scholarly journals The impact of hospital accreditation on the quality of healthcare: a systematic literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammed Hussein ◽  
Milena Pavlova ◽  
Mostafa Ghalwash ◽  
Wim Groot
Keyword(s):  
Empirical Studies ◽  
Hospital Setting ◽  
Quality Of Healthcare ◽  
Hospital Accreditation ◽  
Hospital Readmission Rate ◽  
Reasonable Evidence ◽  
Registration Number ◽  
Meta Analyses ◽  
The Impact

Abstract Background Accreditation is viewed as a reputable tool to evaluate and enhance the quality of health care. However, its effect on performance and outcomes remains unclear. This review aimed to identify and analyze the evidence on the impact of hospital accreditation. Methods We systematically searched electronic databases (PubMed, CINAHL, PsycINFO, EMBASE, MEDLINE (OvidSP), CDSR, CENTRAL, ScienceDirect, SSCI, RSCI, SciELO, and KCI) and other sources using relevant subject headings. We included peer-reviewed quantitative studies published over the last two decades, irrespective of its design or language. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers independently screened initially identified articles, reviewed the full-text of potentially relevant studies, extracted necessary data, and assessed the methodological quality of the included studies using a validated tool. The accreditation effects were synthesized and categorized thematically into six impact themes. Results We screened a total of 17,830 studies, of which 76 empirical studies that examined the impact of accreditation met our inclusion criteria. These studies were methodologically heterogeneous. Apart from the effect of accreditation on healthcare workers and particularly on job stress, our results indicate a consistent positive effect of hospital accreditation on safety culture, process-related performance measures, efficiency, and the patient length of stay, whereas employee satisfaction, patient satisfaction and experience, and 30-day hospital readmission rate were found to be unrelated to accreditation. Paradoxical results regarding the impact of accreditation on mortality rate and healthcare-associated infections hampered drawing firm conclusions on these outcome measures. Conclusion There is reasonable evidence to support the notion that compliance with accreditation standards has multiple plausible benefits in improving the performance in the hospital setting. Despite inconclusive evidence on causality, introducing hospital accreditation schemes stimulates performance improvement and patient safety. Efforts to incentivize and modernize accreditation are recommended to move towards institutionalization and sustaining the performance gains. PROSPERO registration number CRD42020167863.

scholarly journals The perception of healthcare employees and the impact of healthcare accreditation on the quality of healthcare in Korea

2017 ◽  
Vol 6 (6) ◽  
pp. 20 ◽  
Author(s):  
Il-Tae Park ◽  
Yoen-Yi Jung ◽  
Seung-Han Suk
Keyword(s):  
Organizational Culture ◽  
Patient Safety ◽  
Positive Impact ◽  
Empirical Studies ◽  
Healthcare Quality ◽  
Quality Of Healthcare ◽  
Hospital Accreditation ◽  
The Impact ◽  
Healthcare Employees

Objective: In order to encourage more hospitals to participate in the accreditation, there needs to be “substantial evidence of the effectiveness of accreditation”. The aim of this study was to identify and analyze healthcare employees’ perceptions of hospital accreditation and the impact of hospital accreditation on the quality of healthcare in Korea.Methods: Eight electronic databases were searched between June and July 2016. Of the initially identified 392 abstracts, 14 empirical studies on healthcare accreditation in Korea were selected based on the inclusion criteria. These were retrieved and analyzed.Results: The 14 studies assessed healthcare employees’ perception of hospital accreditation as well as the impact of hospital accreditation on the quality of healthcare. The results were classified into four categories according to perception (Need, Purpose, Intent, and Relevance of standards), and into five categories according to the impact of accreditation (Patient safety and healthcare quality, Satisfaction with hospital employees, Leadership, Organizational culture, and Managerial performance). Findings showed that healthcare employees’ had good understanding of the purpose, need, and intention of the healthcare accreditation system, but indicated that limitations exist with the accreditation standards. Moreover, evidence showed that healthcare accreditation in Korea has made a positive impact on “patient safety and healthcare quality”, “leadership” and “organizational culture”.Conclusions: Healthcare accreditation has had a positive overall impact on hospitals and has improved the quality of healthcare as well as patient safety. However, more rigorous research and more diverse research methods are required to determine its long-term effect.

scholarly journals Efficacy and safety of aliskiren combination therapy: a protocol for an umbrella review

