International journal for quality in health care : journal of the International Society for Quality in Health Care最新文献

{"title":"Health conditions that impact fitness-to-practice in physicians: A scoping review.","authors":"Richard Roberts, Tanya Jackson, Ryan Gerdes, Danika Deibert, Liz Dennett, Ellina Lytvyak, Sebastian Straube","doi":"10.1093/intqhc/mzaf108","DOIUrl":"https://doi.org/10.1093/intqhc/mzaf108","url":null,"abstract":"<p><strong>Background: </strong>It has been over 50 years since health conditions in physicians were first suggested to affect their fitness-to-practice, with consequent impacts on patient safety and patient care. Recent policy positions from physician regulatory bodies express a desire for clarity regarding the impact of these health conditions alongside their standardization in physician regulatory processes. Furthermore, these conditions have not been fully enumerated. Therefore, this scoping review intended to find all health conditions which were identified in the literature to impact physician fitness-to-practice.</p><p><strong>Methods: </strong>A specialist librarian developed and executed a systematic literature search in Ovid MEDLINE, Embase via Ovid, APA PsycINFO, and ProQuest Dissertations & Theses Global (to January 2024). The SPIDER framework was used for inclusion criteria and records were screened independently by two reviewers by title and abstract, then by full text. Any study addressing a health condition identified as able to affect fitness-to-practice in physicians and surgeons, physician assistants, or medical trainees was eligible.</p><p><strong>Results: </strong>In 403 eligible records of 2542 screened, 4336 total mentions of 203 fitness-to-practice-related health conditions were identified. Conditions relating to mental health issues (32.0%) and drug/substance use (26.0%) comprised more than half of the condition reports. This was followed by neurological conditions (13.2%), medical conditions (12.8%), alcohol use (6.0%), addiction (3.0%), and aging (2.9%) as well as conditions affecting dexterity/fine motor skills/psychomotor performance (2.1%), vision (1.4%), and hearing (0.6%).</p><p><strong>Conclusions: </strong>This scoping review identified a wide variety of health conditions which could affect physician fitness-to-practice, with a potential impact on patient care and safety. These conditions have persisted in the literature, and we commend them to the attention of practicing physicians, researchers, regulators, and physician health programs.</p>","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246236","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":"Sustaining Quality Improvement in times of crisis: Lessons from Lebanon.","authors":"Maysaa Jaafar","doi":"10.1093/intqhc/mzaf106","DOIUrl":"https://doi.org/10.1093/intqhc/mzaf106","url":null,"abstract":"","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246322","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":"Litigation following Traumatic Brain Injury-what are the challenges and what can we do?","authors":"Nichola Robson, Gemma Bradley, Rebecca Morris, Lee Jones, Zoe Jones","doi":"10.1093/intqhc/mzaf107","DOIUrl":"https://doi.org/10.1093/intqhc/mzaf107","url":null,"abstract":"","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246158","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":"Sustaining Perioperative Patient Safety Improvement: The Relevance of Patient Safety Policies and Contextual Factors in European Healthcare Systems.","authors":"Kaja Kristensen, Sophie Wang, Daniel Arnal Velasco, Kaja Põlluste, Adam Žaludek, Paulo Sousa, Carola Orrego, Oliver Groene","doi":"10.1093/intqhc/mzaf105","DOIUrl":"https://doi.org/10.1093/intqhc/mzaf105","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Perioperative patient safety aims to minimise risk and reduce adverse events throughout the surgical journey. Despite investments in national and international initiatives, sustaining these efforts remains a challenge. Contextual factors such as national policies and legal requirements play a key role in ensuring long-term success. This qualitative study examines the national patient safety policies and frameworks in five European countries and investigates contextual factors to understand how these policies may affect the implementation and sustainability of perioperative patient safety initiatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Semi-structured interviews were conducted with decision-makers from Ministries of Health, regulatory or accreditation bodies, professional medical or scientific societies, managerial hospital staff, and academic patient safety experts from Spain, the Netherlands, Portugal, Estonia, and the Czech Republic. A desktop search for relevant policy and regulatory frameworks around