scholarly journals Evaluation of a Novel Audit Tool for Medication Reconciliation at Hospital Discharge

2019 ◽  
Vol 72 (6) ◽  
Author(s):  
Anne Holbrook ◽  
Heather Bannerman ◽  
Amna Ahmed ◽  
Michael Georgy ◽  
J Tiger Liu ◽  
...  
Keyword(s):  
Medication Reconciliation ◽  
Community Pharmacists ◽  
Audit Tool ◽  
Quality Audit ◽  
General Internal ◽  
Telephone Interviews ◽  
Soins De Santé ◽  
Sécurité Des Patients

ABSTRACTBackground: Discharge medication reconciliation (MedRec) is designed to reduce medication errors and inform patients and key postdischarge providers, but it has been difficult to implement routinely in Canadian hospitals.Objectives: To evaluate and optimize a new discharge MedRec quality audit tool and to use it at 3 urban teaching hospitals.Methods: The discharge MedRec quality audit tool, developed by the Canadian Patient Safety Institute and the Institute for Safe Medication Practices Canada, was assessed and modified to improve comprehensiveness, clarity, and quality. The modified tool was then used to evaluate the quality of the discharge MedRec process for adult patients discharged to home from the general internal medicine service at 3 academic hospitals. Postdischarge telephone interviews were conducted with consenting patients, their community pharmacists, and their family doctors.Results: The audit tool required modification to include aspects of admission MedRec, high-risk medication discrepancies, and direct communication of discharge MedRec to key follow-up providers. Thirty-five patients (mean age 67.7 years, standard deviation [SD] 18.0 years; 17 [49%] women), with a mean of 8.8 (SD 4.5) prescribed medications at discharge, participated in the discharge MedRec evaluation. Documentation of any discharge MedRec was found for only 1 patient (3%), and no discharge MedRec was carried out by pharmacists. Postdischarge follow-up interviews elicited major gaps in communication with community pharmacists and with family physicians, which could lead to serious medication errors.Conclusions: The modified audit tool was useful for identifying gaps in the quality of discharge MedRec.RÉSUMÉContexte : Le bilan comparatif des médicaments (BCM) au moment du congé est conçu pour réduire les erreurs médicamenteuses et informer les patients ainsi que les principaux prestataires de soins de santé après le congé, mais sa mise en œuvre systématique dans les hôpitaux canadiens s’est heurtée à de grandes difficultés.Objectifs : Évaluer et optimiser un nouvel outil d’évaluation de la qualité du BCM au moment du congé et l’utiliser dans trois hôpitaux universitaires urbains.Méthodes : Cet outil développé par l’Institut canadien pour la sécurité des patients (ICSP) et l’Institut pour la sécurité des médicaments aux patients du Canada (ISMP) a fait l’objet d’une évaluation et d’une modification visant à améliorer son exhaustivité, sa clarté et sa qualité. L’outil modifié a ensuite servi à évaluer la qualité du processus du BCM pour des patients adultes ayant obtenu leur congé après un séjour dans un service général de médecine interne dans trois hôpitaux universitaires. Des entretiens téléphoniques après le congé ont été menés avec les patients consentants, leur pharmacien communautaire et leur médecin de famille.Résultats : L’outil d’évaluation a dû être modifié pour inclure le BCM au moment de l’admission, des écarts de médication à haut risque et une communication directe du BCM aux prestataires de soins de santé principaux chargés du suivi après le congé. Trente-cinq patients (âge moyen : 67,7 ans; écart type [ET] 18 ans; 17 [49 %] femmes), chacun ayant reçu en moyenne 8,8 (ET 4,5) médicaments prescrits, ont participé à l’évaluation du BCM au congé de l’hôpital. Au moment du congé, on n’a trouvé de renseignements relatifs au BCM que pour un seul patient (3 %) et aucun BCM n’avait été préparé par les pharmaciens. Le suivi après le congé a généré des écarts de communication importants entre les pharmaciens communautaires et les médecins de famille, ce qui pourrait entraîner des erreurs médicamenteuses importantes.Conclusions : L’outil d’évaluation modifié a été utile pour déterminer les écarts relatifs à la qualité du BCM au moment du congé. 

