scholarly journals Surgical adverse outcomes and patients' evaluation of quality of care: inherent risk or reduced quality of care?

2008 ◽  
Vol 84 (988) ◽  
pp. 93-98 ◽  
Author(s):  
P J Marang-van de Mheen ◽  
N van Duijn-Bakker ◽  
J Kievit
Keyword(s):  
Quality Of Care ◽  
Adverse Outcomes ◽  
Inherent Risk

Surgical Adverse Outcomes in Patients with Serious Mental Illnes

2021 ◽  
Vol 1 (4) ◽  
pp. 71-75
Author(s):  
Gerry Armando
Keyword(s):  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Adverse Outcomes ◽  
Medical Procedure ◽  
Key Factor ◽  
Comorbidity Status

Serious mental illness (SMI) influences 3 % of the populace and incorporates handicapping types of despondency and uneasiness, just as maniacal issues, for example, bipolar and schizophrenia. Patients with schizophrenia were known to have a higher risk of complications during hospitalization. Quality of care has become the key factor in reducing their potential mortality afterwards. Patients with SMI were substantially less liable to have significant medical procedure, in the wake of controlling for age, other segment measures, and illness trouble. For patients of a similar age, sex, race and comorbidity status, having a previous genuine psychological instability passed on a significantly diminished probability of careful mediation. Clinical and careful hospitalizations for people with schizophrenia had in some measure double the chances of a few kinds of unfriendly occasions than those for people without schizophrenia. These antagonistic occasions were related with poor clinical and financial results during the emergency clinic confirmation. Endeavors to decrease these unfriendly occasions should turn into an examination need.

scholarly journals Surgical Adverse Outcomes in Patients with Serious Mental Illnes

2021 ◽  
Vol 1 (4) ◽  
pp. 71-75
Author(s):  
Gerry Armando
Keyword(s):  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Adverse Outcomes ◽  
Medical Procedure ◽  
Key Factor ◽  
Comorbidity Status

Serious mental illness (SMI) influences 3 % of the populace and incorporates handicapping types of despondency and uneasiness, just as maniacal issues, for example, bipolar and schizophrenia. Patients with schizophrenia were known to have a higher risk of complications during hospitalization. Quality of care has become the key factor in reducing their potential mortality afterwards. Patients with SMI were substantially less liable to have significant medical procedure, in the wake of controlling for age, other segment measures, and illness trouble. For patients of a similar age, sex, race and comorbidity status, having a previous genuine psychological instability passed on a significantly diminished probability of careful mediation. Clinical and careful hospitalizations for people with schizophrenia had in some measure double the chances of a few kinds of unfriendly occasions than those for people without schizophrenia. These antagonistic occasions were related with poor clinical and financial results during the emergency clinic confirmation. Endeavors to decrease these unfriendly occasions should turn into an examination need.

scholarly journals Quality of British and American Nationwide Quality of Care and Patient Safety Benchmarking Programs: Case Neurosurgery

Neurosurgery ◽  
2018 ◽  
Vol 85 (4) ◽  
pp. 500-507 ◽  
Author(s):  
Elina Reponen ◽  
Hanna Tuominen ◽  
Miikka Korja
Keyword(s):  
United States ◽  
United Kingdom ◽  
Quality Of Care ◽  
Sample Size ◽  
Health Care Policy ◽  
Adverse Outcomes ◽  
University Hospital ◽  
Improvement Program ◽  
The United Kingdom

Abstract BACKGROUND Multiple nationwide outcome registries are utilized for quality benchmarking between institutions and individual surgeons. OBJECTIVE To evaluate whether nationwide quality of care programs in the United Kingdom and United States can measure differences in neurosurgical quality. METHODS This prospective observational study comprised 418 consecutive adult patients undergoing elective craniotomy at Helsinki University Hospital between December 7, 2011 and December 31, 2012.We recorded outcome event rates and categorized them according to British Neurosurgical National Audit Programme (NNAP), American National Surgical Quality Improvement Program (NSQIP), and American National Neurosurgery Quality and Outcomes Database (N2QOD) to assess the applicability of these programs for quality benchmarking and estimated sample sizes required for reliable quality comparisons. RESULTS The rate of in-hospital major and minor morbidity was 18.7% and 38.0%, respectively, and 30-d mortality rate was 2.4%. The NSQIP criteria identified 96.2% of major but only 38.4% of minor complications. N2QOD performed better, but almost one-fourth (23.2%) of all patients with adverse outcomes, mostly minor, went unnoticed. For NNAP, a sample size of over 4200 patients per surgeon is required to detect a 50.0% increase in mortality rates between surgeons. The sample size required for reliable comparisons between the rates of complications exceeds 600 patients per center per year. CONCLUSION The implemented benchmarking programs in the United Kingdom and United States fail to identify a considerable number of complications in a high-volume center. Health care policy makers should be cautious as outcome comparisons between most centers and individual surgeons are questionable if based on the programs.

