Journal of Healthcare Quality Research最新文献_第3页

Improving Administrative Processes in a Trauma Centre: Lean and Pareto Approach 改进创伤中心的管理流程：精益和帕累托方法。

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Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2025-11-01 DOI: 10.1016/j.jhqr.2025.101172

R. Harsvardhan, A. Jain, S. Singh, M. Suhaib, S. Bose

{"title":"Improving Administrative Processes in a Trauma Centre: Lean and Pareto Approach","authors":"R. Harsvardhan, A. Jain, S. Singh, M. Suhaib, S. Bose","doi":"10.1016/j.jhqr.2025.101172","DOIUrl":"10.1016/j.jhqr.2025.101172","url":null,"abstract":"<div><h3>Background</h3><div>The Central Control Room (CCR) of hospital plays a pivotal role in the hospital operations by overseeing, coordinating and resolving real-time administrative and operational challenges. Trauma centres operate in high-pressure environment and frequently encounter inefficiently designed workflows that impacts service delivery. Pareto analysis and Gemba Walk, based on Lean Management and Total Quality Management approach, focuses on direct observation by identify high-priority issues and real-time problem solving.</div></div><div><h3>Methods</h3><div>An interventional study was conducted over seven months (April–October 2024) at a trauma centre. In Phase I (April–June), all complaints reported in CCR were registered, categorized and analysed using Pareto analysis to identify the most frequent and high-impact issues. In Phase II (July), Gemba Walk by multidisciplinary team was introduced. During Phase III (August–October 2024), complaints were re-evaluated using Pareto analysis to measure the impact of the intervention.</div></div><div><h3>Interventions</h3><div>Introduction of structured complaint tracking using Pareto charts, followed by Gemba Walks involving operations, nursing, engineering, and housekeeping teams to address issues at the point of occurrence.</div></div><div><h3>Results</h3><div>Pareto analysis done in pre-intervention phase revealed that 69.88% of issues stemmed from 28.6% of the complaints. After targeted Gemba Walk introduction, the post-intervention analysis showed that while 67.77% of issues were still from 28.6% of complaints, however, nature of the problems was different.</div></div><div><h3>Conclusion</h3><div>Integration of Pareto analysis and Gemba Walk proved to be an effective approach for identifying and resolving key operational challenges in trauma centre. Findings highlight the importance of structured quality improvement approach in enhancing hospital efficiency.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101172"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432464","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}

引用次数: 0

Análisis de las hospitalizaciones potencialmente evitables en las enfermedades crónicas [潜在可避免的慢性疾病住院分析]。

IF 1

Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2025-09-27 DOI: 10.1016/j.jhqr.2025.101168

F.M. Escandell Rico , L. Pérez Fernández

{"title":"Análisis de las hospitalizaciones potencialmente evitables en las enfermedades crónicas","authors":"F.M. Escandell Rico , L. Pérez Fernández","doi":"10.1016/j.jhqr.2025.101168","DOIUrl":"10.1016/j.jhqr.2025.101168","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze indicators of potentially avoidable hospitalizations obtained through the minimum basic data set for chronic disease management and improving the quality of care.</div></div><div><h3>Method</h3><div>A descriptive retrospective study evaluating gender differences included hospital discharge records from 342 hospitals in the National Health System. The indicators and axes of analysis were from 2021, and the information included the following general data: total discharges, mean stay, mean age, and mortality rate. Four groups of indicators of potentially avoidable hospitalizations were analyzed: diabetes and its complications, cardiovascular disease and hypertension, respiratory and pulmonary diseases, and other acute and chronic conditions.</div></div><div><h3>Results</h3><div>Women have a higher risk of mortality in congestive heart failure (RR=1.35) and diabetes with acute complications. Men have higher mortality rates in respiratory diseases such as COPD and asthma. In acute conditions, there are no significant differences in mortality, but in chronic conditions, women have a higher risk. In diabetes, women have higher mortality from acute complications (RR=1.42), while men face a higher risk of chronic complications.</div></div><div><h3>Conclusions</h3><div>The study reveals variations in mortality and hospitalization associated with cardiovascular and respiratory diseases, and diabetes, with significant differences by gender. Women have higher mortality from acute complications of diabetes, while men have higher mortality from chronic diseases. These findings support the need for a personalized approach to treatment and prevention, considering the specificities of each gender.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101168"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187014","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}

引用次数: 0

30 años de la Ley de Prevención de Riesgos Laborales en España: avances y retos en las organizaciones sanitarias [西班牙健康和安全法30年：医疗保健组织的进展和挑战]。

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Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2025-12-02 DOI: 10.1016/j.jhqr.2025.101181

M. López-Gobernado , J. Hernández Bartolomé , D. Villalba Gil

引用次数: 0

Implementación de la vía RICA en cirugía urgente: adherencia, barreras y facilitadores RICA在急诊手术中的应用：依从性、障碍和促进因素

