scholarly journals Health Care Complaints and Adverse Events as a Means of User Involvement for Quality and Safety Improvement

2019 ◽  
Vol 97 (1) ◽  
pp. 346-349
Author(s):  
SØREN BIRKELAND
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
User Involvement ◽  
Quality And Safety ◽  
Safety Improvement

scholarly journals Quality and Safety Improvement in Spine Surgery

2020 ◽  
Vol 10 (1_suppl) ◽  
pp. 17S-28S
Author(s):  
Fan Jiang ◽  
Jamie R. F. Wilson ◽  
Jetan H. Badhiwala ◽  
Carlo Santaguida ◽  
Michael H. Weber ◽  
...  
Keyword(s):  
Adverse Events ◽  
Spine Surgery ◽  
Practice Guidelines ◽  
Prediction Models ◽  
Narrative Review ◽  
Quality And Safety ◽  
Ovid Medline ◽  
Modern Health Care ◽  
Safety Improvement ◽  
Modern Era

Study Design: Review article. Objectives: A narrative review of the literature on the current advances and limitations in quality and safety improvement initiatives in spine surgery. Methods: A comprehensive literature search was performed using Ovid MEDLINE focusing on 3 preidentified concepts: (1) quality and safety improvement, (2) reporting of outcomes and adverse events, and (3) prediction model and practice guidelines. The search was conducted under appropriate subject headings and using relevant text words. Articles were screened, and manuscripts relevant to this discussion were included in the narrative review. Results: Quality and safety improvement remains a major research focus attracting investigators from the global spine community. Multiple databases and registries have been developed for the purpose of generating data and monitoring the progress of quality and safety improvement initiatives. The development of various prediction models and clinical practice guidelines has helped shape the care of spine patients in the modern era. With the reported success of exemplary programs initiated by the Northwestern and Seattle Spine Team, other quality and safety improvement initiatives are anticipated to follow. However, despite these advancements, the reporting metrics for outcomes and adverse events remain heterogeneous in the literature. Conclusion: Constant surveillance and continuous improvement of the quality and safety of spine treatments is imperative in modern health care. Although great advancement has been made, issues with reporting outcomes and adverse events persist, and improvement in this regard is certainly needed.

scholarly journals A Identificação do paciente no alcance de práticas seguras: concepções e práticas

2019 ◽  
Vol 87 (25) ◽  
Author(s):  
Andréia Guerra
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Adverse Events ◽  
Safety Culture ◽  
Descriptive Study ◽  
Quality And Safety ◽  
Patient Identification ◽  
Nursing Team ◽  
Study Sites

Objetivo: Avaliar as dificuldades, ações e estratégias realizadas pela equipe de enfermagem para alcançar a meta de segurança de identificação dos pacientes em uma unidade de internação de um hospital filantrópico. Método: estudo descritivocom abordagem qualitativa. A coleta de dados foi realizada de junho a julho de 2016, por meio de entrevistas, com roteirosemiestruturado, com vinte profissionais da equipe de enfermagem. Resultados: foram construídas três categorias temáticas: Identificação do Paciente: concepções, ações e dificuldades vivenciadas; Identificação do Paciente: riscos existentes;Estratégias para desenvolver a cultura de segurança do paciente. Conclusão: evidenciou-se a falta de cultura de segurançado paciente nos locais de estudo. Surge a necessidade de criar estratégias educativas que possibilitem uma melhor capacitação, planejamento e organização das ações, assim como as notificações de eventos adversos garantindo qualidade esegurança aos pacientes.Palavras chave: Segurança do Paciente. Qualidade da Assistência à Saúde. Cultura Organizacional. ABSTRACTObjective: To evaluate the difficulties, actions and strategies carried out by the nursing team in order to achieve the goalof identifying patients in an inpatient unit of a philanthropic hospital. Method: descriptive study with qualitative approach.Data collection was carried out from June to July of 2016, through interviews, with semi-structured script, with twentyprofessionals of the nursing team. Results: three thematic categories were constructed: Patient Identification: conceptions,actions and difficulties experienced; Patient identification: existing risks; Strategies for developing a patient safety culture.Conclusion: the lack of safety culture of the patient in the study sites was evidenced. The need to create educationalstrategies that allow better training, planning and organization of actions, as well as the notifications of adverse events,guaranteeing quality and safety to the patients.Keywords: Patient Safety. Quality of Health Care. Organizational Culture

scholarly journals Quality and Safety Management of Health Care Service Delivery among Public Hospitals in Rwanda: a Cross-Sectional Survey

2019 ◽  
Vol 3 (2) ◽  
pp. 95-106
Author(s):  
Deogratias Ndagijimana ◽  
Connie Mureithi ◽  
Nicholas Njau Ngomi
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Service Delivery ◽  
Safety Management ◽  
Care Service ◽  
Health Care Service ◽  
Public Hospitals ◽  
Quality And Safety ◽  
Cross Sectional ◽  
Health Care Service Delivery

