scholarly journals A Board Level Intervention to Develop OrganisationWide Quality Improvement Strategies: Cost-Consequences Analysis in 15 Healthcare Organisations

2020 ◽  
Author(s):  
Estela Capelas Barbosa ◽  
Lorelei Jones ◽  
Linda Pomeroy ◽  
Glenn Robert ◽  
Susan Burnett ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Intervention Development ◽  
Positive Association ◽  
Chief Executive ◽  
High Performing ◽  
Before And After ◽  
Hospital Boards ◽  
Board Level

Background: Hospital boards have statutory responsibility for upholding the quality of care in their organisations. International research on quality in hospitals resulted in a research-based guide to help senior hospital leaders develop and implement quality improvement (QI) strategies, the QUASER Guide. Previous research has established a link between board practices and quality of care; however, to our knowledge, no board-level intervention has been evaluated in relation to its costs and consequences. The aim of this research was to evaluate these impacts when the QUASER Guide was implemented in an organisational development intervention (iQUASER). Methods: We conducted a ‘before and after’ cost-consequences analysis (CCA), as part of a mixed methods evaluation. The analysis combined qualitative data collected from 66 interviews, 60 hours of board meeting observations and documents from 15 healthcare organisations, of which 6 took part on iQUASER, and included direct and opportunity costs associated with the intervention. The consequences focused on the development of an organisation-wide QI strategy, progress on addressing 8 dimensions of QI (the QUASER challenges), how organisations compared to benchmarks, engagement with the intervention and progress in the implementation of a QI project. Results: We found that participating organisations made greater progress in developing an organisation-wide QI strategy and became more similar to the high-performing benchmark than the comparators. However, progress in addressing all 8 QUASER challenges was only observed in one organisation. Stronger engagement with the intervention was associated with the implementation of a QI project. On average, iQUASER costed £23 496 per participating organisation, of which approximately 44% were staff time costs. Organisations that engaged less with the intervention had lower than average costs (£21 267 per organisation), but also failed to implement an organisation-wide QI project. Conclusion: We found a positive association between level of engagement with the intervention, development of an organisation-wide QI strategy and the implementation of an organisation-wide QI project. Support from the board, particularly the chair and chief executive, for participation in the intervention, is important for organisations to accrue most benefit. A board-level intervention for QI, such as iQUASER, is relatively inexpensive as a proportion of an organisation’s budget.

scholarly journals The use of patient feedback by hospital boards of directors: a qualitative study of two NHS hospitals in England

2017 ◽  
Vol 27 (2) ◽  
pp. 103-109 ◽  
Author(s):  
Robert Lee ◽  
Juan I Baeza ◽  
Naomi J Fulop
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Qualitative Study ◽  
Boards Of Directors ◽  
National Health Service Foundation ◽  
Patient Feedback ◽  
Qualitative Feedback ◽  
Hospital Boards ◽  
Foundation Trusts

BackgroundAlthough previous research suggests that different kinds of patient feedback are used in different ways to help improve the quality of hospital care, there have been no studies of the ways in which hospital boards of directors use feedback for this purpose.ObjectivesTo examine whether and how boards of directors of hospitals use feedback from patients to formulate strategy and to assure and improve the quality of care.MethodsWe undertook an in-depth qualitative study in two acute hospital National Health Service foundation trusts in England, purposively selected as contrasting examples of the collection of different kinds of patient feedback. We collected and analysed data from interviews with directors and other managers, from observation of board meetings, and from board papers and other documents.ResultsThe two boards used in-depth qualitative feedback and quantitative feedback from surveys in different ways to help develop strategies, set targets for quality improvement and design specific quality improvement initiatives; but both boards made less subsequent use of any kinds of feedback to monitor their strategies or explicitly to assure the quality of services.Discussion and conclusionsWe have identified limitations in the uses of patient feedback by hospital boards that suggest that boards should review their current practice to ensure that they use the different kinds of patient feedback that are available to them more effectively to improve, monitor and assure the quality of care.

Utilizing QOPI in the quality improvement efforts of the NCI Community Cancer Centers Program (NCCCP).

