scholarly journals Improving the quality of mortality review equity reporting: Development of an indigenous Māori responsiveness rubric

2020 ◽  
Vol 32 (8) ◽  
pp. 517-521
Author(s):  
Denise Wilson ◽  
Sue Crengle ◽  
Fiona Cram
Keyword(s):  
Further Education ◽  
Mortality Data ◽  
Health And Wellbeing ◽  
Effective Implementation ◽  
Aotearoa New Zealand ◽  
Mortality Review ◽  
Multiple Levels ◽  
Maori Health

Abstract Objective To improve consistency in New Zealand’s Mortality Review Committees’ (MRCs) analysis, interpretation and recommendations, specifically related to equity and Māori (the Indigenous peoples of Aotearoa New Zealand) mortality. Design A qualitative Plan-Do-Check-Act design informed by Māori expertise to develop a rubric and guidelines. The rubric and guidelines aimed to improve MRCs’ capability to analyse mortality data, its interpretation and the recommendations for preventing deaths. Setting New Zealand’s MRCs make recommendations to address preventable deaths. Variation existed between the MRCs’ understanding of equity, and its application to reduce avoidable mortality for Māori, which subsequently influenced their analysis, reporting and the recommendations generated. Improving the quality and robustness of MRCs’ recommendations and reporting are crucial for improving equity. Participants Māori Caucus (comprising MRC members with Māori health and wellbeing expertise) designed the rubric and guidelines with input from the secretariat and other MRC Chairs and members. Intervention(s) None. Main Outcome Measure(s) None. Results The rubric comprises four key ‘pou’ (metaphorical posts or domains) ‘Tika’ (doing things right); ‘Manaakitanga’ (caring compassionately); ‘Mana’ (status, authority); and ‘Mahi tahi’ (working collaboratively); and criteria for three levels of practice. Evaluation of the efficacy of the use of the rubric and its implementation showed further education and support was required. Conclusions A shared understanding of equity about mortality is required. Effective implementation of a quality-based rubric into practice requires careful planning and ongoing education and support for staff and committee members at multiple levels. Follow-up support is needed to support its implementation into practice.

scholarly journals How to institutionalise health promotion through legislation?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Hätönen
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Right To Health ◽  
Comprehensive Review ◽  
Health And Wellbeing ◽  
Effective Implementation ◽  
Municipal Council ◽  
Strategic Plans ◽  
Law Making

Abstract Legislation is a powerful tool to enhance health promotion practices. The aim of this presentation is to describe legislation related to health promotion in Finland. The Finnish Constitution (1999) and the Local Government Act (2015) stipulate every citizen’s right to health and wellbeing. Concrete duties and tasks as well roles of different actors are stipulated in detail in the Health Care Act (2010) and many specific acts. General strategic management obligations and tasks of the municipalities have been defined as follows: (1) Municipalities shall assess and take into consideration any effects that their decisions may have on the health and wellbeing of residents. (2) In their strategic plans, municipalities shall identify the objectives and define the measures for health and wellbeing promotion on the basis of local needs. (3) They shall monitor the determinants of health and wellbeing, measures taken and follow-up the health and wellbeing of their residents by population groups. (4) Reports on these shall be drawn up for the municipal council once a year and a more comprehensive review on health and wellbeing shall be produced for the municipal council once during each term of office. (5) They shall assign bodies responsible for health and wellbeing promotion. (6) All departments of the municipality shall work together for health and wellbeing promotion. (7) They shall cooperate with other public local authorities, with private enterprises and non-governmental organisations. The Health Care Act as well other acts further defines the preventive services that municipalities need to offer. In Finland we have ensured effective implementation of the legislation by number of actions. First, different stakeholders were closely involved to the law-making process from the beginning of the process. Secondly, implementation was, and is still, supported by the National Institute for Health and Wellbeing. Finally, the implementation is systematically monitored.

