Quality assurance in maternity care

1993 ◽  
Vol 101 ◽  
pp. 193-205
Author(s):  
Marion H. Hall ◽  
Rosemary Currell
Keyword(s):  
Maternity Care ◽  
Quality Care ◽  
Future Generations ◽  
Good Care ◽  
Limited Evidence ◽  
Family Doctors ◽  
Process And Outcome ◽  
History Of ◽  
Women’S Views

SynopsisThe quality of care for pregnant women and their babies must be a high priority to ensure the health of future generations. Unique features are the need to deal with at least two ‘patients’, that the process of parturition is usually normal, and that there is a long history of incorporating women's views into definitions of good care. Methods of assessing structure, process and outcome of care are described, and the limited evidence of their efficacy in improving care. High-quality care in the future will require collaboration between women, midwives, family doctors and obstetricians.

scholarly journals The International Childbirth Initiative: An Applied Anthropologist’s Account of Developing Global Guidelines

2022 ◽  
pp. 179-197
Author(s):  
Robbie Davis-Floyd
Keyword(s):  
Maternity Care ◽  
Group Process ◽  
Medical Intervention ◽  
Social Scientists ◽  
Creation Story ◽  
Clear Vision ◽  
Centered Care ◽  
History Of ◽  
Global Movements

AbstractThis chapter describes my personal experiences as an applied anthropologist serving as the lead editor in the development of a set of international guidelines focused on improving quality of maternity care: the International Childbirth Initiative (ICI): 12 Steps to Safe and Respectful MotherBaby-Family Maternity Care (2018). The ICI’s purpose is to encourage global awareness and local implementation of the MotherBaby-Family Model of Care. This is a model based on women’s rights and humane, respectful, family-centered care. The ICI’s creation story is continuous with global movements to improve the quality of maternity care and with a deep history of birth activism by practitioners, public health advocates, and social scientists aimed at decreasing unnecessary medical intervention in childbirth. This narrative is widely relevant for understanding how to develop and implement global guidelines that can flexibly adapt to local contexts. The ICI was developed by the merging of the 2015 FIGO Guidelines to Mother-Baby Friendly Birthing Facilities with the pre-existing International MotherBaby Childbirth Initiative (IMBCI) in an intense and rewarding group process. The chapter discusses factors that contributed to the successful development of clear global guidelines for high-quality maternity care. These include attention to process, alignment with key values of the women’s health and midwifery movements, multilevel collaboration and networking around a clear vision, garnering input from many people with diverse voices and perspectives, and patience with and commitment to the tasks at hand.

Assessing the Quality of Pharmaceutical Care II. Application of Concepts of Quality Assessment from Medical Care

1993 ◽  
Vol 27 (2) ◽  
pp. 215-223 ◽  
Author(s):  
Karen B. Farris ◽  
Duane M. Kirking
Keyword(s):  
Medical Care ◽  
Community Pharmacy ◽  
Quality Assessment ◽  
Pharmaceutical Care ◽  
Quality Care ◽  
Pharmacy Practice ◽  
Care Process ◽  
Interpersonal Processes ◽  
Process And Outcome

Objective To present a framework that facilitates quality assessment of pharmaceutical care (PC) so that the profession and the public may identify pharmacists in ambulatory settings who provide quality care in all aspects of their practices. Data Sources A MEDLINE search augmented by a review of International Pharmacy Abstracts was used to identify pertinent quality assessment and pharmacy practice literature; indexing terms included quality assurance, healthcare, pharmacists, community pharmacy services, ambulatory, pharmacy, and process and outcome assessment. Study Selection All identified quality assessments of community pharmacy practice were considered. Studies that documented the effectiveness of specific pharmacist activities and patient satisfaction were also included. Data Extraction The literature was independently reviewed by the primary author. Data Synthesis The structure–process–outcome paradigm is presented as a framework for quality assessment of PC. Structure should be assessed at periodic intervals because it identifies the potential for the provision of quality care. Process, the care that pharmacists provide, must be documented and linked to outcomes before either structure or process can be used to make inferences about the quality of PC. Technical and interpersonal processes should be examined. Outcomes require an interdisciplinary approach that not only considers other medical care inputs but also recognizes the psychologic, economic, and social factors that affect health status and quality of life. Process and outcome must both be assessed to distinguish the contribution of pharmacists from that of other healthcare providers. Examples of criteria are provided and a model to integrate PC within the healthcare system is discussed. Conclusions It is pharmacists’ duty to ensure that patients receive an acceptable level of PC. The structure-process-outcome paradigm provides a framework to identify and link pharmacists’ processes with patients’ outcomes.

