Anaesthetics

Current anaesthetic practice is provided using a combination of many different available techniques and drugs, with the primary aim of ensuring patient safety and high-quality care are provided for patients. Anaesthesia today is extremely safe, with mortality less than one death in 250 000 directly related to anaesthetic intervention alone. This is due to a continued focus on the principles of patient safety and quality of care, underpinned by continued innovation in pharmacology, applied physiology, physics, and engineering. These have yielded improved techniques and technologies to enhance airway management, provide ventilatory assistance and haemodynamic support, and monitor physiological parameters. Modern professional practice is continually seeking to improve by emphasizing the importance of individual non-technical skills in educational curricula and the workplace. In addition, anaesthetists are heavily involved in the integration of human factors science into health-care organizations.

2015 ◽  
Vol 35 (4) ◽  
pp. 45-57 ◽  
Author(s):  
Carol L. Lukasewicz ◽  
Elizabeth Andersson Mattox

Patient safety organizations and health care accreditation agencies recognize the significance of clinical alarm hazards. The Association for the Advancement of Medical Instrumentation, a nonprofit organization focused on development and use of safe and effective medical equipment, identifies alarm management as a major issue for health care organizations. ECRI Institute, a nonprofit organization that researches approaches for improving patient safety and quality of care, identifies alarm hazards as the most significant of the “Top Ten Health Technology Hazards” for 2014. A new Joint Commission National Patient Safety Goal focusing on clinical alarm safety contains new requirements for accredited hospitals to be fully implemented by 2016. Through a fictional unfolding case study, this article reviews selected contributing factors to clinical alarm hazards present in inpatient, high-acuity settings. Understanding these factors improves contributions by nurses to clinical alarm safety practice.


2021 ◽  
Vol 7 (3) ◽  
pp. 125-131
Author(s):  
Vandad Yousefi ◽  
William Coke ◽  
James Eisner

The current COVID-19 pandemic has resulted in significant strain on acute care delivery in Canada and around the world. It has highlighted the importance of hospitals rapidly increasing their resources to meet the capacity demands brought on by a disruptive change. Hospital medicine teams have become central to many acute care sites, caring for increasingly complex hospitalized patients. We believe that the ongoing implementation of hospitalist teams of generalist physicians is critical in ensuring that health care organizations are well positioned to provide high-quality care in uncertain times. We also highlight the need for adequate training and certification for physicians who aim to work as part of such programs.


Author(s):  
Michael A. West ◽  
Joanne Lyubovnikova ◽  
Regina Eckert ◽  
Jean-Louis Denis

Purpose – The purpose of this paper is to examine the challenges that health care organizations face in nurturing and sustaining cultures that ensure the delivery of continually improving, high quality and compassionate care for patients and other service users. Design/methodology/approach – Based on an extensive review of the literature, the authors examine the current and very challenging context of health care and highlight the core cultural elements needed to enable health care organizations to respond effectively to the challenges identified. Findings – The role of leadership is found to be critical for nurturing high-quality care cultures. In particular, the authors focus on the construct of collective leadership and examine how this type of leadership style ensures that all staff take responsibility for ensuring high-quality care for patients. Practical implications – Climates for quality and safety can be accomplished by the development of strategies that ensure leaders, leadership skills and leadership cultures are appropriate to meet the challenges health care organizations face in delivering continually improving, high quality, safe and compassionate patient care. Originality/value – This paper provides a comprehensive integration of research findings on how to foster quality and safety climates in healthcare organizations, synthesizing insights from academic literature, practitioner reports and policy documents to propose clear, timely and much needed practical guidelines for healthcare organizations both nationally and internationally.


2005 ◽  
Vol 10 (2) ◽  
pp. 69-76 ◽  
Author(s):  
Jessica Bartell ◽  
Maureen Smith

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.


