Establishing essential metrics for antifungal stewardship in hospitals: the results of an international Delphi survey

2020 ◽  
Vol 76 (1) ◽  
pp. 253-262 ◽  
Author(s):  
A Khanina ◽  
K F Urbancic ◽  
G M Haeusler ◽  
D C M Kong ◽  
A P Douglas ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Response Rate ◽  
Treatment Guidelines ◽  
Antifungal Stewardship ◽  
Web Based ◽  
Structure Quality ◽  
Core Set ◽  
Antifungal Consumption ◽  
International Experts

Abstract Background Guidance on assessment of the quantity and appropriateness of antifungal prescribing is required to assist hospitals to interpret data effectively and structure quality improvement programmes. Objectives To achieve expert consensus on a core set of antifungal stewardship (AFS) metrics and to determine their feasibility for implementation. Methods A literature review was undertaken to develop a list of candidate metrics. International experts were invited to participate in sequential web-based surveys to evaluate the importance and feasibility of metrics in the area of AFS using Delphi methodology. Three surveys were completed. Consensus was predefined as ≥80% agreement on the importance of each metric. Results Eighty-two experts consented to participate from 17 different countries. Response rate for each survey was >80%. The panel included adult and paediatric physicians, microbiologists and pharmacists with diverse content expertise. Consensus was achieved for 38 metrics considered important to routinely include in AFS programmes, and related to antifungal consumption (n = 5), quality of antifungal prescribing and management of invasive fungal infection (IFI) (n = 24), and clinical outcomes (n = 9). Twenty-one consensus metrics were considered to have moderate to high feasibility for routine collection. Conclusions The identified core AFS metrics will provide a framework to comprehensively assess the quantity and quality of antifungal prescribing within hospitals to develop quality improvement programmes aimed at improving IFI prevention, management and patient-centred outcomes. A standardized approach will support collaboration and benchmarking to monitor the efficacy of current prophylaxis and treatment guidelines, and will provide important feedback to guideline developers.

scholarly journals Criteria list for assessment of methodological quality of economic evaluations: Consensus on Health Economic Criteria

2005 ◽  
Vol 21 (2) ◽  
pp. 240-245 ◽  
Author(s):  
Silvia Evers ◽  
Mariëlle Goossens ◽  
Henrica de Vet ◽  
Maurits van Tulder ◽  
André Ament
Keyword(s):  
Health Economic ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Economic Evaluations ◽  
Delphi Panel ◽  
Policy Makers ◽  
Core Set ◽  
International Experts ◽  
Economic Criteria

Objectives:The aim of the Consensus on Health Economic Criteria (CHEC) project is to develop a criteria list for assessment of the methodological quality of economic evaluations in systematic reviews. The criteria list resulting from this CHEC project should be regarded as a minimum standard.Methods:The criteria list has been developed using a Delphi method. Three Delphi rounds were needed to reach consensus. Twenty-three international experts participated in the Delphi panel.Results:The Delphi panel achieved consensus over a generic core set of items for the quality assessment of economic evaluations. Each item of the CHEC-list was formulated as a question that can be answered by yes or no. To standardize the interpretation of the list and facilitate its use, the project team also provided an operationalization of the criteria list items.Conclusions:There was consensus among a group of international experts regarding a core set of items that can be used to assess the quality of economic evaluations in systematic reviews. Using this checklist will make future systematic reviews of economic evaluations more transparent, informative, and comparable. Consequently, researchers and policy-makers might use these systematic reviews more easily. The CHEC-list can be downloaded freely fromhttp://www.beoz.unimaas.nl/chec/.

scholarly journals PENILAIAN KINERJA TU (TATA USAHA) UNIVERSITAS ISLAM LAMONGAN

JOUTICA ◽  
2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Nur Nafiiyah
Keyword(s):  
Information System ◽  
Quality Improvement ◽  
Data Processing ◽  
Performance Assessment ◽  
Programming Language ◽  
Continuous Quality Improvement ◽  
Service Process ◽  
Web Based ◽  
Continuous Quality