perioperative patient safety informed the development of the semi-structured interview guide. Generated data were coded using an a priori framework adapted from the updated Consolidated Framework for Implementation Research (CFIR) and a framework for assessing health systems'quality improvement and patient safety initiatives. Using content analysis, codes were thematically analysed to delineate and compare the perioperative patient safety landscapes of the five countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 28 high-level decision-makers were interviewed. Based on the insight from interviewees, a patient safety policy profile was generated for each of the five countries, capturing the key features of their frameworks and strategies. While all countries have developed policies to improve patient safety, the scope and structure of these frameworks vary widely. Some countries have established centralized systems with detailed national action plans and robust oversight mechanisms, whereas others rely on more fragmented approaches with responsibilities distributed across various organizations. Common challenges identified include the inconsistent integration of patient safety education into medical curricula and cultural barriers, such as a fear of blame that affects reporting practices. Interviewees provided several propositions how project-based patient safety initiatives could be embedded in national contexts. These propositions differed considerably between countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study highlights the diverse and evolving nature of patient safety policy landscapes across five European countries. The varying scope, structure, and implementation of patient safety frameworks emphasize the need for context-specific approaches to promote the sustainability of perioperative patient safety initiatives. As the field continues to advance, it is important to tailor approaches that aim to sustain p","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246209","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":"Assessment of the Trends of Never Events Across NHS England: A Six-Year Analysis.","authors":"Mohamed Abosheisha, Ahmed Hafez, Islam Omar","doi":"10.1093/intqhc/mzaf109","DOIUrl":"https://doi.org/10.1093/intqhc/mzaf109","url":null,"abstract":"<p><strong>Background: </strong>Never Events (NEs) are serious clinical incidents. Assessing the trends of these incidents over the years will help direct efforts towards specific areas for improvement. The NHS has made significant efforts in this direction by introducing the National Safety Standards (NatSSIPs) in 2015 and updating them in 2023. This study aims to assess the trends of the common themes of NEs and highlight potential solutions in the available literature and NatSSIPs.</p><p><strong>Methods: </strong>A taxonomy development and thematic analysis of the NHS NEs annual reports from 2018 to 2024 to identify the common themes and assess the trends of these incidents.</p><p><strong>Results: </strong>We identified 2485 NEs, including 1091 wrong surgeries, 561 retained objects, 266 wrong implants, and 198 medication-related NEs. The overall incidents showed a downward trend. Wrong implants showed a declining pattern over the study period, while retained objects and wrong surgery showed a fluctuating curve. Medication NE levelled out.Analysis of the individual themes showed a decline in the wrong side/site procedure. Wrong skin lesion biopsy/removal has increased recently. Retained vaginal and surgical swabs, as well as guidewires, were the most common retained items. They showed fluctuating curves without clear improvement. (Wrong hip implants) show a sharp decline after 18-19, followed by fluctuations at lower levels. Wrong-lens incidents remained stable over the years.There was a noticeable decline in incidents of wrong midazolam strength and an upward trend in wrong-route medication administration. NEs related to misplaced nasogastric tubes, falls, and mismatched blood transfusions were stationary without a discernible pattern.</p><p><strong>Conclusions: </strong>An assessment of the trends of NEs provides a clear picture of the current situation, highlighting areas for improvement and further work. This analysis provides a baseline for assessing the effectiveness of the updated version of NatSSIPs in future work.