scholarly journals Quality of Best Possible Medication History upon Admission to Hospital: Comparison of Nurses and Pharmacy Students and Consideration of National Quality Indicators

2018 ◽  
Vol 71 (2) ◽  
Author(s):  
Ashley Sproul ◽  
Carole Goodine ◽  
David Moore ◽  
Amy McLeod ◽  
Jacqueline Gordon ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Quality Indicator ◽  
Prospective Trial ◽  
Pharmacy Students ◽  
Transitions Of Care ◽  
Medication History ◽  
National Quality ◽  
Significant Difference ◽  
Personnel Infirmier

<p><strong>ABSTRACT</strong></p><p><strong>Background: </strong>Medication reconciliation at transitions of care increases patient safety. Collection of an accurate best possible medication history (BPMH) on admission is a key step. National quality indicators are used as surrogate markers for BPMH quality, but no literature on their accuracy exists. Obtaining a high-quality BPMH is often labour- and resource intensive. Pharmacy students are now being assigned to obtain BPMHs, as a cost-effective means to increase BPMH completion, despite limited information to support the quality of BPMHs obtained by students relative to other health care professionals.</p><p><strong>Objectives: </strong>To determine whether the national quality indicator of using more than one source to complete a BPMH is a true marker of quality and to assess whether BPMHs obtained by pharmacy students were of quality equal to those obtained by nurses.</p><p><strong>Methods: </strong>This prospective trial compared BPMHs for the same group of patients collected by nurses and by trained pharmacy students in the emergency departments of 2 sites within a large health network over a 2-month period (July and August 2016). Discrepancies between the 2 versions were identified by a pharmacist, who determined which party (nurse, pharmacy student, or both) had made an error. A panel of experts reviewed the errors and ranked their severity.</p><p><strong>Results: </strong>BPMHs were prepared for a total of 40 patients. Those prepared by nurses were more likely to contain an error than those prepared by pharmacy students (171 versus 43 errors, <em>p </em>= 0.006). There was a nonsignificant trend toward less severe errors in BPMHs completed by pharmacy students. There was no significant difference in the mean number of errors in relation to the specified quality indicator (mean of 2.7 errors for BPMHs prepared from 1 source versus 4.8 errors for BPMHs prepared from ≥ 2 sources, <em>p </em>= 0.08).</p><p><strong>Conclusions: </strong>The surrogate marker (number of BPMH sources) may not reflect BPMH quality. However, it appears that BPMHs prepared by pharmacy students had fewer errors and were of similar quality (in terms of clinically significant errors) relative to those prepared by nurses.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte : </strong>L’établissement du bilan comparatif des médicaments au moment du transfert des soins accroît la sécurité des patients. L’obtention d’un meilleur schéma thérapeutique possible (MSTP) exact à l’admission en est une étape clé. Des indicateurs nationaux de la qualité sont utilizes comme critères de substitution pour évaluer la qualité des MSTP, mais il n’y a pas de documentation se penchant sur leur exactitude. Obtenir un MSTP de grande qualité est souvent exigeant sur le plan du personnel et des ressources. Des étudiants en pharmacie se voient maintenant confier l’élaboration de MSTP, une façon peu coûteuse d’accroître les taux de réalisation de MSTP; or, il n’y a que peu d’information pour valider le degré de qualité des MSTP obtenus par des étudiants en comparaison avec ceux produits par d’autres professionnels de la santé.</p><p><strong>Objectifs : </strong>Déterminer si l’indicateur national de qualité basé sur le recours à plus d’une source de renseignements pour réaliser un MSTP est un vrai marqueur de qualité et évaluer la qualité relative des MSTP de la part des étudiants en pharmacie et du personnel infirmier.</p><p><strong>Méthodes : </strong>Dans la présente étude prospective réalisée sur une période de deux mois (en juillet et en août 2016), les chercheurs ont comparé les MSTP recueillis auprès du même groupe de patients par du personnel infirmier et par des étudiants en pharmacie qualifiés dans les services des urgences de deux établissements faisant partie d’un important réseau de santé. Un pharmacien relevait les divergences entre les deux versions du MSTP et imputait l’erreur soit au personnel infirmier, soit à l’étudiant en pharmacie ou soit aux deux parties. Un groupe d’experts a étudié les erreurs et leur a accordé une cote selon leur degré de gravité.</p><p><strong>Résultats : </strong>Des MSTP ont été réalisés auprès de 40 patients. Ceux préparés par le personnel infirmier étaient plus susceptibles de contenir une erreur que ceux établis par les étudiants en pharmacie (171 contre 43 erreurs, <em>p </em>= 0,006). On a noté une tendance non significative selon laquelle les erreurs commises par les étudiants en pharmacie étaient moins graves. Aucune différence significative n’a été relevée quant au nombre moyen d’erreurs par rapport à l’indicateur de qualité (2,7 pour les MSTP provenant d’une source contre 4,8 pour les MSTP provenant de deux sources ou plus, <em>p </em>= 0,08).</p><p><strong>Conclusions : </strong>Le critère de substitution (nombre de sources pour le MSTP) pourrait ne pas être représentatif de la qualité du MSTP. Cependant, il semble que les MSTP préparés par les étudiants en pharmacie comportaient moins d’erreurs et étaient de qualité comparable (quant aux erreurs cliniquement significatives) à ceux établis par le personnel infirmier.</p>

