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Clinical performance and quality health care最新文献

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Clinical governance and NICE: a close relationship. 临床治理和NICE:密切的关系。
Clinical performance and quality health care Pub Date : 1999-10-01
P Littlejohns
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引用次数: 0
Clinical governance development needs in health service staff. 卫生服务人员临床治理发展需求。
Clinical performance and quality health care Pub Date : 1999-10-01 DOI: 10.1108/14664109910315569
J Firth-Cozens
{"title":"Clinical governance development needs in health service staff.","authors":"J Firth-Cozens","doi":"10.1108/14664109910315569","DOIUrl":"https://doi.org/10.1108/14664109910315569","url":null,"abstract":"<p><p>This paper reports on a study to ascertain the development needs in terms of clinical governance of 220 health service staff across all the key professions from primary and secondary care, including chief executives and clinical governance leads. Interviews suggested that the development of clinical governance was progressing through the structures created by the leads, and that there was considerable goodwill shown towards it in most of the interviews conducted. Of the participants 69 per cent had heard of clinical governance, though detailed knowledge was rare. The author suggests that development overall needs to be carried out using a multi-disciplinary and multi-agency approach where possible, perhaps using pathways of care. It needs also to take account of the expressed fears from medical staff of discussing their care in a multi-disciplinary setting, and of the two potential conflicting themes that are apparent to chief executives of change towards no-blame cultures, while encouraging account-ability and the recognition of risk.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 4","pages":"155-60"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/14664109910315569","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21785791","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: 28
A cost-effectiveness study of changing medical practice in early pregnancy. 改变妊娠早期医疗实践的成本效益研究。
Clinical performance and quality health care Pub Date : 1999-10-01 DOI: 10.1108/14664109910315596
J Wren, B Craven
{"title":"A cost-effectiveness study of changing medical practice in early pregnancy.","authors":"J Wren,&nbsp;B Craven","doi":"10.1108/14664109910315596","DOIUrl":"https://doi.org/10.1108/14664109910315596","url":null,"abstract":"<p><p>Until recent years women with symptoms consistent with miscarriage either referred themselves or were referred by their doctors to the local Accident and Emergency (A&E) department. This generally resulted in admission to a gynaecological ward and delayed treatment. This paper examines the costs and benefits of an early pregnancy assessment clinic (EPAC), at a teaching hospital in North East England, to deal with the complications in the first trimester. The data show clear benefits together with cost savings. There is an unambiguous policy recommendation to implement the proposed clinic. The paper examines the delivery of service provision and the impact on referral patterns to the A&E department and raises the issue of care provision at the margin. Finally, the authors show the results of an evaluative survey of the clinic from returns of a questionnaire sent to and completed by local general practitioners.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 4","pages":"172-7"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/14664109910315596","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21785794","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
Criteria for determining optimal time of discharge after total hip replacement. 确定全髋关节置换术后最佳出院时间的标准。
Clinical performance and quality health care Pub Date : 1999-10-01 DOI: 10.1108/14664109910315578
J Wong, S Wong
{"title":"Criteria for determining optimal time of discharge after total hip replacement.","authors":"J Wong,&nbsp;S Wong","doi":"10.1108/14664109910315578","DOIUrl":"https://doi.org/10.1108/14664109910315578","url":null,"abstract":"<p><p>Total hip replacement is a common and expensive procedure and any attempt to shorten the length of hospital stay safely is desirable. This paper proposes a scoring system specifically designed for this patient population, to determine the optimal timing of safe discharge and post-acute care placement. The authors discuss the implications for the quality of patient care.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 4","pages":"161-6"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/14664109910315578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21785792","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: 9
The relationship between research and service development: an illustrative example of a pilot study introducing complementary therapies into primary care. 研究与服务发展之间的关系:将补充疗法引入初级保健的试点研究的一个说明性例子。
Clinical performance and quality health care Pub Date : 1999-07-01
B Warburton, J Emanuel, P Elton, M Ruane
{"title":"The relationship between research and service development: an illustrative example of a pilot study introducing complementary therapies into primary care.","authors":"B Warburton,&nbsp;J Emanuel,&nbsp;P Elton,&nbsp;M Ruane","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this paper the commissioners of an evaluation and the researchers jointly review the relationship between research and service development at a local level in an evaluated health authority pilot project to introduce complementary therapies into primary care. The article discusses the importance of organisational arrangements between the research and the service development, focusing on the close working relationship between researchers and stakeholders in the research and corresponding service development. The relationship between the research and service development was not linear and the benefits were not based solely on outcomes of the treatment but also on the ways the evaluation gave insight into how the pilot service was delivered. Factors such as personal commitment to the project and close working relationships by all concerned are important. These elements are rarely emphasised but have to be taken into account if evidence-based health care is to achieve its potential.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 3","pages":"125-9"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21691781","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
Is day case tonsillectomy suitable for children in Cumbria? 在坎布里亚郡，儿童扁桃体切除术是否适用?
