scholarly journals A scoping review of registry captured indicators for evaluating quality of critical care in ICU.

2021 ◽  
Author(s):  
Issrah Jawad ◽  
Sumayyah Rashan ◽  
Chathurani Sigera ◽  
Jorge Salluh ◽  
Arjen M Dondorp ◽  
...  
Keyword(s):  
Critical Care ◽  
Quality Indicators ◽  
Scoping Review ◽  
Health Care Quality ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Care Quality ◽  
Patient Reported

Abstract Background Excess morbidity and mortality following critical illness is increasingly attributed to potentially avoidable complications occurring as a result of complex ICU management [1–3]. Routine measurement of quality indicators through an EHR or registries are increasingly used to benchmark care and evaluate improvement interventions. However, existing Indicators of quality for intensive care are derived almost exclusively from relatively narrow subsets of ICU patients from high-income healthcare systems. The aim of this scoping review is to systematically review the literature on quality indicators (QIs) for evaluating critical care, identify QIs, map their definitions, evidence base, and describe the variances in measurement, and the reported challenges of implementation.Method We searched MEDLINE, EMBASE, CINAHL and the Cochrane libraries from the earliest available date through to January 2019. To increase sensitivity of the search, grey literature and reference lists were reviewed. Minimum inclusion criteria were a description of one or more QIs designed to evaluate care for patients in ICU captured through a registry platform- or Electronic Health Record (EHR) adapted for quality of care surveillance.Results The search identified 4780 citations. Review of abstracts led to retrieval of 276 full-text articles, of which 123 articles were accepted. 51 unique QIs in ICU were classified using the three components of health care quality proposed by the High Quality Health Systems (HQSS) framework. Adverse events including hospital acquired infections (13.7%) hospital processes (54.9%) and outcomes (31.4%) were the most common QIs identified. Patient reported outcome QIs accounted for less than 6%. Barriers to the implementation of QIs were described in 35.7% of articles and divided into operational barriers (51%) and acceptability barriers (49%).Conclusions Despite the complexity and risk associated with ICU care, there are only a small number of operational indicators used. Future selection of QIs would benefit from a stakeholder driven approach, whereby the values of patients and communities and the priorities for actionable improvement as perceived by healthcare providers are prioritised and include greater focus on measuring discriminable processes of care.

scholarly journals A scoping review of registry captured indicators for evaluating quality of critical care in ICU

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Issrah Jawad ◽  
Sumayyah Rashan ◽  
Chathurani Sigera ◽  
Jorge Salluh ◽  
Arjen M. Dondorp ◽  
...  
Keyword(s):  
Critical Care ◽  
Scoping Review ◽  
Health Care Quality ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Patient Reported Outcome ◽  
Care Quality ◽  
Patient Reported

Abstract Background Excess morbidity and mortality following critical illness is increasingly attributed to potentially avoidable complications occurring as a result of complex ICU management (Berenholtz et al., J Crit Care 17:1-2, 2002; De Vos et al., J Crit Care 22:267-74, 2007; Zimmerman J Crit Care 1:12-5, 2002). Routine measurement of quality indicators (QIs) through an Electronic Health Record (EHR) or registries are increasingly used to benchmark care and evaluate improvement interventions. However, existing indicators of quality for intensive care are derived almost exclusively from relatively narrow subsets of ICU patients from high-income healthcare systems. The aim of this scoping review is to systematically review the literature on QIs for evaluating critical care, identify QIs, map their definitions, evidence base, and describe the variances in measurement, and both the reported advantages and challenges of implementation. Method We searched MEDLINE, EMBASE, CINAHL, and the Cochrane libraries from the earliest available date through to January 2019. To increase the sensitivity of the search, grey literature and reference lists were reviewed. Minimum inclusion criteria were a description of one or more QIs designed to evaluate care for patients in ICU captured through a registry platform or EHR adapted for quality of care surveillance. Results The search identified 4780 citations. Review of abstracts led to retrieval of 276 full-text articles, of which 123 articles were accepted. Fifty-one unique QIs in ICU were classified using the three components of health care quality proposed by the High Quality Health Systems (HQSS) framework. Adverse events including hospital acquired infections (13.7%), hospital processes (54.9%), and outcomes (31.4%) were the most common QIs identified. Patient reported outcome QIs accounted for less than 6%. Barriers to the implementation of QIs were described in 35.7% of articles and divided into operational barriers (51%) and acceptability barriers (49%). Conclusions Despite the complexity and risk associated with ICU care, there are only a small number of operational indicators used. Future selection of QIs would benefit from a stakeholder-driven approach, whereby the values of patients and communities and the priorities for actionable improvement as perceived by healthcare providers are prioritized and include greater focus on measuring discriminable processes of care.

