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 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.

Care for delirium superimposed on dementia at an early stage

2020 ◽  
Keyword(s):  
Behavioral Problems ◽  
Healthcare Professionals ◽  
Early Stage ◽  
Good Care ◽  
Structured Interviews ◽  
Ethical Considerations ◽  
Appropriate Care ◽  
Adequate Care ◽  
Insight Into ◽  
Delirium Superimposed On Dementia

Delirium is a common serious complication in dementia that is associated with poor prognosis and a high burden on caregivers and healthcare professionals. Appropriate care is therefore important at an early stage for patients with delirium superimposed on dementia To gain insight into the care of six patients with delirium superimposed on dementia, 19 semi-structured interviews were conducted focused on the experiences of caregivers and professionals. The interviews revealed four themes that appeared to play a role: 1. experiences with and views on behavioral problems of these patients, 2. recognition and diagnosis of delirium in dementia, 3. views on good care and 4. organizational aspects. Knowledge gaps about delirium in dementia, as well as ethical considerations, play an important role in organizing timely and adequate care for patients with delirium superimposed on dementia.

scholarly journals Defining standards in colorectal optimisation: a Delphi study protocol to achieve international consensus on key standards for colorectal surgery prehabilitation

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047235
Author(s):  
Iona Pearson ◽  
Sue Blackwell ◽  
Rebecca Fish ◽  
Sarah Daniels ◽  
Malcolm West ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Outcome Measures ◽  
Delphi Study ◽  
Public Involvement ◽  
Healthcare Professionals ◽  
Patient And Public Involvement ◽  
International Consensus ◽  
Elective Colorectal Surgery ◽  
Patient Related Outcome

IntroductionPrehabilitation in colorectal surgery is evolving and may minimise postoperative morbidity and mortality. With many different healthcare professionals contributing to the prehabilitation literature, there is significant variation in reported primary endpoints that restricts comparison. In addition, there has been limited work on patient-related outcome measures suggesting that patients with colorectal cancer needs and issues are being overlooked. The Defining Standards in Colorectal Optimisation Study aims to achieve international consensus from all stakeholders on key standards to provide a framework for reporting future prehabilitation research.Methods and analysisA systematic review will identify key standards reported in trials of prehabilitation in colorectal surgery. Standards that are important to patients will be identified by a patient and public involvement (PPI) event. The longlist of standards generated from the systematic review and PPI event will be used to develop a three-round online Delphi process. This will engage all stakeholders (healthcare professionals and patients) both nationally and internationally. The results of the Delphi will be followed by a face-to-face interactive consensus meeting that will define the final standards for prehabilitation for elective colorectal surgery.Ethics and disseminationThe University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee has approved this protocol, which is registered as a study (200190120) with the Core Outcome Measures in Effectiveness Trials Initiative. Publication of the standards developed by all stakeholders will increase the potential for comparative research that advances understanding of the clinical application of prehabilitation.PROSPERO registration numberCRD42019120381.

scholarly journals Personality disorders in older adults: expert opinion as a first step toward evaluating the criterion validity of an informant questionnaire (HAP)

2013 ◽  
Vol 26 (1) ◽  
pp. 173-174 ◽  
Author(s):  
H.P.J. Barendse ◽  
G. Rossi ◽  
S.P.J. Van Alphen
Keyword(s):  
Older Adults ◽  
Personality Disorders ◽  
Delphi Study ◽  
Elderly Population ◽  
Criterion Validity ◽  
Personality Questionnaire ◽  
Measurement Instruments ◽  
Validated Questionnaires ◽  
Dsm Iv ◽  
Research Questions

There is a lack of validated questionnaires for screening personality disorders (PDs) in older adults (e.g. Van Alphen et al., 2012). The development of measurement instruments is hampered because the criteria of DSM-IV-TR PD are not age-neutral that might lead to over- and underdiagnosis (Balsis et al., 2007). As far as we know only three measurement instruments have been specifically developed for older adults, including the Hetero- Anamnestic Personality questionnaire (HAP; Barendse et al., 2013). However, we did not find any articles concerning the criterion validity of all ten PDs in an elderly population. In this Delphi study, a panel of experts examined two research questions: (1) To what extend are the items of the HAP age-neutral? (2) Does the HAP detect all ten specific PD's of DSM-IV-TR, based on qualitative research?

scholarly journals Quality indicators for ambulatory care for older adults with diabetes and comorbid conditions: A Delphi study

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0208888 ◽  
Author(s):  
Yelena Petrosyan ◽  
Jan M. Barnsley ◽  
Kerry Kuluski ◽  
Barbara Liu ◽  
Walter P. Wodchis
Keyword(s):  
Older Adults ◽  
Ambulatory Care ◽  
Quality Indicators ◽  
Delphi Study ◽  
Comorbid Conditions

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.

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