scholarly journals Association Between Web-Based Physician Ratings and Physician Disciplinary Convictions: Retrospective Observational Study (Preprint)

2019 ◽  
Author(s):  
Jessica Janine Liu ◽  
Hanna R Goldberg ◽  
Eric JM Lentz ◽  
John Justin Matelski ◽  
Asim Alam ◽  
...  
Keyword(s):  
Observational Study ◽  
Health Care Quality ◽  
Quality Care ◽  
Sexual Misconduct ◽  
Poor Quality ◽  
Care Quality ◽  
Web Based ◽  
Sexual Offenses ◽  
Physician Rating ◽  
Physician Rating Website

BACKGROUND Physician rating websites are commonly used by the public, yet the relationship between web-based physician ratings and health care quality is not well understood. OBJECTIVE The objective of our study was to use physician disciplinary convictions as an extreme marker for poor physician quality and to investigate whether disciplined physicians have lower ratings than nondisciplined matched controls. METHODS This was a retrospective national observational study of all disciplined physicians in Canada (751 physicians, 2000 to 2013). We searched ratings (2005-2015) from the country’s leading online physician rating website for this group, and for 751 matched controls according to gender, specialty, practice years, and location. We compared overall ratings (out of a score of 5) as well as mean ratings by the type of misconduct. We also compared ratings for each type of misconduct and punishment. RESULTS There were 62.7% (471/751) of convicted and disciplined physicians (cases) with web-based ratings and 64.6% (485/751) of nondisciplined physicians (controls) with ratings. Of 312 matched case-control pairs, disciplined physicians were rated lower than controls overall (3.62 vs 4.00; <i>P</i>&lt;.001). Disciplined physicians had lower ratings for all types of misconduct and punishment—except for physicians disciplined for sexual offenses (n=90 pairs; 3.83 vs 3.86; <i>P</i>=.81). Sexual misconduct was the only category in which mean ratings for physicians were higher than those for other disciplined physicians (3.63 vs 3.35; <i>P</i>=.003) CONCLUSIONS Physicians convicted for disciplinary misconduct generally had lower web-based ratings. Physicians convicted of sexual misconduct did not have lower ratings and were rated higher than other disciplined physicians. These findings may have future implications for the identification of physicians providing poor-quality care.

scholarly journals Association Between Web-Based Physician Ratings and Physician Disciplinary Convictions: Retrospective Observational Study

10.2196/16708 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e16708
Author(s):  
Jessica Janine Liu ◽  
Hanna R Goldberg ◽  
Eric JM Lentz ◽  
John Justin Matelski ◽  
Asim Alam ◽  
...  
Keyword(s):  
Observational Study ◽  
Health Care Quality ◽  
Quality Care ◽  
Sexual Misconduct ◽  
Poor Quality ◽  
Care Quality ◽  
Web Based ◽  
Sexual Offenses ◽  
Physician Rating ◽  
Physician Rating Website

Background Physician rating websites are commonly used by the public, yet the relationship between web-based physician ratings and health care quality is not well understood. Objective The objective of our study was to use physician disciplinary convictions as an extreme marker for poor physician quality and to investigate whether disciplined physicians have lower ratings than nondisciplined matched controls. Methods This was a retrospective national observational study of all disciplined physicians in Canada (751 physicians, 2000 to 2013). We searched ratings (2005-2015) from the country’s leading online physician rating website for this group, and for 751 matched controls according to gender, specialty, practice years, and location. We compared overall ratings (out of a score of 5) as well as mean ratings by the type of misconduct. We also compared ratings for each type of misconduct and punishment. Results There were 62.7% (471/751) of convicted and disciplined physicians (cases) with web-based ratings and 64.6% (485/751) of nondisciplined physicians (controls) with ratings. Of 312 matched case-control pairs, disciplined physicians were rated lower than controls overall (3.62 vs 4.00; P<.001). Disciplined physicians had lower ratings for all types of misconduct and punishment—except for physicians disciplined for sexual offenses (n=90 pairs; 3.83 vs 3.86; P=.81). Sexual misconduct was the only category in which mean ratings for physicians were higher than those for other disciplined physicians (3.63 vs 3.35; P=.003) Conclusions Physicians convicted for disciplinary misconduct generally had lower web-based ratings. Physicians convicted of sexual misconduct did not have lower ratings and were rated higher than other disciplined physicians. These findings may have future implications for the identification of physicians providing poor-quality care.

