Quality Management in Health Care最新文献

{"title":"Lighting Assessment in the Hospital: An Observational Study in a Tertiary Care Hospital.","authors":"Anuj Vashisht, Jithesh Vishwanathan, Ankita Grover, Shruti Vashisht","doi":"10.1097/QMH.0000000000000529","DOIUrl":"10.1097/QMH.0000000000000529","url":null,"abstract":"<p><strong>Background and objectives: </strong>Proper lighting in hospitals is essential for patient care and operational efficiency. This study assessed lighting compliance in a tertiary care hospital, considering both objective measurements and subjective evaluations.</p><p><strong>Methods: </strong>This observational study was conducted in various hospital departments, including operating theatre, intensive care unit (ICU), accident and emergency (A&E), and wards. Two methods were used: illuminance measurement with a lux meter and checklist-based compliance assessment. Results were compared to national standards (Bureau of Indian Standards, SP 72).</p><p><strong>Results: </strong>The study found that over 90% of areas had lighting below the recommended standards. Operating theatre compliance was 20%, ICU compliance was 18%, and A&E had 0%. Compliance based on checklist assessment was highest in operating theatres (54%) and lowest in acute medical wards (12.5%).</p><p><strong>Conclusions: </strong>The study revealed significant gaps in hospital lighting compliance. The study suggests optimizing lighting placement and types (eg, light emitting diode (LEDs)) and incorporating lighting standards into hospital accreditation guidelines.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"160-164"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542212","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":"From Quality Improvement to Return on Investment: A Cost-Inclusive Playbook.","authors":"Timothy R Fowles, Doug Wolfe, Robb Duffin, Amy Church, Rajendu Srivastava","doi":"10.1097/QMH.0000000000000582","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000582","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":"35 3","pages":"209-210"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405662","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":"Lean Management Helps to Reduce Errors in Histopathology: A Real-life Experience From a Tertiary Care Public Sector Hospital.","authors":"Arpita Joshi, Garima Singh, Aarzoo Jahan, Namrata Sarin, Sompal Singh, Ruchika Gupta","doi":"10.1097/QMH.0000000000000516","DOIUrl":"10.1097/QMH.0000000000000516","url":null,"abstract":"<p><strong>Background and objectives: </strong>Histopathology has been increasingly playing a vital role in patient diagnosis. Histopathology laboratories have been riddled with multiple problems such as inefficiency, errors, and rising costs. Lean management, a concept derived from the Toyota production systems, helps in improving the operational efficiency by removing waste or errors. The lean concept has been demonstrated to reduce waiting times, improve patient safety and satisfaction, and reduce costs in health care. We aimed to assess the impact of lean management on the frequency of errors in the histopathology laboratory of a tertiary level hospital.</p><p><strong>Methods: </strong>This was a before-and-after study where the lean process was implemented in a phased manner beginning with an assessment of its need by the senior specialists, data collection, training of staff, post-training data collection and analysis. The various errors that were possible in the workflow of the laboratory were identified. The frequency of errors in 2018 (pre-intervention) and 2021 (post-intervention) was noted and compared.</p><p><strong>Results: </strong>Data collection from the pre-intervention period revealed that delay in microtomy, incorrect patient identification details on the requisition form, and sample received without appropriate fixative had the highest frequency of events leading to errors in histopathology. After the implementation of lean principles in the laboratory, the error frequency reduced by 30.79%. The highest decline was noted in the delay caused by grossing being performed in the morning hours (64.5% reduction), while the smallest reduction (16.67%) was noted for samples arriving from the clinical departments at erratic times.</p><p><strong>Conclusion: </strong>The present study emphasizes that the implementation of simple measures of lean management in a histopathology laboratory can be effective in reducing errors and improving efficiency without adding to the cost to the laboratory.