Journal of Healthcare Quality Research最新文献

{"title":"Efecto sobre el momento del ingreso en la unidad de cuidados intensivos de la puesta en marcha de un servicio extendido de medicina intensiva","authors":"E. Chicote-Álvarez,&nbsp;I. Mainar-Gil,&nbsp;A. Íñiguez-de Diego,&nbsp;S. Gómez-Camino,&nbsp;L. Corta-Iriarte,&nbsp;L. Martínez-Camarero,&nbsp;E. Monfort-Lázaro,&nbsp;M. Ruiz de la Cuesta-López,&nbsp;L.Á. Vilella-Llop,&nbsp;A. Calvo-Martínez","doi":"10.1016/j.jhqr.2023.09.008","DOIUrl":"10.1016/j.jhqr.2023.09.008","url":null,"abstract":"<div><h3>Introduction</h3><p>The implementation of the Critical Care Outreach Teams can influence the time of admission of patients to the Intensive Care Unit (ICU).</p></div><div><h3>Material and methods</h3><p>Retrospective, descriptive, quasi-experimental “before-after” cohort study. All patients admitted to the unit urgently from Monday to Friday for two periods (between February 1, 2022 and June 30 and between February 1, 2023 and June 30, 2023) are included. The patients were divided into regular shift admissions (08-15<!--> <!-->h) and on-call (15-08<!--> <!-->h). The secondary objective was to assess whether there were differences in mortality between the two periods.</p></div><div><h3>Results</h3><p>During the first period of the study, 239 patients were admitted. 29.29% entered the ordinary shift and 70.71% on duty shift. During the second period, 211 patients were included with 43.13% of admissions in the ordinary shift. The comparison between the two periods observed a significant increase in the percentage of admissions in the morning hours in the second period (<em>P</em>=.0031). Mortality in the first period was 13.80% and in the second period 9.95%. The comparison between the two periods did not reveal significant differences.</p></div><div><h3>Conclusions</h3><p>The start-up of the Critical Care Outreach Teams is associated with an increase in the proportion of ICU admissions in the morning period without any observed changes in mortality.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 1","pages":"Pages 50-54"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61565585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporación de resultados informados por pacientes con psoriasis y dermatitis atópica en las consultas de atención farmacéutica y dermatología: herramienta que mejora la calidad asistencial y resultados en salud","authors":"M.Á. González-Fernández ,&nbsp;P. Herranz-Pinto ,&nbsp;M.L. Alonso-Pacheco ,&nbsp;C. Mateo-Salillas ,&nbsp;Á. Hoyo-Muñoz ,&nbsp;I. Jiménez-Nácher ,&nbsp;F. Moreno-Ramos ,&nbsp;A. Herrero-Ambrosio","doi":"10.1016/j.jhqr.2023.10.004","DOIUrl":"10.1016/j.jhqr.2023.10.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Patient-reported outcomes (PROs) provide subjective information about their disease, treatment, and quality of life.</p></div><div><h3>Objective</h3><p>To introduce a new system of work coordinated between pharmacists and dermatologists, based on the collection and analysis of PROs to assess its clinical impact as well as patients satisfaction.</p></div><div><h3>Method</h3><p>A prospective single-centre observational study was conducted under clinical conditions and included adult patients diagnosed with psoriasis (PS) and atopic dermatitis (AD) between April-2021 and February-2022.</p><p>Pharmacists and dermatologists agreed on this systematic work. A REDCap® database was designed to facilitate data collection and the subsequent analysis.</p></div><div><h3>Results</h3><p>A total of 288 and 41 patients with PS and AD, respectively, were included. Those who started treatment showed significant improvement with a decrease in PROs and clinical parameters (<em>p</em> &lt; 0.001). The pharmacist made 168 and 7 recommendations to dermatologists for PS and AD patients, respectively, of which 66.07% and 57.1% were accepted. The most common recommendations were «consult with rheumatologist» (20.83%), «extend drug regimen» (19.64%) and «consider change in treatment» (11.90%). Adverse events were reported in 55 and 17 patients with PS and AD, respectively. Of 103 patients, 75% were «very satisfied» and 20% «satisfied» with the system.</p></div><div><h3>Conclusions</h3><p>This new working system helps to evaluate the short and long-term effectiveness of treatments and also to identify adverse events, alarm symptoms and co-morbidities in order to optimize therapies. Collaboration between pharmacists and dermatologists reduces decision-making time and patients appreciate better clinical care leading to higher patient satisfaction.