scholarly journals Person-centred Quality, Provider Involvement and Family Planning Continuation in India

2020 ◽  
Author(s):  
Nadia Diamond-Smith ◽  
Beth Phillips ◽  
Patience Afulani ◽  
Aradhana Srivast ◽  
Ginger Golub ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Quality Measures ◽  
Power Dynamics ◽  
Care Experience ◽  
Person Centered Care ◽  
Centered Care ◽  
And Gender ◽  
The Impact

Abstract Background: Quality of care of family planning provision has many dimensions, and measuring and understanding these different components is challenging. Furthermore, understanding which components are most important for women’s experiences and method continuation is essential for improving the quality of care provision. Methods: We use longitudinal data from India to explore the impact of different measures of quality (provider preference, provider involvement, and a newly developed scale of person-centered care experiences) on method continuation. We also look at associations between the quality measures and discuss why different measures may be more salient in different contexts. Results: We find that a woman’s person-centered care experience is not associated with continuation in India. Providers having a strong preference is associated with continuation. Conclusions: Certain measures of person-centered quality appear to impact family planning continuation, but the validated person-centered care measure is not. Socio-cultural factors such as power dynamics and gender norms likely impact expectations, and need to be considered in interpreting and choosing quality measures.

scholarly journals Person-Centred Quality, Provider Involvement and Family Planning Continuation in India

2020 ◽  
Author(s):  
Nadia Diamond-Smith ◽  
Beth Phillips ◽  
Patience Afulani ◽  
Aradhana Srivast ◽  
Ginger Golub ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Uttar Pradesh ◽  
Power Dynamics ◽  
Care Experience ◽  
Person Centered Care ◽  
Centered Care ◽  
Secondary Objective ◽  
And Gender

Abstract Background: Quality of care of family planning provision has many dimensions, including those related to a woman’s experience, or person-centered care, and measuring and understanding these different components is challenging. Understanding which components are most important for women’s experiences and method continuation is essential for improving the quality of care provision. The objective of this paper is to explore weather a recently developed scale to measure person-centered family planning experiences is associated with method continuation in India. The secondary objective is to compare this scale to other commonly used measures of quality, and if other measures are more associated with continuation. Methods: We use longitudinal data collected from women in Uttar Pradesh, India (N=225 at baseline, N=179 6 weeks later) to explore the association between different measures of quality (provider preference, provider involvement, and a newly developed scale of person-centered care experiences) and method continuation. Results: We find that a woman’s person-centered care experience is not associated with continuation in this population in India. Providers having a strong method preference is associated with continuation. Conclusion: Certain measures of person-centered quality appear to impact family planning continuation, but the validated person-centered care measure is not. Socio-cultural factors such as power dynamics and gender norms likely impact expectations, and need to be considered in interpreting and choosing quality measures.

THE IMPACT OF DEMAND FACTORS, QUALITY OF CARE AND ACCESS TO FACILITIES ON CONTRACEPTIVE USE IN TANZANIA

2005 ◽  
Vol 39 (1) ◽  
pp. 1-26 ◽  
Author(s):  
MARY ARENDS-KUENNING ◽  
FLORA L. KESSY
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Cultural Values ◽  
Contraceptive Use ◽  
Data Sets ◽  
Demand Side ◽  
Family Planning Services ◽  
Unmet Demand ◽  
The Impact

The low contraceptive prevalence rate and the existence of unmet demand for family planning services present a challenge for parties involved in family planning research in Tanzania. The observed situation has been explained by the demand-side variables such as socioeconomic characteristics and cultural values that maintain the demand for large families. A small, but growing body of research is examining the effect of supply-side factors such as quality of care of family planning services on the demand for contraceptives. This paper analyses the demand and supply factors determining contraceptive use in Tanzania using the Tanzania Service Availability Survey (1996) and the Tanzania Demographic and Health Survey (1996) data sets. The results show that access to family planning services and quality of care of services are important determinants of contraceptive use in Tanzania even after controlling for demand-side factors.