scholarly journals Guidelines on constructing funnel plots for quality indicators: A case study on mortality in intensive care unit patients

2017 ◽  
Vol 27 (11) ◽  
pp. 3350-3366 ◽  
Author(s):  
Ilona WM Verburg ◽  
Rebecca Holman ◽  
Niels Peek ◽  
Ameen Abu-Hanna ◽  
Nicolette F de Keizer
Keyword(s):  
Intensive Care ◽  
Quality Indicators ◽  
Quality Indicator ◽  
Clinical Performance ◽  
Institutional Characteristics ◽  
Funnel Plots ◽  
Using Data ◽  
Care Evaluation

Funnel plots are graphical tools to assess and compare clinical performance of a group of care professionals or care institutions on a quality indicator against a benchmark. Incorrect construction of funnel plots may lead to erroneous assessment and incorrect decisions potentially with severe consequences. We provide workflow-based guidance for data analysts on constructing funnel plots for the evaluation of binary quality indicators, expressed as proportions, risk-adjusted rates or standardised rates. Our guidelines assume the following steps: (1) defining policy level input; (2) checking the quality of models used for case-mix correction; (3) examining whether the number of observations per hospital is sufficient; (4) testing for overdispersion of the values of the quality indicator; (5) testing whether the values of quality indicators are associated with institutional characteristics; and (6) specifying how the funnel plot should be constructed. We illustrate our guidelines using data from the Dutch National Intensive Care Evaluation registry. We expect that our guidelines will be useful to data analysts preparing funnel plots and to registries, or other organisations publishing quality indicators. This is particularly true if these people and organisations wish to use standard operating procedures when constructing funnel plots, perhaps to comply with the demands of certification.

scholarly journals Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

2018 ◽  
Vol 55 ◽  
pp. 004695801876149 ◽  
Author(s):  
Thomas Petzold ◽  
Stefanie Deckert ◽  
Paula R. Williamson ◽  
Jochen Schmitt
Keyword(s):  
Quality Of Care ◽  
Quality Indicators ◽  
Clinical Guidelines ◽  
Quality Indicator ◽  
Health Care Systems ◽  
Quality Measurement ◽  
Routine Care ◽  
Measurement Properties ◽  
Measurement Instruments

We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted. In Germany, no explicit methodological guidance exists, but 3 different approaches are used. For NICE, a general approach is used for the derivation of quality indicators out of quality standards. Quality indicators were defined in 34 out of 87 CGs (39%) in Germany and for 58 out of 133 (43%) NICE CGs. Statements regarding measurement properties of instruments for quality indicator assessment were missing in German and NICE documents. Thirteen pairs of CGs (32%) have associated quality indicators. Thirty-four quality indicators refer to the same aspect of the quality of care, which corresponds to 27% of the German and 7% of NICE quality indicators. The development of a standardized and internationally accepted methodology for the derivation of quality indicators relevant to CGs is needed to measure and compare quality of care in health care systems.

