Quality Measures to Deliver Safe, High-Quality Care on Hand Surgery Outreach Trips to Low and Middle-Income Countries

2020 ◽  
Vol 103 (8) ◽  
pp. e32
Author(s):  
Lauren M. Shapiro ◽  
Keyword(s):  
Quality Care ◽  
Hand Surgery ◽  
Quality Measures ◽  
High Quality ◽  
Middle Income ◽  
High Quality Care ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Decentralization and Regionalization: Redesigning Health Systems for High Quality Maternity Care Comment on "Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries"

2020 ◽  
Author(s):  
Sanam Roder-DeWan
Keyword(s):  
Health System ◽  
Health Systems ◽  
Maternity Care ◽  
Quality Care ◽  
Surgical Care ◽  
Maternal Complications ◽  
High Quality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

The question of how to optimally design health systems in low- and middle-income countries (LMICs) for high quality care and survival requires context-specific evidence on which level of the health system is best positioned to deliver services. Given documented poor quality of care for surgical conditions in LMICs, evidence to support intentional health system design is urgently needed. Iverson and colleagues address this very important question. This commentary explores their findings with particular attention to how they apply to maternity care. Though surgical maternity care is a common healthcare need, maternal complications are often unpredictable and require immediate surgical attention in order to avert serious morbidity or mortality. A discussion of decentralization for maternity services must grapple with this tension and differentiate between facilities that can provide emergency surgical care and those that can not.

scholarly journals Core outcome set in paediatric sepsis in low- and middle-income countries: a study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e034960
Author(s):  
Gavin Wooldridge ◽  
Srinivas Murthy ◽  
Niranjan Kissoon
Keyword(s):  
Study Protocol ◽  
Core Outcome Set ◽  
Core Outcome ◽  
High Quality ◽  
Middle Income ◽  
Ongoing Research ◽  
Middle Income Countries ◽  
Outcome Set ◽  
Low Middle Income Countries ◽  
Low And Middle Income

IntroductionSepsis is the leading cause of death in children worldwide and has recently been declared a major global health issue. New interventions and a concerted effort to enhance our understanding of sepsis are required to address the huge burden of disease, especially in low- and middle-income countries (LMIC) where it is highest. An opportunity therefore exists to ensure that ongoing research in this area is relevant to all stakeholders and is of consistently high quality. One method to address these issues is through the development of a core outcome set (COS).Methods and analysisThis study protocol outlines the phases in the development of a core outcome set for paediatric sepsis in LMIC. The first step involves performing a systematic review of all outcomes reported in the research of paediatric sepsis in low middle-income countries. A three-stage international Delphi process will then invite a broad range of participants to score each generated outcome for inclusion into the COS. This will include an initial two-step online survey and finally, a face-to-face consensus meeting where each outcome will be reviewed, voted on and ratified for inclusion into the COS.Ethics and disseminationNo core outcome sets exist for clinical trials in paediatric sepsis. This COS will serve to not only highlight the heavy burden of paediatric sepsis in this setting and aid collaboration and participation between all stakeholders, but to promote ongoing essential high quality and relevant research into the topic. A COS in paediatric sepsis in LMIC will advocate for a common language and facilitate interpretation of findings from a variety of settings. A waiver for ethics approval has been granted by University of British Columbia Children’s and Women’s Research Ethics Board.

scholarly journals Participation and Achievement in the Summer Paralympic Games: The Influence of Income, Sex, and Assistive Technology

2021 ◽  
Vol 13 (21) ◽  
pp. 11758
Author(s):  
Giulia Oggero ◽  
Louise Puli ◽  
Emma Maria Smith ◽  
Chapal Khasnabis
Keyword(s):  
Assistive Technology ◽  
Income Level ◽  
High Income ◽  
High Quality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Significant Difference ◽  
Paralympic Games ◽  
Low And Middle Income

