scholarly journals Content comparison and person-centeredness of standards for quality improvement in cardiovascular health care

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244874
Author(s):  
Beatrix Algurén ◽  
Tomas Jernberg ◽  
Peter Vasko ◽  
Melissa Selb ◽  
Michaela Coenen
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Outcomes ◽  
Lived Experience ◽  
Quality Criteria ◽  
Quality Standards ◽  
Daily Activities ◽  
National Quality ◽  
Standard Set ◽  
Standard Sets

Background Quality standards are important for improving health care by providing compelling evidence for best practice. High quality person-centered health care requires information on patients' experience of disease and of functioning in daily life. Objective To analyze and compare the content of five Swedish National Quality Registries (NQRs) and two standard sets of the International Consortium of Health Outcomes Measurement (ICHOM) related to cardiovascular diseases. Materials and methods An analysis of 2588 variables (= data items) of five NQRs—the Swedish Registry of Congenital Heart Disease, Swedish Cardiac Arrest Registry, Swedish Catheter Ablation Registry, Swedish Heart Failure Registry, SWEDEHEART (including four sub-registries) and two ICHOM standard sets–the Heart Failure Standard Set and the Coronary Artery Disease Standard Set. According to the name and definition of each variable, the variables were mapped to Donabedian’s quality criteria, whereby identifying whether they capture health care processes or structures or patients’ health outcomes. Health outcomes were further analyzed whether they were clinician- or patient-reported and whether they capture patients’ physiological functions, anatomical structures or activities and participation. Results In total, 606 variables addressed process quality criteria (31%), 58 structure quality criteria (3%) and 760 outcome quality criteria (38%). Of the outcomes reported, 85% were reported by clinicians and 15% by patients. Outcome variables addressed mainly ‘Body functions’ (n = 392, 55%) or diseases (n = 209, 29%). Two percent of all documented data captured patients’ lived experience of disease and their daily activities and participation (n = 51, 3% of all variables). Conclusions Quality standards in the cardiovascular field focus predominately on processes (e.g. treatment) and on body functions-related outcomes. Less attention is given to patients’ lived experience of disease and their daily activities and participation. The results can serve as a starting-point for harmonizing data and developing a common person-centered quality indicator set.

scholarly journals Study of Water Quality Indicators of Mountain Rivers Used as Source of Drinking Water Supply of the Targu-Jiu Municipality

2020 ◽  
Vol 71 (1) ◽  
pp. 384-389
Author(s):  
Delia Nica-Badea ◽  
Simona Brandibur
Keyword(s):  
Water Quality ◽  
Drinking Water ◽  
Natural Waters ◽  
Ecological Status ◽  
Quality Criteria ◽  
Quality Standards ◽  
Biological Indicators ◽  
Mountainous Area ◽  
Water Quality Criteria ◽  
National Quality

Water quality criteria are all physicochemical and biological indicators that characterize a body of water. The current study aims at investigating the quality of two natural waters in the Gorj County sub-mountainous area (�u�i�a, Vaidei and Runc, capture Runc) used as drinking water sources of Targu-Jiu. Sampling and determinations use spectrophotometric, gravimetric, volumetric or electrometric techniques in accordance with standard methods (SR ISO and / or SR EN) for a series of physicochemical indicators analyzed between January - December 2017: thermal and acidification, oxygen regime, nutrients, salinity, relevant pollutants. Experimental values, annual averages related to the quality standards for potable water, ecological status and classification of water bodies, place the water of the two rivers in the drinking water category A1 and the first class of ecological quality. The Water Quality Index (WQI) for 9 selected parameters highlighted a sensitively close overall level of the water of the two rivers Susita (88) and Runc (85.2), the good quality category (7o-9o), reported to national quality standards for surface water which can be used for delivery as drinking water.The study of indicators of the two rivers in relation to national rules aligned with the European water requirements and research shows a high qualitative status corresponding to community uses.

scholarly journals Health impact, and economic value, of meeting housing quality standards: a retrospective longitudinal data linkage study