scholarly journals The Relationship between CEO Characteristics & External Auditing Quality: A Longitudinal Assessment

2019 ◽  
Vol IV (IV) ◽  
pp. 141-156
Author(s):  
Ashfaque Ali Banbhan ◽  
Khalid Hussain Abbasi ◽  
Farheen Qasim Nizamani
Keyword(s):  
Company Performance ◽  
Longitudinal Assessment ◽  
Publicly Traded ◽  
Financial Reports ◽  
Quality Audit ◽  
Publicly Traded Companies ◽  
Level Manager ◽  
The Impact

All publicly-traded companies are required by law to disclose their accurate financial information in order to reduce information asymmetries. This study focuses quantitatively on the impact of top management on the quality of corporate audits. Using company financial data, this study found that there is a positive correlation between highquality audits and company performance, as a higher quality audit can ensure rigorous follow-up to financial reports. This study also broadens the understanding of a higher-level manager in the presence of a quality audit.

scholarly journals Measuring the quality of Hospital Food Services: Development and reliability of a Meal Quality Audit Tool

2017 ◽  
Vol 74 (2) ◽  
pp. 147-157 ◽  
Author(s):  
Merrilyn Banks ◽  
Mary Hannan-Jones ◽  
Lynda Ross ◽  
Ann Buckley ◽  
Jennifer Ellick ◽  
...  
Keyword(s):  
Food Services ◽  
Audit Tool ◽  
Quality Audit ◽  
Meal Quality

scholarly journals The Status of Quality Assurance in Two Lebanese Universities

Pedagogika ◽  
2016 ◽  
Vol 123 (3) ◽  
pp. 36-41
Author(s):  
Wessam Al Chibani
Keyword(s):  
Private Universities ◽  
Private University ◽  
Ministry Of Education ◽  
Quality Audit ◽  
The Status ◽  
New Students ◽  
The Republic ◽  
University Quality

This study was set to assess and analyze the status of two private university quality measures such as the quality audit, control, and ranking in Lebanon. In addition, it was set to discuss and evaluate the programs given by these universities. Finally, it was set to synthesize and analyze different tools that could be applied on the quality services these universities have. The sample of this study is two private universities in Lebanon where interviews were conducted separately with 6 deans, 6 chairpersons, and 6 coordinators. In addition to the universities, plenty of information was taken directly from the Ministry of Education and Higher Education of the Republic of Lebanon. Thus, qualitative data analyses were conducted. Main results showed that one of the main aims of both universities is to get new students registered and have better quality of education.  They always take into consideration the quality audit, control, and ranking, which allow them to be ranked from the top universities in Lebanon. One University has been accredited in 2015, which makes it necessary to follow up with the quality control; the second university is still working on getting accredited. The study concluded with recommendations addressed to private universities in Lebanon.

scholarly journals A catalogue quality audit tool

2009 ◽  
Vol 26 (82) ◽  
pp. 26-37 ◽  
Author(s):  
Ann Chapman ◽  
Owen Massey
Keyword(s):  
Pilot Study ◽  
Performance Measurement ◽  
Performance Indicators ◽  
The Self ◽  
Audit Tool ◽  
Self Assessment ◽  
Quality Audit ◽  
The University

The current need for performance measurement and quality targets for services to users requires suitable performance indicators for libraries to use. This paper looks at the self-assessment audit tool for catalogue quality developed by UKOLN in collaboration with Essex libraries. For the tool a checklist of errors was drawn up, which can then be used to assess the quality of records within a catalogue using a sample of library stock. The tool can be used to assess the quality of catalogue records for monographs and non-book materials (but not serials), for complete collections or parts of collections and for records created at different periods. This paper describes the tool and the process of making the assessment and reports on the results of the pilot study carried out at the University of Bath Library in 2000.

scholarly journals How do patients and physicians communicate about hereditary angioedema in the United States?