scholarly journals Optimalisasi peran & fungsi manajemen kepala ruangan dalam supervisi dokumentasi asuhan keperawatan di rumah sakit x Jakarta

2021 ◽  
Vol 14 (4) ◽  
pp. 536-544
Author(s):  
Teresa Teresa ◽  
Tuti Afrianti ◽  
Tini Suminarti
Keyword(s):  
Quality Of Care ◽  
Nursing Care ◽  
Health Care Quality ◽  
Descriptive Analysis ◽  
Pilot Project ◽  
Poor Quality ◽  
Care Quality ◽  
Nursing Documentation ◽  
Head Nurse

The role of a head nurse in optimizing of management function in supervision of nursing care documentation at X hospital in JakartaBackground: Nursing documentation is important thing that  is indicator quality of care. Since the nursing documentation is still a poor quality, it requires a supervision by the head nurse.Purpose: The head of nursing is responsible for the direction, organization and strategic planning collaborate with nursing staffs in ensuring the quality of nursing care to achieve accurate, effective and efficient documentation and to complete supervision.Method: A pilot project using questionnaire and observation methods was conducted at difference times on two hospital units in Jakarta.Results: The descriptive analysis results showed that among 18 nurses, 4 nurses believed that nursing documentation is an important, effective and clear way to  ease their job. Hence, supervision is continuity needed to support the improvement of health care quality. The innovative projects will be applied in health care.Conclusion:  Nursing documentation must show continuity and quality of  care nursing under the control and supervision of the head nurse and EMR is used as the instrument for documentation.Keywords :  The role; Head nurse; Management; Supervision; Nursing care; DocumentationPendahuluan: Dokumentasi asuhan keperawatan adalah hal yang penting karena menjadi indikator kualitas perawatan. Penerapan dokumentasi asuhan keperawatan saat ini belum optimal sehingga membutuhkan arahan dan supervisi dari Kepala Ruang/Kepala Unit.Tujuan: Tercapainya supervisi dan keberhasilan pelaksanaan dokumentasi asuhan keperawatan yang komprehensif, berkesinambungan, efektif dan  efisien.Metode: Metode pilot project di salah satu Rumah Sakit di Jakarta dengan pengambilan data melalui  observasi dan kuestioner. Instrumen diujikan pada dua ruangan dalam  waktu yang berbeda.Hasil: Analisis deskripsi pada  sejumlah 18 perawat, 4 orang menyatakan bermanfaat, penting dan mudah dalam penerapannya. Supervisi dilakukan untuk memberikan support terhadap kelangsungan pendokumentasian asuhan keperawatan yang berkesinambungan. Proyek inovasi akan ditindaklanjuti dan diaplikasikan dalam program kerja bidang pelayanan keperawatan.Simpulan: Asuhan keperawatan yang berkualitas memerlukan adanya supervisi. Sarannya penggunaan Instrumen Supervise Dokumentasi Asuhan Keperawatan akan disesuaikan dengan penggunaan pencatatan asuhan keperawatan Elektronic Medical Record/EMR

Trends in Health Quality-related Publications over the past three decades. (Preprint)

2021 ◽  
Author(s):  
Joseph Mendlovic ◽  
Francis B Mimouni ◽  
Iris Arad ◽  
Eyal Heiman
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Case Reports ◽  
Quality Care ◽  
Care Quality ◽  
Publication Type ◽  
The Past ◽  
Management Quality ◽  
Rate Of Increase ◽  
Number Of Publications

BACKGROUND Quality assessment in health care is a process of planned activities whose ultimate goal is to achieve a continuous improvement of medical care through the evaluation of structure, process, and outcome measures. Physicians and health care specialists involved with quality issues are faced with an enormous and nearly always increasing amount of literature to read and integrate OBJECTIVE To test the hypothesis that the number of publications in the field of health care quality increases over time, and particularly the number of high-evidence journal articles such as randomized control trials, systematic reviews, and ultimately, practice guidelines. METHODS We used MEDLINE database to retrieve relevant articles published between during the 29 year-period between 1/1/1989 and 12/31/2018. The search was conducted in March 2021. Publications from 2019 and 2020 were excluded because of incomplete data. We used the keywords "quality care", "quality management", "quality indicators" and "quality improvement” and limited the search fields to title and abstract. RESULTS During the 29-year evaluation period there was a significant cubic increase in the number of publications both in total number of publications and in the variety of publication types studied The rate of increase varied for different types of publications, with the largest increase in reviews, and the smallest increase in case reports. There was a systematic stagnation or even decrease in the number of publications starting in 2015 regardless of publication type. CONCLUSIONS Over the past 29 years the field of quality in health care has seen a significant yearly increase of published original studies with a relative stagnation since 2015. We suggest that contributors to this dynamic field of research should focus on producing more evidence based publications and guidelines

scholarly journals Use of Quality Indicators in Physical Therapist Practice: An Observational Study

