,"abstract":"<p><strong>Background and objectives: </strong>Health information technology (HIT) for patient-engagement can positively influence the quality and efficiency of health care delivery. Although this topic is of significant importance, it has not been fully addressed in the federally qualified health center (FQHC) context. This research investigates the relationship between the level of patient-engagement HIT and FQHC preventive health care quality outcomes.</p><p><strong>Method: </strong>Based on the Uniform Data System (UDS), this study employed multivariable regression analysis to investigate the association between the level of patient-engagement HIT and FQHC preventive health care quality outcomes. FQHCs were placed in 4 mutually exclusive groups based on the level of FQHC use of patient-engagement HIT.</p><p><strong>Results: </strong>The results indicate that compared with the most comprehensive patient-engagement HIT at FQHCs, less comprehensive patient-engagement HIT was associated with lower rates of preventive care provision.</p><p><strong>Conclusions: </strong>Comprehensive patient-engagement HIT across FQHCs may improve preventive health care quality outcomes. The results support policy incentives for FQHCs with less comprehensive levels of patient-engagement HIT to foster improved preventive care for their patients.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748973","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}
引用次数: 0
Internal Audit to Monitor the Injected Activity in PET/CT Using Control Charts. 使用控制图监控 PET/CT 注射活动的内部审计。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-17 DOI: 10.1097/QMH.0000000000000449
Sara Russo, Pedro Almeida, Teresa Lúcio, Luís Oliveira, Isabel Conde, Ana Aleixo, Ana Sofia Matos
{"title":"Internal Audit to Monitor the Injected Activity in PET/CT Using Control Charts.","authors":"Sara Russo, Pedro Almeida, Teresa Lúcio, Luís Oliveira, Isabel Conde, Ana Aleixo, Ana Sofia Matos","doi":"10.1097/QMH.0000000000000449","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000449","url":null,"abstract":"<p><strong>Background and objective: </strong>In an effort to limit the risks associated with medical radiation exposure, the last century witnessed the development of dose control mechanisms, recommended by the International Commission on Radiological Protection. This organization recommends the optimization of radiation protection to provide the highest level of safety that may reasonably be achievable. Adhering to the \"as low as reasonably achievable\" principle, the purpose of this study was to monitor the 18F-FDG injected activity in PET and optimize the radiation protection through an internal audit process. This monitoring allows the identification of opportunities for improvement in patient care and safety, as well as to establish a periodic review of the medical unit reference levels.</p><p><strong>Methods: </strong>The methodology is based on short run Quesenberry (Q) statistics and normalized nonconstant sample size (Z-chart) control charts. Anonymized data from 512 patients were selected from a set of 18F-FDG PET/CT (Siemens, Biograph 6) examinations performed during 10 months. The analyzed variable was the ratio between the 18F-FDG injected activity (MBq) and patient weight (kg).</p><p><strong>Results: </strong>Mean injected 18F-FDG activity was 347.811 ± 64.967 MBq corresponding to a mean effective dose of 6.608 ± 1.234 mSv. The ratio between the 18F-FDG injected activity and the body mass of patients was reduced from 5.243 ± 0.716 to 5.171 ± 0.672 MBq/kg during the statistical data analysis. The study demonstrates that control charts can be a useful tool to signal situations where patients receive an activity significantly different from the standard practice in a medical unit.</p><p><strong>Conclusion: </strong>The use of joint control charts is a suitable tool for detecting nonoptimized radiopharmaceutical administration. This analysis provides opportunities to evaluate and improve the quality of practice in nuclear medicine. This methodology constitutes an internal audit that may help health care professionals to make appropriate decisions to ensure all patients receive the safest and most appropriate care.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748998","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}
引用次数: 0
Generation of Indicators to Assess Quality of Health Care in Hospital at Home Through e-Delphi. 通过 e-Delphi 生成评估家庭住院医疗质量的指标。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-17 DOI: 10.1097/QMH.0000000000000451
Carolina Puchi, Tatiana Paravic-Klijn, Alide Salazar
