scholarly journals Clinical registry of cardiovascular surgeries in a university hospital

2019 ◽  
Vol 65 (1) ◽  
pp. 16-23
Author(s):  
Roberta Senger ◽  
Michelle Dornelles Santarem ◽  
Sílvia Goldmeier
Keyword(s):  
Quality Of Care ◽  
Data Collection ◽  
Cardiovascular Surgery ◽  
Measured Data ◽  
International Standards ◽  
University Hospital ◽  
Clinical Registry ◽  
Health Institutions

SUMMARY OBJECTIVES To create and implement a computerized clinical registry to verify in the short-, medium- and long-term the mortality and the incidence of significant surgical outcomes in adult patients submitted to cardiovascular surgeries. METHODS This is a prospective, observational registry-based study aimed at documenting the characteristics of patients undergoing cardiovascular surgery. RESULTS Variables were standardized according to international references from the Society of Thoracic Surgeons (STS), American College of Cardiology (ACC), Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS) and the Department of Informatics of SUS (DATASUS). The standardization was performed in English with an interface in Portuguese to make the data collection easier in the institution. Quality of care indicators, surgical procedure characteristics, in addition to significant cardiovascular outcomes will be measured. Data were collected during the hospitalization until hospital discharge or at the seventh day, in thirty days, six months, twelve months and annually until completing five years. CONCLUSION The importance of a database maintenance with international standards that can be reproducible was evidenced, allowing the evaluation of techniques and assistance and the integration of data among health institutions.

Abstract P131: Utilization of a Clinical Registry to Drive Practice-Based Learning and Improvement Among Cardiology Fellows in Training: Observations From the American College of Cardiology's PINNACLE Registry™

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Melissa Frederick ◽  
Ramamanohara Pai ◽  
Vamshidhar Guduguntla ◽  
Howard Rosman ◽  
Katie Kehoe ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Data Collection ◽  
Care Delivery ◽  
Medical Center ◽  
Core Competencies ◽  
Initial Step ◽  
Clinical Registry ◽  
Therapeutic Decisions ◽  
Comparative Feedback

Background: The Accreditation Council for Graduate Medical Education (ACGME) has defined six core competencies that reflect changing needs of health care delivery. One of these competencies, practice-based learning and improvement (PBLI), is essential for improving processes and outcomes of care. As an initial step, incorporating a standardized method for data collection is required and helps physicians monitor the quality of their work, identify learning and QI needs and positively change practice behavior. Methods: The PINNACLE Registry is an outpatient practice-based QI program designed to optimize quality of care through the standardized collection and reporting of clinical data on CAD, atrial fibrillation, heart failure and hypertension. Twelve cardiac fellows participate in the PINNACLE Registry at St. John Hospital and Medical Center in Detroit. At each clinic encounter, a data collection form (DCF) which captures patient demographics, history/risk factors, and current therapies were recorded and transmitted to the ACC to generate comparative feedback reports about the quality of care delivered to patients. Use of the DCF was piloted from September 2009 through November 2009 and expanded to all patient encounters from December 1, 2009 through January 31, 2010. Impressions from the first 60 encounters are reported. Results: Fellows reported that the DCF improved their knowledge, though the initial process of collecting data impacted clinic workflow. Utilization of the DCF initially resulted in longer patient visits which decreased over time (average 7 minutes reduced to 4 minutes per patient). As a checklist connecting patient workflow to best cardiology evidence, residents reported that diagnostic and therapeutic decisions were not simply monitored, but guided by the DCF. Conclusions: The DCF was found be a useful tool for data collection and clinical decision support. Participation in the PINNACLE Registry has provided the opportunity to further the ACGME core competencies of patient care and practice-based learning and improvement in a cardiology fellow outpatient clinic.

scholarly journals Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023706 ◽  
Author(s):  
Marzia Lazzerini ◽  
Hematha Senanayake ◽  
Rishard Mohamed ◽  
Athula Kaluarachchi ◽  
Roshini Fernando ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Sri Lanka ◽  
Data Collection ◽  
Low Birthweight ◽  
Technical Problem ◽  
International Standards ◽  
High Rate ◽  
Technical Problems ◽  
Data Completeness