scholarly journals Intra-Articular Hybrid Hyaluronic Acid Injection Treatment in Overweight Patients with Knee Osteoarthritis: A Single-Center, Open-Label, Prospective Study

2021 ◽  
Vol 11 (18) ◽  
pp. 8711
Author(s):  
Dalila Scaturro ◽  
Fabio Vitagliani ◽  
Pietro Terrana ◽  
Daniele Cuntrera ◽  
Vincenzo Falco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Disease Severity ◽  
Prospective Trial ◽  
Open Label ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Significant Difference

Background: A BMI > 25 is the most decisive, albeit modifiable, risk factor for knee osteoarthritis (KOA). This study aimed at assessing the efficacy of intra-articular injections of hybrid hyaluronic acid (HA) complexes (Sinovial® H-L) for the treatment of KOA in overweight patients in terms of disease severity, cardiocirculatory capacity, and quality of life. Materials: In this single-site, open-label, prospective trial, 37 patients with symptomatic knee OA were assessed at baseline and 3 months after ultrasound-guided intra-articular injection of hybrid HA complexes (Sinovial® H-L). Results: Primary variables displaying a statistically significant improvement after treatment were pain (VAS), disease severity (WOMAC), and cardiopulmonary capacity (6 min walk test). Among secondary variables, quality of life (SF-12) improved significantly, as did analgesic intake for pain control. No statistically significant difference was observed in body fat and muscle mass percentage measured by bioelectrical impedance analysis. Conclusions: Intra-articular hybrid HA injections are significantly effective in improving OA-related disease severity, cardiopulmonary function, and analgesic intake. This supports the role of hybrid HA viscosupplementation as a nonpharmacological treatment to relieve pain, reduce disability, improve quality of life, and limit the risk of polypharmacy in overweight patients with knee OA.

scholarly journals Assessment of health care quality in the tertiary level pediatric hospitals in Serbia

2011 ◽  
Vol 68 (1) ◽  
pp. 21-27
Author(s):  
Nina Kuburovic ◽  
Slavisa Djuricic ◽  
Andjelija Neskovic ◽  
Velimir Dedic ◽  
Vladimir Kuburovic
Keyword(s):  
Health Care ◽  
Quality Indicators ◽  
Pediatric Surgery ◽  
Quality Data ◽  
Tertiary Level ◽  
Autopsy Rate ◽  
Quality Of Work ◽  
Number Of Patients ◽  
Significant Difference

Background/Aim. It is necessary to improve the quality of health care for children. Assessment data would provide new insights into better treatment outcomes. The aim of this descriptive study was to estimate and to compare applied quality indicators in five pediatric inpatient tertiary level institutions in Serbia during the period from January 1st to December 31st 2008. Methods. Quality data and indicators were collected in the Institute for Public Health of Serbia ?Dr. Milan Jovanovic Batut?. Descriptive statistics and chisquare test were used for data analysis. Results. The average length of stay (ALOS) in pediatric departments was 7.51 ? 1.30 days (5.88-8.91 days). In the same period, ALOS in pediatric surgery departments was 5.85 ? 1.50 days (3.58-7.57 days). The average number of nurses per occupied bed was 0.76 ? 0.20 and 1.09 ? 0.36 in pediatric and in pediatric surgery departments, respectively. The number of operated patients per surgeon was in the range 51.0-160.5. The annual case fatality rate in pediatric departments was estimated to 0.72% ? 0.20%, whereas in pediatric surgery departments it was 0.34% ? 0.25%. The autopsy rate was estimated to 0.00%-63.16% in pediatric departments, and 37.14%-80.00% in pediatric surgery departments. There was statistically significant difference among the five hospitals regarding the following indicators of quality of work: total annual mortality rate of patients, autopsy rate, number of rate of patients, autopsy rate, number of patients referred to other institutions, both in pediatric and pediatric surgery departments. Conclusion. There is a significant difference among the five hospitals regarding indicators of quality of work. Obligatory set of quality indicators on the basis of legislative acts are the indicators of general quality of work in hospital. It is necessary to establish specific pediatric quality indicators and to define national standards related to these indicators.