{"title":"Generation of Indicators to Assess Quality of Health Care in Hospital at Home Through e-Delphi.","authors":"Carolina Puchi, Tatiana Paravic-Klijn, Alide Salazar","doi":"10.1097/QMH.0000000000000451","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000451","url":null,"abstract":"<p><strong>Background and objectives: </strong>The quality of health care in hospital at home (HaH) has been measured in different countries using simple indicators and clinical results that only contribute to some dimensions of the quality of health care. We sought to generate indicators to comprehensively evaluate the quality of health care provided to HaH users through the e-Delphi technique.</p><p><strong>Methods: </strong>The e-Delphi technique was performed with the participation of 17 HaH experts. The methodological strategy applied in this study was divided into the following 3 phases: a preparatory phase; consultation phase; and consensus phase. Three rounds of consultations were conducted with experts. In round 1, they were asked to identify which aspects of HaH they believed should be evaluated using an indicator for each of the following 6 dimensions of health care quality: effectiveness; efficiency; timeliness; patient-centered care; equity; and safety. In round 2, they were asked to rate each indicator using a 5-point Likert-type scale with the following values: (1) Totally disagree; (2) Disagree; (3) Moderately agree; (4) Agree; and (5) Totally agree. The criteria for evaluating each indicator were as follows: (1) The indicator is a useful measure for assessing the quality of health care provided to HaH users. (2) The indicator is clearly and specifically written and does not require modification. (3) The indicator is essential and incorporates information that can be extracted from HaH program records. An indicator was considered approved if it received at least 65% approval from the expert panel for each evaluation criterion. In round 3, experts were asked to reassess their ratings, taking into account the opinions of the other experts. The reliability of this technique was ensured through credibility, reliability, and confirmability. We obtained ethical approval of the corresponding institutions and informed consent from the participating experts.</p><p><strong>Results: </strong>Nine unpublished and reliable indicators were generated. In addition, 13 indicators were incorporated that evaluate aspects previously analyzed by other authors and/or national and international institutions, which were adapted to be used in HaH. The total indicators generated (n = 22) represented all dimensions of the quality of health care: safety; opportunity; effectiveness; efficiency; equity; and patient-centered care.</p><p><strong>Conclusions: </strong>The 22 indicators generated through the e-Delphi technique permit a comprehensive evaluation of the quality of health care provided to HaH users.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748996","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}
引用次数: 0
Reduction of Chest Drain Overuse Through Implementation of a Pleural Drainage Order Set. 通过实施胸腔引流订单集,减少胸腔引流管的过度使用。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-01 Epub Date: 2024-06-26 DOI: 10.1097/QMH.0000000000000427
Pattraporn Tajarernmuang, David Valenti, Anne V Gonzalez, Giovanni Artho, Mary Tsatoumas, Stéphane Beaudoin
{"title":"Reduction of Chest Drain Overuse Through Implementation of a Pleural Drainage Order Set.","authors":"Pattraporn Tajarernmuang, David Valenti, Anne V Gonzalez, Giovanni Artho, Mary Tsatoumas, Stéphane Beaudoin","doi":"10.1097/QMH.0000000000000427","DOIUrl":"10.1097/QMH.0000000000000427","url":null,"abstract":"<p><strong>Background and objectives: </strong>Small chest drains are used in many centers as the default drainage strategy for various pleural effusions. This can lead to drain overuse, which may be harmful. This study aimed to reduce chest drain overuse.</p><p><strong>Methods: </strong>We studied consecutive pleural procedures performed in the radiology department before (August 1, 2015, to July 31, 2016) and after intervention (September 1, 2019, to January 31, 2020). Chest drains were deemed indicated or not based on criteria established by a local interdisciplinary work group. The intervention consisted of a pleural drainage order set embedded in electronic medical records. It included indications for chest drain insertion, prespecified drain sizes for each indication, fluid analyses, and postprocedure radiography orders. Overall chest drain use and proportion of nonindicated drains were the outcomes of interest.