Journal of Healthcare Quality Research最新文献

{"title":"Design Thinking y su uso para promover la seguridad de los pacientes: revisión de alcance","authors":"L. Del-Valle Quintana ,&nbsp;K. Sichieri ,&nbsp;S. Secoli","doi":"10.1016/j.jhqr.2025.101140","DOIUrl":"10.1016/j.jhqr.2025.101140","url":null,"abstract":"<div><h3>Background and objective</h3><div>Design Thinking is a user centered methodology used to address problems through innovation. Patient safety is a complex issue within healthcare and remains a global priority. International organizations urge the development of joint strategies to tackle this challenge. The objective was to map the current use of Design Thinking as a methodology to promote patient safety in healthcare settings.</div></div><div><h3>Materials and methods</h3><div>A scoping review was conducted following the Joanna Briggs Institute guidelines, using indexed databases such as PubMed, CINAHL, WOS, EMBASE, Scopus, Science Direct, PsycINFO, SciELO, and ERIC, as well as grey literature from CAPES and ProQuest journals. The protocol was registered in Open Science Framework. Data were analyzed and summarized narratively.</div></div><div><h3>Results</h3><div>A total of 55 publications applying Design Thinking in the context of patient safety were included. The six international patient safety goals were addressed, with a focus on effective communication (45%) and medication safety (35%). The study design was not reported in 65% of the cases, and 30% lacked data procedures and analysis. The healthcare team participated in 93% of the studies, while patients were involved in 44%. The most common solutions were mobile applications, software, and dashboards.</div></div><div><h3>Conclusions</h3><div>Design Thinking is contributing to improvements in patient safety by developing co-designed solutions, particularly in the international patient safety goals of communication and medication safety. However, the lack of a rigorous methodological approach limits the validity and replicability of the results.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 4","pages":"Article 101140"},"PeriodicalIF":1.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948760","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":"Analysis of the accuracy of clinical diagnosis in an internal medicine department of a regional hospital: Inter-MONF study","authors":"S. Hernández-Dorta ,&nbsp;I. Izuzquina-Avanzini ,&nbsp;A. Lobelle-Seijas ,&nbsp;I. Fernández-Uzquiano ,&nbsp;L. Ramos-Rúa ,&nbsp;J. López-Castro","doi":"10.1016/j.jhqr.2025.101142","DOIUrl":"10.1016/j.jhqr.2025.101142","url":null,"abstract":"<div><h3>Introduction</h3><div>There are numerous studies examining the diagnostic accuracy of various supplementary tests; however, the literature focused on diagnostic accuracy derived from clinical reasoning and data is limited. Consequently, we conducted a study to assess the diagnostic accuracy of the professionals in the Internal Medicine Department at our hospital and to examine whether there are variations in accuracy related to specific pathologies and across different time periods, particularly before and after the emergence of the SARS-CoV-2 pandemic.</div></div><div><h3>Methods</h3><div>This is a retrospective, longitudinal, and observational study conducted in the Internal Medicine Department of the Regional Hospital of Monforte de Lemos from 2016 to 2022, encompassing both pre- and post-SARS-CoV-2 pandemic periods. The initial diagnosis made upon patient admission was compared with the final diagnosis at discharge through an independent peer review process.</div></div><div><h3>Results</h3><div>The diagnostic concordance at admission and discharge was 77.4%, with statistically significant differences observed between age groups (with higher concordance in patients under 55 years of age) and according to sex, with greater concordance in female patients. No differences were found regarding pathology type or temporal cohort.</div></div><div><h3>Conclusions</h3><div>The diagnostic accuracy of the healthcare professionals in the Internal Medicine Department at Monforte Public Hospital during the study periods was found to be high. Diagnostic concordance was greater in female patients and those under 55 years of age, with no significant differences observed across the most prevalent pathological conditions. Furthermore, the restrictive measures implemented during the SARS-CoV-2 pandemic do not appear to have negative affected diagnostic accuracy when compared to previous periods.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 5","pages":"Article 101142"},"PeriodicalIF":1.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947091","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 patient satisfaction and identifying areas for improvement in gynecological care across various healthcare settings at a tertiary teaching hospital in Pakistan: A cross-sectional study","authors":"S.I. Memon ,&nbsp;A. Aijaz ,&nbsp;R. Jameel ,&nbsp;M. Shafique ,&nbsp;Y. Khan","doi":"10.1016/j.jhqr.2025.101132","DOIUrl":"10.1016/j.jhqr.2025.101132","url":null,"abstract":"<div><h3>Objectives</h3><div>Patient satisfaction is a key indicator of healthcare quality and essential for improving hospital services. This study aimed to assess patient satisfaction and to identify areas for improvement in gynecological care across inpatient, outpatient, and emergency settings.