The mediating role of residents’ wellbeing between program leadership and quality of care: A cross-sectional study

Background Research has shown that organizational leadership and support affect organizational outcomes in several sectors, including healthcare. However, less is known about how organizational leadership might influence the wellbeing of clinical trainees as well as the quality of their patient care practices. Objectives This study examined the mediating effects of burnout and engagement between program director-resident relationship quality and residents’ reported quality of care, and the moderating effect of perceived departmental support. Methods The authors conducted a cross-sectional study in September 2020, using a 41-item questionnaire, among 20 residency programs in an academic medical center in Lebanon. Measures included program director-resident relationship quality, perceived departmental support, burnout subcomponents, engagement, and self-reported quality of care. Ordinary least squares regression was used to conduct parallel mediation and moderated mediation analyses using SPSS macro-PROCESS, to assess the strength and direction of each of the proposed associations. Results A total of 95/332 (28.6%) residents responded. Results revealed that program director-resident relationship quality had a significant indirect effect on residents’ suboptimal patient care practices and attitudes towards patients, through at least one of the wellbeing dimensions (p < .05). Perceived departmental support did not play a dominant role over program director-resident relationship quality, and thus did not influence any of the mediated relationships. Conclusion Our study adds a new dimension to the body of literature suggesting that program director-resident relationship quality plays an important role in promoting residents’ wellbeing and achieving important clinical health outcomes. Such findings imply that the quality of program director-resident relationship could be an important component of residents’ wellbeing and patient safety. If further research confirms these associations, it will become imperative to determine what interventions might improve the quality of relationships between program directors and residents.

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Perceived quality of surgical care in association with patient-related factors and correlation to reported postoperative complications in Finland: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-037708 ◽

2020 ◽

Vol 10 (11) ◽

pp. e037708

Author(s):

Ira Helena Saarinen ◽

Jaana-Maija Koivisto ◽

Antti Kaipia ◽

Elina Haavisto

Keyword(s):

Quality Of Care ◽

Postoperative Complications ◽

Cross Sectional Study ◽

Perceived Quality ◽

Living Alone ◽

Sectional Study ◽

Related Factors ◽

Cross Sectional ◽

Perceived Quality Of Care

ObjectiveTo study if patient-related factors are associated with patient-evaluated quality of care in surgery. To examine if there is an association with postoperative complications and patient-evaluated low quality of care.DesignA correlation cross-sectional study, in addition, a phone call interview at 30 days postoperatively to examine complications.SettingThe data on patients admitted for non-cardiac general and orthopaedic surgery at a central hospital in Southwestern Finland were collected in two phases during an 8-month period.Participants436 consecutive consenting and eligible in-ward non-cardiac general surgery and orthopaedic surgery adult patients. Ambulatory, paediatric and memory disorder patients were excluded. 378 patients completed the questionnaire (Good Nursing Care Scale for Patients (GNCS-P)).MethodsPerceived quality of care was examined by the GNCS-P questionnaire. Patient-related factors were obtained from electronic patient records and questionnaire. A telephone interview related to postdischarge complications was conducted 30 days after discharge.Main outcome measuresPatient evaluation of quality of care at discharge, its association with patient-related factors and patient-reported postdischarge complications.ResultsThe overall quality was evaluated high or very high by the patients. The lowest overall quality of care rate was assessed by surgical patients living alone (p=0.0088) and patients who evaluated their state of health moderate or poor (p=0.0047). Surgical patients reporting postoperative complications after discharge evaluated lower overall quality of care (p=0.0105) than patients with no complications.ConclusionPatient demographic factors do not seem to influence the perceptions of the quality of care. Instead, subjective state of health and living conditions (living alone) may have an influence on the patient experience of quality of care. The perceived quality of care in healthcare staff technical and communication skills may have an association with reported postoperative complications.

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Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care

BMJ Quality & Safety ◽

10.1136/bmjqs-2016-005567 ◽

2016 ◽

Vol 26 (7) ◽

pp. 559-568 ◽

Cited By ~ 203

Author(s):

Linda H Aiken ◽

Douglas Sloane ◽

Peter Griffiths ◽

Anne Marie Rafferty ◽

Luk Bruyneel ◽

...

Keyword(s):

Quality Of Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Skill Mix

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Analysis of adherence to HIV-positive quality of care indicators and their impact on service quality perceptions in patients: a Spanish cross-sectional study

Health and Quality of Life Outcomes ◽

10.1186/s12955-020-01441-w ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

A. Gimeno-García ◽

A. Franco-Moreno ◽

C. Montero-Hernández ◽

S. Arponen ◽

E. García-Carrasco ◽

...

Keyword(s):

Quality Of Care ◽

Service Quality ◽

Cross Sectional Study ◽

Hiv Positive ◽

Sectional Study ◽

Cross Sectional ◽

Quality Perceptions ◽

Positive Quality

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Association between maternal satisfaction and other indicators of quality of care at childbirth: a cross-sectional study based on the WHO standards

BMJ Open ◽

10.1136/bmjopen-2020-037063 ◽

2020 ◽

Vol 10 (9) ◽

pp. e037063

Author(s):

Marzia Lazzerini ◽

Ilaria Mariani ◽

Chiara Semenzato ◽

Emanuelle Pessa Valente

Keyword(s):

Multivariate Analysis ◽

Quality Of Care ◽

Cross Sectional Study ◽

Maternal Satisfaction ◽

Sectional Study ◽

Cross Sectional ◽

Correlated Variables ◽

Care Experience ◽

Who Standards

ObjectivesThis study aimed to explore the association between maternal satisfaction and other indicators of quality of care (QoC) at childbirth, as defined by WHO standards.DesignCross-sectional study.SettingReferral hospital in Northeast Italy.Participants1244 consecutive mothers giving birth in the hospital participated in a survey.Data collection and analysisUnivariate analyses were performed to evaluate the association between maternal satisfaction and 61 variables, including measures of ‘provision of care’, ‘experience of care’, ‘availability of resources’ and other maternal characteristics. Exploratory factor analysis was performed to create groups of correlated variables, which were used in multivariate analysis.ResultsOverall, 509 (40.9%) of women were >35 years of age, about half (52.7%) were highly educated, most (95.2%) were married/living with partner and employed (79.3%) and about half (52.9%) were primiparous. Overall, 189 (15.2%) were not born in Italy and 111 (8.9%) did not have Italian citizenship. Most women (84.2%) were highly satisfied (score ≥7/10) with the care received. Among the 61 variables explored, 46 (75.4%) were significantly associated with women’s satisfaction, 33 with higher satisfaction and 13 with lower satisfaction. Multivariate analysis largely confirmed univariate findings, with six out of eight groups of correlated variables being statistically significantly associated with women’s satisfaction. Factors most strongly associated with women’s satisfaction were ‘effective communication, involvement, listening to women’s needs, respectful and timely care’ (OR 16.84, 95% CI 9.90 to 28.61, p<0.001) and ‘physical structure’ (OR 6.51, 95% CI 4.08 to 10.40, p<0.001). Additionally, ‘victim of abuse, discrimination, aggressiveness’ was inversely associated with the wish to return to the facility or to recommend it to a friend (OR 0.35, 95% CI 0.17 to 0.70, p<0.003).ConclusionThis study suggested that many variables are strongly associated with women’s satisfaction with care during childbirth and support the use of multiple measures to monitor the QoC at childbirth.

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