2012 ◽  
Vol 92 (4) ◽  
pp. 507-524 ◽  
Author(s):  
Diane U. Jette ◽  
Dianne V. Jewell
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Observational Study ◽  
Secondary Prevention ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Care Quality ◽  
Published Evidence

AbstractBackgroundThe Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 contain provisions specific to health care quality that apply to physical therapists. Published evidence examining gaps in the quality of physical therapy services is limited.ObjectiveThe primary purpose of this study was to determine the use of quality indicators in physical therapist practice.DesignThis was an observational study.MethodsAll members of the Orthopaedic and Private Practice sections of the American Physical Therapy Association were invited to participate by completing an electronic survey. The survey included 22 brief patient descriptions, each followed by questions regarding the use of examinations and interventions based on the 2009 list of Medicare-approved quality measures. Separate multivariate logistic regression models were used to determine the odds ratios related to the performance of each examination and intervention on more than 90% of patients, given perceptions of its importance to care, the burden of performing it, and the level of evidence supporting its use.ResultsParticipants (n=2,544) reported a relatively low frequency of performing examinations and interventions supporting primary and secondary prevention (3.6%–51.3%) and use of standardized measures (5.5%–35.8%). Perceptions of high importance and low burden were associated with greater odds of performing an examination or intervention. Importance and burden were more influential factors than the perceived availability of evidence to support use of identified techniques.LimitationsThe survey was not assessed for test-retest reliability. A low response rate was a source of potential bias.ConclusionThe study findings suggest that physical therapists may not see themselves as providers of primary or secondary prevention services. Patient management strategies associated with these types of services also may be perceived as relatively unimportant or burdensome.

Home Health Care Quality, Its Costs and Implications for Home Health Value-Based Purchasing

2020 ◽  
pp. 107755872097452
Author(s):  
Dana B. Mukamel ◽  
Heather Ladd ◽  
Eugene Nuccio ◽  
Jacqueline S. Zinn ◽  
Dara H. Sorkin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Home Health Care ◽  
Marginal Cost ◽  
Health Care Quality ◽  
Quality Care ◽  
Home Health ◽  
Care Quality ◽  
Value Based Purchasing ◽  
Health Value ◽  
Marginal Costs

The Home Health Value-based Purchasing (HHVBP) demonstration, incorporating a payment formula designed to incentivize both high-quality care and quality improvement, is expected to become a national program after 2022, when the demonstration ends. This study investigated the relationship between costs and several quality dimensions, to inform HHVBP policy. Using Medicare cost reports, OASIS and Home Health Compare data for 7,673 home health agencies nationally, we estimated cost functions with instrumental variables for quality. The estimated net marginal costs varied by composite quality measure, baseline quality, and agency size. For four of the five composite quality measures, the net marginal cost was negative for low-quality agencies, suggesting that quality improvement was cost saving for this agency type. As the magnitude of the net marginal cost is commensurate with the payment incentive planned for HHVBP, it should be considered when designing the incentives for HHVBP, to maximize their effectiveness.

scholarly journals An International Comparison of Web-based Reporting About Health Care Quality: Content Analysis

2010 ◽  
Vol 12 (2) ◽  
pp. e8 ◽  
Author(s):  
Olga C Damman ◽  
Ylva KA van den Hengel ◽  
A Jeanne M van Loon ◽  
Jany Rademakers
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
International Comparison ◽  
Health Care Quality ◽  
Care Quality ◽  
Web Based

Care Coordination Models Improve Quality of Care for Adults Aging With Intellectual and Developmental Disabilities