</div></div><div><h3>Material and methods</h3><div>We conducted a descriptive, cross-sectional study among 587 gynecological patients at a tertiary care teaching hospital in Karachi, Pakistan. We assessed multiple dimensions of patient care, such as doctor satisfaction, nursing care, housekeeping services, and value for money using simple random sampling. We used a standard questionnaire to gauge patient satisfaction with care and analyzed the data using Statistical Package for the Social Sciences (SPSS) version 21. We considered a <em>p</em>-value of less than 95% to be statistically significant.</div></div><div><h3>Results</h3><div>The analysis revealed high satisfaction rates across all service areas. Doctor satisfaction scored the highest at 95.4% (95% CI: 0.929–0.978, <em>p</em> <!-->&lt;<!--> <!-->0.0001), followed by value for money at 90.4% (95% CI: 0.870–0.939, <em>p</em> <!-->&lt;<!--> <!-->0.0001). Housekeeping and nursing care were rated 86.2% (95% CI: 0.821–0.902, <em>p</em> <!-->&lt;<!--> <!-->0.0001) and 83.3% (95% CI: 0.790-0.877, <em>p</em> <!-->&lt;<!--> <!-->0.0001), respectively. The hospital achieved a 98.9% recommendation rate, with 54.3% rating their experience as “Excellent,” 36.9% as “Good,” 7.8% as “Average,” and only 1.1% as “Bad.”</div></div><div><h3>Conclusions</h3><div>This study highlights high patient satisfaction in gynecological services, reflected in strong recommendations and positive feedback. While physician care is well-rated, improvements in nursing and housekeeping through enhanced communication are needed. These findings support quality enhancement efforts, fostering a blame-free culture and setting a benchmark for similar institutions in Pakistan.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 5","pages":"Article 101132"},"PeriodicalIF":1.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907673","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":"Beyond administration: The essential role of medical secretaries in the quality of clinical hospital service","authors":"L.M. Ortega ,&nbsp;M. Redondo ,&nbsp;D. Martín-García","doi":"10.1016/j.jhqr.2025.101122","DOIUrl":"10.1016/j.jhqr.2025.101122","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 5","pages":"Article 101122"},"PeriodicalIF":1.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903905","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 weekend effect in hip fracture: The critical role of resource management","authors":"J.C. Segura-Nuez ,&nbsp;M. Infantes-Morales ,&nbsp;A. García-Hernández ,&nbsp;J. Segura-Nuez ,&nbsp;C. Martín-Hernández ,&nbsp;A. Roche-Albero","doi":"10.1016/j.jhqr.2025.101131","DOIUrl":"10.1016/j.jhqr.2025.101131","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The “weekend effect” refers to patients admitted at the end of the week who cannot undergo surgery until the beginning of the following week. The objective is to study the relationship between admission on a specific day of the week and the time to surgery.</div></div><div><h3>Material and methods</h3><div>A retrospective analytical study was conducted, including consecutive patients over 65 years old with a diagnosis of hip fracture admitted to Miguel Servet University Hospital from March 1 to October 31, 2023. Data such as admission day, age, sex, type of fracture, anticoagulant or antiplatelet therapy, and time to surgery were collected. A multivariate analysis was performed to investigate the factors influencing the time to surgery.</div></div><div><h3>Results</h3><div>A total of 348 patients were included. The average time to surgery for patients admitted on Monday was 2.04 days; Tuesday, 2.06; Wednesday, 2.14; Thursday, 2.94; Friday, 3.24; Saturday, 2.91; and Sunday, 2.17. The multivariate analysis showed that admission on Thursday (<em>p</em> <!-->&lt;<!--> <!-->0.001), Friday (<em>p</em> <!-->&lt;<!--> <!-->0.001), or Saturday (<em>p</em> <!-->&lt;<!--> <!-->0.001) increased the time to surgery compared to admission on Monday. Treatment with vitamin K antagonists (<em>p</em> <!-->=<!--> <!-->0.006) and direct oral anticoagulants (<em>p</em> <!-->&lt;<!--> <!-->0.001) also delayed surgery. Subcapital fractures were treated later than basicervical (<em>p</em> <!-->=<!--> <!-->0.039), pertrochanteric (<em>p</em> <!-->=<!--> <!-->0.018), and subtrochanteric (<em>p</em> <!-->=<!--> <!-->0.028) fractures.</div></div><div><h3>Conclusion</h3><div>In our center, admission on Thursday, Friday, or Saturday significantly increased the time to surgery compared to Monday. This may increase hospital costs and the potential complications related to surgical delay.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 5","pages":"Article 101131"},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882957","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":"La experiencia de los cuidadores no profesionales de pacientes crónicos","authors":"A. Picón-Santamaría ,&nbsp;S. Ballesteros-Peña","doi":"10.1016/j.jhqr.2025.101130","DOIUrl":"10.1016/j.jhqr.2025.101130","url":null,"abstract":"<div><h3>Introduction</h3><div>Population aging and the increase in chronic diseases pose significant challenges to healthcare systems. Informal caregivers play a crucial role in caring for these patients, yet their experiences remain underexplored. This study evaluates the experience of informal caregivers of hospitalized chronic patients.</div></div><div><h3>Materials and methods</h3><div>A descriptive observational study was conducted at Hospital Santa Marina, Bilbao, between 2023 and 2024. The IEXPAC-Caregivers scale was used to assess the experience of 182 informal caregivers. Data were analyzed using descriptive and inferential statistics. SPSS v.25 software was used for statistical analysis.</div></div><div><h3>Results</h3><div>The overall average score was 7.1 (±<!--> <!-->2.7) out of 10 (Cronbach's α<!--> <!-->=<!--> <!