</p><p><strong>Results: </strong>We reviewed a total of 288 procedures (pre-intervention) and 155 procedures (post-intervention) (thoracentesis and drains). Order-set implementation led to a reduction in drain use (86.5% vs 54.8% of all procedures, P < .001) and reduction in drain insertions in the absence of an indication (from 45.4% to 29.4% of drains, P = .01). The need for repeat procedures did not increase after order-set implementation (22.0% pre vs 17.7% post, P = .40). Complication rates and length of hospital stay did not differ significantly after the intervention. More pleural infections were treated with drain sizes of 12Fr and greater (31 vs 70%, P < .001) after order-set deployment, and direct procedural costs were reduced by 27 CAN$ per procedure.</p><p><strong>Conclusion: </strong>Implementation of a pleural drainage order-set reduced chest drain use, improved procedure selection according to clinical needs, and reduced direct procedural costs. In institutions where small chest drains are used as the default drainage strategy for pleural effusions, this order set can reduce chest drain overuse.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10119242","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}
引用次数: 0
Patient Comments and Patient Experience Ratings Are Strongly Correlated With Emergency Department Wait Times. 患者意见和患者体验评分与急诊科等候时间密切相关。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-01 Epub Date: 2024-06-26 DOI: 10.1097/QMH.0000000000000460
Diane Kuhn, Peter S Pang, Benton R Hunter, Paul I Musey, Karl Y Bilimoria, Xiaochun Li, Thomas Lardaro, Daniel Smith, Christian C Strachan, Sean Canfield, Patrick O Monahan
{"title":"Patient Comments and Patient Experience Ratings Are Strongly Correlated With Emergency Department Wait Times.","authors":"Diane Kuhn, Peter S Pang, Benton R Hunter, Paul I Musey, Karl Y Bilimoria, Xiaochun Li, Thomas Lardaro, Daniel Smith, Christian C Strachan, Sean Canfield, Patrick O Monahan","doi":"10.1097/QMH.0000000000000460","DOIUrl":"10.1097/QMH.0000000000000460","url":null,"abstract":"<p><strong>Background and objectives: </strong>Hospitals and clinicians increasingly are reimbursed based on quality of care through financial incentives tied to value-based purchasing. Patient-centered care, measured through patient experience surveys, is a key component of many quality incentive programs. We hypothesize that operational aspects such as wait times are an important element of emergency department (ED) patient experience. The objectives of this paper are to determine (1) the association between ED wait times and patient experience and (2) whether patient comments show awareness of wait times.</p><p><strong>Methods: </strong>This is a cross-sectional observational study from January 1, 2019, to December 31, 2020, across 16 EDs within a regional health care system. Patient and operations data were obtained as secondary data through internal sources and merged with primary patient experience data from our data analytics team. Dependent variables are (1) the association between ED wait times in minutes and patient experience ratings and (2) the association between wait times in minutes and patient comments including the term wait (yes/no). Patients rated their \"likelihood to recommend (LTR) an ED\" on a 0 to 10 scale (categories: \"Promoter\" = 9-10, \"Neutral\" = 7-8, or \"Detractor\" = 0-6). Our aggregate experience rating, or Net Promoter Score (NPS), is calculated by the following formula for each distinct wait time (rounded to the nearest minute): NPS = 100* (# promoters - # detractors)/(# promoters + # neutrals + # detractors). Independent variables for patient age and gender and triage acuity, were included as potential confounders. We performed a mixed-effect multivariate ordinal logistic regression for the rating category as a function of 30 minutes waited. We also performed a logistic regression for the percentage of patients commenting on the wait as a function of 30 minutes waited. Standard errors are adjusted for clustering between the 16 ED sites.</p><p><strong>Results: </strong>A total of 50 833 unique participants completed an experience survey, representing a response rate of 8.1%. Of these respondents, 28.1% included comments, with 10.9% using the term \"wait.\" The odds ratio for association of a 30-minute wait with LTR category is 0.83 [0.81, 0.84]. As wait times increase, the odds of commenting on the wait increase by 1.49 [1.46, 1.53]. We show policy-relevant bubble plot visualizations of these two relationships.</p><p><strong>Conclusions: </strong>Patients were less likely to give a positive patient experience rating as wait times increased, and this was reflected in their comments. Improving on the factors contributing to ED wait times is essential to meeting health care systems' quality initiatives.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470495","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}
引用次数: 0
