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

{"title":"Coproducing data-driven organizational safety with patients: development and cognitive testing of a multisetting patient-reported safety concern tool.","authors":"Abubakar Sha'aban, Anna Torrens-Burton, Denitza Williams, Andrew Carson-Stevens, Adrian Edwards, Lee Joseph, Natalie Joseph-Williams","doi":"10.1093/intqhc/mzaf056","DOIUrl":"10.1093/intqhc/mzaf056","url":null,"abstract":"<p><strong>Background: </strong>Patient safety is a critical aspect of healthcare, with patients often being the first to notice safety concerns. However, traditional reporting mechanisms have limitations, and many patients may not report safety issues due to fear of repercussions or lack of clarity in existing systems. There is a growing need for tools that enable patients to report safety concerns easily and effectively. This study aimed to undertake preliminary development and cognitive testing of a Patient Reported Safety Concern Tool, designed to capture a broad range of patient safety issues across various healthcare settings that could enhance quality of care and foster continuous safety improvement.</p><p><strong>Methods: </strong>A two-phase, qualitative study was conducted in Wales, virtually through online platforms (Zoom or MS Teams) between January and September 2023. In Phase 1, 26 adults (aged 25-54, 23.1% female) participated in three online focus groups recruited through purposive sampling. In Phase 2, 10 additional participants (aged 25-84, 70% female) were purposively sampled for online cognitive interviews. Participants were eligible if they were 18+ and had accessed healthcare within the past 6 months. Individuals with professional expertise in patient safety were excluded. Data were analysed using qualitative content analysis in NVivo 12. A coding framework was developed inductively and iteratively refined.</p><p><strong>Results: </strong>Focus group participants preferred the term 'safety concern' over terms like 'incident' or 'event,' as it was more relatable and inclusive of both physical and emotional harm. Feedback led to refinements in item clarity, such as extending the recall period to 6 months and rewording prompts for detail. Cognitive interviews confirmed that version 2.0 was easy to understand and relevant. Minor adjustments were made, including extending the recall period to 12 months and adding 'ambulance services' as a setting. The final version, 3.0, demonstrated high content and face validity, with participants expressing a strong willingness to complete the tool if distributed routinely.</p><p><strong>Conclusion: </strong>The Patient Reported Safety Concern Tool was co-developed with public participants and refined through cognitive testing, demonstrating strong content and face validity. Participants felt confident the tool would help identify safety concerns not captured through conventional systems. Future work will focus on validating the tool in wider populations, understanding barriers to completion, and integrating it into existing patient safety learning systems to inform actionable safety improvements.</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":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532820","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 Power of  Words: what if the health system lived up to its role in addressing frequent use of services?","authors":"Catherine Hudon, Donna Rubenstein","doi":"10.1093/intqhc/mzaf048","DOIUrl":"10.1093/intqhc/mzaf048","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":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251886","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":"Enhancing outpatient layouts and services in tertiary hospitals: innovations for elderly-friendly care.","authors":"Weiwei Lu, Yun Zhao, Haoqi Wang, Zhan Sun","doi":"10.1093/intqhc/mzaf043","DOIUrl":"10.1093/intqhc/mzaf043","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":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251883","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":"Application of DRGs in hospital medical record management and its impact on service quality.","authors":"Qin Zhang,&nbsp;Xiaodong Li","doi":"10.1093/intqhc/mzac090","DOIUrl":"https://doi.org/10.1093/intqhc/mzac090","url":null,"abstract":"<p><strong>Background: </strong>To explore the application of diagnosis-related groups (DRGs) in hospital medical record management and the impact on service quality.