IF 1

Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2025-10-31 DOI: 10.1016/j.jhqr.2025.101170

S. Postigo-Morales , B. Ugarte-Sierra , M. San-Juan-González , J.M. Ramírez-Rodríguez

{"title":"Implementación de la vía RICA en cirugía urgente: adherencia, barreras y facilitadores","authors":"S. Postigo-Morales , B. Ugarte-Sierra , M. San-Juan-González , J.M. Ramírez-Rodríguez","doi":"10.1016/j.jhqr.2025.101170","DOIUrl":"10.1016/j.jhqr.2025.101170","url":null,"abstract":"<div><h3>Background and objective</h3><div>The Enhanced Recovery After Surgery (ERAS) clinical pathway has been shown to improve postoperative outcomes in elective surgery but its implementation in emergency settings remains limited and understudied. The aim of the study is to assess the degree of adherence to selected perioperative ERAS items in frequent emergency surgeries (appendectomy, cholecystectomy and non-neoplastic perforated peptic ulcer), as well as to identify barriers and facilitators for its implementation.</div></div><div><h3>Materials and methods</h3><div>Descriptive, prospective and exploratory observational study including 206 consecutive patients undergoing one of the selected emergency surgeries between November 2021 and July 2022. Adherence to ERAS items was assessed in the preoperative, intraoperative and immediate postoperative phases. Barriers and facilitators were also analysed through literature review, standardised matrix development, unstructured interviews and direct observation.</div></div><div><h3>Results</h3><div>Overall adherence was over 70% for most items, with greater variability, as expected, in those measures dependent on the complexity of the case, such as the use of drains or tubes. The main barrier was organisational and the previous experience of ERAS in elective surgery acted as a facilitator.</div></div><div><h3>Conclusions</h3><div>The implementation of certain perioperative ERAS items in emergency surgery is feasible, presenting high adherence in settings with previous experience in elective surgery. The main barrier detected was organisational, while the consolidated institutional culture was a key facilitator. Studies with methodologically robust designs, including evaluation of clinical outcomes, are needed to support its implementation as a standard of care.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101170"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416612","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}

引用次数: 0

Estudio multicéntrico de validez del Sistema Centralizado de Triaje Pediátrico [多中心研究系统的有效性Pediátrico (STPED)]。

IF 1

Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2025-11-04 DOI: 10.1016/j.jhqr.2025.101173

M.C. Miguez-Navarro , G. Guerrero-Márquez , P. Storch De Gracia Calvo , S. Herranz López , M.A. de la Fuente de la Hoz , M.I. Sainz de la Maza Giménez , Grupo de Triaje Pediátrico-STPED

{"title":"Estudio multicéntrico de validez del Sistema Centralizado de Triaje Pediátrico","authors":"M.C. Miguez-Navarro , G. Guerrero-Márquez , P. Storch De Gracia Calvo , S. Herranz López , M.A. de la Fuente de la Hoz , M.I. Sainz de la Maza Giménez , Grupo de Triaje Pediátrico-STPED","doi":"10.1016/j.jhqr.2025.101173","DOIUrl":"10.1016/j.jhqr.2025.101173","url":null,"abstract":"<div><h3>Introduction</h3><div>This study was conducted to determine the indirect validity of the Sistema Centralizado de Triaje Pediátrico (STPED) –the computer version of the Sistema de Triaje Pediátrico del Hospital Gregorio Marañón (TRIPED-GM)– in eight pediatric emergency departments of the Community of Madrid.</div></div><div><h3>Patients and methods</h3><div>It is a retrospective observational multicenter study. A sample of patients (<18 years) attending triaje from October 2021 to October 2022, for any reason, was randomly selected. The validity of STPED was assessed by analyzing the association between priority level (1 [maximum]- 5 [minimum]) and use of resources utilization (number of complementary tests, procedures, or treatments; need for observation or admissions; mean length of stay [LOS]) with a regression model. A subgroup analysis of secondary and tertiary hospitals was performed. The R software version</div><div>4.3.3 was used.</div></div><div><h3>Results</h3><div>A total of 542 patients were analyzed. For each unit increase in priority, the probability of performing a complementary test, procedure or receiving treatment increased 1.83-fold (Incidence Rate Ratio: 1.83; 95% confidence interval (CI): 1.66-2.02; <em>p</em>  <0.001) and the need for admission, almost 5 (Odds Ratio: 4.93; 95% CI: 2.97-8.43; <em>p</em>   <0.001). The relationship between resource use and priority was higher in tertiary hospitals.</div></div><div><h3>Conclusions</h3><div>The results confirm the indirect validity of STPED, especially in tertiary hospitals. Studies in other regions are needed to ratify these findings.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101173"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453568","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}