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043807
Author(s):  
Jiantong Shen ◽  
Wenming Feng ◽  
Yike Wang ◽  
Qiyuan Zhao ◽  
Billong Laura Flavorta ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Systematic Reviews ◽  
Cochrane Library ◽  
Umbrella Review ◽  
Quality Of Reporting ◽  
Ethical Approval ◽  
Registration Number ◽  
Third Person ◽  
Meta Analyses ◽  
The Impact

IntroductionEfficacy of aliskiren combination therapy with other antihypertensive has been evaluated in the treatment of patients with hypertension in recent systematic reviews. However, most previous reviews only focused on one single health outcome or one setting, none of them made a full summary that assessed the impact of aliskiren combination treatment comprehensively. As such, this umbrella review based on systematic reviews and meta-analyses is aimed to synthesise the evidences on efficacy, safety and tolerability of aliskiren-based therapy for hypertension and related comorbid patients.Methods and analysisA comprehensive search of PubMed, EMBASE, Cochrane Library, CNKI published from inception to August 2020 will be conducted. The selected articles are systematic reviews which evaluated efficacy, safety and tolerability of aliskiren combination therapy. Two reviewers will screen eligible articles, extract data and evaluate quality independently. Any disputes will be resolved by discussion or the arbitration of a third person. The quality of reporting evidence will be assessed using the Assessment of Multiple Systematic Reviews V.2 tool tool. We will take a mixed-methods approach to synthesising the review literatures, reporting summary of findings tables and iteratively mapping the results.Ethics and disseminationEthical approval is not required for the study, as we would only collect data from available published materials. This umbrella review will be also submitted to a peer-reviewed journal for publication after completion.PROSPERO registration numberCRD42020192131.

scholarly journals The Optimal Time of Applying Enteral Immunonutrition in Esophageal Cancer Patients Receiving Esophagectomy: A Network Meta-Analysis of Randomized Clinical Trials

2021 ◽  
Author(s):  
Xu Tian ◽  
Yan-Fei Jin ◽  
Zhao-Li Zhang ◽  
Hui Chen ◽  
Wei-Qing Chen ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Infectious Complications ◽  
Cochrane Library ◽  
Optimal Time ◽  
Registration Number ◽  
Meta Analyses ◽  
The Impact

Abstract Background: Enteral immunonutrition (EIN) has been extensively applied in cancer patients, however its role in esophageal cancer (EC) patients receiving esophagectomy remains unclear. We performed this network meta-analysis to investigate the impact of EIN on patients undergoing surgery for EC and further determine the optimal time of applying EIN.Methods: We searched PubMed, EMBASE, Cochrane library, and China National Knowledgement Infrastructure (CNKI) to identify eligible studies. Categorical data was expressed as the odds ratio with 95% confidence interval (CI), and continuous data was expressed as mean difference (MD) with 95% CI. Pair-wise and network meta-analysis was performed to evaluate the impact of EIN on clinical outcomes using RevMan 5.3 and ADDIS V.1.16.8 softwares. The surface under the cumulative ranking curve (SUCRA) was calculated to rank all nutritional regimes.Results: Total 14 studies involving 1071 patients were included. Pair-wise meta-analysis indicated no difference between EIN regardless of the application time and standard EN (SEN), however subgroup analyses found that postoperative EIN was associated with decreased incidence of total infectious complications (OR=0.47; 95%CI=0.26 to 0.84; p=0.01) and pneumonia (OR=0.47; 95%CI=0.25 to 0.90; p=0.02) and shortened LOH (MD=-1.01; 95%CI=-1.44 to -0.57; p<0.001) compared to SEN, which were all supported by network meta-analyses. Ranking probability analysis further indicated that postoperative EIN has the highest probability of being the optimal option in terms of these three outcomes.Conclusions: Postoperative EIN should be preferentially utilized in EC patients undergoing esophagectomy because it has optimal potential of decreasing the risk of total infectious complications and pneumonia and shortening LOH.OSF registration number: 10.17605/OSF.IO/KJ9UY.

scholarly journals A Systematic Review on Psychological and Biological Mediators Between Adversity and Psychosis: Potential Targets for Treatment

2019 ◽  
Author(s):  
Luis Alameda ◽  
Victoria Rodriguez ◽  
Ewan Carr ◽  
Monica Aas ◽  
Giulia Trotta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Samples ◽  
Traditional Treatment ◽  
Affective Dysregulation ◽  
Cognitive Behavioural ◽  
Study Results ◽  
Registration Number ◽  
Meta Analyses ◽  
Competing Pathways

