Factors influencing the quality of care learning disabled patients receive in hospital

2020 ◽  
Vol 25 (2) ◽  
pp. 83-92
Author(s):  
Alice Durrant
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Quality Of Care ◽  
General Hospital ◽  
Learning Disabled ◽  
Care Staff ◽  
Content Type ◽  
Increased Risk ◽  
Disabled Patients

Purpose In total, 40% of the deaths of patients with learning disabilities have been classed as avoidable, and there is a known increased risk of harm while inpatients in hospital. This paper aims to look at the current experiences and treatment of people with learning disabilities within a general hospital setting to examine factors that affect their care. Design/methodology/approach A comprehensive literature search was conducted of primary research between 2013 and 2019 to evaluate what is known about the quality of care and treatment that learning disabled patients experience within a general hospital. Findings The research suggests that people with learning disabilities receive haphazard care in hospital settings, with inconsistent implementation of reasonable adjustments, insufficient arrangements to support family and other carer input, and poor knowledge of learning disability amongst hospital staff. Originality/value Previously, reviews focussing on hospital care have mainly focussed on access to health care rather than its delivery. This review has found evidence of significant failings in delivering care to this patient group, identifying a gap of knowledge in this field regardless of policies and laws already in place. There should be stricter monitoring of the Equality Act’s enforcement, along with improved and mandatory training for all general health-care staff. It is crucial that health-care professionals learn from mistakes to improve the care and experiences of learning disabled inpatients.

Commentary on “Factors influencing the quality of care learning disabled patients receive in hospital”

2020 ◽  
Vol 25 (2) ◽  
pp. 93-96
Author(s):  
Tricia Handley
Keyword(s):  
Quality Of Care ◽  
Design Methodology ◽  
Learning Disabled ◽  
Care Staff ◽  
Health Care Staff ◽  
Content Type ◽  
Factors Influencing ◽  
Acute Hospitals ◽  
Disabled Patients

Purpose The purpose of this paper is to provide a commentary on Durrant’s paper “Factors influencing the quality of care learning disabled patients receive in hospital”. Design/methodology/approach The commentary identifies examples of practice in acute hospital provision consistent with the themes outlined in Durrant’s paper. Findings The themes identified in Durrant’s paper are easily recognisable. At the same time, there is a need to more fully understand the complexity of acute hospitals and to involve mainstream health-care staff in development and delivery of training on learning disability. Consideration should be given to the development of new specialist roles. Originality/value The commentary provides a practice perspective arising from wide clinical experience.

Patient satisfaction with the quality of care in Ghana’s health-care institutions

2019 ◽  
Vol 13 (2) ◽  
pp. 160-170 ◽  
Author(s):  
Aaron Asibi Abuosi ◽  
Mahama Braimah
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Service Delivery ◽  
National Survey ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Content Type ◽  
Care Facilities

Purpose The purpose of this study was to examine patient satisfaction with the quality of care in Ghana’s health-care facilities using a disaggregated approach. Design/methodology/approach The study was a cross-sectional national survey. A sample of 4,079 males and females in the age group of 15-49 years were interviewed. Descriptive statistics, principal component analysis and t-tests were used in statistical analysis. Findings About 70 per cent of patients were satisfied with the quality of care provided in health-care facilities in Ghana, whereas about 30 per cent of patients were fairly satisfied. Females and insured patients were more likely to be satisfied with the quality of care, compared with males and uninsured patients. Research limitations/implications Because data were obtained from a national survey, the questionnaire did not include the type of facility patients attended to find out whether satisfaction with the quality of care varied by the type of health facility. Future studies may, therefore, include this. Practical implications The study contributes to the literature on patient satisfaction with the quality of care. It highlights that long waiting time remains an intractable problem at various service delivery units of health facilities and constitutes a major source of patient dissatisfaction with the quality of care. Innovative measures must, therefore, be adopted to address the problem. Originality/value There is a paucity of research that uses a disaggregated approach to examine patient satisfaction with the quality of care at various service delivery units of health facilities. This study is a modest contribution to this research gap.

