Home About us Contact
|
Home About us Contact | ||
|
|
||
Hospital Survey (hospital + survey)
Selected AbstractsDevelopment and Evaluation of the CAHPS® Hospital SurveyHEALTH SERVICES RESEARCH, Issue 6p2 2005Charles Darby M.A. First page of article [source] Measuring Hospital Care from the Patients' Perspective: An Overview of the CAHPS® Hospital Survey Development ProcessHEALTH SERVICES RESEARCH, Issue 6p2 2005Elizabeth Goldstein Objective. To describe the developmental process for the CAHPS® Hospital Survey. Study Design. A pilot was conducted in three states with 19,720 hospital discharges. Methods of Analysis. A rigorous, multi-step process was used to develop the CAHPS Hospital Survey. It included a public call for measures, multiple Federal Register notices soliciting public input, a review of the relevant literature, meetings with hospitals, consumers and survey vendors, cognitive interviews with consumer, a large-scale pilot test in three states and consumer testing and numerous small-scale field tests. Findings. The current version of the CAHPS Hospital Survey has survey items in seven domains, two overall ratings of the hospital and five items used for adjusting for the mix of patients across hospitals and for analytical purposes. Conclusions. The CAHPS Hospital Survey is a core set of questions that can be administered as a stand-alone questionnaire or combined with a broader set of hospital specific items. [source] Case-Mix Adjustment of the CAHPS® Hospital SurveyHEALTH SERVICES RESEARCH, Issue 6p2 2005A. James O'Malley Objectives: To develop a model for case-mix adjustment of Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospital survey responses, and to assess the impact of adjustment on comparisons of hospital quality. Data Sources: Survey of 19,720 patients discharged from 132 hospitals. Methods: We analyzed CAHPS Hospital survey data to assess the extent to which patient characteristics predict patient ratings ("predictive power") and the heterogeneity of the characteristics across hospitals. We combined the measures to estimate the impact of each predictor ("impact factor") and selected high impact variables for adjusting ratings from the CAHPS Hospital survey. Principle Findings: The most important case-mix variables are: hospital service (surgery, obstetric, medical), age, race (non-Hispanic black), education, general health status (GHS), speaking Spanish at home, having a circulatory disorder, and interactions of each of these variables with service. Adjustment for GHS and education affected scores in each of the three services, while age and being non-Hispanic black had important impacts for those receiving surgery or medical services. Circulatory disorder, Spanish language, and Hispanic affected scores for those treated on surgery, obstetrics, and medical services, respectively. Of the 20 medical conditions we tested, only circulatory problems had an important impact within any of the services. Results were consistent for the overall ratings of nurse, doctor, and hospital. Although the overall impact of case-mix adjustment is modest, the rankings of some hospitals may be substantially affected. Conclusions: Case-mix adjustment has a small impact on hospital ratings, but can lead to important reductions in the bias in comparisons between hospitals. [source] Nurses' Perceptions of Safety Culture in Long-Term Care SettingsJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2009Laura M. Wagner RN Abstract Purpose: To describe perceptions of workplace safety culture among nurses employed in long-term care (LTC) settings. Design: A cross-sectional survey. Respondents were licensed nurses (N=550) with membership in gerontological nursing professional organizations in the United States (n=296), Canada (n=251), and other (n=3). Methods: An anonymous, self-administered, mail-in questionnaire, which included the Hospital Survey on Patient Safety Culture as well as questions about individual and institutional characteristics. The survey included key aspects of safety culture, such as work setting, supervisor support, communication about errors, and frequency of events reported. Findings: Nurse-managers reported significantly more positive safety culture perceptions compared with licensed staff nurses. Additionally, licensed nurses employed in government-run facilities had significantly less positive safety culture perceptions compared with those working in nonprofit organizations. Conclusions: Interventions designed to improve safety culture in LTC settings should be focused on the concerns of licensed staff nurses and the improvement of communication between these nurses and their managers. Clinical Relevance: Enhancing safety culture in long-term care settings may facilitate improvements in resident safety. Assessment