Abstract P281: Impact of Transradial Approach on Quality of Care for Percutaneous Coronary Intervention: A Single Center Experience

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Chuntao Wu ◽  
Duanping Liao ◽  
Anne-Marie Dyer ◽  
Helen Chen ◽  
Ian C Gilchrist
Keyword(s):  
Quality Of Care ◽  
Lower Risk ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Risk Of Bleeding ◽  
The Difference

Background: Transradial cardiac catheterization has only been used in a small fraction of percutaneous coronary intervention (PCI) procedures in the United States, despite of the evidence that it may be associated with a lower risk of bleeding and mortality following PCI compared to the transfemoral approach. Objective: To evaluate the impact of the transradial approach on adverse outcomes following PCI and its potential of being a process to improve the quality of care for PCI in a single-center practice. Methods: We compared the risks of post-procedural adverse outcomes including in-hospital mortality, bleeding, and vascular complications between the 462 transradial and the 625 transfemoral cases who had undergone PCI procedures between January 2007 and March 2009. The difference in length of stay following PCI between the two entry approaches was also examined. Results: Compared to the transfemoral approach, the transradial cardiac catheterization was associated with significantly lower risk of bleeding (2.60% (12 of 462) vs. 6.08% (38 of 625); adjusted odds ratio (aOR)=0.34, 95% confidence interval (CI): 0.17-0.68, P=0.002) and vascular complications (0% vs. 1.44% (9 of 625), P=0.01). Although the trend was that the transradial approach was associated with lower risk of in-hospital mortality, the difference was not statistically significant (0.87% (4 of 462) vs. 2.24% (14 of 625); aOR=0.55, 95% CI: 0.14-2.10, P=0.38). Transradial patients were more likely to be discharged on the same day of procedure (14.2% vs. 2.2%, P<0.0001). Conclusion: The transradial approach is related to lower risk of bleeding and vascular complications. Introducing this approach to practice could improve the quality of care for PCI.

scholarly journals The Discharge Communication Study: research protocol for a mixed methods study to investigate and triangulate discharge communication experiences of patients, GPs, and hospital professionals, alongside a corresponding discharge letter sample

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Katharine Weetman ◽  
Jeremy Dale ◽  
Emma Scott ◽  
Stephanie Schnurr
Keyword(s):  
Quality Of Care ◽  
Mixed Methods ◽  
Corpus Linguistics ◽  
Care Transitions ◽  
Adverse Outcomes ◽  
Mixed Methods Study ◽  
Discharge Letter ◽  
The Uk ◽  
Discharge Communication

Abstract Background Discharge letters are crucial during care transitions from hospital to home. Research indicates a need for improvement to increase quality of care and decrease adverse outcomes. These letters are often sent from the hospital discharging physician to the referring clinician, typically the patient’s General Practitioner (GP) in the UK, and patients may or may not be copied into them. Relatively little is known about the barriers and enablers to sending patients discharge letters. Hence, the aim of this study was to investigate from GP, hospital professional (HP) and patient perspectives how to improve processes of patients receiving letters and increase quality of discharge letters. The study has a particular focus on the impacts of receiving or not receiving letters on patient experiences and quality of care. Methods The setting was a region in the West Midlands of England, UK. The research aimed to recruit a minimum of 30 GPs, 30 patients and 30 HPs in order to capture 90 experiences of discharge communication. Participating GPs initially screened and selected a range of recent discharge letters which they assessed to be successful and unsuccessful exemplars. These letters identified potential participants who were invited to take part: the HP letter writer, GP recipient and patient. Participant viewpoints are collected through interviews, focus groups and surveys and will be “matched” to the discharge letter sample, so forming multiple-perspective “quartet” cases. These “quartets” allow direct comparisons between different discharge experiences within the same communicative event. The methods for analysis draw on techniques from the fields of Applied Linguistics and Health Sciences, including: corpus linguistics; inferential statistics; content analysis. Discussion This mixed-methods study is novel in attempting to triangulate views of patients, GPs and HPs in relation to specific discharge letters. Patient and practitioner involvement will inform design decisions and interpretation of findings. Recommendations for improving discharge letters and the process of patients receiving letters will be made, with the intention of informing guidelines on discharge communication. Ethics approval was granted in July 2017 by the UK Health Research Authority. Findings will be disseminated in peer-reviewed journals, reports and newsletters, and presentations.

Are we using the right tools to manage variation, errors and omissions?

2020 ◽  
Vol 32 (2) ◽  
pp. 156-159 ◽  
Author(s):  
Dinesh K Arya
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Wide Spread ◽  
Cause Analysis ◽  
Root Cause ◽  
Inherent Risk ◽  
Health Care Consumer ◽  
The Right

Abstract In all processes, there is an inherent risk of variability to occur. In the process of delivering healthcare, variability can occur as a result of an error or omission and compromise the quality of care or affect the safety of the health care consumer. Even though incident reporting, root cause analysis, use of checklists and other quality improvement methods are in wide-spread use, we may not be using these tools appropriately and therefore we are losing an opportunity to improve the quality of care.

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