scholarly journals Adverse event reviews in healthcare: What matters to patients and their family? A qualitative study exploring the perspective of patients and family

2021 ◽  
Author(s):  
Jean McQueen ◽  
Kyle Gibson ◽  
Moira Manson ◽  
Morag Francis
Keyword(s):  
Adverse Event ◽  
Health Service ◽  
Family Involvement ◽  
Review Process ◽  
Traumatic Event ◽  
Healthcare Provision ◽  
Telephone Interviews ◽  
Good Patient ◽  
Improved Outcomes ◽  
Thematic Approach

AbstractObjectivesExplore what ‘good’ patient and family involvement in healthcare adverse event reviews may involve.DesignData was collected using semi-structured telephone interviews. Interview transcripts were analysed using an inductive thematic approach.SettingNHS Scotland.Participants19 interviews were conducted with patients who had experienced an adverse event during the provision of their healthcare, or their family member.ResultsFour key themes were derived from these interviews: trauma, communication, learning and litigation.ConclusionsFindings suggest there are many advantages of actively involving patients and their families in adverse event reviews. An open, collaborative, person-centred approach which listens to, and involves, patients and their families is perceived to lead to improved outcomes for all. For the patient and their family, it can help with reconciliation following a traumatic event and help restore their faith in the healthcare system. For the health service, listening and involving people will likely enhance learning with subsequent improvements in healthcare provision with reduction in risk of similar events occurring for other patients. Communicating in a compassionate manner could also decrease litigation claims following an adverse event. Overall, having personalised conversations and a streamlined review process, with open engagement to enhance learning, was important to most participants in this study.

scholarly journals The Use of Dexmedetomidine in the Emergency Department: A Cohort Study

2021 ◽  
Vol 22 (5) ◽  
pp. 1202-1209
Author(s):  
Joseph Sinnott ◽  
Christopher Holthaus ◽  
Enyo Ablordeppey ◽  
Brian Wessman ◽  
Brian Roberts ◽  
...  
Keyword(s):  
Emergency Department ◽  
Adverse Event ◽  
Cohort Study ◽  
Respiratory Failure ◽  
Adverse Events ◽  
Acute Respiratory Failure ◽  
Tertiary Care ◽  
Multivariable Logistic Regression Model ◽  
Non Invasive Ventilation ◽  
Improved Outcomes

Introduction: Management of sedation, analgesia, and anxiolysis are cornerstone therapies in the emergency department (ED). Dexmedetomidine (DEX), a central alpha-2 agonist, is increasingly being used, and intensive care unit (ICU) data demonstrate improved outcomes in patients with respiratory failure. However, there is a lack of ED-based data. We therefore sought to: 1) characterize ED DEX use; 2) describe the incidence of adverse events; and 3) explore factors associated with adverse events among patients receiving DEX in the ED. Methods: This was a single-center, retrospective, cohort study of consecutive ED patients administered DEX (January 1, 2017–July 1, 2019) at an academic, tertiary care ED with an annual census of ~90,000 patient visits. All included patients (n= 103) were analyzed for characterization of DEX use in the ED. The primary outcome was a composite of adverse events, bradycardia and hypotension. Secondary clinical outcomes included ventilator-, ICU-, and hospital-free days, and hospital mortality. To examine for variables associated with adverse events, we used a multivariable logistic regression model. Results: We report on 103 patients. Dexmedetomidine was most commonly given for acute respiratory failure, including sedation for mechanical ventilation (28.9%) and facilitation of non-invasive ventilation (17.4%). Fifty-four (52.4%) patients experienced the composite adverse event, with hypotension occurring in 41 patients (39.8%) and bradycardia occurring in 18 patients (17.5%). Dexmedetomidine was stopped secondary to an adverse event in eight patients (7.8%). Duration of DEX use in the ED was associated with an increase adverse event risk (adjusted odds ratio, 1.004; 95% confidence interval, 1.001, 1.008). Conclusion: Dexmedetomidine is most commonly administered in the ED for patients with acute respiratory failure. Adverse events are relatively common, yet DEX is discontinued comparatively infrequently due to adverse events. Our results suggest that DEX could be a viable option for analgesia, anxiolysis, and sedation in ED patients.