Improve Healthcare Quality Through Mortality Committee: Retrospective Analysis of Bambino Gesù Children Hospital’s Ten Years’ Experience 2008-2017

2019 ◽  
Vol 20 (8) ◽  
pp. 635-642 ◽  
Author(s):  
Caterina Offidani ◽  
Maria Lodise ◽  
Vittorio Gatto ◽  
Paola Frati ◽  
Stefano D'Errico ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Healthcare Quality ◽  
Mortality Rates ◽  
Mortality Data ◽  
Systematic Analysis ◽  
Mortality Review ◽  
Hospital Deaths ◽  
The Impact

Background: Healthcare quality improvements are one of the most important goals to reach a better and safer healthcare system. Reviewing in-hospital mortality data is useful to identify areas for improvement, and to monitor the impact of actions taken to avoid preventable cases, such as those related to healthcare associated infections (HAI). Methods: In this paper, we present the experience of the Mortality Committee of Bambino Gesù Children Hospital (OPBG). OPBG has instituted a process of systematic revision of all in-hospital deaths conducted by a multidisciplinary team. The goal is to identify system-wide issues that could be improved to reduce in-hospital preventable deaths. In this way, the mortality review goes alongside all the other risk management activities for the continuous quality improvement and patient safety. Results: In years 2008-2017, we performed a systematic analysis of 1148 inpatient deaths. In this time period, the overall mortality rate was 0.4%. Forty-seven deaths were caused due to infections, 10 of which involved patients with HAI transferred to OPBG from other facilities or patients with community- acquired infections. Six deaths related to HAI were followed by claims compensations. All these cases were not followed by compensation because the onset of HAI was considered an inevitable consequence of the underlying disease. Conclusion: Introduction of the mortality review committee has proved to be a valid instrument to improve the quality of the care provided in a hospital, allowing early identification of care gaps that could lead to an increase in mortality rates. Article Highlights Box: Reduction of preventable deaths is one of the most important goals to be achieved for any health-care system and to improve the quality of care. • Several studies have shown that analysis of morbidity and mortality rate helps to detect any factors that can lead to an increase in in-hospital mortality rates. • The review of in-hospital deaths allows to learn how to improve the quality and safety of care through identification of critical issues that lead to an increase in mortality ratio. • In some medical areas, such as intensive care units or surgery, the implementation of the conference on mortality and morbidity is more useful for assessing procedures at high risk of errors. • The implementation of existing databases with data deriving from the systematic review of medical records and in-hospital deaths appears to be desirable. • Mortality Review Committees can represent a very useful tool for all the health facilities for the reduction of preventable deaths, such as those related to HAI.

scholarly journals A longitudinal population-based study of carers of people with psychosis

2016 ◽  
Vol 26 (3) ◽  
pp. 265-275 ◽  
Author(s):  
A. W. C. Poon ◽  
C. Harvey ◽  
A. Mackinnon ◽  
L. Joubert
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Psychological Distress ◽  
Mental Health Service ◽  
Health Service Delivery ◽  
Mental Health Service Delivery ◽  
Health And Wellbeing ◽  
Over Time

Aims.Few studies have examined the experiences of carers of people with psychosis using a representative sample. Aiming to obtain generalisable results concerning carers in the context of increased emphasis on involving carers in Australian mental health service delivery and policy frameworks, this study recruited carers within the second Australian national survey of psychotic disorders (Survey of High Impact Psychosis, SHIP). Given that most SHIP participants had long-term illness and extended relationships with carers, the health and wellbeing of carers as a group were expected to be relatively stable. However, since it is unknown whether carers’ health and wellbeing would change, our main aim was to explore change and stability in carers’ health and wellbeing and the relationship between any changes experienced by individual carers and corresponding SHIP participants’ functioning over time.Methods.Ninety-eight caregivers of SHIP participants were recruited at baseline and completed validated instruments assessing their health and wellbeing. Seventy-eight carers were re-interviewed at 1-year follow-up. Clinical factors were extracted from the SHIP database. Wilcoxon matched-pairs signed-rank test and t-test were used to analyse changes in variables over time. Cross-lagged analyses were conducted to identify possible causative relationships in changes in SHIP participant and carer variables.Results.A substantial percentage of carers experienced social isolation (28.6%), psychological distress (37.7%) and poorer quality of life than population norms. There were no statistically significant changes between baseline and follow-up scores for almost all carers’ health and wellbeing variables, other than a poorer perception of their quality of life in relation to their physical health after 1 year. Cross-lagged analyses suggested that poorer functioning of people with psychosis influenced carers’ social isolation, grief and psychological distress.Conclusions.Findings show that carers’ perception of their health and wellbeing did not improve within current mental health service delivery frameworks over time. Carer's persistently poor health and wellbeing suggests a pressing need to enhance services that improve carers’ health and wellbeing especially their physical health and the functioning of people with psychosis whom they support.