Global participation at the Paralympic Games has been steadily growing in the past 60 years. However, inequities in relation to geographic representation of Paralympians, sex representation, access to assistive technology, and medal success remain. The objectives of this research are to describe and compare trends in Paralympians’ participation and achievements in the Summer Paralympic Games by income level and sex, including in events requiring assistive products (wheelchairs, hand cycles/trikes, and prostheses). A retrospective secondary analysis of publicly available data was conducted. Participation, sex, and medal tally data were extracted from data available on the International Paralympic Committee website and archives. Data regarding income and population were collected from publicly available data available from the World Bank website. Participation in the Summer Paralympic Games differs significantly by income level (p = 0.000) with high- income countries sending, on average, more Paralympians than low- and middle-income countries. There is a significant difference between male and female participation (p = 0.00), with approximately 29% of all Paralympians being female. High-income countries demonstrate significantly higher achievement than low- and middle-income countries (p = 0.000), including in events requiring assistive products (p = 0.007). Despite growth in overall participation, low- and middle-income countries remain severely underrepresented in both participation and achievement at the Paralympic Games, especially in the events that require high quality assistive products to succeed. More equitable participation and achievement in the Paralympics may be supported by addressing the barriers for females, for people from low- and low-middle income countries, and for those without access to high quality assistive products required.

scholarly journals In Low- And Middle-Income Countries, Is Delivery In High-Quality Obstetric Facilities Geographically Feasible?

2019 ◽  
Vol 38 (9) ◽  
pp. 1576-1584 ◽  
Author(s):  
Anna D. Gage ◽  
Fei Carnes ◽  
Jeff Blossom ◽  
Jalemba Aluvaala ◽  
Archana Amatya ◽  
...  
Keyword(s):  
High Quality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Effect of Disability on High Quality of Life among Older Adults in Low and Middle-income Countries

2021 ◽  
Author(s):  
Mohammad Hifz Ur Rahman ◽  
Shobhit Srivastava ◽  
Pradeep Kumar ◽  
Ashish Singh ◽  
Deepak Gupta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
High Quality ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

The role of ACOs in accelerating high-quality care: Implications for prostate cancer.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 151-151
Author(s):  
Grant Picarillo ◽  
Natasha Jivani ◽  
Colin Nash ◽  
Kristi Mitchell
Keyword(s):  
Prostate Cancer ◽  
Quality Improvement ◽  
Cancer Care ◽  
Quality Care ◽  
Quality Measures ◽  
Coordination Of Care ◽  
High Quality ◽  
High Quality Care ◽  
Potential Impact ◽  
Shared Savings

151 Background: Accountable Care Organizations (ACOs) seek to promote high quality, coordinated care by eliminating unnecessary procedures, sharing clinical information, and meeting quality targets. Of the 65 proposed quality measures outlined in the Medicare Shared Savings Program (MSSP), only two relate specifically to cancer care, calling into question how such models will accelerate high quality care in oncology. Prostate cancer offers an insightful case study as it is characterized by a lack of consensus around diagnosis and treatment and the involvement of several providers throughout the care continuum. Methods: As part of a multi-layered analysis to evaluate the impact of the ACO model on quality improvement and the management and treatment of prostate cancer, Avalere examined recent legislation (e.g., the Affordable Care Act, MSSP) to identify key characteristics of the model. Avalere then reviewed the potential impact of these characteristics in oncology by examining clinical guidelines and reviewing public statements by key opinion leaders. After identifying gaps specifically related to prostate cancer, Avalere categorized the characteristics into three groups based on their potential impact on prostate cancer care: high, moderate, and low. Results: Our analysis yielded the following categorization of the ACO characteristics: High Impact: Streamlined coordination of care between facilities and providers Focus on high-risk, high-cost populations Moderate Impact: Emphasis on preventative health Standardized use of outcomes-based quality measures Low Impact: Improved medication continuity Chronic disease management Shared savings incentives Conclusions: As providers involved in prostate cancer care explore the ACO concept, it will be critical to identify the characteristics with the greatest potential to improve the quality and coordination of care, and to incorporate these characteristics into the guideline recommendations influencing the standard of care. Our research indicates that prostate cancer guidelines should emphasize the low quality and high cost of fragmented care in this patient population and develop recommendations on proven methods of care coordination and quality improvement.

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