An Effective System to Measure and Report Quality Indicators in Acute Medical Units

The Society for Acute Medicine has developed a number of clinical quality indicators by which all UK Acute Medicine Units can bench mark their activity. These will help to ensure high quality care for patients, inform the continuing development of acute medical services and demonstrate the positive impact of this new speciality. Prospective collection of these data may be a challenge for many busy units. This paper describes a local solution developed in house in a North East hospital. It demonstrates how the data collected can be analysed to assess the effect of changes in consultant presence on the unit and also time taken for patients to be seen by a doctor. The limitations of the system and potential for future development are considered.

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Development of provincial clinical standards for the province of Ontario.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.29_suppl.117 ◽

2015 ◽

Vol 33 (29_suppl) ◽

pp. 117-117

Author(s):

Sara Urowitz ◽

Denise Marshall ◽

Jeff Myers ◽

Deanna Bryant

Keyword(s):

Palliative Care ◽

Stakeholder Engagement ◽

Best Practice ◽

Positive Impact ◽

Quality Care ◽

Clinical Environment ◽

Consensus Process ◽

High Quality ◽

Clinical Change ◽

Clinical Standards

117 Background: The province of Ontario is committed to improving palliative care services. This commitment to change is outlined in The Declaration of Partnership, the provincial roadmap for improving palliative care. To help drive this change in the clinical environment, a Clinical Council for Palliative Care was established to be responsible for providing direction on clinical implications of policy, and advancing clinical improvement in palliative care in Ontario. To this end, Clinical Council has articulated a set of 12 interrelated provincial clinical standards which outline priority areas for clinical change and improvement in the province. Methods: Key stakeholder engagement was undertaken to identify evidence-based, best practices for delivery of palliative services. A consensus process was used to identify the priority set of essential clinical standards for high quality care that is both practical and scalable. Expert working groups were established to refine the standards based on evidence and leading or best practice to the Ontario context. Response was solicited from stakeholders, and qualitative analysis was conducted; standards will be refined based on feedback. Results: Based on the results of the stakeholder engagement, a “Clinical Change Strategy” was identified and a set 12 “clinical imperatives” were identified. Through the consensus process 12 Provincial Clinical Standards were endorsed. Conclusions: Engaging in an evidence informed process with key stakeholders has enabled the creation of a set of 12 interconnected Provincial Clinical Standards for palliative care in Ontario. These standards will help to advance high quality palliative care in the province. The standards represent a population health based strategy for change, which can have a positive impact at the systems level. Stakeholder feedback will result in further refinement of the standards, which will ultimately provide the foundation for standardized approaches for palliative services across Ontario.

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Defining Quality Indicators for Inflammatory Bowel Disease (IBD): 10 Processes to Ensure High Quality Care

The American Journal of Gastroenterology ◽

10.14309/00000434-201110002-01222 ◽

2011 ◽

Vol 106 ◽

pp. S461

Author(s):

Gil Melmed ◽

Corey Siegel ◽

Brennan Spiegel ◽

John Allen ◽

Themos Dassopoulos ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Quality Indicators ◽

Bowel Disease ◽

Quality Care ◽

High Quality ◽

High Quality Care ◽

Inflammatory Bowel

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The Modern Matron's role in influencing safe practice

Clinical Risk ◽

10.1258/1356262053723221 ◽

2005 ◽

Vol 11 (3) ◽

pp. 93-98 ◽

Cited By ~ 2

Author(s):

Olwen Keeley ◽

Claire Goodman ◽

Pippa Bark

Keyword(s):

Patient Safety ◽

Positive Impact ◽

Quality Care ◽

Theoretical Framework ◽

Small Study ◽

Positive Contribution ◽

High Quality ◽

High Quality Care ◽

Effective Care ◽

Nursing Roles

The 'Modern Matron' is one of the prominent nursing roles to emerge from the NHS Plan. The underpinning principle is to have a professional leader who is accountable for co-ordinating safe, high-quality care to improve patients' NHS experience. This paper discusses findings from a study of the implementation of the Modern Matron role in an acute NHS Trust in the East of England. The theoretical framework of 'limiting harm' was used to assess the extent to which the Modern Matron could contribute towards safe effective care and the reduction of harm. The study found that error-prone situations were clearly identified and that the Matrons were perceived to have a positive impact on a range of clinical issues. The evidence from this small study suggests that the Modern Matron role has the potential to make a positive contribution to patient safety.

