Journal of quality in clinical practice最新文献

筛选
英文 中文
Phenomenon of quality and health-care: Snowball or an avalanche? 质量与医疗保健现象:滚雪球还是雪崩?
Journal of quality in clinical practice Pub Date : 2008-06-28 DOI: 10.1111/j.1440-1762.2001.00402.pp.x
Joseph E Ibrahim PhD, FRACP
{"title":"Phenomenon of quality and health-care: Snowball or an avalanche?","authors":"Joseph E Ibrahim PhD, FRACP","doi":"10.1111/j.1440-1762.2001.00402.pp.x","DOIUrl":"https://doi.org/10.1111/j.1440-1762.2001.00402.pp.x","url":null,"abstract":"<p> <b>Abstract</b> The quality-of-care in health as a phenomenon is developing through small incremental steps. Some suggest this approach is too slow and more rapid change is warranted. It is possible to achieve more rapid change by reaching a ‘tipping point’ or a critical level. To reach a critical level requires (i) identifying key people, (ii) having an idea that sticks, and (iii) having the right context. Examples from selected aspects of quality in health-care including the use of report cards, recognition and remedial action for adverse events, the substantial reviews of health systems for quality-of-care suggest the critical level has been achieved. However, when the three rules for reaching the ‘tipping point’ are examined closely, it would seem that much more work is required to transform quality in health-care from a snowball into an avalanche.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"21 1-2","pages":"40-42"},"PeriodicalIF":0.0,"publicationDate":"2008-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1762.2001.00402.pp.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137715139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The nature and extent of drug-related hospitalisations in Australia 澳大利亚与毒品有关的住院的性质和程度
Journal of quality in clinical practice Pub Date : 2002-02-28 DOI: 10.1046/j.1440-1762.1999.00288.x
EE Roughead BPharm, MAppSc
{"title":"The nature and extent of drug-related hospitalisations in Australia","authors":"EE Roughead BPharm, MAppSc","doi":"10.1046/j.1440-1762.1999.00288.x","DOIUrl":"10.1046/j.1440-1762.1999.00288.x","url":null,"abstract":"<p> <b>Abstract</b> In order to determine the nature and extent of drug-related hospitalisation in Australia, the Australian National Hospital Morbidity Collection, the Quality in Australian Health Care Study and Australian studies assessing drug-related hospital admissions were reviewed. The incidence figures, drugs and conditions most commonly implicated, and estimates of avoidability of medication-related problems were compared. The three data sources were found to provide consistent results, with all sources implicating cytotoxics, antirheumatics, anticoagulants, corticosteroids, antihypertensives and cardiovascular agents in medication-related hospitalisations. Estimates of the extent of the problem were also consistent, suggesting that at least 80 000 medication-related hospitalisations occur in Australia each year; between 32% and 69% of these hospitalisations were considered avoidable. It was concluded that medication-related hospitalisations are a major public health problem in Australia. The avoidability estimates suggest that much can and should be done to reduce this problem.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"19 1","pages":"19-22"},"PeriodicalIF":0.0,"publicationDate":"2002-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1762.1999.00288.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20969004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 97
Towards excellence in quality patient care: A clinical pathway for myocardial infarction 迈向卓越的优质病人护理:心肌梗死的临床途径
Journal of quality in clinical practice Pub Date : 2002-02-28 DOI: 10.1046/j.1440-1762.1999.00311.x
DM Smith RGON, P Gow BMedSc, FRACP, FAFRM
{"title":"Towards excellence in quality patient care: A clinical pathway for myocardial infarction","authors":"DM Smith RGON,&nbsp;P Gow BMedSc, FRACP, FAFRM","doi":"10.1046/j.1440-1762.1999.00311.x","DOIUrl":"10.1046/j.1440-1762.1999.00311.x","url":null,"abstract":"<p> <b>Abstract</b> A major initiative to implement a clinical pathway for myocardial infarction has provided a model on which to further develop pathways within our organization. Two of the primary objectives were to reduce time to thrombolysis and length of stay. Two years after the implementation of the myocardial infarction pathway there has been a reduction in the thrombolysis times from 80 to 49 min and in length of stay from 7.28 to 6.13 days. These results highlight significant improvements in patient and process outcomes. There is heightened awareness about best practice for patients who have sustained myocardial infarctions.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"19 2","pages":"103-105"},"PeriodicalIF":0.0,"publicationDate":"2002-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1762.1999.00311.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21275657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 17