The performance assessment of administration staff in the college did in order to improve the quality of the service process and internal continuous quality improvement. This study aims at the development of information systems web-based performance assessment. This system was built using the programming language PHP (Hypertext Processor) and MySql database, which is expected to provide a more efficient and effective in conducting this evaluation, all the colleges are trying to have an information system that not only presents a variety of important information, but also can perform the data processing. Assessmentof the performance is measurements made on various activities with the questioner. The results of the study give a rank of accumulation is obtained by calculating the second component of the assessment, the results of this can be seen anyone to find the highest rank to lowest. It is hoping that every values obtained can push Employees the administration in Lamongan Islamic university to improve its performance.

Sa1121 Feasibility and Accuracy of Patients Reporting Quality-of-Life and Quality-of-Care Metrics Utilizing a Web-Based Patient-Centric Platform: A Model for Quality Improvement Initiatives

2012 ◽  
Vol 142 (5) ◽  
pp. S-221
Author(s):  
Rubin Bahuva ◽  
Ashish Atreja ◽  
Jean-Paul Achkar ◽  
Bo Shen ◽  
Ahmed Kandiel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Reporting Quality ◽  
Web Based ◽  
Patient Centric

scholarly journals Adherence to Established Treatment Guidelines Among Unguided Digital Interventions for Depression: Quality Evaluation of 28 Web-Based Programs and Mobile Apps (Preprint)

2019 ◽  
Author(s):  
Stefan Bubolz ◽  
Gwendolyn Mayer ◽  
Nadine Gronewold ◽  
Thomas Hilbel ◽  
Jobst-Hendrik Schultz
Keyword(s):  
Relaxation Training ◽  
Treatment Guidelines ◽  
Mobile Apps ◽  
Intraclass Correlation ◽  
Individual Treatment ◽  
Smartphone Apps ◽  
Quality Factors ◽  
Web Based ◽  
Extensive Evaluation

BACKGROUND Web-based interventions for depression have been widely tested for usability and functioning. However, the few studies that have addressed the therapeutic quality of these interventions have mainly focused on general aspects without consideration of specific quality factors related to particular treatment components. Clinicians and scientists are calling for standardized assessment criteria for web-based interventions to enable effective and trustworthy patient care. Therefore, an extensive evaluation of web-based interventions at the level of individual treatment components based on therapeutic guidelines and manuals is needed. OBJECTIVE The objective of this study was to evaluate the quality of unguided web-based interventions for depression at the level of individual treatment components based on their adherence to current gold-standard treatment guidelines and manuals. METHODS A comprehensive online search of popular app stores and search engines in January 2018 revealed 11 desktop programs and 17 smartphone apps that met the inclusion criteria. Programs and apps were included if they were available for German users, interactive, unguided, and targeted toward depression. All programs and apps were tested by three independent researchers following a standardized procedure with a predefined symptom trajectory. During the testing, all web-based interventions were rated with a standardized list of criteria based on treatment guidelines and manuals for depression. RESULTS Overall interrater reliability for all raters was substantial with an intraclass correlation coefficient of 0.73 and Gwet AC1 value of 0.80. The main features of web-based interventions included mood tracking (24/28, 86%), psychoeducation (21/28, 75%), cognitive restructuring (21/28, 75%), crisis management (20/28, 71%), behavioral activation (19/29, 68%), and relaxation training (18/28, 64%). Overall, therapeutic meaningfulness was rated higher for desktop programs (mean 4.13, SD 1.17) than for smartphone apps (mean 2.92, SD 1.46). CONCLUSIONS Although many exercises from manuals are included in web-based interventions, the necessary therapeutic depth of the interventions is often not reached, and risk management is frequently lacking. There is a need for further research targeting general principles for the development and evaluation of therapeutically sound web-based interventions for depression.

