Letter to the Editor

PEDIATRICS ◽  
1972 ◽  
Vol 49 (6) ◽  
pp. 926-927
Author(s):  
Ralph I. Fried
Keyword(s):  
Quality Of Care ◽  
Child Behavior ◽  
Private Practice ◽  
Allied Health ◽  
Health Workers ◽  
Emotional Problems ◽  
Routine Care ◽  
Parental Concerns ◽  
Life Saving

I gratefully accept your invitation to comment on the letter by Dr. Pick on allied health workers in the private practice of pediatrics. I support Dr. Pick in his statement that this would constitute a regression in the quality of care offered to our children. Dr. Charles A. Janeway remarked in 1957 that during his career the practice of pediatrics had reversed itself from 80% life-saving and 20% routine care, to the opposite figures, so that pediatricians have had to deal increasingly with parental concerns about child behavior and emotional problems.

Utilization of Allied Health Workers: Does It Solve the Basic Problem?

PEDIATRICS ◽  
1972 ◽  
Vol 49 (3) ◽  
pp. 477-477
Author(s):  
William G. Crook
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Allied Health ◽  
Basic Problem ◽  
Health Workers ◽  
School Problems ◽  
American Children ◽  
Sick Children ◽  
Care Demands

American physicians seem unable to meet the health care demands of all American children. As one solution, Dr. Martin Baren1 would have nonphysicians deal with some of the sick children, while pediatricians supervise development, give guidance, handle school problems, and so on. My associates and I suggested (in an exhibit at the Academy's meeting in April, 19712) that with appropriate space, supporting personnel, systems, and management, a pediatrician can double his productivity and improve the quality of care he gives.

scholarly journals Collaborative care: enough of the why; what about the how?

2019 ◽  
Vol 215 (04) ◽  
pp. 573-576 ◽  
Author(s):  
Parashar Pravin Ramanuj ◽  
Harold Alan Pincus
Keyword(s):  
Quality Of Care ◽  
Cost Effectiveness ◽  
Health Plan ◽  
Collaborative Care ◽  
American Psychiatric Association ◽  
Routine Care ◽  
Healthcare Improvement

The clinical and cost-effectiveness of collaborative care for improving outcomes in people with mental and physical comorbidities is well established. However, translating these models into enduring change in routine care has proved difficult. In this editorial we outline how to shift the conversation on collaborative care from ‘what are we supposed to do?’ to ‘how we can do this’.Declaration of interestP.P.R. has received honoraria from Publicis LifeBrands and the Institute for Healthcare Improvement outside of the submitted work. H.A.P. reports personal fees from the BIND Health Plan outside of the submitted work; and is a Member of the Council on Quality of Care of the American Psychiatric Association.

scholarly journals Birth Companions, Health workers perspective: Mixed Method Study in St. Paul’s Hospital and Millennium Medical College and its Catchment Centers in Addis Ababa, Ethiopia

2021 ◽  
Author(s):  
Kidist Gizachew ◽  
Tewodros Getinet ◽  
Delayehu Bekele
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Addis Ababa ◽  
Post Partum ◽  
Care Providers ◽  
Child Birth ◽  
Medical College

Abstract Background: Birth companions have been shown to improve quality of care provided to laboring women. Various studies have shown the benefits of companion during child birth. The objective of this study was to assess the knowledge, attitude and practice of health care providers towards the involvement of birth companions during child birth in St Paul’s Hospital Millennium Medical College (SPHMMC) and its selected catchment health centers. Methods: The study used a cross-sectional study which was supplemented by qualitative study design which employed phenomenological design was conducted using in depth interview of health care providers who were on practice during the study period in SPHMMC. Result: The study included a total 58 health care providers. The finding from the study showed that great proportion of health care providers involved in the study (90 %) have positive attitude towards involvement of birth companions but majority 82.4 % didn’t allow birth companions. The commonest reasons mentioned for not involving companions include fear of breach of privacy, interference with routine medical care and risk of litigation/complaints.Conclusion and Recommendation: The findings from this study showed that majority of the health care providers are against the practice of involving birth companions. Since involvement of birth companions is one way to ensure the quality of care provided there should be an effort to increase the knowledge of health professionals on benefits of birth companions. There is also a need for improvement of the work setup. Simple measures like providing screens, providing separate rooms for laboring and post-partum women will have a significant impact on the quality of care provided.

