scholarly journals Exploring variation in the use of feedback from national clinical audits: a realist investigation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Natasha Alvarado ◽  
Lynn McVey ◽  
Joanne Greenhalgh ◽  
Dawn Dowding ◽  
Mamas Mamas ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Healthcare Providers ◽  
Realist Evaluation ◽  
Quality Of Data ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
Healthcare Settings ◽  
Context Shapes ◽  
Clinical Audits

Abstract Background National Clinical Audits (NCAs) are a well-established quality improvement strategy used in healthcare settings. Significant resources, including clinicians’ time, are invested in participating in NCAs, yet there is variation in the extent to which the resulting feedback stimulates quality improvement. The aim of this study was to explore the reasons behind this variation. Methods We used realist evaluation to interrogate how context shapes the mechanisms through which NCAs work (or not) to stimulate quality improvement. Fifty-four interviews were conducted with doctors, nurses, audit clerks and other staff working with NCAs across five healthcare providers in England. In line with realist principles we scrutinised the data to identify how and why providers responded to NCA feedback (mechanisms), the circumstances that supported or constrained provider responses (context), and what happened as a result of the interactions between mechanisms and context (outcomes). We summarised our findings as Context+Mechanism = Outcome configurations. Results We identified five mechanisms that explained provider interactions with NCA feedback: reputation, professionalism, competition, incentives, and professional development. Professionalism and incentives underpinned most frequent interaction with feedback, providing opportunities to stimulate quality improvement. Feedback was used routinely in these ways where it was generated from data stored in local databases before upload to NCA suppliers. Local databases enabled staff to access data easily, customise feedback and, importantly, the data were trusted as accurate, due to the skills and experience of staff supporting audit participation. Feedback produced by NCA suppliers, which included national comparator data, was used in a more limited capacity across providers. Challenges accessing supplier data in a timely way and concerns about the quality of data submitted across providers were reported to constrain use of this mode of feedback. Conclusion The findings suggest that there are a number of mechanisms that underpin healthcare providers’ interactions with NCA feedback. However, there is variation in the mode, frequency and impact of these interactions. Feedback was used most routinely, providing opportunities to stimulate quality improvement, within clinical services resourced to collect accurate data and to maintain local databases from which feedback could be customised for the needs of the service.

scholarly journals Effectiveness of a Psychosocial Care Quality Improvement Strategy to Address Quality of Life in Patients With Cancer

2021 ◽  
Vol 4 (10) ◽  
pp. e2128667
Author(s):  
Caterina Caminiti ◽  
Maria Antonietta Annunziata ◽  
Claudio Verusio ◽  
Carmine Pinto ◽  
Mario Airoldi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Quality Improvement ◽  
Psychosocial Care ◽  
Care Quality ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
Patients With Cancer

scholarly journals QUALITY IMPROVEMENT OF MIN 1 YOGYAKARTA

2020 ◽  
Vol 4 (1) ◽  
pp. 109-120
Author(s):  
Nasrin Nabila
Keyword(s):  
Quality Improvement ◽  
Quality Standards ◽  
Quality Standard ◽  
Quality Of Education ◽  
Research Approach ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
National Education ◽  
National Education System

This study examines strategies for improving the quality of schools in MIN 1 Jogja. The focus of discussion in this research is what is meant by the quality of education, what is the quality standard of education in Indonesia, and how is the quality improvement strategy in MIN 1 Yogyakarta. This research uses a qualitative research approach, with research methods in the field study. The results of this study indicate that the strategy of improving quality in MIN 1 Yogyakarta as a whole is trying as much as possible to carry out all the process activities in MIN 1 Yogyakarta in accordance with UU No. 20 of 2003 concerning the National Education System in Chapter IX, namely 8 quality standards of education and additional programs in the form of five achievements, wherein the quality improvement will be carried out gradually but continuously

scholarly journals Strategy for Prevention and Quality Improvement of Urban Slumps Based on Community Empowerment

2021 ◽  
Vol 2 (2) ◽  
pp. 98-109
Author(s):  
Sulsalman Moita ◽  
Darmin Tuwu ◽  
Allan Darmawan
Keyword(s):  
Quality Improvement ◽  
Community Involvement ◽  
Public Awareness ◽  
High Capacity ◽  
Community Empowerment ◽  
High Rate ◽  
Improvement Strategy ◽  
Improvement Program ◽  
Quality Improvement Strategy

The purpose of this study was to examine the characteristics of slum areas and to analyze strategies for preventing and improving the quality of community empowerment-based slum settlements in Langara City, Konawe Islands Regency. This research method is descriptive qualitative with a case study approach, while the research informants are individuals and groups who are involved in the slum prevention and quality improvement program. The data were collected using in-depth interviews, observation, and document studies, while the data analysis techniques were carried out qualitatively. The results show that the indicators of a slum in Langara City are: the condition and quality of houses are generally less regular, dense, with minimal air and light circulation, environmental sanitation is not supported by wastewater disposal, access to settlements is relatively good, the garbage disposal system is not supported by landfills. Finally, limited distribution of net water, and the unavailability of fire protection. Furthermore, the strategy for preventing and improving the quality of slum based on community empowerment shows 1) slum prevention strategies with indicators: the high rate of community participation in attending counseling on the importance of maintaining environmental health and the high involvement of residents in preventing slums through cooperation, community service, and helping out; 2) slum quality improvement strategy with indicators: high capacity and community involvement in the renovation and restoration of slum shelters; and the low level of public awareness of joining the relocation program in slum pockets.