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"183-188"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094730","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":"Enhancing Patient Safety Awareness Among Medical Students: A Pilot Study.","authors":"Ana C Corona-Pantoja, María F Rodelo-Uraga, Diana M Barreto-Navarro, Ilse S Dávalos-Higareda, Edgar O Zamora-González, Ángel R Castro-Navarro, Benjamín Gómez-Díaz, Marcela M Rodríguez-Baeza, Norma A Vázquez-Cárdenas, Luz B López-Hernández","doi":"10.1097/QMH.0000000000000507","DOIUrl":"10.1097/QMH.0000000000000507","url":null,"abstract":"<p><strong>Background and objectives: </strong>The practice of medicine involves the risk of causing harm, even under the best circumstances and despite having optimal training. Therefore, patient safety is not only an essential part of healthcare but is also crucial for the training of resilient future doctors. The awareness of medical students regarding patient safety issues is of utmost importance for their professional formation. The objective of the present study was to gain insights into the awareness of medical students at the Autonomous University of Guadalajara about patient safety problems and the expectations of how patient safety is being managed in the health system.</p><p><strong>Methods: </strong>A descriptive and longitudinal study was carried out in which eighth-semester medical students were invited to participate. The questionnaire was adapted from the World Health Organization Medical School Curricular Guide for Patient Safety questionnaire and applied before and after the course \"Seminar on Quality and Safety in Medical Care.\" In total, 419 students answered the questionnaire.</p><p><strong>Results: </strong>The data showed a significant increase in the scores on the questionnaire after the course ( P < .05).</p><p><strong>Conclusion: </strong>Students showed satisfactory awareness and positive expectations with regard to reporting and learning from errors and helping others when medical errors occur, which has implications for health care quality. Application of the WHO questionnaire in other settings and countries may contribute to a better comprehension of awareness and expectations of future health professionals in the world.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"165-174"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244927","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":"Safety, Efficiency, and Cost Conflicts in Emergency Department Point of Care Troponin Testing.","authors":"Zoe Grabinski, Jordan L Swartz, Yelan Wang, Aya Itani, Maria Aguero-Rosenfeld, Neldis Sanchez, Rajneesh Gulati, Ian G Wittman, Silas W Smith","doi":"10.1097/QMH.0000000000000502","DOIUrl":"10.1097/QMH.0000000000000502","url":null,"abstract":"<p><strong>Background and objectives: </strong>Assessment of acute coronary syndrome (ACS) has pressured rapid diagnostic evaluation through point of care troponins (POCT-Tns). However, POCT-Tns have demonstrated inconsistent accuracy compared to laboratory (LABT)-Tn. A POCT-Tn used inappropriately to \"rule-out\" ACS can lead to premature diagnostic closure. We aimed to minimize indiscriminate POCT-Tn testing, while balancing test turnaround time (TAT), institutional cost, and impact on patient time to disposition (TTD).</p><p><strong>Methods: </strong>A quality improvement (QI) initiative from 2018 to 2022 included educational interventions and electronic health record (EHR) adaptations. We evaluated test characteristics, trended test frequency, TATs, cost, and TTD. We used statistical process control charts to evaluate changes in test frequency over time. We used the Mann-Whitney U and Wilcoxon Signed-Rank Sum test to analyze changes in TAT, TTD, and cost.</p><p><strong>Results: </strong>POCT-Tn had high discordance with LAB-Tn (9.7%) and low sensitivity (52.5%). SPCs showed a significant decrease in POCT-Tn tests performed over time. LABT-Tn TATs were longer than POCT-Tn (54 vs 21 min; P < .001). Total Tn testing costs decreased by $668 827.83 annually. Compared to pre-initiative, arrival to disposition was 20 min longer for patients receiving a LABT-Tn ( P < .001) and 37 min shorter for patients receiving a POCT with reflex to LABT-Tn ( P < .001).</p><p><strong>Conclusion: </strong>POCT-Tn test characteristics may place patients at risk for missed ACS. A combined approach using education and EHR adaptations decreased use of indiscriminate POCT-Tn tests, decreased health care costs, and resulted in clinically appropriate changes in disposition times for this large cohort of ED patients.