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 1","pages":"Pages 13-22"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consideraciones sobre el uso de ChatGPT en la práctica médica","authors":"A. Iglesias-Puzas,&nbsp;A. Conde-Taboada,&nbsp;E. López-Bran","doi":"10.1016/j.jhqr.2023.09.007","DOIUrl":"10.1016/j.jhqr.2023.09.007","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 1","pages":"Pages 55-56"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolución de la percepción de la cultura de seguridad de los profesionales sanitarios en una urgencia pediátrica","authors":"B. Collado-González,&nbsp;C. Ferrero-García-Loygorri,&nbsp;M. Escobar-Castellanos,&nbsp;V. Barrera-Brito,&nbsp;M. Salvador-Rodríguez,&nbsp;R. Marañón,&nbsp;A. Mora-Capín","doi":"10.1016/j.jhqr.2023.11.005","DOIUrl":"10.1016/j.jhqr.2023.11.005","url":null,"abstract":"<div><h3>Background and aim</h3><p>Safety culture (SC) is a fundamental tool for minimizing adverse events and improving safety and quality of care. Our objective, therefore was to analyze the evolution of the SC of healthcare professionals in a pediatric emergency department (PED) after the implementation of a risk management system for patient safety based on the UNE:EN:ISO 179003 Standard and the execution of new safe practices for Joint Commission International accreditation. At the same time describe the current strengths and weaknesses.</p></div><div><h3>Methods</h3><p>Quasi-experimental, single-center study. All PED professionals participated in the study. An initial measurement of SC was performed through the Hospital Survey on Patient Safety Culture (HSOPS) questionnaire of the Agency for Healthcare Research and Quality adapted to Spanish in 2014. Pro-patient safety strategies were implemented between 2015 and 2022. A subsequent measurement was performed in 2022.</p></div><div><h3>Results</h3><p>The response rate in 2014 was 55% and 78% in 2022. On both occasions the group with the highest participation was nurses with 35.1% and 34.8%, respectively.</p><p>Five dimensions improved after the interventions: frequency of adverse events (25.2%, <em>p</em><span>&lt;</span>0.001), organizational learning (25%, <em>p</em><span>&lt;</span>0.001), feedback and communication about errors (22.3%, <em>p</em><span>&lt;</span>0.001), non-punitive response to errors (6.5%, <em>p</em> = 0.176), and management support (4%, <em>p</em> = 0.333).</p></div><div><h3>Conclusions</h3><p>The actions carried out had a positive influence on organizational learning and the frequency of adverse events reported and communication within the team. In contrast, the perception of SC did not increase.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 1","pages":"Pages 41-49"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pronóstico en pacientes ancianos con caídas atendidos en servicios de urgencias: estudio EDEN-3","authors":"P. Llorens ,&nbsp;A. Guillén Bobe ,&nbsp;P. Gallardo Vizcaíno ,&nbsp;P. Ponte Márquez ,&nbsp;Ll. Llauger ,&nbsp;M. Cañete ,&nbsp;E. Ruescas ,&nbsp;B. Espinosa","doi":"10.1016/j.jhqr.2023.10.003","DOIUrl":"10.1016/j.jhqr.2023.10.003","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate whether falls in people ≥65 years old are a prognostic factor for adverse events compared to the rest of older patients who consult emergency departments, and identify factors related to a worse long-term evolution.</p></div><div><h3>Method</h3><p>EDEN cohort that included patients ≥65 years old. Those patients who consulted for fall and the rest were distinguished. Twelve variables were collected. For comparison: two groups matched by fall propensity score. We compared mortality at one year and combined adverse event post-discharge at one year. In patients with falls, variables independently related to evolution were identified.</p></div><div><h3>Results</h3><p>Two thousand seven hundred and forty-five patients treated for falls and 22,920 for other reasons. Mortality at one year was 14.4% (9.5% vs. 15.0%, respectively, <em>P</em>&lt;.001) and the combined post-discharge adverse event at one year was 60.6% (52.2% vs. 61.7%, respectively, <em>P</em>&lt;.001). In 4748 patients matched by fall propensity score (2372 in each group), the inverse association between consultation for fall and mortality (HR: 0.705, 95% CI: 0.5880.846) and post-discharge combined adverse event (0.758, 0.701-0.820) remained significant. Factors associated with mortality in patients with falls were ≥80 years (2.097, 1.521-2.891) and comorbidity (2.393, 1.574-3.636) while being female was a protective factor (0.758, 0.584-0.985). Between the factors associated with post-discharge combined adverse hospitalization in the index event was a protective factor (0.804, 0.685-0.943).</p></div><div><h3>Conclusions</h3><p>Patients over 65 years of age treated in the emergency room for falls have a better prognosis. Hospitalization was a protective factor of combined postdischarge adverse event.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 1","pages":"Pages 3-12"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the implementation of a comprehensive quality management system for cross-sectoral psycho-oncology in Germany","authors":"L. Derendorf ,&nbsp;M. Kusch ,&nbsp;S. Stock ,&nbsp;C. Lemmen","doi":"10.1016/j.jhqr.2023.10.007","DOIUrl":"10.1016/j.jhqr.2023.10.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Quality management in healthcare is essential for safe, effective, and patient-centered services. Quality management systems (QMS) monitor and improve healthcare quality. Integrating QMS is crucial for optimal quality of care, but previous studies show gaps in integration. This study aims to assess program adherence to a QMS in cross-sectoral psycho-oncological care and to develop strategies for better integration, ultimately improving healthcare quality.