Journal of Healthcare Quality Research最新文献

{"title":"Failure to rescue in colon surgery","authors":"J.J. Rubio-García ,&nbsp;F. Mauri Barberá ,&nbsp;C. Villodre Tudela ,&nbsp;J. Ferri Romero ,&nbsp;M. Marco Gómez ,&nbsp;T. Viñas Martínez ,&nbsp;C. Gómez Alcázar ,&nbsp;M. Romero Simo ,&nbsp;J.M. Ramia-Ángel","doi":"10.1016/j.jhqr.2025.101118","DOIUrl":"10.1016/j.jhqr.2025.101118","url":null,"abstract":"<div><h3>Background</h3><div>Major complications (MC) after colorectal surgery are not uncommon and can have serious consequences for patient survival. Failure to rescue (FTR) is an indicator used to measure the capacity for correct management of MC, calculated as the number of patients who die among all those who present MC.</div></div><div><h3>Methods</h3><div>Observational study with retrospective data analysis of all patients undergoing scheduled colon cancer surgery at a Spanish university hospital from September-2012 to August-2016. Preoperative, intraoperative and postoperative variables were recorded. Postoperative complications Clavien–Dindo scores<!--> <!-->&gt;<!--> <!-->II were considered MC. FTR was defined as death within 90 postoperative days in patients with at least one MC.</div></div><div><h3>Results</h3><div>A total of 564 patients were included, of whom 140 (24.8%) presented MC. Of these, 22 died, representing an FTR rate of 15.7%. Patients with MC had a mean age of 69.6 years, and 30.7% were women. An open approach was used in 81.4%. Compared with survivors, the group of non-survivors presented a higher proportion of ASA III and IV (<em>P</em> <!-->=<!--> <!-->0.008), a higher mean age (<em>P</em> <!-->=<!--> <!-->0.001) and a higher proportion of anastomotic leaks (<em>P</em> <!-->=<!--> <!-->0.009). Multivariate analysis confirmed that age (OR 1.161; <em>P</em> <!-->=<!--> <!-->000), anastomotic leak (OR 18; <em>P</em> <!-->=<!--> <!-->0.001) and sepsis of origin other than anastomotic leak or intra-abdominal collection (OR 26; <em>P</em> <!-->=<!--> <!-->0.001) were significantly associated with FTR as independent factors.</div></div><div><h3>Conclusion</h3><div>The FTR rate after colectomy in our series was similar or slightly lower than other series. Age, anastomotic leakage, and sepsis of non-abdominal origin were independent factors associated with FTR. We contend that FTR is an excellent indicator of a center's ability to resolve MC. It is particularly useful for implementing measures to ensure effective treatment of MC.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 4","pages":"Article 101118"},"PeriodicalIF":1.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783583","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":"Textbook outcome in thyroid surgery: A new approach to assess quality in an endocrine surgery unit","authors":"D. Costa Navarro ,&nbsp;J.J. Rubio-García ,&nbsp;A. Gomis-Martín ,&nbsp;T. Viñas Martínez ,&nbsp;J. López-Noguera ,&nbsp;M. Franco-Campello ,&nbsp;A. Carrion-Tomás ,&nbsp;J.M. Ramia","doi":"10.1016/j.jhqr.2025.101120","DOIUrl":"10.1016/j.jhqr.2025.101120","url":null,"abstract":"<div><h3>Background</h3><div>Thyroidectomy is a term encompassing various surgical procedures involving the thyroid gland. Assessing quality is imperative for patient safety and clinical auditing and textbook outcome (TO) offers more comprehensive information on overall quality than single indicators. This study aims to define the parameters constituting TO in thyroid surgery, evaluate the outcomes based on TO criteria within an endocrine surgery unit at a tertiary hospital, and identify factors associated with failure to achieve TO in these cases.</div></div><div><h3>Methods</h3><div>A retrospective observational study of consecutive patients undergoing thyroid surgery at the Endocrine Surgery Unit in Spain between January 2020 and December 2022. The analyzed variables included, among others, age and sex, comorbidities, diagnosis, intrathoracic goiter, type of thyroidectomy, and several postoperative complications. The first TO definition in thyroid surgery was made.</div></div><div><h3>Results</h3><div>A total of 244 patients were included in the study. TOTS was achieved in 153 patients (62.7%), and there were no reported mortalities. Diabetes (18% vs 8.61%) and endothoracic goiter (40% vs 22%) were statistically associated with textbook outcome non-achievement. Also, the endothoracic goiter parameter was identified as a statistically significant predictor of textbook outcome non-achievement.</div></div><div><h3>Conclusion</h3><div>The implementation of the TO concept in thyroid surgery offers a comprehensive method for assessing surgical quality, encapsulating a range of critical postoperative outcomes. The rate of TO in our serie was 62.7%, identifying that endothoracic goiter is the main parameter of textbook outcome non-achievement.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 4","pages":"Article 101120"},"PeriodicalIF":1.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767514","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":"Análisis de los indicadores de seguridad del paciente en las complicaciones por cuidados durante la hospitalización","authors":"F.M. Escandell Rico ,&nbsp;L. Pérez Fernández","doi":"10.1016/j.jhqr.2025.01.001","DOIUrl":"10.1016/j.jhqr.