scholarly journals Design of an instrument to measure the quality of care in Physical Therapy

2015 ◽  
Vol 13 (2) ◽  
pp. 260-268 ◽  
Author(s):  
Leny Vieira Cavalheiro ◽  
Raquel Afonso Caserta Eid ◽  
Claudia Talerman ◽  
Cristiane do Prado ◽  
Fátima Cristina Martorano Gobbi ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Physical Therapy ◽  
Physical Therapist ◽  
Lean Six Sigma ◽  
Set Up ◽  
Management Groups ◽  
Care Index ◽  
Care Outcome ◽  
Therapy Service

ABSTRACT Objective: To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. Methods: The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Results: Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. Conclusion: The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care.

scholarly journals Adjustment of oxygen use by means of pulse oximetry: an important tool for patient safety

2010 ◽  
Vol 8 (4) ◽  
pp. 449-455 ◽  
Author(s):  
Telma de Almeida Busch Mendes ◽  
Paola Bruno de Araújo Andreoli ◽  
Leny Vieira Cavalheiro ◽  
Claudia Talerman ◽  
Claudia Laselva
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Physical Therapy ◽  
Confidence Interval ◽  
Pulse Oximetry ◽  
Patient Care ◽  
Physical Therapists ◽  
Severe Damage ◽  
Margin Of Error

ABSTRACT Objective: To assess patient's level of oxygenation by means of pulse oximetry, avoiding hypoxia (that causes rapid and severe damage), hyperoxia, and waste. Methods: Calculations were made with a 7% margin of error and a 95% confidence interval. Physical therapists were instructed to check pulse oximetry of all patients with prescriptions for physical therapy, observing the scheduled number of procedures. Results: A total of 129 patients were evaluated. Hyperoxia predominated in the sectors in which the patient was constantly monitored and hypoxia in the sectors in which monitoring was not continuous. Conclusions: Professionals involved in patient care must be made aware of the importance of adjusting oxygen use and the risk that non-adjustment represents in terms of quality of care and patient safety.

Implementing a patient-centred outcome measure in daily routine in a specialist palliative care inpatient hospital unit: An observational study

2016 ◽  
Vol 31 (3) ◽  
pp. 275-282 ◽  
Author(s):  
Alze Pereira dos Santos Tavares ◽  
Carolina Paparelli ◽  
Carolina Sassaki Kishimoto ◽  
Silvia Avo Cortizo ◽  
Karen Ebina ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
Missing Data ◽  
Outcome Measure ◽  
Symptom Control ◽  
Daily Practice ◽  
Daily Routine ◽  
Palliative Care Outcome Scale ◽  
Care Outcome

Background: Gathering clinical evidence data on patients’ palliative care needs is paramount to identify changes in outcomes over time and maintaining on-going quality improvement. Implementation of patient-centred outcome measures has been widely recommended. The routine use of these instruments in daily practice is challenging and not widespread. Aim: To implement a patient-centred outcome measure in daily practice and fulfil one quality indicator: improve pain during the 72 h after admission, in at least 75% of patients. Design: An observational prospective study. The Palliative care Outcome Scale was used at admission (T0), third day (T1) and weekly. Setting/participants: Hospital palliative care unit with 17 individual rooms. All patients admitted to the unit were included in the study. Results: Preliminary results ( N = 84) revealed inconsistent and missing data (14%). Symptoms were sub-optimally controlled by T1. Processes changed, and only a team member could apply Palliative care Outcome Scale. Doctors were encouraged to grasp the meaning of Palliative care Outcome Scale results for each patient. The post-pilot included 317 patients. No missing data occurred. There was an improvement in most items between T0 and T1: ‘pain’ and ‘other symptoms’ presented statistical significant differences ( p < 0.05). Conclusion: Implementing a patient-centred outcome measure in a hospital palliative care service is feasible and improves quality of care. Controlling high pain at T0 improved (>80%) by T1. Results became more consistent and symptom control was improved overall. Patients are evaluated based on holistic domains by an interdisciplinary team and we have added a much needed measure to help guide improvement of the quality of care provided.

scholarly journals BACK TO THE GRASS ROOT

2014 ◽  
Vol 3 (2) ◽  
pp. 41-43
Author(s):  
Ali Farhad ◽  
Saad Saleem ◽  
Zainab Abdul Razzak
Keyword(s):  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Direct Access ◽  
Self Assessment ◽  
Professional Advancement ◽  
Health Networks ◽  
Grass Root

