The reciprocity of the quality of care providers' occupational life of and the quality of care: A cycle model

2013 ◽  
Author(s):  
Marco Ferrara ◽  
Sara Viotti ◽  
Daniela Converso ◽  
Valentina Trotta ◽  
Gloria Guidetti ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Maria Jennings ◽  
Joanna Morrison ◽  
Kohenour Akter ◽  
Hassan Haghparast-Bidgoli ◽  
Carina King ◽  
...  

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.


2018 ◽  
Vol 34 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Tracy Wharton ◽  
Daniel Paulson ◽  
Kimberly Burcher ◽  
Heather Lesch

For individuals with dementia, disorientation and both external and internal stimuli may trigger behaviors that are difficult to manage or dangerous to health-care providers. Identification of correlational risk factors to aggressive behavior in patients who are unknown to the hospital can allow providers to adapt patient care quickly. Records for patients aged 60+ who spent at least 24 hours at the hospital other than in the psychiatric unit were used (N = 14 080). The first 4000 records and every 10th person who met criteria (N = 5008) were searched for documentation of dementia (n = 505). Logistic regressions and χ2 tests were used to examine relationships between variables. Recognition of delirium ( P = .014, Exp(B) = 2.53), coupled with an existing prescription for antipsychotic medication at intake ( P < .001, Exp(B) < 4.37), may be a reliable means of screening for risk and intervening at the earliest possible contact, improving quality of care and safety in acute care for individuals with dementia.


Medicine ◽  
2017 ◽  
Vol 96 (1) ◽  
pp. e5755 ◽  
Author(s):  
Xiaolin Wei ◽  
Jia Yin ◽  
Samuel Y.S. Wong ◽  
Sian M. Griffiths ◽  
Guanyang Zou ◽  
...  

2021 ◽  
Author(s):  
Kidist Gizachew ◽  
Tewodros Getinet ◽  
Delayehu Bekele

Abstract Background: Birth companions have been shown to improve quality of care provided to laboring women. Various studies have shown the benefits of companion during child birth. The objective of this study was to assess the knowledge, attitude and practice of health care providers towards the involvement of birth companions during child birth in St Paul’s Hospital Millennium Medical College (SPHMMC) and its selected catchment health centers. Methods: The study used a cross-sectional study which was supplemented by qualitative study design which employed phenomenological design was conducted using in depth interview of health care providers who were on practice during the study period in SPHMMC. Result: The study included a total 58 health care providers. The finding from the study showed that great proportion of health care providers involved in the study (90 %) have positive attitude towards involvement of birth companions but majority 82.4 % didn’t allow birth companions. The commonest reasons mentioned for not involving companions include fear of breach of privacy, interference with routine medical care and risk of litigation/complaints.Conclusion and Recommendation: The findings from this study showed that majority of the health care providers are against the practice of involving birth companions. Since involvement of birth companions is one way to ensure the quality of care provided there should be an effort to increase the knowledge of health professionals on benefits of birth companions. There is also a need for improvement of the work setup. Simple measures like providing screens, providing separate rooms for laboring and post-partum women will have a significant impact on the quality of care provided.


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S136-S137
Author(s):  
Emily Beckwith ◽  
Megan Zynkian

Abstract Introduction CAUTIs, or Catheter-associated Urinary Tract Infection, are one of the leading causes of healthcare associated infections. Since 2008, Centers for Medicare and Medicaid Services (CMS) stopped reimbursing hospital for the cost of CAUTIs, forcing hospitals to modify and improve care provided to patients with indwelling urinary catheters (IUC). They are reportable events to CMS, which can signify the quality of care provided at any medical institution. These infections also cause extra pain and suffering and can complicate any hospital stay. Treatment requires antibiotic use, which helps create and spread antibiotic-resistant organisms with excessive use. Methods BICU and BSC staff were evaluated for knowledge of IUC care, maintenance and policies using a quiz dispersed to RNs. This quiz identified knowledge gaps to help focus on specific topics for training. During Skills Day, all Burn RNs were given a mandatory training, including a PowerPoint presentation, hands-on training performing catheter care, and a handout with quick tips for maintenance. All technical partners (TP) were also trained, though they were not given the quiz. To assess effectiveness of training, RNs were encouraged to take a post-training quiz. Rates of CAUTI will also be closely monitored. Results For the pre-training quiz, average scores were 13.1 correct answers (out of 23 questions) or 56.5%. Post-training quiz scores were 18.5 correct answers (out of 23 questions) or 81%. Since the training in September 2018, no new CAUTIs have been recorded. Conclusions The training provided helped enhance burn staff skills to maintain and care for indwelling urinary catheters, as well as changed attitudes on the unit. Applicability of Research to Practice CAUTIs are a reflection of the quality of care an institution and unit provides its patients. It is also closely monitored and used to compare similar units across the nation. The training provided to the burn staff has shown to decrease the number of CAUTIs in the Burn ICU and Burn Special Care environments, thus decreasing costs, pain and suffering and antibiotic use.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Dalia Dreiher ◽  
Olga Blagorazumnaya ◽  
Ran Balicer ◽  
Jacob Dreiher