2018 ◽  
Vol 6 (8) ◽  
pp. 1-104 ◽  
Author(s):  
Sarah E Rodgers ◽  
Rowena Bailey ◽  
Rhodri Johnson ◽  
Wouter Poortinga ◽  
Robert Smith ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Outcomes ◽  
Hospital Admissions ◽  
Quality Standards ◽  
Health Impact ◽  
Health Care Utilisation ◽  
Housing Quality ◽  
Data Set ◽  
Care Utilisation

BackgroundPoor-quality housing adversely affects residents’ health but there is a paucity of high-quality evidence to support this.ObjectiveThis research investigated the health impact of bringing housing to a national quality standard.DesignA natural experiment of improvements to housing quality analysed using repeated measures of health-care utilisation and economic outcomes at an individual person level.SettingCarmarthenshire, UK.ParticipantsA total of 32,009 residents registered for a minimum of 60 days at 8558 social homes that received housing improvements between January 2005 and March 2015.InterventionsMultiple internal and external housing improvements, including wall and loft insulation, windows and doors, heating system upgrades, new kitchens and bathrooms, garden path safety improvements and electrical system upgrades (adding power sockets, and extractor fans in kitchens and bathrooms).Main outcome measuresEmergency hospital admissions for cardiorespiratory conditions and injuries. Primary health-care utilisation for respiratory and common mental health disorders, emergency department injury attendances and health-care utilisation costs.Data sourcesCarmarthenshire County Council home address and intervention records were anonymously linked within the Secure Anonymous Information Linkage databank to demographic information from the Welsh Demographic Service data set; hospital admission data from the Patient Episode Dataset for Wales; primary care contacts and prescribed medications from general practice data; emergency department attendances from the Emergency Department Data Set; and deaths from the Office for National Statistics mortality register.MethodsThe study used a longitudinal panel design to examine changes in standard of eight housing cointervention from intervention records, and linked to individuals registered at intervention homes. Health outcomes were obtained retrospectively for each individual in a dynamic cohort and were captured for up to 123 consecutive months. An additional local authority region could not be utilised as a comparator owing to different reporting pressures resulting in the recording of a different intervention. The exposure group for each cointervention was compared with an internal reference group of people living in homes that did not receive the cointervention during their tenancy. A multilevel modelling approach was used to account for repeated observations for individuals living in intervention homes. Counts of health outcomes were analysed using negative binomial regression models to determine the effect of each cointervention that reached housing quality standards during an individual’s period of tenancy, compared with those living in properties that did not. We adjusted for potential confounding factors and for background trends in the regional general population. A cost–consequences analysis was conducted as part of the health economic evaluation.ResultsResidents aged ≥ 60 years living in homes in which electrical systems were upgraded were associated with 39% fewer admissions than those living in homes in which they were not [incidence rate ratio (IRR) 0.61, 95% confidence interval (CI) 0.53 to 0.72;p < 0.01]. Reduced admissions were also associated with windows and doors (IRR 0.71, 95% CI 0.63 to 0.81;p < 0.01), wall insulation (IRR 0.75, 95% CI 0.67 to 0.84;p < 0.01) and gardens and estates (IRR 0.73, 95% CI 0.64 to 0.83;p < 0.01) for those living in homes in which these cointervention were upgraded. There were no associations of change in emergency admissions with upgrading heating (IRR 0.91, 95% CI 0.82 to 1.01;p = 0.072), loft insulation (IRR 0.98, 95% CI 0.86 to 1.11;p = 0.695), kitchens (IRR 0.98, 95% CI 0.83 to 1.17;p = 0.843) or bathrooms (IRR 0.93, 95% CI 0.81 to 1.06;p = 0.287).LimitationsThere was no randomisation, there were incomplete data on the scale of the intervention for individual households and there were no estimates for the impact of the whole programme.ConclusionsThis complex interdisciplinary study found that hospital admissions could be avoided through improving housing quality standards.Future workAt their initiation, future non-health projects should have a built-in evaluation to allow intervention exposures to be randomly allocated to residents, with the simultaneous analysis of multiple health outcomes in one statistical model.FundingThe National Institute for Health Research Public Health Research programme.

scholarly journals What matters to patients: Parental and caregiver opinions on International Consortium for Health Outcomes Measurements overall health outcomes for children in Singapore