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"175-182"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080037","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":"Improving Transitions of Care for Heart Failure Patients: A Novel Payer-Provider Partnership.","authors":"Mark E Patterson, Paul S Chan, Susan Melton, Tracie Breeding, Stacy L Farr, John A Spertus","doi":"10.1097/QMH.0000000000000551","DOIUrl":"10.1097/QMH.0000000000000551","url":null,"abstract":"<p><strong>Background and objective: </strong>Disease management (DM) programs are a promising strategy to reduce readmissions after hospitalization for acute heart failure (HF). Although commercial health insurers (payers) often offer DM programs, engaging patients early after discharge can be challenging. To better support the use of payers' DM programs, we developed a referral process for hospital teams to identify and refer patients prior to discharge by educating them about the benefits of DM and to anticipate contact from their insurer, while also alerting the payers to the treatment plans for individual patients.</p><p><strong>Methods: </strong>A pilot of the referral program was tested between a non-profit hospital and 2 regional payers from August 2020 to May 2022. Collaboratively designed by payers, clinicians, and researchers, the process aimed to educate and refer patients being discharged after HF hospitalization. Screening and referral logs tracked referral rates over time, and monthly stakeholder calls were conducted among payers and hospital clinicians to identify barriers and facilitators to iteratively improve the process.</p><p><strong>Results: </strong>Among 331 patients hospitalized for HF, 76% ( N = 257) were screened. Of those screened, 77.8% ( N = 200) were eligible for referral, and 74.5% ( N = 149) of patients chose to be referred. Of those referred, 17.4% ( N = 26) enrolled in the program. Initially, staff shortages were associated with delayed or incomplete referrals, leading to a centralized process of a single person assuming responsibility for screening and referral, which significantly increased screening rates from 51.9% to 82.4% ( P  < 0.001). Enhanced referral forms containing additional clinical data, alongside payers' electronic health record access, improved enrollment. The lack of a central enrollment registry led to data reconciliation challenges.</p><p><strong>Conclusion: </strong>This study underscores the potential effectiveness of dedicated staffing to support screening and effectively make referrals to insurers' DM programs. Future initiatives should consider facilitating payers' access to patients' electronic health records, deploying dedicated staff for screening and referral, and creating registries for real-time referral and enrollment tracking.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"189-198"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768390","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 Complex Context of Emergency Department Diagnostic Work: Using a Human Factors and Sociotechnical Systems Approach for Artificial Intelligence.","authors":"Emily Newsome, Shawna J Perry, Gary Klein, Shannon L Cole, Ayse P Gurses","doi":"10.1097/QMH.0000000000000584","DOIUrl":"https://doi.org/10.1097/QMH.0000000000000584","url":null,"abstract":"","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":"35 3","pages":"211-212"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405645","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":"Improving the Quality of Care and the Health of Patients with Non-English Language Preference: The Experience of an Academic Department of Medicine in Developing a Multidisciplinary, Stakeholder-Engaged Program.","authors":"Sucharita Kher, Kristin Huang, Karen M Freund","doi":"10.1097/QMH.0000000000000534","DOIUrl":"10.1097/QMH.0000000000000534","url":null,"abstract":"<p><strong>Background and objectives: </strong>Health care institutions must provide equitable quality of care for all patient populations. Despite this, data supports that hospitals struggle to do so for patients with non-English language preference (NELP). We describe the efforts of an academic department of medicine at a tertiary care hospital that serves a large number of patients with NELP.</p><p><strong>Methods: </strong>We describe our stakeholder-engaged approach in developing a strategy for caring for patients with NELP.</p><p><strong>Results: </strong>The lessons learned during the process of developing a departmental strategy for caring for patients with NELP are described. The paper ends with future directions of our work.</p><p><strong>Conclusion: </strong>Leveraging multidisciplinary stakeholder engagement, our department raised awareness of the challenges that the patients with NELP can face as they navigate health care, resulting in institutional support for building a program for improving quality of care for the population.