Uncovering the causes of poor quality pathology laboratory services in acute myocardial infarction 揭示急性心肌梗死病理实验室服务质量差的原因
Journal of quality in clinical practice Pub Date : 2002-02-28 DOI: 10.1046/j.1440-1762.1998.00283.x
G ISOUARD BSc, MHA, PhD
{"title":"Uncovering the causes of poor quality pathology laboratory services in acute myocardial infarction","authors":"G ISOUARD BSc, MHA, PhD","doi":"10.1046/j.1440-1762.1998.00283.x","DOIUrl":"10.1046/j.1440-1762.1998.00283.x","url":null,"abstract":"<p>A study was undertaken to identify the causes that contributed to poor quality pathology services for hospitalized patients with acute myocardial infarction. Through the use of continuous quality improvement (CQI) strategies, the procedure involved a systematic process analysis which assessed the types and sources of variation, and possible causal factors for changes in performance. Thirteen suspected causes of poor quality were identified and data collected to confirm or reject their involvement. The study demonstrated that even strongly suspected causes of poor quality need to be confirmed by data. We found that 23% of the suspected root causes were not substantiated by the data collected. The CQI approach was process driven and should be adaptable to other clinical situations and not just pathology services.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"18 4","pages":"233-239"},"PeriodicalIF":0.0,"publicationDate":"2002-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1762.1998.00283.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20771145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Towards safer drug prescribing, dispensing and administration in hospitals 促进医院更安全的药物处方、配药和管理
Journal of quality in clinical practice Pub Date : 2002-02-28 DOI: 10.1046/j.1440-1762.1999.00290.x
PD Thornton BPharm, FSHP, MPS, S Simon RN, BN, TH Mathew MBBS, FRACP
{"title":"Towards safer drug prescribing, dispensing and administration in hospitals","authors":"PD Thornton BPharm, FSHP, MPS,&nbsp;S Simon RN, BN,&nbsp;TH Mathew MBBS, FRACP","doi":"10.1046/j.1440-1762.1999.00290.x","DOIUrl":"10.1046/j.1440-1762.1999.00290.x","url":null,"abstract":"<p> <b>Abstract</b> A multidisciplinary workshop was held in order to identify strategies likely to produce a reduction in adverse drug events, by targeting hospital systems involved in drug prescribing, dispensing and administration. Strategies identified at the workshop included: (i) improving the education and practice development of medical and nursing staff, concerning drug therapy and safe prescribing principles; (ii) introducing and using information technology and electronic prescribing processes; (iii) implementing the Australian Pharmaceutical Advisory Council (APAC) national guidelines to achieve the continuum of quality use of medicines between hospitals and the community; (iv) enhancing the importance of medication history taking as a routine part of the admission process; (v) instituting individual patient supply as the standard method of drug distribution in hospitals; and (vi) stimulating the hospital-based clinical pharmacy workforce.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"19 1","pages":"41-45"},"PeriodicalIF":0.0,"publicationDate":"2002-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1762.1999.00290.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20968957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 35
Addressing adverse events through clinical indicators 通过临床指标处理不良事件
Journal of quality in clinical practice Pub Date : 2002-02-28 DOI: 10.1046/j.1440-1762.1999.00294.x
R Portelli BAppSc (MRA), Grad Cert (Qual Imp in Health Care), B Collopy AM, MBBS, FRCS, FRACS, FRACMA, P Desmond MBBS, FRACP
