scholarly journals Fostering the Quality of Care for People with Chronic Diseases, from Theory to Practice: The Development of Good Practices in Disease Prevention and Care in JA CHRODIS PLUS Using JA CHRODIS Recommendations and Quality Criteria

2020 ◽  
Vol 17 (3) ◽  
pp. 951 ◽  
Author(s):  
Jelka Zaletel ◽  
Marina Maggini
Keyword(s):  
Quality Of Care ◽  
Chronic Diseases ◽  
Health Care Organizations ◽  
Quality Care ◽  
Quality Criteria ◽  
The European Union ◽  
The Core ◽  
Core Set ◽  
Care Health

In the frame of joint action in chronic diseases (JA CHRODIS), an extensive process at the European Union level was carried out to identify a core set of quality criteria and to formulate recommendations that improved prevention, early detection, and quality of care for people with chronic diseases. Diabetes was used as a model disease. The core set of quality criteria may be applied to develop and improve practices, programs, strategies, and policies in various domains (e.g., prevention, care, health promotion, education, and training). The quality criteria are general enough to be applied in countries with different political, administrative, social, and health care organizations. Moreover, they can be applied to a number of other chronic diseases. JA CHRODIS recommendations and quality criteria are being tested in a series of pilot actions within the JA CHRODIS PLUS. A total of 15 partners representing nine European countries worked together to implement pilot actions and generate practical lessons that could contribute to the further uptake and use of JA CHRODIS recommendations. Special emphasis is given to meaningful patient involvement in co-designing the pilot actions and to the sustainability and scalability of the pilot actions. These insights were found to be at the core of the learning from pilot actions to foster high quality care for people with chronic diseases.

scholarly journals Parental Involvement Policies for Minors Seeking Abortion in the Southeast and Quality of Care

2021 ◽  
Author(s):  
Kari White ◽  
Subasri Narasimhan ◽  
Sophie A. Hartwig ◽  
Erin Carroll ◽  
Alexandra McBrayer ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Parental Involvement ◽  
Service Delivery ◽  
Quality Care ◽  
Health Service Delivery ◽  
Policy Implications ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Staff Members

Abstract Introduction Thirty-seven states require minors seeking abortion to involve a parent, either through notification or consent. Little research has examined how implementation of these laws affect service delivery and quality of care for those who involve a parent. Methods Between May 2018 and September 2019, in-depth interviews were conducted with 34 staff members involved in scheduling, counseling, and administration at abortion facilities in three Southeastern states. Interviews explored procedures for documenting parental involvement, minors’ and parents’ reactions to requirements, and challenges with implementation and compliance. Both inductive and deductive codes, informed by the Institute of Medicine’s healthcare quality framework, were used in the thematic analysis. Results Parental involvement laws adversely affected four quality care domains: efficiency, patient-centeredness, timeliness, and equity. Administrative inefficiencies stemmed from the extensive documentation needed to prove an adult’s relationship to a minor, increasing the time and effort needed to comply with state reporting requirements. If parents were not supportive of their minor’s decision, participants felt they had a duty to intervene to ensure the minor’s decision and needs remained centered. Staff further noted that delays to timely care accumulated as minors navigated parental involvement and other state mandates, pushing some beyond gestational age limits. Lower income families and those with complex familial arrangements had greater difficulty meeting state requirements. Conclusions Parental involvement mandates undermine health service delivery and quality for minors seeking abortion services in the Southeast. Policy Implications Removing parental involvement requirements would protect minors’ reproductive autonomy and support the provision of equitable, patient-centered healthcare.

Content of antenatal care and perception about services provided by primary hospitals in Nepal: a convergent mixed methods study

2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Yubraj Acharya ◽  
Nigel James ◽  
Rita Thapa ◽  
Saman Naz ◽  
Rishav Shrestha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Mixed Methods ◽  
Antenatal Care ◽  
Quality Care ◽  
National Level ◽  
Poor Quality ◽  
Public Hospitals ◽  
World Health ◽  
Outcome Variable