2020 ◽  
pp. 201010582097932
Author(s):  
Moira Suyin Chia ◽  
John Yeow Yang Wong ◽  
Irene Pheck Mui Chan ◽  
Kee Chong Ng
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Outcomes ◽  
Working Group ◽  
Online Survey ◽  
Measurement Tools ◽  
Open Review ◽  
Standard Set ◽  
Paediatric Health ◽  
Parents And Caregivers

Background: Health in children is multifaceted. More than just the absence of disease, good child health also comprises psychological well-being and social functioning. In paediatrics, optimal health care is a partnership between caregivers and doctors. Value-based medicine strengthens this partnership. Monitoring and tracking these patient-reported outcomes using validated measurement tools in a life-course manner helps us to understand and ultimately improve overall child health better. Objectives: This study aimed to assess parental opinions in Singapore on recommended outcome measures and approach recommended by the International Consortium for Health Outcomes Measurements (ICHOM) Overall Pediatric Health (OPH) working group. Methods: An international working group comprising 25 experts in paediatric health was formed under the auspices of ICHOM. Through a series of literature reviews, patient focus groups and open review periods, a set of health outcomes and case-mix variables was proposed, with the aim of improving paediatric care globally. Parents and caregivers were invited to participate in this survey from around the world, including from the USA, UK, Colombia and Singapore. The survey covered domains that were included in the ICHOM OPH Standard Set. An international anonymised online patient validation survey tool online survey was initiated to evaluate caregiver opinions of these proposed ICHOM OPH outcomes, and this was conducted from November 2019 to January 2020. Singapore participated in this caregiver survey on overall paediatric health outcomes. Of the 270 respondents in this ICHOM OPH consumer international open review online survey, 160 were from Singapore. We report here a cross-sectional study with data from the Singapore group of respondents. Results: Of the 160 responses from Singapore, 73.8% had no more than two children, and 38.8% of caregivers had children between 0 and 5 years old. In general, 76.9% of caregivers were satisfied with the health care that they received, and 60% of caregivers had had between one and four health-care appointments in the last 12 months. Assessment was done on a scale of 1 to 9, with importance defined as a score of ⩾7. All outcome measures were ranked to be important, with an overall mean score of 7.9 on a scale ranging from 1 to 9. Development was assessed as being the most important ( M=8.34±0.93), and sexual health was assessed as being the least important ( M=7.09±1.71). Almost all respondents felt that the list of ICHOM-recommended outcomes proposed was complete. Parents and caregivers in Singapore placed development and mental health as the most important across all age groups surveyed. They felt that the framework provided by the ICHOM OPH working group was adequate in addressing their concerns. Most parents and caregivers were satisfied with the health care they had received. Conclusion: Child health is a continuum that requires longitudinal attention from both the family and the clinician, and should take a life-course approach, utilising validated measurement tools to monitor and track key parameters. Parents and caregivers in Singapore place high importance on their child’s development and mental functioning. While there has been much community effort on development and mental functioning in children, more can be done in these two areas and to increase the emphasis and awareness on sex education both within the home and in schools. A framework for evaluating children during follow-up clinic visits would be helpful in continuing longitudinal care of children to provide holistic care and to improve adult health in the long term, guided by the framework set down by the ICHOM OPH standard set. As we recognise and embrace the importance not just of health care but the health of the next generation, we will need to use validated measurement tools to monitor and track these importance parameters in the journey of our children, so that we can identify and improve these outcomes in a timely manner.

Health Outcomes and Health Care Utilization Among Obstetric Deliveries With Concurrent CKD in the United States

2020 ◽  
Vol 75 (1) ◽  
pp. 148-150 ◽  
Author(s):  
Andrea L. Oliverio ◽  
Lindsay K. Admon ◽  
Laura H. Mariani ◽  
Tyler N.A. Winkelman ◽  
Vanessa K. Dalton
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Utilization ◽  
Health Outcomes ◽  
The United States ◽  
Care Utilization

Importance of the universal precautions among health care personnel and its impact against Covid-19 spread - A survey

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 675-684
Author(s):  
Preethi Shankar ◽  
Abilasha R ◽  
Preetha S
Keyword(s):  
Health Care ◽  
Statistical Analysis ◽  
Health Care Workers ◽  
Medical Personnel ◽  
Health Care Personnel ◽  
Universal Precaution ◽  
Universal Precautions ◽  
Care Workers ◽  
Standard Set ◽  
Spread Of Infection

