Global journal on quality and safety in healthcare最新文献

{"title":"Impact of Clinical Pharmacy Residents on Medication Reconciliation upon Admission in a Tertiary Care Hospital.","authors":"Mohammed Ali Aseeri, Rawan Bukhari, Sabirin Bakhsh, Marwah Almuzaini, Shouq Turkistani, Khulood Abdulghani","doi":"10.36401/JQSH-25-24","DOIUrl":"10.36401/JQSH-25-24","url":null,"abstract":"<p><strong>Introduction: </strong>Medication errors represent a global issue that can adversely affect patients and healthcare systems. Inappropriate medication reconciliation (MedRec) is the leading cause of prescribing errors, with over 40% of such incidents. Evidence shows that clinical pharmacy resident-run MedRec programs can identify and resolve unintentional medication discrepancies (UMDs) in 60.2% of patients, demonstrating these services' potential impact on patient care. This study evaluated clinical pharmacy residents' impact on MedRec during their clinical rotations in a tertiary care hospital.</p><p><strong>Methods: </strong>This retrospective, observational, single-center study was conducted from November 2021 to the end of March 2022 by four clinical pharmacy residents on adult patients aged 18 years or older who were admitted to the hospital within 48 hours. Data were obtained by using a MedRec form and the hospital's electronic medical record system during a 5-month period. The primary outcome was to measure clinical pharmacy residents' impact on the MedRec service by identifying the number and proportion of UMDs observed among admitted patients during residents' clinical rotations.</p><p><strong>Results: </strong>In total, 205 patients were included, with 193 UMDs identified. Most of the discrepancies were omissions (119 [62%]), followed by non-compliance (20 [11%]), commission (19 [9%]), and duplication (13 [7%]). Healthcare providers accepted 151 (86%) physician-directed interventions. Resumption of medication was the most common intervention, accounting for 66% of all interventions.</p><p><strong>Conclusion: </strong>Clinical pharmacy residents significantly contribute to improving medication safety by detecting and resolving UMDs during patient admission. Their involvement highlights the value of pharmacist-led MedRec and supports its integration as a core element of residency training to reduce adverse drug events and improve outcomes.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 3","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414018","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":"Improving Effective Prenatal Care for New Obstetric Patients Using a Standardized Intake Template and Pregnancy Risk Calculator.","authors":"Morgan De Kleine, Sharanna S Johnson, Kaya S Belknap","doi":"10.36401/JQSH-25-22","DOIUrl":"10.36401/JQSH-25-22","url":null,"abstract":"<p><strong>Introduction: </strong>Kenya has the 16^th highest maternal mortality rate and the 58^th highest infant mortality rate in the world. Most of these deaths are preventable and attributed to inadequate prenatal care. A chart audit at Africa Inland Church Kijabe Hospital revealed significant gaps in care at the initial prenatal visit. This project aimed to increase effective prenatal care for all new obstetric patients seen at the Maternal and Child Health Clinic to 75% within 8 weeks.</p><p><strong>Methods: </strong>This quality improvement initiative consisted of two core interventions implemented over four Plan-Do-Study-Act cycles. Each 2-week cycle was guided by a test of change, and the data were analyzed at the end of each cycle. The first core intervention was implementing a new obstetric standard of care, based on 32 evidence-based guidelines from the World Health Organization and the Kenya Ministry of Health, which were embedded into a standardized intake template at the initial prenatal visit. The second core intervention was implementing a pregnancy risk calculator, using the Alberta Antenatal Risk Assessment, to classify each new obstetric patient's pregnancy as low, moderate, or high risk.</p><p><strong>Results: </strong>This project achieved its aim statement and increased effective prenatal care from 21% to 77% in 8 weeks. Implementing the standardized intake template increased the mean standard-of-care score from 42% to 83%, with the greatest improvements seen in documenting a complete medical history and ordering prenatal labs. The number of high- or moderate-risk pregnancies identified was 33%, providing an opportunity for timely referral to the high-risk pregnancy clinic.</p><p><strong>Conclusion: </strong>The tools used in this quality improvement initiative provided a low-cost method to promote high-quality prenatal care. The standardized intake template can be adapted to other countries and contexts; further studies are needed to evaluate its impact on birth outcomes. This is the first known report of the implementation of a pregnancy risk calculator in Kenya to identify high-risk pregnancies. Further research is needed to analyze its effectiveness and to develop and validate a pregnancy risk calculator for sub-Saharan Africa.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 3","pages":"71-80"},"PeriodicalIF":0.