Quality Objectives in Standardized Quality Management Systems. 标准化质量管理体系中的质量目标。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-01 Epub Date: 2024-06-26 DOI: 10.1097/QMH.0000000000000426
Marek Bugdol
{"title":"Quality Objectives in Standardized Quality Management Systems.","authors":"Marek Bugdol","doi":"10.1097/QMH.0000000000000426","DOIUrl":"10.1097/QMH.0000000000000426","url":null,"abstract":"<p><strong>Background and objectives: </strong>The effectiveness of a quality management system consistent with the ISO 9001 standard depends on how quality objectives are established and pursued. The aims of this article are to identify quality objectives in selected certified organizations providing medical services, assess their compliance with the requirements of the ISO 9001 standard, and determine factors influencing such objectives.</p><p><strong>Methods: </strong>The first theoretical part of the article is based on a systematic literature review. The empirical part contains an analysis of documentation related to quality management systems and conducted audits. The data were collected during 42 quality management system audits conducted in 16 health care organizations in the years 2015-2020. Uncategorized interviews were conducted with quality management system representatives. The data were verified by interviews with 6 management system auditors having at least 15 years' experience in auditing health care organizations. The assessment of the methodological correctness is based on the ISO 9001:2015 standard criteria.</p><p><strong>Results: </strong>The most frequently formulated quality objectives include improving customer satisfaction, task-based objectives related to planned works, improvements, and development of new medical services. The quality objectives fulfill the requirements of the ISO 9001 standard. However, they are not ambitious. The most significant factors influencing the processes of goal setting are economic (financial incentives, available resources for modernization), social (community needs), and managerial (the scope of performed analyses, the quality of the audit process, and the calculation of necessary effort).</p><p><strong>Conclusions: </strong>Health care organizations need to pursue more ambitious objectives, intensify the use of performed medical analyses, and integrate quality objectives into management remuneration systems.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128033","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}
引用次数: 0
An Analysis of Inpatient Satisfaction with Trust-related Factors of Public Secondary and Tertiary Hospitals in China. 中国公立二级和三级医院住院病人对信任相关因素的满意度分析。
IF 1.2 4区 医学
Quality Management in Health Care Pub Date : 2024-07-01 Epub Date: 2024-06-26 DOI: 10.1097/QMH.0000000000000480
Jingjing Yan
{"title":"An Analysis of Inpatient Satisfaction with Trust-related Factors of Public Secondary and Tertiary Hospitals in China.","authors":"Jingjing Yan","doi":"10.1097/QMH.0000000000000480","DOIUrl":"10.1097/QMH.0000000000000480","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patient satisfaction surveys are implemented as an essential quality improvement tool in healthcare markets. This study investigates patient satisfaction in public secondary and tertiary hospitals and identifies factors contributing to inpatient satisfaction, particularly trust-related factors, to eventually improve the quality of care in the healthcare system.</p><p><strong>Methods: </strong>A population-based cross-sectional survey was conducted between February and April 2021 in 31 Chinese provinces. Telephone interviews with computer assistance were used to gather data. Spearman Rank Correlation was used to analyze satisfaction with hospitalization services between secondary and tertiary hospitals. Multiple Linear Regression was used to determine the influencing factors of overall patient satisfaction.</p><p><strong>Results: </strong>Inpatients reported more satisfaction with inpatient care when doctors treated them respectfully (p < 0.01). Inpatients with higher self-identified social class reported higher satisfaction (p < 0.01). Inpatients who trust in most people in society (p < 0.01) and trust in the Chinese healthcare system (p < 0.01) reported higher satisfaction. Female inpatients reported higher overall satisfaction (p < 0.01).</p><p><strong>Conclusions: </strong>The study of Chinese inpatients in secondary and tertiary hospitals highlighted the importance of respect from doctors, their self-identified social class, and their trust in influencing satisfaction during their hospital stay and called for additional research into policy measures.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470492","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}
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