AbstractVarious psychological and biological pathways have been proposed as mediators between childhood adverse events (CA) and psychosis. A systematic review of the evidence in this domain is needed. The aim of this work is to systematically review the evidence on psychological and biological mediators between CA and psychosis across the psychosis spectrum. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (registration number: CRD42018100846). Articles published between 1979 and July 2019 were identified through a literature search in OVID (PsychINFO; Medline and Embase). The evidence by each analysis and each study results are presented by group of mediator categories found in the review. The percentage of total effect mediated was calculated. 47 studies were included, with a total of 79,668 from general population (GP) and 3,189 from clinical samples. The quality of studies was judged as “fair”. Our results showed (i) solid evidence of mediation between CA and psychosis by negative cognitive schemas about the self, the world, and others (NS); by dissociation and other PTSD symptoms; (ii) evidence of al mediation through an affective pathway (affective dysregulation, anxiety, and depression) in GP; (iii) lack of studies exploring biological mediators. To conclude, we found evidence suggesting that various overlapping and not competing pathways contribute partially to the link between adversity and psychosis. Experiences of adversity, along with relevant mediators such as PTSD and mood related symptoms and NS, should be routinely assessed in patients with psychosis. Targeting such mediators through cognitive behavioural aproaches using trauma-focused therapy and/or pharmacological means could be a useful addition to the traditional treatment of positive symptoms.

scholarly journals Effects of five types of selenium supplementation for treatment of Kashin-Beck disease in children: a systematic review and network meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e017883 ◽  
Author(s):  
Dongmei Xie ◽  
Yulin Liao ◽  
Jirong Yue ◽  
Chao Zhang ◽  
Yanyan Wang ◽  
...  
Keyword(s):  
Sodium Selenite ◽  
Meta Analysis ◽  
Selenium Supplementation ◽  
Assessment Development ◽  
Registration Number ◽  
Selenium Supplements ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
Beck Disease

ObjectiveTo compare the effectiveness of five kinds of selenium supplementation for the treatment of patients with Kashin-Beck disease, and rank these selenium supplementations based on their performance.DesignWe searched for all publications between 1 January 1966 and 31 March 2017 using seven electronic databases. GRADE system to network meta-analyses (NMAs) was applied to rate the quality of the evidence. We conducted a random effects model NMA in STATA 12.1 to determine comparative effectiveness of each intervention. Rankings were obtained by using the surface under the cumulative ranking curve (SUCRA) values and mean ranks.ResultsA total of 15 randomised controlled trials involving 2931 patients were included. After assessment of the overall quality of the evidence, we downgraded our primary outcomes from high to low or very low quality. NMAs showed that all five kinds of selenium supplementation had higher metaphysis X-ray improvement which were superior to placebo. Ranking on efficacy indicated that selenium salt was ranked the highest, followed by sodium selenite + vitamin E, selenium enriched yeast, sodium selenite and then sodium selenite + vitamin C.ConclusionsBased on the results of NMA, all five types of selenium supplements are more effective than placebo and so that selenium supplementation is of help in repairing metaphyseal lesions. Since the overall quality of the evidence was low or very low, the SUCRA values may be misleading and should be considered jointly with the The Grading of Recommendations Assessment, Development and Evaluation (GRADE) confidence in the estimates for each comparison. The quality of the evidence is insufficient to draw a conclusion about what method of selenium supplementation is most effective.PROSPERO registration numberCRD42016051874.

Music therapy effectiveness by duration in patients with cancer: a meta-regression

2021 ◽  
pp. bmjspcare-2021-003163
Author(s):  
Ronald Chow ◽  
Robert Bergner ◽  
Elizabeth Prsic
Keyword(s):  
Quality Of Life ◽  
Music Therapy ◽  
Positive Association ◽  
Well Being ◽  
Patients With Cancer ◽  
Therapy Effectiveness ◽  
Meta Regression ◽  
Meta Analyses ◽  
The Impact

ObjectivesSeveral reviews and meta-analyses have reported on music therapy for physical and emotional well-being among patients with cancer. However, the duration of music therapy offered may range from less than 1 hour to several hours. The aim of this study is to assess whether longer duration of music therapy is associated with different levels of improvement in physical and mental well-being.MethodsTen studies were included in this paper, reporting on the endpoints of quality of life and pain. A meta-regression, using an inverse-variance model, was performed to assess the impact of total music therapy time. A sensitivity analysis was conducted for the outcome of pain, among low risk of bias trials.ResultsOur meta-regression found a trend for positive association between greater total music therapy time and improved better pain control, but it was not statistically significant.ConclusionThere is a need for more high-quality studies examining music therapy for patients with cancer, with a focus on total music therapy time and patient-related outcomes including quality of life and pain.

