scholarly journals Current Quality Management Practices In U.S. Hospitals: A Survey

2011 ◽  
Vol 7 (7) ◽  
Author(s):  
BJayanta K. Bandyopadhyayeth
Keyword(s):  
Health Care ◽  
Quality Management ◽  
Patient Care ◽  
Management Practices ◽  
Health Care Cost ◽  
Care Quality ◽  
Insurance Cost ◽  
Malpractice Insurance ◽  
Patient Care Quality ◽  
Management Policies

<p class="MsoNormal" style="text-align: justify; margin: 0in 0.5in 0pt;"><span style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 10pt;">For decades, the U.S. health care industry has been operating on its own, ignoring emerging factors, such as competition, patient safety, skyrocketing health care cost, liability, malpractice insurance cost, and DRG for Medicare payment. However, as these factors became more prevalent and competition within the industry intensified, many U.S. hospitals have been<span style="mso-spacerun: yes;">&nbsp; </span>becoming increasingly aware of the critical needs of controlling the operating costs and attempting to meet the needs and expectations of patient care quality. This paper presents the findings of a questionnaire survey unveiling the current quality management policies and practices in U.S. hospitals for achieving excellence in patient care quality.</span></p>

scholarly journals The Effectiveness of Health Care Information Technologies: Evaluation of Trust, Security Beliefs, and Privacy as Determinants of Health Care Outcomes (Preprint)

2017 ◽  
Author(s):  
Victoria Kisekka ◽  
Justin Scott Giboney
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Information ◽  
Information Assurance ◽  
Care Quality ◽  
Patient Access ◽  
Health Records ◽  
Privacy Concerns ◽  
Access To Health ◽  
Patient Care Quality

BACKGROUND The diffusion of health information technologies (HITs) within the health care sector continues to grow. However, there is no theory explaining how success of HITs influences patient care outcomes. With the increase in data breaches, HITs’ success now hinges on the effectiveness of data protection solutions. Still, empirical research has only addressed privacy concerns, with little regard for other factors of information assurance. OBJECTIVE The objective of this study was to study the effectiveness of HITs using the DeLone and McLean Information Systems Success Model (DMISSM). We examined the role of information assurance constructs (ie, the role of information security beliefs, privacy concerns, and trust in health information) as measures of HIT effectiveness. We also investigated the relationships between information assurance and three aspects of system success: attitude toward health information exchange (HIE), patient access to health records, and perceived patient care quality. METHODS Using structural equation modeling, we analyzed the data from a sample of 3677 cancer patients from a public dataset. We used R software (R Project for Statistical Computing) and the Lavaan package to test the hypothesized relationships. RESULTS Our extension of the DMISSM to health care was supported. We found that increased privacy concerns reduce the frequency of patient access to health records use, positive attitudes toward HIE, and perceptions of patient care quality. Also, belief in the effectiveness of information security increases the frequency of patient access to health records and positive attitude toward HIE. Trust in health information had a positive association with attitudes toward HIE and perceived patient care quality. Trust in health information had no direct effect on patient access to health records; however, it had an indirect relationship through privacy concerns. CONCLUSIONS Trust in health information and belief in the effectiveness of information security safeguards increases perceptions of patient care quality. Privacy concerns reduce patients’ frequency of accessing health records, patients’ positive attitudes toward HIE exchange, and overall perceived patient care quality. Health care organizations are encouraged to implement security safeguards to increase trust, the frequency of health record use, and reduce privacy concerns, consequently increasing patient care quality.

Bridging hospital quality leadership to patient care quality

2021 ◽  
Vol 233 ◽  
pp. 108010
Author(s):  
Subhajit Chakraborty ◽  
Hale Kaynak ◽  
José A. Pagán
Keyword(s):  
Patient Care ◽  
Care Quality ◽  
Hospital Quality ◽  
Patient Care Quality

Original Investigations of Anesthetic Practice 

1997 ◽  
Vol 86 (5) ◽  
pp. 1170-1196 ◽  
Author(s):  
Mehernoor F. Watcha ◽  
Paul F. White
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Gas Flow ◽  
Health Care Cost ◽  
Care Quality ◽  
New Drugs ◽  
Recent Analysis ◽  
Clinical Practices ◽  
Anesthetic Drugs ◽  
Acquisition Costs