Background or Objectives: Quality and safety of health care service delivery remain a challenge worldwide due to unsafe care, inappropriate practices, adverse events and medication errors that result in harm, disability and death of patients. This study examines the status of quality and safety management of health care service delivery in public hospitals in Rwanda. Methods: The study was a descriptive cross-sectional study. Overall population of interest comprised of 564 hospital managers from 47 hospitals. An online email-based questionnaire was used for data collection. Statistical analysis included bivariate, multivariable, and logistic regression analyses with significance at p<0.05. Data were analyzed using Statistical Package for social Sciences (SPSS) Software v.21. Results: The study sample population was 235 managers (5 persons from each hospital). Of the 235 responses received, 72.3% were from male managers and 27.7% were from female managers. The prevalence of adverse events among public hospitals in Rwanda is 0.007% (p=0.02, 95% CI: 0.017-0.023) with risk of incidents of 0.073%. In all, 98.7% of public hospitals reported incidents, and only 39.3% of them have regularly reported all types of incidents. The most common incidents were adverse drug event (25.3%), loss to follow-up/referrals (25%), and surgical site infection (20%). Rwanda has 0.043 (IQR: 0.032-0.060) doctors per 1,000 population. The country also has 0.25 (IQR: 0.18-0.33) nurses per 1,000 population. The 76.5% of respondents reported that variation of consultation time is between 10-15 minutes (p=0.003, 95% CI: 0.002-0.004) which is associated with 0.12% risk of incidents. The public hospitals have on average 44.25 ± 13.46 SD consultations per clinician per day. More than a half of respondents 54.3% (p=0.033, 95%CI: 0.029- 0.036) reported that 10-20% of treatment given to patients were not needed and are significantly associated with high risk of incidents. The public hospitals score Level 1(documentation) (p=0.016, 95%CI: 0.014-0.019) for quality health care services delivery and, over half score Level 2(implementation). They also score Level 1(documentation) (p: 0.209, 95%CI: 0.201-0.216) for safe health care, and approximately half of them score Level 2(implementation). Conclusion and Implications for Translation: The quality and safety of health care services should be a priority for health care professionals and healthcare systems. The culture of blame and punishment is a challenge across hospitals. Reassuring adverse events reporting and learning from errors need to be emphasized and prioritized in public hospitals. Key words: • Quality and Safety Management • Health Care Service Delivery • Rwanda • Quality and Safety Score levels   Copyright © 2019 Ndagijimana et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A systematic review of patient complaints about general practice

2019 ◽  
Vol 37 (3) ◽  
pp. 297-305
Author(s):  
Emily O’Dowd ◽  
Sinéad Lydon ◽  
Caoimhe Madden ◽  
Paul O’Connor
Keyword(s):  
Health Care ◽  
General Practice ◽  
Secondary Care ◽  
Methodological Quality ◽  
Assessment Tool ◽  
Future Research ◽  
Analysis Tool ◽  
Quality And Safety ◽  
Safety Improvement ◽  
Negative Impacts

Abstract Background Health care complaints are an underutilized resource for quality and safety improvement. Most research on health care complaints is focused on secondary care. However, there is also a need to consider patient safety in general practice, and complaints could inform quality and safety improvement. Objective This review aimed to synthesize the extant research on complaints in general practice. Methods Five electronic databases were searched: Medline, Web of Science, CINAHL, PsycINFO and Academic Search Complete. Peer-reviewed studies describing the content, impact of and motivation for complaints were included and data extracted. Framework synthesis was conducted using the Healthcare Complaints Analysis Tool (HCAT) as an organizing framework. Methodological quality was appraised using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Results The search identified 2960 records, with 21 studies meeting inclusion criteria. Methodological quality was found to be variable. The contents of complaints were classified using the HCAT, with 126 complaints (54%) classified in the Clinical domain, 55 (23%) classified as Management and 54 (23%) classified as Relationships. Motivations identified for making complaints included quality improvement for other patients and monetary compensation. Complaints had both positive and negative impacts on individuals and systems involved. Conclusion This review highlighted the high proportion of clinical complaints in general practice compared to secondary care, patients’ motivations for making complaints and the positive and negative impacts that complaints can have on health care systems. Future research focused on the reliable coding of complaints and their use to improve quality and safety in general practice is required.

scholarly journals Hospital managers’ perspectives with implementing quality improvement measures and a new regulatory framework: a qualitative case study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042847 ◽  
Author(s):  
Sina Furnes Øyri ◽  
Geir Sverre Braut ◽  
Carl Macrae ◽  
Siri Wiig
Keyword(s):  
Quality Improvement ◽  
Adaptive Capacity ◽  
Qualitative Content Analysis ◽  
Regulatory Framework ◽  
Local Context ◽  
Quality And Safety ◽  
Hospital Practice ◽  
Hospital Managers ◽  
Safety Improvement