Assessment tools for palliative care.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 66-66
Author(s):  
Sarina Isenberg ◽  
Rebecca Aslakson ◽  
Sydney Morss Dy ◽  
Renee Wilson ◽  
Julie Waldfogel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Clinical Practice ◽  
Quality Indicators ◽  
Systematic Reviews ◽  
Grey Literature ◽  
Care Quality ◽  
Assessment Tools ◽  
Patient Reported

66 Background: Recent reviews have not comprehensively addressed palliative care (PC) assessment tools. This project summarizes the extent of evidence about PC assessment tools for patients and families, and how tools have been used for clinical care, quality indicators, and evaluation of interventions. Methods: We searched MEDLINE, CINAHL, and Cochrane Database of Systematic Reviews for systematic reviews of assessment tools for PC, from January 2007 to March 2016. We searched the grey literature for domains without systematic reviews, and for domains with systematic reviews > three years old. Paired investigators independently screened search results and grey literature to determine eligibility, and assessed risk of bias of systematic reviews. The team selected the most recent and highest-quality systematic reviews for each domain. One investigator abstracted information, and a second investigator checked the information. Results: Using the National Consensus Project Palliative Care Guidelines domains, we included nine systematic reviews with 167 tools, and six tools from grey literature. Most tools were in physical, psychological, psychiatric, and social aspects of care, care at the end of life, and tools that cross domains (quality of life and caregiver-reported experience). Only two tools directly addressed spiritual aspects and none addressed cultural or patient-reported experience. Internal consistency reliability was evaluated for almost all tools; most reported construct validity; and few reported responsiveness (sensitivity to change). Few studies evaluated the use of assessment tools in quality indicators or clinical practice. A systematic review of 38 PC interventions and the assessment tools used found that at least 25 interventions included physical, psychosocial and psychiatric, and quality of life tools, but the tools varied extensively, and only nine included patient experience tools. Conclusions: Although assessment tools exist in many PC domains, tools are needed to assess spiritual and cultural aspects of care, and patient-reported experience. Research is needed concerning: tools in clinical practice and quality of care; comparison of existing tools; and evaluation and dissemination tools with evidence of responsiveness.

scholarly journals Quality indicators of dental health care in Serbia

2019 ◽  
Vol 66 (1) ◽  
pp. 36-42
Author(s):  
Svetlana Jovanović ◽  
Maja Milošević ◽  
Irena Aleksić-Hajduković ◽  
Jelena Mandić
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health System ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Care Quality ◽  
System Quality ◽  
Quality Health Care ◽  
Quality Health

Summary Health care has witnessed considerable progresses toward quality improvement over the past two decades. More precisely, there have been global efforts aimed to improve this aspect of health care along with experts and decision-makers reaching the consensus that quality is one of the most significant dimensions and features of health system. Quality health care implies highly efficient resource use in order to meet patient’s needs in terms of prevention and treatment. Quality health care is provided in a safe way while meeting patients’ expectations and avoiding unnecessary losses. The mission of continuous improvement in quality of care is to achieve safe and reliable health care through mutual efforts of all the key supporters of health system to protect patients’ interests. A systematic approach to measuring the process of care through quality indicators (QIs) poses the greatest challenge to continuous quality improvement in health care. Quality indicators are quantitative indicators used for monitoring and evaluating quality of patient care and treatment, continuous professional development (CPD), maintaining waiting lists, patients and staff satisfaction, and patient safety.