Workplace-based clinical leadership training increases willingness to lead

2015 ◽  
Vol 28 (2) ◽  
pp. 100-118 ◽  
Author(s):  
Aleece MacPhail ◽  
Carmel Young ◽  
Joseph Elias Ibrahim
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Leadership Training ◽  
Low Cost ◽  
Leadership Role ◽  
Leadership Roles ◽  
Senior Executive ◽  
Clinical Leadership ◽  
Content Type

Purpose – The purpose of this paper is to reflect upon a workplace-based, interdisciplinary clinical leadership training programme (CLP) to increase willingness to take on leadership roles in a large regional health-care centre in Victoria, Australia. Strengthening the leadership capacity of clinical staff is an advocated strategy for improving patient safety and quality of care. An interdisciplinary approach to leadership is increasingly emphasised in the literature; however, externally sourced training programmes are expensive and tend to target a single discipline. Design/methodology/approach – Appraisal of the first two years of CLP using multiple sourced feedback. A structured survey questionnaire with closed-ended questions graded using a five-point Likert scale was completed by participants of the 2012 programme. Participants from the 2011 programme were followed up for 18 months after completion of the programme to identify the uptake of new leadership roles. A reflective session was also completed by a senior executive staff that supported the implementation of the programme. Findings – Workplace-based CLP is a low-cost and multidisciplinary alternative to externally sourced leadership courses. The CLP significantly increased willingness to take on leadership roles. Most participants (93 per cent) reported that they were more willing to take on a leadership role within their team. Fewer were willing to lead at the level of department (79 per cent) or organisation (64 per cent). Five of the 11 participants from the 2011 programme had taken on a new leadership role 18 months later. Senior executive feedback was positive especially around the engagement and building of staff confidence. They considered that the CLP had sufficient merit to support continuation for at least another two years. Originality/value – Integrating health-care professionals into formal and informal leadership roles is essential to implement organisational change as part of the drive to improve the safety and quality of care for patients and service users. This is the first interdisciplinary, workplace-based leadership programme to be described in the literature, and demonstrates that it is possible to deliver low-cost, sustainable and productive training that increases the willingness to take on leadership roles.

Quality Improvement: Buzz Words or Boon?

1993 ◽  
Vol 14 (6) ◽  
pp. 208-213 ◽  
Author(s):  
David A. Bergman
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Of Care ◽  
General Hospital ◽  
Surgical Procedures ◽  
Massachusetts General Hospital ◽  
Quality In Health Care

Background Assessment of quality in health care has a long history, dating back to the works of E.A. Codman, who wrote in 1914 about improving the quality of care by evaluating the results of treatments.1 These views were not widely accepted at the time. Codman experienced considerable frustration in persuading his colleagues to keep accurate records and note the outcomes of their treatment. Ultimately, he resigned from the staff of the Massachusetts General Hospital and formed his own hospital, where he diligently kept records of his surgical procedures and patients' outcomes. Codman's ideas concerning outcome-based quality improvement were not considered seriously again until the 1980s. In the interim, many physicians regarded the quality of care they provided to be high, but they could neither define nor measure it exactly. This attitude toward quality perhaps is illustrated by a quotation from Pirsig's Zen and the Art of Motorcycle Maintenance: "Quality.... you know what it is, yet you don't know what it is....But when you try to say what quality is, apart from the things that have it, it all goes poof! There is nothing to talk about. But if you can't say what quality is, how do you know what it is, or how do you know that it even exists?"2

Determinants of good and poor quality as perceived by US health care managers

2018 ◽  
Vol 32 (5) ◽  
pp. 708-725 ◽  
Author(s):  
Rebecca Amati ◽  
Amer A. Kaissi ◽  
Annegret F. Hannawa
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Quality Care ◽  
Poor Quality ◽  
Health Care Managers ◽  
Content Type ◽  
Written Narratives ◽  
Care Managers ◽  
Care Assessment

Purpose The scientific literature evidences that the quality of care must be improved. However, little research has focused on investigating how health care managers – who are responsible for the implementation of quality interventions – define good and poor quality. The purpose of this paper is to develop an empirically informed taxonomy of quality care as perceived by US managers – named the Integrative Quality Care Assessment Tool (INQUAT) – that is grounded in Donabedian’s structure, process and outcome model. Design/methodology/approach A revised version of the critical incident technique was used to collect 135 written narratives of good and poor quality care from 74 health care managers in the USA. The episodes were thematically analyzed. Findings In total, 804 units were coded under the 135 written narratives of care. They were grouped under structure (9 percent, n=69), including organizational, staff and facility resources; process (52 percent, n=419), entailing communication, professional diligence, timeliness, errors, and continuity of care; outcomes (32 percent, n=257), embedding process- and short-term outcomes; and context (7 percent, n=59), involving clinical and patient factors. Process-related categories tended to be described in relation to good quality (65 percent), while structure-related categories tended to be associated with poor quality (67 percent). Furthermore, the data suggested that managers did not consider their actions as important factors influencing quality, but rather tended to attribute the responsibility for quality care to front-line practitioners. Originality/value The INQUAT provides a theoretically grounded, evidence-based framework to guide health care managers in the assessment of all the components involved with the quality of care within their institutions.