Impact of Health Information Technologies on the Quality of Healthcare Deliveries

2021 ◽  
Vol 6 (1) ◽  
pp. 30-44
Author(s):  
Patricia Whitley ◽  
Hossain Shahriar ◽  
Sweta Sneha
Keyword(s):  
Patient Care ◽  
Health Information ◽  
Medical Errors ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Well Being ◽  
Quality Of Healthcare ◽  
Quality Healthcare ◽  
The Impact

Through a literary review of recent research, this paper examines the mixed impact of health information technology (HIT) on patient care, medical errors, and the quality of healthcare delivery in selected hospital settings such as emergency departments. Specific technologies examined include the electronic health record (EHR), medical devices, artificial intelligence, and robotics. The paper identifies that some healthcare technologies are increasingly valuable in reducing medical errors, improving healthcare quality, and in producing better patient-centered outcomes. It also determines that technologies have complicated the delivery of quality patient care, increased the incidences of clinician burnout, and made receiving quality healthcare in America's hospital systems possibly less sure. The paper concludes with some suggestions for improving HIT's implementations and confirms the need for further evaluation of the impact of HIT in increasing patient safety and clinician well-being.

Early palliative care in haematological patients: a systematic literature review

2020 ◽  
Vol 10 (4) ◽  
pp. 395-403
Author(s):  
Silvia Tanzi ◽  
Francesco Venturelli ◽  
Stefano Luminari ◽  
Franco Domenico Merlo ◽  
Luca Braglia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Comparative Studies ◽  
English Language ◽  
Meta Analysis ◽  
Early Palliative Care ◽  
Study Results ◽  
Registration Number ◽  
Integrated Or ◽  
The Impact

BackgroundEarly palliative care together with standard haematological care for advanced patients is needed worldwide. Little is known about its effect. The aim of the review is to synthesise the evidence on the impact of early palliative care on haematologic cancer patients’ quality of life and resource use.Patients and methodsA systematic review was conducted. The search terms were early palliative care or simultaneous or integrated or concurrent care and haematological or oncohaematological patients. The following databases were searched: PubMed, Embase, Cochrane, CINHAL and Scopus. Additional studies were identified through cross-checking the reference articles. Studies were in the English language, with no restriction for years. Two researchers independently reviewed the titles and abstracts, and one author assessed full articles for eligibility.ResultsA total of 296 studies titles were reviewed. Eight articles were included in the synthesis of the results, two controlled studies provided data on the comparative efficacy of PC interventions, and six one-arm studies were included. Since data pooling and meta-analysis were not possible, only a narrative synthesis of the study results was performed. The quality of the two included comparative studies was low overall. The quality of the six non-comparative studies was high overall, without the possibility of linking the observed results to the implemented interventions.ConclusionsStudies on early palliative care and patients with haematological cancer are scarce and have not been prospectively designed. More research on the specific population target, type and timing of palliative care intervention and standardisation of collected outcomes is required.PROSPERO registration numberCRD42020141322.

scholarly journals Assessing women's satisfaction with family planning services in Mozambique

2016 ◽  
Vol 43 (3) ◽  
pp. 222-228 ◽  
Author(s):  
Leonardo Chavane ◽  
Martinho Dgedge ◽  
Patricia Bailey ◽  
Osvaldo Loquiha ◽  
Marc Aerts ◽  
...  
Keyword(s):  
Family Planning ◽  
Rural Areas ◽  
User Satisfaction ◽  
National Level ◽  
Quality Of Healthcare ◽  
Family Planning Services ◽  
Health Service Provision ◽  
Urban And Rural Areas ◽  
The Impact

BackgroundThe contraceptive prevalence rate in Mozambique was estimated as 11.3% in the last Demographic and Health Survey. The impact of family planning (FP) on women's health and on the reduction of maternal mortality is well known.MethodsAcknowledging the importance of user satisfaction in the utilisation of health services, exit interviews were used to assess women's satisfaction with FP services in Mozambique. The survey, conducted in 174 health facilities, was representative at the national level, covered all provinces, and both urban and rural areas.ResultsOverall, 86% of respondents were satisfied with FP services, but issues such as insufficient supplies of oral contraceptives and the low quality of healthcare provider/client interactions were given as reasons for women's dissatisfaction.ConclusionDefined actions at the level of health service provision are needed to tackle the identified issues and ensure improved satisfaction with, and better utilisation of, FP services in Mozambique.

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