Profession is, not to squeak like a grateful and apologetic mouse, but to roar like a lion out of pride1. Throughout a professional vocation, professionals change the span of their skill, through becoming more specific, through inspiring into recently emergent areas of professional work, or by taking on administration or enlightening positions. They will also be continually developing the quality of their work in a number of areas, beyond the level of proficiency of one’s ability or skill. Professional advancement inculcates a process of incessant development, long-term knowledge, and augmentation, which allow professionals to get better in their practices so as to better serve patients, clients, associations, the profession, and society2. A physical therapist has an enduring professional accountability for maintaining proficiency through ongoing self-assessment, education, and augmentation of information and skills. Physical Therapy, by 2020, will offer such Physiotherapist who are doctors of Physical Therapy and who may be board–licensed experts3. Clients will have direct access to Physical Therapists in all milieus for patient/client management, expectation, and wellness services. Physiotherapist will be practitioners of choice in clients’/patients’ health networks and will hold all rights of autonomous practice4. Physical Therapists may be assisted by Physical Therapy assistants, who are erudite and qualified to provide Physical Therapist–directed and controlled, components of intervention. Physical Therapy profession in Pakistan is rising with a great pace. Every passing minute brings extraordinary revolution in this field and now it is a high time to have some institution takes the responsibility on its shoulder to curtail the nourishing elements of quackery and bring autonomy and sovereignty to the field.

scholarly journals Exploring the Relationship between Window View Quantity, Quality, and Ratings of Care in the Hospital

2021 ◽  
Vol 18 (20) ◽  
pp. 10677
Author(s):  
Sahar Mihandoust ◽  
Anjali Joseph ◽  
Sara Kennedy ◽  
Piers MacNaughton ◽  
May Woo
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Healthcare Settings ◽  
Hospital Access ◽  
Room Design ◽  
Unit Increase ◽  
Set Up ◽  
Perception Of Care ◽  
Satisfaction Measures

Hospital ratings reflect patient satisfaction, consumer perception of care, and create the context for quality improvement in healthcare settings. Despite an abundance of studies on the health benefits of the presence and content of window views, there is a gap in research examining how these features may impact patient satisfaction and consumer perceptions of the quality of care received. A quantitative exploratory study collected data from 652 participants regarding their previous stay in the hospital, their perception of windows in their room, and their perception of their room, the hospital, and the quality of care received. On a scale of 0–10, participants with access to windows gave a 1-unit higher rating for the hospital. Access to window views from their bed provided a 1-unit increase, and having a view to green spaces resulted in a 2-unit increase in hospital ratings. Statistically significant results were also found for room ratings and care ratings. Windows in the patient rooms impact the key patient satisfaction measures and patient experience during the hospital stay. Patient room design, bed set up, and quantity and quality of window views may play an important role in shaping the patient’s experience.

Community oncology care delivery staffing model.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 87-87
Author(s):  
David C. Fryefield ◽  
Roberta Kafora ◽  
Lori Bradshaw-Hucko ◽  
Chris Tribble ◽  
Terry Jensen ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Six Sigma ◽  
Care Delivery ◽  
Core Competencies ◽  
Lean Six Sigma ◽  
Advisory Council ◽  
Physician Services ◽  
Staffing Model ◽  
Community Oncology

87 Background: In 2010, the US Oncology Network’s Clinical Advisory Council (CAC), a practice-based clinical leadership team, reviewed the care delivery process at 5 pilot community oncology clinics to determine how licensed and unlicensed clinical resources were used. The Lean Six Sigma methodology, which employs statistical analysis within a structured approach to problem-solving, was used to understand the required clinical activities of the practices within 3 primary areas. The objective of this pilot was to ensure patients receive timely, effective treatment from qualified personal in a cost-efficient model. Methods: A team led by a certified Master Black Belt studied tasks performed by licensed vs. non-licensed staff in the areas of physician services, treatment services and triage services at each practice. Based on the findings, tasks were realigned to maintain quality of care but to deliver care more efficiently. Results: Care Delivery processes comprised 95 tasks at baseline vs. 80 tasks in the redefined model. Within physician services, changes to workflow included rooming and clinic support (vitals, cleaning, and patient comfort) to be provided by Medical Assistants (MAs) instead of RN. RN duties were changed to MA supervision and tasks that require licensure. Changes to triage services included use of RNs to coordinate care and MAs for phone call screening, centralized triage (non-patient facing), and normal lab follow-up. Increased clarity of tasks and re-assignment of responsibilities reduced RN work load by 17% or 16.6 hours/day based on 120 patient visits. Each pilot site realized an annualized labor savings in excess of $100,000. This prospective, patient volume-based Care Delivery Staffing Model was adopted by the CAC as Network standard after completion of the pilot. Conclusions: Using Lean Six Sigma methods, the care delivery process was successfully re-designed such that clinical staff were re-aligned to better utilize each resource’s core competencies. Implementation of this care delivery model resulted in improved cost effectiveness while maintaining quality of care and also enabled prospective staff planning so that costs can be kept competitive in the future.

