scholarly journals Physicians’ clinical experience and its association with healthcare quality: a systematised review

2021 ◽  
Vol 10 (4) ◽  
pp. e001545
Author(s):  
Soffien Chadli Ajmi ◽  
Karina Aase
Keyword(s):  
Outcome Measures ◽  
Clinical Experience ◽  
Healthcare Quality ◽  
Positive Association ◽  
Final Analysis ◽  
Clinical Effectiveness ◽  
Healthcare Services ◽  
Early Career ◽  
Original Research ◽  
Different Dimensions

Background and purposeThere is conflicting evidence regarding whether physicians’ clinical experience affects healthcare quality. Knowing whether an association exists and which dimensions of quality might be affected can help healthcare services close quality gaps by tailoring improvement initiatives according to physicians’ clinical experience. Here, we present a systematised review that aims to assess the potential association between physicians’ clinical experience and different dimensions of healthcare quality.MethodsWe conducted a systematised literature review, including the databases MEDLINE, Embase, PsycINFO and PubMed. The search strategy involved combining predefined terms that describe physicians’ clinical experience with terms that describe different dimensions of healthcare quality (ie, safety, clinical effectiveness, patient-centredness, timeliness, efficiency and equity). We included relevant, original research published from June 2004 to November 2020.ResultsFifty-two studies reporting 63 evaluations of the association between physicians’ clinical experience and healthcare quality were included in the final analysis. Overall, 27 (43%) evaluations found a positive or partially positive association between physicians’ clinical experience and healthcare quality; 22 (35%) found no association; and 14 (22%) evaluations reported a negative or partially negative association. We found a proportional association between physicians’ clinical experience and quality regarding outcome measures that reflect safety, particularly in the surgical fields. For other dimensions of quality, no firm evidence was found.ConclusionWe found no clear evidence of an association between measures of physicians’ clinical experience and overall healthcare quality. For outcome measures related to safety, we found that physicians’ clinical experience was proportional with safer care, particularly in surgical fields. Our findings support efforts to secure adequate training and supervision for early-career physicians regarding safety outcomes. Further research is needed to reveal the potential subgroups in which gaps in quality due to physicians’ clinical experience might exist.

Impact of hospital atmosphere on perceived health care outcome

2015 ◽  
Vol 28 (2) ◽  
pp. 129-140 ◽  
Author(s):  
Ritu Narang ◽  
Pia Polsa ◽  
Alabi Soneye ◽  
Wei Fuxiang
Keyword(s):  
Service Quality ◽  
Healthcare Service ◽  
Service Use ◽  
Service Providers ◽  
Healthcare Quality ◽  
Clinical Effectiveness ◽  
Healthcare Services ◽  
Content Type ◽  
The People ◽  
Developed Nations

Purpose – Healthcare service quality studies primarily examine the relationships between patients ' perceived quality and satisfaction with healthcare services, clinical effectiveness, service use, recommendations and value for money. These studies suggest that patient-independent quality dimensions (structure, process and outcome) are antecedents to quality. The purpose of this paper is to propose an alternative by looking at the relationship between hospital atmosphere and healthcare quality with perceived outcome. Design/methodology/approach – Data were collected from Finland, India, Nigeria and the People ' s Republic of China. Regression analysis used perceived outcome as the dependent variable and atmosphere and healthcare service quality as independent variables. Findings – Results showed that atmosphere and healthcare service quality have a statistically significant relationship with patient perceived outcomes. Research limitations/implications – The sample size was small and the sampling units were selected on convenience; thus, caution must be exercised in generalizing the findings. Practical implications – The study determined that service quality and atmosphere are considered significant for developing and developed nations. This result could have significant implications for policy makers and service providers developing healthcare quality and hospital atmosphere. Originality/value – Studies concentrate on healthcare outcome primarily regarding population health status, mortality, morbidity, customer satisfaction, loyalty, quality of life, customer behavior and consumption. However, the study exposes how patients perceive their health after treatment. Furthermore, the authors develop the healthcare service literature by considering atmosphere and perceived outcome.

scholarly journals Association between Blood Pressure and Serum Thyroid-Stimulating Hormone Concentration within the Reference Range: A Population-Based Study

