scholarly journals Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020617 ◽  
Author(s):  
Bastiaan Van Grootven ◽  
Lynn McNicoll ◽  
Daniel A Mendelson ◽  
Susan M Friedman ◽  
Katleen Fagard ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Delphi Study ◽  
Western Europe ◽  
Outcome Indicators ◽  
Process And Outcome ◽  
Stay Time ◽  
The Usa ◽  
Level Of Agreement ◽  
Process And Outcome Indicators

ObjectiveTo find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes.DesignAn international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers).SettingWestern Europe and the USA.ParticipantsThirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate).MeasuresParticipants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method.ResultsIn the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications.ConclusionThe indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes.

Are we measuring what matters in health technology assessment of disease management? Systematic literature review

2006 ◽  
Vol 22 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Lotte Steuten ◽  
Bert Vrijhoef ◽  
Hans Severens ◽  
Frits van Merode ◽  
Cor Spreeuwenberg
Keyword(s):  
Disease Management ◽  
Literature Review ◽  
Health Technology Assessment ◽  
Systematic Literature Review ◽  
Technology Assessment ◽  
Health Technology ◽  
Substantial Part ◽  
Outcome Indicators ◽  
Process And Outcome ◽  
Process And Outcome Indicators

Objectives:An overview was produced of indicators currently used to assess disease management programs and, based on these findings, provide a framework regarding sets of indicators that should be used when taking the aims and types of disease management programs into account.Methods:A systematic literature review was performed.Results:Thirty-six studies met the inclusion criteria. It appeared that a link between aims of disease management and evaluated structure, process, as well as outcome indicators does not exist in a substantial part of published studies on disease management of diabetes and asthma/chronic obstructive pulmonary disease, especially when efficiency of care is concerned. Furthermore, structure indicators are largely missing from the evaluations, although these are of major importance for the interpretation of outcomes for purposes of decision-making. Efficiency of disease management is mainly evaluated by means ofprocessindicators; the use ofoutcomeindicators is less common. Within a framework, structure, process, and outcome indicators for effectiveness and efficiency are recommended for each type of disease management program.Conclusions:The link between aims of disease management and evaluated structure, process, and outcome indicators does not exist in a substantial part of published studies on disease management. The added value of this study mainly lies in the development of a framework to guide the choice of indicators for health technology assessment of disease management.

Talent development: a systematic literature review of empirical studies

2018 ◽  
Vol 42 (1/2) ◽  
pp. 75-90 ◽  
Author(s):  
Fatemeh Rezaei ◽  
Michael Beyerlein
Keyword(s):  
Literature Review ◽  
Organizational Development ◽  
Systematic Literature Review ◽  
Empirical Studies ◽  
Talent Development ◽  
Content Type ◽  
Individual Level ◽  
Development Interventions ◽  
The Usa ◽  
The Individual

Purpose The purpose of this study is to identify and examine findings from empirical research regarding organizations’ talent development (TD) strategies, taking into consideration the countries in which the studies were conducted and the TD-approach organizations adopted, and recognize the positive outcomes of TD implementation, as well as potential issues and challenges. Design/methodology/approach This systematic literature review used Garrard’s matrix method to organize the review of publications. It identified 31 empirical articles from the total of 551 publications. Findings The findings indicate that a majority of the studies were conducted in countries other than the USA and that they were all published recently, after 2007. The results show that organizations have mostly applied organizational development interventions at the individual level for developing talented employees, followed by formal training and development. Additionally, managerial issues were identified as the most common issue on the way of implementing TD interventions. Research limitations/implications Trying to define TD as a discrete concept from HRD could be considered as both differentiating the current literature review and a limitation. Originality/value This article is among the first to identify TD interventions through a systematic literature review and provides a model of TD’s intervention antecedents and outcomes for the follow-up empirical works.

Objectives and outcomes of clinical ethics services: a Delphi study

2019 ◽  
Vol 45 (12) ◽  
pp. 761-769
Author(s):  
Leah McClimans ◽  
Geah Pressgrove ◽  
Emmaling Campbell
Keyword(s):  
Delphi Study ◽  
Clinical Ethics ◽  
Moral Distress ◽  
Medical College ◽  
Ethics Support ◽  
Starting Point ◽  
The Usa ◽  
American Society ◽  
Level Of Agreement

ObjectivesTo explore the objectives and outcomes most appropriate for evaluating clinical ethics support services (CESs) in the USA.MethodsA three-round e-Delphi was sent to two professional medical ethics listservs (Medical College of Wisconsin-Bioethics and American Society for Bioethics and Humanities) as well as 19 individual experts. The survey originally contained 15 objectives and 9 outcomes. In round 1, participants were asked to validate the content of these lists. In round 2, we had 17 objectives and 10 outcomes, and participants were asked to rank them for appropriateness in a top 10 list of objectives and a top 5 list of outcomes.ResultsParticipants came to a high(at least 70%) level of agreement on seven objectives: mediate, educate, develop policy, improve the moral quality of a decision or action, counsel, create a moral space and manage moral distress. Participants came to a moderate (at least 51%) level of agreement on three objectives: empower, awareness of ethics and preventative ethics. Participants also came to a moderate (at least 51%) level of agreement on five outcomes: ethical justification, transformation of institution, improvement of quality of life, principled consensus and satisfaction with the expertise of a CES.ConclusionThis e-Delphi identified 10 objectives and 5 outcomes that are a good starting point for developing outcome measures to evaluate CESs in the USA, while reminding us of the diversity of perspectives still evident in the field.