{"title":"Addressing adverse events through clinical indicators","authors":"R Portelli BAppSc (MRA), Grad Cert (Qual Imp in Health Care),&nbsp;B Collopy AM, MBBS, FRCS, FRACS, FRACMA,&nbsp;P Desmond MBBS, FRACP","doi":"10.1046/j.1440-1762.1999.00294.x","DOIUrl":"10.1046/j.1440-1762.1999.00294.x","url":null,"abstract":"<p> <b>Abstract</b> In an attempt to improve the reporting rate of adverse drug reactions the Adverse Drug Reaction Advisory Committee approached the Australian Council on Healthcare Standards Care Evaluation Program to develop a set of indicators to improve healthcare standards by heightening awareness amongst clinical staff of the morbidity, mortality and financial implications of adverse drug reactions. Ten clinical indicators addressing: (i) reporting of adverse drug reactions; (ii) adherence to treatment protocols for anaphylaxis; (iii) monitoring of warfarin; and (iv) monitoring of streptokinase, were field tested in ten Australian health-care organizations, to determine that the data were available, that the indicators were relevant to clinical practice and that the measures were achievable. Based on the results of this field test, six adverse drug reaction clinical indicators will be introduced into the Australian Council on Healthcare Standards Evaluation and Quality Improvement Program from January 1999.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"19 2","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"2002-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1762.1999.00294.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21275153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
A classification for adverse drug events 药物不良事件的分类
Journal of quality in clinical practice Pub Date : 2002-02-28 DOI: 10.1046/j.1440-1762.1999.00286.x
A Malpass BHSc(Hons), SC Helps MSc, PhD, EJ Sexton RN, DipNsg, D Maiale BPharm, WB Runciman MBBCh, FANZCA, FFICANZCA, FRCA, FHKCA, PhD
{"title":"A classification for adverse drug events","authors":"A Malpass BHSc(Hons),&nbsp;SC Helps MSc, PhD,&nbsp;EJ Sexton RN, DipNsg,&nbsp;D Maiale BPharm,&nbsp;WB Runciman MBBCh, FANZCA, FFICANZCA, FRCA, FHKCA, PhD","doi":"10.1046/j.1440-1762.1999.00286.x","DOIUrl":"10.1046/j.1440-1762.1999.00286.x","url":null,"abstract":"<p> <b>Abstract</b> There is considerable evidence that a large number of patients suffer adverse events arising from their health-care management. A significant proportion of these iatrogenic injuries occur as a result of medication errors. Before prevention strategies can be developed, it is necessary to understand the types of errors that are occurring. In order to set priorities, it is necessary to identify the frequency and impact of the various types of medication errors. To fully investigate medication incidents, it is necessary to classify the information in a way that allows the frequencies, causes and contributing factors to be analysed. The development of a sub-branch of the ‘Generic Occurrence Classification’, specific to medication incidents, allows this analysis to occur.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"19 1","pages":"23-26"},"PeriodicalIF":0.0,"publicationDate":"2002-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1762.1999.00286.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20968953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 22
The Australian National Medicinal Drug Policy 澳大利亚国家药品政策
Journal of quality in clinical practice Pub Date : 2002-02-28 DOI: 10.1046/j.1440-1762.1999.00291.x
L Sansom PhD, FPS
{"title":"The Australian National Medicinal Drug Policy","authors":"L Sansom PhD, FPS","doi":"10.1046/j.1440-1762.1999.00291.x","DOIUrl":"10.1046/j.1440-1762.1999.00291.x","url":null,"abstract":"<p> <b>Abstract</b> A responsibility of Government is to ensure that safe and efficacious medicines are available for people, from local industry, to treat illness and to maintain health. However, the cost of these medications to the public must be such that access is not denied because of financial barriers. Accessibility alone does not ensure that health outcomes are maximized. It is also necessary to have in place structures and processes which involve all stakeholders in ensuring the quality use of medicines. All of these components need to be incorporated in a national, co-ordinated policy which acts as a reference point for appropriate drug use, policy development and evaluation.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"19 1","pages":"31-35"},"PeriodicalIF":0.0,"publicationDate":"2002-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1762.1999.00291.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20968955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 17
Can a PC-based model assist the management of waiting lists? Observations from a case study 基于个人电脑的模式能否协助管理等候名单?来自案例研究的观察