Medical Staffing Organization and Quality of Care Outcomes in Post-acute Care Settings

2020 ◽  
Author(s):  
Laura M Wagner ◽  
Paul Katz ◽  
Jurgis Karuza ◽  
Connie Kwong ◽  
Lori Sharp ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Acute Care ◽  
Quality Measures ◽  
Medical Providers ◽  
Medical Provider ◽  
Provider Characteristics ◽  
The Impact

Abstract Background and Objectives Medical providers are significant drivers of care in post-acute long-term care (PALTC) settings, yet little research has examined the medical provider workforce and its role in ensuring quality of care. Research Design and Methods This study examined the impact of nursing home medical staffing organization (NHMSO) dimensions on the quality of care in U.S. nursing homes. The principal data source was a survey specifically designed to study medical staff organization for post-acute care. Respondents were medical directors and attending physicians providing PALTC. We linked a number of medical provider and nursing home characteristics to the Centers for Medicaid and Medicare Services Nursing Home Compare quality measures hypothesized to be sensitive to input by medical providers. Results From the sample of nursing home medical providers surveyed (n = 1,511), 560 responses were received, yielding a 37% response rate; 425 medical provider responses contained sufficient data for analysis. The results of the impact of NHMSO dimensions were mixed, with many domains not having any significance or having negative relationships between provider characteristics and quality measures. Respondents who reported having a formal process for granting privileges and nursing homes with direct employment of physicians reported significantly fewer emergency visits. Discussion and Implications Further research is needed regarding what quality measures are sensitive to both medical provider characteristics and NHMSO characteristics.

scholarly journals VALIDATING THE CARE PREFERENCE ASSESSMENT OF SATISFACTION TOOL TO MEASURE QUALITY OF CARE IN NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S885-S885
Author(s):  
Caroline Madrigal ◽  
Kimberly VanHaitsma ◽  
Jacqueline Mogle ◽  
Donna Fick ◽  
Dennis Scanlon ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Care Delivery ◽  
Preference Assessment ◽  
Policy Makers ◽  
Care Experience ◽  
Resident Care ◽  
Centered Care ◽  
Study Support ◽  
Minimum Dataset

Abstract The Institute for Healthcare Improvement’s Triple Aim calls for measures of the ‘patient care experience’ to understand and improve the quality of care delivery. But, quality measures in the nursing home (NH) historically lack the resident perspective. Measuring whether residents are satisfied with the fulfillment of their care preferences using the Care Preference Assessment of Satisfaction Tool (ComPASS) has been encouraged nationally by the Centers for Medicare and Medicaid (CMS); however, the ComPASS has not been validated as a measure of the resident care experience. The purpose of this study was to compare ComPASS to the Ohio NH Resident Satisfaction Survey (a widely accepted quality measure for reimbursement). We examined 196 resident responses from 28 NHs in Pennsylvania using multilevel modeling to account for dependencies in the data (residents in the same NH may respond similarly compared to residents from different NHs). Residents were 81.2 years old (SD= 11.1), female (70.4%), and white (80.1%). Residents with higher scores on the ComPASS reported significantly higher levels of satisfaction with care (B=2.94, SE B=0.59, p<0.000). Results from this study support the potential use of ComPASS to measure, track, and improve the quality of NH care. Using ComPASS aligns with CMS’s Section F of the Minimum Dataset, an assessment of residents’ preferences which promotes the delivery of more person-centered care. Ultimately, ComPASS can help benchmark the quality of the resident care experience across facilities which aids staff, facilities, policy-makers, and NH-shoppers in improving decision-making and care delivery.

scholarly journals Validation and psychometric evaluation of the Dutch Person-centred care of Older People with cognitive impairment in Acute Care (POPAC)