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 208-208
Author(s):  
Robert D. Siegel ◽  
Holley Stallings ◽  
Donna M. Bryant ◽  
Pamela Kadlubek ◽  
Laurel Borowski ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Best Practices ◽  
New England ◽  
Community Based ◽  
Quality Initiatives ◽  
Cancer Centers ◽  
High Performing ◽  
Oncology Practice

208 Background: The NCCCP is a network of community based institutions from New England to Hawaii funded by the NCI. Quality of care is a priority of the NCCCP with participation in ASCO’s Quality Oncology Practice Initiative (QOPI) playing a fundamental role. QOPI provides a process for quality assessment but we have also used it as a measure of quality improvement (QI) network-wide. Using QOPI methodology, we have analyzed our performance twice a year in an effort to enhance our implementation of quality indicators relevant to program aims. Methods: A data sharing agreement allows individual practice QOPI data to be electronically sent to the NCI where it is aggregated with the other NCCCP QOPI participants. Data are presented via webinar within the network using a variety of QI strategies. For example, blinded site performance distributions are benchmarked against NCCCP national averages on specific indicators. High performing practices voluntarily present their QI initiatives and best practices to the network. The NCCCP Quality of Care Subcommittee then selects QI projects and areas to focus quality improvement efforts. Results: In Spring 2012, 44 practices affiliated with 25 NCCCP sites participated in QOPI, a consistent pattern since Fall 2010. The table below describes the percent compliance with certain QOPI measures for the NCCCP aggregate over time. Selected measures were perceived as having had suboptimal compliance in Fall 2010. Conclusions: QOPI is an effective tool for assessing quality within a network and for measuring quality improvement efforts. Best practices from within the network can be leveraged and disseminated to enhance the quality of cancer care. This methodology facilitates quality initiatives despite the logistical challenges of working with practices across the country. [Table: see text]

scholarly journals Improving nursing documentation for surgical patients in a referral hospital in Freetown, Sierra Leone: protocol for assessing feasibility of a pilot multifaceted quality improvement hybrid type project

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nataliya Brima ◽  
Nick Sevdalis ◽  
K. Daoh ◽  
B. Deen ◽  
T. B. Kamara ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Sierra Leone ◽  
Referral Hospital ◽  
Audit And Feedback ◽  
Health System Strengthening ◽  
Theory Of Change ◽  
Improve Quality ◽  
Nursing Documentation

Abstract Background There is an urgent need to improve quality of care to reduce avoidable mortality and morbidity from surgical diseases in low- and middle-income countries. Currently, there is a lack of knowledge about how evidence-based health system strengthening interventions can be implemented effectively to improve quality of care in these settings. To address this gap, we have developed a multifaceted quality improvement intervention to improve nursing documentation in a low-income country hospital setting. The aim of this pilot project is to test the intervention within the surgical department of a national referral hospital in Freetown, Sierra Leone. Methods This project was co-developed and co-designed by in-country stakeholders and UK-based researchers, after a multiple-methodology assessment of needs (qualitative, quantitative), guided by a participatory ‘Theory of Change’ process. It has a mixed-method, quasi-experimental evaluation design underpinned by implementation and improvement science theoretical approaches. It consists of three distinct phases—(1) pre-implementation(project set up and review of hospital relevant policies and forms), (2) intervention implementation (awareness drive, training package, audit and feedback), and (3) evaluation of (a) the feasibility of delivering the intervention and capturing implementation and process outcomes, (b) the impact of implementation strategies on the adoption, integration, and uptake of the intervention using implementation outcomes, (c) the intervention’s effectiveness For improving nursing in this pilot setting. Discussion We seek to test whether it is possible to deliver and assess a set of theory-driven interventions to improve the quality of nursing documentation using quality improvement and implementation science methods and frameworks in a single facility in Sierra Leone. The results of this study will inform the design of a large-scale effectiveness-implementation study for improving nursing documentation practices for patients throughout hospitals in Sierra Leone. Trial registration Protocol version number 6, date: 24.12.2020, recruitment is planned to begin: January 2021, recruitment will be completed: December 2021.

CQI: Meeting the Mandate for Quality

1995 ◽  
Vol 112 (5) ◽  
pp. P111-P111
Author(s):  
Carl A. Patow
Keyword(s):  
Quality Improvement ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Continuous Quality Improvement ◽  
Educational Objectives ◽  
Continuous Quality

Educational objectives: To understand the principles of continuous quality improvement and to use these principles to enhance patient satisfaction through increased efficiency and improved quality of care.

