scholarly journals Avaliação do transporte crítico de pacientes: Uma revisão sistemática

2019 ◽  
Vol 19 (1) ◽  
pp. 615-647
Author(s):  
Leonardo Nogueira Melo ◽  
Vera Lúcia Freitas ◽  
Emanuel Pereira dos Santos ◽  
Raphael Dias de Mello Pereira ◽  
Vanessa Silva De Oliveira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Adverse Events ◽  
Care Practice ◽  
Transportation Of Patients ◽  
Time Space ◽  
Revisión Sistemática ◽  
Trabajo En Equipo ◽  
Main Factors

Objetivo: Evaluar, según la literatura, cuáles son los principales factores considerados facilitadores y/o agravantes en la realización del transporte de pacientes en estado crítico.Método: Este estudio se trata de una revisión sistemática realizada con el método PICOResultado: Los periódicos seleccionados comprendían un espacio temporal en los últimos diez años, donde 6 periódicos fueron elegibles, basado en los criterios establecidos. Los resultados relatan que los temas encontrados en esta revisión demuestran una alineación entre la práctica asistencial y la literatura, pero para que el transporte sea realizado sin eventos adversos, es necesario que haya unión entre la gestión y los profesionales involucrados.Conclusión: Aunque los hallazgos demuestren una gran preocupación en relación a la calidad en la asistencia y en la preparación del equipo, los autores creen que más estudios deben ser fomentados una vez que el trabajo en equipo, a pesar de ser complejo, es la clave para la realización de los procedimientos con efectividad. Objective: To evaluate, according to the literature, the main factors considered facilitators and/or aggravating in the transportation of patients in critical condition.Method: This study is a systematic review performed using the PICO method.Results: The selected journals comprised a time space in the last 10 years, with six journals eligible, based on the established criteria. The results report that the themes found in this review demonstrate an alignment between care practice and literature, but, for a transportation without adverse events, there must be a union between the management and the professionals involved.Conclusion: Although the findings demonstrate a great concern regarding the quality of care and team preparation, the authors believe that more studies should be encouraged since teamwork, despite being complex, is the key to performing the procedures with effectiveness. Objetivo: Avaliar segundo a literatura quais são os principais fatores que são considerados facilitadores e/ou agravantes na realização do transporte de pacientes em estado crítico.Método: Este estudo trata-se de uma revisão sistemática realizada com método PICOResultado: Os periódicos selecionados compreendiam um espaço temporal nos últimos dez anos, onde 6 periódicos foram elegíveis, baseado nos critérios estabelecidos. Os resultados relatam que os temas encontrados nesta revisão demonstram um alinhamento entre a prática assistencial e a literatura, porém para que o transporte seja realizado sem eventos adversos, é necessário que haja união entre a gestão e os profissionais envolvidos.Conclusão: Embora os achados demonstrem uma grande preocupação em relação à qualidade na assistência e no preparo da equipe, os autores acreditam que mais estudos devem ser fomentados uma vez que o trabalho em equipe apesar de ser complexo, é a chave para a realização dos procedimentos com efetividade.

Impact of Morbidity and Mortality Conferences on Analysis of Mortality and Critical Events in Intensive Care Practice

2010 ◽  
Vol 19 (2) ◽  
pp. 135-145 ◽  
Author(s):  
Hatem Ksouri ◽  
Per-Yann Balanant ◽  
Jean-Marc Tadié ◽  
Guillaume Heraud ◽  
Imad Abboud ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Quality Of Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Morbidity And Mortality ◽  
Care Practice ◽  
Unplanned Extubation ◽  
Morbidity And Mortality Conferences