</p><p><strong>Objective: </strong>This study introduced DGRs management into hospital medical record management in order to improve the quality of hospital medical record management.</p><p><strong>Method: </strong>The medical record management of our hospital was analysed retrospectively between August 2020 and April 2021. A total of 7263 cases without DRG management before January 2021 were included in a control group, and 7922 cases with DRG management after January 2021 were included in a study group. The error rate of medical records, the specific error items and the scores of service capability, service efficiency and service quality were compared along with the comprehensive scores of the two groups.</p><p><strong>Results: </strong>The error rate of medical records in the study group was significantly lower than that in the control group (19.35% vs. 31.24%, P < 0.05). The error rates in terms of diagnosis on admission, surgical procedures, main diagnosis and other diagnoses in the study group were significantly lower than those in the control group. The scores for service ability, service efficiency and service quality were significantly higher in the study group than in the control group (P < 0.05). The comprehensive evaluation score of the study group was significantly higher than that of the control group (P < 0.01).</p><p><strong>Conclusion: </strong>Applying DRGs in the hospital medical record management can effectively reduce the error rate of medical records and improve the quality of hospital services.</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":2.6,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/1a/mzac090.PMC9718026.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40684829","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 cost of dispensing errors in Iranian health system: a retrospective evaluation.","authors":"Nazila Yousefi,&nbsp;Farideh Asadi,&nbsp;Zahra Sharif,&nbsp;Akram Khani,&nbsp;Dana Baymaninezhad,&nbsp;Jamshid Salamzade,&nbsp;Farzad Peiravian","doi":"10.1093/intqhc/mzac083","DOIUrl":"https://doi.org/10.1093/intqhc/mzac083","url":null,"abstract":"<p><strong>Objective: </strong>The problem of medication errors (MEs) has constantly been receiving considerable attention worldwide due to their health impact and costly consequences. MEs occur in all phases of prescription, preparation, administration, distribution and delivery to the patient; however, dispensing errors are more common in this study, we have attempted to identify various MEs that occurred by pharmacists and calculate their financial and physical harm costs.</p><p><strong>Design: </strong>This was a 8-year retrospective study.</p><p><strong>Setting: </strong>This study evaluated the costs of MEs in the Iranian health system caused by dispensing mistakes from 2012 to 2019. We retrieved documents and reports from the Tehran Medical Council Archive. Then, we extracted dispensing error data from ME record forms and analyzed them using SPSS software.</p><p><strong>Main outcome measures: </strong>Cost of dispensing errors.</p><p><strong>Results: </strong>Among 3000 available MEs documents, only 2.6% of cases were dispensing errors. Errors included dispensing of wrong medication (75.6%), delivering expired medicines (11.5%), wrong medication order (9%), wrong medicine compounding (2.6%) and wrong dose of medication (1.3%). The most common cause of dispensing errors was physicians' poor handwriting (23.1%). Legal reactions, due to MEs, occurred in a range of actions from written reprimand in the professional records to some months of deprivation from professional activities.</p><p><strong>Conclusion: </strong>The analysis of the MEs that lead to the legal prosecution in the Iranian Medical Council shows that most cases, according to the severity of harm, were dispensing wrong medicines which caused temporary patients harm.</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":2.6,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40701368","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":"A qualitative study exploring challenges and solutions to negotiating goals of care at the end of life in hospital settings.","authors":"Kim Devery,&nbsp;Megan Winsall,&nbsp;Deb Rawlings","doi":"10.1093/intqhc/mzac089","DOIUrl":"https://doi.org/10.1093/intqhc/mzac089","url":null,"abstract":"<p><strong>Background: </strong>Negotiating goals of care (GoC) with patients is an essential skill for all health-care professionals (HCPs) in hospitals. End-of-Life Essentials (EOLE) is a Commonwealth-funded project that delivers free, peer-reviewed, evidence-based, online education and practice change resources. To date, around 26 000 doctors, nurses and allied health professionals have registered to access the education. 