of workplace safety culture is the first step in identifying barriers that nurses face to provide safe resident care. [source] Case-Mix Adjustment of the CAHPS® Hospital SurveyHEALTH SERVICES RESEARCH, Issue 6p2 2005A. James O'Malley Objectives: To develop a model for case-mix adjustment of Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospital survey responses, and to assess the impact of adjustment on comparisons of hospital quality. Data Sources: Survey of 19,720 patients discharged from 132 hospitals. Methods: We analyzed CAHPS Hospital survey data to assess the extent to which patient characteristics predict patient ratings ("predictive power") and the heterogeneity of the characteristics across hospitals. We combined the measures to estimate the impact of each predictor ("impact factor") and selected high impact variables for adjusting ratings from the CAHPS Hospital survey. Principle Findings: The most important case-mix variables are: hospital service (surgery, obstetric, medical), age, race (non-Hispanic black), education, general health status (GHS), speaking Spanish at home, having a circulatory disorder, and interactions of each of these variables with service. Adjustment for GHS and education affected scores in each of the three services, while age and being non-Hispanic black had important impacts for those receiving surgery or medical services. Circulatory disorder, Spanish language, and Hispanic affected scores for those treated on surgery, obstetrics, and medical services, respectively. Of the 20 medical conditions we tested, only circulatory problems had an important impact within any of the services. Results were consistent for the overall ratings of nurse, doctor, and hospital. Although the overall impact of case-mix adjustment is modest, the rankings of some hospitals may be substantially affected. Conclusions: Case-mix adjustment has a small impact on hospital ratings, but can lead to important reductions in the bias in comparisons between hospitals. [source] Hospital inpatients' experiences of access to food: a qualitative interview and observational studyHEALTH EXPECTATIONS, Issue 3 2008Smriti Naithani BSc MSc Abstract Background, Hospital surveys indicate that overall patients are satisfied with hospital food. However undernutrition is common and associated with a number of negative clinical outcomes. There is little information regarding food access from the patients' perspective. Purpose, To examine in-patients' experiences of access to food in hospitals. Methods, Qualitative semi-structured interviews with 48 patients from eight acute wards in two London teaching hospitals. Responses were coded and analysed thematically using NVivo. Results, Most patients were satisfied with the quality of the meals, which met their expectations. Almost half of the patients reported feeling hungry during their stay and identified a variety of difficulties in accessing food. These were categorized as: organizational barriers (e.g. unsuitable serving times, menus not enabling informed decision about what food met their needs, inflexible ordering systems); physical barriers (not in a comfortable position to eat, food out of reach, utensils or packaging presenting difficulties for eating); and environmental factors (e.g. staff interrupting during mealtimes, disruptive and noisy behaviour of other patients, repetitive sounds or unpleasant smells). Surgical and elderly patients and those with physical disabilities experienced greatest difficulty accessing food, whereas younger patients were more concerned about choice, timing and the delivery of food. Conclusions, Hospital in-patients often experienced feeling hungry and having difficulty accessing food. These problems generally remain hidden because staff fail to notice and because patients are reluctant to request assistance. [source] Epidemiological characteristics of retinoblastoma in children attending the Mexican Social Security Institute in Mexico City, 1990,94PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2002Víctor Amozorrutia-Alegría Summary The object of this study is to present descriptive epidemiological characteristics of retinoblastoma (Rb) in children aged 0,14 years, seen at the Mexican Social Security Institute hospitals in Mexico City (MC) from 1990 to 1994. This is a retrospective, observational hospital survey. Clinical records of 52 Rb cases were reviewed; 39 were patients who did not reside in MC (non-residents), and 13 were MC residents. The study period was 1990,94. The male/female ratio (M/F) was 1.6. Average annual incidence (AAI) was estimated by age and sex (rates per 1 000 000). Annual average percentage change (AAPC) in incidence rates was estimated in children from 0 to 14 years. The AAI for MC residents was 3.2; the highest rate being