Background Morbidity and mortality conferences are a tool for evaluating care management, but they lack a precise format for practice in intensive care units. Objectives To evaluate the feasibility and usefulness of regular morbidity and mortality conferences specific to intensive care units for improving quality of care and patient safety. Methods For 1 year, a prospective study was conducted in an 18-bed intensive care unit. Events analyzed included deaths in the unit and 4 adverse events (unexpected cardiac arrest, unplanned extubation, reintubation within 24–48 hours after planned extubation, and readmission to the unit within 48 hours after discharge) considered potentially preventable in optimal intensive care practice. During conferences, events were collectively analyzed with the help of an external auditor to determine their severity, causality, and preventability. Results During the study period, 260 deaths and 100 adverse events involving 300 patients were analyzed. The adverse events rate was 16.6 per 1000 patient-days. Adverse events occurred more often between noon and 4 pm (P = .001).The conference consensus was that 6.1% of deaths and 36% of adverse events were preventable. Preventable deaths were associated with iatrogenesis (P = .008), human errors (P < .001), and failure of unit management factors or communication (P = .003). Three major recommendations were made concerning standardization of care or prescription and organizational management, and no similar incidents have recurred. Conclusion In addition to their educational value, regular morbidity and mortality conferences formatted for intensive care units are useful for assessing quality of care and patient safety.

scholarly journals The impact of asynchronous e-visits on clinical outcomes and healthcare delivery: A systematic review (Preprint)

2021 ◽  
Author(s):  
Oliver T. Nguyen ◽  
Amir Alishahi Tabriz ◽  
Jinhai Huo ◽  
Karim Hanna ◽  
Christopher M. Shea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Clinical Outcomes ◽  
Healthcare Costs ◽  
Healthcare Delivery ◽  
Healthcare Quality ◽  
Antibiotic Prescribing ◽  
Infection Management ◽  
The Impact

BACKGROUND E-visits involve asynchronous communication between providers and patients through a secure web-based platform, such as a patient portal, to elicit symptoms and determine a diagnosis and treatment plan. E-visits are now reimbursable through Medicare due to the COVID-19 pandemic. The state of the evidence regarding e-visits, such as the impact on clinical outcomes and healthcare delivery, is unclear. OBJECTIVE To address this gap, this systematic review examines how e-visits have impacted clinical outcomes and healthcare quality, access, utilization, and costs. METHODS MEDLINE, Embase, and Web of Science were searched from January 2000 through October 2020 for peer-reviewed studies that assessed e-visits’ impact on clinical and healthcare delivery outcomes. RESULTS Out of 1,858 papers, 19 studies met the inclusion criteria. E-visit usage was associated with improved or comparable clinical outcomes, especially for chronic disease management (e.g., diabetes care, blood pressure management). The impact on quality of care varied across conditions. Quality of care was equivalent or better for chronic conditions but variable quality was observed in infection management (e.g., appropriate antibiotic prescribing). Similarly, the impact on healthcare utilization varied across conditions (e.g., lower utilization for dermatology) but mixed impact in primary care. Healthcare costs were lower for e-visits for a wide-range of conditions (e.g., dermatology and acute visits). No studies examined the impact of e-visits on healthcare access. Available studies are observational in nature and it is difficult to draw firm conclusions about effectiveness or impact on care delivery. CONCLUSIONS Overall, the evidence suggests e-visits may provide comparable clinical outcomes to in-person care and reduce healthcare costs for certain healthcare conditions. At the same time, there is mixed evidence on healthcare quality, especially regarding infection management (e.g., sinusitis, urinary tract infections, conjunctivitis). Further studies are needed to test implementation strategies that might improve delivery (e.g., clinical decision support for antibiotic prescribing) and to assess which conditions are amenable to e-visits and which conditions require in-person or face-to-face care (e.g., virtual visit). CLINICALTRIAL not applicable

QUALITY-OF-CARE INDICATORS FOR WOMEN WITH OVERACTIVE BLADDER: A SYSTEMATIC REVIEW OF THE LITERATURE

2009 ◽  
Vol 181 (4S) ◽  
pp. 5-5
Author(s):  
Aviva E. Weinberg ◽  
Jennifer T Anger ◽  
Ja-Hong Kim ◽  
Paul Shekelle ◽  
Shlomo Raz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Overactive Bladder ◽  
Review Of The Literature

