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

{"title":"Using an evidence-informed co-design approach to develop a mechanism to measure experiences of the open disclosure process: an Irish case study.","authors":"Aoife De Brún, Eilish McAuliffe, Maria Boylan, Helen Thompson, Catherine Hand, Alexandria Collins, Geraldine Kilkelly, Noreen Kennedy, Clara Meehan, Lorraine Schwanberg, Éidín Ní Shé","doi":"10.1093/intqhc/mzag129","DOIUrl":"10.1093/intqhc/mzag129","url":null,"abstract":"<p><strong>Introduction: </strong>Open disclosure (OD) is an open discussion with a patient and/or family member about an incident(s) that resulted in harm to that patient while they were receiving healthcare. It is widely considered an ethical and moral imperative and is what patients and families want when harm occurs. However, there is a dearth of research on patient and family experiences of OD and limited measures available to measure the quality of current processes. This research aimed to address this gap by using an evidence-informed approach to working with experts by experience to co-design a mechanism to measure patient experience of OD.</p><p><strong>Methods: </strong>We adopted a co-design approach, which involves partnering with stakeholders in the healthcare system to address a shared goal and working collaboratively to develop consensus about how best to address an identified challenge. A co-design team was established which included experts by experience (those with direct patient/family experience of OD; n = 5), patient advocates (n = 2), patient and service user engagement leads in the health system (n = 2), quality and patient safety managers/advisors (n = 3), members of the National Open Disclosure Team (n = 3) and academics/researchers (n = 3). A one-day in-person workshop was held using the World Café approach whereby a series of small group discussions on sub-topics helped develop consensus on how to measure experience.</p><p><strong>Results: </strong>Participants agreed that a brief survey, focusing on key aspects of the OD process would be the optimal way for patients and relevant others to provide feedback that could support learning and quality improvement. Participants acknowledged the use of open text comment boxes within the survey would be useful to allow respondents to elaborate on their experience further, if desired. Furthermore, the survey should provide the option for the respondent to indicate if they would like to speak to someone about their experience of OD in more detail. The co-design team agreed that everyone who has experience of OD, regardless of level of harm, should be eligible and invited to take part in providing feedback on their experiences. A draft survey was developed by the group and is presented in full.</p><p><strong>Conclusions: </strong>This paper documents the co-design approach adopted on this sensitive topic and shares recommendations that emerged from the co-design process of how experiences of OD should be measured for the purposes of improvement. While the survey was deemed optimal by co-design group members, it is acknowledged that this could be challenging for some to complete. This draft survey, however, offers a valuable starting point to understanding if the process is working as intended for patients and families who experience 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":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908559","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: High-quality primary healthcare: addressing the challenges here and now.","authors":"","doi":"10.1093/intqhc/mzag120","DOIUrl":"10.1093/intqhc/mzag120","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":"38 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908586","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":"Interventions to improve Cultural Safety in healthcare in CANZUS countries: a systematic mixed studies review of First Nations Peoples' experiences.","authors":"Anne van der Breggen, Stuart Leske, Judith A Dean, Saira Sanjida, Jane Wallace, Natasha Lee, James Ward","doi":"10.1093/intqhc/mzag057","DOIUrl":"10.1093/intqhc/mzag057","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Assessing patient perspectives is fundamental to determining whether anti-racism and cultural training programs and services associated with an intervention achieve their intended outcomes, yet reviews frequently focus on health provider perspectives. This systematic review, therefore, aimed to investigate First Nations Peoples' experiences, as patients, of interventions to improve their Cultural Safety and experiences in secondary and tertiary healthcare settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;American Psychological Association's PsycInfo (via EBSCOhost), Cumulative Index to Nursing and Allied Health Literature Complete (via EBSCOhost), PubMed, and Scopus (via Elsevier) were all searched from inception to 9 December 2025. Eligible intervention studies needed to report the experiences of First Nations' people as care recipients in secondary and tertiary healthcare settings. Eligible