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260805
Author(s):  
Gagan Jain ◽  
Lauren Walter ◽  
Carolyn Reed ◽  
Patricia O’Donnell ◽  
Jeffrey Troy
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Hereditary Angioedema ◽  
The United States ◽  
Telephone Interviews ◽  
Institutional Review ◽  
Communication Dynamics ◽  
The Impact

Background Hereditary angioedema (HAE) is a rare disease that manifests as recurrent and debilitating angioedema attacks, significantly impacting patients’ quality of life. Objective To assess communication dynamics between patients with HAE and treating physicians and the impact this has on the treatment of HAE in the United States. Methods This observational study used an institutional review board–approved protocol to collect four sources of patient–physician communication data from the period between January 2015 and May 2017: in-office conversations between patients aged ≥18 years with HAE and physicians, follow-up dictations with physicians, telephone interviews with patients and physicians, and publicly available social media posts from patients. Participant language was qualitatively assessed and key communication elements and communication gaps identified. Results Twenty-five in-office conversations, 14 follow-up physician dictations, and 17 telephone interviews were conducted with a total of 29 unique patients, 4 caregivers, and 14 physicians. In-office conversations were generally physician-driven and focused primarily on symptom frequency, location, and severity; lexicon from both parties centered on “episodes” and “swelling.” During visits, impact on quality of life was not routinely assessed by physicians nor discussed proactively by patients; however, during telephone interviews and online, patients frequently described the multifaceted burden of HAE. Patients highlighted the difficulties they experience by using repetition, emphasis, and metaphors; they also varied the descriptors used for attacks depending on the communication goal. Physicians used intensifiers to emphasize the necessity of rescue medication access, whereas prophylactic treatments were positioned as an option for frequent or laryngeal attacks. Conclusion Vocabulary differences suggest that the full impact of HAE is not consistently communicated by patients to physicians during clinical visits, indicating the potential for misaligned understanding of disease burden. A patient-driven, rather than physician-driven approach to the discussions may elicit valuable information that could help to optimize treatment approaches.

scholarly journals Trialists perspectives on sustaining, spreading, and scaling-up of quality improvement interventions

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Celia Laur ◽  
Ann Marie Corrado ◽  
Jeremy M. Grimshaw ◽  
Noah Ivers
Keyword(s):  
Quality Improvement ◽  
Snowball Sampling ◽  
Case Examples ◽  
Telephone Interviews ◽  
Effective Interventions ◽  
Improvement Interventions ◽  
Quality Improvement Interventions

Abstract Background Quality improvement (QI) evaluations rarely consider how a successful intervention can be sustained long term, nor how to spread or scale to other locations. A survey of authors of randomized trials of diabetes QI interventions included in an ongoing systematic review found that 78% of trials reported improved quality of care, but 40% of these trials were not sustained. This study explores why and how the effective interventions were sustained, spread, or scaled. Methods A qualitative approach was used, focusing on case examples. Diabetes QI program trial authors were purposefully sampled and recruited for telephone interviews. Authors were eligible if they had completed the author survey, agreed to follow-up, and had a completed a diabetes QI trial they deemed “effective.” Snowball sampling was used if the participant identified someone who could provide a different perspective on the same trial. Interviews were transcribed verbatim. Inductive thematic analysis was conducted to identify barriers and facilitators to sustainability, spread, and/or scale of the QI program, using case examples to show trajectories across projects and people. Results Eleven of 44 eligible trialists participated in an interview. Four reported that the intervention was “sustained” and nine were “spread,” however, interviews highlighted that these terms were interpreted differently over time and between participants. Participant stories highlighted the varied trajectories of how projects evolved and how some research careers adapted to increase impact. Three interacting themes, termed the “3C’s,” helped explain the variation in sustainability, spread, and scale: (i) understanding the concepts of implementation, sustainability, sustainment, spread, and scale; (ii) having the appropriate competencies; and (iii) the need for individual, organizational, and system capacity. Conclusions Challenges in defining sustainability, spread and scale make it difficult to fully understand impact. However, it is clear that from the beginning of intervention design, trialists need to understand the concepts and have the competency and capacity to plan for feasible and sustainable interventions that have potential to be sustained, spread and/or scaled if found to be effective.

Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Personality Traits ◽  
Rating Scales ◽  
Suicide Attempts ◽  
World Health ◽  
Life Questionnaire ◽  
Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

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