Do performance measurement models have any impact on primary health care? A systematic review

2020 ◽  
Vol 25 (4) ◽  
pp. 319-334
Author(s):  
Brahim Zaadoud ◽  
Youness Chbab ◽  
Aziz Chaouch
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Performance Measurement ◽  
Conceptual Framework ◽  
Conceptual Frameworks ◽  
Content Type ◽  
Primary Health

PurposeThe purpose of this article is to analyze and compare between the frameworks of performance measurement in primary health care in the world. The subject of search is to compare if the frameworks of performance measurement in primary health care have an influence on performances of health centers.Design/methodology/approachWe conducted a systematic review of the literature to (1) identify the conceptual framework for measuring quality management systems, (2) assess the effects of conceptual framework on quality improvement and quality of care outcomes. We opted for the frameworks that are more cited in the literature and we analyzed and compared between these frameworks.FindingsEight dimensions were identified for assessing performance in Primary Health Care Facilities “PHCF” in more than 50% frameworks: Effectiveness, Safety, Accessibility, Equity, Efficiency, Acceptability, Patient Centeredness and Timeliness.Research limitations/implicationsThe limits of this study can be represented by the following elements: (1) lack of exhaustiveness with regard to the current Frameworks. (2) The evaluation of reliability and validity of the qualitative studies remains difficult to appreciate. (3) Most of the evaluation tools of the primary health care are not validated yet. (4) The difference in performance levels between countries, especially for the developed countries and the multitude of the frames of measure of performance, limits the comparability of the results.Practical implicationsThis study provides a conceptual and descriptive literature on the different conceptual frameworks for performance measurement in primary health care, and a practical and useful tool for comparison between the different conceptual frameworks. Several organisations of accreditation or certification introduced, developed, incorporated and checked the indicators of clinical quality in the organizations of health care. Some studies revealed links with the governance, the access, the continuity, the coordination, the efficiency and the strength primary care (Dionne Kringos, 2018). Improvements in the quality of care have been observed in the results of accreditation and certification bodies regarding hospital infection control infrastructure, organization and performance.Originality/valueEven if the links are not established within the framework of a scientific research, quality approaches are generally recognized as an essential tool to help establishments to improve the quality and the safety of the patients. Until now, it is not still common to make evaluation of the quality of care in the “PHCF” to obtain the relevant information. The necessity of having performance measurement tools, which puts in coherence the piloting of the operational level with the strategy, to integrate the organizational objectives into the measures of operational performances and make estimate its structures towards a real management by the quality.

Value-based health-care principles in health-care organizations

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Fiorella Pia Salvatore ◽  
Simone Fanelli ◽  
Chiara Carolina Donelli ◽  
Michele Milone
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Organizations ◽  
Organizational Changes ◽  
Content Type ◽  
Health Care Outcomes ◽  
Analytical Technique ◽  
A Value ◽  
Care Outcomes

Purpose This study aims to analyze the value-based health-care model in defining a strategy to guide the evolution of health-care organizations toward a value-oriented model. To improve the quality of care by ensuring economic sustainability, it is necessary to redefine the concept of competition in healthcare and align it with the concept of maximizing value for patients. Design/methodology/approach Performance measurement is a crucial aspect of the analysis of health-care organizations. Porter developed an effective analytical technique and presented the measurement of health-care outcomes based on health conditions, the efficiency of health-care organizations and the type of service provided. Findings Clinical outcomes and data on the costs of care of each patient are essential to evaluate improvement in treatment value over time. Engaging in the evaluation of what happens to patients in their course of care enables the expansion of the measurement of outcomes because it measures all the health services related to it. Originality/value Building a health-care system based on the value and continuous improvement of care and services provided is a goal shared by many countries and international organizations. Today, the analysis of outcomes is important for making informed decisions, directing and planning clinical and organizational changes by improving the quality of care and services.

Creating a fractal-based quality management infrastructure

2014 ◽  
Vol 28 (4) ◽  
pp. 576-586 ◽  
Author(s):  
Peter J Pronovost ◽  
Jill A Marsteller
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Quality Of Care ◽  
Quality Management ◽  
Health System ◽  
Fractal Structure ◽  
Coordination Theory ◽  
Content Type ◽  
Fractal System