Self-reported patient experience and quality of care among elderly patients with colon cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 33-33 ◽  
Author(s):  
Rebecca A Snyder ◽  
Rebecca Wardrop ◽  
Alexander Mclain ◽  
Alexander A. Parikh ◽  
Anna Cass
Keyword(s):  
Health Care ◽  
Patient Experience ◽  
Cancer Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Stage I ◽  
Stage Iii ◽  
Experience Of Care ◽  
Patient Reported

33 Background: Although studies have identified demographic and clinical factors associated with quality colorectal cancer care, the association between patient-reported experience of care and quality of care is unknown. Our primary aim was to assess the relationship between patient-reported experience of care and receipt of guideline-concordant colon cancer (CC) treatment. Methods: Fee-For-Service Medicare beneficiaries with resected stage I-III CC (2003-2013) were identified in the linked SEER registry and Consumer Assessment of Healthcare Providers and Systems patient experience survey (SEER-CAHPS) dataset. Patient-reported ratings were compared based on receipt of care consistent with recommended treatment guidelines [resection of ≥ 12 lymph nodes (LN) (stage I-III) and receipt of adjuvant chemotherapy (stage III)]. Linear regression was performed to compare mean patient experience scores by receipt of guideline concordant care, adjusting for patient and hospital factors. Results: 1010 patients with stage I-III CC were identified (mean age 76.7, SE 6.9). Of these, 58.4% of stage I (n = 192/329) and 73.4% of stage II (n = 298/406) patients underwent resection of ≥ 12 LN. Among stage III patients, 76.0% (n = 209/275) underwent resection of ≥ 12 LN and 52.4% (n = 144/275) received adjuvant chemotherapy. By multivariable analysis, patient-reported ratings of health care quality, personal and specialty physicians, customer service, physician communication, getting needed care, and getting care quickly were similar among patients who received guideline-concordant treatment compared to those who did not. However, mean ratings of overall health care quality [91.3 (SE 2.0) vs. 82.4 (SE 1.7), p = 0.0004] and getting needed care [92.8 (SE 2.4) vs. 86.8 (SE 2.0), p = 0.047] were higher among stage III patients who received guideline concordant care compared to those who did not. Conclusions: Patient-reported ratings of health care quality and ability to get needed care are associated with guideline concordant cancer care among elderly patients with stage III CC. Further investigation is needed to determine if patient-reported experience correlates with other clinical measures of quality of colorectal cancer care.

Moving specialist care into the community: An initial evaluation

2008 ◽  
Vol 13 (4) ◽  
pp. 233-239 ◽  
Author(s):  
Bonnie Sibbald ◽  
Susan Pickard ◽  
Hugh McLeod ◽  
David Reeves ◽  
Nicola Mead ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Care Quality ◽  
Service Providers ◽  
Care Quality ◽  
Local Health ◽  
Hospital Services ◽  
Specialist Care ◽  
Significant Difference ◽  
Patient Reported

Objectives: To assess the likely impact on patients and local health economies of shifting specialist care from hospitals to the community in 30 demonstration sites in England. Methods: The evaluation comprised: interviews with service providers at 30 sites, supplemented by interviews with commissioners, GPs and hospital doctors at 12 sites; economic case studies in six sites; and patient surveys at 30 sites plus at nine conventional outpatient services. Outcomes comprised: staff views of service organization and development, impact on primary and secondary care, and benefits for patients; cost per consultation and cost per patient in new services compared to estimates of the price of services if undertaken by hospitals; patients’ views of waiting time, access, quality (technical and interpersonal), coordination and satisfaction. Results: New services required high initial investment in staff, premises and equipment, and the support of hospital consultants. Most new services were added to existing hospital services so expanded capacity. Patient reported waiting times (6.7 versus 10.1 weeks; p = 0.001); technical quality of care (96.2 versus 94.5; p < 0.001), overall satisfaction (88.2 versus 85.4; p = 0.04); and access (72.2 versus 65.8; p = 0.001) were significantly better for new compared to conventional services but there was no significant difference in coordination or interpersonal quality of care. Some service providers expressed concerns about service quality. New services dealt with less complex conditions and undercut the price tariff applied to hospitals thus providing a cost saving to commissioners. There was some concern that expansion of new services might destabilize hospitals. Conclusions: Moving specialist care into the community can improve patient access, particularly when new services are added to existing hospital services. Wider impacts on health care quality, capacity and cost merit closer scrutiny before rollout.