‘It makes you someone who changes with the times’: health worker and client perspectives on a smartphone-based counselling application deployed in rural Tanzania

2019 ◽  
Vol 34 (4) ◽  
pp. 307-315 ◽  
Author(s):  
Kristy Hackett ◽  
Mina Kazemi ◽  
Curtis Lafleur ◽  
Peter Nyella ◽  
Lawelu Godfrey ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health System ◽  
Data Management ◽  
Low Income ◽  
Community Intervention ◽  
Health Workers ◽  
Low Income Countries ◽  
Maternal And Newborn Health ◽  
Pregnancy And Childbirth

AbstractMobile health (mHealth) applications have been developed for community health workers (CHW) to help simplify tasks, enhance service delivery and promote healthy behaviours. These strategies hold promise, particularly for support of pregnancy and childbirth in low-income countries (LIC), but their design and implementation must incorporate CHW clients’ perspectives to be effective and sustainable. Few studies examine how mHealth influences client and supervisor perceptions of CHW performance and quality of care in LIC. This study was embedded within a larger cluster-randomized, community intervention trial in Singida, Tanzania. CHW in intervention areas were trained to use a smartphone application designed to improve data management, patient tracking and delivery of health messages during prenatal counselling visits with women clients. Qualitative data collected through focus groups and in-depth interviews illustrated mostly positive perceptions of smartphone-assisted counselling among clients and supervisors including: increased quality of care; and improved communication, efficiency and data management. Clients also associated smartphone-assisted counselling with overall health system improvements even though the functions of the smartphones were not well understood. Smartphones were thought to signify modern, up-to-date biomedical information deemed highly desirable during pregnancy and childbirth in this context. In this rural Tanzanian setting, mHealth tools positively influenced community perceptions of health system services and client expectations of health workers; policymakers and implementers must ensure these expectations are met. Such interventions must be deeply embedded into health systems to have long-term impacts on maternal and newborn health outcomes.

scholarly journals Patients’ satisfaction with quality of care in general hospitals in Ebonyi State, Nigeria, using SERVQUAL theory

2020 ◽  
Vol 8 ◽  
pp. 205031212094512
Author(s):  
MaryJoy Umoke ◽  
Prince Christian Ifeanachor Umoke ◽  
Ignatius O Nwimo ◽  
Chioma Adaora Nwalieji ◽  
Rosemary N Onwe ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Workers ◽  
Health Sector ◽  
Sampling Technique ◽  
Healthcare Facility ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
General Hospitals ◽  
Patients Satisfaction

Background: Patient satisfaction is an essential parameter in the assessment of quality of care and healthcare facility performance. Objective: To investigate patients’ satisfaction with quality of care in general hospitals in Ebonyi State, South East, Nigeria, using the SERVQUAL. Methods: A cross-sectional descriptive study design was employed on a sample of 400 patients using a 27-item structured open-ended patients’ satisfaction questionnaire with a multi-stage cluster sampling technique. Patients included in the study were those who must have come for an outpatient clinic within the period, be 18 years and above, and those who gave consent to participate. Of 400 questionnaires administered, 396 (99%) were retrieved. SPSS version 20 was used for data analysis. Descriptive statistics, such as frequencies, percentages, mean score ( x), and standard deviation, were employed for interpretation. Results: Out of 396 patients, 156 (39.4%) were male and 240 (60.6%) were females. Most patients were 18–39 years (233 (58.8%)), had secondary education (139 (35.1%)), married (221 (55.8%)), earned <18,000 (170(42.9%)), and were traders (136 (34.3%)). Patients were satisfied with tangibility (2.57 ± 0.99) and reliability (2.84 ± 0.95) and very satisfied with responsiveness (3.06 ± 0.63), assurance (3.07 ± 0.63), and empathy (3.12 ± 0.57). Conclusions: Patients were satisfied with the quality of care. However, satisfaction was highest with empathy and lowest with tangibility. Thus, managers should focus their quality improvement efforts on areas of the neat appearance of health workers, waiting facilities for attendants and patients, and hygienic conditions at the hospital. Also, biannual assessment of patients’ satisfaction should be done and the results generated use judiciously to provide a platform for health sector reform.

Predictors of electronic health management information system for improving the quality of care for women and people with disabilities

2020 ◽  
pp. 026666692094714
Author(s):  
Edda Tandi Lwoga ◽  
Raphael Zozimus Sangeda ◽  
Restituta Mushi
Keyword(s):  
Information System ◽  
Quality Of Care ◽  
Management Information System ◽  
User Satisfaction ◽  
Health Workers ◽  
People With Disabilities ◽  
Health Management Information System ◽  
Management Information ◽  
Factors Influencing

The electronic Hospital management Information System (eHMIS) can improve care for vulnerable patients, help collect important disability and maternal health data, and improve the hospital’s overall data management. This study assessed the use of HMIS and factors influencing the usage and behavioral intentions to use the eHMIS at the Comprehensive Community Based Rehabilitation in Tanzania (CCBRT). We investigated both clinical and non-clinical staff (n=69) using tablets and online surveys, with a rate of return of 71.9%. The ICT staff were also interviewed to supplement data from the survey. The survey questionnaire was guided by the updated Information System Success (ISS) model. Most health workers (81.2%) used the eHMIS several times a day to support different decision-making activities. The better educated personnel were more likely to enter data more effectively into eHMIS as compared to their counterparts. Among six predictors, self-efficacy positively influenced self-reported use and user satisfaction of HMIS, while service quality negatively affected self-reported use of eHMIS. The system quality positively influenced health workers to be satisfied with the eHMIS, and user satisfaction positively influenced continued usage intention of the eHMIS. Both user satisfaction and continued usage intention were positively related to individual impact of eHMIS. Individual impact had positive effects on organizational impact of eHMIS. This is a comprehensive study conducted in Tanzania regarding the implementation of eHMIS, and factors influencing post-adoptive use of HMIS to improve quality of care of women and people with disabilities.

