scholarly journals Shortened cataract surgery by standardisation of the perioperative protocol according to the Joint Commission International accreditation: a retrospective observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028656 ◽  
Author(s):  
Yuichi Okumura ◽  
Takenori Inomata ◽  
Masao Iwagami ◽  
Atsuko Eguchi ◽  
Ju Mizuno ◽  
...  
Keyword(s):  
Observational Study ◽  
Cataract Surgery ◽  
Operating Time ◽  
Joint Commission ◽  
Retrospective Observational Study ◽  
Single Centre ◽  
Before And After ◽  
Joint Commission International ◽  
The Impact ◽  
The Joint Commission

ObjectivesTo investigate the impact of standardisation of the perioperative protocol based on the Joint Commission International (JCI) accreditation guidelines for operating time in cataract surgery.DesignRetrospective observational study.SettingSingle centre in Japan.ParticipantsBetween March 2014 and June 2016, 3127 patients underwent cataract surgery under topical anaesthesia including 2581 and 546 patients before and after JCI accreditation, respectively.Primary and secondary outcomesWe compared three time periods, comprising the preprocedure/surgery time (pre-PT), PT and post-PT, and total PT (TPT) of cataract surgery between patients before and after JCI accreditation, by regression analysis adjusted for age, sex and cataract surgery-associated confounders.ResultsThe main outcomes were pre-PT, PT, post-PT and TPT. Pre-PT (19.8±10.5 vs 13.9±8.5 min, p<0.001) and post-PT (3.5±4.6 vs 2.6±2.1 min, p<0.001) significantly decreased after JCI accreditation, while PT did not significantly change (16.8±6.7 vs 16.2±6.3 min, p=0.065). Consequently, TPT decreased on average by 7.3 min per person after JCI accreditation (40.1±13.4 vs 32.8±10.9 min, p<0.001). After adjusting for confounders, pre-PT (β=−5.82 min, 95% CI −6.75 to −4.88), PT (β=−0.76 min, 95% CI −1.34 to −1.71), post-PT (β=−0.85 min, 95% CI −1.24 to −0.45) and TPT (β=−7.43 min, 95% CI −8.61 to −6.24) were significantly shortened after JCI accreditation.ConclusionPerioperative protocol standardisation, based on JCI accreditation, shortened TPT in cataract surgery under local anaesthesia.

scholarly journals The impact of Joint Commission International accreditation on time periods in the operating room: A retrospective observational study

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0204301 ◽  
Author(s):  
Takenori Inomata ◽  
Ju Mizuno ◽  
Masao Iwagami ◽  
Shiori Kawasaki ◽  
Akie Shimada ◽  
...  
Keyword(s):  
Observational Study ◽  
Operating Room ◽  
Joint Commission ◽  
Retrospective Observational Study ◽  
Joint Commission International ◽  
Time Periods ◽  
The Impact

scholarly journals P237 Annual incidence and prevalence of ulcerative colitis and Crohn’s disease from 2010 to 2017 in four Nordic countries: Results from the TRINordic study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S261-S262
Author(s):  
M Lördal ◽  
J Burisch ◽  
E Langholz ◽  
T Knudsen ◽  
M Voutilainen ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Observational Study ◽  
Nordic Countries ◽  
Annual Incidence ◽  
University Hospital ◽  
Retrospective Observational Study ◽  
Western World ◽  
The Impact

Abstract Background Incidence and prevalence of inflammatory bowel diseases (IBD) have been increasing for the past decades in the western world, however with an emerging trend of incidence stabilisation in recent years. There is an indication of higher IBD incidence and prevalence in northern Europe, especially in the Nordic region, compared with southern Europe. Methods This retrospective observational study collected data from the National Patient Registries and National Prescription Registries (Sweden [SWE], Norway [NOR], Denmark [DEN]) and one university hospital database (Turku, Finland [FIN]) during 2010–2017 to investigate the annual incidence and prevalence of ulcerative colitis (UC) and Crohn’s disease (CD). Patients with ≥2 ICD-10 diagnosis codes for UC (K51) or CD (K50) from 2010 or later and no K51 or K50 codes prior to 2010 were included; patients were classified according to their last code. The look-back period for SWE was until 2000, for NOR until 2008, for DEN until 1995, and for FIN until 2004. Incidence proportions highlight results through 2016, as 2017 patients had less than 1-year follow-up. Results In total, 69,876 patients were included (SWE n = 27,902, NOR n = 20,761, FIN n = 2,118, DEN n = 19,095), of which 44 367 patients were diagnosed with UC and 25,509 with CD. In 2016, the annual incidence of UC was 28 patients per 100,000 persons in NOR, 32 patients per 100,000 persons in DEN, 25 patients per 100,000 persons in SWE, and 44 patients per 100,000 in FIN. The corresponding results for the annual incidence of CD per 100,000 persons were 22 in NOR, 16 in DEN, 16 in SWE, and 21 in FIN. The prevalence per 100,000 persons of both UC and CD was the highest in DEN, followed by SWE and NOR, and lowest in FIN. Prevalence estimates increased in all four Nordic countries during 2010–2017: for UC, from 409 to 488 patients in SWE, from 256 to 428 in NOR, from 129 to 375 in FIN, and from 577 to 798 in DEN. For CD, it increased from 261 to 313 patients in SWE, from 164 to 258 in NOR, from 54 to 164 in FIN, and from 280 to 400 in DEN. Conclusion This retrospective observational study showed that during 2016, the annual incidence of UC ranged from 25–44 patients per 100,000 persons across the evaluated Nordic countries, whereas the annual incidence of CD was 16–22 patients per 100,000 persons. Prevalence of both UC and CD increased during 2010–2017 in all four countries. Estimates of UC and CD incidence and prevalence in this analysis are greater than reported in the published literature. Additional analyses are underway to further explore the impact of methodological decisions on the estimates of UC and CD annual incidence and prevalence.