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407315","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":"Outcomes of Depression and Anxiety in a Virtual Collaborative Care Program: A Quality Improvement Study.","authors":"Allison O'Mara, Esra Uyanik, Jason Caplan, Erum Azhar","doi":"10.36401/JQSH-26-1","DOIUrl":"10.36401/JQSH-26-1","url":null,"abstract":"<p><strong>Introduction: </strong>Behavioral health conditions affect a substantial proportion of the United States population each year, yet many individuals do not receive treatment due to multiple barriers. The Clinically Optimal Access to Collaborative Healthcare (COACH) program is a virtual implementation of the Collaborative Care Model (CCM) that addresses these barriers.</p><p><strong>Methods: </strong>This was a retrospective study evaluating the outcomes of a QI project aimed at improving the care of patients with major depressive disorder (MDD) and/or generalized anxiety disorder (GAD) through enrollment into the COACH Program from Nov 1, 2021, to Oct 31, 2024. Patient Health Questionnaire-9 (PHQ-9), GAD-7 scores, and demographics were collected from electronic medical records at baseline and 3 and 6 months after enrollment in the COACH program. Remission and attrition rates were calculated at 3 and 6 months. A phase analysis over 18 months was conducted of PHQ-9 and GAD-7 mean scores before and after enrollment in the COACH program A paired <i>t</i>-test was used to assess changes in scores from baseline to follow-up, with statistical significance set at <i>p</i> < 0.05, using SPSS.</p><p><strong>Results: </strong>A total of 531 patients were included in the analysis (median age 45 y, 50% White, 27% Hispanic). Most patients were referred from primary care provider (PCP) offices (95%) and spoke English (99%). Fifty-four percent (<i>n</i> = 284) had MDD as a primary diagnosis, and 75% (<i>n</i> = 211) had GAD as a secondary diagnosis. By 3 months, 32% with MDD and 40.1% with GAD achieved remission with an overall attrition of 26%. Over 18 months, the phase analysis showed that post-intervention mean monthly PHQ-9 and GAD-7 scores dropped from 11.8 to 7.5 and 10.8 to 6.4, respectively, indicating a shift in the process, which was statistically significant (<i>p</i> < 0.001 and < 0.0001, respectively).</p><p><strong>Conclusion: </strong>The care provided using the COACH Program was associated with a reduction in depression and anxiety symptoms at 3 and 6 months, achieving significant remission rates, while maintaining good patient engagement. The COACH program, as an iteration of the collaborative care model, presents an alternative for the traditional delivery of care for anxiety and depression.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 3","pages":"63-70"},"PeriodicalIF":0.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407309","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":"Clinical Audit: Improving Clinical Performance for Patient Safety.","authors":"Mohammed Sameer","doi":"10.36401/JQSH-26-X4","DOIUrl":"10.36401/JQSH-26-X4","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 3","pages":"60-62"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363925","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 Societal and Economic Burden of COPD in Saudi Arabia.","authors":"Gihan El-Sisi, Waleed AlSowayan, Yahya Habis, Amr Alwakeel, Hussein Aljuwayed, Bader Jammah Alghamdi, Riyad Al-Lehebi, Nesreen Tayeb, Yousra Hamid, Aljawharah Alkoraishi, Nabila S Ben Slimane, Maha Abushal, Wedad Alnemari","doi":"10.36401/JQSH-25-20","DOIUrl":"10.36401/JQSH-25-20","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is a chronic, inflammatory, progressive respiratory disease characterized by chronic symptoms, such as cough, dyspnea, and expectoration, owing to persistent airway abnormalities that can lead to airflow limitations and inflammation, increasing the risk of exacerbations. Exacerbations are a characteristic feature of moderate and severe COPD, and they are considered a main cause of morbidity, mortality, and reduced quality of life. Patients with moderate to severe COPD are more susceptible to future exacerbations, which usually necessitate hospital admission and readmission, imposing a devastating burden on patients' quality of life and daily activities while posing an enormous burden on healthcare systems. This study aimed to assess the societal and economic burden of different COPD severity stages and their associated events among adult patients in Saudi Arabia over a 10-year period.</p><p><strong>Methods: </strong>A prevalence- and incidence-based cost-of-illness Markov model was constructed in Microsoft Excel 365 to estimate the direct medical and indirect costs incurred by patients with COPD in Saudi Arabia. The model projects the burden over 10 years. We developed a state-transition Markov model comprising five health states defined by exacerbation status. The five health states included: no exacerbations, one moderate exacerbation; two or more moderate exacerbations; one or more severe exacerbations; and death. Based on the ABE scheme classification in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, we mapped the health states accordingly; the no exacerbation state was considered equivalent to A₀/B₀; one moderate exacerbation corresponded to A1/B1; and the E group was equally divided between patients experiencing two or more moderate exacerbations and those with one or more severe exacerbations. A 4-week cycle was used to capture changes in health states based on exacerbation status. Sensitivity analysis was conducted.