scholarly journals Capturing the complexity of healthcare for people with Down syndrome in quality indicators - a Delphi study involving healthcare professionals and patient organisations

2019 ◽  
Author(s):  
Francine A. van den Driessen Mareeuw ◽  
Antonia M.W. Coppus ◽  
Diana M.J. Delnoij ◽  
Esther de Vries
Keyword(s):  
Down Syndrome ◽  
Quality Indicators ◽  
Delphi Study ◽  
Healthcare Professionals ◽  
Relevant Information ◽  
Quality Of Healthcare ◽  
Measurement Instruments ◽  
Patient Organisations ◽  
Insight Into

Abstract Background Insight into quality of healthcare for people with Down Syndrome (DS) is limited. Quality indicators (QIs) can provide this insight. This study aims to find consensus among participants regarding QIs for healthcare for people with DS.Methods We conducted a four-round Delphi study, in which 33 healthcare professionals involved in healthcare for people with DS and two patient organisations’ representatives in the Netherlands participated. Median and 75-percentiles were used to determine consensus among the answers on 5-point Likert-scales. In each round, participants received an overview of participants’ answers from the previous round.Results Participants agreed (consensus was achieved) that a QI-set should provide insight into available healthcare, enable healthcare improvements, and cover a large diversity of quality domains and healthcare disciplines. However, the number of QIs in the set should be limited in order to prevent registration burden. Participants were concerned that QIs would make quality information about individual healthcare professionals publicly available, which would induce judgement of healthcare professionals and harm quality, instead of improving it.Conclusions We unravelled the complexity of capturing healthcare for people with DS in a QI-set. Patients’ rights to relevant information have to be carefully balanced against providers’ entitlement to a safe environment in which they can learn and improve. A QI-set should be tailored to different healthcare disciplines and information systems, and measurement instruments should be suitable for collecting information from people with DS. Results from this study and two preceding studies, will form the basis for the further development of a QI-set.

scholarly journals Capturing the complexity of healthcare for people with Down syndrome in quality indicators - a Delphi study involving healthcare professionals and patient organisations

2020 ◽  
Author(s):  
Francine A. van den Driessen Mareeuw ◽  
Antonia M.W. Coppus ◽  
Diana M.J. Delnoij ◽  
Esther de Vries
Keyword(s):  
Down Syndrome ◽  
Quality Indicators ◽  
Delphi Study ◽  
Healthcare Professionals ◽  
Relevant Information ◽  
Quality Of Healthcare ◽  
Measurement Instruments ◽  
Patient Organisations ◽  
Previous Round ◽  
Insight Into

Abstract Background: Insight into quality of healthcare for people with Down Syndrome (DS) is limited. Quality indicators (QIs) can provide this insight. This study aims to find consensus among participants regarding QIs for healthcare for people with DS.Methods: We conducted a four-round Delphi study, in which 33 healthcare professionals involved in healthcare for people with DS and two patient organisations’ representatives in the Netherlands participated. Median and 75-percentiles were used to determine consensus among the answers on 5-point Likert-scales. In each round, participants received an overview of participants’ answers from the previous round.Results: Participants agreed (consensus was achieved) that a QI-set should provide insight into available healthcare, enable healthcare improvements, and cover a large diversity of quality domains and healthcare disciplines. However, the number of QIs in the set should be limited in order to prevent registration burden. Participants were concerned that QIs would make quality information about individual healthcare professionals publicly available, which would induce judgement of healthcare professionals and harm quality, instead of improving it. Conclusions: We unravelled the complexity of capturing healthcare for people with DS in a QI-set. Patients’ rights to relevant information have to be carefully balanced against providers’ entitlement to a safe environment in which they can learn and improve. A QI-set should be tailored to different healthcare disciplines and information systems, and measurement instruments should be suitable for collecting information from people with DS. Results from this study and two preceding studies, will form the basis for the further development of a QI-set.

scholarly journals Capturing the complexity of healthcare for people with Down syndrome in quality indicators - a Delphi study involving healthcare professionals and patient organisations

2020 ◽  
Author(s):  
Francine A. van den Driessen Mareeuw ◽  
Antonia M.W. Coppus ◽  
Diana M.J. Delnoij ◽  
Esther de Vries
Keyword(s):  
Down Syndrome ◽  
Quality Indicators ◽  
Delphi Study ◽  
Healthcare Professionals ◽  
Relevant Information ◽  
Quality Of Healthcare ◽  
Measurement Instruments ◽  
Patient Organisations ◽  
Previous Round ◽  
Insight Into