Indicators of quality of prenatal assistance: pregnants at family’s health unit

2009 ◽  
Vol 4 (1) ◽  
pp. 212
Author(s):  
Janaiana Lemos Uchoa ◽  
Ana Amélia da Rocha Sales ◽  
Emanuella Silva Joventino ◽  
Lorena Barbosa Ximenes
Keyword(s):  
Health Care ◽  
Hepatitis B ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Care Quality ◽  
Las Mujeres ◽  
Minimum Criteria

ABSTRACT Objective: to characterize a profile of gynecoobstetric and to identify the main quality indicators of prenatal pregnant women saw in the Unidade Básica de Saúde da Família (UBASF). Methods: it’s a documentary study, retrospective and quantitative study of 38 pregnant women. A questionnaire was used with aspects of characterization and of the indicators of the Programa de Humanização no Pré-Natal e Nascimento-PHPN. Data was analyzed accord to pertinent literature. The research project has been approved by the Ethics Committee of the UNIFOR (protocol number 039/2009). Results: the majority consisted of pregnant women between the ages of 15 and 35 years old, with basic education, one partner, multiple gestations, of low weight and a vaginal childbirth. It was observed that 63.2% of the women had not initiated prenatal care until 14th week of gestation; 52.6% did not attend six or more consultation; 94.7% were immunized against tetanus; 65.8% participated in educational activities on self breast examination and 68.4% received training on breastfeeding. The majority of the pregnant did not obtain tests for hepatitis B, toxoplasmosis, HIV. Only one woman (2.6%) obtained a uterine cytopathology examination during her pregnancy period.  Conclusion: there was an inadequate prenatal care, because the minimum criteria of PHPN was not fulfilled. Descriptors: maternal and child health; prenatal care; quality of health care; primary health care; quality indicators, health care. RESUMOObjetivo: caracterizar o perfil gineco-obstétrico e identificar os principais indicadores de qualidade do pré-natal de gestantes acompanhadas em uma Unidade Básica de Saúde da Família (UBASF). Métodos: estudo documental, retrospectivo e quantitativo, com amostra de 38 gestantes. Utilizou-se um formulário abordando aspectos de caracterização da amostra e dos indicadores do Programa de Humanização no Pré-Natal e Nascimento (PHPN). O projeto de estudo foi aprovado pelo Comitê de Etica em Pesquisa da UNIFOR (número de protocolo 039/2009). Resultados: predominaram no estudo gestantes com idades entre 15 e 35 anos, Ensino Fundamental, com companheiro fixo, multigestas, com baixo peso e que tiveram parto vaginal. Em relação ao PHPN, observou-se que 63,2% das grávidas não iniciaram o pré-natal até a 14ª semana de gestação; 52,6% não realizaram seis ou mais consultas; 94,7% realizaram a imunização contra o tétano; 65,8% participaram de atividades educativas sobre o exame das mamas e 68,4% receberam orientações sobre aleitamento materno. A maioria das gestantes não realizou sorologias para hepatite B, toxoplasmose e HIV. Apenas uma mulher (2,6%) realizou o exame citopatológico de colo uterino no período gravídico. Conclusão: constatou-se uma assistência pré-natal inadequada, pois não foram cumpridos os critérios mínimos preconizados pelo PHPN. Descritores: saúde materno-infantil; cuidado pré-natal; qualidade da assistência à saúde; atenção primária à saúde; indicadores de qualidade em assistência à saúde.  RESUMEN Objetivo: caracterizar el perfil gineco-obstétrico y determinar los principales indicadores de la calidad de la atención prenatal de mujeres embarazadas atendidas en una Unidad Básica de Salud de la Familia (UBASF). Métodos: estudio documental, retrospectivo y cuantitativo, con muestras de 38 mujeres. Utiliza un instrumento sobre características y indicadores del Programa de Humanización del Prenatal y Nacimiento (PHPN). Se analizaron datos como la documentación pertinente. El estudio fue aprobó por parte del Comité de Ética de la UNIFOR (número de registro 039/2009). Resultados: Predominaron en este estudio mujeres de 15 a 35 años, con educación primaria, compañero fijo, multigravidas, bajo peso y tenían parto vaginal. Mostró que 63,2% de las mujeres embarazadas no han iniciado la atención prenatal hasta la 14ª semana de gestación; 52,6% no tenían seis o más consultas; 94,7% se sometió a la inmunización contra el tétanos; 65,8% participaron de actividades educativas sobre examen de los senos y 68,4% recibieron orientación sobre la lactancia materna. La mayoría de las mujeres no realizaron la serología para hepatitis B, toxoplasmosis y VIH. Sólo una mujer (2,6%) realizó el examen cytopathologic del cuello del útero durante el embarazo. Conclusión: Existe una inadecuada atención prenatal, ya que no han alcanzado los criterios mínimos recomendados por el PHPN. Descriptores: salud materno-infantil;  atención prenatal; calidad de la atención de salud; atención primaria de salud; indicadores de calidad de la atención de salud.   