Abstract Background Nepal has made significant strides in maternal and neonatal mortality over the last three decades. However, poor quality of care can threaten the gains, as maternal and newborn services are particularly sensitive to quality of care. Our study aimed to understand current gaps in the process and the outcome dimensions of the quality of antenatal care (ANC), particularly at the sub-national level. We assessed these dimensions of the quality of ANC in 17 primary, public hospitals across Nepal. We also assessed the variation in the ANC process across the patients’ socio-economic gradient. Methods We used a convergent mixed methods approach, whereby we triangulated qualitative and quantitative data. In the quantitative component, we observed interactions between providers (17 hospitals from all 7 provinces) and 198 women seeking ANC and recorded the tasks the providers performed, using the Service Provision Assessments protocol available from the Demographic and Health Survey program. The main outcome variable was the number of tasks performed by the provider during an ANC consultation. The tasks ranged from identifying potential signs of danger to providing counseling. We analyzed the resulting data descriptively and assessed the relationship between the number of tasks performed and users’ characteristics. In the qualitative component, we synthesized users’ and providers’ narratives on perceptions of the overall quality of care obtained through focus group discussions and in-depth interviews. Results Out of the 59 tasks recommended by the World Health Organization, providers performed only 22 tasks (37.3%) on average. The number of tasks performed varied significantly across provinces, with users in province 3 receiving significantly higher quality care than those in other provinces. Educated women were treated better than those with no education. Users and providers agreed that the overall quality of care was inadequate, although providers mentioned that the current quality was the best they could provide given the constraints they faced. Conclusion The quality of ANC in Nepal’s primary hospitals is poor and inequitable across education and geographic gradients. While current efforts, such as the provision of 24/7 birthing centers, can mitigate gaps in service availability, additional equipment, infrastructure and human resources will be needed to improve quality. Providers also need additional training focused on treating patients from different backgrounds equally. Our study also points to the need for additional research, both to document the quality of care more objectively and to establish key determinants of quality to inform policy.

scholarly journals The relationship between inequitable gender norms and provider attitudes and quality of care in maternal health services in Rwanda: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kate Doyle ◽  
Shamsi Kazimbaya ◽  
Ruti Levtov ◽  
Joya Banerjee ◽  
Myra Betron ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Care Provider ◽  
Quality Care ◽  
Gender Norms ◽  
Mixed Methods Study ◽  
Gender Attitudes ◽  
Power Dynamics ◽  
Health Providers ◽  
Men’S Involvement

Abstract Background Rwanda has made great progress in improving reproductive, maternal, and newborn health (RMNH) care; however, barriers to ensuring timely and full RMNH service utilization persist, including women’s limited decision-making power and poor-quality care. This study sought to better understand whether and how gender and power dynamics between providers and clients affect their perceptions and experiences of quality care during antenatal care, labor and childbirth. Methods This mixed methods study included a self-administered survey with 151 RMNH providers with questions on attitudes about gender roles, RMNH care, provider-client relations, labor and childbirth, which took place between January to February 2018. Two separate factor analyses were conducted on provider responses to create a Gender Attitudes Scale and an RMNH Quality of Care Scale. Three focus group discussions (FGDs) conducted in February 2019 with RMNH providers, female and male clients, explored attitudes about gender norms, provision and quality of RMNH care, provider-client interactions and power dynamics, and men’s involvement. Data were analyzed thematically. Results Inequitable gender norms and attitudes – among both RMNH care providers and clients – impact the quality of RMNH care. The qualitative results illustrate how gender norms and attitudes influence the provision of care and provider-client interactions, in addition to the impact of men’s involvement on the quality of care. Complementing this finding, the survey found a relationship between health providers’ gender attitudes and their attitudes towards quality RMNH care: gender equitable attitudes were associated with greater support for respectful, quality RMNH care. Conclusions Our findings suggest that gender attitudes and power dynamics between providers and their clients, and between female clients and their partners, can negatively impact the utilization and provision of quality RMNH care. There is a need for capacity building efforts to challenge health providers’ inequitable gender attitudes and practices and equip them to be aware of gender and power dynamics between themselves and their clients. These efforts can be made alongside community interventions to transform harmful gender norms, including those that increase women’s agency and autonomy over their bodies and their health care, promote uptake of health services, and improve couple power dynamics.

scholarly journals Perceived Support Among Families Deciding About Organ Donation for Their Loved Ones: Donor Vs Nondonor Next Of Kin

