We-care ibd score: assessing high-quality care in the perspective of patients with inflammatory bowel diseases

2020 ◽  
Author(s):  
Serena Barello ◽  
Elena Guida ◽  
Andrea Bonanomi ◽  
Julia Menichetti ◽  
Salvatore Leone ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Quality Care ◽  
Psychometric Evaluation ◽  
Healthcare Services ◽  
Care Patient ◽  
Psychosocial Needs ◽  
High Quality ◽  
Patient Reported ◽  
Inflammatory Bowel

Abstract Background and Aims PREMs are today a core asset to orient healthcare quality improvements. They are particularly relevant in clinical situations requiring frequent interactions between patients and the healthcare system, like inflammatory bowel disease (IBD). Indeed, IBD chronic care requires continuous therapies, psychological interventions and follow-ups. The characteristics of healthcare services play an important role in the life of these patients and in their satisfaction with the care received. The aim of this study was to develop and validate an IBD-specific questionnaire (WE-CARE IBD SCORE) able to capture IBD patients’ needs and priorities for their own healthcare and rooted in patients’ perspectives. Methods The WE-CARE IBD SCORE was developed and validated through a multi-stage process (qualitative and quantitative) and administered to 1176 patients with IBD. Psychometric evaluation included an assessment of internal consistency and factor analysis. Results The WE-CARE IBD SCORE is a short and self-administered questionnaire that includes six items assessing one unique dimension of “IBD patients-rooted high-quality of care” . Psychometric evaluations demonstrate the reliability (Cronbach’s Alpha =0.93) and validity (invariance to gender and diagnosis) of the questionnaire as an instrument able to detect and assess IBD patients’ main psychosocial needs and priorities for receiving healthcare services. Conclusions The WE-CARE IBD SCORE contributes to the panorama of existing quality of care patient-reported measures by providing a patient-rooted, psychosocial perspective in the evaluation of a key aspect for chronic - and particularly for IBD patients - care.

Patients' participation in end-of-life care: Relations to different variables as documented in the patients' records

2010 ◽  
Vol 8 (3) ◽  
pp. 247-253 ◽  
Author(s):  
Irma Lindström ◽  
Fannie Gaston-Johansson ◽  
Ella Danielson
Keyword(s):  
Quality Of Care ◽  
End Of Life ◽  
Cognitive Dysfunction ◽  
End Of Life Care ◽  
Healthcare Professionals ◽  
Healthcare Services ◽  
Life Care ◽  
High Quality ◽  
Care And Treatment

AbstractObjective:Patients' participation in care is crucial for assuring patients a high quality of care based on values such as autonomy. The patients are supposed to be actively involved in care and treatment, even though these situations are complex, as in the context of end-of-life-care. The aim in this study was to identify demographic and health-related variables‘ relation to patients’ participation during the last three months in life as documented in patients' records.Method:The population in the present study consists of 229 patients from 49 municipalities in a county in Sweden. Data were collected from all available documentation about deceased patients who were ≥18 years of age at the time of death and who had received healthcare services during the last 3 months of their life.Results:This article demonstrates patients' participation in end-of-life care as it was noted in the patients' documentation. Demographic variables such as age, gender, and residence did not differ between those who participated and those who did not. Patients with dementia and disorientation were separated from those who were not disoriented. There was no information about the wishes of the patients with dementia and disorientation and they were not described as participating in care and treatment. Cognitive intact patients were participating significant more often. These patients had also more symptom describes in the records. These results can indicate that a patient's participation depends upon either the patient's cognitive capability or the healthcare professionals' competence to communicate and provide adequate documentation regarding patients' participation at end-of-life. The documentation about the participation of patients with cognitive dysfunction is poor and needs further investigation, to achieve the goal of dignified end-of-life care for all patients.Significance of results:The results of the presents study call attention to the importance of finding innovative solutions to make patients with cognitive dysfunction involved in their care and treatment at end-of-life. Improvement of documentation showing patients' involvement in care is necessary, as is a discussion of how healthcare professionals can assure patients a high quality of care at end-of-life even if patients voices are not heard.

