Assessment Of Quality Of Care In A Cardiothoracic High Dependency Unit (HDU) : Development Of New Patient Survey Tool

Abstract Introduction A good handover is fundamental in providing continuity of care within a multidisciplinary team, allowing for safe and effective management of patients. Method Handovers between the neurosurgical high dependency unit and the ward team were prospectively evaluated as patients were stepped down over a 6-week period. The handover rate and consequences of poor handovers (missed investigations, referrals, or delayed discharges) were documented. After 6-weeks, handover proforma was introduced and the rates were recalculated. Results In the initial 6-week period, 36 patients were transferred, with only 2(5.6%) appropriately handed-over. Consequently, 9(26%) patients had delayed scans, 5(15%) missed referrals, and 24(71%) delayed discharges. In the 6-week period following the introduction of the proforma, a total of 28 patients were transferred, with 19(67.8%) documented handovers. Consequently, 1(3.5%) patient had a scan delay, 0 missed referrals and only 2(7%) patients had delayed discharges. Conclusions By raising awareness of handovers and introducing a proforma, we improved documented handovers by 62.3% whilst reducing the rate of missed investigations, referrals, and delayed discharges by over 90%. This project highlights how small, simple, and easy to enforce changes can lead to significant improvements in the quality of care provided to patients.

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248 Improving Handovers from A Neurosurgical High Dependency Unit to Ward Teams

British Journal of Surgery ◽

10.1093/bjs/znab134.391 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

R Faderani ◽

A Mohamed ◽

P Stewart

Keyword(s):

Quality Of Care ◽

Continuity Of Care ◽

Multidisciplinary Team ◽

High Dependency Unit ◽

Effective Management ◽

High Dependency ◽

Raising Awareness ◽

Delayed Discharges

Abstract Introduction A good handover is fundamental in providing continuity of care within a multidisciplinary team, allowing for safe and effective management of patients. Method Handovers between the neurosurgical high dependency unit and the ward team were prospectively evaluated as patients were stepped down over a 6-week period. The handover rate and consequences of poor handovers (missed investigations, referrals, or delayed discharges) were documented. After 6-weeks, handover proforma was introduced and the rates were recalculated. Results In the initial 6-week period, 36 patients were transferred, with only 2(5.6%) appropriately handed-over. Consequently, 9(26%) patients had delayed scans, 5(15%) missed referrals, and 24(71%) delayed discharges. In the 6-week period following the introduction of the proforma, a total of 28 patients were transferred, with 19(67.8%) documented handovers. Consequently, 1(3.5%) patient had a scan delay, 0 missed referrals and only 2(7%) patients had delayed discharges. Conclusions By raising awareness of handovers and introducing a proforma, we improved documented handovers by 62.3% whilst reducing the rate of missed investigations, referrals, and delayed discharges by over 90%. This project highlights how small, simple, and easy to enforce changes can lead to significant improvements in the quality of care provided to patients.

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Client Satisfaction and Experience With Telepsychiatry: Development and Validation of a Survey Using Clinical Quality Domains (Preprint)

10.2196/preprints.19198 ◽

2020 ◽

Author(s):

Eva Serhal ◽

Anne Kirvan ◽

Marcos Sanches ◽

Allison Crawford

Keyword(s):