scholarly journals DATA QUALITY OF NATIONAL QUALITY INDICATORS AND THEIR ACCEPTANCE IN SWISS NURSING HOMES

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 421-421
Author(s):  
F Zuniga ◽  
C Blatter ◽  
M Simon
Keyword(s):  
Nursing Homes ◽  
Data Quality ◽  
Quality Indicators ◽  
National Quality

scholarly journals Generalized indicator of qualimetry objects quality of various nature

2021 ◽  
Vol 109 (1) ◽  
pp. 94-101
Author(s):  
N. Kim ◽  
Keyword(s):  
Quality Indicators ◽  
Technological Process ◽  
Quality Indicator ◽  
Form Parameter ◽  
Nonlinear Relationships ◽  
Process System ◽  
Generalized Indicator

Generalized indicator of qualimetry objects quality of various nature The article presents a methodology for determining a generalized quality indicator of qualimetry objects of various nature, including products, technological process, system, or anything that is subject to assessment. Based on the analysis of the existing nonlinear relationships between the measured quality indicator and its assessment on a dimensionless scale, a method based on the use of generalized quality indicators is proposed. Keywords: generalized quality indicator, qualimetry objects, form parameter, assessment of quality indicators.

scholarly journals THE REALITY OF APPLYING THE QUALITY INDICATORS OF ACADIMC STAFF IN LIBYAN UNIVERSITIES: THE FACULTY OF ARTS, THE UNIVERSITY OF TRIPOLI, AS A MODEL

2021 ◽  
Vol 03 (02) ◽  
pp. 141-151
Author(s):  
Faiza Salem GRIFA
Keyword(s):  
Quality Indicators ◽  
Academic Staff ◽  
Faculty Members ◽  
Validity And Reliability ◽  
Academic Degree ◽  
Academic Qualification ◽  
Significant Difference ◽  
Analytical Research ◽  
The University

The study aimed to identify the reality of applying indicators of academic staff’s quality in Libyan universities. Furthermore, the study attempted to know the obstacles that prevent the application of it. Moreover, the study aimed to explore whether there is a difference in estimating the degree of importance of these obstacles according to: academic degree, academic qualification, and experience years. A descriptive and analytical research design was adopted. To answer the study questions, a questionnaire was developed and its validity and reliability were assured. The study sample (N=50) was drawn from academic staff at Tripoli University, Faculty of Arts. Results related to the first dimension showed that all indicators of this dimension were weak), which indicates a low availability of indicators to achieve the quality of the faculty academic members. With regard to the second dimension, the results showed that all indicators of this dimension were high, which indicates however, the level of availability of obstacles to the application of quality indicators for faculty members was high. The findings also indicated that there was no significant difference in estimating the degree of importance of obstacles to the application of quality indicators of faculty academic members according to: academic degree, academic qualification, and years of experience.

scholarly journals STUDY OF THE INFLUENCE OF MICELLAR CASEIN AND SPELT FLOUR ON YOGHURT QUALITY INDICATORS

2020 ◽  
Vol 4 ◽  
pp. 44-52
Author(s):  
Galyna Polischuk ◽  
Nataliia Breus ◽  
Oxana Kochubey-Litvinenko ◽  
Tetiana Osmak ◽  
Tetiana Semko ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Quality Indicator ◽  
Nutritional Value ◽  
Complete Replacement ◽  
Maximum Value ◽  
Micellar Casein ◽  
New Type ◽  
Scientific Substantiation ◽  
Optimal Values