Clinical performance and quality health care Pub Date : 1999-07-01
H Kubba, R Messersmith
{"title":"Is day case tonsillectomy suitable for children in Cumbria?","authors":"H Kubba,&nbsp;R Messersmith","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Day case tonsillectomy has been advocated as a means of reducing health-care costs associated with in-patient care. The authors studied 74 consecutive children undergoing conventional overnight stay tonsillectomy using a parental questionnaire and a retrospective case note review. Medical exclusion criteria for day surgery were present in 21 per cent, and social exclusion criteria in 82 per cent. Overall, only 16 per cent of children satisfied all the criteria for suitability. On the day of surgery, 29 per cent of children were reported as having poorly controlled pain and 31 per cent as having nausea and vomiting, such that unplanned admission would have been likely had they been done as day cases. In total 63 per cent of parents were unhappy or very unhappy with the possibility of same day discharge. The authors do not plan to introduce day case tonsillectomy in Cumbria.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 3","pages":"130-3"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21691784","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
Incomplete excision of basal cell carcinomas: an audit. 基底细胞癌的不完全切除:一次审计。
Clinical performance and quality health care Pub Date : 1999-07-01 DOI: 10.1108/14664109910306712
F Schreuder, B W Powell
{"title":"Incomplete excision of basal cell carcinomas: an audit.","authors":"F Schreuder,&nbsp;B W Powell","doi":"10.1108/14664109910306712","DOIUrl":"https://doi.org/10.1108/14664109910306712","url":null,"abstract":"<p><p>The Plastic Surgery Department undertook an audit of the rate of excision of basal cell carcinomas (BCCs) at St George's Hospital. The aim of the audit was to determine the rate of incomplete excision of BCCs excised by the department over a six-month period and compare it with national audit figures. The rate of incomplete excision was 13.73 per cent or seven out of 51 BCCs, which compared favourably with the rates quoted in the literature. No change in the management of basal cell carcinomas was made.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 3","pages":"119-20"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/14664109910306712","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21691779","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: 16
The patients' perspective on clinical governance. 患者对临床治理的看法。
Clinical performance and quality health care Pub Date : 1999-07-01
J Neuberger
{"title":"The patients' perspective on clinical governance.","authors":"J Neuberger","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 3","pages":"116-8"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21691783","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 relationship between research and service development: an illustrative example of a pilot study introducing complementary therapies into primary care. 研究与服务发展之间的关系:将补充疗法引入初级保健的试点研究的一个说明性例子。
Clinical performance and quality health care Pub Date : 1999-07-01 DOI: 10.1108/14664109910306776
B. Warburton, J. Emanuel, P. Elton, M. Ruane
{"title":"The relationship between research and service development: an illustrative example of a pilot study introducing complementary therapies into primary care.","authors":"B. Warburton, J. Emanuel, P. Elton, M. Ruane","doi":"10.1108/14664109910306776","DOIUrl":"https://doi.org/10.1108/14664109910306776","url":null,"abstract":"In this paper the commissioners of an evaluation and the researchers jointly review the relationship between research and service development at a local level in an evaluated health authority pilot project to introduce complementary therapies into primary care. The article discusses the importance of organisational arrangements between the research and the service development, focusing on the close working relationship between researchers and stakeholders in the research and corresponding service development. The relationship between the research and service development was not linear and the benefits were not based solely on outcomes of the treatment but also on the ways the evaluation gave insight into how the pilot service was delivered. Factors such as personal commitment to the project and close working relationships by all concerned are important. These elements are rarely emphasised but have to be taken into account if evidence-based health care is to achieve its potential.","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"26 1","pages":"125-9"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76612870","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: 4
The care pathway: a tool to enhance clinical governance. 护理路径:加强临床治理的工具。
Clinical performance and quality health care Pub Date : 1999-07-01
B W Ellis, S Johnson
{"title":"The care pathway: a tool to enhance clinical governance.","authors":"B W Ellis,&nbsp;S Johnson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A care pathway defines in detail the individual components of treatment for a group of patients. A well-written pathway can lead to consistent care of the highest quality. There are both educational and audit advantages to the approach. The authors detail the means by which groups are selected and the care pathways written. An example of the benefits that can accrue comes from their experience at Ashford Hospital of running a pathway for patients having prostate surgery. The pathways are appreciated by patients, nurses, doctors and managers. Care is improved, costs contained and clinical governance enhanced.</p>","PeriodicalId":79831,"journal":{"name":"Clinical performance and quality health care","volume":"7 3","pages":"134-44"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21691650","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
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