scholarly journals Quality indicators for clinical care of patients with hypertension: scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026167
Author(s):  
Hanevi Djasri ◽  
Sekar Laras ◽  
Adi Utarini
Keyword(s):  
Quality Indicators ◽  
Scoping Review ◽  
Medical Information ◽  
Clinical Care ◽  
Research Question ◽  
Grey Literature ◽  
Healthcare Research ◽  
Health Coverage ◽  
Medical Subject Headings

IntroductionCardiovascular diseases impose significant financial impact on countries implementing universal health coverage (UHC). Hypertension is a primary disease that will lead to more severe conditions without adequate clinical care. The quality of its clinical care must be well assessed in order to measure the effective coverage of people with hypertension in UHC. This study aims to identify indicators that can be used to measure the quality of clinical care provided to patients with hypertension in healthcare facilities.Methods and analysisThis review will be conducted using the six stages of the scoping review method: identifying the research question, searching for relevant studies, selecting studies, charting the data, collating, summarising and reporting the results, and conducting consultation exercises. The review will include all quality indicators used for clinical care of patients with hypertension at any healthcare facility. All research designs will be included. Search strategies are developed using the medical subject headings and keywords related to hypertension and quality indicators. Several electronic databases, that is, MEDLINE, Cochrane, Scopus and Web of Science, including clinical-guideline databases from Agency for Healthcare Research and Quality, National Institute for Health and Care Excellence, National Health Service Evidence and Medical Information Network Distribution Service, and also grey literature will be used. Two researchers will screen the titles and abstracts and review the full text of selected articles to determine the final inclusion. The results will be summarised quantitatively, using numerical counts, and qualitatively, using thematic analysis. The data extraction will include a complete list and detailed profile of all indicators. Stakeholder consultation will be conducted at the beginning and after preliminary results to translate findings to the potential knowledge users.Ethical considerations and disseminationReviews of published articles are considered secondary analysis and do not need ethical approval. The findings will be disseminated through various strategies, such as policy briefs, conferences, peer-reviewed journals, and on selected websites relevant to the subject.Study statusData collection for the scoping review will include publications up to May 2019, and the analysis will start in June 2019.

