scholarly journals Does accreditation of general practice promote patient-reported quality of care? A natural cluster randomised experiment

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e034465
Author(s):  
Helle Riisgaard ◽  
Frans Boch Waldorff ◽  
Merethe Kirstine Andersen ◽  
Line Bjørnskov Pedersen
Keyword(s):  
General Practice ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
General Practitioner ◽  
Outcome Measures ◽  
Negative Relationship ◽  
Secondary Outcome ◽  
Cluster Randomised ◽  
Patient Reported

ObjectiveTo investigate whether accreditation of general practice in Denmark promotes patient-reported quality of care and patient satisfaction.DesignA national cluster randomised case control study based on an online version of the Danish Patients Evaluate Practice questionnaire. Mixed effects ordered logit regression models taking account of clustering of patients in different municipalities were used in the analyses.SettingGeneral practice in Denmark.ParticipantsA representative sample of the Danish population.Primary and secondary outcome measuresThe primary outcome measure was patient-reported quality of care, and patient satisfaction with general practice and patient satisfaction with the general practitioner served as secondary outcome measures.ResultsIn total, 3609 respondents answered the survey. We found no statistically significant relationships between patient-reported quality of care and practice accreditation (2016: OR=0.89, 95% CI 0.73 to 1.07 and 2017: OR=0.85, 95% CI 0.71 to 1.02) and between patient satisfaction with the general practitioner and accreditation (2016: OR=0.93, 95% CI 0.76 to 1.13 and 2017: OR=0.86, 95% CI 0.70 to 1.04). However, there was a statistically significant negative relationship between patient satisfaction with the general practice and recent practice accreditation compared with satisfaction with practices not yet accredited (OR=0.81, 95% CI 0.67 to 0.97) but no significant relationship between patient satisfaction with the general practice and previous accreditation (OR=0.91, 95% CI 0.76 to 1.09).ConclusionAccreditation does not promote patient-reported quality of care or patient satisfaction. On the contrary, patient satisfaction with the general practice decreases when general practice is recently accredited.

Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery

Neurosurgery ◽  
2015 ◽  
Vol 77 (5) ◽  
pp. 769-776 ◽  
Author(s):  
Elina Reponen ◽  
Hanna Tuominen ◽  
Juha Hernesniemi ◽  
Miikka Korja
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Status ◽  
Patient Experience ◽  
University Hospital ◽  
Term Outcome ◽  
Major Morbidity ◽  
Patient Reported ◽  
Relationship Of

Abstract BACKGROUND: Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist. OBJECTIVE: To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a proxy for quality of care in elective cranial neurosurgery. METHODS: We conducted an observational study on the relationship of overall patient satisfaction at 30 postoperative days with surgical and functional outcome (modified Rankin Scale [mRS] score) in a prospective, consecutive, and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 at Helsinki University Hospital, Helsinki, Finland. RESULTS: Postoperative overall (subjective and objective) morbidity was present in 194 (46.4%) patients; yet almost 94% of all study patients reported high overall satisfaction. Low overall patient satisfaction at 30 days was not associated with postoperative major morbidity in elective cranial neurosurgery. Dependent functional status (mRS score ≥3) at 30 days, minor infections, poor postoperative subjective overall health status, and patient-reported severe symptoms (double vision, poor balance) may contribute to unsatisfactory patient experience. CONCLUSION: Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery.

Creation of a standardized set of patient-centered outcomes for advanced prostate cancer: An international effort.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 282-282
Author(s):  
Alicia Katherine Morgans ◽  
Annelotte van Bommel ◽  
Caleb Stowell ◽  
David F. Penson ◽  
Keyword(s):  
Prostate Cancer ◽  
Quality Of Care ◽  
Outcome Measures ◽  
Clinical Data ◽  
Advanced Prostate Cancer ◽  
International Health ◽  
Bowel Dysfunction ◽  
Patient Reported Outcome Measures ◽  
Patient Reported