</p>","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246227","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":"Quality improvement and workplace wellbeing capacity and capability in Aotearoa New Zealand emergency departments. A nationwide mixed methods survey.","authors":"Mike Nicholls, Natalie Anderson, Rebecca Jarden, Vanessa Selak, Chris Frampton, Stuart R Dalziel","doi":"10.1093/intqhc/mzaf073","DOIUrl":"10.1093/intqhc/mzaf073","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Healthcare workers in emergency departments (EDs) need to function optimally to deliver high-quality healthcare. High levels of burnout negatively impact these workers' delivery of quality care to their patients. Quality improvement and workplace wellbeing programmes may simultaneously improve quality of care and burnout. Global recommendations for strengthening quality improvement and workplace wellbeing are increasingly available for healthcare services. Understanding organizational capacity and capability for improvement and wellbeing is an important first step in co-designing change. This study sought to assess the capacity and capability for quality improvement and workplace wellbeing initiatives in New Zealand EDs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In a convergent mixed methods study, a cross-sectional online survey was conducted in August-October 2022. Quality and/or workplace wellbeing leaders were invited to participate from each of the 35 EDs across New Zealand. Questions were based on a range of published tools described below. Participants were invited to contribute further details in free-response items. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed thematically, then data were integrated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixty leaders (30 medical, 29 nursing, 1 other) representing 29/35 (83%) of EDs responded. Overall quantitative results demonstrated considerable gaps between reported and best-possible capacity and capability for quality improvement and workplace wellbeing. Institute for Healthcare Improvement Self-Assessment Tool mean score was 2.4 (maximum 5; SD 0.8); Improvement Readiness scale mean score was 3.1 (maximum 5; SD 0.9); a positive improvement climate was identified in 13/60 (22%) EDs; Australasian College for Emergency Medicine Quality Standards Implementation Toolkit measures, means were 51 (maximum 100; SD 21) for quality improvement and 46 (SD 20) for wellbeing; Shanafelt's Era of workplace wellbeing mean score was 3.1 (maximum 5; SD 0.6); for 11/59 (19%) respondents, none of the measures of the Joy in Medicine Health System Recognition Program applied to their ED. Three qualitative themes were identified: 'work-related frustration and distress'; 'desire, motives, actions, effort to make things better'; and the 'interdependence of high-quality care and workplace wellbeing'. Data integration strengthens understanding of quantitative and qualitative results and analyses, which were congruent throughout the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Capacity and capability for quality improvement and workplace wellbeing across all survey items were generally perceived to be low. Participants expressed perceptions of healthcare worker distress and wasted efforts. Addressing and building capacity and capability in both quality improvement and workplace wellbeing initiatives is a potential first step in improving quality of patient care and","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839885","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}

{"title":"Correction to: A unified approach assessing Hospitals' Quality and Patient Safety Compliance at organizational and national level using an evidence-based Mapping Tool.","authors":"","doi":"10.1093/intqhc/mzaf090","DOIUrl":"10.1093/intqhc/mzaf090","url":null,"abstract":"","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":"37 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240571","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}

{"title":"The protective effect of Pathway to Excellence designation on patient satisfaction during the COVID-19 pandemic.","authors":"Hyunmin Yu, Daniela Golinelli, Linda H Aiken, Matthew D McHugh, J Margo Brooks Carthon","doi":"10.1093/intqhc/mzaf096","DOIUrl":"10.1093/intqhc/mzaf096","url":null,"abstract":"<p><strong>Background: </strong>The Pathway to Excellence® (Pathway) program, operated by the American Nurses Credentialing Center (ANCC), recognizes healthcare organizations globally for fostering optimal work environments for nurses. While its role in supporting nurses is well established, its impact on patient satisfaction during crises like the COVID-19 pandemic remains largely unstudied. This investigation examined the longitudinal association between Pathway status and patient satisfaction during and after the pandemic. We hypothesized that Pathway hospitals would have a protective effect, exhibiting a slower decline in patient satisfaction scores compared to non-Pathway hospitals, despite the nationwide downturn during the pandemic.