Abstract Background: Insight into quality of healthcare for people with Down Syndrome (DS) is limited. Quality indicators (QIs) can provide this insight. This study aims to find consensus among participants regarding QIs for healthcare for people with DS. Methods: We conducted a four-round Delphi study, in which 33 healthcare professionals involved in healthcare for people with DS and two patient organisations’ representatives in the Netherlands participated. Median and 75-percentiles were used to determine consensus among the answers on 5-point Likert-scales. In each round, participants received an overview of participants’ answers from the previous round. Results: Participants agreed (consensus was achieved) that a QI-set should provide insight into available healthcare, enable healthcare improvements, and cover a large diversity of quality domains and healthcare disciplines. However, the number of QIs in the set should be limited in order to prevent registration burden. Participants were concerned that QIs would make quality information about individual healthcare professionals publicly available, which would induce judgement of healthcare professionals and harm quality, instead of improving it. Conclusions: We unravelled the complexity of capturing healthcare for people with DS in a QI-set. Patients’ rights to relevant information have to be carefully balanced against providers’ entitlement to a safe environment in which they can learn and improve. A QI-set should be tailored to different healthcare disciplines and information systems, and measurement instruments should be suitable for collecting information from people with DS. Results from this study and two preceding studies, will form the basis for the further development of a QI-set.

scholarly journals Quantity and Quality of Healthcare Professionals, Transfer Delay and In-Hospital Mortality Among ST-Segment Elevation Myocardial Infarction: A Mixed-Method Cross-Sectional Study of 89 Emergency Medical Stations in China

2021 ◽  
Author(s):  
Qiang Zhou ◽  
Wenya Tian ◽  
Rengyu Wu ◽  
Chongzhen Qin ◽  
Hongjuan Zhang ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Healthcare Professionals ◽  
Quality Of Healthcare ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
St Segment Elevation ◽  
Transfer Delay ◽  
Emergency Medical ◽  
St Segment

Abstract Background Transfer delay provokes prolongation of prehospital time, which contributes to treatment delay that endangers patients with ST-segment elevation myocardial infarction (STEMI). A key constraint in reducing transfer delay is the shortage of emergency healthcare workers. This study was to explore the influence of the quality and quantity of healthcare professionals at emergency medical stations on transfer delay and in-hospital mortality among STEMI patients. Methods A cross-sectional study using mixed methods was conducted at 89 emergency stations in 9 districts in China’s Shenzhen province. Based on a sample of 31 hospitals, 1255 healthcare professionals, and 3131 patients with STEMI, a generalized linear model was used to explore the associations between the quality and quantity of healthcare professionals and transfer delay and in-hospital mortality among STEMI patients. Qualitative data were collected and analyzed to explore the reasons for the lack of qualified healthcare professionals at emergency medical stations. Results The analysis of the quantity of healthcare professionals showed that an increase of one physician per 100,000 individuals was associated with decreased transfer delay for patients with STEMI by 5.087 min (95% CI − 6.722, − 3.452; P < 0.001). An increase of one nurse per 100,000 individuals was associated with decreased transfer delay by 1.471 min (95% CI − 2.943, 0.002; P = 0.050). Analysis of the quality of healthcare professionals showed that an increase of one physician with an undergraduate degree per 100,000 individuals was associated with decreased transfer delay for patients with STEMI by 8.508 min (95% CI − 10.457, − 6.558; P < 0.001). An increase of one nurse with an undergraduate degree per 100,000 individuals was associated with decreased transfer delay by 6.645 min (95% CI − 8.218, − 5.072; P < 0.001). Qualitative analysis illustrated that the main reasons for low satisfaction of healthcare professionals at emergency medical stations included low income, limited promotion opportunities, and poor working environment. Conclusions The quantity and quality of emergency healthcare professionals are key factors influencing transfer delay in STEMI patients. The government should increase the quantity of healthcare professionals at emergency medical stations, strengthen the training, and improve their performance by linking with clinical pathways to enhance job enthusiasm among emergency healthcare professionals.

scholarly journals The Value of Abstraction

2019 ◽  
Author(s):  
Mark K Ho ◽  
David Abel ◽  
Tom Griffiths ◽  
Michael L. Littman
Keyword(s):  
Problem Solving ◽  
Relevant Information ◽  
Scaling Up ◽  
Limited Resources ◽  
Abstract Representations ◽  
Learning Research ◽  
Crucial Ingredient ◽  
Insight Into ◽  
Shed Light