scholarly journals Valuation and Appreciation of Biodiversity: The “Maintenance of Options” Provided by the Variety of Life

2021 ◽  
Vol 9 ◽  
Author(s):  
Daniel P. Faith
Keyword(s):  
Ecosystem Services ◽  
Phylogenetic Diversity ◽  
Future Generations ◽  
Option Value ◽  
Critical Elements ◽  
Biotic Diversity ◽  
Option Values ◽  
History Of ◽  
Important Pathway

“Nature’s contributions to people” (NCP) is an important expansion beyond the standard ecosystem services framework, particularly as a pathway to better address global/regional biodiversity values. NCP18, “maintenance of options,” refers broadly to the capacity of ecosystems, habitats, species, or genotypes to keep options open to support a good quality of life. “Biodiversity,” interpreted as living variation, is an important, but under-appreciated, aspect of “maintenance of options.” IPBES refers to “the “option values of biodiversity,” that is, the value of maintaining living variation in order to provide possible future uses and benefits.” IPBES assessments include biodiversity option value, and use phylogenetic diversity (PD) as an indicator of change in status of NCP18. At the same time, IPBES notes the need for greater appreciation of option values of biodiversity. Popular ecosystem services framings forget the long history of consideration of these global benefits of biotic diversity to humanity, and their normative links. Popular ecological definitions mean that many current valuations of “biodiversity” neglect the benefits of biodiversity-as-variety. Economic valuations of “biodiversity” typically have focused on ecosystem aspects, not variety; related ecosystems framings value “biodiversity” with a focus on those critical elements relating to functioning of ecosystems. Greater appreciation of biodiversity option value and NCP18 may depend on clearer messaging from academia, better highlighting of the link between biodiversity and intergenerational justice, and greater communication of stories of past surprising discoveries of benefits from species that highlight biodiversity as an ongoing source of future benefits. An important pathway for better appreciation of insurance and investment benefits of variety is to understand and communicate the reasons why we value these benefits from variety. Biodiversity-as-variety is valued because we care about the welfare of future generations.

scholarly journals Beyond Accreditation: Issues in Healthcare Quality

2015 ◽  
Vol 3 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Feroz Ikbal
Keyword(s):  
Quality Care ◽  
Healthcare Providers ◽  
Healthcare Quality ◽  
Policy Makers ◽  
Hospital Administrators ◽  
Continuous Quality ◽  
Australian Council ◽  
Accreditation Programme ◽  
History Of

ABSTRACT In the last few years, there is an increased interest among Indian Healthcare institutions to get accredited from bodies, such as national accreditation board for hospitals and healthcare providers (NABH), Joint Commission International (JCI), Australian Council on Healthcare Standards (ACHS), and college of american pathologists Laboratory accreditation programme (CAP), etc. Hospital administrators, clinicians, academicians, promoters of the hospitals, policy makers and even government feel that accreditation is a panacea for all the problems associated with healthcare quality. But with the incidence of fire in one of the NABH accredited hospital in a metropolitan city, questions began to be asked on the correlation between quality and accreditation. Most of the hospitals use accreditation as a promotional tool, rather than a tool for continuous quality improvement. Often the entire focus of quality in a hospital is confined to the process of accreditation and re-accreditation. Time has come to think on the entire process of accreditation of hospitals in India, though it has a history of less than a decade. This paper intends to discuss various issues of quality in hospitals, outside the realms of accreditation. Need for strengthening and re-engineering the accreditation is also discussed. Accreditation essentially identifies the capability of the hospital to deliver quality care. It does not assure that hospitals delivers quality care. This aspect of accreditation has been often forgotten by the various stakeholders in healthcare. In this paper, an attempt is made to discuss other issues of quality, such as spurious drugs, quality of biomaterials, such as stents and biomedical equipments, quality of human resources, etc. which are often neglected by health institutions in its obsession to accreditation. How to cite this article Ikbal F. Beyond Accreditation: Issues in Healthcare Quality. Int J Res Foundation Hosp Healthc Adm 2015;3(1):1-4.