'Planning End-of-Life Care-Goals of Care' features in the suite of EOLE modules and includes education around negotiating GoC with patients and families.</p><p><strong>Objective: </strong>The aim of the study was to explore the views of module learners (HCPs) on challenges they have faced when negotiating GoC at the EOL with patients and families.</p><p><strong>Methods: </strong>Participants were learners (HCPs) who registered to the EOLE website and engaged with the GoC module. Learners' responses to the question posed at the end of the module 'What are the hardest or most challenging things about negotiating GoC with patients and families?' were extracted for a 12-month period. Qualitative data were analysed thematically in NVivo V.12, guided by the theoretical framework of pragmatism. An open, inductive approach was used to code the data, with axial coding used to refine and organize themes and subthemes.</p><p><strong>Results: </strong>A total of 451 learner statements were analysed. Five themes emerged from the data: (i) differing views and opinions; (ii) challenges to understanding; (iii) managing emotions; (iv) initiating the EOL conversation and (v) lack of professional knowledge or capacity. Five subthemes were also organized under the theme 'differing views and opinions'.</p><p><strong>Conclusion: </strong>Planning EOL care demands high-level, compassionately skilful and sensitive care and services, which are in line with the patient's and family's wishes. In practice, however, there are many challenges to this, such as ensuring that patients, families, and HCPs are aware of different expectations regarding future health-care possibilities, and that HCPs are prepared for negotiating GoC to achieve quality and safe EOL care in hospitals.</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":2.6,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/76/mzac089.PMC9683075.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40652344","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":"Accelerating improvement: The Pediatric Acute Care Cardiology Collaborative data timeliness project.","authors":"Margaret Graupe,&nbsp;Ashlin Tignor,&nbsp;Kelly Veneziale,&nbsp;Megan Jensen,&nbsp;Lara Khadr,&nbsp;Heather Beckstrom,&nbsp;Martin Gister,&nbsp;Karen Hendricks,&nbsp;Nicolas L Madsen,&nbsp;Frederick Roberts,&nbsp;Sarah Youngberg,&nbsp;Susan Schachtner","doi":"10.1093/intqhc/mzac086","DOIUrl":"https://doi.org/10.1093/intqhc/mzac086","url":null,"abstract":"<p><strong>Background: </strong>The Pediatric Acute Care Cardiology Collaborative (PAC3) is a learning network focused on improving acute care cardiology patient outcomes. Data submission timeliness is a vulnerability for PAC3 and most clinical registries, directly affecting collaborative benchmarking, quality improvement (QI) and research projects.</p><p><strong>Objective: </strong>PAC3 conducted a collaborative-wide QI project addressing data timeliness and efficiency. Data analysis of submitted cases from September 2019 to February 2020 revealed nine 'High Performer' centers who submitted cases within 67 days of hospital discharge (the limit for timeliness) >90% of the time and eight 'High Potential' sites who submitted timely cases <75% of the time. The primary aim was to increase case submission timeliness in 'High Potential' centers from 41% to 80% by December 2020. The secondary aim was to maintain timeliness in 'High Performer' sites.</p><p><strong>Method: </strong>During the intervention phase (March-December 2020), plan-do-study-act (PDSA) cycles included webinars, facilitated exploratory conversations, data review and development of a best practice guide ('Getting Started Toolkit'). On-boarded 'New Centers' starting in 2020 were also invited to test intervention effectiveness. Balancing measures included data collector job satisfaction and stress and resubmission rates.</p><p><strong>Results: </strong>'High Performer' and 'High Potential' centers submitted 11 358 cases from November 2019 to December 2020. Timely submission rates for 'High Potential' centers improved from 40.6% to 74.6% and were maintained at >90% for 'High Performer' centers. 'New Centers' averaged 92.6% timely case submissions during their first 6 months. Data collector job satisfaction and stress were not impacted, and the resubmission rates did not increase.