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Clinical performance and quality health care最新文献

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Comparison of clinical indicators for performance measurement of health care quality: a cautionary note. 卫生保健质量绩效衡量临床指标的比较:一个警示性说明。
Clinical performance and quality health care Pub Date : 2000-12-01 DOI: 10.1108/14664100010361755
Peter A. Gross, B. Braun, S. Kritchevsky, B. Simmons
{"title":"Comparison of clinical indicators for performance measurement of health care quality: a cautionary note.","authors":"Peter A. Gross, B. Braun, S. Kritchevsky, B. Simmons","doi":"10.1108/14664100010361755","DOIUrl":"https://doi.org/10.1108/14664100010361755","url":null,"abstract":"The use of clinical performance data is increasing rapidly. Yet, substantial variation exists across indicators designed to measure the same clinical event. We compared indicators from several indicator measurement systems to determine the consistency of results. Five measurement systems with well-defined indicators were selected. They were applied to 24 hospitals. Indicators for mortality from coronary artery bypass graft surgery and mortality in the perioperative period were chosen from these measurement systems. Analyses results and concludes that it is faulty to assume that clinical indicators derived from different measurement systems will give the same rank order. Widespread demand for external release of outcome data from hospitals must be balanced by an educational effort about the factors that influence and potentially confound reported rates.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"163 1","pages":"202-11"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86393805","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: 26
An audit of psychiatric case notes in relation to antipsychotic medication and information giving. 精神病病例记录的审计与抗精神病药物和信息提供。
Clinical performance and quality health care Pub Date : 2000-12-01 DOI: 10.1108/14664100010361773
N. Bowler, Susanna Moss, M. Winston, M. Coleman
{"title":"An audit of psychiatric case notes in relation to antipsychotic medication and information giving.","authors":"N. Bowler, Susanna Moss, M. Winston, M. Coleman","doi":"10.1108/14664100010361773","DOIUrl":"https://doi.org/10.1108/14664100010361773","url":null,"abstract":"This paper reports upon a Welsh Office funded \"clinical effectiveness\" project. The project aimed to produce evidence-based practice guidelines for depot neuroleptic medication. An audit was conducted to establish current practice regarding the provision of illness and treatment specific information to out-patients and their informal carers. Sixty-five patients' case-notes, under the care of a single community mental health team were examined for evidence of the type, nature and frequency of information given to patients receiving typical depot neuroleptic medications. Service guidelines were produced and are presented.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"1 1","pages":"212-6"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90119461","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: 5
Risk management in practice: how are we managing? 实践中的风险管理:我们如何管理?
Clinical performance and quality health care Pub Date : 2000-09-01 DOI: 10.1108/14664100010351251
A. Harris
{"title":"Risk management in practice: how are we managing?","authors":"A. Harris","doi":"10.1108/14664100010351251","DOIUrl":"https://doi.org/10.1108/14664100010351251","url":null,"abstract":"Aims to identify awareness of and involvement in risk assessments, training, incident reporting, information giving and consenting in an acute health care context. Explores how nurse managers perceived risk management as a concept and if they saw advanced neonatal nurse practitioners having a role to play in this activity. The method used was a postal survey of 62 nurse managers or clinical specialists responsible for neonatal nursing care services within NHS Trusts in the UK. Results show that while the nurse managers studies understood the definition of risk management in general, they were more vague about certain aspects of that definition. The nurse managers appeared to be passive in their dissemination and taking forward of risk management strategies, rather than proactively \"promoting and helping them forward\" as may be expected in facilitative managerial behaviour. Concludes that the challenges of clinical governance demand more proactive approaches to effect and demonstrate change, and support ongoing clinical quality improvements.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"39 1","pages":"142-9"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81812963","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: 12