引用次数: 0

Habilidades no técnicas en cuidados intensivos. Importantes, pero aún desconocidas [重症监护的非技术技能。很重要，但仍然未知]。

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Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2025-10-06 DOI: 10.1016/j.jhqr.2025.101162

E. Chicote-Álvarez, E. Cervantes-Marrodán, A. Sáenz-Pinillos, M. Macías-Pascual, A. Calvo-Martínez

引用次数: 0

Surgical safety checklist in crisis: We do either it right or we do it right 危机中的手术安全清单：我们要么做对，要么做对。

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Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2025-12-24 DOI: 10.1016/j.jhqr.2025.101182

D. Parés

引用次数: 0

A retrospective cohort study of onco-hematologic inpatients with SACT at the end of life in a single cancer institution: Differences between solid tumors and hematological neoplasms 一项回顾性队列研究，在单一癌症机构对SACT晚期肿瘤-血液学住院患者：实体瘤和血液学肿瘤之间的差异

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Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2025-09-09 DOI: 10.1016/j.jhqr.2025.101160

L. Pétriz , A. Vidal , J.R. Germà , E. Loureiro , J. Muniesa , T. Ferro

{"title":"A retrospective cohort study of onco-hematologic inpatients with SACT at the end of life in a single cancer institution: Differences between solid tumors and hematological neoplasms","authors":"L. Pétriz , A. Vidal , J.R. Germà , E. Loureiro , J. Muniesa , T. Ferro","doi":"10.1016/j.jhqr.2025.101160","DOIUrl":"10.1016/j.jhqr.2025.101160","url":null,"abstract":"<div><h3>Background</h3><div>This study compares mortality indicators in patients with solid tumors (ST) and hematological neoplasms (HN) who died in the hospital during systemic anticancer therapy (SACT) in the last 30 days of life. We used indicators described by Earle: SACT<30d, SACT<14d, therapeutic regimen changes, and palliative care referrals. We also analyzed the impact of palliative care availability on patient survival.</div></div><div><h3>Methods</h3><div>Between 2017 and 2022, we identified, validated, and registered 2285 cases through our institution's Mortality Subcommittee (MS) that met the inclusion criteria for this cohort.</div></div><div><h3>Results</h3><div>We observed differences in indicators between ST and HN consistent with published literature. These differences occurred both in therapeutic intensity (higher in HN) and in palliative care referrals (higher percentage for ST). When analyzing survival from advanced disease definition to death, no statistically significant differences emerged between patients with HN versus ST, or between those with and without palliative care.</div></div><div><h3>Conclusions</h3><div>The published differences between subgroups (ST vs HN) persist even in our hospital death cohort, confirming the need for pathology-specific standards.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101160"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019284","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}

引用次数: 0

Estrategia para la mejora del Servicio de Atención a la persona Usuaria de un Sistema Público de Salud [改善公共卫生系统病人和使用者服务的战略]。

IF 1

Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2026-01-12 DOI: 10.1016/j.jhqr.2025.101185

Aitziber Echevarria Echevarria

{"title":"Estrategia para la mejora del Servicio de Atención a la persona Usuaria de un Sistema Público de Salud","authors":"Aitziber Echevarria Echevarria","doi":"10.1016/j.jhqr.2025.101185","DOIUrl":"10.1016/j.jhqr.2025.101185","url":null,"abstract":"<div><h3>Introduction</h3><div>The current health situation necessitates a paradigm shift in Patient Care Services to meet societal needs.</div><div>The general objective wasto improve the quality and effectiveness of the Patient Care Service and users of a public health system.</div></div><div><h3>Material and methods</h3><div>A systematic bibliographic review of aspects related to the Patient/User/Citizen Care Service was conducted, and a survey was developed on general and organizational aspects and the strategies followed by different hospitals in various Autonomous Communities.</div></div><div><h3>Results</h3><div>Significant differences in User Care Services exist between the Autonomous Communities in Spain due to the decentralization of the health system and outdated regulations. These differences include nomenclature, hierarchical dependence, organization and management, services offered, responsibilities, professional training, accessibility, implementation of user rights and duties, and citizen participation in health centers.</div></div><div><h3>Conclusion</h3><div>The results highlight the need for a comprehensive model that combines personalization, technology, and citizen participation. This approach enhances the efficiency of User Care Services, strengthens equity, and reinforces institutional trust. In the face of the sociodemographic and structural challenges of the healthcare system, it is essential to move towards person-centered models, where the patient's voice is integrated as a driver of quality and transformation.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101185"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965982","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}

引用次数: 0

Float nurses, patient safety and humanised care: A global challenge 浮动护士、患者安全和人性化护理：一项全球性挑战

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Journal of Healthcare Quality Research Pub Date : 2026-01-01 Epub Date: 2025-10-25 DOI: 10.1016/j.jhqr.2025.101171

R. Allande-Cussó , J. Gómez-Salgado

引用次数: 0