</p><p><strong>Conclusion: </strong>PAC3's multicenter QI project increased data submission timeliness in a large pediatric subspecialty registry. The lessons learned and the Toolkit developed can be applied in other registries to improve data submission efficiency, with resultant improvement in benchmarking, QI, research, length of stay and outcomes.</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":2.6,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40657075","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":"Effects of an educational intervention for rational cardiac enzyme requisitions in critically ill patients: a pre-post intervention study.","authors":"Natália Sarracceni Tedesco,&nbsp;Frederico Augusto Gurgel Pinheiro,&nbsp;José Mauro Vieira Júnior,&nbsp;Leandro Utino Taniguchi","doi":"10.1093/intqhc/mzac088","DOIUrl":"https://doi.org/10.1093/intqhc/mzac088","url":null,"abstract":"<p><strong>Background: </strong>Although cardiac troponin is recommended as the biomarker of choice to evaluate myocardial injury, inappropriate low-value ordering practice is frequent, particularly routine ordering of creatine kinase-myocardial band (CK-MB) tests where troponin is available.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the impact of an educational intervention for rational request of cardiac biomarkers in the intensive care unit.</p><p><strong>Method: </strong>We conducted a quasi-experimental, pre-post implementation study of an educational program (expository-dialogue presentation and disclosure of a decision algorithm) for rational cardiac biomarker testing in adult critically ill patients. The study was divided into two 12-month periods: pre-intervention (September 2017-August 2018) and post-intervention (October 2018-September 2019). An interrupted time series with a segmented regression model was applied to analyze variation over time in CK-MB and troponin testing.</p><p><strong>Results: </strong>We included 4429 patients: 2181 patients in the pre-intervention period and 2248 patients in the post-intervention period. A reduction in the concomitance of CK-MB and troponin testing was observed (concomitance in 1415 tests in the pre-intervention period vs 348 tests in the post-intervention period). The interrupted time series analysis demonstrated a noticeable immediate reduction in the concomitance of CK-MB with troponin after the intervention (-0.13 tests per patient, P = 0.0016) but not in the secular trend for the concomitance. The proportion of patients with the acute coronary syndrome as a discharge diagnosis was not different between the pre- and post-intervention period.</p><p><strong>Conclusion: </strong>Our pre-post interventional study demonstrated a significant decrease in the concomitance of CK-MB and troponin tests. A rational high-value ordering practice of cardiac biomarkers is possible in critically ill patients and might be suitable for educational interventions.</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":2.6,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40571875","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":"Development and validation of questionnaire assessing the perception of hospital patient safety practices in public health facilities of India.","authors":"Yuvaraj Krishnamoorthy,&nbsp;Gerald Samuel,&nbsp;Venmathi Elangovan,&nbsp;Krishna Kanth,&nbsp;Murali Krishnan,&nbsp;Isha Sinha","doi":"10.1093/intqhc/mzac087","DOIUrl":"https://doi.org/10.1093/intqhc/mzac087","url":null,"abstract":"<p><strong>Background: </strong>In 'To Err is Human' released by the Institute of Medicine Committee on Quality of Health Care, it was emphasized that it is important to establish a safety culture in the hospitals and ensure that patients are not inadvertently harmed by errors.</p><p><strong>Objective: </strong>Hence, we developed and validated a questionnaire for assessing the perception of patient safety practices across secondary and tertiary care facilities in India.</p><p><strong>Method: </strong>The scale was developed based on the literature review and expert opinion. It consisted of 10 questions, and the responses to these items were based on a five-point Likert scale ranging from 'strongly agree' to 'strongly disagree'. All analysis was performed using STATA version 14.2 software. Exploratory factor analysis (EFA) was run using principal component analysis with oblique promax rotation and confirmatory factor analysis (CFA) using structural equation modelling with maximum likelihood estimation.