Clinical governance: its origins and its foundations. 临床治理:起源和基础。
Clinical performance and quality health care Pub Date : 2000-09-01 DOI: 10.1108/14777270010734055
S. Nicholls, R. Cullen, S. O'Neill, A. Halligan
{"title":"Clinical governance: its origins and its foundations.","authors":"S. Nicholls, R. Cullen, S. O'Neill, A. Halligan","doi":"10.1108/14777270010734055","DOIUrl":"https://doi.org/10.1108/14777270010734055","url":null,"abstract":"This article from the NHS Clinical Governance Support Team (NCGST) outlines the development of quality concerns since the NHS was founded in 1948. It traces the development of clinical governance as a means of achieving continuous quality improvement and describes what the implementation of clinical governance means for patients and professionals. It analyses features of the cultural shift necessary to underpin quality improvement initiatives and describes with practical examples the constituents of the culture necessary for successful clinical governance. Future articles in this series will address other issues around clinical governance and will explain the model being followed by delegates to the NCGST's Clinical Governance Development Programme as they implement clinical governance \"on the ground\".","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"30 1","pages":"172-8"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72980226","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: 85
A strategic approach to falls prevention. 预防跌倒的战略方针。
Clinical performance and quality health care Pub Date : 2000-09-01 DOI: 10.1108/14664100010351233
Maureen Carson, Jonathan Cook
{"title":"A strategic approach to falls prevention.","authors":"Maureen Carson, Jonathan Cook","doi":"10.1108/14664100010351233","DOIUrl":"https://doi.org/10.1108/14664100010351233","url":null,"abstract":"As part of the Trust's clinical governance arrangements and to facilitate a systematic approach to clinical governance a risk assessment was conducted. This assessment identified that falls were a significant risk of patients, both during episodes of in-patient care and in their own homes. There is little evidence nationally to guide good practice; therefore a multidisciplinary steering group was set up to develop a comprehensive approach to falls prevention. This resulted in the development of evidence based falls prediction tools, Trust policy and guidelines and extensive staff training programmes. Information leaflets have been provided to patients and additional services such as falls groups have been developed.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"1 1","pages":"136-41"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87194190","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: 8
Clinical effectiveness on an acute in-patient psychiatric unit. 急性精神科住院病人的临床效果。
Clinical performance and quality health care Pub Date : 2000-09-01 DOI: 10.1108/14664100010352557
E. H. Collier, S. Pyke
{"title":"Clinical effectiveness on an acute in-patient psychiatric unit.","authors":"E. H. Collier, S. Pyke","doi":"10.1108/14664100010352557","DOIUrl":"https://doi.org/10.1108/14664100010352557","url":null,"abstract":"The paper outlines a model for addressing clinical effectiveness, and an illustration of how this is practically implemented through team working in a multidisciplinary in-patient environment. This is particularly relevant given the number of recent reports that highlight the need to develop and invest in the in-patient services. The difficulty in implementing evidence-based practice for mental health interventions is also addressed and initiatives being developed to enable a realistic approach in such an environment are described. The paper describes a structure and a process, using examples from audit, research and other initiatives particular to the unit, in providing accessible evidence based interventions for ward based staff, and improved clinical effectiveness generally.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"30 1","pages":"158-63"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73229329","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: 5
Clinical governance and clinical documentation: still a long way to go? 临床治理和临床文献:还有很长的路要走?