scholarly journals Pengembangan Model Sistem Pencetakan Online Berbasis Web

2010 ◽  
Vol 1 (2) ◽  
pp. 621
Author(s):  
Diyurman Gea
Keyword(s):  
Quality Of Service ◽  
Quality Improvement ◽  
The Internet ◽  
Work Efficiency ◽  
Web Based ◽  
Network Computer ◽  
Use Of Technology ◽  
Printing System ◽  
Satisfactory Quality

Work efficiency and service quality improvement are two important things in competing with other businesses. Keep costs as low as possible with a satisfactory quality of service, can be optimized through the use of technology. One type of business that has the potential to be improved quality of service is a document copying services as implemented in Binus University. In addition to the staff and lecturers, students need the service for various types of documents such as copying lecture materials and other administrative documents. By leveraging the technology capabilities possessed by a photocopy machine to connect to a network computer, a system that supports the printing of documents through the Internet can be made. The online printing system is web-based, and capable of storing printing information into a database, so records can provide tracking information, which affects the quality of service and good performance. 

scholarly journals Infectious Disease Providers’ Knowledge of and Engagement in Quality Improvement

2021 ◽  
Author(s):  
Kathleen R Sheridan ◽  
Michael A Lane ◽  
Thomas J Kim ◽  
Joshua C Eby
Keyword(s):  
Infectious Disease ◽  
Quality Improvement ◽  
Response Rate ◽  
Medical Center ◽  
Professional Activity ◽  
Limited Participation ◽  
Web Based ◽  
Measurement Systems ◽  
Disease States ◽  
Physician Engagement

Abstract Background Although engagement of infectious disease physicians has been demonstrated to improve clinical outcomes in a variety of disease states, the extent of ID physician engagement in quality improvement or their knowledge of QI has not been assessed. Methods A 12 question, web-based survey was distributed to members of the Infectious Disease Society of America between August and October 2019 to assess knowledge of and engagement in QI. The survey link was sent to IDSA members that self-identified patient care as their primary professional activity. Results Responses were received from 200 individuals (5.4% response rate which is just below standard IDSA survey response rate of 6%) consisting of 175 adult IDP. Most respondents were employed in a hospital or clinic (41%), private or group practice (25%), or university/medical center (24%). 58% of respondents currently participate in QI projects while 38% serve on QI oversight committees. Among respondents, 27% reported not being engaged in QI. Infection Prevention/Hospital Epidemiology (77%), stewardship (72%), and antimicrobial resistance (56%) were the most commonly reported measure types. Respondents reported barriers that limited participation in QI including cost (61%), lack of time (56%), lack of data collection resources (48%), and lack of an ID-specific registry (46%). IDPs report significant interest in additional training in QI and new quality measures. Conclusion Although IDPs participate in QI, there are gaps in QI knowledge and measurement systems. The low response rate of our survey also suggests a lack of engagement in QI amongst IDPs. Closing these gaps will benefit ID in a value-driven healthcare economy.

scholarly journals Adherence to Established Treatment Guidelines Among Unguided Digital Interventions for Depression: Quality Evaluation of 28 Web-Based Programs and Mobile Apps

10.2196/16136 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e16136
Author(s):  
Stefan Bubolz ◽  
Gwendolyn Mayer ◽  
Nadine Gronewold ◽  
Thomas Hilbel ◽  
Jobst-Hendrik Schultz
Keyword(s):  
Relaxation Training ◽  
Treatment Guidelines ◽  
Mobile Apps ◽  
Intraclass Correlation ◽  
Individual Treatment ◽  
Smartphone Apps ◽  
Quality Factors ◽  
Web Based ◽  
Extensive Evaluation