study countries were Australia, Canada, Aotearoa (New Zealand), and the United States of America (USA). General study quality was assessed using the Mixed Methods Appraisal Tool. Study quality was also examined with a modified version of the Aboriginal and Torres Strait Islander Quality Appraisal Tool to provide a First Nations perspective. Qualitative meta-aggregation was conducted to synthesize both qualitative and quantitative data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 22 reports (11 qualitative, 7 quantitative, and 4 mixed methods) of 20 eligible studies, including 2092 First Nations care recipients. Interventions and quantitative outcomes were heterogeneous, precluding meta-analysis. Four studies reported on cultural training for health professionals, with the remainder service-level interventions. The qualitative meta-aggregation resulted in six synthesized findings, which reflected the mechanisms by which these programs worked and their outcomes. Four synthesized findings described mechanisms. These included emotional and practical support; acknowledgement, respect, and support for culture; feeling accepted, heard, valued, safe, comfortable, and respected; and navigating treatment and the system. The two synthesized findings related to outcomes concerned perceptions of health services and, relatedly, impacts on health service access. Quality appraisal revealed no discussion of existing and newly created intellectual property considerations. Study limitations included undefined terminology, terms being used interchangeably, and a few studies from the USA and Aotearoa (New Zealand).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Published intervention studies assessing First Nations care recipients' experiences appear to be increasing. Future interventions must clearly define the terminology in the intervention, use mixed-methods approaches, and report intellectual property considerations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;Systematic review: PROSPERO, CRD42024521218 (prospective, available at https://www.crd.york.ac.uk/PROSPE","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":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849299","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":"Illness does not stop childhood: rethinking play as a dimension of quality in paediatric healthcare.","authors":"Katherine Andrea Dinamarca-Aravena, Ezequiel García-Elorrio","doi":"10.1093/intqhc/mzag107","DOIUrl":"10.1093/intqhc/mzag107","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":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709362","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 knowledge, attitudes, and practices around cervical cancer screening in the Gulu district of Northern Uganda: a cross-sectional study.","authors":"Tana Chongsuwat, Andre Nana, Aaliyah O Ibrahim, Ann E Evensen, James H Conway, Sumba O Pius, Ibrahim Sseddangira, Usman Iqbal, William Oloya","doi":"10.1093/intqhc/mzag118","DOIUrl":"10.1093/intqhc/mzag118","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is a global health issue, particularly Sub-Saharan Africa, including Uganda, where it poses a severe burden. Despite the availability of screening methods, uptake remains low due to various barriers, such as limited resources and a lack of awareness. This study primarily aimed to assess the knowledge, attitudes, and practices related to cervical cancer screening among men and women in the Gulu District of Northern Uganda, with secondary objectives on understanding gender differences, the impact of HIV status, and identifying barriers to screening.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in December 2021 using a structured questionnaire administered in both English and Acholi to evaluate participants' knowledge of cervical cancer, attitudes toward the disease, and screening practices. We described knowledge, attitudes, and practices, and applied logistic regression to explore the associations between gender, HIV status, and correctness of responses.</p><p><strong>Results: </strong>A total of 379 participants aged 18 years and above were included. Most respondents self-reported low overall knowledge of cervical cancer (n = 298 of 376 responses, 79.3%), which is reflected in the low percentage of correct responses to questions related to the recommended age for screening (1.9%) and the frequency of screening for HIV-negative/unknown (4.5%), and HIV-positive (9.8%) persons. Gender and HIV status among female respondents were not associated with knowledge levels. Stigma related to cervical cancer was reported among 40.8% of participants (n = 147 out of 360 responses). Most participants never had a pelvic exam for cervical cancer (n = 183 out of 258 responses, 70.9%) or testing for HPV (n = 198 out of 246 responses, 80.5%). Among women living with HIV-, 41.7% (n = 20 of 48 respondents) reported having received a pelvic examination for cervical cancer screening, and 18.6% (n = 8 of 43 respondents) reported having been screened for HPV. The majority identified cost (n = 166 out of 273 responses, 60.8%) and access to healthcare facilities (n = 246 out of 373 responses, 66%) as barriers to screening.