scholarly journals Reflections and Future Directions on Extending Physical Therapist Scope of Practice to Improve Quality of Care and Preserve Health Care Resources

2018 ◽  
Vol 98 (10) ◽  
pp. 827-829 ◽  
Author(s):  
Jean-Michel Brismée ◽  
John L Pape ◽  
Linda J Woodhouse ◽  
Duncan Reid ◽  
Nicolas Bellot ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Physical Therapist ◽  
Scope Of Practice ◽  
Improve Quality ◽  
Future Directions ◽  
Health Care Resources

scholarly journals Outcomes research shifting the dominant research paradigm in physical therapy

1997 ◽  
Vol 53 (2) ◽  
pp. 4-9
Author(s):  
Alan M. Jette
Keyword(s):  
Quality Of Care ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Clinical Research ◽  
Clinical Outcomes ◽  
Outcomes Research ◽  
Direct Impact ◽  
Research Paradigm ◽  
Care Assessment

This article discusses outcomes research in physical therapy and places its conceptual roots within the work on quality-of-care assessment. An argument is advanced that the outcomes research movement in medicine has stimulated clinical researchers in physical therapy to address disability outcomes in addition to traditional impairment outcomes. If physical therapy clinical research moves beyond this broadening of clinical outcomes to investigate explicitly the hypothesized relationship between impairment and disability, outcomes research will have stimulated a shift in the dominant research paradigm in the profession. The development and testing of theory regarding the pathogenesis of disability will be needed to guide the direction of this type of physical therapy research. Such a shift in the dominant research paradigm in physical therapy could produce dramatic findings that have direct impact on clinical practice.

Improving Quality of Care and Life in Nursing Homes

1988 ◽  
Vol 7 (3) ◽  
pp. 406-419 ◽  
Author(s):  
Anne P. Glass
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Quality Care ◽  
Nursing Home Residents ◽  
Institutional Quality ◽  
Care Policy ◽  
Regulatory Systems ◽  
Nursing Home Patients ◽  
Care Index

For nursing home residents, quality of life is largely determined by the quality of the care they receive. Unfortunately, that quality is all too often inadequate. Current regulatory systems have failed in their efforts to assure high-quality care. Policy could vitally improve institutional quality of care in three ways: (1) increase efforts to derive a valid and reliable quality of care index that incorporates resident outcomes; (2) change the emphasis of resident care inspections; and (3) expand outside involvement. These elements are all essential and interdependent. They offer a myriad of creative opportunities for researchers, practitioners, and volunteers to make major contributions toward improving the quality of care, and, ultimately of life, for nursing home patients.

scholarly journals Benchmarking Physical Therapy Clinic Performance: Statistical Methods to Enhance Internal Validity When Using Observational Data

2008 ◽  
Vol 88 (9) ◽  
pp. 1078-1087 ◽  
Author(s):  
Linda Resnik ◽  
Dawei Liu ◽  
Dennis L Hart ◽  
Vince Mor
Keyword(s):  
Quality Of Care ◽  
Physical Therapy ◽  
Statistical Methods ◽  
Service Utilization ◽  
Internal Validity ◽  
Observational Research ◽  
Provider Performance ◽  
Ranking Procedures ◽  
Therapy Clinic

Many clinics and payers are beginning programs to collect and interpret outcomes related to quality of care and provider performance (ie, benchmarking). Outcomes assessment is commonly done using observational research designs, which makes it important for those involved in these endeavors to appreciate the underlying challenges and limitations of these designs. This perspective article discusses the advantages and limitations of using observational research to evaluate quality of care and provider performance in order to inform clinicians, researchers, administrators, and policy makers who want to use data to guide practice and policy or critically appraise observational studies and benchmarking efforts. Threats to internal validity, including potential confounding, patient selection bias, and missing data, are discussed along with statistical methods commonly used to address these limitations. An example is given from a recent study comparing physical therapy clinic performance in terms of patient outcomes and service utilization with and without the use of these methods. The authors demonstrate that crude differences in clinic outcomes and service utilization tend to be inflated compared with the differences that are statistically adjusted for selected threats to internal validity. The authors conclude that quality of care measurement and ranking procedures that do not use similar methods may produce findings that may be misleading.

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