ObjectivesThis study was aimed at piloting a prospective individual patient database on hospital deliveries in Colombo, Sri Lanka, and at exploring its use for developing recommendations for improving quality of care (QoC).DesignObservational study.SettingDe Soysa Maternity Hospital, the largest referral hospital for maternity care in Sri Lanka.Data collection and analysisFrom July 2015 to June 2017, 150 variables were collected for each delivery using a standardised form and entered into a database. Data were analysed every 8 months, and the results made available to local staff. Outcomes of the study included: technical problems; data completeness; data accuracy; key database findings; and use of data.Results7504 deliveries were recorded. No technical problem was reported. Data completeness exceeded that of other existing hospital recording systems. Less than 1% data were missing for maternal variables and less than 3% for newborn variables. Mistakes in data collection and entry occurred in 0.01% and 0.09% of maternal and newborn data, respectively. Key QoC indicators identified in comparison with international standards were: relatively low maternal mortality (0.053%); relatively high maternal near-miss cases (3.4%); high rate of induction of labour (24.6%), caesarean section (30.0%) and episiotomy (56.1%); relatively high rate of preterm births (9.4%); low birthweight rate (16.5%); stillbirth (0.97%); and of total deaths in newborn (1.98%). Based on key indicators identified, a list of recommendations was developed, including the use checklists to standardise case management, training, clinical audits and more information for patients. A list of lessons learnt with the implementation of the data collection system was also drawn.ConclusionsThe study shows that the implemented system of data collection can produce a large quantity of reliable information. Most importantly, this experience provides an example on how database findings can be used for discussing hospital practices, identifying gaps and to agree on recommendations for improving QoC.

Quality of care in longer term mental health institutions in Portugal

2011 ◽  
Vol 26 (S2) ◽  
pp. 2148-2148
Author(s):  
G. Cardoso ◽  
C. Pacheco ◽  
J. Caldas-de-Almeida
Keyword(s):  
Quality Of Care ◽  
Mentally Ill ◽  
Hospital Setting ◽  
Residential Facilities ◽  
Health Institutions ◽  
Gaf Scores ◽  
The City ◽  
Mixed Gender

IntroductionDeinstitutionalisation of the mentally ill is an ongoing process in European countries. Quality of care in residential facilities, however, was seldom assessed in part due to the lack of adequate instruments.ObjectivesTo assess the quality of care in Portuguese residential facilities for long term mental patients.MethodsQuality of care in residential facilities was assessed with the toolkit developed by the DEMoBinc study using interviews with the units’ managers, and the users.ResultsThe 20 units assessed across Portugal were mainly located in the city; 13 were in a hospital setting and 7 in the community. Most of the units (90%) had no maximum length of stay, and 60% were mixed-gender; 85% of the users were not compulsory. Most of the units (60%) had no one-bedrooms, and their aim was rehabilitative in 40%, and rehabilitative plus providing support in 40%. The rate of patients with a bank account was 49.4%, 32.4% were in charge of their finances, while only 14.1% had voted.In hospital vs. community units patients were more frequently men (80.5 vs. 53.8%) and older (51.1 ± 13.7 vs. 43.3 ± 9.6, p < .001). In community units the treatment was more frequently explained (50 vs. 26.3%), patients’ involvement was higher (40.4 vs. 19.5%), while mean GAF scores (64.9 vs. 60.2) did not differ.ConclusionsPortuguese results show that in spite of the effort to create new facilities for the longer term mentally ill, a lot still has to be done to improve the quality of care they provide.

Quality of care in longer term mental health institutions in Portugal

2011 ◽  
Vol 38 (S 01) ◽  
Author(s):  
G Cardoso ◽  
C Pacheco ◽  
J Caldas-de-Almeida
Keyword(s):  
Mental Health ◽  
Quality Of Care ◽  
Health Institutions ◽  
Mental Health Institutions

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.

Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery

Neurosurgery ◽  
2015 ◽  
Vol 77 (5) ◽  
pp. 769-776 ◽  
Author(s):  
Elina Reponen ◽  
Hanna Tuominen ◽  
Juha Hernesniemi ◽  
Miikka Korja
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Status ◽  
Patient Experience ◽  
University Hospital ◽  
Term Outcome ◽  
Major Morbidity ◽  
Patient Reported ◽  
Relationship Of

Abstract BACKGROUND: Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist. OBJECTIVE: To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a proxy for quality of care in elective cranial neurosurgery. METHODS: We conducted an observational study on the relationship of overall patient satisfaction at 30 postoperative days with surgical and functional outcome (modified Rankin Scale [mRS] score) in a prospective, consecutive, and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 at Helsinki University Hospital, Helsinki, Finland. RESULTS: Postoperative overall (subjective and objective) morbidity was present in 194 (46.4%) patients; yet almost 94% of all study patients reported high overall satisfaction. Low overall patient satisfaction at 30 days was not associated with postoperative major morbidity in elective cranial neurosurgery. Dependent functional status (mRS score ≥3) at 30 days, minor infections, poor postoperative subjective overall health status, and patient-reported severe symptoms (double vision, poor balance) may contribute to unsatisfactory patient experience. CONCLUSION: Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery.

scholarly journals POS1494-HPR THE COLLABORATION OF RHEUMATOLOGY-DERMATOLOGY IN THE EVALUATION OF RHEUMATIC DISEASES PATIENTS: EXPERIENCE IN A UNIVERSITY HOSPITAL

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1031.1-1032
Author(s):  
G. Figueroa-Parra ◽  
A. Moreno-Salinas ◽  
C. M. Gamboa-Alonso ◽  
M. A. Villarreal-Alarcón ◽  
D. Á. Galarza-Delgado
Keyword(s):  
Quality Of Care ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Direct Interaction ◽  
Final Diagnosis ◽  
Underlying Disease ◽  
University Hospital ◽  
Rheumatology Clinic ◽  
Important Interaction