A Recent Systematic Review on Simulation Modeling and Emergency Departments

2019 ◽  
pp. 1232-1264
Author(s):  
Soraia Oueida ◽  
Seifedine Kadry ◽  
Pierre Abi Char
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Simulation Modeling ◽  
Recommended Care ◽  
Recent Systematic Review ◽  
Increase Patient Satisfaction ◽  
System Review

Healthcare, being a complex and huge system, suffers from low quality of care delivered to arriving patients. The quality of care depends on the patient's condition and the availability of hospital's resources. Therefore, many authors have studied the problems faced by such systems and emphasized in their articles the importance of a system review for better performance. In healthcare, different departments interact with each other in order to deliver a certain service to arriving patients and provide the recommended care. In particular, the emergency department (ED) is proven to be the busiest unit of the hospital; thus, the exiting problems and recommended solutions are highlighted in this study by a literature systematic review. The main goal of this article is to study the problems that EDs face nowadays and how simulation modeling can interfere in order to alleviate these problems, propose corresponding solutions and increase patient satisfaction.

Innovating in healthcare delivery: a systematic review and a preference-based framework of patient and provider needs

2019 ◽  
Vol 5 (2-3) ◽  
pp. 92-100
Author(s):  
Joseph S Salama ◽  
Alex Lee ◽  
Ashkan Afshin
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Conceptual Framework ◽  
Unmet Needs ◽  
Healthcare Delivery ◽  
Process Of Care ◽  
Literature Reviews ◽  
Reducing Costs ◽  
Healthcare Innovation

Healthcare innovation is becoming a popular but poorly defined option for those who are seeking new ways of reducing costs while also improving the quality of care. The process of innovating in healthcare delivery can be improved by identifying and understanding the unmet needs of patients and providers. We conducted two systematic literature reviews to identify the needs of these stakeholders throughout healthcare delivery and developed a conceptual framework for innovating in healthcare. Our results reveal tension between patients’ and providers’ preferences across three major categories—treatment and outcomes, process of care and structure of care. Therefore, innovating in healthcare may be better understood as addressing the unmet needs of each stakeholder by easing or eliminating tensions between stakeholders. This conceptual framework may serve as a useful instrument for health policymakers, payers and innovators to alike make better decisions as they invest in healthcare innovations.

scholarly journals Acupuncture for refractory gastro-oesophageal reflux disease: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030713 ◽  
Author(s):  
Dacheng Li ◽  
Li Zhu ◽  
Daming Liu
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Adverse Events ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Oesophageal Reflux ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Oesophageal Reflux Disease

IntroductionRefractory gastro-oesophageal reflux disease (rGORD) is a common disease, affecting patients’ quality of life. Since conventional medicines have limitations, like low effective rates and adverse events, acupuncture may be a promising therapy for rGORD. While no related systematic review has been published, the present study is designed to evaluate the efficacy and safety of acupuncture for rGORD.Methods and analysisPubMed, the Cochrane Central Register of Controlled Trials and Chinese electronic databases, including China National Knowledge Infrastructure, Wan Fang database, VIP, SinoMed and the Chinese Clinical Trial Registry, will be searched from establishment of the database to 31 August 2019. There will be no limitations on language, and all articles will be screened and collected by two reviewers independently. RevMan V.5.3.5 software will be used for meta-analysis, and the conduction of study will refer to the Cochrane Handbook for Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. The efficacy and safety of acupuncture for rGORD will be evaluated based on outcomes, including global symptom improvement, oesophageal sphincter function test measured by high-resolution manometry, quality of life, recurrence rate and adverse events.Ethics and disseminationThere is no necessity for this study to acquire an ethical approval, and this review will be disseminated in a peer-reviewed journal or conference presentation.Trial registration numberCRD42018111912.

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