2020 ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie Roodbol
Keyword(s):  
Factor Analysis ◽  
Cognitive Impairment ◽  
Quality Of Care ◽  
Confirmatory Factor Analysis ◽  
Acute Care ◽  
Mean Square ◽  
Person Centered Care ◽  
Confirmatory Factor ◽  
Centered Care

Abstract Background: Person-centered care is the preferred model for caring for people with dementia. Knowledge of the level of person-centered care is essential for improving the quality of care for patients with dementia. The Person-centred care of Older People with cognitive impairment in Acute Care scale (POPAC) is a tool to determine the level of person-centered care. This study aimed to translate and validate the Dutch POPAC and evaluate its psychometric properties to enable international comparison of data and outcomes.Methods: After double-blinded forward and backward translations, a total of 159 nurses recruited from six hospitals (114) and via social media (45) completed the POPAC. By performing confirmatory factor analysis, the construct validity was tested. Cronbach’s alpha scale was utilized to establish the internal consistency.Results: The confirmatory factor analysis showed that the Confirmatory Fit Index (0.89) was slightly smaller than the cut-off value of 0.9. The Root Mean Square Error of Approximation (0.075, p=0.012, CI 0.057-0.092) and the Standardized Root Mean Square Residual (0.063) were acceptable with values less than 0.08. Findings confirm a three-dimensional structure. The loadings of the items (0.69-0.77) indicate that these are strong associated with each of the factors. This study confirms that deleting Item 5 improves the Cronbach’s alpha of the instrument as well as of the subscale. Instead of deleting this item, we suggest considering rephrasing it into a positive item.Conclusions: Our findings suggest that the Dutch POPAC is sufficiently valid and reliable and can be utilized for assessing person-centered care in acute care hospitals. The study enables nurses to interpret and compare person-centered care levels in wards and hospital levels between regions and countries. The results form an important basis for improving the quality of care and nurse-sensitive outcomes, such as preventing complications and hospital stay length.

Nurse–Patient Connectedness and Nurses’ Professional Quality of Life: Experiences of Volunteering at a Pediatric Oncology Camp

2019 ◽  
Vol 37 (2) ◽  
pp. 136-147 ◽  
Author(s):  
Brooke Cherven ◽  
Dorothy Jordan ◽  
Sally Hale ◽  
Martha Wetzel ◽  
Curtis Travers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pediatric Oncology ◽  
Odds Ratio ◽  
Oncology Nurses ◽  
Professional Quality Of Life ◽  
Person Centered Care ◽  
Professional Quality ◽  
Centered Care ◽  
The Impact

Objective: Pediatric oncology nurses can experience burnout, vicarious traumatization, and compassion fatigue related to the unique stressors of their profession. Opportunities to enhance nurses’ professional commitment and nurse–patient connectedness may mitigate these stressors. This study explored the impact of volunteering at a local oncology camp on pediatric oncology nurses’ professional quality of life and connectedness with their oncology patients. Method and Sample: Pediatric oncology nurses from a single institution were invited to participate in this mixed methods study. Participants completed a survey assessing professional quality of life, professional commitment, and patient connectedness. Nurses who had oncology camp volunteer experience were invited to participate in a qualitative interview. Results: Compared with noncamp nurses ( n = 23), camp nurses ( n = 25) had increased odds of a low burnout score (odds ratio = 6.74, 95% confidence interval [1.10, 41.43], p = .039) and increased odds of a high compassion satisfaction score (odds ratio = 4.69, 95% confidence interval [1.14, 19.32], p = .033). Qualitative interviews supported the impact of volunteering at camp on nurses’ personal and professional perspective, nursing practice, and delivery of person-centered care. Conclusion: Volunteering at a pediatric oncology camp provided nurses the opportunity to engage with patients, share experiences, and view patients as individuals while still maintaining professional boundaries. Nurses who volunteer at camp described a perspective moving beyond patient-centered to person-centered care, and for some pediatric oncology nurses, camp volunteering may be a novel way to mitigate burnout and an important tool to enhance resiliency.

scholarly journals Quality of care at safety-net hospitals and the impact on pay-for-performance reimbursement

