Trends in Quality of Anesthesia Care Associated with Changing Staffing Patterns, Productivity, and Concurrency of Case Supervision in a Teaching Hospital 

1999 ◽  
Vol 91 (3) ◽  
pp. 839-839 ◽  
Author(s):  
Karen L. Posner ◽  
Peter R. Freund
Keyword(s):  
Critical Incident ◽  
Human Error ◽  
Injury Rate ◽  
Error Rates ◽  
University Hospital ◽  
Anesthesia Care ◽  
Continuous Quality ◽  
Staffing Patterns ◽  
Team Productivity

Background The authors used continuous quality improvement (CQI) program data to investigate trends in quality of anesthesia care associated with changing staffing patterns in a university hospital. Methods The monthly proportion of cases performed by solo attending anesthesiologists versus attending-resident teams or attending-certified registered nurse anesthetist (CRNA) teams was used to measure staffing patterns. Anesthesia team productivity was measured as mean monthly surgical anesthesia hours billed per attending anesthesiologist per clinical day. Supervisory ratios (concurrency) were measured as mean monthly number of cases supervised concurrently by attending anesthesiologists. Quality of anesthesia care was measured as monthly rates of critical incidents, patient injury, escalation of care, operational inefficiencies, and human errors per 10,000 cases. Trends in quality at increasing productivity and concurrency levels from 1992 to 1997 were analyzed by the one-sided Jonckheere-Terpstra test. Results Productivity was positively correlated with concurrency (r = 0.838; P<0.001). Productivity levels ranged from 10 to 17 h per anesthesiologist per clinical day. Concurrency ranged from 1.6 to 2.2 cases per attending anesthesiologist. At higher productivity and concurrency levels, solo anesthesiologists conducted a smaller percentage of cases, and the proportion of cases with CRNA team members increased. The patient injury rate decreased with increased productivity levels (P = 0.002), whereas the critical incident rate increased (P = 0.001). Changes in operational inefficiency, escalation of care, and human error rates were not statistically significant (P = 0.072, 0.345, 0.320, respectively). Conclusions Most aspects of quality of anesthesia care were apparently not effected by changing anesthesia team composition or increased productivity and concurrency. Only team performance was measured; the role of individuals (attending anesthesiologist, resident, or CRNA) in quality of care was not directly measured. Further research is needed to explain lower patient injury rates and increases in critical incident reporting at higher concurrency and productivity levels.

Looking to CQI for Improvements in Clinical Documentation and Coding

1997 ◽  
Vol 27 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Joanne Callen ◽  
Jodee Meehan ◽  
Saranuj Tomornsak
Keyword(s):  
Quality Improvement ◽  
Health Information ◽  
Continuous Quality Improvement ◽  
Error Rates ◽  
Clinical Documentation ◽  
Philosophical Basis ◽  
Healthcare Environment ◽  
Continuous Quality ◽  
Funding Environment

The following paper examines how the philosophy of Continuous Quality Improvement (CQI) can be used to improve the quality of clinical documentation and coding. The philosophical basis of CQI and its application in the healthcare environment is outlined. Health information managers need to explore inventive ways of solving the problem of inadequate clinical documentation and high coding error rates, particularly in light of the current casemix-based funding environment.

scholarly journals Management of pre-analytical nonconformities at the biochemistry laboratory in Antananarivo in 2019

2021 ◽  
Vol 5 (2) ◽  
pp. 006-011
Author(s):  
Miora Koloina Ranaivosoa ◽  
Valdo Rahajanirina ◽  
Zafindrasoa Domoina Rakotovao Ravahatra ◽  
Jaquinot Randriamora ◽  
Olivat Rakoto Alsone, Andry Rasamindrakotroka
Keyword(s):  
Human Error ◽  
Medical Service ◽  
Research Unit ◽  
University Hospital ◽  
Reliability Of Results ◽  
Surgical Intensive Care ◽  
Know How ◽  
Analytical Phase ◽  
Hospital Center

Management of pre analytical nonconformities within a laboratory is a critical step in ensuring the reliability of results. The objectives of this study are to evaluate the non-compliance of the pre-analytical phase at the Paraclinical Training and Biochemistry Research Unit of the Joseph Ravoahangy Andrianavalona University Hospital Center, to describe in detail the state of play and the progress of this stage. This is a retrospective descriptive study over a period of 5 months from November 01, 2018 to March 31, 2019 within the Paraclinical Training and Biochemistry Research Unit of Joseph Ravoahangy Andrianavalona University Hospital Center. All patient files recorded during this study period have been exploited. Only inpatient records were included in this study. In this study, 5, 71% of pre-analytical non-conformities were recorded. The most frequent non-conformities (recorded 248 times that means 56.88% of the whole nonconformities) were related to the swab or its container, followed by non-conformities related to the prescription sheet (recorded 96 times, that means 22.02%). Pre-analytical non-conformities were the most frequently identified in the surgical intensive care department with 25.24%, followed by the medical service (17.92%). Most of the nonconformities observed were due to preventable human error. However, the laboratory must know how to control nonconformities in order to prevent them and ensure the quality of the analyses.

