scholarly journals Quality of care associated with number of cases seen and self-reports of clinical competence for Japanese physicians-in-training in internal medicine

2006 ◽  
Vol 6 (1) ◽  
Author(s):  
Yasuaki Hayashino ◽  
Shunich Fukuhara ◽  
Kunihiko Matsui ◽  
Yoshinori Noguchi ◽  
Taro Minami ◽  
...  
Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2543-2555
Author(s):  
Anja Kahanpää ◽  
Anja Noro ◽  
Marja-Leena Perälä

Resident self-reports are considered the primary source of quality of care information, but proxy reports by family or staff can also be used to supplement or substitute resident reports. This study analyses how the results of proxy reports vary according to residents’ cognition level. The data set used covers proxy reports of family ( n = 558) and staff ( n = 801), divided by the availability of resident self-reports (family yes n = 289, no n = 269; staff yes 393, no = 408). Family and staff proxies assessed residents’ quality of care as better when resident self-reports were also available, and quality of care tended to be assessed as poorer among those with higher cognitive decline. The results of this methodological study indicate the importance of using several proxy evaluations; however, these can only supplement resident self-reports, not replace them. The interpretation rules acknowledging dependency between residents’ cognition and proxy assessments could be used as a basis for future comparisons of quality improvement in long-term care and for painting a more comprehensive picture of service quality.


2008 ◽  
Vol 23 (7) ◽  
pp. 914-920 ◽  
Author(s):  
Jeanette Mladenovic ◽  
Judy A. Shea ◽  
F. Daniel Duffy ◽  
Lorna A. Lynn ◽  
Eric S. Holmboe ◽  
...  

2019 ◽  
Vol 95 (1119) ◽  
pp. 1-5 ◽  
Author(s):  
Arifeen Sylvanna Rahman ◽  
Siyu Shi ◽  
Pamela Katherine Meza ◽  
Justin Lee Jia ◽  
David Svec ◽  
...  

BackgroundDecreasing delays for hospitalised patients results in improved hospital efficiency, increased quality of care and decreased healthcare expenditures. Delays in subspecialty consultations and procedures can cause increased length of stay due to reasons outside of necessary medical care.ObjectiveTo quantify, describe and record reasons for delays in consultations and procedures for patients on the general medicine wards.MethodologyWe conducted weekly audits of all admitted patients on five Internal Medicine teams over 8 weeks. A survey was reviewed with attending physicians and residents on five internal medicine teams to identify patients with a delay due to consultation or procedure, quantify length of delay and record reason for delay.ResultsDuring the study period, 316 patients were reviewed and 48 were identified as experiencing a total of 53 delays due to consultations or procedures. The average delay was 1.8 days for a combined total of 83 days. Top reasons for delays included scheduling, late response to page and a busy service. The frequency in length of consult delays vary among different specialties. The highest frequency of delays was clustered in procedure-heavy specialties.ConclusionThis report highlights the importance of reviewing system barriers that lead to delayed service in hospitals. Addressing these delays could lead to reductions in length of stay for inpatients.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Christian Scheffer ◽  
Diethard Tauschel ◽  
Melanie Neumann ◽  
Gabriele Lutz ◽  
Maria Valk-Draad ◽  
...  

Objectives. To examine the impact of active student participation on quality of care in an integrative inpatient setting.Methods. Over a two-year period, we surveyed all patients treated on the Clinical Education Ward for Integrative Medicine (CEWIM), where final-year medical students are integrated into an internal medicine ward complementing conventional medicine with anthroposophic medicine. Patients treated on the regular wards of the same internal medicine department served as the control group (CG). General quality of care was studied with the Picker Inpatient Questionnaire, physician empathy with the Consultation and Relational Empathy measure, and patient enablement with the Patient Enablement Index. ANCOVA was used to control for covariates while examining significant differences between both patient groups.Results. Comparison of the CG wards and the CEWIM revealed no significant differences in medical treatment success. The CEWIM, however, achieved better results for physician-patient interaction, physician empathy, and patient enablement. Eighty Percent of the CEWIM patients rated student participation as positively impacting quality of care.Conclusion. Our results indicate that incorporating students in an integrative healthcare setting may result in greater patient centeredness. Further studies are needed to determine whether this is due to organizational advantages, students' empathic activity, the impact of teaching, or learner-teacher interaction.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242603
Author(s):  
Marjolein N. T. Kremers ◽  
Elsemieke E. M. Mols ◽  
Yvonne A. E. Simons ◽  
Sander M. J. van Kuijk ◽  
Frits Holleman ◽  
...  

Background Providing high quality care is important and has gained more attention since the introduction of value-based healthcare. Value should be measured by outcomes achieved, relevant for patients. Patient-centeredness is one domain for quality improvement determined by the Institute of Medicine, aiming to deliver care responsive to the patient. The development and implementation of patient reported outcome- and experience measures can be used for this goal. Recently, we developed the Patient Reported Measure (PRM)-acute care, based on five relevant domains to evaluate and improve the quality of care in the Emergency Department (ED). Objective To validate the PRM-acute care, in order to evaluate and improve patient-centered care in the ED. Methods We performed a prospective questionnaire-based study. Patients ≥18 years presenting for internal medicine in the ED were eligible. The validity of the PRM-acute care was evaluated according to the COSMIN-criteria. We performed hypotheses testing to evaluate construct validity. The perceived quality of care was evaluated by statistical analysis. Results Face- and content validity was evaluated based on previously performed research and deemed good. Construct validity was supported by demonstrated differences between subgroups; patients with severe symptoms had a higher perceived quality of care. The correlation between overall satisfaction and the total mean score of the PRM-acute care (r = 0,447, p = 0.01) was significant. Overall, patients reported a mean perceived quality of care of 4.67/6.0. Conclusion The PRM-acute care is a valid instrument to measure the perceived quality of care in an acute setting for internal medicine patients. Additionally, patients reported a good perceived quality of care in the ED with scores ranging from moderate to well for each of the relevant domains. Therefore, we believe that the PRM-acute care can be implemented in daily practice to evaluate the perceived quality of care and to improve the quality of acute care.


PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e106763 ◽  
Author(s):  
Jessica Liu ◽  
Joshua Griesman ◽  
Rosane Nisenbaum ◽  
Chaim M. Bell

1999 ◽  
Vol 38 (02) ◽  
pp. 140-143 ◽  
Author(s):  
F. P. Sarasin ◽  
F. Bolla ◽  
J.-M. Gaspoz ◽  
F. Borst ◽  
M. P. Kossovsky

AbstractReadmission rate is often used as an indicator for the quality of care. However, only unplanned readmissions may have a link with substandard quality of care. We compared two databases of the Geneva University Hospitals to determine which information is needed to distinguish planned from unplanned readmissions. All patients readmitted within 42 days after a first stay in the wards of the Department of Internal Medicine were identified. One of the databases contained encoded information needed to compute DRGs. The other database consisted of full-text discharge reports, addressed to the referring physician. Encoded reports allowed the classification of 64% of the readmissions, whereas full-text reports could classify 97% of the readmissions (p <0.001). The concordance between encoded reports and full-text reports was fair (kappa = 0.40). We conclude that encoded reports alone are not sufficient to distinguish planned from unplanned readmissions and that the automation of detailed clinical databases seems promising.


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