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"199-205"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542283","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 Blaylock Risk Assessment Screening Score in Neurology-A Monocentric Cohort Study.","authors":"Andrea Streit, Magdalena Hoffmann, Andreas Blesl, Christine Maria Schwarz, Andrea Borenich, Gerhard Pretterhofer, Gernot Brunner","doi":"10.1097/QMH.0000000000000543","DOIUrl":"10.1097/QMH.0000000000000543","url":null,"abstract":"<p><strong>Background and objectives: </strong>Effective discharge planning is an important factor of hospital care and should follow a comprehensive assessment of patients at risk for adverse events during discharge. The study's aim was to analyze whether the use of the Blaylock Risk Assessment Screening Score (BRASS) at admission leads to a reduction in the hospital length of stay (LOS), a reduction in readmission rates, an influence on the discharge destination at the University Hospital of Graz, and an increase of the end user's satisfaction.</p><p><strong>Methods: </strong>BRASS was implemented into the routine nursing assessment at admission for 3 months in 2021 at 2 Neurology wards at the University Hospital of Graz. These data were retrospectively compared to 2 previous time periods without BRASS. For the prospective part of this study, a paper-based survey was performed to analyze the satisfaction of the nurses at the 2 wards with the application of BRASS.</p><p><strong>Results: </strong>The median LOS was significantly longer during the time of the assessment with BRASS as compared to the 2 years before [8 (4, 14) days in 2021, 6 (4, 10) days in 2020, 6 (4, 9) days in 2019; 2021 vs 2020: P = .002; 2021 vs 2019: P < .001]. Readmission rates did not differ significantly, but outpatient readmission decreased compared to 2019 (17% in 2021, 23% in 2019, P = .040).</p><p><strong>Conclusion: </strong>The use of BRASS did not reduce the length of hospital stay compared to the 2 years before, but outpatient readmission rates decreased and discharge home was more frequent. Therefore, BRASS might be a helpful tool to improve discharge management and avoid readmissions.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"153-159"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355808","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":"Hospital Performance Assessment: A Global Perspective.","authors":"Steven Howard, Michael Counte, Mohammed Alzeen, Dilorom Zuparova, Zhengmin Qian","doi":"10.1097/QMH.0000000000000552","DOIUrl":"10.1097/QMH.0000000000000552","url":null,"abstract":"<p><strong>Background and objectives: </strong>Globally, healthcare has experienced unsustainable cost inflation. Therefore, innovative approaches must be considered to curb these ever-increasing costs. Hospitals, which play a central role in every healthcare system, contribute significantly to cost increases, largely through the acceleration of operational complexity. Such evolutionary phenomena have rendered Hospital Performance Assessments (HPA) vitally important to healthcare leaders, health service researchers, and policymakers, especially amid the current global revolution in value-based payments. This study aimed to examine the growing importance of HPA in hospital and healthcare system management and to propose the development of a comprehensive HPA framework.</p><p><strong>Methods: </strong>We conducted a comprehensive literature review considering the historical and current frameworks and operational HPAs. This includes an overview of the most common quantitative methods, global and national health databases, and methodological integration into hospital performance assessments. We propose a new comprehensive framework to develop more effective HPAs.</p><p><strong>Results: </strong>This study proposes a comprehensive framework that captures the intricate complexities of healthcare evolution that encompasses service area attributes, Hospital Attributes, the Organizational Processes and Managerial Technologies in place, and the measured Domains of Hospital Performance.</p><p><strong>Conclusion: </strong>There is a critical need to develop innovative HPAs and associated assessment frameworks to facilitate researchers and leaders in studying and managing healthcare systems worldwide.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":" ","pages":"141-152"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378487","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}