A consultation journey: developing a Kaupapa Māori research methodology to explore Māori whānau experiences of harm and loss around birth

2017 ◽  
Vol 14 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Kendall Stevenson
Keyword(s):  
New Zealand ◽  
Indigenous Peoples ◽  
Culturally Responsive ◽  
Safe Space ◽  
Similar Process ◽  
Structural Barriers ◽  
Health And Wellbeing ◽  
Aotearoa New Zealand ◽  
Kaupapa Māori ◽  
Maori Health

Kaupapa Māori (by Māori, for Māori, with Māori) researchers have provided a space to undertake research that is culturally responsive, ensures the voices of Māori (Indigenous peoples of Aotearoa New Zealand) are heard, and challenges structural barriers to Māori health and wellbeing. This article describes my journey to develop a Kaupapa Māori methodology appropriate for exploring whānau (families) experiences following the harm or loss of their infant around birth. Guidance from key informants was sought and a Kaupapa Māori methodology was then developed based on their wisdom, expertise, and experience. The five components of this methodology are designed to keep all involved in this research safe: whānau (family), wāhi haumaru (providing a safe space), whakaaro (engaging in Māori philosophies), kaitiaki (being empathetic), and hononga (building and maintaining relationships). Researchers undertaking Kaupapa Māori research are invited to use this methodology, or follow a similar process to develop their own expert-informed methodology.

scholarly journals Getting the Story Right: Reflecting on an Indigenous Rubric to Guide the Interpretation of Mortality Data

2021 ◽  
pp. 088626052110425
Author(s):  
Fiona Cram ◽  
Heidi Cannell ◽  
Pauline Gulliver
Keyword(s):  
Indigenous Peoples ◽  
Mortality Data ◽  
Spiritual Power ◽  
Review Committee ◽  
Aotearoa New Zealand ◽  
The Family ◽  
Mortality Review ◽  
Working Together ◽  
Health Quality ◽  
Socially Responsive

The Family Violence Death Review Committee (FVDRC) is one of five Mortality Review Committees (MRCs) that sit within the Health Quality & Safety Commission, Aotearoa, New Zealand. A key goal of the work of these committees is the reduction of the unequal burden of disparities shouldered by Māori (Indigenous peoples). Guidance to the committees on interpreting and reporting Māori mortality comes from Te Pou (the pillar/post), a Māori responsiveness rubric published in 2019 by Ngā Pou Arawhenua (the caucus of Māori MRC members). This guidance was called upon by the FVDRC in the preparation of its sixth report, “Men who use violence,” published in 2020. In this article, the FVDRC reflects on how it strove to uphold responsibilities toward Te Titiriti o Waitangi 1 in its sixth report to get the story right ( Tika—to be correct or true), be culturally and socially responsive ( Manaakitanga—hospitability, kindness, support), advance equity, self-determination and social justice ( Mana—prestige, authority, spiritual power), and establish relationship for positive change ( Mahi Tahi—working together). Opportunities for improved responsiveness in FVDRC reporting are identified, alongside suggestions for extending the guidance in Te Pou. Reflective practice on responsiveness to Māori/Indigenous peoples is recommended more generally for MRCs.

Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Personality Traits ◽  
Rating Scales ◽  
Suicide Attempts ◽  
World Health ◽  
Life Questionnaire ◽  
Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

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