Purpose – The purpose of this paper is to describe how a fractal-based quality management infrastructure could benefit quality improvement (QI) and patient safety efforts in health care. Design/methodology/approach – The premise for this infrastructure comes from the QI work with health care professionals and organizations. The authors used the fractal structure system in a health system initiative, a statewide collaborative, and several countrywide efforts to improve quality of care. It is responsive to coordination theory and this infrastructure is responsive to coordination theory and repeats specific characteristics at every level of an organization, with vertical and horizontal connections among these levels to establish system-wide interdependence. Findings – The fractal system infrastructure helped a health system achieve 96 percent compliance on national core measures, and helped intensive care units across the USA, Spain, and England to reduce central line-associated bloodstream infections. Practical implications – The fractal system approach organizes workers around common goals, links all hospital levels and, supports peer learning and accountability, grounds solutions in local wisdom, and effectively uses available resources. Social implications – The fractal structure helps health care organizations meet their social and ethical obligations as learning organizations to provide the highest possible quality of care and safety for patients using their services. Originality/value – The concept of deliberately creating an infrastructure to manage QI and patient safety work and support organizational learning is new to health care. This paper clearly describes how to create a fractal infrastructure that can scale up or down to a department, hospital, health system, state, or country.

scholarly journals Multiple burdens of stigma for prisoners participating in opioid antagonist treatment (OAT) programmes in Indonesian prisons: a qualitative study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rita Komalasari ◽  
Sarah Wilson ◽  
Sudirman Nasir ◽  
Sally Haw
Keyword(s):  
Health Care ◽  
Drug Use ◽  
Care Staff ◽  
Opioid Antagonist ◽  
Health Care Staff ◽  
Prison Staff ◽  
Content Type ◽  
Effective Strategies ◽  
Programme Participation

Purpose In spite of the effectiveness of opioid antagonist treatment (OAT) in reducing injecting drug use and needle sharing, programmes in prison continue to be largely stigmatised. This affects programme participation and the quality of programmes delivered. This study aims to explore how Indonesian prison staff and prisoners perceived and experienced stigma relating to prison OAT programmes and identify potential strategies to alleviate this stigma. Design/methodology/approach Three prisons in Indonesia were selected as part of a qualitative case study. Two of the prisons provided OAT, in the form of methadone maintenance treatment (MMT). Purposive and snowball sampling were used to recruit study participants. In total, 57 semi-structured interviews were conducted with prison governors, health-care staff, prison officers and prisoners. Prisoners included both participants and non-participants in methadone programmes. The data were analysed thematically. Findings MMT programme participants were perceived by both prison staff and other prisoners to be engaged in illicit drug use, and as lazy, poor, dirty and unproductive people. They were also presumed to be HIV-positive. These multi-layered, intersectional sources of (inter-personal) stigma amplified the effects on prisoners affecting not only their quality of life and mental health but also their access to prison parole programmes, and therefore the possibility of early release. In addition, organisational factors – notably non-confidential programme delivery and lack of both family and institutional supports for methadone prisoners – exacerbated the stigmatisation of MMT programme participants. Practical implications Effective strategies to alleviate stigma surrounding OAT programmes such as MMT programmes are urgently needed to ensure participation in and the quality of programmes in prisons. Originality/value Many prisoners reported experiencing stigma relating to their participation in MMT programmes in both the methadone prisons studied. They often emphasised the ways that this stigmatisation was amplified by the ways that MMT programme participation was associated with drug use and HIV infection. However, these intersecting experiences and concerns were not recognised by health-care staff or other prison staff. Effective strategies to alleviate stigma surrounding OAT programmes such as MMT programmes are urgently needed to ensure participation in and the quality of programmes in prisons.

Assessing health care quality in adolescent clinics, implications for quality improvement

2018 ◽  
Vol 23 (4) ◽  
pp. 269-280 ◽  
Author(s):  
Emmanuel Anongeba Anaba ◽  
Aaron Asibi Abuosi
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Adolescent Health ◽  
Health Care Quality ◽  
Care Quality ◽  
Urban Setting ◽  
Content Type ◽  
Seek Health Care

Purpose Adolescents are more exposed to risky health behaviors. However, many adolescents do not seek health care due to the poor quality of care. The purpose of this paper is to assess health care quality in adolescent clinics in Tema, a suburb of Ghana. Design/methodology/approach Cross-sectional survey design was adopted to collect data from 365 adolescent respondents. Data were analyzed with the aid of Statistical Package for Social Science (version 20) using descriptive statistics and multiple linear regression. Findings The results demonstrate that adolescents perceived quality of care in adolescent clinics to be good. The significant predictors of adolescents’ overall perceptions of quality of care were provider competencies (β=0.311, p<0.01), adolescent’s health literacy (β=0.359, p<0.01), appropriate package of services (β=0.093, p<0.05), and equity and non-discrimination (β=0.162, p<0.01). Research limitations/implications The study was conducted in an urban setting. Therefore, the generalization of findings must be done with caution. Originality/value Adolescent health care quality in Ghana is below expectation. However, it has received little attention from researchers. This study provides empirical evidence for adolescent health care quality improvement in developing countries like Ghana.

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