IMPACT OF JOINT COMMISSION INTERNATIONALACCREDITATION (JCIA) ON HEALTH CARE PROCESSES AND THE CHALLENGES FACED BY PHYSICIANS AND NURSES.

2021 ◽  
pp. 34-35
Author(s):  
Binu Thomas ◽  
Ankur Joshi
Keyword(s):  
Health Care ◽  
Employee Engagement ◽  
Interdisciplinary Collaboration ◽  
Joint Commission ◽  
Health Centers ◽  
Cross Sectional ◽  
Care Processes ◽  
Before And After ◽  
Collaboration And Communication ◽  
The Impact

Purpose: To evaluate the impact of joint commission international accreditation on health care processes as well as to assess the challenges faced by the physicians and nurses . Method: Conducted a cross sectional study in 11 health centers belong to Dubai health authority. Prepared a checklist and questionnaire to assess the changes in the processes brought by accreditation as well as the challenges faced by employees respectively. Studied perceived challenges by recruiting physician (n=106) and nurses (n=194) using convenience sampling technique. Done content validity of the tools with clinical quality experts. Conducted pilot study for the questionnaire and checked the reliability using Cronbach alpha (0.924). After obtaining ethical clearance and consent from subjects, the researcher visited health centers and administered questionnaire to the participants. To evaluate the process improvements, the researcher audited documents for the availability of processes before and after accreditation using the validated checklist, which consisted of 25 processes reecting various domains of quality, employee engagement, interdisciplinary collaboration and communication. Results: Observed tremendous improvements in the availability of processes. The proportion of processes before and after the accreditation was statistically signicantly different (p <.001) for quality of health care. However for employee engagement (p=.250) and interdisciplinary collaboration and communication (p=1.000) no statistical signicance were noted even though there were signicant improvements. Majority (57.5%) of doctors and nurses perceived that the accreditation processes were challenging. Discussion: Observed processes improvements ensuring quality, employee engagement, interdisciplinary collaboration and communication after accreditation.However,majority ofthe employees perceived that, the accreditationwas challenging in terms ofworkload, communication and documentation.

scholarly journals Ultra-processed foods and binge eating: A retrospective observational study

2020 ◽  
Author(s):  
Agnes Ayton ◽  
Ali Ibrahim ◽  
James Dugan ◽  
Eimar Galvin ◽  
Oliver Wroe-Wright
Keyword(s):  
Eating Disorder ◽  
Observational Study ◽  
Binge Eating ◽  
Clinical Sample ◽  
Self Report ◽  
Retrospective Observational Study ◽  
Processed Foods ◽  
Eating Behaviours ◽  
Male Patients ◽  
The Impact

OBJECTIVEThere is increasing evidence of the impact of ultra-processed foods on multiple metabolic and neurobiological pathways, including those involved in eating behaviours, both in animals and in humans. In this pilot study, we aimed to explore ultra-processed foods and their link with disordered eating in a clinical sample. METHODSThis was a single site, retrospective observational study in a specialist eating disorder service using self report on the electronic health records. Patients with a DSM-5 diagnosis of anorexia nervosa (AN), bulimia nervosa (BN) or binge eating disorder (BED) were randomly selected from the service database in Oxford from 2017 to 2019. The recently introduced NOVA classification was used to determine the degree of industrial food processing in each patient’s diet. Frequencies of ultra-processed foods were analysed for each diagnosis, at each mealtime and during episodes of bingeing.RESULTS71 female and 3 male patients were included in the study. 22 had AN, 25 BN and 26 had BED. Patients with AN reported consuming 55% NOVA-4 foods, as opposed to approximately 70% in BN and BED. Binge foods were 100% ultra-processed.DISCUSSIONFurther research into the metabolic and neurobiological effects of reducing ultra-processed food intake on bingeing behaviour is needed.

