Home  About us  Contact
 

Quality Improvement Strategies (quality + improvement_strategy)

Distribution by Scientific Domains
Medical Sciences40%

Selected Abstracts

Implementing Quality Improvement Strategies in Brazilian Hospitals: A Model for Guidance of the Initial Stage of Implementation

INTERNATIONAL TRANSACTIONS IN OPERATIONAL RESEARCH, Issue 1 2002
T. Diana.
Since the early 1990s, Brazilian hospitals have increasingly adopted quality improvement strategies with a view to attending more demanding customers and to the higher performance standards required by the Ministry of Health. However, most efforts have not been successful, partly because hospitals lack adequate methodologies, namely implementation models. This paper presents a two-stage model to help Brazilian hospitals deploy such strategies more effectively. It focusses on the development and pilot-test of the model for the buy-in stage. Distinctive features of the model were found to be critical for results at this stage: 1) An ad hoc structure to manage the changes involved; 2) A performance measurement system to lever and monitor its implementation, while aligning the actions taken with strategy objectives. Other aspects found to be crucial for success were creative application of model elements to the culture of the hospital and to Brazilian contingencies. [source]

Impact of quality circles for improvement of asthma care: results of a randomized controlled trial

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2008
Antonius Schneider MD
Abstract Rationale and aims, Quality circles (QCs) are well established as a means of aiding doctors. New quality improvement strategies include benchmarking activities. The aim of this paper was to evaluate the efficacy of QCs for asthma care working either with general feedback or with an open benchmark. Methods, Twelve QCs, involving 96 general practitioners, were organized in a randomized controlled trial. Six worked with traditional anonymous feedback and six with an open benchmark; both had guided discussion from a trained moderator. Forty-three primary care practices agreed to give out questionnaires to patients to evaluate the efficacy of QCs. Results, A total of 256 patients participated in the survey, of whom 185 (72.3%) responded to the follow-up 1 year later. Use of inhaled steroids at baseline was high (69%) and self-management low (asthma education 27%, individual emergency plan 8%, and peak flow meter at home 21%). Guideline adherence in drug treatment increased (P = 0.19), and asthma steps improved (P = 0.02). Delivery of individual emergency plans increased (P = 0.008), and unscheduled emergency visits decreased (P = 0.064). There was no change in asthma education and peak flow meter usage. High medication guideline adherence was associated with reduced emergency visits (OR 0.24; 95% CI 0.07,0.89). Use of theophylline was associated with hospitalization (OR 7.1; 95% CI 1.5,34.3) and emergency visits (OR 4.9; 95% CI 1.6,14.7). There was no difference between traditional and benchmarking QCs. Conclusions, Quality circles working with individualized feedback are effective at improving asthma care. The trial may have been underpowered to detect specific benchmarking effects. Further research is necessary to evaluate strategies for improving the self-management of asthma patients. [source]

Quality Improvement from the Viewpoint of Statistical Method

QUALITY AND RELIABILITY ENGINEERING INTERNATIONAL, Issue 4 2003
Jeroen De Mast
Abstract With the purpose of guiding professionals in conducting improvement projects in industry, several quality improvement strategies have been proposed which strongly rely on statistical methods. Examples are the Six Sigma programme, the Shainin System and Taguchi's methods. This paper seeks to make a rational reconstruction of these types of improvement strategies, which results in a methodological framework. The paper gives a demarcation of the subject of study and proposes a reconstruction research approach. Thereupon, the elements of the methodological framework are listed and briefly discussed. Finally, the effectiveness of the framework is illustrated by showing to what extent it reconstructs Six Sigma's Breakthrough Cookbook. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Implementing bedside handover: strategies for change management

JOURNAL OF CLINICAL NURSING, Issue 17-18 2010
Anne McMurray
Aims and objectives., To identify factors influencing change in two hospitals that moved from taped and verbal nursing handover to bedside handover. Background., Bedside handover is based on patient-centred care, where patients participate in communicating relevant and timely information for care planning. Patient input reduces care fragmentation, miscommunication-related adverse events, readmissions, duplication of services and enhances satisfaction and continuity of care. Design., Analysing change management was a component of a study aimed at developing a standard operating protocol for bedside handover communication. The research was undertaken in two regional acute care hospitals in two different states of Australia. Method., Data collection included 532 semi-structured observations in six wards in the two hospitals and 34 in-depth interviews conducted with a purposive sample of nursing staff involved in the handovers. Observation and interview data were analysed separately then combined to generate thematic analysis of factors influencing the change process in the transition to bedside handover. Results and conclusion., Themes included embedding the change as part of the big picture, the need to link the project to standardisation initiatives, providing reassurance on safety and quality, smoothing out logistical difficulties and learning to listen. We conclude that change is more likely to be successful when it is part of a broader initiative such as a quality improvement strategy. Relevance to clinical practice., Nurses are generally supportive of quality improvement initiatives, particularly those aimed at standardising care. For successful implementation, change managers should be mindful of clinicians' attitudes, motivation and concerns and their need for reassurance when changing their practice. This is particularly important when change is dramatic, as in moving from verbal handover, conducted in the safety of the nursing office, to bedside handover where there is greater transparency and accountability for the accuracy and appropriateness of communication content and processes. [source]