Family interventions in psychosis

2020 ◽  
pp. 531-537
Author(s):  
Juliana Onwumere ◽  
Elizabeth Kuipers
Keyword(s):  
Patient Outcomes ◽  
Family Involvement ◽  
Lived Experiences ◽  
Treatment Guidelines ◽  
Well Being ◽  
Evidence Base ◽  
Family Interventions ◽  
Improved Outcomes ◽  
The Impact

Families can play an important role in supporting individuals living with psychosis disorders and helping to facilitate their improved outcomes. This chapter, offered by Juliana Onwumere and Elizabeth Kuipers, provides an overview of the literature reporting on family involvement in the care of adults with lived experiences of psychosis, the impact of the caregiving role on carer well-being, and the predictive links between caregiving relationships and key patient outcomes including relapse. The chapter reports on the application of family interventions, the evidence base supporting its application and inclusion in treatment guidelines, and implementation issues.

scholarly journals Factors Affecting Early Services for Children Who Are Hard of Hearing

2016 ◽  
Vol 47 (1) ◽  
pp. 16-30 ◽  
Author(s):  
Melody Harrison ◽  
Thomas A. Page ◽  
Jacob Oleson ◽  
Meredith Spratford ◽  
Lauren Unflat Berry ◽  
...  
Keyword(s):  
Family Involvement ◽  
Hard Of Hearing ◽  
Spoken Language ◽  
Comfort Level ◽  
Online Questionnaire ◽  
Factors Affecting ◽  
Telephone Interviews ◽  
Modest Contribution ◽  
Home Based ◽  
Relationship Of

PurposeTo describe factors affecting early intervention (EI) for children who are hard of hearing, we analyzed (a) service setting(s) and the relationship of setting to families' frequency of participation, and (b) provider preparation, caseload composition, and experience in relation to comfort with skills that support spoken language for children who are deaf and hard of hearing (CDHH).MethodParticipants included 122 EI professionals who completed an online questionnaire annually and 131 parents who participated in annual telephone interviews.ResultsMost families received EI in the home. Family participation in this setting was significantly higher than in services provided elsewhere. EI professionals were primarily teachers of CDHH or speech-language pathologists. Caseload composition was correlated moderately to strongly with most provider comfort levels. Level of preparation to support spoken language weakly to moderately correlated with provider comfort with 18 specific skills.ConclusionsResults suggest family involvement is highest when EI is home-based, which supports the need for EI in the home whenever possible. Access to hands-on experience with this population, reflected in a high percentage of CDHH on providers' current caseloads, contributed to professional comfort. Specialized preparation made a modest contribution to comfort level.

scholarly journals Improving the quality of acute inpatient care

2010 ◽  
Vol 19 (4) ◽  
pp. 287-290 ◽  
Author(s):  
Paul Lelliott ◽  
Sarah Bleksley
Keyword(s):  
Health Service ◽  
Inpatient Care ◽  
Review Process ◽  
Mental Healthcare ◽  
Acute Admission ◽  
National Surveys ◽  
The Past ◽  
Weakest Link ◽  
Per Capita

AbstractOver the past ten years, the National Health Service in England has introduced home treatment teams throughout the country. Despite this, and the fact that England now has the fourth lowest number of beds per capita in Europe, no mental health service has been able to dispense with acute admission beds altogether. One unintended consequence of new investment in community alternatives to inpatient care is that the threshold for admission has risen and acute wards now accommodate a patient group that is more severe with regard to levels of disturbance and social disadvantage. This has compounded the challenge of providing high quality inpatient care and repeated national surveys suggest that acute admission wards are the weakest link in the English mental healthcare system. In response to this, the Royal College of Psychiatrists has established an accreditation scheme for acute admission wards. Only 22 of the first 132 wards to have completed the review process so far are considered to be excellent. Although 59 wards (45% of the total) failed to meet one or more essential standard, 43 of these were able to rectify the problem.Declaration of Interest: None.

