A multifaceted quality improvement program can have a robust impact on the quality of primary care

2008 ◽  
Diabetes Care ◽  
2008 ◽  
Vol 31 (11) ◽  
pp. 2166-2168 ◽  
Author(s):  
M. C.E. Rossi ◽  
A. Nicolucci ◽  
A. Arcangeli ◽  
A. Cimino ◽  
G. De Bigontina ◽  
...  

2006 ◽  
Vol 72 (11) ◽  
pp. 994-998 ◽  
Author(s):  
Shukri F. Khuri

The Institute of Medicine 1999 publication, To Err is Human, focused attention on preventable provider errors in surgery, and prompted numerous new national initiatives to improve patient safety. It is uncertain whether these initiatives have actually improved patient safety, mainly because of the lack of a quantitative metric for the assessment of patient safety in surgery. A 15-year experience with the National Surgical Quality Improvement Program, which originated in the Veteran's Administration in 1991 and was recently made available to the private sector, prompts the surgical community to place patient safety in surgery within a much larger conceptual framework than that of the Institute of Medicine report, and provides a quantitative metric for the assessment of patient safety initiatives. This conceptual framework defines patient safety in surgery as safety from all adverse outcomes (not only preventable errors and sentinel events); regards safety as an integral part of quality of surgical care; recognizes that adverse outcomes, and hence patient safety, are primarily determined by quality of systems of care; and uses comparative risk-adjusted outcome data as a metric for the identification of system problems and for the assessment and improvement of patient safety from adverse outcomes.


Author(s):  
Cathy Kande ◽  
Robert Mash

Background: Although there are no prevalence studies on hypertension in Botswana, this condition is thought to be common and the quality of care to be poor.Aim: The aim of this project was to assess and improve the quality of primary care forhypertension.Setting: Moshupa clinic and catchment area, Botswana.Methods: Quality improvement cycle.Results: Two hundred participants were included in the audit. Sixty-eight per cent were women with a mean age of 55 years. In the baseline audit none of the target standards were met. During the re-audit six months later, six out of nine structural target standards, five out of 11 process target standards and one out of two outcome target standards were achieved. Statistically-significant improvement in performance (p < 0.05) was shown in 10 criteria although the target standard was not always met. In the re-audit, the target of achieving blood pressure control (< 140/90) in 70% of patients was achieved.Conclusion: The quality of care for hypertension was suboptimal in our setting. Simple interventions were designed and implemented to improve the quality of care. These interventions led to significant improvement in structural and process criteria. A corresponding significant improvement in the control of blood pressure was also seen.


2017 ◽  
Vol 20 (2) ◽  
pp. 324-333 ◽  
Author(s):  
Romsai T. Boonyasai ◽  
Kathryn A. Carson ◽  
Jill A. Marsteller ◽  
Katherine B. Dietz ◽  
Gary J. Noronha ◽  
...  

Author(s):  
Gerald Craver ◽  
Amy Burkett

Certified nursing assistants (CNAs) perform an important role in the long-term care system because they provide the majority of paid care to nursing facility residents. Unfortunately, annual CNA turnover often exceeds 100 percent nationally. Many factors account for this, including stressful working conditions, low pay, and limited benefits. The end result of high turnover is compromised continuity of care for residents, which often leads to poor quality and substandard care. In an effort to improve quality of care and staffing, the Virginia Department of Medical Assistance Services in 2009 implemented a pilot program, known as the Virginia Gold Quality Improvement Program, which provided funding to five nursing facilities to develop projects that improved working conditions for CNAs. This study presents the results of an evaluation performed on the program toward the end of its first year using 10 CNA and resident focus groups. Eight themes emerged from the focus groups, suggesting that both quality of care and working conditions improved in the pilot facilities after the program was implemented. However, these findings are preliminary and additional research is needed to more fully understand how the program influenced conditions in the pilot facilities.


2006 ◽  
Vol 151 (5) ◽  
pp. 1033-1042 ◽  
Author(s):  
J. Richard Goss ◽  
Charles Maynard ◽  
Gabriel S. Aldea ◽  
Miriam Marcus-Smith ◽  
Richard W. Whitten ◽  
...  

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