Background Web-based interventions for depression have been widely tested for usability and functioning. However, the few studies that have addressed the therapeutic quality of these interventions have mainly focused on general aspects without consideration of specific quality factors related to particular treatment components. Clinicians and scientists are calling for standardized assessment criteria for web-based interventions to enable effective and trustworthy patient care. Therefore, an extensive evaluation of web-based interventions at the level of individual treatment components based on therapeutic guidelines and manuals is needed. Objective The objective of this study was to evaluate the quality of unguided web-based interventions for depression at the level of individual treatment components based on their adherence to current gold-standard treatment guidelines and manuals. Methods A comprehensive online search of popular app stores and search engines in January 2018 revealed 11 desktop programs and 17 smartphone apps that met the inclusion criteria. Programs and apps were included if they were available for German users, interactive, unguided, and targeted toward depression. All programs and apps were tested by three independent researchers following a standardized procedure with a predefined symptom trajectory. During the testing, all web-based interventions were rated with a standardized list of criteria based on treatment guidelines and manuals for depression. Results Overall interrater reliability for all raters was substantial with an intraclass correlation coefficient of 0.73 and Gwet AC1 value of 0.80. The main features of web-based interventions included mood tracking (24/28, 86%), psychoeducation (21/28, 75%), cognitive restructuring (21/28, 75%), crisis management (20/28, 71%), behavioral activation (19/29, 68%), and relaxation training (18/28, 64%). Overall, therapeutic meaningfulness was rated higher for desktop programs (mean 4.13, SD 1.17) than for smartphone apps (mean 2.92, SD 1.46). Conclusions Although many exercises from manuals are included in web-based interventions, the necessary therapeutic depth of the interventions is often not reached, and risk management is frequently lacking. There is a need for further research targeting general principles for the development and evaluation of therapeutically sound web-based interventions for depression.

scholarly journals The Pulmonary Hypertension Association Registry: Rationale, Design, and Role in Quality Improvement

2018 ◽  
Vol 16 (4) ◽  
pp. 185-188 ◽  
Author(s):  
Michael P. Gray ◽  
Steven M. Kawut
Keyword(s):  
Pulmonary Hypertension ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Health Services ◽  
Health Outcomes ◽  
Medical Management ◽  
Treatment Guidelines ◽  
Professional Knowledge ◽  
Improve Quality

The Pulmonary Hypertension Association (PHA) Scientific Leadership Council (SLC) prioritized the development of the PH Care Centers (PHCC) initiative in part to identify centers that adhere to expert consensus diagnostic and treatment guidelines in both community and academic practice settings, decreasing the chances of misdiagnosis and inappropriate medical management. The overall goal of the PHCC is to improve outcomes of patients with pulmonary hypertension (PH). It is generally accepted that measurement of processes and outcomes are required in order to improve quality of care: the degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge. The PHA Registry (PHAR) was developed to collect data regarding key measures to facilitate the achievement of these goals of the PHCC.

Physician experience and challenges obtaining unfunded oral chemotherapy across Canada.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 155-155
Author(s):  
D. Han ◽  
S. Hogeveen ◽  
M. Trinkaus ◽  
M. Mamdani ◽  
S. R. Berry ◽  
...  
Keyword(s):  
Response Rate ◽  
Oral Chemotherapy ◽  
Oral Drugs ◽  
Web Based ◽  
Survey Tool ◽  
Drug Access ◽  
Solid Malignancies ◽  
Medical Oncologists ◽  
Special Request