2007 ◽  
Vol 92 (3) ◽  
pp. 841-845 ◽  
Author(s):  
Bjørn O. Åsvold ◽  
Trine Bjøro ◽  
Tom I. L. Nilsen ◽  
Lars J. Vatten
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Outcome Measures ◽  
Odds Ratio ◽  
Reference Range ◽  
Positive Association ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
Cross Sectional ◽  
Population Based Study

Abstract Context: The association between thyroid function and blood pressure is insufficiently studied. Objective: The objective of the investigation was to study the association between TSH within the reference range and blood pressure. Design and Setting: This was a cross-sectional, population-based study. Subjects: A total of 30,728 individuals without previously known thyroid disease were studied. Main Outcome Measures: The main outcome measures were mean systolic and diastolic blood pressure and pulse pressure and odds ratio for hypertension (>140/90 mm Hg or current or previous use of antihypertensive medication), according to categories of TSH. Results: Within the reference range of TSH (0.50–3.5 mU/liter), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mm Hg [95% confidence interval (CI) 1.4–2.6 mm Hg] per milliunit per liter increase in TSH among men, and 1.8 mm Hg (95% CI 1.4–2.3 mm Hg) in women. The corresponding increase in diastolic blood pressure was 1.6 mm Hg (95% CI 1.2–2.0 mm Hg) in men and 1.1 mm Hg (95% CI 0.8–1.3 mm Hg) in women. Comparing TSH of 3.0–3.5 mU/liter (upper part of the reference) with TSH of 0.50–0.99 mU/liter (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI 1.56–2.53) in men and 1.23 (95% CI 1.04–1.46) in women. Conclusion: Within the reference range of TSH, we found a linear positive association between TSH and systolic and diastolic blood pressure that may have long-term implications for cardiovascular health.

scholarly journals Lactobacillus Kefiri LKF01 (Kefibios®) for Prevention of Diarrhoea in Cancer Patients Treated with Chemotherapy: A Prospective Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 385
Author(s):  
Michele Ghidini ◽  
Mariaceleste Nicoletti ◽  
Margherita Ratti ◽  
Gianluca Tomasello ◽  
Veronica Lonati ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Final Analysis ◽  
Clinical Effectiveness ◽  
High Grade ◽  
Combination Therapies ◽  
Grade 3 ◽  
Lactobacillus Kefiri ◽  
A Prospective Study

Diarrhoea is one of the main side effects that cancer patients face. The literature showsthat the incidence of chemotherapy (CT)-induced diarrhoea (grade 3–4) in treated patients is in the range of 10–20%, particularly after 5-fluorouracil (5-FU) bolus or some combination therapies of irinotecan and fluoropyrimidines. The aim of the present study was to evaluate the clinical effectiveness of Lactobacillus kefiri LKF01 (Kefibios®) in the prevention or treatment of CT-related diarrhoea in the cancer population. We conducted a prospective observational study. Patients enrolled were adults treated for at least four months with 5-FU-based CT. Kefibios® was administered to patients every day. The primary outcome was the evaluation of the incidence of grade 3–4 CT-induced diarrhoea. We included 76 patients in the final analysis. A 6.6% incidence of high-grade diarrhoea was found in the evaluated population (4.7% of patients treated with 5-FU-based therapy and 8.5% of patients treated with capecitabine-based CT). The overall incidence of high-grade diarrhoea observed was higher in the 1st and 2nd cycles (3.9%), with a subsequent sharp reduction from the 3rd cycle (1.3%) and negativisation from the 5th cycle. Lactobacillus kefiri LKF01 (Kefibios®) is safe and effective in preventing severe diarrhoea in cancer patients receiving 5-FU or capecitabine-based treatment.

Cardiorespiratory Responses During Underwater and Land Treadmill Exercise in College Athletes

2011 ◽  
Vol 20 (3) ◽  
pp. 345-354 ◽  
Author(s):  
Peter Brubaker ◽  
Cemal Ozemek ◽  
Alimer Gonzalez ◽  
Stephen Wiley ◽  
Gregory Collins
Keyword(s):  
Athletic Training ◽  
Outcome Measures ◽  
Sports Medicine ◽  
Perceived Exertion ◽  
College Athletes ◽  
Random Order ◽  
Original Research ◽  
Cardiorespiratory Responses ◽  
Significant Difference ◽  
The Relationship