for those <1 year olds (rate of 20.8); AAPC was 6.9% [95% CI ,27.5, 57.4]; the highest incidence was for the south-eastern region of MC residents (rate of 5.9); 13 cases (25%) were diagnosed at stage III or IV, and 11 cases (21.2%) were bilateral. Incidence of Rb is similar to that in developed countries and shows no increasing trend. Patients from communities outside MC are more frequently diagnosed at stages III and IV. [source] Sharing obstetric care: barriers to integrated systems of careAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2000WENDY DAWSON Objectives: To map the provision of shared obstetric care in Victoria, and investigate the views of care providers about the ways in which current practice could be improved. Method: All Victorian public hospitals with <300 births per annum and a purposive sample of hospitals with <300 births per annum were mailed a questionnaire seeking information about current practice. Interviews with key informants (n = 32) were conducted at four case study sites. Results: The response rate to the hospital survey was 98% (42/43). Fourteen different models of shared care were identified. Two,thirds of hospitals with <300 births per annum (16/28) had three or more different models of shared care. Six hospitals (15%) had written guidelines for all models of shared care offered; 13 (32%) had written guidelines covering some models. Practice varied considerably in relation to: exclusion criteria, recommended schedule of visits and use of patient,held records. There was little consensus about the content of visits and responsibility fa covering particular aspects of care. Few hospitals (6/42) had written information for women about shared care. Care providers expressed divergent views regarding the question of where ultimate responsibility lies for individual patient care and for the overall management of shared care. Conclusions: Current funding arrangements provide strong incentives to expand enrolment in shared obstetric care. Expansion of shared care has occurred without the development of formal, consultative and agreed arrangements between providers, or adequate provision for monitoring, evaluation and review. The variety, complexity and fluidity of models of shared care and lack of agreed procedures contribute to difficulties experienced by both providers and women participating in shared care. Implications: Detailed evidence,based agreed guidelines developed in consultation with hospital and community providers, and provision of improved information to women about what to expect in shared care arrangements are urgently required. [source] Economic evaluation of surgically trained assistant medical officers in performing major obstetric surgery in MozambiqueBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2007ME Kruk Objective, To compare the training and deployment costs and surgical productivity of surgically trained assistant medical officers (técnicos de cirurgia) and specialist physicians (surgeons and obstetrician/gynaecologists) in Mozambique in order to inform health human resource planning in a developing country with low availability of obstetric care and severe physician shortages. Técnicos de cirurgia have been previously shown to have quality of care outcomes comparable to physicians. Design, Economic evaluation of costs and productivity of surgically trained assistant medical officers and specialist physicians. Setting, Hospitals and health science training institutions in Mozambique. Population, Surgically trained assistants, medical officers, surgeons and obstetrician/gynaecologists in Mozambique. Methods, The costs of training and deploying the two cadres of health workers were derived from a review of budgets, annual expenditure reports, enrolment registers, and accounting statements from training institutions and interviews with directors and administrators. Productivity estimates were based on a hospital survey of physicians and técnicos de cirurgia. Main outcome measures, Cost per major obstetric surgical procedure over 30 years in 2006 US dollars. Results, The 30-year cost per major obstetric surgery was $38.9 for técnicos de cirurgia and $144.1 for surgeons and obstetrician/gynaecologists. Doubling the salaries of técnicos de cirurgia resulted in a smaller but still substantial difference in cost per surgery between the groups ($60.3 versus $144.1 per procedure). One-way sensitivity analysis to test the impact of varying other inputs did not substantially change the magnitude of the cost advantage of técnicos de cirurgia. Conclusion, Training more mid-level health workers in surgery can be part of the response to the health worker shortage, which today threatens the achievement of the health Millennium Development Goals in developing countries. [source] | ||||||||||