</p><p><strong>Results: </strong>The entire dataset was split into testing set to run EFA (with 692 participants) and validation set to run CFA (with 645 participants). In EFA, two factors were retained as they had eigenvalue more than one (4.76, 1.09) and the scree plot also showed that the slope flattens off after two factors. Factor loadings were generated using oblique promax rotation. Factor 1 consisted of seven items (Item 1, Item 2, Item 3, Item 4, Item 5, Item 6 and Item 7-questions related to patient-doctor communication, hospital environment and procedures) accounting for 47.6% of variance, and Factor 2 had three items (Item 8, Item 9 and Item 10-infection prevention and control practices in hospital) explaining 10.9% of the variance. Thus, together, the two factors explained 58.5% of the variance. CFA revealed good confirmatory fit indices of 0.85, standardized root mean square residual of 0.07 and acceptable Tucker-Lewis Index of 0.80. The reliability coefficient was 0.88 indicating very good internal consistency.</p><p><strong>Conclusion: </strong>This study develops and validates a scale that can be used universally for assessing the patients' perception on hospital safety practices across secondary and tertiary care facilities in India.</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":2.6,"publicationDate":"2022-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40659093","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":"Outcomes among patients admitted for non-ST-segment myocardial infarction in the pre-pandemic and pandemic COVID-19 era: Israel Nationwide study.","authors":"Elad Asher,&nbsp;Alexander Fardman,&nbsp;Hezzy Shmueli,&nbsp;Katia Orvin,&nbsp;Daniel Oren,&nbsp;Natalia Kofman,&nbsp;Jameel Mohsen,&nbsp;Gassan Moady,&nbsp;Louay Taha,&nbsp;Ronen Rubinshtein,&nbsp;Osherov Azriel,&nbsp;Roi Efraim,&nbsp;Dabbah Saleem,&nbsp;Philippe Taieb,&nbsp;Eyal Ben-Assa,&nbsp;Tal Cohen,&nbsp;Robert Klempfner,&nbsp;Amir Orlev,&nbsp;Roy Beigel,&nbsp;Amit Segev,&nbsp;Shlomi Matetzky","doi":"10.1093/intqhc/mzac085","DOIUrl":"https://doi.org/10.1093/intqhc/mzac085","url":null,"abstract":"<p><strong>Background: </strong>Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic in 2019, several countries have reported a substantial drop in the number of patients admitted with non-ST-segment myocardial infarction (NSTEMI).</p><p><strong>Objective: </strong>We aimed to evaluate the changes in admissions, in-hospital management and outcomes of patients with NSTEMI in the COVID-19 era in a nationwide survey.</p><p><strong>Method: </strong>A prospective, multicenter, observational, nationwide study involving 13 medical centers across Israel aimed to evaluate consecutive patients with NSTEMI admitted to intensive cardiac care units over an 8-week period during the COVID-19 outbreak and to compare them with NSTEMI patients admitted at the same period 2 years earlier (control period).</p><p><strong>Results: </strong>There were 624 (43%) NSTEMI patients, of whom 349 (56%) were hospitalized during the COVID-19 era and 275 (44%) during the control period. There were no significant differences in age, gender and other baseline characteristics between the two study periods. During the COVID-19 era, more patients arrived at the hospital via an emergency medical system compared with the control period (P = 0.05). Time from symptom onset to hospital admission was longer in the COVID-19 era as compared with the control period [11.5 h (interquartile range, IQR, 2.5-46.7) vs. 2.9 h (IQR 1.7-6.8), respectively, P < 0.001]. Nevertheless, the time from hospital admission to reperfusion was similar in both groups. The rate of coronary angiography was also similar in both groups. The in-hospital mortality rate was similar in both the COVID-19 era and the control period groups (2.3% vs. 4.7%, respectively, P = 0.149) as was the 30-day mortality rate (3.7% vs. 5.1%, respectively, P = 0.238).</p><p><strong>Conclusion: </strong>In contrast to previous reports, admission rates of NSTEMI were similar in this nationwide survey during the COVID-19 era. With longer time from symptoms to admission, but with the same time from hospital admission to reperfusion therapy and with similar in-hospital and 30-day mortality rates. Even in times of crisis, adherence of medical systems to clinical practice guidelines ensures the preservation of good clinical outcomes.</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":2.6,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9620304/pdf/mzac085.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40650005","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}