Agents that can make better use of computation, experience, time, and memory can solve a greater range of problems more effectively. A crucial ingredient for managing such finite resources is intelligently chosen abstract representations. But, how do abstractions facilitate problem solving under limited resources? What makes an abstraction useful? To answer such questions, we review several trends in recent reinforcement-learning research that provide insight into how abstractions interact with learning and decision making. During learning, abstraction can guide exploration and generalization as well as facilitate efficient tradeoffs---e.g., time spent learning versus the quality of a solution. During computation, good abstractions provide simplified models for computation while also preserving relevant information about decision-theoretic quantities. These features of abstraction are not only key for scaling up artificial problem solving, but can also shed light on what pressures shape the use of abstract representations in humans and other organisms.

scholarly journals Dissonant roles: the experience of Maori in cancer care.

2020 ◽  
Author(s):  
Kevin Dew ◽  
L Signal ◽  
C Davies ◽  
T Huia ◽  
C Hooper ◽  
...  
Keyword(s):  
Survival Rates ◽  
Quality Of Healthcare ◽  
Sick Role ◽  
Membership Categorization Analysis ◽  
Care Access ◽  
Aotearoa New Zealand ◽  
Membership Categorization ◽  
Alternative Approaches ◽  
Insight Into

© 2015 Elsevier Ltd. Indigenous peoples have poorer health outcomes than their non-indigenous counterparts and this applies to cancer outcomes for Maori in Aotearoa/New Zealand. Differential access to and quality of healthcare contributes to poorer survival rates for Maori. This research provides insight into some of the mechanisms that hinder and facilitate care access. Thirty four people who had undergone cancer treatment (19Maori and 15 non-Maori) were interviewed by two Maori researchers. The analysis of the interview transcripts was informed by membership categorization analysis. This form of analysis attends to the categories that are used and the activities and characteristics associated with those categories. From this analysis it is argued that the classical patient role, or sick role, inadequately captures the kind of role that some Maori take in relation to their healthcare. Maori can also have culturally specific family (whanau) influences and a greater draw towards alternative approaches to healthcare. Dissonant roles contribute to a different experience for Maori. A better understanding of the categories and roles that are relevant to those who have cancer provides opportunities to attenuate the monocultural impacts of healthcare.

An Android-Enabled PHR-based System for the Provision of Homecare Services

2013 ◽  
Vol 3 (2) ◽  
pp. 1-18 ◽  
Author(s):  
Vassiliki Koufi ◽  
Flora Malamateniou ◽  
George Vassilacopoulos
Keyword(s):  
Healthcare Professionals ◽  
Point Of Care ◽  
Treatment Plan ◽  
Personal Health Record ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Appropriate Treatment ◽  
Treatment Plans ◽  
The Continuum

Homecare is an important component of the continuum of care as it provides the potential to improve quality of life and quality of healthcare delivery while containing costs. Personal Health Record (PHR) systems are intended to reach patients outside of care settings and influence their behaviors thus allowing for more effective homecare services. To this end, these systems need to evolve well beyond providing a consolidated patient record, in ways that make it more widely applicable and valuable to health systems. The development of applications on top of PHR systems can allow them to function as a platform for both patients and healthcare professionals to exchange information and interact with the health system. This paper presents a prototype PHR-based system that aims at supporting chronic disease management at any point of care or decision making through familiar environments such as Google’s Android. In particular, it assists healthcare professionals in assessing an individual’s condition and in forming the appropriate treatment plan for him/her while it provides individuals with step-to-step guidance to their treatment plans.

scholarly journals Communication and access to information in assessing the quality of multiprofessional care of patients

2010 ◽  
Vol 8 (3) ◽  
pp. 303-307
Author(s):  
Leny Vieira Cavalheiro ◽  
Paola Bruno de Araújo Andreoli ◽  
Nadia Sueli de Medeiros ◽  
Telma de Almeida Busch Mendes ◽  
Roselaine Oliveira ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Healthcare Professionals ◽  
Clinical Information ◽  
Relevant Information ◽  
Cross Sectional Study ◽  
Model Group ◽  
Cross Sectional ◽  
Multiprofessional Team ◽  
Under Performing