A Model for Predicting Human Error in the Nuclear Industry

1982 ◽  
Vol 26 (10) ◽  
pp. 850-852 ◽  
Author(s):  
Neville Moray
Keyword(s):  
Nuclear Power ◽  
Human Error ◽  
Error Rates ◽  
Nuclear Industry ◽  
Summary Statistics ◽  
Plant Personnel ◽  
Using Data ◽  
Error Probabilities ◽  
Direct Measures

Usually the Theory of Signal Detection is used to estimate summary statistics, d' and β from measured false alarm and hit rates. Here we estimate d' and β directly and thus can estimate p(F) and p(M). This is possible even for very rare errors where it is difficult or impossible to obtain direct measures of error probabilities. An example of the model is provided using data collected from nuclear power plant personnel. The predicted error rates depend on the quality of the displays, and from the examples given the error rates appear quite close to those predicted by Swain and Guttman (1980).

Article Review: The Impact of Fun and Enjoyment on Adult Learning

2019 ◽  
Vol 1 (2) ◽  
pp. 96
Author(s):  
Laily Yahya
Keyword(s):  
Adult Learners ◽  
Adult Learning ◽  
Teaching And Learning ◽  
Educational Programme ◽  
Continuous Quality ◽  
Teachers Beliefs ◽  
Critical Issues ◽  
Affective Experiences ◽  
The Impact

The article review of ‘The Impact of Fun and Enjoyment on Adult Learning’ (Lucardie, 2014) opens doors to the kaleidoscope of fun and enjoyment amongst adult learners. The essence of this review is an informative snapshot on the critical issues of how fun and joy have impacted adult learning through a qualitative research drawing upon traditions of phenomenology. It aims to explore the affective experiences of fun and enjoyment. This article review attempts to highlight an insightful assessment of the ideas and the arguments that are being discussed by the author. The different interpretation of this concept draws out contrasting elements between learners and teachers’ beliefs. A twist to this review is a reflective stance procured to address central issues emerging in the article related to the Malaysian context. It is through the lens of the reader, Continuous Quality Improvement (CQI):4R is proposed. This refers to the process of continuously improving the quality of teaching and learning of an educational programme. This review concludes with the framing of CQI:4R to illustrate reflect, revisit, realign and reconstruct processes that could possibly navigate the architectural landscape of the Malaysian Teacher Education.

Pengaruh Kompetensi Coder terhadap Keakuratan dan Ketepatan Pengkodean Menggunakan ICD 10 di Rumah Sakit X Pekanbaru Tahun 2016

2018 ◽  
Vol 1 (1) ◽  
pp. 31-43
Author(s):  
Nur Maimun ◽  
Jihan Natassa ◽  
Wen Via Trisna ◽  
Yeye Supriatin
Keyword(s):  
Medical Record ◽  
Human Error ◽  
Medical Personnel ◽  
Quality Of Data ◽  
Accuracy And Precision ◽  
Result Show ◽  
Study Implementation ◽  
Icd 10 ◽  
The Cost

The accuracy in administering the diagnosis code was the important matter for medical recorder, quality of data was the most important thing for health information management of medical recorder. This study aims to know the coder competency for accuracy and precision of using ICD 10 at X Hospital in Pekanbaru. This study was a qualitative method with case study implementation from five informan. The result show that medical personnel (doctor) have never received a training about coding, doctors writing that hard and difficult to read, failure for making diagnoses code or procedures, doctor used an usual abbreviations that are not standard, theres still an officer who are not understand about the nomenclature and mastering anatomy phatology, facilities and infrastructure were supported for accuracy and precision of the existing code. The errors of coding always happen because there is a human error. The accuracy and precision in coding very influence against the cost of INA CBGs, medical and the committee did most of the work in the case of severity level III, while medical record had a role in monitoring or evaluation of coding implementation. If there are resumes that is not clearly case mix team check file needed medical record the result the diagnoses or coding for conformity. Keywords: coder competency, accuracy and precision of coding, ICD 10

Sustainability Failure in the Antimicrobial Stewardship Program in a Secondary Care Hospital from Cuba: A Historical Review of 30 Years and 3 Shots

2020 ◽  
Vol 18 ◽  
Author(s):  
Humberto Guanche Garcell ◽  
Juan José Pisonero Socias ◽  
Gilberto Pardo Gómez
Keyword(s):  
Antimicrobial Stewardship ◽  
Historical Review ◽  
Original Data ◽  
Care Hospital ◽  
Antimicrobial Stewardship Program ◽  
Continuous Quality ◽  
Stewardship Program ◽  
History Of ◽  
Health Organization

Background: During the last 30 years an antimicrobial stewardship program (ASP) was implemented in a facility with periods of weakness. We aim to describe the history of the sustainability failure in the local ASP. Methods: A historical review was conducted using original data from the facility library and papers published. An analysis of factors related to the failure was conducted based on the Doyle approach. Results: The first ASP was implemented from 1989 to 1996 based on the international experiences and contributes to the improvement in the quality of prescription, reduction of 52% in cost and in the incidence of nosocomial infection. The second program restarts in 2008 and decline in 2015, while the third program was guided by the Pan-American Health Organization from 2019. This program, in progress, is more comprehensive than previous ones and introduced as a novel measure the monitoring of antibiotic prophylaxis in surgery. The factors related to the sustainability were considered including the availability of antimicrobials, the leader´s support, safety culture, and infrastructure. Conclusions: The history behind thirty years of experiences in antimicrobial stewardship programs has allowed us to identify the gaps that require proactive strategies and actions to achieve sustainability and continuous quality improvement.

Sign in / Sign up

Export Citation Format

Share Document