QUALITY OF CARE FOR PRESCHOOL CHILDREN WITH ASTHMA: THE ROLE OF SOCIAL FACTORS AND PRACTICE SETTING

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 330-331
Author(s):  
James M. Tracy ◽  
Roger H. Koabayshi
Keyword(s):  
Quality Of Care ◽  
Social Factors ◽  
Quality Care ◽  
Preventive Therapy ◽  
Practice Setting ◽  
High Quality ◽  
Children With Asthma ◽  
Hispanic Patients

Racial minorities admitted for asthma were less likely to have received maximally effective preventive therapy. Marked differences in the quality of care planned after hospital discharge differed significantly when comparing white patients with black and Hispanic patients. In an era of health care reform, attention should focus on the area of high quality care for underserved children who are already at high-risk for asthma-related morbidity. [See table in the PDF file]

scholarly journals Responsibilities for patients? A comparison between US-based VA and the Danish healthcare system

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Jervelund ◽  
I Miake-Lye ◽  
P Shekelle ◽  
C Goldzweig ◽  
A Froelich ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Healthcare Systems ◽  
Care Patient ◽  
Coordinated Care ◽  
High Quality ◽  
Vulnerable Patients ◽  
Patient Outreach ◽  
The Individual ◽  
Danish Healthcare System

Abstract Background The European healthcare systems aim to leave no one behind. Responsibility for the patients may nevertheless be less clearly placed, even in a welfare context such as the Danish healthcare system (DHS). Contrastingly, the Veterans Affairs (VA) in the US is known for their high quality of care and strong care coordination. To understand how responsibility for patients is understood in VA and DHS, we investigated how health providers in the two healthcare systems view their responsibilities to the patients and which tools are used to support responsibility for patients. Methods Semi-structured face-to-face interviews with 23 managers and healthcare providers in VA and DHS were conducted in 2013 and 2014. The interviews were of 42-82 minutes of duration and transcribed verbatim. Data were analysed using thematic analysis. Results The responsibility for the individual patient was clearly placed on the general practitioner in VA, and VA providers felt responsible for their enrolled patients and not just the patients who seek care. In DHS, the responsibility of the treatment was often divided between several providers and this often created dissonance on who is responsible for the care. VA providers made a systematic and active effort to reach out to the individual patients who do not turn up for an appointment as well as for clinical outliers who had pronounced medical needs. In DHS, the responsibility of seeking and attending healthcare laid upon the individual patient. DHS providers seldom played an active part in contacting no-show patients resulting that vulnerable patients may not get the care they need. Conclusions Learning from VA suggests that a clear placement of responsibility will help patients, especially vulnerable patients, to get timely and well-coordinated care. Patient outreach is an important tool to grasp vulnerable patients who are likely to fall between two stools or who need the care the most supporting high quality of care. Key messages Clear placement of responsibility for patients will help vulnerable patients to get timely and well-coordinated care. Patient outreach is an important tool to grasp vulnerable patients who are likely to fall between two stools.

scholarly journals Coding for quality? Accountability work in standardised cancer patient pathways (CPPs)

2021 ◽  
pp. 136345932110138
Author(s):  
Erna Håland ◽  
Line Melby
Keyword(s):  
Quality Of Care ◽  
Cancer Patient ◽  
Health Personnel ◽  
Quality Care ◽  
Important Work ◽  
High Quality ◽  
Patient Pathways ◽  
Work Health ◽  
Crucial Part

A vital part of standardised care pathways is the possibility to measure performance through different indicators – for example, codes. In this article, based on interviews with health personnel in a project evaluating the introduction of standardised cancer patient pathways (CPPs) in Norway, we explore the specific types of work involved when health personnel produce codes as (intended) signifiers of quality. All the types of work are dimensions of what we define as accountability work – work health personnel do to make the codes signifiers of quality of care in the CPP. Codes and coding practices raise questions of what quality of care represents and how it could and should be measured. Informants in our study advocate for coding as important work for the patient more than for ‘the system’. This shows how organising for quality becomes a crucial part of professional work, expanding what it means to perform high quality care.

Accreditation Before, During, and After COVID

2021 ◽  
Vol 1 (1) ◽  
pp. 55-62
Author(s):  
Elizabeth Ziemba
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Care Patient ◽  
Lessons Learned ◽  
Delivery Of Healthcare ◽  
The Future ◽  
Control And Prevention ◽  
Infection Control And Prevention

Nationally and/or internationally accredited hospitals, in general, had standards in place to address the challenges presented by COVID-19 including infection control and prevention, clinical outcomes, quality of care, patient safety, risk management, and patient satisfaction. The pandemic presents healthcare providers with enormous challenges, some of which were or could have been ameliorated by accreditation standards. Responding to the pandemic and extracting lessons learned will impact the delivery of healthcare services in the future. Healthcare systems and providers have six distinct opportunities to shape a better future: faster learning, the value of standards, protecting the workforce, virtual care, preparedness for threats, and addressing inequity. Accreditation organizations will continue to contribute to improving quality of care during and post-pandemic by providing standards to improve access to and the delivery of healthcare services in the future.