scholarly journals Clinical effectiveness – a series of perspectives

1997 ◽  
Vol 21 (7) ◽  
pp. 389-389
Author(s):  
Sarah Marriott
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Clinical Effectiveness ◽  
Effective Practice ◽  
Healthcare Provision ◽  
Service Models

Ensuring clinically effective practice and service models is now a major challenge for the National Health Service. It requires a clear focus on the purpose of healthcare provision – care which is most likely to result in the best possible individual or population outcomes within existing resources.

scholarly journals Factors Affecting the Perceived Quality of Service and Patient Satisfaction on Inpatient Care of Nabire Hospital Papua

2020 ◽  
Author(s):  
Agustina Utii ◽  
◽  
Bhisma Murti ◽  
Yulia Lanti Retno Dewi ◽  
Priscilla Jessica Pihahey ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Satisfaction ◽  
Health Insurance ◽  
Length Of Stay ◽  
Health Service ◽  
Inpatient Care ◽  
Patient Perception ◽  
Factors Affecting ◽  
Good Patient

ABSTRACT Background: The government’s efforts to improve public health level are by providing excellent health service facilities, including promotion, preventive, curative, and rehabilitative. The outcome of quality health service can be measured by patient perception and satisfaction. This study aimed to examine factors affecting the perceived quality of service and patient satisfaction on inpatient care of Nabire Hospital, Papua, Indonesia. Subjects and Method: A cross-sectional study was carried out at Nabire regional hospital, Papua, Indonesia, from March to Mey 2020. A sample of 207 inpatients was selected by stratified random sampling. The dependent variable was patient satisfaction. The independent variables were age, income, and length of stay type class health insurance, working, and patient perception toward doctor, nurse, and inpatients facilities. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Inpatients satisfaction decreased with age ≥50 years (OR= 0.72; 95% CI= 0.24 to 2.65; p= 0.720), income ≥Papua minimum wage (OR= 0.77; 95% CI= 0.22 to 2.73; p= 0.685), and length of stay ≥7 days (OR= 0.13; 95% CI= 0.03 to 0.53; p= 0.004). Inpatients satisfaction increased with class 2 and 3 (OR= 1.15; 95% CI= 0.43 to 3.07; p= 0.773), non national health insurance (OR= 1.21; 95% CI= 0.46 to 3.23; p= 0.700), working (OR= 2.13; 95% CI= 0.58 to 7.85; p= 0.258), good patient perception toward doctor (OR= 3.03; 95% CI= 1.15 to 7.99; p<0.001), good persepsi patient perception toward nurse (OR= 4.04; 95% CI= 1.15 to 14.17; p<0.001), and patient perception toward inpatients facilities (OR= 26.8; 95% CI= 11.0 to 65.32; p<0.001). Conclusion: Inpatients satisfaction decreases with age ≥50 years, income ≥Papua minimum wage, and length of stay ≥7 days. Inpatients satisfaction increases with class 2 and 3, non national health insurance, working, good patient perception toward doctor, good persepsi patient perception toward nurse, and patient perception toward inpatients facilities. Keywords: inpatients satisfaction, patient perception, health insurance Correspondence: Agustina Utii. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 081240051451. DOI: https://doi.org/10.26911/the7thicph.04.46

scholarly journals Influence of Politics on Accountability of Health Professionals in Bangladesh: An Analysis of the Quality of Health Service Delivery

2017 ◽  
Vol 12 (1) ◽  
pp. 75-82
Author(s):  
Mohammad Shafiqul Islam
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health System ◽  
Healthcare Delivery ◽  
Health Service Delivery ◽  
Elected Officials ◽  
Political Commitment ◽  
Healthcare Provision ◽  
Administrative Authority ◽  
Political Actors