Journal of quality in clinical practice Pub Date : 2002-02-28 DOI: 10.1046/j.1440-1762.1999.00304.x
DP CROMWELL Bsc, MSc, L MAYS Mbbs, MHA, MRACMA
{"title":"Can a PC-based model assist the management of waiting lists? Observations from a case study","authors":"DP CROMWELL Bsc, MSc,&nbsp;L MAYS Mbbs, MHA, MRACMA","doi":"10.1046/j.1440-1762.1999.00304.x","DOIUrl":"10.1046/j.1440-1762.1999.00304.x","url":null,"abstract":"<p> <b>Abstract</b> Routine statistics provide only limited support to doctors and managers responsible for the management of surgical waiting lists. Therefore, a study developed a PC-based model that could assist medium-term planning activities that, for example, aim to reduce excessive waiting times. The model allows the user to create scenarios that describe possible future activity levels and calculates how these will affect waiting list behaviour. A key feature of the model is that it recognizes that a waiting list consists of different categories of patients that move through the list at different speeds. The model can be used with routinely available data. The model was tested at three sites where it proved capable of providing valuable insights and assisting doctors and managers to better understand waiting list dynamics. However, although the model quantified the changes required to reduce waiting times, the sites could not always implement these changes owing to resource constraints.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"19 3","pages":"173-178"},"PeriodicalIF":0.0,"publicationDate":"2002-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1762.1999.00304.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21346402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Care co-ordination improves quality-of-care at South Auckland Health 护理协调提高了南奥克兰保健中心的护理质量
Journal of quality in clinical practice Pub Date : 2002-02-28 DOI: 10.1046/j.1440-1762.1999.00312.x
P Gow BMedSci, FAFRM, FACRM, S Berg BA, MPH, D Smith FRACP, FAFPHM, D Ross RGON, BHSc
{"title":"Care co-ordination improves quality-of-care at South Auckland Health","authors":"P Gow BMedSci, FAFRM, FACRM,&nbsp;S Berg BA, MPH,&nbsp;D Smith FRACP, FAFPHM,&nbsp;D Ross RGON, BHSc","doi":"10.1046/j.1440-1762.1999.00312.x","DOIUrl":"10.1046/j.1440-1762.1999.00312.x","url":null,"abstract":"<p> <b>Abstract</b> Inpatient discharge surveys at Middlemore hospital, a 600 bed hospital in South Auckland, New Zealand, consistently rate communication and co-ordination of care as parameters in need of improvement. A case management model of care was suggested as a means of achieving this. The objective of this study was to determine the effectiveness of care co-ordination in an acute general medical setting in a pilot study over a 4 week period. A care co-ordinator identified 18 patients with complex problems among 48 patients admitted to a single medical ward under the care of a single multidisciplinary team, with their care being co-ordinated over the entire episode of illness. A control group of 59 similarly complex patients admitted to other wards and teams without care co-ordination over the same period was also studied and the outcomes compared. Communication and co-ordination, discharge information, involvement in discharge planning and information on post-discharge services were rated by the study patients as good or very good by 77, 85, 69 and 77%, respectively, compared with 62, 30, 41 and 45% in the control group. The same parameters were rated as poor or very poor by 13, 30, 36 and 15% of the control patients, compared with 0% in all these measures in the study group. Twenty-one clinical staff involved in the study agreed that there was an improvement in care co-ordination with respect to efficiency, reduction of workload and better communication, with approval ratings being 71, 76 and 76%, respectively. There was no difference in Average Length of Stay between the control and study groups, but three of the patients in the control group may have had their preventable readmissions within 10 days avoided if their care had been co-ordinated during their initial admission.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"19 2","pages":"107-110"},"PeriodicalIF":0.0,"publicationDate":"2002-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1440-1762.1999.00312.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21275658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 18
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信