scholarly journals Quality and accreditation in health care services

2021 ◽  
Vol 12 (2) ◽  
pp. 539-543
Author(s):  
Christos Iliadis ◽  
Aikaterini Frantzana ◽  
Kiriaki Tachtsoglou ◽  
Maria Lera ◽  
Petros Ouzounakis

Introduction: The quality of health care services is one of the most frequently mentioned terms and concepts regarding principles of health policy and it is currently high on the agenda of National, European and International policy makers. Purpose: The purpose of this descriptive review is to investigate the correlation between quality in health services and the promotion of health care quality provided by health services. Methodology: The study material consisted of recent articles on the subject mainly found in the Medline electronic database and the Hellenic Academic Libraries Association (HEAL-Link). Results: The clinical quality of services is often difficult to be assessed by "clients" even after the service has been provided. This is due to the fact that customers experience illness, pain, uncertainty, fear and perceived lack of control. Thus, clients may be reluctant to "co-produce" because healthcare is a service they need while they may not want it and because the risk to harm their health is prominent. In the field of healthcare management, patients' perception refers to perceived quality, as opposed to the actual or absolute quality that requires critical management. This is why health care managers face constant pressure to provide qualitative health services. Conclusions: Continuous monitoring of health care services for quality assessment is essential, hence, the evaluation of patients' perceptions of quality of healthcare, has received considerable attention in recent years.

Author(s):  
Anna Beata Rosiek ◽  
Krzysztof Leksowski

This article describes a model of health-care services that ensure the high quality of health-care service and effective brand creation for a hospital. The problems described here that are connected to improving the quality of health care in Poland indicates that high quality of health care builds a positive and strong image of a health-care unit on the medical market. The contents of this article involve basic definitions of quality in health care and also the way the quality is understood and perceived from patient’s and hospital’s point of view. The article also describes a health care quality model, to which health care units should aspire in order to create a positive picture of said units, simultaneously improving and maintaining high quality of health care services. The article investigates the quality factors of health care services, which influence the healthcare units’ brand, its functioning on the market and patient-perceived quality of services. The described management model, which ensures efficient brand-building of healthcare units through services’ quality, takes into account changes in healthcare system and does so in order to ensure the improvement in healthcare units’ functioning.


2020 ◽  
Vol 7 (6) ◽  
pp. 906-910
Author(s):  
Patrick Oben

The patient experience is now globally recognized as an independent dimension of health-care quality. However, although patients, providers, health-care managers, and policy-makers agree on its importance, there is no standardized definition of the patient experience. A clear understanding of the basic concepts that make up the foundation of the patient experience is more important than a statement defining the patient experience. The fundamental nature of health care involves people taking care of other people in unique times of distress. Thus, the human experience is at the very core of understanding what the patient experience is. This article reviews a framework of the basic human experience of patients as they progress from being unique, healthy individuals to a state of experiencing both disease and health-care services. This novel framework naturally leads to a basic understanding of the patient experience as a human experience of health-care services.


1970 ◽  
Vol 6 (2) ◽  
pp. 74-83 ◽  
Author(s):  
B Devkota

Background: Ensuring delivery of quality health services in a sustainable and equitable manner is a challenge in Nepal. A host of factors may have impeded the access, quality and utilization of the health services particularly by the marginalized and disadvantaged sections of the population. Review essential health care services (EHCS) provided by the public health facilities, level of progress, effectiveness, sustainability, equity and efficiency, quality of care and inclusion of marginalized and disadvantaged populations in health care servicesMethods: A total of 40 VDCs from 10 districts representing five regions and three eco-zones were covered. Altogether 800 mothers with under two year children, 40 health service providers, 145 key informants and 40 exit clients were interviewed. Forty focused group discussions were also conducted. From each district, health records of one hospital, PHCC, HP, SHP and Ayurvedic health facility each were collected.Results: More than two-third (68.2%) of the mothers received antenatal checks, highest in hills (85%) followed by terai (64.5%) and mountain districts (52.8%).Tetanus vaccine coverage (80.7%) seems higher compared to Nepal Demographic Health Survey 2001 (45%). FP use rate in mountain, hill and terai are 57.6%, 54.1% and 49.7%, higher than in DoHS 2003/2004 statistics, which were 26.8%, 36.4% and 45.3% respectively. Nine out of ten patients visiting the health facilities were outpatients. The coverage of DPT 3, Polio 3, BCG and measles are 92.8%, 93.4%, 95.2% and 90.7% respectively. From the service utilization perspective, disparities in terms of gender, ecological regions, season of the year and health facility were revealed.Conclusion: Health sector services are yet to be made responsive to the ecological and district specific health problems, and be made more inclusive linking with doable safety nets.  Key words: Essential health care services; Effectiveness; Sustainability; Equity and efficiency; Quality of care and inclusion  doi: 10.3126/jnhrc.v6i2.2188Journal of Nepal Health Research Council Vol. 6 No. 2 Issue 13 Oct 2008 Page: 74-83 