This study explored the role and responsibility of elected officials including political actors and addressed the factors of politics, decentralisation, bureaucratic management, and political commitment to understanding accountability in health service delivery. This study used qualitative case studies for which a total of 68 in-depth interviews and five focus group discussions were conducted in two areas of rural and urban Bangladesh. The findings show that political actors have poor commitment to improving accountability and healthcare delivery. The elected officials are not interested in organising regular meetings and they are even reluctant to organise a health service committee to make health officials accountable. The opposition political parties have no participation in health service organisations as the existing political culture does not allow it. Moreover, elected officials have a limited administrative authority because of an inadequate decentralised health system that leads to poor accountability and inadequate healthcare delivery. Further, bureaucrats want to capture power and are unwilling to decentralise the health system. The policy recommendation includes the decentralisation of healthcare provision and increased participation of elected representatives in a decentralised system. Abbreviations: ADP – Annual Development Plan; MP – Member of Parliament; NGO – Non Government Organisation; UHC – Upazilia Health Complex; UP – Upazilia Parishad.

The Place-Based Challenge

2020 ◽  
pp. 117-165
Keyword(s):  
Health Service ◽  
Health Inequalities ◽  
Local Level ◽  
Healthcare Services ◽  
Public Healthcare ◽  
Local Health ◽  
Healthcare Provision ◽  
Welfare Benefits ◽  
Health Service Providers ◽  
Healthcare Interventions

When considering the provision of healthcare services, it is necessary to examine action at a local level and problems that local health service providers must face. This is essentially because it is within individual communities and neighbourhoods that most public healthcare interventions take place. Local intervention is also important in order to coordinate a more even pattern of healthcare provision across the regions. There are significant disparities between regions and inter-regions of the UK. Recent cuts to public services, welfare benefits, and public employment have severely affected those regions. This chapter will thus explore health inequalities and inequity of supply across the devolved administrations, regions, and sub-regions. It will then review policy to address health inequalities and consider to what extent the current public health service governance framework, and especially health service provision at the local level, can mitigate disparities in health outcomes. It includes a short section on the response to the Covid-19 pandemic in the regions.

Personal and Public Involvement in Healthcare Provision

2020 ◽  
pp. 89-116
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
National Health Service ◽  
Health Service ◽  
Public Involvement ◽  
Healthcare Providers ◽  
Healthcare Provision ◽  
Governance Framework ◽  
Levels Of Care ◽  
National Healthcare

Personal and public involvement in healthcare provision has become an essential part of the governance framework of the National Health Service (NHS) today. Patient safety, quality, and responsiveness of care are the main priorities of national healthcare providers. Yet in practice, there are significant limitations to the introduction of a true patient- or person-centred approach, which will be described in this chapter. Two case studies have been included to illustrate the challenges to implementing a true person-centred approach in the NHS. The first relates to the Mid-Staffordshire Hospital Trust where hundreds of patients died as a result of sub-standard levels of care. The second focuses on a family's struggle to access a joined-up package of care for a Parkinson's disease sufferer in a primary care setting.

Financial Governance and the NHS

2020 ◽  
pp. 36-65
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Essential Medicines ◽  
Financial Control ◽  
Healthcare Provision ◽  
Financial Costs ◽  
Point Of Use ◽  
Financial Governance

Faced with significant difficulties to meet financial costs owing to increased demand for healthcare, National Health Service (NHS) organisations are looking to maintain tight financial control and reduce expenditure where possible. Significant price hikes in essential medicines can also raise challenges to the supply of necessary drugs for the population. The NHS continues to supply healthcare free at the point of use and any attempts to introduce charges remain unpopular. There have been a number of ways in which providers endeavour to reduce costs: rationalisation (reduction of services or certain costly drugs) or through increasing the role of private providers in healthcare provision. This chapter thus reviews the funding challenges the NHS is currently facing and how financial governance is evolving to meet those challenges.

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