The aim of the research is to study the effect of protein-containing ingredients of animal and plant origin on the quality indicators of yoghurt for the scientific substantiation of its recipe composition. Micellar casein and spelled flour are characterized by high nutritional value, exhibit functional and technological properties and can significantly affect the quality indicators of yogurt. To confirm this, the possibility of complete replacement of the structure stabilizer in the composition of yoghurt with micellar casein and spelled flour, both separately and in various ratios, was studied. As a single criterion for optimizing the recipe composition of yoghurt at various ratios between casein and spelled flour, product quality indicators were used: the degree of syneresis, effective viscosity, organoleptic indicators. The optimal values of the single criteria were obtained at different ranges of ratios between natural ingredients, which don’t allow developing uniform recommendations for the formulation of a new type of yogurt. Therefore, to study the combined effect of protein and spelled flour on the characteristics of yoghurt and the coefficients of their significance, a complex quality indicator was used. This indicator was determined as a function of estimates of single quality indicators, converted to scaled values, taking into account the coefficients of significance of individual indicators. Using a complex quality indicator, the ranges of optimal values of the content of micellar casein and spelled flour in yoghurt were established. So, when adding casein in an amount of 1.25 to 3.0 % and spelled flour - from 0.75 to 1.50 %, the quality of yoghurt reached its maximum value. The use of these ingredients alone showed a significantly lower technological effect in comparison with their compositions. Therefore, a conclusion was made about the synergistic interaction of casein and spelled flour, as well as the advisability of using the compositional composition of these ingredients in the yogurt technology

scholarly journals Change in Quality of Tuberculosis (TB) Care since National Quality Assessment Program of TB Healthcare Service

2021 ◽  
Vol 27 (2) ◽  
pp. 73-82
Author(s):  
Seong-Ja Jang ◽  
Mi-Jin Hwang ◽  
Chung-Hun Lee ◽  
Hyeon-Ju Lee ◽  
Tae-Sun Shim ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Quality Indicators ◽  
Healthcare Service ◽  
Care Management ◽  
Drug Susceptibility ◽  
Susceptibility Test ◽  
Drug Susceptibility Test ◽  
National Quality ◽  
Medical Facilities

Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1<sup>st</sup> to 3<sup>rd</sup> national quality assessment (QA) program for TB healthcare service in Korea was conducted.Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy).Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%.Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.

235 5-YEAR FOLLOW-UP OF A PROSPECTIVE CLINICAL TRIAL OF AN ENDOSCOPIC FULL-THICKNESS PLICATION DEVICE (GERDX™) FOR THE TREATMENT OF GERD

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Andreas Tschoner ◽  
Paul Punkenhofer ◽  
Georg Spaun ◽  
Oliver Koch ◽  
Reinhold Fuegger
Keyword(s):  
Quality Of Life ◽  
Laparoscopic Fundoplication ◽  
Prospective Trial ◽  
Full Thickness ◽  
Reflux Symptoms ◽  
Redo Fundoplication ◽  
Significant Difference ◽  
Gerd Symptoms

Abstract   The gold-standard in the operative treatment of gastroesophageal reflux disease (GERD) is the laparoscopic fundoplication. Alternatively, endoscopic devices to rebuild the gastroesophageal valve were invented. The aim of our study is to assess the improvement of GERD symptoms and quality of life in patients five years after the endoscopic full-thickness plication with the GERDx™ device. Methods Between 2013 and 2016 a prospective trial was implemented with forty patients and an endoscopic plication due to reflux symptoms with a pathologic workup for GERD. Limitation for the use of GERDx™ was a 2 cm hiatal hernia. Follow-up workup was done with high resolution manometry (HRM), 24 h-pH-impedance-catheter gastroscopy and questionaires for quality of life (GIQLI) and reflux-symptoms (SCL). Results Median follow-up time was 57 months (36–74 months). There was a significant improvement of the DeMeester score, GIQLI and SCL between pre- and postoperative values in short-term as well as long-term follow-up. At least 55% of patients were assessed as failure of the plication device due to redo operations with laparoscopic fundoplication in 25% and/or necessary PPI use for GERD symptoms (40%). There is no pre- and postoperative significant difference in quality of life or reflux scores between successful and failed endoplications, but patients with laparoscopic redo operations showed significant higher DeMeester scores before and after endoscopic treatment. Conclusion There is a higher failure rate to the endoscopic full-thickness plication than to the laparoscopic fundoplication. A small group of well selected patients is eligible for the endoscopic GERDx™ device. In case of therapeutic failure a classic laparoscopic redo fundoplication is possible under more challenging operative conditions.

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