Universal precautions are a vital standard set of rules applied to be followed by patients and doctors while carrying out any clinical procedure, but especially in patients with blood-borne diseases or infections. It is carried out to prevent the spread of infection from one person to another. Universal precautions are of great significance to medical personnel, where they expose themselves to numerous infectious diseases. The research aimed to assess and improve knowledge about universal precautions among health care personnel to reduce the rate of harmful exposure and infections among them. A questionnaire comprising 20 questions was created and circulated among 100 health care workers through the online platform &quot;Google forms&quot;. The results were collected and analysed. Statistical analysis was performed using SPSS. It was evident that many people were not aware of the seriousness of universal precautions. Fortunately, many medical personals followed and were aware of universal precaution to an extent. Universal precaution should be followed religiously and judiciously to prevent the spread of deadly diseases.

Preventative health screening community events, a mechanism to target minority ethnic populations in improving primary care utilisation to improve health outcomes

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711005
Author(s):  
Raza Naqvi ◽  
Octavia Gale
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Outcomes ◽  
Ethnic Minority ◽  
Access To Health Care ◽  
Health Screening ◽  
Service Utilisation ◽  
Community Based ◽  
Access To Health ◽  
Minority Ethnic

BackgroundPreventative medicine has become a central focus in primary care provision, with greater emphasis on education and access to health care screening. The Department of Health reports existing health inequalities and inequalities in access within ethnic minority groups. Studies assessing the value of community engagement in primary care have reported variable outcomes in term of subsequent service utilisation.AimTo consider the benefit of community-based health screening checks to improve access and health outcomes in minority ethnic groups.MethodAn open community health screening event (n = 43), to allow targeted screening within an ethnic minority population. Screening included BP, BMI, BM and cholesterol. Results were interpreted by a healthcare professional and counselling was provided regarding relevant risk factors. Post-event feedback was gathered to collate participant opinion and views.ResultsSeventy-nine per cent of participants were from ethnic minority backgrounds: 64% were overweight or obese and 53% of participants were referred to primary care for urgent review following abnormal findings. All those referred would not have accessed healthcare without the event referral. All (100%) participants believed it improved health education and access to health care.ConclusionThis study clearly demonstrates the value of targeted community-led screening and education events in public health promotion. There was a significant benefit in providing community-based screening. There is a need for a longitudinal analysis to determine the impact on health outcomes and long-term access to healthcare provision.

Transforming Health Care Through the Medical Home: The Example of Heart Failure

2009 ◽  
Vol 15 (9) ◽  
pp. 736-738 ◽  
Author(s):  
Marvin A. Konstam ◽  
Barry Greenberg
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Medical Home

Living with Heart Failure during the COVID-19 Pandemic: An Interpretative Phenomenological Analysis

2021 ◽  
pp. 105477382110166
Author(s):  
Alessia Martina Trenta ◽  
Davide Ausili ◽  
Rosario Caruso ◽  
Cristina Arrigoni ◽  
Massimo Moro ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coping Strategies ◽  
Lived Experience ◽  
Interpretative Phenomenological Analysis ◽  
Phenomenological Analysis ◽  
Structured Interviews ◽  
Hospital Organization ◽  
Challenging Situation ◽  
And Coping ◽  
Negative Feelings

This study aimed to explore lived experience of patients with heart failure (HF) during the COVID-19 pandemic. A qualitative study was conducted using an interpretative phenomenological analysis (IPA). Data collection performed in March-May 2020, using in-depth, semi-structured interviews on a purposive sample. Data were analyzed according to the IPA methodology, and triangulation, bracketing, journaling, and member checking were used to assure rigor. 14 patients with HF were enrolled, and three main themes described their lived experience during the COVID-19 pandemic: Vulnerability, Hanging in the balance, and Coping strategies. These people felt particularly vulnerable to the novel virus and experienced uncertainty due to hospital organization changes. Because of this, they felt like they were hanging in the balance, experiencing various negative feelings. Nevertheless, they managed to deal with this challenging situation by implementing some peculiar coping strategies. The COVID-19 represents a significant challenge for patients with HF, impacting significantly on their lives.

Sign in / Sign up

Export Citation Format

Share Document