2010 ◽  
Vol 19 (5) ◽  
pp. e52-e61 ◽  
Author(s):  
Liva Jacoby ◽  
James Jaccard
Keyword(s):  
Quality Of Care ◽  
Organ Donation ◽  
Demographic Data ◽  
Quality Care ◽  
Family Members ◽  
Care Staff ◽  
Next Of Kin ◽  
Perceived Quality Of Care ◽  
Brain Dead

BackgroundFamilies’ experiences in the hospital influence their decisions about donating organs of brain-dead relatives. Meeting families’ support needs during this traumatic time is an obligation and a challenge for critical care staff.Objectives(1) To elicit family members’ accounts of various types of support received and perceived quality of care for themselves and their loved ones when they made the donation decision, and (2) to examine the relationship between these factors and the families’ donation decision.MethodsRetrospective telephone interviews of 199 families from different regions of the country were completed. Aside from demographic data, the survey addressed perceptions of informational, emotional, and instrumental support and quality of care.ResultsOne hundred fifty-four study participants consented to donation; 45 declined. White next of kin were significantly more likely than African Americans to consent. Specific elements of reported support were significantly associated with consent to donate. Donor and nondonor families had differing perceptions of quality care for themselves and their loved ones. Receiving understandable information about organ donation was the strongest predictor of consent.ConclusionsSpecific supportive behaviors by staff as recounted by family members of potential donors were significantly associated with consent to donation. These behaviors lend themselves to creative training and educational programs for staff. Such interventions are essential not only for next of kin of brain-dead patients, but also for staff and ultimately for the public as a whole.

Using Employer Purchasing Power to Improve the Quality of Perinatal Care

PEDIATRICS ◽  
1999 ◽  
Vol 103 (Supplement_E1) ◽  
pp. 248-254 ◽  
Author(s):  
Anne G. Castles ◽  
Arnold Milstein ◽  
Cheryl L. Damberg
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Services ◽  
Health Care Organizations ◽  
Perinatal Care ◽  
Quality Measurement ◽  
Quality Data ◽  
Purchasing Power ◽  
Care Services

Large employers have become increasingly involved in helping to set the agenda for quality measurement and improvement. Moreover, they are beginning to hold health care organizations accountable for their performance through marketplace incentives, including the public reporting of comparative quality data and the linkage of reimbursement to performance on quality measures. The Pacific Business Group on Health (PBGH) is an employer coalition that has been prominent in establishing models for collaborative quality measurement and improvement in the California marketplace. PBGH's involvement in quality stems from an environment in which purchasers were faced with high health care costs, yet virtually no information with which to assess the value their employees received from that care. Research indicating widespread variation in performance across health care organizations and seemingly limited oversight for quality of care within the industry has further motivated purchasers' efforts to better understand the quality of care being delivered to their em-ployees. Using the purchasing power of employers representing 2.5-million covered lives, PBGH endeavors to encourage the transition of the health care marketplace from one that competes solely on price to one that competes on price and quality. This entails collaborating with the health care industry to develop and publicly report valid performance data for use by both large employers and consumers of health care services. It also includes communicating to the marketplace purchasers' commitment to making purchasing decisions based on quality as well as cost. PBGH efforts to measure, report, and improve quality have been demonstrated by several undertakings in the perinatal care arena, including research to assess cesarean section rates and newborn readmission rates across California hospitals. employer coalition, purchaser, quality measurement, quality improvement, report cards, perinatal quality of care.

Guilhème Pérodeau et Denyse Côté (Eds.). Le virage ambulatoire : Défis et enjeux. Sainte-Foy, QC: Presses de l'Université du Québec. 2002.

2004 ◽  
Vol 23 (2) ◽  
pp. 191-192
Author(s):  
Aline Vézina
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Home Care ◽  
Family Member ◽  
Informal Caregivers ◽  
Nursing Personnel ◽  
Negative Consequences ◽  
The Core ◽  
Care At Home

ABSTRACTThis book is comprised of three sections: the problems and consequences of the push for more de-institutionalized health care, the issues that crop up in this context, and the perceptions of the caregiver. At the core of this text are the two groups of women who are most present in this new context: the informal caregivers or family helpers and the nurses. Three conclusions become evident. Firstly, the push for home care has many negative consequences, especially for women. Secondly, although the help of a family member makes possible the dispensation of care at home, something wished for by most patients, it also entails an increase in, and professionalization of, the tasks for the caregiving family member. Finally, using the home as the place of care also has the consequence of increasing the tasks of nursing personnel, to the point where there is a perception that the quality of care has decreased.