scholarly journals Improving Quality Management - the Way Toward Economic Prosperity and Quality of Life

2019 ◽  
Vol 24 (24) ◽  
pp. 10-13
Author(s):  
Renata Nováková ◽  
Jana Šujanová ◽  
Natália Nováková
Keyword(s):  
Quality Of Life ◽  
Quality Improvement ◽  
Quality Management ◽  
National Economy ◽  
Slovak Republic ◽  
Economic Prosperity ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
National Quality

Abstract The National Quality Programme of the Slovak Republic for 2017-2021 strongly emphasises the primary objectives and priorities of the Quality Improvement Strategy. This should be one of the main priorities of the Slovak Government in the upcoming period. The Quality Improvement Strategy should, in general, lead to an improvement in the quality of life. The aim of the paper is to point out the opportunities for improvement by applying indicators aimed at defining the excellence of organisations within the national economy of the Slovak Republic.

scholarly journals Implementation of a Quality Improvement Strategy to Increase Outpatient Kidney Transplant Referrals

2020 ◽  
Author(s):  
Samira Farouk ◽  
Sarah Atallah ◽  
Kirk N Campbell ◽  
Joseph A Vassalotti ◽  
Jaime Uribarri
Keyword(s):  
Quality Improvement ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Outpatient Setting ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
Important Barrier ◽  
Transplant Evaluation ◽  
End Stage ◽  
The Impact

Abstract Background: Kidney transplantation remains the optimal therapy for patients with end stage kidney disease (ESKD), though a small fraction of patients on dialysis are on organ waitlists. An important barrier to preemptive kidney transplantation and successful waitlisting is timely referral to a kidney transplant center. We implemented a quality improvement strategy to improve outpatient kidney transplant referrals in a single center academic outpatient nephrology clinic. Methods: Over a 3 month period (July 1 - September 30, 2016), we assessed the baseline kidney transplantation referral rate at our outpatient nephrology clinic for patients 18 - 75 years old with an estimated glomerular filtration rate (eGFR) of less than 20 mL/min/1.73m 2 (2 values over 90 days apart). Charts were manually reviewed by two reviewers to look for kidney transplant referrals and documentation of discussions about kidney transplantation. We then performed a root cause analysis to explore potential barriers to kidney transplantation. Our intervention began on July 1, 2017 and included the implementation of a column in the electronic medical record (EMR) which displayed the patient's last eGFR as part of the clinic schedule. Physicians were given a document listing their patients to be seen that day with an eGFR of < 20 mL/min/1.73m 2 . Results: 54 unique patients with eGFR ≤ 20 ml/min/1.73 m 2 were identified who were seen in the Clinic between July 1, 2016 and September 30, 2016. 29.6% (16) eligible patients were referred for kidney transplantation evaluation. 69.5% (37) of these patients were not referred for kidney transplant evaluation. 46.3% (25) did not have documentation regarding kidney transplant in the EMR. Following the intervention, 66 unique patients met criteria for eligibility for kidney transplant evaluation. Kidney transplant referrals increased to 60.6% (p < 0.001). Conclusions: Our pilot implementation study of a strategy to improve outpatient kidney transplant referrals showed that a free, simple, scalable intervention can significantly improve kidney transplant referrals in the outpatient setting Next steps include further study of the impact of early referral to kidney transplant centers on preemptive and living donor kidney transplantation as well as successful waitlisting.

Peningkatan Kualitas Data Bidang Tanah di Kantor Pertanahan Kota Administrasi Jakarta Selatan

Tunas Agraria ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. 168-174
Author(s):  
Maslusatun Mawadah
Keyword(s):  
Quality Improvement ◽  
Data Quality ◽  
Research Method ◽  
The South ◽  
Quality Of Data ◽  
Regional Division ◽  
Land Administration ◽  
Problems And Solutions ◽  
Descriptive Approach

The South Jakarta Administrative City Land Office is one of the cities targeted to be a city with complete land administration in 2020. The current condition of land parcel data demands an update, namely improving the quality of data from KW1 to KW6 towards KW1 valid. The purpose of this study is to determine the condition of land data quality in South Jakarta, the implementation of data quality improvement, as well as problems and solutions in implementing data quality improvement. The research method used is qualitative with a descriptive approach. The results showed that the condition of the data quality after the implementation of the improvement, namely KW1 increased from 86.45% to 87.01%. The roles of man, material, machine, and method have been fulfilled and the implementation of data quality improvement is not in accordance with the 2019 Complete City Guidelines in terms of territorial boundary inventory, and there are still obstacles in the implementation of improving the quality of land parcel data, namely the absence of buku tanah, surat ukur, and gambar ukur at the land office, the existence of regional division, the boundaries of the sub district are not yet certain, and the existence of land parcels that have been separated from mapping without being noticed by the office administrator.

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