155 Background: Previous studies have shown hematologists and medical oncologists may not accept the financial limits set by governing agencies on access to oral chemotherapy for their patients. This requires increased time and effort on the clinician’s part to obtain funding. We captured physicians’ perceptions of barriers to obtaining unfunded chemotherapies and methods used to overcome these barriers. Methods: A total of 640 medical oncologists and hematologists were surveyed using a web-based survey tool. A thirteen-item survey was designed to assess the practice type along with time spent and methods used on obtaining unfunded oral chemotherapy. Results: Of the 640 invitees, 568 were delivered and 168 responded (response rate 30%). 91 respondents were medical oncologists, 44 were hematologists and 33 treated both solid and non-solid malignancies. 65% of physicians spent an average of 1-4 hours obtaining funding for oral drugs for patients per week. 62% indicated their institution has a drug access coordinator (DAC). Having a DAC did not impact the proportion of physicians spending >4 hrs/ week accessing oral drugs (38% vs 29%, p=NS). To overcome barriers to funding, physicians’ enrolled patients on clinical trials (91%), used compassionate access programs (96%) or special request forms to government (92%). Other methods included writing false claims on forms to fit funding criteria for a drug (36%) or use of leftover drug supplies (36%). The majority of physicians felt that their inability to obtain unfunded medications for their patients has negatively impacted patients’ clinical outcomes (56%) and psychosocial quality of life (74%). Of all respondents, only 28% of physicians contacted their governing body with concerns of funding for oral chemotherapy. Conclusions: Practicing hematologists and medical oncologists in Canada use numerous methods to obtain unfunded oral chemotherapies, including lying on access forms. Overall, the majority of physicians spend 1-4 hours a week on obtaining funding; this did not differ for physicians with or without a DAC at their practice. Despite the challenges in accessing oral chemotherapies, most physicians have not contacted governing bodies for legislative change.

Organizational partnership to expand the ASCO Quality Training Program to oncology pharmacists.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 198-198
Author(s):  
Emily R. Mackler ◽  
Amy Morris ◽  
George W. Carro ◽  
Vedner Guerrier ◽  
Gene Cunningham ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Training Program ◽  
Response Rate ◽  
Medication Management ◽  
Interdisciplinary Team ◽  
Training And Education ◽  
American Society ◽  
Oncology Practice

198 Background: Pharmacists have a recognized role in optimizing medication management and enhancing patient quality of care. In an effort to enhance knowledge related to oncology quality improvement (QI), the Hematology/Oncology Pharmacy Association (HOPA) partnered with the American Society of Clinical Oncology (ASCO) Quality Training Program (QTP) to provide a 1-day HOPA-ASCO QTP Workshop. Methods: HOPA’s Quality Oversight Committee identified several areas of priority focus, including identifying and developing opportunities for members to participate in education focused on oncology value and quality-based patient care. The ASCO QTP program most closely met HOPA goals for training due to the practical outcomes associated with the program, the interdisciplinary focus, the successful experience of prior HOPA-member participants, and expertise of the faculty. In addition, both organizations have a unified goal in improving the care of cancer patients. Surveys were formulated to assess knowledge pre- and post-participation and actionable efforts participants made given knowledge gained from the workshop. Results: A total of 24 HOPA members participated in the 1-day workshop with 40% having been in oncology practice for 15+ years and 70% involved in some aspect of QI within their role. Primary reasons for participation were – to help lead oncology multidisciplinary initiatives in my organization (44%), to increase skills to complete QI projects (28%), and to help lead oncology pharmacy practitioners in my organization (20%). Measures of knowledge and competence increased after participation. Knowledge increased by an average of 3 points from 4.57 to 7.55 (0-10 scale) and competence increased an average of 2.8 points from 4.48 to 7.32. In a 3-month follow-up survey (67% response rate), the majority (93%) of participants indicated they were very likely or extremely likely to use the skills gained from the workshop in practice and 88% of respondents indicated they used the skills gained from the program somewhat often, very often or extremely often. Since the 9 months from the workshop, 2 pharmacists who participated have enrolled in the ASCO QTP 6-month course. Conclusions: The 1-day HOPA-ASCO QTP Workshop proved to be a successful partnership between the two organizations, providing excellent training and education to HOPA members. Next steps of this collaboration include additional 1-day workshops available to more members and a modified 6-month ASCO QTP program for HOPA members with oncology pharmacists serving as the interdisciplinary team leader.

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