Fighting Violence against Health Workers: A Way to Improve Quality of Care?

2014 ◽  
Vol 62 (6) ◽  
pp. 220-222 ◽  
Author(s):  
Maxime Gignon ◽  
Jean-Charles Verheye ◽  
Cécile Manaouil ◽  
Christine Ammirati ◽  
Emmanuelle Turban-Castel ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Workers ◽  
Improve Quality

Nurse, oncologist, and patient impressions of electronic symptom monitoring via patient-reported outcomes in community oncology practices: Qualitative results from the U.S. national PRO-TECT trial (AFT-39, NCT03249090).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7044-7044
Author(s):  
Ethan M. Basch ◽  
Randall Teal ◽  
Amylou C. Dueck ◽  
Jennifer Jansen ◽  
Sydney Henson ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Patient Reported Outcomes ◽  
Positive Impact ◽  
Care Delivery ◽  
Routine Care ◽  
Office Visits ◽  
Symptom Monitoring ◽  
Community Oncology ◽  
Patient Reported

7044 Background: There is growing interest to implement electronic patient-reported outcomes in oncology practices for symptom monitoring. It is not well known what nurse, physician, and patient impressions of benefits, acceptability, and challenges are in routine care use. Methods: PRO-TECT is an ongoing U.S. national trial including 26 community oncology practices across 15 states that implemented PRO symptom monitoring [NCT03249090]. Patients complete weekly PROs between visits, nurses receive alerts for severe/worsening symptoms, and oncologists review PROs at office visits. Interviews were conducted with 147 stakeholders including nurses (N = 46), oncologists (N = 27), data managers (N = 15), and patients (N = 59). Each stakeholder group had different interview guides with overlapping topics to explore experiences with the PRO system. Interviews lasted 15-60 minutes, were digitally recorded, transcribed, and entered into a qualitative analysis software program. A codebook was developed from the research questions, interview guides, and discussions with the project team. Standardized coding methods were applied, with transcripts double coded for thematic analysis. Feedback surveys were also completed by nurses (N = 57), oncologists (N = 38), and patients (N = 435). Results: Key benefits perceived across stakeholder groups included increased patient self-awareness of symptoms; improved direct communication of patients with care teams; more open and honest conveying of symptom experiences; ability to track symptoms over time; and increased involvement of patients in their own care. Most stakeholders felt PRO symptom monitoring had a positive impact on quality of care delivery, and believed benefits of PROs outweighed necessary staff efforts. Challenges included additional work by nurses to review and respond to alerts, staff turnover requiring retraining, and limited time of oncologists. In the survey, 39/56 (70%) nurses felt the PRO system improved quality of care; 27/33 (82%) oncologists noted PROs were useful for team discussions and care delivery; and 320/434 (74%) patients agreed that weekly PRO reporting improved discussions with their care team. Conclusions: Clinicians and patients perceived weekly PRO symptom monitoring between visits to be valuable despite added staff effort. Results of additional analyses are forthcoming. Clinical trial information: NCT03249090 .

scholarly journals Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

2018 ◽  
Vol 55 ◽  
pp. 004695801876149 ◽  
Author(s):  
Thomas Petzold ◽  
Stefanie Deckert ◽  
Paula R. Williamson ◽  
Jochen Schmitt
Keyword(s):  
Quality Of Care ◽  
Quality Indicators ◽  
Clinical Guidelines ◽  
Quality Indicator ◽  
Health Care Systems ◽  
Quality Measurement ◽  
Routine Care ◽  
Measurement Properties ◽  
Measurement Instruments

We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted. In Germany, no explicit methodological guidance exists, but 3 different approaches are used. For NICE, a general approach is used for the derivation of quality indicators out of quality standards. Quality indicators were defined in 34 out of 87 CGs (39%) in Germany and for 58 out of 133 (43%) NICE CGs. Statements regarding measurement properties of instruments for quality indicator assessment were missing in German and NICE documents. Thirteen pairs of CGs (32%) have associated quality indicators. Thirty-four quality indicators refer to the same aspect of the quality of care, which corresponds to 27% of the German and 7% of NICE quality indicators. The development of a standardized and internationally accepted methodology for the derivation of quality indicators relevant to CGs is needed to measure and compare quality of care in health care systems.

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