US physicians' perceptions of the effect of practice guidelines and ability to provide high-quality care

2005 ◽  
Vol 10 (2) ◽  
pp. 69-76 ◽  
Author(s):  
Jessica Bartell ◽  
Maureen Smith
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Practice Guidelines ◽  
Primary Care Physicians ◽  
Quality Care ◽  
Care Organization ◽  
High Quality ◽  
High Quality Care ◽  
Negative Perceptions

Objectives: In the USA, health care organizations frequently disseminate practice guidelines to physicians, but physicians often resist implementing guidelines when they perceive no improvements in quality of care will result. Greater involvement with a single health care organization may affect physicians' perceptions of guidelines. We examined the relationship between the perceived effect of guidelines on practice and perceived quality of care for US primary care physicians (PCPs) and specialists with varying levels of financial involvement with a single managed care organization. Methods: Data were from the 1996-1997 Community Tracking Study, a nationally representative, cross-sectional survey of 12,528 physicians. Data were adjusted for possible confounders using ordinal logistic regression. Results: Almost half the physicians described a moderate to very large perceived effect of guidelines (46% of PCPs, 46% of specialists). Physicians' financial involvement with a single organization was modest: PCPs received on average 24% of their revenue from their largest contract, while specialists averaged 18%. For specialists, increasing perceived effect of guidelines was associated with increasingly negative perceptions of quality of care [β= –0.16, 95% confidence interval (–0.22, –0.10)]. Similar results were obtained for PCPs with low levels of financial involvement with a single organization. However, this negative association disappeared for PCPs with higher levels of financial involvement. Conclusions: PCPs with substantial financial involvement with a single organization who perceive greater effects of guidelines on practice have less negative perceptions of their ability to provide high-quality care. Although our data cannot confirm a causal relationship, financial involvement with a single organization may be one factor linking practice guidelines to high-quality care.

scholarly journals DOP81 Quality improvement by semi-automated benchmarking of a core outcome quality indicator set in Inflammatory Bowel Disease: A multicentric feasibility study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S112-S112
Author(s):  
P Bossuyt ◽  
D Baert ◽  
F Baert ◽  
E Hoefkens ◽  
I Huys ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Quality Of Care ◽  
Quality Indicators ◽  
Bowel Disease ◽  
Patient Reported Outcome ◽  
Outcome Quality ◽  
Outcome Indicators ◽  
Patient Reported ◽  
Inflammatory Bowel

Abstract Background Quality of care in inflammatory bowel disease (IBD) depends on multiple factors and is assessed through structure, process and outcome indicators. Structure and process indicators are more static and can easily be measured by an audit. Patient-oriented outcome indicators that impact on the quality of life are more difficult to assess. The aim of the project was to build a platform that automatically captures key outcome quality indicators and provide benchmarking output to improve quality of care in IBD centres. Methods Literature was reviewed for relevant quality indicators in IBD. After two non-anonymized Delphi like review and consensus meetings, twelve quality indicators were selected for implementation. The definitions of the outcomes were aligned in consensus with the available International Consortium for Health Outcomes Measurement (ICHOM). A web-based interface was built in three large volume IBD centres in Belgium to collect data on multiple ways: (i) Patients complete patient-reported outcome questionnaires and disease specific questions when attending the outpatient clinic and/or day clinic; (ii) The software automatically extracts data from the electronic medical files including biochemical and endoscopic reports; (iii) The medical baseline characteristics and outcome indicators for each patient are completed by the healthcare professional at inclusion and after this on a yearly basis. Results In total 265 patients were included in the participating IBD centres. Three indicators could be directly extracted from the patient-reported outcome questionnaires (clinical remission, fatigue, work productivity). Two items could be retrieved by use of the bot that automatically extracts biochemical and endoscopic reports from the medical files (anaemia, deep remission). The other items were collected throughout yearly confirmation by a health care professional (colorectal cancer, steroid use [systemic/topical], severe infections, hospital admission, IBD surgery [perianal/abdominal]). All items are benchmarked in an anonymous way on a benchmarking dashboard. Each centre can only see his own position in the benchmarking diagram. Additionally, the case mix per centre (type IBD, severity, demographic data) was added to the benchmarking output to provide a balanced evaluation of the outcome indicators. Conclusion This is the first partially automated benchmarking initiative for quality of care in IBD. The data collection is feasible and provides an objective assessment and comparison of the IBD related quality of care in different centres. Further prospective evaluation needs to confirm that implementation of benchmarking improves the performance and quality of IBD management.