Context:Underwater treadmill (UTM) exercise is being used with increased frequency for rehabilitation of injured athletes, yet there has been little research conducted on this modality.Objective:To determine the cardiorespiratory responses of UTM vs land treadmill (LTM) exercise, particularly with respect to the relationship between heart rate (HR) and oxygen consumption (VO2).Design and Setting:This quantitative original research took place in sports medicine and athletic training facilities at Wake Forest University.Participants:11 Wake Forest University student athletes (20.8 ± 0.6 y, 6 women and 5 men).Intervention:All participants completed the UTM and LTM exercise-testing protocols in random order. After 5 min of standing rest, both UTM and LTM protocols had 4 stages of increasing belt speed (2.3, 4.9, 7.3, and 9.6 km/h) followed by 3 exercise stages at 9.6 km/h with increasing water-jet resistance (30%, 40%, and 50% of jet capacity) or inclines (1%, 2%, and 4% grade).Main Outcome Measures:A Cosmed K4b2 device with Polar monitor was used to collect HR, ventilation (Ve), tidal volume (TV), breathing frequency (Bf), and VO2 every minute. Ratings of perceived exertion (RPE) were also obtained each minute.Results:There was no significant difference between UTM and LTM for VO2 at rest or during any stage of exercise except stage 3. Furthermore, there were no significant differences between UTM and LTM for HR, Ve, Bf, and RPE on any exercise stage. Linear regression of HR vs VO2, across all stages of exercise, indicates a similar relationship in these variables during UTM (r = .94, y = .269x − 10.86) and LTM (r = .95, y = .291x − 12.98).Conclusions:These data indicate that UTM and LTM exercise elicits similar cardiorespiratory responses and that HR can be used to guide appropriate exercise intensity for college athletes during UTM.

scholarly journals The “business” of dentistry: Consumers’ (patients’) criteria in the selection and evaluation of dental services

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0253517
Author(s):  
Laura Gray ◽  
Lisa McNeill ◽  
Weiming Yi ◽  
Anastasia Zvonereva ◽  
Paul Brunton ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Treatment Options ◽  
Clinical Effectiveness ◽  
Healthcare Services ◽  
Geographic Region ◽  
Online Questionnaire ◽  
Chi Square ◽  
Dental Services ◽  
Dental Practitioners ◽  
Chi Square Analysis

The dimensions of patient-centred care include not only clinical effectiveness and patient safety, but, importantly, the preferences of patients as consumers of healthcare services. A total of 249 participants were included in the study, with a balanced population proportional representation by age, gender, ethnicity and geographic region of New Zealand. An online questionnaire was used to identify participants’ decision-making process, and what factors and barriers for participants to seek dental treatment. Cross-tabulations, Spearman correlation analysis and Pearson Chi-Square analysis were used for the statistical analyses. Three most common reasons for visit were check-up (77%), clean (57%) and relief of pain 36%). A desire to treat a perceived problem was the most common encouraging factor to seek dental care. Cost was the most common barrier to seeking dental services. The majority of participants attended a private practice (84%), with convenience of location and referral from professionals the most likely to influence their choice. Participants felt the most important trait a dental practitioner could demonstrate was to discuss treatment options with them before any treatment. Dental check-up, teeth cleaning and relief of pain were the most common reasons for patients to choose dental services. Cost and ethnicity of the consumers had a significant impact on how dental services were perceived and sought. Dental practitioners may need to reorientate how they express value of oral health practice, not just in regard to communication with patients, but also with government funding agencies.

scholarly journals Clinical benefits and adverse effects of siwak (S. persica) use on periodontal health: a scoping review of literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haslinda Ramli ◽  
Tuti Ningseh Mohd-Dom ◽  
Shahida Mohd-Said
Keyword(s):  
Adverse Effects ◽  
Scoping Review ◽  
Oral Hygiene ◽  
English Language ◽  
Final Analysis ◽  
Clinical Effectiveness ◽  
Periodontal Health ◽  
Clinical Attachment Loss ◽  
Tooth Cleaning ◽  
Wide Range