Abstract Background The quality of healthcare in Israel is considered “high”, and this achievement is due to the structure and organization of the healthcare system. The goal of the present review is to describe the major achievements and challenges of quality improvement in the Israeli healthcare system. Body In recent years, the Ministry of Health has made major strides in increasing the public’s access to comparative data on quality, finances and patient satisfaction. Several mechanisms at multiple levels help promote quality improvement and patient safety. These include legislation, financial incentives, and national programs for quality indicators, patient experience, patient safety, prevention and control of infection and accreditation. Over the years, improvements in quality indicators, infection prevention and patient satisfaction can be demonstrated, but other fields show little change, if at all. Challenges and barriers include reluctance by unions, inconsistent and unreliable flow of information, the fear of overpressure by management and the loss of autonomy by physicians, and doubts regarding “gaming” of data. Accreditation has its own challenges, such as the need to adjust it to local characteristics of the healthcare system, its high cost, and the limited evidence of its impact on quality. Lack of interest by leaders, lack of resources, burnout and compassion fatigue, are listed as challenges for improving patient experience. Conclusion Substantial efforts are being made in Israel to improve quality of care, based on the use of good data to understand what is working and what needs particular attention. Government and health care providers have the tools to continue to improve. However, several mechanisms for improving the quality of care, such as minimizing healthcare disparities, training for quality, and widespread implementation of the “choosing wisely” initiative, should be implemented more intensively and effectively.


Diagnosis ◽  
2016 ◽  
Vol 3 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Traber Davis Giardina ◽  
Urmimala Sarkar ◽  
Gato Gourley ◽  
Varsha Modi ◽  
Ashley N.D. Meyer ◽  
...  

AbstractDiagnostic errors pose a significant threat to patient safety but little is known about public perceptions of diagnostic errors. A study published inWe searched the World Wide Web for any news article reporting findings from the study. We then gathered all the online comments made in response to the news articles to evaluate public reaction to the newly reported diagnostic error frequency (n=241). Two coders conducted content analyses of the comments and an experienced qualitative researcher resolved differences.Overall, there were few comments made regarding the frequency of diagnostic errors. However, in response to the media coverage, 44 commenters shared personal experiences of diagnostic errors. Additionally, commentary centered on diagnosis-related quality of care as affected by two emergent categories: (1) US health care providers (n=79; 63 commenters) and (2) US health care reform-related policies, most commonly the Affordable Care Act (ACA) and insurance/reimbursement issues (n=62; 47 commenters).The public appears to have substantial concerns about the impact of the ACA and other reform initiatives on the diagnosis-related quality of care. However, policy discussions on diagnostic errors are largely absent from the current national conversation on improving quality and safety. Because outpatient diagnostic errors have emerged as a major safety concern, researchers and policymakers should consider evaluating the effects of policy and practice changes on diagnostic accuracy.


2020 ◽  
pp. JOP.19.00583
Author(s):  
Julien Lejeune ◽  
Severine Chevalier ◽  
Evelyne Fouquereau ◽  
Denis Chenevert ◽  
Hélène Coillot ◽  
...  

PURPOSE: Psychological health at work for care providers is an important issue, because they are directly involved in quality of patient care. Managerial and organizational determinants have been found to be indicators of psychological health at work. The main objective of this study was to explore the relationships between the psychological health at work of pediatric oncology care workers with managerial and organizational determinants and with quality of care. MATERIALS AND METHODS: We performed regression analysis between psychological health at work (quality of work life [QWL], job satisfaction, and so on), managerial determinants (transformational leadership, perceived autonomy support), organizational determinants (organizational support, organizational justice, and participatory approach), and perceived quality of care. RESULTS: Participants were 510 health care professionals working in French pediatric oncology centers. No significant differences in the psychological health at work of the participants were found based on age, sex, length of employment, or professional discipline. In simple regression, significant associations were found between psychological health at work with all managerial and organizational determinants. In multiple regression, a significant link was found between QWL and perceived organizational support (β = .21; P < .001), organizational justice (β = .20, P < .001), and overall participatory approach (β = .10; P < .02). Job satisfaction was also related to perceived organizational support (β = .16; P < .01). Finally, perceived quality of care was linked to QWL (β = .15; P < .01) and job satisfaction (β = .30; P < .001). CONCLUSION: These results emphasize the importance of the role of managers and the organization in psychological health at work of health care providers and also in the quality of patient care


2015 ◽  
Vol 78 (4) ◽  
Author(s):  
Raffaele Griffo ◽  
Marco Ambrosetti ◽  
Giuseppe Furgi ◽  
Roberto Carlon ◽  
Carmine Chieffo ◽  
...  

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic problem in Italy. Costs and resources required are increasing in close correlation to both the improved quality of care and to the population ageing. There is an overwhelming evidence of the efficacy of cardiac rehabilitation (CR) in terms of reduction in morbidity and mortality after acute cardiac events. CR services are by definition multi-factorial and comprehensive. Furthermore, systematic analysis and monitoring of the process of delivery and outcomes is of paramount importance. The aim of this position paper promoted by the Italian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR) is to provide specific recommendations to assist CR staff in the design, evaluation and development of their care delivery organization. The position paper should also assist health care providers, insurers, policy makers and consumers in the recognition of the quality of care requirements, standards and outcome measure, quality and performance indicators, and professional competence involved in such organization and programs. The position paper i) include comprehensive CR definition and indications, ii) describes priority criteria based on the clinical risk for admission to both inpatient or outpatient CR, and iii) defines components and technological, structural and organizing requirements for inpatient or outpatient CR services, with specific indicators and standards, performance measures and required professional skills. A specific chapter is dedicated to the requirements for highly specialized CR services for patients with more advanced cardiovascular diseases.


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