scholarly journals Patient-Reported Experiences with a Relicensed Generic: Thioguanine for the Treatment of Inflammatory Bowel Diseases

2018 ◽  
Vol 27 (4) ◽  
pp. 385-389
Author(s):  
Melek Simsek ◽  
Tineke M.L. Markus-de Kwaadsteniet ◽  
Danielle Van der Horst ◽  
Chris J.J. Mulder ◽  
Nanne K.H. De Boer
Keyword(s):  
Quality Of Care ◽  
Inflammatory Bowel Diseases ◽  
Patient Reported Outcomes ◽  
Daily Life ◽  
Self Report ◽  
Patient Reported ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Impact

Background & Aim: Patient-reported outcomes and experiences are indicative of the impact and the quality of care. Thioguanine, a generic drug initially developed for leukemia, has been explored and relicensed as a certified treatment for patients with inflammatory bowel diseases (IBD). The patients‘ perception of this treatment has not been evaluated before. In this study, we aimed to assess self-reported experiences with thioguanine for IBD.Methods: Questionnaires were sent out to members of the Dutch National Crohn‘s and Colitis patient organization. The Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) was used to address questions regarding the satisfaction and impact of thioguanine therapy on the disease and their daily life. Furthermore, data on demographics, disease and (historical) treatment characteristics were collected. Openended questions were used for additional comments to the questionnaire.Results: A total of 173 organization members (73% female) reported to be previous or current users of thioguanine. A total of 74% were satisfied with the effectiveness of thioguanine, whereas 5% were not. Eighty percent of the respondents were satisfied with the quality of care. A good or excellent impact on daily life was reported by 54%. A neutral or bad impact on daily life was reported by 40% and 6%, respectively. Improvement of disease activity was reported by 58%. This remained stable or worsened in 39% and 3%, respectively.Conclusion: In this self-report survey, among thioguanine treated patients with IBD who had failed with traditional therapies, 80% reported satisfaction with medical care and 74% with the effectiveness of the therapy. In the evaluation of new or rediscovered therapies, patient-reported outcomes and experiences should be considered as a key instrument.

scholarly journals Measurement properties of patient-reported outcome measures (PROMs) in hyperhidrosis: a systematic review

2021 ◽  
Author(s):  
Michaela Gabes ◽  
Helge Knüttel ◽  
Gesina Kann ◽  
Christina Tischer ◽  
Christian J. Apfelbacher
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
High Quality ◽  
High Quality Evidence ◽  
Patient Reported ◽  
Quality Evidence

Abstract Purpose To critically appraise, compare and summarize the quality of all existing PROMs that have been validated in hyperhidrosis to at least some extend by applying the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Thereby, we aim to give a recommendation for the use of PROMs in future clinical trials in hyperhidrosis. Methods We considered studies evaluating, describing or comparing measurement properties of PROMs as eligible. A systematic literature search in three big databases (MEDLINE, EMBASE and Web of Science) was performed. We assessed the methodological quality of each included study using the COSMIN Risk of Bias checklist. Furthermore, we applied predefined quality criteria for good measurement properties and finally, graded the quality of the evidence. Results Twenty-four articles reporting on 13 patient-reported outcome measures were included. Three instruments can be further recommended for use. They showed evidence for sufficient content validity and moderate- to high-quality evidence for sufficient internal consistency. The methodological assessment showed existing evidence gaps for eight other PROMs, which therefore require further validation studies to make an adequate decision on their recommendation. The Hyperhidrosis Disease Severity Measure-Axillary (HDSM-Ax) and the short-form health survey with 36 items (SF-36) were the only questionnaires not recommended for use in patients with hyperhidrosis due to moderate- to high-quality evidence for insufficient measurement properties. Conclusion Three PROMs, the Hyperhidrosis Quality of Life Index (HidroQoL), the Hyperhidrosis Questionnaire (HQ) and the Sweating Cognitions Inventory (SCI), can be recommended for use in future clinical trials in hyperhidrosis. Results obtained with these three instruments can be seen as trustworthy. Nevertheless, further validation of all three PROMs is desirable. Systematic review registration PROSPERO CRD42020170247

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