Quality Assurance in Psychiatry: Concept and Methods

1997 ◽  
Vol 12 (S2) ◽  
pp. 79s-87s ◽  
Author(s):  
W Gaebel
Keyword(s):  
Quality Control ◽  
Quality Assurance ◽  
Practice Guidelines ◽  
Psychiatric Care ◽  
Quality Care ◽  
Outcome Indicators ◽  
Continuous Quality ◽  
Process And Outcome ◽  
Standards And Guidelines ◽  
Process And Outcome Indicators

SummaryQuality assurance is the corrective action applied to any observed discrepancy between optimal and actual level of medical care requiring continuous quality control. Obviously, quality assurance is of utmost importance also in psychiatric practice. Quality care as defined by the degree of adherence to standards and guidelines can be measured in terms of structural, process and outcome indicators applied to inpatient, outpatient and complementary services. To promote the implementation of practice guidelines into psychiatric care conceptual, methodological, and organisational requirements must be taken into account.

Process and outcome indicators for evaluation of surgical activity in a high-risk gastric cancer area.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. e16537-e16537
Author(s):  
O. Nanni ◽  
M. Altini ◽  
P. Morgagni ◽  
A. Rossi ◽  
E. Ciotti ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Outcome Indicators ◽  
Process And Outcome ◽  
Process And Outcome Indicators

Systematic Literature Review of the Economic Burden and Cost of Illness in Patients with Myelofibrosis

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2184-2184
Author(s):  
Derek Tang ◽  
Ankush Taneja ◽  
Preety Rajora ◽  
Renu Patel
Keyword(s):  
Bone Marrow ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Resource Use ◽  
Economic Burden ◽  
Healthcare Costs ◽  
Productivity Losses ◽  
Annual Productivity ◽  
Independent Reviewer ◽  
The Usa

Introduction: Myelofibrosis (MF) is a rare bone marrow cancer classified as a myeloproliferative neoplasm in which bone marrow is replaced by fibrous (scar) tissue, impairing the production of normal blood cells. MF has a global incidence of approximately 0.58 new cases per 100,000 person-years, with many patients experiencing short survival (approximately 6 years). Most patients with MF are found to have either intermediate-2 or high-risk MF, as per their prognostic score (International Prognostic Scoring System [IPSS] or Dynamic IPSS). The economic impact of MF has been studied in individual real-world settings, each of which may have limited generalizability; however, the holistic economic burden of MF is not well understood. The objective of this systematic literature review (SLR) was to describe economic evidence for patients with MF including cost and resource use data. Methods: A SLR was conducted in Embase®, MEDLINE®, the National Health Service Economic Evaluation Database (NHS EED), and the American Economic Association (AEA) EconLit® to identify evidence published from database inception to July 2018. Conference proceedings and bibliographies were also searched. Studies were included if they were published in the English language and reported economic burden associated with adult patients with MF. The evidence was not restricted by any country or time limits. Two reviewers assessed each citation against predefined eligibility criteria, with discrepancies reconciled by a third independent reviewer. All the extracted data were quality checked by a second independent reviewer. A descriptive qualitative analysis was conducted to identify the patterns of economic burden in MF across different countries. Results: A total of 771 potentially relevant abstracts were identified and screened, of which 23 studies were included in the final analysis. Eleven studies reported cost data only, 10 studies reported both cost and resource use data, and 2 studies reported on the budget impact of treatment for MF. Eight of the included studies were conducted in the USA, 2 each in the UK, Canada, and Ireland, and the remaining 9 reported data from other countries. Eight of the included studies reported total MF costs, 4 studies reported productivity losses related to employment, and 3 studies reported indirect costs related to productivity and informal care. The remaining studies reported cost-effectiveness data for the treatment of MF. Of the 5 studies that reported categorical costs, 3 reported that outpatient costs were the major driver of costs, followed by inpatient costs. Among the studies conducted in the USA, total medical healthcare costs associated with MF ranged from USD 21,000 to USD 66,000 per patient. Three European studies reported that the annual productivity losses per patient ranged from EUR 7,774 to EUR 11,000, with total annual productivity losses as high as EUR 217,975. Two US studies compared the total MF-related healthcare costs with age- and sex-matched controls; costs were significantly higher in the MF cohort compared with matched controls (P < 0.05), especially for inpatient costs, outpatient costs, and pharmacy costs (Figure). Four studies, with a majority of the MF patients aged > 50 years, reported that 20-60% of the patients were absent from work, with a mean of 6.2 hours of work missed in the past 7 days. Among the hospitalized patients, 3 studies reported that the median length of stay for patients with MF ranged from 2.5 to 6.6 days, with 46% of patients utilizing emergency room visits and services. Conclusions: MF is associated with significant economic burden and work productivity loss to the health system, patients, and their families. Sustained efforts to develop more effective treatments are required in order to reduce the economic burden associated with MF and help patients and physicians improve disease management. Disclosures Tang: Celgene Corporation: Employment, Equity Ownership. Taneja:BresMed Health Solutions Ltd: Employment. Rajora:BresMed Health Solutions Ltd: Employment. Patel:BresMed: Employment.

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