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Acute Care Fellow: a brief introduction

Acute Medicine Journal ◽

10.52964/amja.0505 ◽

2011 ◽

Vol 10 (4) ◽

Author(s):

Mark Temple

Keyword(s):

Medical Care ◽

Acute Care ◽

Royal College ◽

Quality Care ◽

Good Practice ◽

High Quality ◽

Medical Specialties ◽

Acute Medicine ◽

High Quality Care ◽

Acute Medical Care

Chris Roseveare has kindly invited me to introduce myself through this ‘Guest Editorial’ page of Acute Medicine. I was appointed to the new post of Acute Care Fellow at the Royal College of Physicians of London in July of this year. This is a new post, created by the College in recognition of the immense pressures currently being experienced by acute medical services. The remit includes identifying the difficulties faced by physicians in delivering high quality care and seeking out and sharing examples of good practice. I will chair the new acute medical care committee at the College which will have wide representation from all medical specialties involved in the provision of acute medical care. Acute medical units are the hub of the acute medical take and acute medicine will be well represented on the new committee with SAM consultant, trainee and nursing representatives. One practical work stream that is underway is a series of acute care toolkits commissioned by the College. The first on “Handover” was published in May 2011. The second, “High quality acute care”, has just been launched and is available on the Royal College of Physicians’ website: http://www.rcplondon.ac.uk/press-releases/new-toolkit-support-high-quality-care-acutely-ill-patients The toolkits focus on problem areas in acute care and provide practical advice, examples of best practice and recommendations. “High quality acute care” lists 14 key principles of acute care, drafted in close consultation with SAM. One particular concern is the evidence that the outcomes for patients admitted as medical emergencies at week-ends are inferior to those admitted on weekdays. In November 2010 the RCP issued a statement that “Hospitals undertaking admission of acutely ill medical patients should have a consultant physician on site for at least 12 hours per day, seven days per week”. Most acute hospitals are well on the way to providing this level of cover on weekdays – but weekends and bank holidays continue to present a major challenge. The RCP will be working closely with SAM to look at ways in which changes to staffing patterns at weekends can be realised, including reorganisation of rota patterns. Recommendations will be incorporated into a later toolkit.

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Quality Indicators for the Diagnosis and Management of Acute Bacterial Rhinosinusitis

American Journal of Rhinology and Allergy ◽

10.1177/1945892420912158 ◽

2020 ◽

Vol 34 (4) ◽

pp. 519-531 ◽

Cited By ~ 1

Author(s):

Justin Cottrell ◽

Jonathan Yip ◽

Yvonne Chan ◽

Christopher J Chin ◽

Ali Damji ◽

...

Keyword(s):

Los Angeles ◽

Quality Indicators ◽

Pay For Performance ◽

Quality Care ◽

Supporting Evidence ◽

High Quality ◽

Diagnosis And Management ◽

Quality Guidelines ◽

Acute Bacterial Rhinosinusitis

Background Acute bacterial rhinosinusitis (ABRS) is a highly prevalent disease that is treated by a variety of specialties, including but not limited to, family physicians, emergency physicians, otolaryngology—head and neck surgeons, infectious disease specialists, and allergy and immunologists. Unfortunately, despite high-quality guidelines, variable and substandard care continues to be demonstrated in the treatment of ABRS. Objective This study aimed to develop ABRS-specific quality indicators (QIs) to evaluate the diagnosis and management that reduces symptoms, improves quality of life, and prevents complications. Methods A guideline-based approach, proposed by Kötter et al., was used to develop QIs for ABRS. Candidate indicators (CIs) were extracted from 4 guiding documents and evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Each CI and its supporting evidence was summarized and reviewed by an expert panel based on validity, reliability, and feasibility of measurement. Final QIs were selected from CIs utilizing the modified RAND/University of California at Los Angeles appropriateness methodology. Results Twenty-nine CIs were identified after literature review and evaluated by our panel. Of these, 5 CIs reached consensus as being appropriate QIs, with 1 requiring additional discussion. After a second round of evaluations, the panel selected 7 QIs as appropriate measures of high-quality care. Conclusion This study proposes 7 QIs for the diagnosis and management of patients with ABRS. These QIs can serve multiple purposes, including documenting the quality of care; comparing institutions and providers; prioritizing quality improvement initiatives; supporting accountability, regulation, and accreditation; and determining pay for performance initiatives.