scholarly journals Good nursing care: Rodgers’ evolutionary concept analysis

2020 ◽  
Author(s):  
Akram Ghahramanian ◽  
Maryam Rassouli ◽  
Vahid Zamanzadeh ◽  
Leila Valizadeh ◽  
Elnaz Asghari
Keyword(s):  
Nursing Practice ◽  
Quality Care ◽  
Quality Of Healthcare ◽  
Concept Analysis ◽  
Care Quality ◽  
Evolutionary Approach ◽  
Good Care ◽  
Antecedents And Consequences ◽  
Care Costs

Background & Aim: Considering that the main responsibility of the nurses is to give care to the patients, concept analysis of good care by providing a clear definition will promote nursing practice and quality of healthcare. This study aims to clarify the concept of good care through the use of Rodgers's evolutionary approach. Methods & Materials: This study used Rodgers's evolutionary approach. The keywords of good care, quality care, and similar words were used for searching from CINHAL, PubMed, Emerald, Elsevier, and Scopus databases. Literature published in English between 2000- 2018 was included. Forty-one articles were selected and content analysis was used to distinguish attributes, antecedents, and consequences of good care. Results: According to the finding, care was considered as good that was accompanied by the up-to-date knowledge and by doing procedural care skillfully and safely led to recovery, reducing health care costs, and patient satisfaction through an effective and efficient relationship with the patient. Conclusion: Skillful practice, well-informed knowledge, and effective communication are the most important inputs for nurses to provide good care for the patients and the lack of these, especially in the case of using an unprofessional workforce in nursing, is a serious threat to patient care.

scholarly journals Deliver on Your Own: Disrespectful Maternity Care in rural Kenya

2019 ◽  
Author(s):  
Adelaide M Lusambili ◽  
Violet Naanyu ◽  
Terrance J. Wade ◽  
Lindsay Mossman ◽  
Michaela Mantel ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Maternity Care ◽  
Health Workers ◽  
Quality Care ◽  
Sustainable Use ◽  
Standard Of Care ◽  
Respectful Maternity Care ◽  
Mortality And Morbidity ◽  
Using Data

ABSTRACTBackgroundUnder the Free Maternity Policy (FMP), Kenya has witnessed an increase health facility deliveries rather than home deliveries with Traditional Birth Attendants (TBA) resulting in improved maternal and neonatal outcomes. Despite these gains, maternal and infant mortality and morbidity rates in Kenya remain unacceptably high indicating that more work needs to be done.AimUsing data from the Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project’s qualitative gender assessment, this paper examines and describes women’s experience of disrespectful care during pregnancy, labour and delivery. The goal is to promote improved understanding of actual care conditions in order to develop interventions that can lift the standard of care, increase maternity facility use, and improve health outcomes for both women and newborns.MethodologyWe conducted sixteen focus group discussions (FGDs) with female adolescents, women, men and community health committee members. Twenty four key informants interviews (KII) including religious leaders, local government representatives, Ministry of Health (MOH) and local women’s organizations were conducted. Data were captured through audio recordings and reflective field notes.Research siteKisii and Kilifi Counties in Kenya.FindingsFindings show Nursing and medical care was sometimes disrespectful, humiliatings, uncompassionate, and neglectful. In both sites, male health workers were the most preferred by women as they were friendly and sensitive. Young women were more likely to be abused and women with disabled children were stigmatized.ConclusionsKenya needs to enforce the implementation of the quality of care guidelines for pregnancy and delivery, including respectful maternity care of pregnant women. To make sure these procedures are enforced, measurable benchmarks for maternity care need to be established, and hospitals need to be regularly monitored to make sure they are achieved. Quality of care and compassionate and caring staff may lead to successful and sustainable use of facility care.