A new regulatory framework to support local quality and safety efforts in hospitals was introduced to the Norwegian healthcare system in 2017. This study aimed to investigate hospital managers’ perspectives on implementation efforts and the resulting work practices, to understand if, and how, the new Quality Improvement Regulation influenced quality and safety improvement activities.DesignThis article reports one study level (the perspectives of hospital managers), as part of a multilevel case study. Data were collected by interviews and analysed according to qualitative content analysis.SettingThree hospitals retrieved from two regional health trusts in Norway.Participants20 hospital managers or quality advisers selected from different levels of hospital organisations.ResultsFour themes were identified in response to the study aim: (1) adaptive capacity in hospital management and practice, (2) implementation efforts and challenges with quality improvement, (3) systemic changes and (4) the potential to learn. Recent structural and cultural changes to, and development of, quality improvement systems in hospitals were discovered (3). Participants however, revealed no change in their practice solely due to the new Quality Improvement Regulation (2). Findings indicated that hospital managers are legally responsible for quality improvement implementation and participants described several benefits with the new Quality Improvement Regulation (2). This related to adaptation and flexibility to local context, and clinical autonomy as an inevitable element in hospital practice (1). Trust and a safe work environment were described as key factors to achieve adverse event reporting and support learning processes (4).ConclusionsThis study suggests that a lack of time, competence and/or motivation, impacted hospitals’ implementation of quality improvement efforts. Hospital managers’ autonomy and adaptive capacity to tailor quality improvement efforts were key for the new Quality Improvement Regulation to have any relevant impact on hospital practice and for it to influence quality and safety improvement activities.

Re: Quality and Safety in Health Care, Part XLVIII

2020 ◽  
Vol 45 (6) ◽  
pp. 497
Author(s):  
Imran Karim Janmohamed ◽  
Hamza El-Omar
Keyword(s):  
Health Care ◽  
Quality And Safety

The survival of patients admitted because of health-care-related adverse events is similar to that after admission for other reasons

2015 ◽  
Vol 26 (2) ◽  
pp. 146-147
Author(s):  
Fabienne J.H. Magdelijns ◽  
L. Schepers ◽  
E. Pijpers ◽  
C.D.A. Stehouwer ◽  
P.M. Stassen
Keyword(s):  
Health Care ◽  
Adverse Events

Development of the perceptions of preventable adverse events assessment tool (PPAEAT): measurement properties and patients’ mental health status

2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Franziska Maria Keller ◽  
Christina Derksen ◽  
Lukas Kötting ◽  
Martina Schmiedhofer ◽  
Sonia Lippke
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Patient Safety ◽  
Primary Health Care ◽  
Adverse Events ◽  
Health Care Professionals ◽  
Discriminant Validity ◽  
Assessment Tool ◽  
Primary Health ◽  
Item Scale

Abstract Background Patient-centered care and patient involvement have been increasingly recognized as crucial elements of patient safety. However, patient safety has rarely been evaluated from the patient perspective with a quantitative approach aiming at making patient safety and preventable adverse events measurable. Objectives The objectives of this study were to develop and evaluate the psychometric properties of a questionnaire assessing patient safety by perceived triggers of preventable adverse events among patients in primary health-care settings while considering mental health. Methods Two hundred and ten participants were recruited through various digital and print channels and asked to complete an online survey between November 2019 and April 2020. Exploratory factor analysis was performed to identify domains of triggers of preventable adverse events affecting patient safety. Furthermore, a multi-trait scaling analysis was performed to evaluate internal reliability as well as item-scale convergent–discriminant validity. A multivariate analysis of covariance evaluated whether individuals below and above the symptom threshold for depression and generalized anxiety perceive triggers of preventable adverse events differently. Results The five factors determined were information and communication with patients, time constraints of health-care professionals, diagnosis and treatment, hygiene and communication among health-care professionals, and knowledge and operational procedures. The questionnaire demonstrated a good total and subscale internal consistency (α = 0.90, range = 0.75–0.88), good item-scale convergent validity with significant correlations between 0.57 and 0.78 (P &lt; 0.05; P &lt; 0.01) for all items with their associated subscales, and satisfactory item-scale discriminant validity between 0.14 and 0.55 (P &gt; 0.05) with no significant correlations between the items and their competing subscales. The questionnaire further revealed to be a generic measure irrespective of patients’ mental health status. Patients older than 50 years of age perceived a significantly greater threat to their own safety compared to patients below that age. Conclusion The developed Perceptions of Preventable Adverse Events Assessment Tool (PPAEAT) exhibits good psychometric properties, which supports its use in future research and primary health-care practice. Further validation of the PPAEAT in different settings, languages and larger samples is needed. The results of this study need to be considered when assessing patient safety in the context of health-care research.

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