Quality of care in adult heart surgery: proposal for a self-assessment approach based on a french multicenter study

1995 ◽  
Vol 9 (8) ◽  
pp. 433-440 ◽  
Author(s):  
F ROQUES ◽  
F GABRIELLE ◽  
P MICHEL ◽  
C DEVINCENTIIS ◽  
M DAVID ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Multicenter Study ◽  
Heart Surgery ◽  
Self Assessment ◽  
Adult Heart ◽  
Assessment Approach

scholarly journals Evaluating equity in healthcare: pilot implementation of a self-assessment tool

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Chiarenza ◽  
D Domenig ◽  
S Cattacin
Keyword(s):  
Quality Of Care ◽  
Assessment Tool ◽  
Healthcare Providers ◽  
The Self ◽  
Vulnerable Groups ◽  
Service Users ◽  
Cross Sectional Survey ◽  
Self Assessment ◽  
Cross Sectional

Abstract Background Several sets of standards aiming at improving access and quality of care for service users have been published in recent years. Certain standards focused on improving healthcare providers’ responsiveness to specific target groups. The general goal of this research was to improve organisations’ awareness of equity standards that are not focused on specific groups, but on all contributing factors that put vulnerable groups at risk of exclusion. The specific objective was to evaluate the degree of compliance with a set of equity standards in 52 health care organisations from 16 countries. Methods A self-assessment tool (SAT) was developed to allow healthcare organisations to measure their capacity to provide equitable care for service users. The SAT indicates the main areas that should be addressed: equity in policy; equitable access and utilisation; equitable quality of care; equity in participation; promoting equity. A cross-sectional survey addressing participants from pilot-organisations was used for data collection, concerning both the self-reported compliance score with the standards, as well as the additional information provided to support the score assigned. Data were analysed quantitatively as well as qualitatively. Results The findings confirm that healthcare providers do invest in improving equity in the access and delivery of services to vulnerable groups. However, many health organisations have inadequate strategies to address inequities and are insufficiently engaged in improving equity in participation and promoting equity outside the organisation. Conclusions The participating organisations reported a significant impact from use of the self-assessment tool: some received the support from regional/national authorities to continue working on improving equity in healthcare; others linked the equity standards to existing performance-measurement strategies; others invested in new frameworks to improve service users engagement. Key messages The implementation of the SAT contributes to a self-reflective process, involving health professionals and managers, in which gaps and potential improvements are identified. Pilot organisations utilised the SAT as part of a process of increasing their awareness of equity issues and changing their organisational culture.

Evaluation of the Quality of Care in Congenital Heart Surgery: Contribution of the Aristotle Complexity Score

2007 ◽  
Vol 54 (1) ◽  
pp. 67-83 ◽  
Author(s):  
Francois Lacour-Gayet ◽  
Jeffrey P. Jacobs ◽  
David R. Clarke ◽  
Bohdan Maruszewski ◽  
Marshall L. Jacobs ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Complexity Score

scholarly journals Measuring Quality of Care in the Treatment of Colorectal Cancer: The Moffitt Quality Practice Initiative

2007 ◽  
Vol 3 (2) ◽  
pp. 60-65 ◽  
Author(s):  
Paul B. Jacobsen ◽  
David Shibata ◽  
Erin M. Siegel ◽  
Mihaela Druta ◽  
Ji-Hyun Lee ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Of Care ◽  
Cancer Care ◽  
Medical Records ◽  
Initial Phase ◽  
Pathology Report ◽  
Self Assessment ◽  
Specific Level ◽  
Lower Adherence

Purpose The Moffitt Quality Practice Initiative (MQPI) is a practice-based system of quality self-assessment, the ultimate goal of which is to improve the quality of cancer care at a statewide level. The initial phase of this project focused on developing procedures, determining feasibility, and evaluating utility for assessing quality of care for colorectal cancer within an existing affiliate network. Patients and Methods Representatives from four oncology groups selected quality measures consistent with evidence-, consensus-, and safety-based guidelines that could be abstracted from medical records. Trained abstractors then reviewed records of all eligible colorectal patients seen by each practice in 2004. Frequencies of responses for each indicator were tabulated for overall and practice-specific level of adherence and were compared among practices. Results Adherence was uniformly high for several indicators, including confirmatory pathology report, staging information, and chemotherapy discussion or recommendation. Lower adherence was evident across practices for performance of carcinoembryonic tests and complete colonoscopic evaluations. Significant variation among practices was evident only for consent for chemotherapy. Conclusion The initial phase of MQPI demonstrated the feasibility and utility of assessing quality indicators for colorectal cancer among members of an existing affiliate network. Findings identified areas where adherence to care was uniformly high, but also identified areas where both overall and practice-specific adherence were less than optimal. These efforts lay the groundwork for expanding MQPI in several directions that have in common the potential to improve the quality of cancer care on a statewide basis.