Probiotics in gastroenterology – from a different angle

2013 ◽  
Vol 154 (8) ◽  
pp. 294-304 ◽  
Author(s):  
György Miklós Buzás
Keyword(s):  
Side Effects ◽  
Beneficial Effect ◽  
Analytical Data ◽  
Well Being ◽  
Gastrointestinal Diseases ◽  
Convincing Evidence ◽  
Probiotic Treatment ◽  
History Of ◽  
Irritable Bowel

After a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. The indications of probiotic administration have been defined and extended in recent years. The author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. Probiotics are useful in preventing and treating diarrhoea caused by antibiotics and Clostridium difficile caused diarrhoea. In the treatment of Helicobacter pylori infection, preparations containing certain Lactobacillus,Bifidobacterium strains or Saccaromyces boulardii could enhance by 5–10% the rate of successful eradication and reduce the incidence and severity of the side effects. Some symptoms of irritable bowel syndrome and thus the quality of life can be improved by probiotics. Their beneficial effect in ulcerative colitis was proven, while in Crohn’s disease has not yet been defined. The use of probiotics is not included in guidelines, with the exception of the Maastricht IV/Florence consensus. For each disease it is advisable to use probiotics containing strains only with proven beneficial effect. The efficiency of preparations containing mixed strains has not yet been properly investigated. The author reviews the rare but potentially serious side effects of probiotics. In Hungary, there are many probiotic preparations available which can be purchased in pharmacies without prescription: their use is more empirical than evidence-based. The European Food Safety Authority has recently rejected claims for probiotics to be classed as medicines given the lack of convincing evidence on the effects of probiotics on human health and well-being. Clearly, further research is needed to collect evidence which could be incorporated into the international guidelines. Orv. Hetil., 2013, 154, 294–304.

SINGING THE SECOND CHIMURENGA (WAR OF LIBERATION): AN AFROCENTRIC ELUCIDATION OF SIMON CHIMBETU’S SELECTED SONGS

2016 ◽  
Vol 3 (1) ◽  
pp. 32-42
Author(s):  
Allan T Maganga ◽  
Charles Tembo ◽  
Peterson Dewah
Keyword(s):  
Reference Point ◽  
Future Generations ◽  
History Of ◽  
Liberation Struggle ◽  
Past Experiences

Oral sources such as proverbs, songs and folktales have been used to reconstruct people’s identities. As a primary ‘means of communication’ music is often used to capture or record peoples’ experiences in history. In Zimbabwe, Simon Chimbetu exemplifies one musician who is in search of his country’s past in as far as he uses his music to record the history of the liberation struggle. This paper provides an in-depth examination of Chimbetu’s selected songs. Singing after the war itself is over, it is argued, the music functions as a reference point to the citizens because it is a transcript of their past experiences something which is essential to the present and future generations. By insisting on educating his audiences on the liberation struggle, Chimbetu satisfies Sankofan approach. It is argued in this paper that Chimbetu’s musical reflections provide enriching experiences and reveals that it is historical music.

EXPLORING HEALTHCARE ARCHITECTURE THROUGH THE MEDIUM OF FILM: Motives and Techniques

2014 ◽  
Vol 8 (1) ◽  
pp. 29
Author(s):  
Stephen Verderber
Keyword(s):  
Real World ◽  
The Real ◽  
Healthcare Settings ◽  
Interdisciplinary Field ◽  
Body Of Knowledge ◽  
Behavior Setting ◽  
Physical Environments ◽  
Scant Attention ◽  
History Of

The interdisciplinary field of person-environment relations has, from its origins, addressed the transactional relationship between human behavior and the built environment. This body of knowledge has been based upon qualitative and quantitative assessment of phenomena in the “real world.” This knowledge base has been instrumental in advancing the quality of real, physical environments globally at various scales of inquiry and with myriad user/client constituencies. By contrast, scant attention has been devoted to using simulation as a means to examine and represent person-environment transactions and how what is learned can be applied. The present discussion posits that press-competency theory, with related aspects drawn from functionalist-evolutionary theory, can together function to help us learn of how the medium of film can yield further insights to person-environment (P-E) transactions in the real world. Sampling, combined with extemporary behavior setting analysis, provide the basis for this analysis of healthcare settings as expressed throughout the history of cinema. This method can be of significant aid in examining P-E transactions across diverse historical periods, building types and places, healthcare and otherwise, otherwise logistically, geographically, or temporally unattainable in real time and space.

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