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Healthcare Quality (healthcare + quality)
Selected AbstractsHospital Patient Safety Levels among Healthcare's "Most Wired" InstitutionsJOURNAL FOR HEALTHCARE QUALITY, Issue 2 2010Feliciano Yu Abstract: Our study compared adverse patient safety events among hospitals that have received the distinction "Most Wired" as rated by the Hospital and Health Network publication versus comparison hospitals. Risk-adjusted Patient Safety Indicators (PSIs) were calculated for 558 general adult medical/surgical hospitals participating in the Agency for Healthcare Quality and Research's Nationwide Inpatient Sample. When compared using mean risk-adjusted PSI rates, no significant differences in performance for specific PSIs were observed between hospitals affiliated with the "Most Wired" label and those without the designation using objective measures of safety. [source] Interview with a Quality Leader,Karen Davis, Executive Director of The Commonwealth FundJOURNAL FOR HEALTHCARE QUALITY, Issue 2 2009Lecia A. Albright Dr. Davis is a nationally recognized economist, with a distinguished career in public policy and research. Before joining the Fund, she served as chairman of the Department of Health Policy and Management at The Johns Hopkins School of Public Health, where she also held an appointment as professor of economics. She served as deputy assistant secretary for health policy in the Department of Health and Human Services from 1977 to 1980, and was the first woman to head a U.S. Public Health Service agency. Before her government career, Ms. Davis was a senior fellow at the Brookings Institution in Washington, DC; a visiting lecturer at Harvard University; and an assistant professor of economics at Rice University. A native of Oklahoma, she received her PhD in economics from Rice University, which recognized her achievements with a Distinguished Alumna Award in 1991. Ms. Davis is the recipient of the 2000 Baxter-Allegiance Foundation Prize for Health Services Research. In the spring of 2001, Ms. Davis received an honorary doctorate in human letters from John Hopkins University. In 2006, she was selected for the Academy Health Distinguished Investigator Award for significant and lasting contributions to the field of health services research in addition to the Picker Award for Excellence in the Advancement of Patient Centered Care. Ms. Davis has published a number of significant books, monographs, and articles on health and social policy issues, including the landmark books HealthCare Cost Containment, Medicare Policy, National Health Insurance: Benefits, Costs, and Consequences, and Health and the War on Poverty. She serves on the Board of Visitors of Columbia University, School of Nursing, and is on the Board of Directors of the Geisinger Health System. She was elected to the Institute of Medicine (IOM) in 1975; has served two terms on the IOM governing Council (1986,90 and 1997,2000); was a member of the IOM Committee on Redesigning Health Insurance Benefits, Payment and Performance Improvement Programs; and was awarded the Adam Yarmolinsky medal in 2007 for her contributions to the mission of the Institute of Medicine. She is a past president of the Academy Health (formerly AHSRHP) and an Academy Health distinguished fellow, a member of the Kaiser Commission on Medicaid and the Uninsured, and a former member of the Agency for Healthcare Quality and Research National Advisory Committee. She also serves on the Panel of Health Advisors for the Congressional Budget Office. [source] Patient-orientated web sites on laryngectomy: is their information readable?EUROPEAN JOURNAL OF CANCER CARE, Issue 6 2009L. POTHIER m, language therapist , macmillan, speech POTHIER L. & POTHIER D.D. (2009) European Journal of Cancer Care Patient-orientated web sites on laryngectomy: is their information readable? The objective of the study was to determine levels of readability of commonly accessed websites containing patient information on laryngectomy. A Cross-sectional study of Internet websites was designed. The first 20 websites obtained from a GoogleŽ search of the word "laryngectomy" that contained a patient information section were selected. Primary outcome measures were the Flesch Readability Ease Score (FRE) and Flesch-Kincaid readability grade (FKRG) score; from these data UK reading age was calculated. The secondary outcome measure was whether or not a site was accredited by an online readability organisation. The reading ages of the 20 sites ranged from 7.8 to 14.7 years with a median of 11.7 years. Half of the Flesch Reading Ease scores were in the "Difficult" or "Fairly difficult" category with 30% falling into the "Standard" or "Fairly easy" categories. Only 20% sites fell into the "Easy" or "Very Easy" categories that are the recommended level for comprehension by the general UK population. Sites not accredited by an online healthcare quality and content control organisation had worse readability scores than those that were not (FRE: p = 0.007, FKRG: p = 0.012). The poor readability of many of the encountered sites about laryngectomy on the Internet may confuse patients who turn to the Internet for information. Methods to improve patient information websites are discussed. [source] Validity of