Background:Dermatological manifestations are not rare in patients with rheumatic diseases (RD). Multidisciplinary management and direct interaction between these disciplines are essential. According to Dermatology-Rheumatology clinics, most diagnoses evaluated are systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), with dermatitis being the most common manifestation. It is important to be aware that skin problems in RD patients are not always related to the underlying condition(1). Nowadays, there is significant evidence to support the manifold advantages of the joint dermatology-rheumatology clinics, including improved quality of care for patients and multidisciplinary training for new physicians(2). This ongoing trend is intended to highlight the important interaction between specialties that treat overlapping conditions, and it has been incorporated in academic health centers to give a comprehensive approach to patients.Objectives:Our purpose was to describe the collaboration between the Rheumatology and Dermatology services during the evaluation of RD patients.Methods:An observational, retrospective study was performed in the Rheumatology Service of the University Hospital “Dr. Jose Eleuterio Gonzalez” in Monterrey, Mexico, between March 2019 and February 2020. All the patients with a Rheumatology or Dermatology consultation requested were included (hospitalized and outpatients). Demographic (age, gender, baseline diagnosis), the reason for consultation, specialty requested, type of treatment, final diagnoses, and agreement in final diagnosis were registered. Results are shown in descriptive statistics.Results:One hundred and seventy-four patients were included, 142 (81.6%) patients from the outpatient clinic and 32 (18.4%) patients hospitalized. The mean age was 45.1 (SD±15.8) years, 135 (77.6%) were females, 54 (31%) patients were under initial diagnosis evaluation, 30 (17.2%) had RA, 25 (14.4%) patients had SLE, 15 (8.6%) patients had psoriatic arthritis, 12 (6.9%) patients had systemic sclerosis, 6 (3.4%) patients had dermatomyositis. The main reasons for consultation in hospitalized patients were acute lupus (15.6%), subacute lupus (12.5%), purpura (12.5%), cutaneous vasculitis (9.4%), urticarial dermatitis (9.4%), dermatomyositis (6.3%) and others (34.3%). The consultation requested was: 156 (89.7%) to Dermatology and 18 (10.3%) to Rheumatology. The type of treatment prescribed was topic/local in 37 (21.3%) patients, systemic in 25 (14.4%) and both in 92 (52.9%) patients. The final diagnoses were related to the underlying disease in 102 (77%) patients and unrelated in 40 (23%) patients. The agreement between initial clinical suspicion and final diagnoses reached 75.9% between Rheumatology and Dermatology services. Figure 1.Conclusion:The collaboration between Rheumatology and Dermatology services are very important. Most of the patients were under initial evaluation. All the rheumatologists and dermatologists should be aware of the interdependence from both specialties to give the best quality of care to the patients.References:[1]Samycia M, McCourt C, Shojania K, Au S. Experiences From a Combined Dermatology and Rheumatology Clinic: A Retrospective Review. J Cutan Med Surg. 2016;20(5):486-489. doi:10.1177/1203475416649138.[2]Theodorakopoulou E, Dalamaga M, Katsimbri P, Boumpas DT, Papadavid E. How does the joint dermatology-rheumatology clinic benefit both patients and dermatologists?. Dermatol Ther. 2020;33(3):e13283. doi:10.1111/dth.13283Figure 1.Disclosure of Interests:None declared

scholarly journals Satisfacción laboral de los profesionales sanitarios de un Hospital Universitario: análisis general y categorías laborales

2015 ◽  
Vol 31 (2) ◽  
pp. 645 ◽  
Author(s):  
César Carrillo-García ◽  
María E. Martínez-Roche ◽  
Carmen I. Gómez-García ◽  
Mariano Meseguer-DePedro
Keyword(s):  
Health Professionals ◽  
Public University ◽  
University Hospital ◽  
General Satisfaction ◽  
Demographic Questionnaire ◽  
Health Institutions ◽  
Management Groups ◽  
Auxiliary Nurses ◽  
General Scale

Job satisfaction in health services is measured by the quality of care provided, hence the importance of surveying the workers of health institutions. The objective was to explore and analyze the phenomenon of the satisfaction of working in a sample made up of 546 health professionals belonging to a public University Hospital. Both a socio-demographic questionnaire and General Scale of Satisfaction (<em>Overall</em> <em>Job</em> <em>Satisfacción</em>) that were both validated in Spanish were given to the participants. The results of general satisfaction showed a mean of 71.37 (<em>SD</em> = 14.03). The subscales with better results were: colleagues and immediate superior. There were important differences in satisfaction scores between the different professional categories. The higher levels of general satisfaction were found in hospital management groups and resident doctors, while the lower levels of general satisfaction were found in medical area specialists, nurses and auxiliary nurses.

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