Anesthesiologists, like all other specialists, need to examine carefully their clinical practices so that excessive costs and waste can be reduced without compromising patient care or safety. While costs of drugs used for anesthesia constitute only a small fraction of total health care cost, they are highly visible costs which are easy for administrators to scrutinize. Although cost savings in an individual case may be small, the total savings may be impressive because of the large volume of cases performed. In a recent analysis of strategies to decrease PACU costs, Dexter and Tinker found that anesthesiologists have "little control over PACU economics via the choice of anesthetic drugs". Greater savings could be achieved by timing the arrival of patients into the PACU to reduce the peak requirement of nursing personnel. Hospital and operating room management would be better served by concentrating on these simple measures to improve efficiency rather than forcing anesthesiologists to base drug usage on acquisition costs. Even in countries that have nationalized health services, salaries make up the largest part of the costs, and the expenses in delaying an operation by 30 min exceeds the costs of a 2 h propofol infusion. It is becoming increasingly apparent that attempts at better scheduling of cases, more efficient processing of patients in the PACU to optimize admission rates, and reduced wastage of anesthetic and surgical supplies lead to greater savings than reducing anesthetic-related drug costs. Nevertheless, it is still important for anesthesiologists to participate in the ongoing effort to reduce medical costs without affecting the quality of patient care. Quality care and fiscally sound decision-making are not necessarily mutually exclusive. Simple, effective cost containment measures that all anesthesiologists can practice include using low fresh gas flow rates with inhalation agents and opening sterile packages and drug ampules only if the contents will be used. The choice of an anesthetic agent for routine use depends not only on its demonstrated efficacy and side effect profile, but also on economic factors. It is important to perform careful pharmacoeconomic evaluations of these newer drugs, including assessing all associated costs and benefits for subsets of patients undergoing different types of surgical procedures. These evaluations should also include input from patients regarding their personal preferences. Excessive emphasis on the acquisition costs of drugs may lead to blanket bans on the use of new drugs because of their higher costs rather than permitting physicians to individualize therapy according to their clinical experience and the perceived needs of a given patient. Institutional and individual variations in clinical practices, their associated costs and outcomes may alter conclusions about acceptability and economic evaluation of a particular drug or technique. The information in this review can be used to provide a rational basis for incorporating cost considerations into the decision-making process regarding the drugs, devices and techniques used in anesthesiology.

Evaluation of Ceiling Lifts in Health Care Settings

AAOHN Journal ◽  
2009 ◽  
Vol 57 (9) ◽  
pp. 374-380 ◽  
Author(s):  
Hasanat Alamgir ◽  
Olivia Wei Li ◽  
Erin Gorman ◽  
Catherine Fast ◽  
Shicheng Yu ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Pressure Ulcer ◽  
Care Facility ◽  
Care Quality ◽  
Patient Perceptions ◽  
Term Care ◽  
Health Care Settings ◽  
The Relationship

Ceiling lifts have been introduced into health care settings to reduce manual patient lifting and thus occupational injuries. Although growing evidence supports the effectiveness of ceiling lifts, a paucity of research links indicators, such as quality of patient care or patient perceptions, to the use of these transfer devices. This study explored the relationship between ceiling lift coverage rates and measures of patient care quality (e.g., incidence of facility-acquired pressure ulcers, falls, urinary infections, urinary incontinence, and assaults [patient to staff] in acute and long-term care facilities), as well as patient perceptions of satisfaction with care received while using ceiling lifts in a complex care facility. Qualitative semi-structured interviews were used to generate data. A significant inverse relationship was found between pressure ulcer rates and ceiling lift coverage; however, this effect was attenuated by year. No significant relationships existed between ceiling lift coverage and patient outcome indicators after adding the “year” variable to the model. Patients generally approved of the use of ceiling lifts and recognized many of the benefits. Ceiling lifts are not detrimental to the quality of care received by patients, and patients prefer being transferred by ceiling lifts. The relationship between ceiling lift coverage and pressure ulcer rates warrants further investigation.

The Mandate Project: Institutionalizing a System of Patient Care Quality Assurance

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 775-782
Author(s):  
Daniel S. Fleisher ◽  
Clement R. Brown ◽  
Carter Zeleznik ◽  
Gerald H. Escovitz ◽  
Charles Omdal
Keyword(s):  
Medical Education ◽  
Quality Assurance ◽  
Patient Care ◽  
Psychosocial Factors ◽  
Continuing Medical Education ◽  
Care Quality ◽  
Quality Assurance Program ◽  
Patient Care Quality

In 1970, prior to present-day requirements for quality assurance programs, a project was undertaken to institute such a program voluntarily in ten hospitals. Five hospitals succeeded in fully implementing the program which was based on the "Bi-Cycle Process" and each documented improvements in desired patient care behaviors. Two hospitals partially implemented the process and demonstrated no significant changes in desired patient care behaviors. Two hospitals failed to provide the data upon which assessments could be made and one hospital never got beyond preliminary efforts at instituting the process. The project demonstrates that a voluntary quality assurance program is feasible and has important implications for PSROs and continuing medical education. It also provides evidence that attention to psychosocial factors is essential in the institutionalization of programs designed to produce desired changes in patient care behaviors.

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