</p></div><div><h3>Materials and methods</h3><p>The study used a utility analysis to assess the program adherence of a cross-sectoral psycho-oncology care program using a 5-point scale. The evaluation process involved breaking down the program into distinct areas, and used key figures and developed indicators to assess adherence. Descriptive statistics were used.</p></div><div><h3>Results</h3><p>The study conducted a comprehensive assessment of program adherence in a complex care program, analysing 4460 evaluation cases based on 128 quality indicators. The results showed a score of 4.2 out of 5 points (84%), indicating a highly effective implementation of the QMS. Notably, the study observed successful implementation of top-down elements, while encountering more challenges in integrating bottom-up aspects.</p></div><div><h3>Conclusion</h3><p>The study demonstrates effective implementation of a comprehensive QMS. Successful integration was observed in areas such as care concept, care management, quality assurance, and IT-based documentation, while challenges remain in quality development and indicators. Active leadership involvement, staff training, data collection, and a learning culture are essential for successful implementation. Future research should assess the impact and cost-effectiveness of QMSs and develop tailored approaches to sustain healthcare professionals’ motivation in quality improvement efforts.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 1","pages":"Pages 32-40"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absolute survival as a measure of effectiveness of screening programs","authors":"M. Caicoya","doi":"10.1016/j.jhqr.2023.11.003","DOIUrl":"10.1016/j.jhqr.2023.11.003","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 3","pages":"Pages 137-138"},"PeriodicalIF":1.2,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El valor de la persistencia en el modelo de la Medicina 5P en enfermedades crónicas","authors":"J. Borras-Blasco ,&nbsp;E. Ramírez-Herráiz ,&nbsp;A. Navarro Ruiz","doi":"10.1016/j.jhqr.2023.10.005","DOIUrl":"10.1016/j.jhqr.2023.10.005","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 3","pages":"Pages 196-198"},"PeriodicalIF":1.2,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diabetes education material on diabetes for website: Results of a validation process","authors":"L. Velázquez López ,&nbsp;R. Achar de la Macorra ,&nbsp;E. Colin Ramirez ,&nbsp;A.V. Muñoz Torres ,&nbsp;I. Pineda del Aguila ,&nbsp;P.G. Medina Bravo ,&nbsp;M. Klünder Klünder ,&nbsp;O.S. Medina Gómez ,&nbsp;J. Escobedo de la Peña","doi":"10.1016/j.jhqr.2023.07.001","DOIUrl":"10.1016/j.jhqr.2023.07.001","url":null,"abstract":"<div><h3>Objective</h3><p>To validate an educational material on diabetes through an expert consensus for its implementation into a web site.</p></div><div><h3>Material and methods</h3><p>An observational study was carried out in a group of health professionals, for which an educational material was developed for patients with diabetes. Topics included nutrition, physical exercise, control indicators, complications, pharmacological treatment, among others. The language, text and figures were focused on easy comprehension, additionally, a section of didactic activities to be answered by the patient with diabetes at the end of each module was included. To evaluate the educational material by health professionals, an instrument was designed and validated. Once all the educational material was available, each of the modules was sent by e-mail to at least three clinical experts in the assigned topic, as well as the instrument for the evaluation of the module.</p></div><div><h3>Results</h3><p>Thirty-seven experts were included in the study, 76% rated the educational modules evaluated as highly adequate, while only 24% rated them as adequate. The instrument used obtained a good level of internal consistency, with a Cronbach's alpha coefficient of 0.92. In the dimensions of the instrument, the lowest Cronbach's alpha score was that of “call-to-action”, with a value of 0.71.</p></div><div><h3>Conclusion</h3><p>The diabetes educational material was rated as highly appropriate by the clinical experts. The developed instrument has an adequate content validity, as well as a good level of internal consistency.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"38 6","pages":"Pages 346-353"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10351089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second and double victims – Achievements and challenges in ensuring psychological safety of caregivers","authors":"R. Strametz","doi":"10.1016/j.jhqr.2023.05.001","DOIUrl":"10.1016/j.jhqr.2023.05.001","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"38 6","pages":"Pages 327-328"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10206588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9531847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}