282 Background: Clinical trials and international registries assess outcomes considered relevant to men with advanced prostate cancer (CaP). However, we lack a single standardized set of outcomes, making direct comparisons between populations and quality of care assessments challenging. We sought to create a minimum standardized set of outcomes relevant to men with advanced CaP. Methods: The International Consortium for Health Outcomes Measurement assembled a multi-disciplinary working group to create a minimum set of measures to collect for men with advanced CaP. We used a modified Delphi method to establish pertinent measures and case-mix characteristics. Results: Approximately 24 experts, including clinicians and patient advocates, from North America, Europe, and Australia participated. We defined the included population as men with metastatic prostate cancer or biochemical recurrence who failed or were ineligible for salvage therapy. Outcomes important to all men with advanced CaP, such as overall survival, and measures specific to subgroups, such as time to metastasis, were identified. Measures gathered from clinical data include risk-stratification characteristics and measures of disease control. Patient-reported outcome measures, like pain control, depression, and erectile, urinary, and bowel dysfunction, were also identified. Conclusions: Standardized outcome measures are necessary to assess quality of care across different populations, and are critical to ensure value in health care. Our international, multi-disciplinary team identified clinical data and patient-reported outcomes to provide a basis for international health outcome comparisons and future assessments of quality of care for men with advanced CaP.

scholarly journals Chronic Pain Practices: An Evaluation of Positive and Negative Online Patient Reviews

2019 ◽  
Vol 5 (22;5) ◽  
pp. E477-E486
Author(s):  
Vwaire Orhurhu
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Retrospective Study ◽  
Study Design ◽  
Secondary Outcome ◽  
Online Review ◽  
Online Platforms

Background: The role of patient satisfaction continues to play an important role in health care quality measures. The use of online review platforms has been adopted by patients to share their perceptions about the quality of care provided by physicians. Chronic pain practice has unique challenges regarding patient satisfaction. Objectives: The main goal of this study is to identify the themes associated with positive and negative reviews of chronic pain physicians at publicly available online review platforms. Study Design: A retrospective study design. Setting: We evaluated publicly available online patient-generated reviews of chronic pain physicians from Yelp and Healthgrades. Methods: This retrospective study evaluated patient-generated reviews of chronic pain physicians from 2 online platforms—Yelp and Healthgrades—between the September 1, 2018 through November 1, 2018. Ninety chronic pain physicians were randomly selected from 4 diverse geographic cities in the United States: New York (NY), Houston (TX), Chicago (IL), and Seattle (WA). Primary outcome was defined as high and low rating scores. Secondary outcome was the proportion of positive and negative attributes (patient, physician, procedure, and administrative attributes) that was associated with high and low rating scores. Results: A total of 1,627 reviews were extracted from 90 physicians evaluated at Yelp and Healthgrades. Of this total review, 1,296 (79.7%) were high scoring and (331) 20.3% were low scoring. Chronic pain providers who were high scoring had positive reviews that consisted of physician attributes (63.5%), administrative attributes (23.4%), and patient attributes (12.2%). The highest proportion of the first 3 physician attributes associated with high ratings were knowledgeable, helpful, and caring. Chronic pain providers who were low scoring had negative reviews that consisted of physician attributes (41.4%), administrative attributes (52.1%), and procedure attributes (5.2%). The highest proportion of the first 3 physician attributes associated with low ratings were disrespectful, unhelpful, and uncaring. Limitations: First, this study looks at reviews of 4 large cities, thus we may have excluded patient populations with substantially different preferences as health care consumers. Second, it is impossible to confirm the validity of individual reviewers’ interactions with the pain management specialist who provided care or validate the identity of the reviewers. Third, it is very difficult, or even impossible, to tell if the rater is a patient or someone posing as a patient, such as an unhappy employee or a business competitor. Conclusions: Online platforms provide a medium that facilitates immediate communication among patients. These platforms may provide timely data for chronic pain physicians to gain more insight into the quality of care perceived by patients, thereby aiding providers to improve on ways to optimize patient-care experiences and encounters. Key words: Chronic pain practice, online review, patient review, patient satisfaction

scholarly journals Impact of the implementation of a fast-track on emergency department length of stay and quality of care indicators in the Champagne-Ardenne region: a before–after study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026200 ◽  
Author(s):  
Jan Chrusciel ◽  
Xavier Fontaine ◽  
Arnaud Devillard ◽  
Aurélien Cordonnier ◽  
Lukshe Kanagaratnam ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Of Care ◽  
Length Of Stay ◽  
Outcome Measures ◽  
Fast Track ◽  
Secondary Outcome ◽  
Large Hospital ◽  
Intervention Hospital ◽  
Hospital Bed