</p><p><strong>Results: </strong>The total cost per patient per year was estimated at SAR 273,874 ($148,040 USD). The percent of work impairment among patients with moderate or severe exacerbations of COPD was the most impactful parameter that could increase costs.</p><p><strong>Conclusion: </strong>COPD imposes a substantial and growing burden on the Saudi economy, both in terms of direct and indirect medical costs. Our findings underscore the need to adopt policies that ensure comprehensive prevention and management strategies.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 3","pages":"50-59"},"PeriodicalIF":0.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297528","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":"Effectiveness of Plan-Do-Check-Act Approach in Improving Patient Satisfaction and Quality of Care in Parenteral Iron Deficiency Treatment.","authors":"Rehab Y Al-Ansari, Alexander Woodman, Sami Abuanz, Tawasoul Fadoul, Aida Ortiguerra, Brenda C Reyes, Kamal Al-Zahrani, Muhammad F Abdellatif, Nada Rajab Alzahrani","doi":"10.36401/JQSH-25-14","DOIUrl":"10.36401/JQSH-25-14","url":null,"abstract":"<p><strong>Introduction: </strong>Given the high incidence of iron deficiency anemia (IDA) in Saudi Arabia, this quality improvement research project was initiated to improve patient care by establishing an intravenous (IV) iron administration room with the use of two cycles of plan-do-check-act (PDCA) model.</p><p><strong>Methods: </strong>The first PDCA cycle began in September 2018, and the second in the second half of 2021. Comparisons were made between these cycles, based on the total number of hospitalizations, admission waiting times, patient satisfaction, and cost-effectiveness. After the intervention, comparisons of results for each improvement area were verified with benchmarks.</p><p><strong>Results: </strong>After the first PDCA cycle, hospitalizations increased by 72.88%, and the wait time for IV iron therapy was reduced to 10 weeks, resulting in savings of approximately 1,329,120 SAR ($354,093.77 USD). A comparison of baseline data as of September 2018 and the first PDCA cycle showed a significant improvement (<i>p</i> ≤ 0.0002). After the second PDCA cycle, a further increase in patient satisfaction with a total score of ± 95%, a reduction in waiting time to less than 1 week, and a cost-effectiveness of approximately 3,557,952 SAR ($947,881.78 USD) were achieved. At follow-up, significant improvements were also observed, reflecting maintenance of results with subsequent changes in type IV iron levels (<i>p</i> ≤ 0.0001).</p><p><strong>Conclusion: </strong>The creation of an IV administration room dedicated to parenteral procedures resulted in reduced patient wait times, improved quality of care, increased patient satisfaction, increased bed occupancy, and substantial cost savings.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 2","pages":"39-49"},"PeriodicalIF":0.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038293","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":"Abstracts for the 2026 Innovations in Healthcare Quality and Safety Summit: May 9, 2026 (Virtual).","authors":"","doi":"10.36401/JQSH-26-X3","DOIUrl":"https://doi.org/10.36401/JQSH-26-X3","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 2","pages":"18-38"},"PeriodicalIF":0.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038287","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":"Reply to Zhao: Integrating Implementation Science in Quality Improvement for Patient Discharge Optimization.","authors":"Sultanah Alharbi, Lamia Elmassry, Eidah Aljuaid, Abdulrahman Attar, Josethe Nuñez, Minimol Joseph, Kristin Diamat, Meshari Alzahrani, Saud Algubaishi","doi":"10.36401/JQSH-26-X1","DOIUrl":"10.36401/JQSH-26-X1","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 2","pages":"14-15"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438234","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":"Exploring the Generalizability of Discharge Process Optimization: An Implementation Science Perspective.","authors":"Daren Zhao","doi":"10.36401/JQSH-25-25","DOIUrl":"10.36401/JQSH-25-25","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 2","pages":"12-13"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438204","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":"Why Do Healthcare Gaps Persist Despite Strong Evidence? A Proposed Conceptual Framework for Real-World Implementation.","authors":"Abdul Rahman Jazieh","doi":"10.36401/JQSH-26-X2","DOIUrl":"10.36401/JQSH-26-X2","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"9 2","pages":"16-17"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438194","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}