Mental Health ◽

Patient Satisfaction ◽

Quality Of Care ◽

Quality Care ◽

Clinical Intervention ◽

Strongly Correlated ◽

Clinical Quality ◽

Survey Tool ◽

Development And Validation

BACKGROUND Telepsychiatry is an increasingly used model of mental health care that connects patients with psychiatrists at a distance via videoconference. Telepsychiatry is an effective clinical intervention that improves access to quality care in regions with limited resources or in clinical situations where in-person care is unavailable. OBJECTIVE This study aims to develop a validated survey tool to measure patient experience and satisfaction with telepsychiatry based on the quality of care domains. This study also seeks to understand which health service outcomes were most strongly correlated with overall satisfaction in the context of telepsychiatry. METHODS The survey created in this study was developed and validated with a panel of subject matter and process experts and was piloted with 274 patients who received clinical consultations through the TeleMental Health Program at the Centre for Addiction and Mental Health. Factor analysis was used to determine correlations between questions and quality of care domains and was also used to assess model fit. RESULTS The study provides a validated survey to measure patient satisfaction and experience with telepsychiatry across 4 domains: access and timeliness, appropriateness, effectiveness, and safety. Both safety and access and timeliness were found to be statistically significant predictors of satisfaction in our sample. CONCLUSIONS By situating patient satisfaction and experience within this framework, the survey facilitates patient data collection and interpretation through a clinical quality lens.

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Quality of Sleep among the Patients in High Dependency Unit (Hdu)- A Descriptive Study

Indian Journal of Forensic Medicine & Toxicology ◽

10.37506/ijfmt.v14i4.12262 ◽

2020 ◽

Keyword(s):

Descriptive Study ◽

High Dependency Unit ◽

Quality Of Sleep ◽

High Dependency

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IBD2020 global forum: results of an international patient survey on quality of care

Intestinal Research ◽

10.5217/ir.2018.00041 ◽

2018 ◽

Vol 16 (4) ◽

pp. 537-545 ◽

Cited By ~ 3

Author(s):

Peter Irving ◽

Johan Burisch ◽

Richard Driscoll ◽

Mats Olsson ◽

John R Fullarton ◽

...

Keyword(s):

Quality Of Care ◽

Patient Survey ◽

Global Forum

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Development of a Phone Survey Tool to Measure Respectful Maternity Care During Pregnancy and Childbirth in India: Study Protocol (Preprint)

10.2196/preprints.12173 ◽

2018 ◽

Author(s):

Amnesty E LeFevre ◽

Kerry Scott ◽

Diwakar Mohan ◽

Neha Shah ◽

Aarushi Bhatnagar ◽

...

Keyword(s):

Quality Of Care ◽

Maternity Care ◽

Quality Data ◽

Respectful Maternity Care ◽

Validity And Reliability ◽

Survey Tool ◽

Face To Face ◽

Pregnancy And Childbirth ◽

Phone Survey

BACKGROUND Respectful maternity care (RMC) is a key barometer of the underlying quality of care women receive during pregnancy and childbirth. Efforts to measure RMC have largely been qualitative, although validated quantitative tools are emerging. Available tools have been limited to the measurement of RMC during childbirth and confined to observational and face-to-face survey modes. Phone surveys are less invasive, low cost, and rapid alternatives to traditional face-to-face methods, yet little is known about their validity and reliability. OBJECTIVE The primary objective of this study was to develop validated face-to-face and phone survey tools for measuring RMC during pregnancy and childbirth for use in India and other low resource settings. The secondary objective was to optimize strategies for improving the delivery of phone surveys for use in measuring RMC. METHODS To develop face-to-face and phone surveys for measuring RMC, we describe procedures for assessing content, criterion, and construct validity as well as reliability analyses. To optimize the delivery of phone surveys, we outline plans for substudies, which aim to assess the effect of survey modality, and content on survey response, completion, and attrition rates. RESULTS Data collection will be carried out in 4 districts of Madhya Pradesh, India, from July 2018 to March 2019. CONCLUSIONS To our knowledge, this is the first RMC phone survey tool developed for India, which may provide an opportunity for the rapid, routine collection of data essential for improving the quality of care during pregnancy and childbirth. Elsewhere, phone survey tools are emerging; however, efforts to develop these surveys are often not inclusive of rigorous pretesting activities essential for ensuring quality data, including cognitive, reliability, and validity testing. In the absence of these activities, emerging data could overestimate or underestimate the burden of disease and health care practices under assessment. In the context of RMC, poor quality data could have adverse consequences including the naming and shaming of providers. By outlining a blueprint of the minimum activities required to generate reliable and valid survey tools, we hope to improve efforts to develop and deploy face-to-face and phone surveys in the health sector. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12173

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