scholarly journals Transitional care quality indicators to assess quality of care following hospitalisation for chronic obstructive pulmonary disease and heart failure: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032764
Author(s):  
Faith Michael ◽  
Sera Whitelaw ◽  
Harriette GC Van Spall
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Quality Indicators ◽  
Transitional Care ◽  
Care Quality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Patient Reported ◽  
Hospital To Home

IntroductionThe period following hospitalisation for chronic obstructive pulmonary disease (COPD) or heart failure (HF)—when patients transition between settings and clinicians—is one of high risk. Transitional care services that bridge the gap from hospital to home can improve outcomes, but there are no widely accepted indicators to assess their quality.Methods and analysisIn this systematic review, we will summarise transitional care quality indicators, and describe their associations with clinical, patient-reported and cost outcomes. We will search MEDLINE, Embase, CINAHL and HealthSTAR, as well as grey literature and reference lists of included articles. We will screen all studies published between January 1990 and October 2019 that test an intervention that aims to improve the hospital-to-home transition for patients with COPD and/or HF; and measure at least one process (eg, medication errors), clinical (eg, hospital readmissions) or patient-reported (eg, health-related quality of life) outcome which will serve as a transitional care quality indicator . We will include randomised controlled trials, cohort studies, cross-sectional studies, interrupted time series studies and before–after studies. We will extract data in duplicate and classify transitional care quality indicators as structural, process-related or outcome-related. When possible, we will assess associations between transitional care quality indicators and clinical outcomes. In anticipation of conceptual and statistical heterogeneity, we will provide a qualitative synthesis and narrative review of the results.Ethics and disseminationThis review will provide a list of transitional care quality indicators and their associations with clinical outcomes. These results can be used by hospitals, administrators and clinicians for assessing the quality of transitional care provided to patients with COPD and HF. The findings can also be used by policy-makers to assess and incentivise transitional care quality. We will disseminate results through publications, social media releases and presentations.PROSPERO registration numberThis study is registered on PROSPERO.

scholarly journals Measuring patient-centred system performance: a scoping review of patient-centred care quality indicators

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023596 ◽  
Author(s):  
Maria-Jose Santana ◽  
Sadia Ahmed ◽  
Diane Lorenzetti ◽  
Rachel J Jolley ◽  
Kimberly Manalili ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Indicators ◽  
Scoping Review ◽  
Point Of Care ◽  
Grey Literature ◽  
Healthcare Delivery ◽  
Healthcare Quality ◽  
Care Quality ◽  
Eligibility Criteria ◽  
Patient Centred Care

ObjectivesThe shift to the patient-centred care (PCC) model as a healthcare delivery paradigm calls for systematic measurement and evaluation. In an attempt to develop patient-centred quality indicators (PC-QIs), this study aimed to identify quality indicators that can be used to measure PCC.MethodsDesign: scoping review. Data Sources: studies were identified through searching seven electronic databases and the grey literature. Search terms included quality improvement, quality indicators, healthcare quality and PCC. Eligibility Criteria: articles were included if they mentioned development and/or implementation of PC-QIs. Data Extraction and Synthesis: extracted data included study characteristics (country, year of publication and type of study/article), patients’ inclusion in the development of indicators and type of patient populations and point of care if applicable (eg, in-patient, out-patient and primary care).ResultsA total 184 full-text peer-reviewed articles were assessed for eligibility for inclusion; of these, 9 articles were included in this review. From the non–peer-reviewed literature, eight documents met the criteria for inclusion in this study. This review revealed the heterogeneity describing and defining the nature of PC-QIs. Most PC-QIs were presented as PCC measures and identified as guidelines, surveys or recommendations, and therefore cannot be classified as actual PC-QIs. Out of 502 ways to measure PCC, only 25 were considered to be actual PC-QIs. None of the identified articles implemented the quality indicators in care settings.ConclusionThe identification of PC-QIs is a key first step in laying the groundwork to develop evidence-based PC-QIs. Research is needed to continue the development and implementation of PC-QIs for healthcare quality improvement.

Sign in / Sign up

Export Citation Format

Share Document