2019 ◽  
Author(s):  
Reith R. Sarkar ◽  
Patrick T. Courtney ◽  
Katie Bachand ◽  
Paige Sheridan ◽  
Paul Riviere ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Cancer Patients ◽  
Low Income ◽  
Pay For Performance ◽  
Young Male ◽  
Quality Measures ◽  
Safety Net ◽  
High Burden ◽  
The Impact

AbstractBackgroundPay-for-performance reimbursement ties hospital payments to standardized quality of care metrics. The impact of pay-for-performance reimbursement models on safety-net hospitals, which care primarily for uninsured or underinsured patients, remains poorly defined. This study evaluates how standardized quality of care metrics vary by a hospital’s safety-net status, and helps us better understand the potential impact that pay-for-performance reimbursement could have on funding of safety-net hospitals.MethodsWe identified 1,703,865 bladder, breast, cervix, colon, endometrium, gastric, lung, ovary, or rectum cancer patients treated at 1,344 hospitals diagnosed between 2004 and 2015. Safety-net burden was defined for each hospital as the percentage of uninsured or Medicaid patients cared for by that hospital. Hospitals were grouped into low-, medium-, and high-burden hospitals. We evaluated the impact of safety-net burden on concordance with 20 standardized quality of care measures, adjusting for differences in patient age, gender, stage at diagnosis, and comorbidity.ResultsPatients seen at high-burden hospitals were more likely to be young, male, black, Hispanic, and to reside in a low-income and low-educated region. High-burden hospitals had lower adherence to 13 of 20 quality measures compared to low-burden hospitals (all p<0.05). Among the 350 high-burden hospitals, the quality measures were lowest for those caring for the highest fraction of uninsured or Medicaid patients, minority serving hospitals, and those caring for less educated patients (all p<0.001).DiscussionCancer care at safety-net hospitals was associated with lower concordance to standardized quality of care measures. Under a pay-for-performance reimbursement model these lower quality of care scores could decrease payments to safety-net hospitals, potentially increasing health disparities for at-risk cancer patients.

scholarly journals Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity

2017 ◽  
Vol 1 ◽  
pp. 1 ◽  
Author(s):  
May Sudhinaraset ◽  
Patience Afulani ◽  
Nadia Diamond-Smith ◽  
Sanghita Bhattacharyya ◽  
France Donnay ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Reproductive Health ◽  
Health Equity ◽  
Reproductive Health Care ◽  
Person Centered Care ◽  
Centered Care ◽  
Women’S Reproductive Health ◽  
Women's Reproductive Health

Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care—across its many dimensions—is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women’s reproductive health: societal and community determinants of health equity, women’s health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women’s reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.

Philippines and Senegal: Services improve quality of care but fail to increase FP continuation

2002 ◽  
Author(s):  
Keyword(s):  
Quality Of Care ◽  
Family Planning ◽  
Reproductive Health ◽  
Service Delivery ◽  
The Philippines ◽  
Supportive Supervision ◽  
Improve Quality ◽  
Population Council ◽  
The Impact

In 1999, Frontiers in Reproductive Health collaborated on studies on the impact of interventions to improve quality of care in the Philippines and Senegal. The two interventions were part of a multicountry Population Council study (also undertaken in Pakistan and Zambia) to test whether improving quality affects women’s contraceptive continuation. The Philippines study focused on training in family planning (FP), supportive supervision, and refresher courses to improve client-provider interaction. The Senegal study compared the impact of improved quality of care at five newly established “reference centers” with five clinics that served as controls. Data were gathered through analyses of quality of care at all 10 sites in 1997, when the reference centers had begun implementation, and in 1998, 16 months later. As detailed in this brief, the introduction of client-centered service delivery with a focus on the client-provider interaction resulted in better quality of care at sites in the Philippines and Senegal. However, improving quality of care alone was not found to be sufficient to significantly increase the length of time women continued to use contraception.

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