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>To Analyze AHRQ Patient Safety Indicators (PSI) obtained through the Minimum Basic Data Set (MBDS) in improving patient safety.</div></div><div><h3>Method</h3><div>Observational descriptive and retroprective study. The CMBD hospital discharge registry of 342 hospitals of the National Health System was included. The MBDS indicators and analysis axes were from 2021 and the hospitalization MBDS information included the following general data: total discharges, average stay, average age and % mortality. Four patient safety indicators were analyzed: Pressure ulcers (PSI 03), Iatrogenic pneumothorax (PSI 06), Accidental puncture or tear in adults (PSI 15) and CVC-related to bloodstream infection (PSI 07).</div></div><div><h3>Results</h3><div>The PSI 06 and PSI 07 categories not only have a higher number of discharges, but also a longer average stay and mortality. In comparison, PSI 03 and PSI 15 categories show a much lower number of discharges, and a lower mortality and average stay. Conditions associated with PSI 06 and PSI 07 categories could be more severe or complex, leading to a longer hospital stay and a higher risk of mortality. According to relative risk analyses, all indicators show a slightly higher mortality risk in men than in women.</div></div><div><h3>Conclusions</h3><div>Advanced age and serious diagnoses, such as circulatory diseases or neoplasia, are associated with higher mortality and hospital stay. In relation to hospital size, smaller ones show higher risks and worse mortality outcomes. Therefore, these results could guide strategies to optimize resources and focus interventions on the most vulnerable groups.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 3","pages":"Article 101116"},"PeriodicalIF":1.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781413","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":"Optimización del reprocesado de materiales sanitarios en centros de atención primaria","authors":"E.A. Sabuco Tébar ,&nbsp;Á.R. Sáez Soto ,&nbsp;M. Culiañez Alenda ,&nbsp;Y. López Benavente ,&nbsp;R. López Alegría ,&nbsp;F.J. Campayo Rojas","doi":"10.1016/j.jhqr.2025.101124","DOIUrl":"10.1016/j.jhqr.2025.101124","url":null,"abstract":"<div><h3>Introduction and objetive</h3><div>Reprocessing of medical devices in Primary Care Centers (PCC) can be a source of infections. The aim of this study was to improve the quality of reprocessing devices in the PCCs of Area VII-Murcia/Este through an improvement cycle.</div></div><div><h3>Methods</h3><div>This prospective intervention study. was carried out in 12 PCC, 14 Local Clinics (LC), 4 Oral Health Units (OHU) and the professionals involved in the reprocessing. Between 09/2022-03/2023, a working group was created, and a situation analysis was carried out: inventory of autoclaves, consumption of materials, and visits to the PCCs. Between 04/2023-03/2024, improvement actions were implemented: purchasing plan, use of Chemical Indicators (CHI) and Biological Indicators (BI), training with prior knowledge surveys, work procedure, and processes traceability.</div></div><div><h3>Results</h3><div>In total 11 autoclaves were acquired. The percentage of BI completion was ≥ 45%, and 80% of professionals were trained. The following improvements were obtained: detergent technical data sheet in the washing Area (45% to 73%), sterilization dates traceability (10% to 78%), sterilization cycles traceability (11% to 66%), use of instrument brush (55% to 74%), bag labeling (45% to 68%), correct storage (45% to 78%), and use of tap water to generate steam (2% to 0%).</div></div><div><h3>Conclusions</h3><div>The implementation of an improvement cycle, through the training of professionals, standardization of procedures, and traceability of processes, in addition to having an expert nurse as a reference, increases the quality in the reprocessing of medical devices.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 4","pages":"Article 101124"},"PeriodicalIF":1.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759915","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":"Experiencias, percepciones y emociones de los pacientes crónicos hospitalizados tras un programa de intervencion musical","authors":"L. Ortiz de Villacián-Fernández ,&nbsp;I. Apraiz-Sánchez ,&nbsp;N. Martínez-Domínguez ,&nbsp;A. Picón-Santamaría ,&nbsp;S. Ballesteros-Peña","doi":"10.1016/j.jhqr.2025.101121","DOIUrl":"10.1016/j.jhqr.2025.101121","url":null,"abstract":"<div><h3>Aim</h3><div>Musical interventions for hospitalized patients have shown benefits such as improved mood and reduced stress, but their impact from a qualitative perspective is under-explored. This study aimed to understand the experiences, perceptions, and emotions of chronically ill hospitalized patients who participated in a program of individual micro-concerts during their hospital stay.</div></div><div><h3>Methodology</h3><div>A qualitative study was conducted in a hospital in Bilbao, Spain, in 2024. Hospitalized patients were offered 20-minute micro-concerts three times a week. Semi-structured interviews were conducted with 21 patients selected through purposive sampling. The interviews were transcribed and analyzed inductively to identify thematic patterns.