Perverse financial incentives reward poor quality care, says report

BMJ ◽  
2009 ◽  
Vol 339 (sep01 2) ◽  
pp. b3549-b3549
Author(s):  
M. Pownall
Keyword(s):  
Financial Incentives ◽  
Quality Care ◽  
Poor Quality ◽  
Poor Quality Care

scholarly journals The “Spirit of New Orleans”: Translating a model of intervention with maltreated children and their families for the Glasgow context

2010 ◽  
Vol 15 (4) ◽  
pp. 497-509 ◽  
Author(s):  
Helen Minnis ◽  
Graham Bryce ◽  
Louise Phin ◽  
Phil Wilson
Keyword(s):  
New Orleans ◽  
Mental Health Problems ◽  
Quality Care ◽  
Poor Quality ◽  
Vulnerable Children ◽  
Maltreated Children ◽  
Innovative System ◽  
The Uk ◽  
Children In Care ◽  
Poor Quality Care

Children in care have higher rates of mental health problems than the general population and placement instability contributes to this. Children are both most vulnerable to the effects of poor quality care and most responsive to treatment in the early weeks and months of life yet, in the UK, permanency decisions are generally not in place until around the age of four. We aimed to understand the components of an innovative system for assessing and intervening with maltreated children and their families developed in New Orleans and to consider how it might be implemented in Glasgow, UK. During and after a visit to New Orleans by a team of Glasgow practitioners, eight key interviews and meetings with New Orleans and Glasgow staff were audio-recorded. Qualitative analysis of verbatim transcripts identified key themes. Themes highlighted shared aspects of the context and attitudes of the two teams, identified gaps in the Glasgow service and steps that would be needed to implement a version of the New Orleans model in Glasgow. Our discussions with the New Orleans team have highlighted concrete steps we can take, in Glasgow, to make better decision-making for vulnerable children a reality.

scholarly journals Responding to Poor-Quality Care During Research in Nursing Homes

2010 ◽  
Vol 4 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Melanie R. Krause ◽  
Janice L. Palmer ◽  
Barbara J. Bowers ◽  
Kathleen C. Buckwalter
Keyword(s):  
Nursing Homes ◽  
Quality Care ◽  
Poor Quality ◽  
Poor Quality Care

scholarly journals Quality health care in extreme adversity—an action framework

2019 ◽  
Author(s):  
Sheila Leatherman ◽  
Linda Tawfik ◽  
Dilshad Jaff ◽  
Grace Jaworski ◽  
Matthew Neilson ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Care ◽  
Poor Quality ◽  
Lessons Learned ◽  
Initial Assessment ◽  
Quality And Safety ◽  
Quality Health Care ◽  
Quality Health ◽  
Care Costs ◽  
Poor Quality Care

Abstract Quality problem or issue There are record-setting numbers of people living in settings of extreme adversity and they continue to increase each year. Initial assessment There is a paucity of validated data on quality and safety across settings of extreme adversity. Choice of solution This paper argues for an action framework to address the unique challenges of providing quality in extreme adversity. Implementation We describe a preliminary Quality in Extreme Adversity framework which has been informed by—and will continue to be validated through—literature, data collection, WHO expert consultations and through working in settings of extreme adversity with national authorities and NGOs. Lessons learned Poor quality care costs lives, livelihoods and trust in health services. The recommended framework, based on evidence and experiential lessons, intends to address the WHO goal for 2019–2023 of ‘one billion people better protected from health emergencies’ (9).

scholarly journals Care dependence in old age: preferences, practices and implications in two Indonesian communities

2012 ◽  
Vol 34 (3) ◽  
pp. 361-387 ◽  
Author(s):  
ELISABETH SCHRÖDER-BUTTERFILL ◽  
TENGKU SYAWILA FITHRY
Keyword(s):  
Ethnic Groups ◽  
Old Age ◽  
Quality Care ◽  
Poor Quality ◽  
Social Constraints ◽  
Care Provision ◽  
Actual Care ◽  
Ethnographic Data ◽  
Poor Quality Care ◽  
Physical Care

ABSTRACTThe provision of physical care is a sensitive matter in all cultures and is circumscribed by moral injunctions and personal preferences. Research on Western cultures has shown care networks to be narrow subsets of people's wider networks and revealed dependence to be deeply undermining of full personhood. In non-Western societies these issues have received little attention, although it is sometimes assumed that care provision and dependence are much less problematic. This paper uses longitudinal ethnographic data from two ethnic groups in rural Indonesia to compare care preferences and practices in old age and to examine the implications of care dependence. The groups manifest varying degrees of daughter preference in care and differ in the extent to which notions of shame and avoidance prohibit cross-gender intimate care and care by ‘non-blood’ relatives. Demographic and social constraints often necessitate compromises in actual care arrangements (e.g. dependence on in-laws, neighbours or paid carers), not all of which are compatible with quality care and a valued identity. We argue that by probing the norms and practices surrounding care provision in different socio-cultural settings, it becomes possible to arrive at a deeper understanding of kinship, personhood and sociality. These insights are not only of sociological interest but have implications for people's vulnerability to poor quality care in old age.

Evaluating the Performance of a Single-Item, Global, Estimate of Missed Nursing Care

2017 ◽  
Vol 25 (1) ◽  
pp. 121-141 ◽  
Author(s):  
Patti Hamilton ◽  
Eileen Willis ◽  
Terry Jones ◽  
Rhonda McKelvie ◽  
Ian Blackman ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Nursing Care ◽  
Convergent Validity ◽  
Characteristic Curve ◽  
Quality Care ◽  
Poor Quality ◽  
Single Item ◽  
Missed Care ◽  
Missed Nursing Care ◽  
Poor Quality Care

Background and Purpose: Current measures of missed nursing care employ inventories of tasks which are rated for the frequency with which each is missed. These lists have shortcomings for research and clinical evaluation. There is a need for measures with less response burden, wider generalizability, and greater sensitivity and specificity for identifying poor quality care. Methods: We tested a single-item, global, measure using data from a large study of missed care in Australia. We employed traditional and innovative analysis techniques such as receiver operating characteristic curve and item response theory. Results: The single-item measure had adequate concurrent and convergent validity when compared to one list-format measure of missed care and strong sensitivity and specificity for identifying poor quality care. Conclusions: A well-crafted single-item measure, such as the one tested, can be useful for measuring missed nursing care.

scholarly journals Time to Ensure Sufficient Nursing Home Staffing and Eliminate Inequities in Care

2021 ◽  
Vol 7 (3) ◽  
pp. 1-5
Author(s):  
Charlene Harrington ◽  
Keyword(s):  
Nursing Home ◽  
Quality Care ◽  
Nursing Home Residents ◽  
Nurse Staffing ◽  
Poor Quality ◽  
Turnover Rates ◽  
Staffing Levels ◽  
High Staff Turnover ◽  
Underlying Causes ◽  
Poor Quality Care

The overwhelming nursing home resident infection and death rates from the COVID-19 pandemic has led to the question: What policies can best protect nursing home residents now and in the future? In this article we present data that inadequate nurse staffing levels and high staff turnover rates are the fundamental underlying causes of poor quality care in many nursing homes.

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