-->0.914). The best-rated items were communication during emergencies and medication administration. However, deficiencies were noted in training, information about available resources, and coordination between services. Significant differences were found in aspects such as emotional support and treatment follow-up based on the gender of the caregiver and the patient.</div></div><div><h3>Conclusions</h3><div>Informal caregivers play an essential role in the care of chronic patients. There is a need to improve service coordination and provide ongoing training and emotional support to them. Gender differences highlight the importance of personalized approaches to enhance their experience and reduce caregiving burden.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 5","pages":"Article 101130"},"PeriodicalIF":1.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852331","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":"Improving efficiency in a total hip arthroplasty program","authors":"X. Buyse ,&nbsp;J.Á. Fernández-Valencia ,&nbsp;A. Alías ,&nbsp;M. Tió ,&nbsp;M. Pablo ,&nbsp;A. Serra","doi":"10.1016/j.jhqr.2025.101117","DOIUrl":"10.1016/j.jhqr.2025.101117","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the application of Lean Six Sigma methodology to increase efficiency in a morning total hip arthroplasty program and analyze the challenges in improving operating room efficiency.</div></div><div><h3>Methods</h3><div>A quasi-experimental study with pre-post intervention analysis was conducted in a public university hospital. Multidisciplinary meetings and a retrospective analysis of the previous year were carried out to define improvement points. Study period: June–December 2023, with 24 planned sessions in Monday and Thursday morning modules. Measures implemented included selection of low-complexity cases, early start of surgeries, optimization of changeover times, and use of efficiency-facilitating systems.</div></div><div><h3>Results</h3><div>The feasibility of performing three procedures in one morning was confirmed, with 72% of cases having surgery times under 90<!--> <!-->min. 67% of the proposed target was achieved, despite the loss of an operating room module for four months. The average start time of the first surgery improved from 9:23<!--> <!-->±<!--> <!-->54<!--> <!-->min to 8:32<!--> <!-->±<!--> <!-->22<!--> <!-->min. The average number of procedures per module increased from 1.76 to 2.79. The average changeover time reduced from 29<!--> <!-->±<!--> <!-->12<!--> <!-->min to 18<!--> <!-->±<!--> <!-->12<!--> <!-->min.</div></div><div><h3>Conclusions</h3><div>The Lean Six Sigma methodology has improved operating room efficiency for hip arthroplasty by 50%. Identifying easily modifiable stoppers is crucial for successful implementation of improvements in the clinical process. Additional studies are required to address the challenges identified in post-surgery clinical process and to ensure continuous process optimization.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 5","pages":"Article 101117"},"PeriodicalIF":1.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838782","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":"Ethical decisions on the end of life during internal medicine on-call shifts","authors":"R. García Caballero ,&nbsp;D. Real de Asúa ,&nbsp;K. Olaciregui Dague ,&nbsp;G. de vega González ,&nbsp;B. Herreros","doi":"10.1016/j.jhqr.2025.101129","DOIUrl":"10.1016/j.jhqr.2025.101129","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the frequency of decisions of withholding and withdrawing life-sustaining treatment and palliative sedation in patients previously unknown to physicians during on-call.</div></div><div><h3>Methods</h3><div>Observational study (survey) of Spanish internists.</div></div><div><h3>Results</h3><div>Two hundred seventy-three surveys. In patients they did not know, 95.2% decided during an on-call whether they should enter the Intensive Care Unit and 89% whether to initiate sedation. Measures most identified as “aggressive”: admission to the Intensive Care Unit, use of invasive techniques, cardiopulmonary resuscitation and invasive treatments. 48.4% make the decision to start sedation as a team and 4 out of 10 do not consult the patient. Decisions are planned most commonly with cancer patients (73%), with heart failure (60.4%) and chronic obstructive pulmonary disease (58%).</div></div><div><h3>Conclusions</h3><div>During the on-call, almost all internists make decisions about admission to the Intensive Care Unit or about sedation in unknown patients. It is planned more the decisions with cancer patients. The decision to sedate is usually made as a team and the patient is often not consulted.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 4","pages":"Article 101129"},"PeriodicalIF":1.1,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826195","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":"Data: Europe's own path in artificial intelligence","authors":"A. Bahamonde","doi":"10.1016/j.jhqr.2025.101126","DOIUrl":"10.1016/j.jhqr.2025.101126","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 5","pages":"Article 101126"},"PeriodicalIF":1.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807492","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 organizational well-being of healthcare professionals","authors":"M. Macías ,&nbsp;J.J. Mira ,&nbsp;I. Mediavilla ,&nbsp;E. Foglia ,&nbsp;E. Garagiola ,&nbsp;L. Ferrario","doi":"10.1016/j.jhqr.2025.101125","DOIUrl":"10.1016/j.jhqr.2025.101125","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 4","pages":"Article 101125"},"PeriodicalIF":1.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791250","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}