Clinical performance and quality health care Pub Date : 2000-09-01 DOI: 10.1108/14777270010734064
J. Cowan
{"title":"Clinical governance and clinical documentation: still a long way to go?","authors":"J. Cowan","doi":"10.1108/14777270010734064","DOIUrl":"https://doi.org/10.1108/14777270010734064","url":null,"abstract":"Maintaining good standards of clinical documentation remains a problem in the health service despite continued and consistent advice from protection organisations and professional bodies over many years. This article discusses some of the issues that arise from poor quality note keeping and the need for improvement and the establishment of basic minimum standards for all health records. Requirements are now being placed on NHS bodies to ensure that effective and robust systems are in place to ensure that record management meets Controls Assurance Standards and CNST standards. This article stresses the need to put the current house in order before we lose any opportunities to influence those aspects of electronic systems where appropriate risk management should help reduce the potential for documentation error.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"21 1","pages":"179-82"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80064610","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: 24
Case management: a controlled evaluation of persons with diabetes. 病例管理:对糖尿病患者进行对照评估。
Clinical performance and quality health care Pub Date : 2000-06-01 DOI: 10.1108/14664100010344006
S. Lob, N. Kohatsu
{"title":"Case management: a controlled evaluation of persons with diabetes.","authors":"S. Lob, N. Kohatsu","doi":"10.1108/14664100010344006","DOIUrl":"https://doi.org/10.1108/14664100010344006","url":null,"abstract":"Case management has been widely used with the intent of improving clinical outcomes while reducing medical costs. Studies of case management, however, have shown variable effectiveness. This study assessed the impact of a state health department case management program on hospitalizations, emergency department (ED) visits, and preventive services among persons with diabetes receiving Medicaid fee-for-service health care. The patients enrolled in the non-disease-specific case management program were low-income, chronically ill and medically complex. Nurse case managers authorized and coordinated services in the home for these patients and established links to health-care professionals and community resources. A retrospective, non-randomized, controlled time series design using paid claims files was employed. Case management reduced admissions and hospital days but did not significantly impact ED visits or use of preventive services.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"58 2 1","pages":"105-11"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88442003","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: 10
Management of nasal trauma--widespread misuse of radiographs. 鼻外伤的处理——普遍滥用x线片。
Clinical performance and quality health care Pub Date : 2000-06-01 DOI: 10.1108/14664100010343872
A. F. Oluwasanmi, A. L. Pinto
{"title":"Management of nasal trauma--widespread misuse of radiographs.","authors":"A. F. Oluwasanmi, A. L. Pinto","doi":"10.1108/14664100010343872","DOIUrl":"https://doi.org/10.1108/14664100010343872","url":null,"abstract":"OBJECTIVE\u0000To assess the reasons behind the widespread use of X-ray in the management of nasal trauma despite the fact that it has no useful purpose, comparing the responses of doctors in Accident and Emergency (A&E) departments between the District General Hospitals (DGH) and the Teaching Hospitals.\u0000\u0000\u0000METHOD\u0000A multiple-choice questionnaire was sent to all doctors in Accidents and Emergency departments in the North-West Region of England.\u0000\u0000\u0000RESULT\u0000212 questionnaires were sent out and 159 were returned. Amongst the 92 (57.9 per cent) doctors who use nasal radiographs, the overall most common reason is medico-legal in 48 (52.1 per cent). A high proportion of DGH doctors use radiographs for diagnostic purposes and 35 (28.9 per cent) will refer patients based on X-ray demonstration of nasal bone fracture. Other stated reasons included detection of unsuspected facial fracture, diagnosis of compound nasal fracture and foreign body detection.\u0000\u0000\u0000CONCLUSION\u0000Doctors need to be better informed that nasal radiography has no useful value. A clear clinical guideline should be set up nationwide to protect patients from unnecessary exposure to radiation. This will also save the time of the doctors, radiographers and patients. It will prevent inappropriate referrals. Money and other resources will therefore be better utilized.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"52 1","pages":"83-5"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75013256","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: 21
An evidence-based patient information leaflet about otitis media with effusion. 关于积液中耳炎的循证患者信息传单。
Clinical performance and quality health care Pub Date : 2000-06-01 DOI: 10.1108/14664100010343908
H. Kubba
{"title":"An evidence-based patient information leaflet about otitis media with effusion.","authors":"H. Kubba","doi":"10.1108/14664100010343908","DOIUrl":"https://doi.org/10.1108/14664100010343908","url":null,"abstract":"Leaflets are a useful resource for information provision. Many otolaryngology patients have poor reading skills, and may have difficulty understanding medical jargon. The aim of this project was to produce a patient information leaflet on otitis media with effusion whose content is based on the best available research evidence, and which is presented in a clear format with simple language. Patients were involved at the planning stage, and in testing the final draft. The leaflet was preferred by the majority compared to existing information material and was felt to be more informative and easier to understand. The leaflet has been given the Crystal Mark for clarity of language by the Plain English Campaign. This study shows that existing guidelines can be used to improve the quality of written information provision.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"1 1","pages":"93-9"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91113246","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: 14
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