2019 ◽  
Vol 30 (4) ◽  
pp. 191-201 ◽  
Author(s):  
Sarah Ruiz ◽  
Katherine Giuriceo ◽  
Joe Caldwell ◽  
Lynne Page Snyder ◽  
Michelle Putnam
Keyword(s):  
Health Care ◽  
Developmental Disabilities ◽  
Care Coordination ◽  
Health Care Quality ◽  
Quality Care ◽  
Care Quality ◽  
Social Needs ◽  
Evidence Based ◽  
Intellectual And Developmental Disabilities ◽  
Residential Setting

A significant gap remains between existing evidence-based care coordination techniques for the general population and those that have been successfully translated for people with intellectual and developmental disabilities (IDD). Two models funded through the Health Care Innovation Awards have dedicated resources to the translation of evidence-based practices in community or clinical settings. This study analyzes quasi-experimental mixed-methods evaluation data, including Medicaid/Medicare claims on more than 600 beneficiaries who participated in the two models and survey data, site visits, and focus groups with participants and caregivers. Qualitative data suggest that both models address key contextual factors, considering residential setting, health disparities, and heterogeneity of the population. We identify key improvements in health care quality related to timeliness, patient safety, and medication reconciliation. In addition, both models show some evidence of reduced claims utilization. This study represents the first step to understand the potential of care coordination to improve the lives of adults aging with IDD. As health systems continue to struggle to manage the cost of their most expensive users and deliver high quality care, these models hold promise as vehicles to reduce utilization and cost among adults who have lived long-term with disability by addressing their unique health care and social needs.

scholarly journals Pressure points: learning from Serious Case Reviews of failures of care and pressure ulcer problems in care homes

2017 ◽  
Vol 19 (5) ◽  
pp. 284-296 ◽  
Author(s):  
Jill Manthorpe ◽  
Stephen Martineau
Keyword(s):  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Local Level ◽  
Quality Care ◽  
Care Home ◽  
Poor Quality ◽  
Care Quality ◽  
Home Setting ◽  
Content Type ◽  
Documentary Analysis

Purpose Serious Case Reviews (SCRs, now Safeguarding Adults Reviews (SARs)) may be held at local level in England when a vulnerable adult dies or is harmed, and abuse or neglect is suspected, and there is cause for concern about multi-agency safeguarding practice. There has been no analysis of SCRs focussing on pressure ulcers. The purpose of this paper is to present findings from a documentary analysis of SCRs/SARs to investigate what recommendations are made about pressure ulcer prevention and treatment in a care home setting in the context of safeguarding. This analysis is presented in cognisance of the prevalence and risks of pressure ulcers among care home residents; and debates about the interface of care quality and safeguarding systems. Design/methodology/approach Identification of SCRs and SARs from England where the person who died or who was harmed had a pressure ulcer or its synonym. Narrative and textual analysis of documents summarising the reports was used to explore the Reviews’ observations and recommendations. The main themes were identified. Findings The authors located 18 relevant SCRs and 1 SAR covering pressure ulcer care in a care home setting. Most of these inquiries into practice, service communications and the events leading up to the death or harm of care home residents with pressure ulcers observed that there were failings in the care home, but also in the wider health and care systems. Overall, the reports reveal specific failings in multi-agency communication and in quality of care. Pressure ulcers featured in several SCRs, but it is problems and inadequacies with care and treatment that moved them to the safeguarding arena. The value of examining pressure ulcers as a key line of inquiry is that they are “visible” in the system, with consensus about what they are, how to measure them and what constitutes optimal care and treatment. In the new Care Act 2014 context they may continue to feature in safeguarding enquiries and investigations as they may be possible symptoms of system failures. Research limitations/implications Reviews vary in content, structure and accessibility making it hard to compare their approach, findings and recommendations. There are risks in drawing too many conclusions from the corpus of Reviews since these are not published in full and contexts have subsequently changed. However, this is the first analysis of these documents to take pressure ulcers as the focus and it offers valuable insights into care home practices amid other systems and professional activity. Practical implications This analysis highlights that it is not inevitably poor quality care in a care home that gives rise to pressure ulcers among residents. Several SCRs note problems in wider communications with healthcare providers and their engagement. Nonetheless, poor care quality and negligence were reported in some cases. Various policies have commented on the potential overlap between the raising of concerns about poor quality care and about safeguarding. These were highlighted prior to the Care Act 2014 although current policy views problems with pressure ulcers more as care quality and clinical concerns. Social implications The value of this documentary analysis is that it rests on real case examples and scrutiny at local level. Future research could consider the findings of SARs, similar documents from the rest of the UK, and international perspectives. Originality/value The value of having a set of documents about adult safeguarding is that they lend themselves to analysis and comparison. This first analysis to focus on pressure ulcers addresses wider considerations related to safeguarding policy and practice.