</p><p><strong>Conclusion: </strong>The study highlights a low level of knowledge, understanding, and practice concerning cervical cancer screening, emphasizing the need for targeted interventions to reduce stigma and increase awareness of recommended screening intervals and risk reduction methods in Northern Uganda. Improving accessibility and affordability of screening services may also help reduce persistent structural barriers to screening.</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":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809776","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":"Clinical champions as an implementation strategy: evidence and practical considerations.","authors":"Ulfat Shaikh, John Brennan, Anuradha Pichumani, Shin Ushiro","doi":"10.1093/intqhc/mzag114","DOIUrl":"10.1093/intqhc/mzag114","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":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the quality of patient safety incident investigation reports.","authors":"Lorelle Bowditch, Charlotte J Molloy, Brandon King, Masoumeh Abedi, Samantha Jackson, Mia Bierbaum, Yinghua Yu, Louise Raggett, Paul Salmon, Raghu Lingam, Sandy Middleton, Jeffrey Braithwaite, Johanna Westbrook, Robyn Clay-Williams, Peter D Hibbert","doi":"10.1093/intqhc/mzag077","DOIUrl":"10.1093/intqhc/mzag077","url":null,"abstract":"<p><strong>Background: </strong>Between 4% and 17% of hospital inpatients experience a patient safety incident. Many healthcare organizations undertake analysis and investigation of serious incidents to understand them and prevent future occurrences. Tools have been developed to assess investigation quality as a reflection of a health service's learning and improvement process. However, a broad-scale examination of the quality of investigation reports has not been conducted in Australia. This study aimed to assess the quality of a sample of Australian patient safety incident investigation reports.</p><p><strong>Methods: </strong>A deductive, directed content analysis was conducted to assess the quality of 300 incident investigation reports from 56 Australian health services. Each report was assessed on the extent to which they met predefined quality criteria using the Dutch Health and Youth Care Inspectorate (IGZ) scoring instrument and the United Kingdom's Learning Response Review and Improvement Tool (LRRT).</p><p><strong>Results: </strong>A detailed and complete description of events was present in just over half of the reports (57%). There was also variable application of systems approaches to incident causation in the reports. Generally, there was evidence that the people affected were engaged with, and the avoidance of blame and counterfactual reasoning was well executed, as was overall writing quality. Areas in need of improvement included identifying contributing factors beyond the staff and local hospital, the use of appropriate scientific literature and using observational insights to enhance understanding of work-as-done-in our sample only 4% used observation techniques to examine healthcare processes.</p><p><strong>Conclusion: </strong>This study establishes that stronger foundational, evidence-based approaches to incident investigation are necessary. These approaches include using multiple data sources, like observations of real work, and inclusion of people with skills to apply a systems thinking-driven analytical process to effectively identify contributing factors beyond the individual to drive learning and continuous systemic improvement.</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":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038430","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":"Satisfaction with clinical practice environments among early-career health professionals in South Africa: findings from the WiSDOM cohort study.","authors":"Laetitia C Rispel, Prudence Ditlopo, Duane Blaauw","doi":"10.1093/intqhc/mzag124","DOIUrl":"10.1093/intqhc/mzag124","url":null,"abstract":"<p><strong>Background: </strong>The work or practice environments of health professionals play a central role in their retention in the healthcare system and their ability to provide quality patient care. The aim of the study was to examine and compare the satisfaction of early-career health professionals in the WiSDOM (Wits longitudinal Study to Determine the Operation of the labour Market among its health professional graduates) study with their clinical practice environments (CPEs) in South Africa, and the factors influencing their satisfaction.</p><p><strong>Methods: </strong>WiSDOM, a prospective longitudinal cohort study, consists of eight health professions: clinical associates, dentists, doctors, nurses, occupational therapists, oral hygienists, pharmacists, and physiotherapists. Every year we collect information on the cohort's involvement in direct patient care, their perceived workload, availability of medicines and equipment for patients in their care, and their satisfaction with the CPE.We used Stata®19 for analysis. We used panel linear regression to investigate factors associated with the cohort's satisfaction with their CPEs from 2018 to 2024 and logistic regression to evaluate the association between CPE and intention to leave in 2024.