Stratification of complexity: The Risk Adjustment for Congenital Heart Surgery-1 Method and The Aristotle Complexity Score – past, present, and future

2008 ◽  
Vol 18 (S2) ◽  
pp. 163-168 ◽  
Author(s):  
Marshall Lewis Jacobs ◽  
Jeffrey Phillip Jacobs ◽  
Kathy J. Jenkins ◽  
Kimberlee Gauvreau ◽  
David R. Clarke ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Quality Of Care ◽  
Risk Adjustment ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Case Mix ◽  
Objective Data ◽  
Complexity Score

AbstractMeaningful evaluation of quality of care must account for variations in the population of patients receiving treatment, or “case-mix”. In adult cardiac surgery, empirical clinical data, initially from tens of thousands, and more recently hundreds of thousands of operations, have been used to develop risk-models, to increase the accuracy with which the outcome of a given procedure on a given patient can be predicted, and to compare outcomes on non-identical patient groups between centres, surgeons and eras.In the adult cardiac database of The Society of Thoracic Surgeons, algorithms for risk-adjustment are based on over 1.5 million patients undergoing isolated coronary artery bypass grafting and over 100,000 patients undergoing isolated replacement of the aortic valve or mitral valve. In the pediatric and congenital cardiac database of The Society of Thoracic Surgeons, 61,014 operations are spread out over greater than 100 types of primary procedures. The problem of evaluating quality of care in the management of pediatric patients with cardiac diseases is very different, and in some ways a great deal more challenging, because of the smaller number of patients and the higher number of types of operations.In the field of pediatric cardiac surgery, the importance of the quantitation of the complexity of operations centers on the fact that outcomes analysis using raw measurements of mortality, without adjustment for complexity, is inadequate. Case-mix can vary greatly from program to program. Without stratification of complexity, the analysis of outcomes for congenital cardiac surgery will be flawed. Two major multi-institutional efforts have attempted to measure the complexity of pediatric cardiac operations: the Risk Adjustment in Congenital Heart Surgery-1 method and the Aristotle Complexity Score. Both systems were derived in large part from subjective probability, or expert opinion. Both systems are currently in wide use throughout the world and have been shown to correlate reasonably well with outcome.Efforts are underway to develop the next generation of these systems. The next generation will be based more on objective data, but will continue to utilize subjective probability where objective data is lacking. A goal, going forward, is to re-evaluate and further refine these tools so that, they can be, to a greater extent, derived from empirical data. During this process, ideally, the mortality elements of both the Aristotle Complexity Score and the Risk Adjustment in Congenital Heart Surgery-1 methodology will eventually unify and become one and the same. This review article examines these two systems of stratification of complexity and reviews the rationale for the development of each system, the current use of each system, the plans for future enhancement of each system, and the potential for unification of these two tools.

scholarly journals Artificial Intelligence and Deep Learning based Information Retrieval Framework for Assessing Students Performance

2022 ◽  
Vol 12 (1) ◽  
pp. 0-0
Keyword(s):  
Neural Network ◽  
Deep Learning ◽  
Performance Indicators ◽  
Information Gain ◽  
Educational Institution ◽  
Academic Quality ◽  
Self Assessment ◽  
Continuous Quality ◽  
Assessment Approach

Improving the quality of education is a challenging activity in every educational institution. Through this research paper, a model has been proposed representing the challenges in order to manage the trade-off to maintain the philosophy of continuous quality improvement and strict control based on Higher Education Institutions (HEIs). Several standards criteria, performance parameters, and Key Performance Indicators are studied and suggested for a quality self-assessment approach. After the data is collected, the significant features are selected for analysis of data using dedicated gain, which are designed by integrating the information gain and the dedicated weight constants. After that, deep learning methodologies like regression analysis, the artificial neural network, and the Matlab model are used for evaluating the academic quality of institutions. Finally, areas of development have been recommended using the probabilistic model to the administrators of the institutions based on the prediction made using a deep neural network.

scholarly journals Equitable perinatal healthcare for migrants, Portugal: Comparative analysis of a self-assessment tool

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Doetsch ◽  
R Almendra ◽  
M Carrapatoso ◽  
C Teixeira ◽  
H Barros
Keyword(s):  
Quality Of Care ◽  
Assessment Tool ◽  
Healthcare Access ◽  
Healthcare Quality ◽  
P Value ◽  
Median Score ◽  
Migrant Women ◽  
Self Assessment ◽  
Access And Quality

Abstract Migration is seen as a common risk factor in obstetric management. Migrants often have a higher risk of experience worse pregnancy outcomes, higher rates of operative delivery, and a higher likelihood to receive less adequate postpartum care when compared to native women. This study evaluates self-perceived assessment of migrant women and hospital directors on equitable migrant friendly perinatal healthcare quality and access during intrapartum and postpartum period at public maternity units across Portuguese mainland between 2017-2019. This cross-sectional study analyses perinatal health data from migrant women over 18 years giving birth in public maternity units from between April 2017 and March 2019 as part of the baMBINO project. Data on the assessments of maternity units' directors on equitable migrant friendly healthcare was collected in a self-assessment tool. Two standards on healthcare access and on healthcare quality were developed by: 1) scoring 25 and 30 questions, respectively, from 0 (worst) to 5 (best); 2) calculating the average of each score. The One-Sample Wilcoxon Test (non-parametric) was applied to compare the assessment of hospital directors with the migrant mothers and the Kruskal-Wallis one-way analysis of variance to test for regional differences. Significant differences between migrant woman and healthcare directors' assessments on migrant friendly healthcare access and quality of care were found. Directors rated healthcare access with a median score of 2.4, twice as good as migrant women (1.3). Migrant women rated healthcare quality with a median score of 4.0 (directors: 3.2). Significant differences between the regions for quality of care and healthcare access were found. Statistically significant difference between migrants from Portuguese and non-Portuguese speaking countries was identified for healthcare access (p-value < 0.001) and healthcare quality (p-value < 0.05). Key messages The need to guarantee equitable healthcare access and quality contemplates as a first step to overcome health inequalities for migrant women in Portugal. The comparison between patients and healthcare providers’ assessments assists in the understanding of existent barriers in access to health care and improves quality assurance.

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