Value-based dentistry: Putting the patient first

2016 ◽  
Vol 7 (3) ◽  
pp. 126-129 ◽  
Author(s):  
Sreenivas Koka ◽  
Galya Raz
Keyword(s):  
Risk Management ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Dental Care ◽  
Time Cost ◽  
Safety Risk ◽  
The Cost ◽  
Over Time

What does ‘value’ mean? In the context of dental care, it can be defined as the quality of care received by a patient divided by the cost to the patient of receiving that care. In other words: V =Q/C, where Q equals the quality improvement over time, which most patients view in the context of the outcome, the service provided and safety/risk management, and C equals the financial, biological and time cost to the patient. Here, the need for, and implications of, value-based density for clinicians and patients alike are explored.

scholarly journals Baseline Quality-of-Care Data From a Quality-Improvement Program Implemented by a Network of Diabetes Outpatient Clinics

Diabetes Care ◽  
2008 ◽  
Vol 31 (11) ◽  
pp. 2166-2168 ◽  
Author(s):  
M. C.E. Rossi ◽  
A. Nicolucci ◽  
A. Arcangeli ◽  
A. Cimino ◽  
G. De Bigontina ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Quality Improvement Program ◽  
Outpatient Clinics ◽  
Improvement Program

scholarly journals PENERAPAN PRAKTIK KEPERAWATAN BERBASIS BUKTI PURSED LIP BREATHING PADA PASIEN DENGAN PENYAKIT PARU OBSTRUKTIF KRONIK DI RUANG RSU PUSAT PERSAHABATAN JAKARTA

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Seven Sitorus
Keyword(s):  
Quality Of Care ◽  
Pulmonary Disease ◽  
Significant Influence ◽  
Exercise Tolerance ◽  
P Value ◽  
Evidence Based ◽  
Copd Exacerbation ◽  
Before And After ◽  
Evidence Based Nursing

Background: Chronic Obstruction Pulmonary Disease (COPD) is disease characterized by obstruction air flow in the breath not wholly reversible. One treatment can be done on improving exercise tolerance is exercise respiration as pursed lip breathing ( PLB ). Purse lip breathing is a techniques of breathing carried out to expelling air by creating power through  in move closer /pursed lips. Purpose: provide an illustration of the application of the practice of evidence based nursing of pursed lip breathing in patients COPD in RSUP Persahabatan Jakarta. Method:  the implementation of the practice of evidence based nursing pursed lip breathing is applied to 12 people sample ( 10 men and 2 women ) diagnosed with COPD exacerbation. Result: the majority of sex respondents is man as many as 10 ( 83,3 % ) persons and women as many as 2 ( 16,7 % ) a person .mean the age of respondents is 61,5 years ± 10.4 .mean the value of PEF ( Peak Expiratory Flow ), the value of the saturation oxygen , the value of respiratori rate before the intervention in a consecutive manner is 131.6 ±  44.6; 92.1 ± 2.44; 31.5 ±  2 . While value after the intervention is 175.0 ±  60.0; 97,1 ± 1.6; 22,6 ± 1.7 with P value = 0.001, α = 0.05. Conclusions: there are significant influence the application of pursed lip breathing between before and after the intervention in patients COPD. Advice: Intervention evidence based nursing can be applied to all patients COPD so reached the quality of care of nursing based on research

scholarly journals Quality of care for patients with diabetes mellitus type 2 in ‘model practices’ in Slovenia – first results

2016 ◽  
Vol 55 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Davorina Petek ◽  
Mitja Mlakar
Keyword(s):  
Diabetes Mellitus ◽  
Quality Of Care ◽  
Quality Indicators ◽  
Diabetes Mellitus Type 2 ◽  
Process Quality ◽  
Diabetes Mellitus Type ◽  
Before And After ◽  
Patients With Diabetes

Abstract Background A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone. The aim of the study is to compare the quality of management of patients with diabetes mellitus type 2 before and after the introduction of model practices. Methods A cohort retrospective study was based on medical records from three practices. Process quality indicators, such as regularity of HbA1c measurement, blood pressure measurement, foot exam, referral to eye exam, performance of yearly laboratory tests and HbA1c level before and after the introduction of model practices were compared. Results The final sample consisted of 132 patients, whose diabetes care was exclusively performed at the primary care level. The process of care has significantly improved after the delivery of model practices. The most outstanding is the increase of foot exam and HbA1c testing. We could not prove better glycaemic control (p>0.1). Nevertheless, the proposed benchmark for the suggested quality process and outcome indicators were mostly exceeded in this cohort. Conclusion The introduction of a nurse into the team improves the process quality of care. Benchmarks for quality indicators are obtainable. Better outcomes of care need further confirmation.

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