scholarly journals Quantitative Ratings and Narrative Comments on Swiss Physician Rating Websites: Frequency Analysis (Preprint)

2019 ◽  
Author(s):  
Stuart McLennan
Keyword(s):  
Health Care Quality ◽  
Rating Scale ◽  
Care Quality ◽  
The Past ◽  
Reliable Source ◽  
Stratified Sample ◽  
Physician Rating ◽  
Quantitative Rating ◽  
First Time ◽  
Narrative Comments

BACKGROUND Physician rating websites (PRWs) have been developed as part of a wider move toward transparency around health care quality, and these allow patients to anonymously rate, comment, and discuss physicians’ quality on the Web. The first Swiss PRWs were established in 2008, at the same time as many international PRWs. However, there has been limited research conducted on PRWs in Switzerland to date. International research has indicated that a key shortcoming of PRWs is that they have an insufficient number of ratings. OBJECTIVE The aim of this study was to examine the frequency of quantitative ratings and narrative comments on the Swiss PRWs. METHODS In November 2017, a random stratified sample of 966 physicians was generated from the regions of Zürich and Geneva. Every selected physician was searched for on 4 rating websites (OkDoc, DocApp, Medicosearch, and Google) between November 2017 and July 2018. It was recorded whether the physician could be identified, what the physician’s quantitative rating was, and whether the physician had received narrative comments. In addition, Alexa Internet was used to examine the number of visitors to the PRWs, compared with other websites. RESULTS Overall, the portion of physicians able to be identified on the PRWs ranged from 42.4% (410/966) on OkDoc to 87.3% (843/966) on DocApp. Of the identifiable physicians, only a few of the selected physicians had been rated quantitatively (4.5% [38/843] on DocApp to 49.8% [273/548] on Google) or received narrative comments (4.5% [38/843] on DocApp to 31.2% [171/548] on Google) at least once. Rated physicians also had, on average, a low number of quantitative ratings (1.47 ratings on OkDoc to 3.74 rating on Google) and narrative comments (1.23 comment on OkDoc to 3.03 comments on Google). All 3 websites allowing ratings used the same rating scale (1-5 stars) and had a very positive average rating: DocApp (4.71), Medicosearch (4.69), and Google (4.41). There were significant differences among the PRWs (with the majority of ratings being posted on Google in past 2 years) and regions (with physicians in Zurich more likely to have been rated and have more ratings on average). Only Google (position 1) and Medicosearch (position 8358) are placed among the top 10,000 visited websites in Switzerland. CONCLUSIONS It appears that this is the first time Google has been included in a study examining physician ratings internationally and it is noticeable how Google has had substantially more ratings than the 3 dedicated PRWs in Switzerland over the past 2 and a half years. Overall, this study indicates that Swiss PRWs are not yet a reliable source of unbiased information regarding patient experiences and satisfaction with Swiss physicians; many selected physicians were unable to be identified, only a few physicians had been rated, and the ratings posted were overwhelmingly positive.

Glancing Back, Looking Forward: Some Comments on Health Research in Asian American Communities

2006 ◽  
Vol 4 (1) ◽  
pp. 53-60 ◽  
Author(s):  
David Takeuchi ◽  
Seunghye Hong
Keyword(s):  
Asian American ◽  
Social Factors ◽  
Race And Ethnicity ◽  
Health Care Quality ◽  
Poor Quality ◽  
Care Quality ◽  
Health Issues ◽  
Political Climate ◽  
Creative Research

Despite scientific advances that documents race and ethnicity as critical factors associated with inequities in health and health care quality, the general political climate has the potential to undermine efforts to improve the quality of life for people in diverse communities. We call for more creative research programs on health issues in Asian American communities to move beyond prevalence and risk factors toward investigating the mechanisms and processes that produce illness and lead to poor quality of health. We emphasize a compelling need to revisit traditional and accepted findings to determine their appropriateness for Asian American communities. We also suggested that as we establish the mechanisms that link social factors and health, we must also place them within the appropriate historical and cultural contexts that are essential for the health of people in their communities.

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