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METODOLOGIA PARA LA ELABORACIÓN DE PASTA DE TOMATE CON ZANAHORIA

Revista de Investigaciones en Energía Medio Ambiente y Tecnología RIEMAT ISSN 2588-0721 ◽

10.33936/riemat.v1i1.213 ◽

2016 ◽

Vol 1 (1) ◽

pp. 57

Author(s):

Luzmila Burbano Mera ◽

Marcos Dávila Cedeño ◽

Tatiana Martínez Santana ◽

Ramón E. Cevallos Cedeño

Keyword(s):

Positive Impact ◽

Beta Carotene ◽

Industrial Product ◽

High Quality ◽

Nutritional Properties ◽

Tomato Paste ◽

Physical Chemical ◽

Index Terms

Abstract: Manabí and Ecuadorian population in general are consumers of tomato paste in different forms, so that producers and industrial product processing always looking to have a high quality and good prices for the benefit of its customers. This research based on the results obtained, it leaves a number of very valuable conclusions for determining the carrot pulp will have a positive impact on the physical, chemical and organoleptic, when combined with the tomato paste features, without diminishing or provide a look that could adversely affect its commercial presentation to the client. The objective of this research was to get the development of a tomato paste mixed with carrot paste, with the purpose of obtaining an improved nutritional properties (fiber and beta-carotene) for the benefit of the consumer. Index Terms: Pasta, tomato, carrot, consistency, nutritional properties.

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Best of Five MCQs for the Acute Medicine SCE

10.1093/oso/9780199680269.001.0001 ◽

2016 ◽

Keyword(s):

Multiple Choice ◽

Multiple Choice Questions ◽

Self Assessment ◽

High Quality ◽

High Stakes ◽

Acute Medicine ◽

Acute Conditions

Best of Five MCQs for the Acute Medicine SCE is a new revision resource designed specifically for this high-stakes exam. Containing over 350 Best of Five multiple choice questions, this dedicated guide will help candidates to prepare successfully. The content mirrors the SCE in Acute Medicine Blueprint to ensure candidates are fully prepared for all the topics that may appear in the exam. Topics range from how to manage acute problems in cardiology or neurology to managing acute conditions such as poisoning. All answers have full explanations and further reading to ensure high quality self-assessment and quick recognition of areas that require further study.

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Doctor–Patient Communication in Primary Health Care: A Mixed-Method Study in Fiji

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147548 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7548

Author(s):

Swastika Chandra ◽

Masoud Mohammadnezhad

Keyword(s):

Mixed Method ◽

Positive Impact ◽

Quality Care ◽

Outpatient Setting ◽

Patient Communication ◽

Mixed Method Study ◽

Limited Information ◽

Factors Affecting ◽

Communication Behaviour ◽

Doctor Patient Communication

From a clinical perspective, effective and efficient communication is part of a strategy to ensure doctors are providing high-quality care to their patients. Despite the positive impact of effective doctor–patient communication on health outcomes, limited information is available on this in Fiji. This study was carried out to determine the current patients’ perception of doctors’ communication behaviour and identify factors affecting the doctor–patient communication in Fiji. This mixed-method study was conducted in the outpatient setting of three randomly selected health centres in the Suva Subdivision, Fiji. For the quantitative phase, systematic random sampling was used to select the 375 participants who completed the structured questionnaire; of those, 20 participants were selected for the qualitative interview. From the patients’ perception, 45.6% of them perceived doctors’ communication behaviour as good, 53.6% as fair, and 0.8% as poor communication behaviour. Qualitative findings highlight factors such as the attitude of the doctors, their approach, their interaction with the patients, and them providing an explanation as important factors during doctor–patient communication. In Fiji, the majority of patients perceived doctors’ communication behaviour as fair to good and the doctors’ skills were important for effective doctor–patient communication. This study highlighted the importance of doctor–patient communication and suggested that doctors might not be practicing patient-centred care and communication; thus, they need to upgrade their patient-centred communication skills.

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