ObjectivesWe aimed to evaluate the effect of the implementation of a fast-track on emergency department (ED) length of stay (LOS) and quality of care indicators.DesignAdjusted before–after analysis.SettingA large hospital in the Champagne-Ardenne region, France.ParticipantsPatients admitted to the ED between 13 January 2015 and 13 January 2017.InterventionImplementation of a fast-track for patients with small injuries or benign medical conditions (13 January 2016).Primary and secondary outcome measuresProportion of patients with LOS ≥4 hours and proportion of access block situations (when patients cannot access an appropriate hospital bed within 8 hours). 7-day readmissions and 30-day readmissions.ResultsThe ED of the intervention hospital registered 53 768 stays in 2016 and 57 965 in 2017 (+7.8%). In the intervention hospital, the median LOS was 215 min before the intervention and 186 min after the intervention. The exponentiated before–after estimator for ED LOS ≥4 hours was 0.79; 95% CI 0.77 to 0.81. The exponentiated before–after estimator for access block was 1.19; 95% CI 1.13 to 1.25. There was an increase in the proportion of 30 day readmissions in the intervention hospital (from 11.4% to 12.3%). After the intervention, the proportion of patients leaving without being seen by a physician decreased from 10.0% to 5.4%.ConclusionsThe implementation of a fast-track was associated with a decrease in stays lasting ≥4 hours without a decrease in access block. Further studies are needed to evaluate the causes of variability in ED LOS and their connections to quality of care indicators.

scholarly journals Establishing a global quality of care benchmark report

2021 ◽  
Vol 27 (2) ◽  
pp. 146045822110157
Author(s):  
Fanny Sampurno ◽  
Justin Cally ◽  
Jacinta L Opie ◽  
Ashwini Kannan ◽  
Jeremy L Millar ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Outcome Measures ◽  
Large Scale ◽  
Best Practice ◽  
Response Rate ◽  
Care Delivery ◽  
Current Data ◽  
Data Display ◽  
Patient Reported

Background: The Movember funded TrueNTH Global Registry (TNGR) aims to improve care by collecting and analysing a consistent dataset to identify variation in disease management, benchmark care delivery in accordance with best practice guidelines and provide this information to those in a position to enact change. We discuss considerations of designing and implementing a quality of care report for TNGR. Methods: Eleven working group sessions were held prior to and as reports were being built with representation from clinicians, data managers and investigators contributing to TNGR. The aim of the meetings was to understand current data display approaches, share literature review findings and ideas for innovative approaches. Preferred displays were evaluated with two surveys (survey 1: 5 clinicians and 5 non-clinicians, 83% response rate; survey 2: 17 clinicians and 18 non-clinicians, 93% response rate). Results: Consensus on dashboard design and three data-display preferences were achieved. The dashboard comprised two performance summary charts; one summarising site’s relative quality indicator (QI) performance and another to summarise data quality. Binary outcome QIs were presented as funnel plots. Patient-reported outcome measures of function score and the extent to which men were bothered by their symptoms were presented in bubble plots. Time series graphs were seen as providing important information to supplement funnel and bubble plots. R Markdown was selected as the software program principally because of its excellent analytic and graph display capacity, open source licensing model and the large global community sharing program code enhancements. Conclusions: International collaboration in creating and maintaining clinical quality registries has allowed benchmarking of process and outcome measures on a large scale. A registry report system was developed with stakeholder engagement to produce dynamic reports that provide user-specific feedback to 132 participating sites across 13 countries.

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