scholarly journals 144 QUALITY OF CARE IN PEDIATRIC CHRONIC DISEASES: A STUDY IN ITALY

1994 ◽  
Vol 36 (1) ◽  
pp. 26A-26A
Author(s):  
Federico Marcheai ◽  
Maurizio Bonati ◽  
Gianni Tognoni ◽  
Giuseppe La Gamba ◽  
Giancarlo Biasini
Keyword(s):  
Quality Of Care ◽  
Chronic Diseases ◽  
Pediatric Chronic Diseases

Comparing Quality of Care Between a Consumer-Directed Health Plan and a Traditional Plan: An Analysis of HEDIS Measures Related to Management of Chronic Diseases

2009 ◽  
Vol 12 (2) ◽  
pp. 61-67 ◽  
Author(s):  
Amy R. Wilson ◽  
Holly Rodin ◽  
Nancy A. Garrett ◽  
Eric P. Bargman ◽  
Lori A. Harris ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Chronic Diseases ◽  
Health Plan

scholarly journals Quality of care transition and its association with hospital readmission

Aquichan ◽  
2020 ◽  
Vol 19 (4) ◽  
pp. 1-11
Author(s):  
Luciana Andressa Feil Weber ◽  
Maria Alice Dias da Silva Lima ◽  
Aline Marques Acosta
Keyword(s):  
Quality Of Care ◽  
Chronic Diseases ◽  
Hospital Readmission ◽  
Care Transition ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Hospital Management System ◽  
Student’S T ◽  
Inpatient Units

Objective: To evaluate the quality of care transition for patients with chronic diseases and to verify its association with hospital readmission within 30 days after discharge. Method: Cross-sectional epidemiological study of 210 patients with chronic diseases discharged from a hospital in southern Brazil. The Care Transition Measure-15 (CTM-15) instrument was used, through a telephone contact and, in order to identify readmissions within 30 days, the hospital management system was consulted. Student’s t-tests analysis of variance and nonparametric Pearson or Spearman correlation tests were performed. Results: CTM-15 score was 74.7 (± 17.1). No significant association was found between the quality of care transition and hospital readmission. 12.3 % of the patients were readmitted, and 46.2 % of these readmissions were to the emergency service. Conclusions: The quality of the care transition for chronic patients from inpatient units to home, showed a satisfactory score. However, there was no association between the quality of care transition and hospital readmission within 30 days after discharge.

scholarly journals Client Satisfaction and Experience With Telepsychiatry: Development and Validation of a Survey Using Clinical Quality Domains (Preprint)

2020 ◽  
Author(s):  
Eva Serhal ◽  
Anne Kirvan ◽  
Marcos Sanches ◽  
Allison Crawford
Keyword(s):  
Mental Health ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Quality Care ◽  
Clinical Intervention ◽  
Strongly Correlated ◽  
Clinical Quality ◽  
Survey Tool ◽  
Development And Validation

BACKGROUND Telepsychiatry is an increasingly used model of mental health care that connects patients with psychiatrists at a distance via videoconference. Telepsychiatry is an effective clinical intervention that improves access to quality care in regions with limited resources or in clinical situations where in-person care is unavailable. OBJECTIVE This study aims to develop a validated survey tool to measure patient experience and satisfaction with telepsychiatry based on the quality of care domains. This study also seeks to understand which health service outcomes were most strongly correlated with overall satisfaction in the context of telepsychiatry. METHODS The survey created in this study was developed and validated with a panel of subject matter and process experts and was piloted with 274 patients who received clinical consultations through the TeleMental Health Program at the Centre for Addiction and Mental Health. Factor analysis was used to determine correlations between questions and quality of care domains and was also used to assess model fit. RESULTS The study provides a validated survey to measure patient satisfaction and experience with telepsychiatry across 4 domains: access and timeliness, appropriateness, effectiveness, and safety. Both safety and access and timeliness were found to be statistically significant predictors of satisfaction in our sample. CONCLUSIONS By situating patient satisfaction and experience within this framework, the survey facilitates patient data collection and interpretation through a clinical quality lens.

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