scholarly journals Improving rapid response system performance in a Chinese Joint Commission International Hospital

2019 ◽  
Vol 47 (7) ◽  
pp. 2961-2969
Author(s):  
Minfei Yang ◽  
Lanlan Zhang ◽  
Yuwei Wang ◽  
Yue Zhan ◽  
Xiaofei Zhang ◽  
...  
Keyword(s):  
Medical Emergency Team ◽  
Joint Commission ◽  
Rapid Response ◽  
Medical Emergency ◽  
Rapid Response System ◽  
Serious Adverse Events ◽  
Emergency Team ◽  
Response System ◽  
Joint Commission International ◽  
The Impact

Objective To assess the impact of a regional rapid response system (RRS) implemented in a Chinese Joint Commission International Hospital on the timely treatment of patients with serious adverse events (SAEs). Methods Clinical SAEs, activation periods, reasons for RSS activation, and patient outcomes were assessed using SAE response sheets at admission to the hospital and over 31 months of follow-up. Results We found that 192 events were called by medical staff and 6 were called by auxiliary staff. Reasons for the 385 RRS activations included: unconsciousness (133; 34.5%), and airway obstruction and absent carotid pulse (49 each; 12.7%). The average arrival time of the medical emergency team was 2.4 ± 0.1 minutes. There were 123 (62.1%) RRS activations during daytime working hours (8:00–17:00); CPR was performed in 86 (43.4%) cases. Outcomes of RRS were: vital signs stabilized in 82 (41.4%) patients and 61 (30.8%) patients were transferred to ICU. Conclusion Our experience showed that the regional RRS has led to better integrated multidisciplinary cooperation and reduced time for treating patients with SAEs, resulting in success of the RRS.

scholarly journals Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027112
Author(s):  
Wallace Chow ◽  
Christopher Wong ◽  
Jerrett K Lau ◽  
Vincent Chow ◽  
Leonard Kritharides ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Observational Study ◽  
Acute Pulmonary Embolism ◽  
Retrospective Observational Study ◽  
Study Cohort ◽  
Prognostic Impact ◽  
Tertiary Referral Centre ◽  
Baseline Haemoglobin ◽  
The Impact ◽  
Acute Pe

ObjectivesAnaemia is associated with increased mortality in acute pulmonary embolism (PE) patients. However, prior studies have not examined the prognostic impact of trends in plasma haemoglobin during admission. This study investigates the impact of changes in haemoglobin level on mortality during hospital stay in acute PE.Study designA retrospective observational study.SettingTertiary-referral centre in Australia.ParticipantsConsecutive patients from 2000 to 2012 admitted with confirmed acute PE were identified from a dedicated PE database. Haemoglobin levels on days 1, 3–4, 5–6 and 7 of admission were retrieved. Patients without both baseline haemoglobin and subsequent haemoglobin levels were excluded (n=327), leaving 1099 patients as the study cohort. Anaemia was defined as haemoglobin <130 g/L for men and <120 g/L for women. There were 576 patients without anaemia throughout admission, 65 with transient anaemia (anaemic on day 1, but subsequently normalised during admission), 122 with acquired anaemia (normal on day 1 but developed anaemia during admission) and 336 with persistent anaemia. A total of 71 patients received blood transfusion during admission.Main outcome measure6-month mortality was tracked from a state-wide death database and analysed using multivariable modelling.ResultsAfter adjusting for transfusion, patietns with persistent anaemia had a significantly increased 6-month mortality risk (adjusted HR 1.97, 95% CI 1.26 to 3.09, p=0.003) compared with patients without anaemia. There was no difference in mortality between patients with transient or acquired anaemia and patients without anaemia.ConclusionAmong patients who had anaemia during their admission for acute PE, only the subgroup with persistent anaemia demonstrated worse outcomes.

Single-centre retrospective observational study comparing trough blood concentration and safety of teicoplanin formulations

2019 ◽  
Vol 25 (7) ◽  
pp. 563-566 ◽  
Author(s):  
Rie Shinoda ◽  
Yasutaka Shinoda ◽  
Kengo Ohashi ◽  
Tomoko Matsuoka ◽  
Tatsuya Hirose ◽  
...  
Keyword(s):  
Observational Study ◽  
Blood Concentration ◽  
Retrospective Observational Study ◽  
Single Centre ◽  
Trough Blood
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