Abstract Background Siwak is a chewing stick used as an oral hygiene aid associated with Muslim communities across the globe since more than 1500 years ago. Used either exclusively or in conjunction with a regular toothbrush, there is evidence supporting its clinical effectiveness in plaque control, but adverse effects on periodontal health remains inconclusive. Objective This study aims to systematically review the wide range of data and literatures related to siwak practice and its effect on periodontal health. Method The review was conducted based on scoping review techniques, searching literature in EBSCOHOST, PubMed, SCOPUS and Google scholar databases using the following search terms: “siwak’ or ‘miswak’ or ‘chewing stick” for intervention, and “periodontium or ‘periodontal’ or ‘periodontal health’ or ‘periodontal disease” for outcome. Articles published between January 1990 to March 2021 and written in English language were included. Results A total of 721 articles collected from the search and 21 of them were eligible for the final analysis. Results of this study was described based on clinical and antibacterial reporting of siwak, method of siwak practice and its adverse effect on oral health. Siwak was found effective at removing dental plaque and improving periodontal health over time although its effect on subgingival microbiota was inconclusive. Presence of gingival recession and clinical attachment loss were much more commonly reported in siwak users, attributable to variations in the methods employed for tooth cleaning using the siwak. Conclusion There is substantial evidence that the lack of standardised reporting for effective siwak use may have resulted in contradictory findings about its oral hygiene benefits and adverse effects. As such, future work on safe and effective siwak practice is to be advocated among its users.

scholarly journals Nurses' practices in the context of primary healthcare in Portugal

2018 ◽  
Vol 23 (6) ◽  
pp. 520-532
Author(s):  
Carlise Rigon Dalla Nora ◽  
Rafaela Schaefer ◽  
João Neves-Amado
Keyword(s):  
Health Promotion ◽  
Latin American ◽  
Primary Healthcare ◽  
National Health System ◽  
Healthcare Services ◽  
Health Sciences ◽  
Cochrane Library ◽  
Original Research ◽  
Electronic Library ◽  
Effective Use

Aim The aim of this study was to identify and categorise the nursing practices of Portuguese nurses in the context of primary healthcare services. Methods A scoping review was undertaken using the Latin American and Caribbean Health Sciences literature database; Spanish Bibliographic Index of Health Sciences; Medical Literature Analysis and Retrieval System Online; Cochrane Library; Scientific Electronic Library Online; El Banco de Datos de Enfermería nursing database; and Cumulative Index to Nursing and Allied Health Literature databases. The search strategy included articles of original research, which involved nurses or nursing practices in the context of Portugal’s primary healthcare, published in Portuguese, Spanish and/or English. The review involved the analysis of 11 studies published in Latin American, Brazilian and Portuguese journals, therefore all were available in Portuguese, published between 2007 and 2013. Results From the analysis it was possible to establish four categories of primary healthcare nurses’ work: technical procedures, health promotion, independent actions, and management and training practices. Conclusions Primary healthcare nursing in Portugal is challenged in the context of making more effective use of its own competences, investing more in actions of health promotion and disease prevention and less in technical curative procedures, thus contributing to better performance in the Portuguese National Health System.

Development of the Key Performance Indicators for Digital Health Interventions: A Scoping Review (Preprint)

2021 ◽  
Author(s):  
Maria Brenner ◽  
Arielle Weir ◽  
Margaret McCann ◽  
Carmel Doyle ◽  
Mary Hughes ◽  
...  
Keyword(s):  
Scoping Review ◽  
Performance Indicators ◽  
Delphi Study ◽  
Current Knowledge ◽  
Digital Health ◽  
Stakeholder Involvement ◽  
Key Performance Indicators ◽  
Healthcare Services ◽  
Health Interventions ◽  
Original Research