</p><p><strong>Methods: </strong>This longitudinal, observational study integrated hospital data from three sources: Care Compare data from the Centers for Medicare & Medicaid Services from 2019 to 2023, the American Hospital Association Annual Survey, and the list of Pathway hospitals from the ANCC. The dependent variables were two global patient satisfaction scores: overall hospital ratings and likelihood to recommend the hospitals. The independent variable was hospitals' Pathway status. Linear mixed-effects models evaluated the longitudinal associations between Pathway designation and patient satisfaction outcomes, accounting for hospital-level covariates, including hospital size, teaching status, percentage of Medicaid patients, nursing hours per patient day, specialized service capacity, ownership type, metropolitan classification, and system affiliation.</p><p><strong>Results: </strong>Of the 3242 unique hospitals, 133 (4.1%) held Pathway status for at least one year between 2019 and 2023, while 3109 (95.9%) did not. Pre-pandemic patient satisfaction scores did not differ significantly between the groups. During the pandemic, patient satisfaction scores declined across all hospitals, but the decline in overall hospital ratings (b = 0.17; 95% CI: 0.03, 0.31) and likelihood to recommend the hospital (b = 0.20; 95% CI: 0.03, 0.37) was significantly slower in Pathway hospitals than in non-Pathway hospitals.</p><p><strong>Conclusion: </strong>Pathway hospitals exhibited a protective effect on patient satisfaction during the COVID-19 pandemic. These findings emphasize the critical role of nurse work environments in maintaining patient-centered care during crisis situations.</p>","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093428","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":"Why patient safety is akin to weaving textiles: an International Society for Quality in Health Care perspective on the 7th Global Ministerial Summit on Patient Safety 2025.","authors":"Jeffrey Braithwaite, Anuradha Pichumani, Shin Ushiro, Leslee Thompson, Peter Hibbert, Ezequiel Garcia Elorrio","doi":"10.1093/intqhc/mzaf072","DOIUrl":"10.1093/intqhc/mzaf072","url":null,"abstract":"<p><p>The 7th Global Ministerial Summit on Patient Safety, convened in Manila in April 2025, advanced global efforts to reduce harm in healthcare under the theme 'Weaving Strengths for the Future of Patient Safety'. Drawing on the metaphor of textile weaving, the Summit emphasised that safeguarding patients is a collaborative endeavour, requiring integrated action across sectors and systems. The Mandaluyong Declaration reaffirmed commitments to the WHO Global Patient Safety Action Plan (2021-2030) and made four pledges: strengthening global collaboration, advancing leadership and governance, integrating patient safety into disaster preparedness and climate resilience, and building people-centred safety systems. The mission of the International Society for Quality in Health Care (ISQua), a key presence at the Summit, is aligned with these aims, contributing through its White Paper on patient safety, its Green Paper on climate-resilient health systems, and its Person-Centred Care White Paper. The Summit marked a shift from commitment to implementation, recognising the importance of climate change, digital transformation, and equity as integral to safe care. Patient safety now stands as both a global health and environmental priority. ISQua will continue supporting this work through advocacy, standards development, and partnerships, helping to weave patient safety into the daily practice of healthcare worldwide.</p>","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839888","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}

{"title":"Do not blame the organizational culture for poor performance.","authors":"Dinesh K Arya","doi":"10.1093/intqhc/mzaf092","DOIUrl":"10.1093/intqhc/mzaf092","url":null,"abstract":"<p><p>The formal and informal ways in which things are done in an organisation explain the behaviours that guide activities in that organisation's environment, or in other words, the culture of the organisation. When things go wrong, it is not unusual for an organisation's culture to be implicated as 'bad' and labelled as the reason for inadequate or underperformance. The underlying supposition in making the culture of an organisation an issue is to make a case that a change in the culture will, in some way, improve organisational performance. Programs to effect this change are implemented, despite little evidence that a change in organisational culture will result in different performance or outcomes. Moreover, more often than not, strategies implemented to deliver cultural change do not change the culture of an organisation.</p>","PeriodicalId":520651,"journal":{"name":"International journal for quality in health care : journal of the International Society for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093378","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}