the indicator ,death in low-mortality diagnosis-related groups' for measuring patient safety and healthcare quality in hospitalsINTERNAL MEDICINE JOURNAL, Issue 4 2010S. Mihrshahi Abstract The indicator ,death in low-mortality diagnosis-related groups (DRG)' is a patient safety indicator (PSI) that can be derived from routinely collected administrative data sources. It is included in a group of PSI that have been proposed to compare and monitor standards of hospital care in Australia. To summarize the attributes of this indicator as a measure of quality and safety in healthcare and examine issues regarding the development process, definitions and use of the indicator in practice. A structured literature search was conducted using the Ovid Medline database to identify peer-reviewed published literature which used ,death in low-mortality DRG' as a quality/safety indicator. Key quality websites were also searched. The studies were critically appraised using a standardized method. A total of 12 articles was identified which met our search criteria. Most were of low methodological quality because of their retrospective study designs. Only three studies provided evidence that the quality of care gap is higher in ,deaths in low-mortality DRG' than in other cases. Most of the studies reviewed show that there are several limitations of the indicator for assessing patient safety and quality of care. The few studies that have assessed associations with other measures of hospital quality have shown only weak and inconsistent associations. Higher quality, prospective, analytic studies are required before ,death in low-mortality DRG' is used as an indicator of quality and safety in healthcare. Based on current evidence, the most appropriate use is as a screening tool for institutions to quickly and easily identify a manageable number of medical records to investigate in more detail. [source] Does Pediatric Patient-Centeredness Affect Family Trust?JOURNAL FOR HEALTHCARE QUALITY, Issue 3 2010Stephen J. Aragon Abstract: Despite its recognition as a key dimension of healthcare quality, it is often unclear what exactly patient-centeredness means. A generally accepted measurement model of patient-centeredness is still nonexistent, current operational definitions lack sufficient specificity to inform providers how it relates to outcomes, and the influence of patient-centeredness on pediatric patients and families has not been quantified. This study demonstrates that patient-centeredness is a measurable ability of pediatricians that increases family trust. As an ability, it is teachable. The study offers an evidence-based model for future research with specific implications for quality measurement and improvement in the outpatient pediatrician's office. [source] Interview with a Quality Leader: Dale W. Bratzler, DO, MPH on Performance MeasuresJOURNAL FOR HEALTHCARE QUALITY, Issue 2 2010Jason Trevor Fogg Abstract: Dale Bratzler, DO, MPH, currently serves as the President and CEO of the Oklahoma Foundation for Medical Quality (OFMQ). In addition, he provides support as the Medical Director of the Patient Safety Quality Improvement Organization Support Center at OFMQ. In these roles, he provides clinical and technical support for local and national hospital quality improvement initiatives. He is a Past President of the American Health Quality Association and a recent member of the National Advisory Council for the Agency for Healthcare Research and Quality. Dr. Bratzler has published extensively and frequently presents locally and nationally on topics related to healthcare quality, particularly associated with improving care for pneumonia, increasing vaccination rates, and reducing surgical complications. He received his Doctor of Osteopathic Medicine degree at the Kansas City University of Medicine and Biosciences, and his Master of Public Health degree from the University of Oklahoma Health Sciences Center College of Public Health. Dr. Bratzler is board certified in internal medicine. [source] Effect of non-response bias in pressure ulcer prevalence studiesJOURNAL OF ADVANCED NURSING, Issue 2 2006Nils Lahmann BA RN Aim., This paper reports a study to determine the prevalence of pressure ulcers in German hospitals and nursing homes for national and international comparison, and analyses the influence of non-response bias. Background., Outcome rates are often used to evaluate provider performance. The prevalence of pressure ulcers is seen as a possible parameter of outcome healthcare quality. However, the results from different pressure ulcer prevalence studies cannot be compared, because there is no standardized methodology and terminology. Observed and published prevalence rates may reflect variations in quality of care, but differences could also relate to differences in case-mix or to random variation. Methods., A point prevalence survey was carried out for 2002 and 2003 using data from 21,574 patients and residents in 147 different kinds of institutions throughout Germany. Participation rates and reasons for not participating in the study were documented. Non-responders were considered in different calculations to show the range of possible prevalence rate for a hypothetic 100% participation. Results., In 2002 and 2003, the calculated prevalence