</p><p><strong>Results: </strong>In 2024, the mean age of the cohort was 30.9 (± 2.0), the majority were female (74.4%) and working in urban areas (92.7%). In 2024, 59.7% of the overall cohort reported a heavy workload compared to 69.2% in 2018. Over the follow-up period, reported problems with the availability of medicines or equipment were worse in the public sector and in rural areas, compared to the private sector and urban areas respectively.The cohort's satisfaction score with the CPE was 6.7 out of 10 in 2018 and 6.9 in 2024. The predictors of CPE were year of follow-up, health profession, employment sector, and geographic location. Nurses (β = -1.2; 95% CI -1.7, -0.7; P < .001), and pharmacists (β = -0.7; 95% CI -1.1, -0.4; P < .001) scored their CPE significantly lower than the other professional groups. Health professionals in the public sector (β = -1.1; 95% CI -1.3, -0.9; P < .001) and in rural areas (β = -0.6; 95% CI -0.9, -0.3; P < .001) were less satisfied with their CPE compared to those in the private sector and urban areas respectively. Dissatisfaction with the CPE was significantly associated with intention to leave the workplace and the profession.</p><p><strong>Conclusion: </strong>The study findings underscore the need for positive CPEs for early-career health professionals in South Africa both as a health workforce and patient safety imperative.</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":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868894","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":"What is a Mortality Committee for? Autopsy as a quality indicator.","authors":"Francisco Ortuño-Andériz, María Jesús Fernández-Aceñero, Natividad Calvo-Romero","doi":"10.1093/intqhc/mzag086","DOIUrl":"10.1093/intqhc/mzag086","url":null,"abstract":"<p><strong>Background: </strong>Clinical autopsy has played a central role in medical education, research, and quality assurance. Despite major advances in diagnostic technologies, clinically relevant discrepancies between premortem diagnoses and postmortem findings persist. However, declining autopsy rates have raised concerns about the loss of this tool as a marker of diagnostic accuracy and patient safety. Hospital Mortality Review Committees may help to integrate autopsy findings into quality improvement processes, although their real impact on clinical practice remains uncertain. We evaluate the contribution of clinical autopsies to the detection of major diagnostic discrepancies and examine how Hospital Mortality Review Committees may facilitate autopsy-based quality assessment in a tertiary care hospital.</p><p><strong>Methods: </strong>A retrospective observational study of adult in-hospital deaths undergoing clinical autopsy over a 10-year period was conducted at a large tertiary hospital in Spain. Premortem clinical diagnoses were compared with postmortem findings using the modified Goldman classification. Major diagnostic discrepancies were analyzed overall and by clinical department.</p><p><strong>Results: </strong>Two hundred eighty-four clinical autopsies were analyzed. Major clinicopathological discrepancies were identified in 30.3% of cases. The most frequent missed diagnoses were malignancies, pneumonias, invasive fungal infections, aortic dissections, pulmonary embolism, and acute pancreatitis. Major discrepancies were most commonly observed in patients from the intensive care unit and internal medicine services. In 12.7% of cases, autopsy did not identify a definitive cause of death, particularly among critically ill and multimorbid patients.</p><p><strong>Conclusion: </strong>Major clinicopathological discrepancies (Goldman classes I-II) were identified in approximately one-third of autopsies, most commonly involving malignancies, infections, and cardiovascular diseases. Incorporation of autopsy findings allowed the identification of more clinically relevant diagnostic discrepancies than the initial clinical review alone. In this context, Hospital Mortality Review Committees may contribute to the systematic review of deaths and to the identification of potential areas for diagnostic and healthcare improvement. However, the low autopsy rate and the absence of structured feedback mechanisms may limit the translation of these findings into improvements in clinical practice and quality-of-care processes.</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":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The circular supply chain: a strategic framework for hospital operations in the era of value-based care.","authors":"Soo Hoon Lee, Nicholas M Dalesio, Phillip H Phan","doi":"10.1093/intqhc/mzag102","DOIUrl":"10.1093/intqhc/mzag102","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":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611568","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}