</div></div><div><h3>Results</h3><div>The analysis identified four categories. The first was emotional and cognitive well-being, where patients reported improvements in mood and cognitive stimulation. The second category, the operational aspects of the intervention, highlighted the positive perception of the frequency, duration, and personalization of the sessions. The third category was personal evaluation, where the role of the music therapist was highlighted as a key factor in the success of the intervention. Finally, suggestions for improvement included recommendations to extend the program to other areas of the hospital and combine musical interventions with complementary activities.</div></div><div><h3>Conclusions</h3><div>Personalized musical interventions have a positive impact on the emotional and cognitive well-being of patients. It is essential to design flexible interventions that adapt to individual needs and promote integrated care models.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 4","pages":"Article 101121"},"PeriodicalIF":1.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759926","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":"Influencia de la adherencia en el valor de persistencia dentro de la Medicina 6P","authors":"J. Borrás-Blasco ,&nbsp;E. Ramírez-Herráiz ,&nbsp;A. Navarro-Ruiz","doi":"10.1016/j.jhqr.2025.101123","DOIUrl":"10.1016/j.jhqr.2025.101123","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 4","pages":"Article 101123"},"PeriodicalIF":1.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759927","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 modelo MUFACE: un anacronismo contrario a la equidad ciudadana y la congruencia normativa del Sistema Nacional de Salud","authors":"R. Urbanos-Garrido ,&nbsp;B. González López-Valcárcel","doi":"10.1016/j.jhqr.2025.101127","DOIUrl":"10.1016/j.jhqr.2025.101127","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 3","pages":"Article 101127"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773455","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":"MUFACE: un buen modelo para un sistema basado en la coexistencia de lo público y lo privado","authors":"J. Abarca Cidón","doi":"10.1016/j.jhqr.2025.101119","DOIUrl":"10.1016/j.jhqr.2025.101119","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 3","pages":"Article 101119"},"PeriodicalIF":1.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765345","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":"Elaboración de un checklist para la transferencia en UCIP del paciente pediátrico quirúrgico","authors":"M.Á. Rivas Paterna ,&nbsp;M. Abelaira García ,&nbsp;D. Ortega Martínez ,&nbsp;B. Joyanes Abancens ,&nbsp;A.I. Alguacil Pau ,&nbsp;E. Aleo Luján","doi":"10.1016/j.jhqr.2024.12.004","DOIUrl":"10.1016/j.jhqr.2024.12.004","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Pages 134-136"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956419","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":"Adecuación del consentimiento informado en la investigación clínica: estudio descriptivo transversal","authors":"M.D. Monge-Muñoz ,&nbsp;G. Rodríguez-Caravaca ,&nbsp;J.L. del-Barrio-Fernández","doi":"10.1016/j.jhqr.2024.12.001","DOIUrl":"10.1016/j.jhqr.2024.12.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The principle of patient autonomy in the participation and incorporation of their health data in research projects is a legal and deontological obligation that must be fulfilled. The aim of this study was to know the degree of compliance and adequacy of informed consent in clinical research projects in a university hospital.</div></div><div><h3>Material and methods</h3><div>Through this cross-sectional study, the adequacy of the way patient data are obtained in the research projects presented to the Research Committee of a university hospital was analyzed. The adequacy of the way patient data were obtained in the research projects, dealing with informed consent and causes of exemption, was described with their frequencies distributions. It was assessed by means of the adjusted odds ratio through a backstep logistic regression model, including the predictable significant variables previously analyzed in the univariant analysis.</div></div><div><h3>Results</h3><div>A total of 565 protocols were included. The most frequent type of studies assessed were observational retrospectives (49.6%) and end-of-year projects (28.1%). The most frequent way of obtaining the patient data were by means of soliciting exemption of informed consent (48.3%). Obtaining the patient data process was considered appropriated in 51.1% of the projects. Projects with higher adequacy were those solicited by students (OR<!--> <!-->=<!--> <!-->4.2; CI_95% <!-->=<!--> <!-->2.0–8.8) and residents OR<!--> <!-->=<!--> <!-->3.0; CI_95% <!-->=<!--> <!-->1.2–2.4).</div></div><div><h3>Conclusions</h3><div>The majority of the projects assessed was retrospective observational studies in which exemption of informed consent was solicited. Projects with higher adequacy were solicited by students and residents.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Pages 107-115"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877975","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}