BACKGROUND Development of the Key Performance Indicators for Digital Health Interventions: A Scoping Review OBJECTIVE Digital health interventions (DHIs) offer new methods for delivering healthcare, with the potential to innovate healthcare services. Key performance indicators (KPIs) play a role in evaluation, measurement, and improvement in healthcare quality and service performance. The scoping review question was developed following an initial search to identify literature to assist in the development of KPIs for an ongoing DHI initiative. During the initial search, it became clear that there was limited literature on how to develop specific and measurable KPIs that evaluate DHIs. The aim of this scoping review was to identify current knowledge and evidence surrounding the development of KPIs for DHIs. METHODS A rigorous literature search was conducted across ten key databases: AMED - The Allied and Complementary Medicine Database, CINAHL Complete, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycINFO, EMBASE, EBM Reviews - Cochrane Database of Systematic Reviews, EBM Reviews - Database of Abstracts of Reviews of Effects, EBM Reviews - Health Technology Assessment, and IEEE Xplore. A descriptive summary of the literature was performed, and thematic analysis identified important or reoccurring themes. RESULTS Five references (representing four unique publications) were eligible for the review. Of the four included publications, two were articles on original research studies of a specific DHI, and two were overviews of methods for developing DHIs (not specific to a single DHI). All the included reports discussed the involvement of stakeholders in developing KPIs for DHIs. The step of identifying and defining the KPIs was completed using various methodologies, but all centered on a form of stakeholder involvement. Potential options for stakeholder involvement for KPI identification include the use of an elicitation framework, a factorial survey approach, or a Delphi study. Most of the included articles recognised the lack of literature relating to KPI development for DHIs, compared to the breath of literature available on the development of KPIs in other fields like health or informatics CONCLUSIONS Few articles were identified, highlighting a significant gap in the evidence-based knowledge in this domain. All the included articles discussed the involvement of stakeholders in developing KPIs for DHIs, which was performed using various methodologies. The articles acknowledged a lack of literature related to KPI development for DHIs. To allow comparability between KPI initiatives and facilitate work in the field, further research would be beneficial to develop a common methodology for KPI development for DHIs.

Evaluation Considerations for E-Health Systems

2010 ◽  
pp. 263-277 ◽  
Author(s):  
Anastasia N. Kastania
Keyword(s):  
Health Systems ◽  
Scientific Literature ◽  
Evaluation Studies ◽  
Healthcare Quality ◽  
Evaluation Procedure ◽  
Health Evaluation ◽  
Reliability Improvement ◽  
Quality Dimensions ◽  
Different Dimensions ◽  
Quality And Reliability

E-health evaluation, which involves different dimensions, has increased. In traditional healthcare, quality dimensions exist but these are not sufficiently exploited for e-health. Reliability is often examined regarding technology, software, demand and survival. This chapter reviews the reasons that e-health systems need to be evaluated, the methods followed for conducting e-health evaluation studies and the main points that characterize an evaluation procedure as successful. Many researchers have presented evaluation considerations for e-health. Herein, the emphasis is on analyzing a series of ideas mined from the scientific literature that allows drawing up practical considerations for e-health evaluation. These considerations focus both on quality and reliability assurance as well as on quality and reliability improvement.

Clinical effectiveness of a silicone foam dressing for the prevention of heel pressure ulcers in critically ill patients: Border II Trial

2020 ◽  
Vol 29 (Sup9a) ◽  
pp. S26-S31
Author(s):  
N. Santamaria ◽  
M. Gerdtz ◽  
W. Liu ◽  
S. Rakis ◽  
S. Sage ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Pressure Ulcers ◽  
Final Analysis ◽  
Clinical Effectiveness ◽  
Control Group ◽  
Royal Melbourne Hospital ◽  
Physiological Variables ◽  
Silicone Foam ◽  
Initial Cohort

• Objective: Critically ill patients are at high risk of developing pressure ulcers (PU), with the sacrum and heels being highly susceptible to pressure injuries. The objective of our study was to evaluate the clinical effectiveness of a new multi-layer, self-adhesive soft silicone foam heel dressing to prevent PU development in trauma and critically ill patients in the intensive care unit (ICU). • Method: A cohort of critically ill patients were enrolled at the Royal Melbourne Hospital. Each patient had the multi-layer soft silicone foam dressing applied to each heel on admission to the emergency department. The dressings were retained with a tubular bandage for the duration of the patients' stay in the ICU. The skin under the dressings was examined daily and the dressings were replaced every three days. The comparator for our cohort study was the control group from the recently completed Border Trial. • Results: Of the 191 patients in the initial cohort, excluding deaths, loss to follow-up and transfers to another ward, 150 patients were included in the final analysis. There was no difference in key demographic or physiological variables between the cohorts, apart from a longer ICU length of stay for our current cohort. No PUs developed in any of our intervention cohort patients compared with 14 patients in the control cohort (n=152; p<0.001) who developed a total of 19 heel PUs. • Conclusion: We conclude, based on our results, that the multi-layer soft silicone foam dressing under investigation was clinically effective in reducing ICU-acquired heel PUs. The findings also support previous research on the clinical effectiveness of multi-layer soft silicone foam dressings for PU prevention in the ICU.

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