2011 ◽  
Vol 26 (6) ◽  
pp. 491-501 ◽  
Author(s):  
Muriel Jean-Jacques ◽  
Stephen D. Persell ◽  
Romana Hasnain-Wynia ◽  
Jason A. Thompson ◽  
David W. Baker

Reducing disparities in care requires that health care providers identify populations at risk for suboptimal quality of care. Stratified analyses are often used to examine disparities (eg, by race or sex). However, stratified analyses can be misleading if the variables are confounded. The authors examined disparities in quality within a large ambulatory care practice using both unadjusted and adjusted methods for 18 measures. In unadjusted analyses, differences in quality were identified for 9 measures by race. However, in analyses adjusted simultaneously for race, sex, age, socioeconomic status, and chronic medical conditions, racial differences were apparent for only 4 measures. Women received lower quality care for 4 measures in both unadjusted and adjusted analyses. The pattern of observed disparities can differ significantly based on whether unadjusted or adjusted methods are applied. Health care organizations should consider the routine use of adjusted methods to measure disparities in order to better inform disparity reduction initiatives.


2013 ◽  
Vol 18 (1) ◽  
pp. 4-13
Author(s):  
Michael Clark ◽  
Clare Hilton ◽  
Wendy Shiels ◽  
Carole Green ◽  
Christina Walters ◽  
...  

PEDIATRICS ◽  
1999 ◽  
Vol 103 (Supplement_E1) ◽  
pp. 248-254 ◽  
Author(s):  
Anne G. Castles ◽  
Arnold Milstein ◽  
Cheryl L. Damberg

Large employers have become increasingly involved in helping to set the agenda for quality measurement and improvement. Moreover, they are beginning to hold health care organizations accountable for their performance through marketplace incentives, including the public reporting of comparative quality data and the linkage of reimbursement to performance on quality measures. The Pacific Business Group on Health (PBGH) is an employer coalition that has been prominent in establishing models for collaborative quality measurement and improvement in the California marketplace. PBGH's involvement in quality stems from an environment in which purchasers were faced with high health care costs, yet virtually no information with which to assess the value their employees received from that care. Research indicating widespread variation in performance across health care organizations and seemingly limited oversight for quality of care within the industry has further motivated purchasers' efforts to better understand the quality of care being delivered to their em-ployees. Using the purchasing power of employers representing 2.5-million covered lives, PBGH endeavors to encourage the transition of the health care marketplace from one that competes solely on price to one that competes on price and quality. This entails collaborating with the health care industry to develop and publicly report valid performance data for use by both large employers and consumers of health care services. It also includes communicating to the marketplace purchasers' commitment to making purchasing decisions based on quality as well as cost. PBGH efforts to measure, report, and improve quality have been demonstrated by several undertakings in the perinatal care arena, including research to assess cesarean section rates and newborn readmission rates across California hospitals. employer coalition, purchaser, quality measurement, quality improvement, report cards, perinatal quality of care.


Mediscope ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Mst Jannatul Ferdousi

Bangladesh government has initiated a project with the title of "Revitalization of Community Health Care Initiatives in Bangladesh (RCHCIB)" to further develop the Community Clinics (CCs) and strengthen their operations in delivering primary health care. Measuring patient satisfaction with CC service users can play an important role in developing quality care. The objectives of this study were to measure patient satisfaction with CC through facility (CC) based survey and to measure overall patient satisfaction with CC through household based survey. The overall mean patient satisfaction score was 3.7 ± 1.0 and 2.4 ± 1.1 for facility based survey and household based survey, respectively. Policy and strategy should be done to increase quality of care resulting high level of patient satisfaction to service provided at CCs. DOI: http://dx.doi.org/10.3329/mediscope.v1i1.21633 Mediscope Vol. 1, No. 1: 2014, Pages 23-28


2019 ◽  
Vol 11 (02) ◽  
pp. 64-76
Author(s):  
ADIRATNA SEKAR SIWI

Patient’s parent is an essential part of holistically care treatment, especially when the patients are still too young to responsible for their own. Nurse have to understand regarding parents need to deliver high quality care for patients and their family. Parents’ needs during accompanying their children could be very specific and unique. The knowledge regarding this issue is crucial to increase the quality of care and prevent parents’ psychological problem. This is a descriptive study with cross sectional approach. Total sample in this study are respondent who are chosen by using consecutive sampling. The NICU Family Needs Inventory (NFNI) was used in this study. This study shows that the parents’ needs during accompanying their children in critical care setting are need for closeness with their children, Certainty regarding patient condition, comfort, information, and the needs of support.


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