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Y Adja ◽  
C Reno ◽  
J Lenzi ◽  
M P Fantini

Abstract Background Amenable mortality is an indicator that measures the extent to which health services contribute to the improvement of the health of a population. It can also highlight geographical and socioeconomic inequalities. Therefore, it is used to assess quality and performance of health care systems, both at national and subnational level. The Italian National Health Service sets the essential levels of care (Livelli Essenziali di Assistenza, LEA), a health-benefit package for all citizens. Because every region is responsible for providing the LEA and can offer additional health care, monitoring the performance of the Regional Health Services (RHSs) is of increasing interest. Methods We used Nolte and McKee's list of amenable conditions to analyze the temporal trend of the standardized mortality rate (per 100.000) in Italy from 2006 to 2015, overall and by gender. We also examined the standardized rate at regional level by comparing the two-year periods 2006/7 and 2014/5, overall and by gender. Results Between 2006 and 2015, the overall mortality rate decreased from 81 to 68 per 100.000 population; this reduction was more pronounced in men (91 to 76 per 100.000, -16.5%) than in women (72 to 62 per 100.000, -13.9%). The decreasing trend in amenable mortality affected Italian regions differently, with northern regions showing steeper reductions as compared to southern regions. As a result, 2014/5 was the first time men's mortality in North Italy (68 per 100.000) was lower than women's mortality in South Italy (72 per 100.000). Conclusions The overall reduction of amenable mortality shows that Italy's health care services keep contributing to the improvement of population health. Nevertheless, by analyzing RHS performance we saw that differences in organization of care lead to differences in health care quality and performance across regions. Deaths amenable to health care services contribute to inequalities between Northern and Southern Italy. Key messages Because universal health coverage is necessary but not sufficient to reduce health inequalities, investing into better-quality services should be recognized as a priority. Amenable mortality can highlight areas of intervention to reduce inequalities in the provision of health care services.


Author(s):  
Mohammad Ali Sahraian ◽  
Abdorreza Naser Moghadas ◽  
Sharareh Eskandarieh

Background: After intensified economic sanctions against Iran, decreased welfare of patients were more recognizable. The present study was aimed at identifying the challenges and stress level experienced by patients with multiple sclerosis (MS) regarding treatment and health care services in 2018-2019 after strengthening of economic sanctions against Iran. Methods: A cross-sectional study was conducted on MS patients in Tehran, Iran. A structured questionnaire was designed to measure the main variables addressing the challenges and stress level of MS patients with respect to receiving care and treatment services. Results: In total, 1039 MS patients were enrolled into the study. Among the patients who answered yes to the questions, 873 (85.8%) and 837 (86%) were concerned about medicine unavailability and supply and purchase of internationally branded medicine, respectively. Moreover, 671 (70.3%) subjects were concerned about replacing their medicines with cheaper alternatives due to financial problems and 427 (41.4%) were unwilling to continue their treatment due to the economic burden of MS. In total, 795 (82%) were concerned about the effectiveness of Iranian drugs in comparison with internationally branded drugs. Generally, 970 (93.53%) subjects had experienced increased current living costs and 711 had experienced (68.82%) reduced nutrition quality, which (OR: 2.68; 95% CI: 1.99, 3.60) was significantly higher among subjects who had an income of less than or equal to 250 US$ per month. Conclusion: The sanctions can impose greater stress and hardship on patients due to the unavailability and costs of medicines. Iran should manage health care quality and provide services to prevent the adverse effects of sanctions on MS patients and guarantee patients’ right to receive well-established medication and health services.  


2019 ◽  
Vol 6 (2) ◽  
pp. 83-90
Author(s):  
Seyed Jalil Hosseinin Irani ◽  
Leila Riahi ◽  
Ali Komeili ◽  
Reza Masoudi

Background and aims: Patient safety, as one of the main components of the health care quality, implies avoiding any injury and damage to the patient when providing health care services. In other words, patient safety means his or her safety against any adverse and harmful event when receiving health care services. Based on the above-mention explanations, the present study was conducted to determine the patterns of patient safety management. Methods: A systematic review method was used to meet the objectives of the study. In order to access the scientific documentation and evidence related to the subject published during 1998-2018, English keywords including "Patient Safety Model", "Patient Safety", and "Patient Safety of Management" were searched in Medine, PubMed, and Google Scholar databases and Persian versions of these keywords were also looked for in Jihad-e Daneshgahi’s Scientific Information Database (SID) and Iranian Journals database (Magiran). Results: The findings of this study suggested that most of the studies on designing a model for patient safety highlighted important dimensions including guidance and leadership, communication, organizing, information management, control and monitoring, participation and decision-making, as well as planning and coordination. Conclusion: In general, using patterns and frameworks designed for patient safety improves patient safety against uncertain incidents since the human and financial consequences of such incidents impose overwhelming sufferings on patients.