ABSTRACT Objective: To assess the quality of a multiprofessional healthcare model for in-hospital patients by means of two performance indicators (communication and knowledge about the case). Methods: A cross-sectional study assessed the knowledge that professionals had about the clinical information of patients and the use of communication strategies by the team. Healthcare professionals were interviewed during their work period. Seven occupational categories were interviewed. A total of 199 medical charts were randomly selected for interviews, and 312 professionals of different categories were interviewed. The sample comprised mostly nurses and physical therapists in the charts that were interviewed. Results: There were no statistically significant differences between the expected performing model group and the under-performing model group for sex, location and job. In the under-performing model group, a larger number of professionals correlated with less knowledge. Communication was improved when nurses had the relevant information about interdisciplinary care (97.4%), appropriate use of the Plan of Care form (97.0%), and formalized discussions with physicians (88.2%). In the expected performing model group, it was observed that the higher the number of healthcare professionals involved, the higher the communication levels. Conclusions: This model of care based on case knowledge and multiprofessional team communication performance indices allowed to assess quality of care. This assessment is measurable and there is the possibility of establishing the quality of care delivered.

scholarly journals Leveraging massive open online courses to expand quality of healthcare education to health practitioners in Rwanda

2019 ◽  
Vol 8 (4) ◽  
pp. e000532 ◽  
Author(s):  
Kirstin Woody Scott ◽  
Theophile Dushime ◽  
Vincent Rusanganwa ◽  
Liana Woskie ◽  
Clint Attebery ◽  
...  
Keyword(s):  
Patient Safety ◽  
Global Health ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Lessons Learned ◽  
Online Course ◽  
Massive Open Online ◽  
District Hospitals

Improving the quality of healthcare delivery is increasingly a global health priority. However, quality improvement training opportunities that provide theoretical foundations and basic skills for patient safety and other quality initiatives have been limited or historically out of reach, especially in low-and-middle income countries (LMICs). To address this gap, the Harvard Initiative on Global Health Quality (HIGHQ) created and launched a massive open online course (MOOC) in 2014 focused on patient safety and quality of care using the edX platform. More than 30 000 students from across 195 countries registered for the online course. This paper summarises an innovative educational partnership between the course team and one of these countries, Rwanda, to develop a blended-learning model to bolster participation in this new course among Rwandan healthcare professionals. Although a small country, Rwanda was among the top performing countries for attracting course registrants and was the leading country for the proportion of enrollees who ultimately completed the course. Further, half (21 of 42) of Rwanda’s district hospitals opted to appoint a PH555x course facilitator at their site to help lead regular meetings and discussions about the course content at their facility. The majority of Rwandan enrollees were health professionals (63%) and 81% reported that PH555x was their first experience taking an online course. Among those participating in the ‘flipped’ component at hospital sites, 94% reported that the course helped them to think of specific ways to improve healthcare quality at their facility. In this paper, we describe this innovative public–private educational model, challenges to implementation and lessons learned that may be helpful for future MOOC developers who wish to augment learning opportunities among healthcare professionals in LMICs.

scholarly journals COSMIN Risk of Bias tool to assess the quality of studies on reliability or measurement error of outcome measurement instruments: a Delphi study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
L. B. Mokkink ◽  
M. Boers ◽  
C. P. M. van der Vleuten ◽  
L. M. Bouter ◽  
J. Alonso ◽  
...  
Keyword(s):  
Measurement Error ◽  
Delphi Study ◽  
Outcome Measurement ◽  
Research Question ◽  
Measurement Instrument ◽  
Measurement Properties ◽  
Measurement Instruments ◽  
Sources Of Variation ◽  
The Impact

Abstract Background Scores on an outcome measurement instrument depend on the type and settings of the instrument used, how instructions are given to patients, how professionals administer and score the instrument, etc. The impact of all these sources of variation on scores can be assessed in studies on reliability and measurement error, if properly designed and analyzed. The aim of this study was to develop standards to assess the quality of studies on reliability and measurement error of clinician-reported outcome measurement instruments, performance-based outcome measurement instrument, and laboratory values. Methods We conducted a 3-round Delphi study involving 52 panelists. Results Consensus was reached on how a comprehensive research question can be deduced from the design of a reliability study to determine how the results of a study inform us about the quality of the outcome measurement instrument at issue. Consensus was reached on components of outcome measurement instruments, i.e. the potential sources of variation. Next, we reached consensus on standards on design requirements (n = 5), standards on preferred statistical methods for reliability (n = 3) and measurement error (n = 2), and their ratings on a four-point scale. There was one term for a component and one rating of one standard on which no consensus was reached, and therefore required a decision by the steering committee. Conclusion We developed a tool that enables researchers with and without thorough knowledge on measurement properties to assess the quality of a study on reliability and measurement error of outcome measurement instruments.

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