rate (among participating persons at risk) in hospitals was 25ˇ1% and 24ˇ2% respectively, while in nursing homes it was 17ˇ3% and 12ˇ5% respectively. Non-response varied from 15ˇ1% to 25ˇ1%. The majority of non-responders in hospitals and nursing homes had not been willing to participate in the study. Based on different assumptions about the characteristics of the non-responders, we calculated minimum and maximum prevalence rates as if 100% participation was achieved. Conclusions., Calculating the non-response bias of prevalence rates is an inconvenient but necessary thing to do because its influence on calculated prevalence rates was high in this study. High participation rates in clinical studies will minimize non-response bias. If non-response cannot be avoided, the formula provided will help researchers calculate possible minimum and maximum prevalence rates for the total sample of both the responding and non-responding groups. [source] Multi-institutional study of barriers to research utilisation and evidence-based practice among hospital nursesJOURNAL OF CLINICAL NURSING, Issue 13-14 2010Caroline E Brown Aims., The study aims were to explore the relationships between perceived barriers to research use and the implementation of evidence-based practice among hospital nurses and to investigate the barriers as predictors of implementation of evidence-based practice. Background., Evidence-based practice is critical in improving healthcare quality. Although barriers to research use have been extensively studied, little is known about the relationships between the barriers and the implementation of evidence-based practice in nursing. Design., Cross-sectional study. Method., Data were collected between December 2006,January 2007 for this cross-sectional study using computerised Evidence-Based Practice Questionnaire and BARRIERS surveys. A convenience sample (n = 1301) of nurses from four hospitals in southern California, USA, participated. Hierarchical multiple regression analyses were performed for each of the three dependent variables: practice, attitude and knowledge/skills associated with evidence-based practice. BARRIERS subscales were used as predictor variables. Results., The perceived barriers to research use predicted only 2ˇ7, 2ˇ4 and 4ˇ5% of practice, attitude and knowledge/skills associated with evidence-based practice. Conclusions., It was unexpected that the barriers to research use predicted such small fractions of practice, attitude and knowledge/skills associated with evidence-based practice. The barriers appear to have minimal influence over the implementation of evidence-based practice for most hospital nurses. Relevance to clinical practice., In implementing evidence-based practice, the focus on barriers to research use among general nursing staff may be misplaced. Further studies are needed to identify the predictors of evidence-based practice and to identify the subset of nurses who are most amenable to adopting evidence-based practice. [source] International Experts' Perspectives on the State of the Nurse Staffing and Patient Outcomes LiteratureJOURNAL OF NURSING SCHOLARSHIP, Issue 4 2007Koen Van den Heede Purpose: To assess the key variables used in research on nurse staffing and patient outcomes from the perspective of an international panel. Design: A Delphi survey (November 2005-February 2006) of a purposively-selected expert panel from 10 countries consisting of 24 researchers specializing in nurse staffing and quality of health care and 8 nurse administrators. Methods: Each participant was sent by e-mail an up-to-date review of all evidence related to 39 patient-outcome, 14 nurse-staffing and 31 background variables and asked to rate the importance/usefulness of each variable for research on nurse staffing and patient outcomes. In two subsequent rounds the group median, mode, frequencies, and earlier responses were sent to each respondent. Findings: Twenty-nine participants responded to the first round (90.6%), of whom 28 (87.5%) responded to the second round. The Delphi panel generated 7 patient-outcome, 2 nurse-staffing and 12 background variables in the first round, not well-investigated in previous research, to be added to the list. At the end of the second round the predefined level of consensus (85%) was reached for 32 patient outcomes, 10 nurse staffing measures and 29 background variables. The highest consensus levels regarding measure sensitivity to nurse staffing were found for nurse perceived quality of care, patient satisfaction and pain, and the lowest for renal failure, cardiac failure, and central nervous system complications. Nursing Hours per Patient Day received the highest consensus score as a valid measure of the number of nursing staff. As a skill mix variable the proportion of RNs to total nursing staff achieved the highest consensus level. Both age and comorbidities were rated as important background variables by all the respondents. Conclusions: These results provide a snapshot of the state of the science on nurse-staffing and patient-outcomes research as of 2005. The results portray an area of nursing science in evolution and an understanding of the connections between human resource issues and healthcare quality based on both empirical findings and opinion. [source] | ||||||||||