2019 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland

Abstract Background The number of people aged 80 years and above is projected to triple over the next 30 years. People in this age group normally have at least two chronic conditions (multimorbidity). The impact of multimorbidity is often significantly greater than expected from the sum of the effects of each condition. The World Health Organization has indicated that health care systems must prepare for a change in the focus of clinical care for older people. The WHO defines health care quality as care that is effective, efficient, integrated, patient centered, equitable and safe. The degree to which health care quality can be defined as acceptable is determined by services’ ability to meet the needs of users and adapt to patients’ expectations and perceptions. This study explores experiences of the quality of the health services in hospital and the first 30 days at home after discharge by patients over 80 years of age. Method We took a phenomenological perspective to explore older patients’ subjective experiences and conducted semistructured individual interviews. Eighteen patients (aged from 82 to 100 years) were interviewed twice after discharge from hospital. The interview transcriptions were analyzed thematically. Results The patients found their meetings with the health service to be complex and demanding. They reported attempting to restore a sense of security and meaning in everyday life, balancing their own needs against external requirements. Five overarching themes emerged from the interviews: hospital stay and the person behind the diagnosis, poor communication and coordination, life after discharge, relationship with their next of kin, and organizational and systemic determinants. Conclusion According to the WHO, to deliver quality health care, services must include all six of the dimensions listed above. Our findings show that they do not. Health care focused on measurable values and biomedical inquiries. Few opportunities for participation, scant information and suboptimal care coordination left the patients with a feeling of being in limbo, where they struggled to find balance in their everyday life. Further work must be done to ensure that integrated services are provided without a financial burden, centered on the needs and rights of older people.


2013 ◽  
Vol 23 (1) ◽  
pp. 149-154 ◽  
Author(s):  
Geriuldas Žiliukas ◽  
Danguolė Drungilienė ◽  
Rima Užkurėlytė ◽  
Ligija Švedienė

As the quality of health care is getting better, patients’ demands for medics and health care organizations are getting higher. The permanent growth of costs and limited resources force to look for new possibilities of problem solving. Insufficient capacity of the leaders of a health care institution in matters of health care management and low motivation of the personnel leads to dissatisfaction by the provided services to patients and personnel. There was a patient opinion research made, a Picker Institute Europe questionnaire was used for the survey. 138 patients were interviewed, who, by their characteristics, represented all patients, treated in Hospital X all year round. Microsoft Office Excel 2010 and SPSS Statistics version 17.0 programs were used for the analysis of research data. During the research, it emerged that the majority of patients (78,7 percent) rated the conditions of care in the hospital as very good or good. Most of patients are satisfied with provided services of the hospital. Positive opinion of the patients on the care quality in the hospital was influenced by close communication with medics, providing clear information about their health situation and treatment, the respect shown by the personnel determined the trust in medics. Although, patients were actively involved in the treatment process, about one third of them did not participate in making decisions about their health situation or treatment; every fifth hospitalized patient by a planned order did not have an ability to choose a treatment institution. More than a half of patients, who participated in the research, did not have an opportunity to choose their doctor, or did not know about this opportunity. The development of patient’s and juridical knowledge creates preconditions to improve the quality of health care services.


2018 ◽  
Author(s):  
David J Carter ◽  
James J. Brown ◽  
Carla Saunders

The regulation of health care services has a range of goals. Improving the safety and quality of healthcare is one of them. However, there is a lack of good quality evidence about what members of the Australian community believe and expect in relation to the regulation of healthcare safety. To elicit the Australian public’s voice on issues related to the governance of health care quality and safety, we developed a survey instrument that reflected core elements of Australian approach to regulating health care safety and quality. This Policy Brief describes the results of the survey, highlighting the important areas of similarity and difference between the views of the community and existing regulatory frameworks. In summary, the general public expect a graduated approach to stakeholder responsibility, monitoring and regulatory responses to failures in the quality and safety of healthcare. However, Reliance on decentralised accreditation-centric quality improvement mechanisms is not sufficient. The community expects more centralised oversight, including strict norm-referenced monitoring and performance testing – including in-person ‘spot inspections’, rather than reliance on self-monitoring and reporting.


2017 ◽  
Vol 13 (1) ◽  
Author(s):  
Jakub Stachowski ◽  
Johan Fredrik Rye

Transnational Health Practices Among Polish Labor Migrants in NorwayThe article discusses the use of health-care services among Polish labor migrants in Norway. We apply theories of patient–physician relationship, trust, and transnationalism to analyze a material of qualitative in-depth interviews with eleven Polish labor migrants about their health practices. The material demonstrates how and why many Polish labor migrants evaluate Norwegian primary health care negatively. Their main reason for doing so is the non-paternalistic doctor–patient relationship. They therefore supplement Norwegian health services with health services available in their home country. However, the labor migrants tend to evaluate the Norwegian health system more favorably as time passes. In total, the Poles establish creative, reflexive, competent, and dynamic health practices that go beyond national state borders and combine elements of two health-care systems. We argue that these practices enable migrants to enhance the total quality of their health care.


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