Clinical Risk Management: As Modern Tool for Prevention and Management of Care and Prevention Occupational Risk

Clinical Risk Management aims to improve the performance quality of healthcare services through procedures that identify and prevent circumstances that could expose both the patient and the healthcare personnel to risk of an adverse event [...]

Dentistry during COVID-19: patients' knowledge and satisfaction toward health protocols COVID-19 during dental treatment

Background Coronavirus disease 2019 (COVID-19) as an infectious disease primarily spreading through droplet infection in dental treatment. Patient satisfaction is an indicator of healthcare quality service. Quality of healthcare service and patient satisfaction has been affected by the COVID‑19 pandemic. This study aims to assess the knowledge and satisfaction toward health protocols COVID-19 during dental treatment among dental patients. Methods An institutional-based cross-sectional study was conducted on 270 dental patients using a self‑designed questionnaire consisting of knowledge and satisfaction about health protocols COVID-19 during dental treatment through a random sampling technique. Data were imported to SPSS version 21 for analysis. Descriptive and analytical statistics were used to identify the factors associated with their knowledge and satisfaction. A p value < 0.05 was considered statistical significance. Results Totally, 270 dental patients with mean age of 37.6 ± 6.7 years participated in the study. The mean knowledge score was 36.7 ± 3.5, as considerable number of participants were unaware about the risk associated with dental treatment as well as restrictions imposed on dental procedures. About 18% of participants experienced one or other form of dental complaints during the lockdown period. The overall level of patient satisfaction was 44.6%. Conclusion It can be concluded that, public knowledge is to be improved about risk of virus transmission that can be related with dental treatment and also people should be encouraged to use virtual facilities, such as teledentistry, so that no dental emergencies is left untreated during the pandemic time. In addition, the level of satisfaction was in a medium level for dental patients in the study area. Specifically, we deduced from the results that social/physical distancing measures are one of the mechanisms to decrease the fear of exposure to the COVID-19.

Job Satisfaction and Quality of Healthcare Delivery: A Cross-Sectional Study in Ogun State Hospitals Management Board, Nigeria

Job satisfaction is vitally necessary in the daily life of the workforce, and the essential elements, materials and mechanism that drives job satisfaction demand great attention. At present, the situation of healthcare workers in the employment of Ogun State Hospitals Management Board, Nigeria, seems to be less satisfied with the policies of the healthcare institutions. The study examined job satisfaction and the quality of healthcare delivery in Ogun State Hospitals Management Board (HMB) in Nigeria. This study adopted a cross-sectional design method and was conducted among the healthcare professionals in the study area. A total of 729 copies of a well-structured questionnaire were administered using a multi-staged sampling technique to obtain information from all the available healthcare professionals in the study area. Data collected were analysed using descriptive statistics. Findings of this study revealed that 12.5 % of healthcare professionals in Ogun State Hospitals strongly agreed, 21.9% moderately, and 32% slightly agreed with the level of satisfaction of the leadership and management styles. 25.7% of the healthcare professionals disagreed (7.4% strongly, 4.0% moderately and 14.3% slightly) that they would recommend employment in the study area. The results further revealed that 47.9% of healthcare workers had a low level of job satisfaction that could lead to many factors. In addendum, 43.6% of the respondents believed that the healthcare delivery was not low but with moderate quality. The study concluded that majority of the healthcare workers had low level of job satisfaction. The quality of healthcare delivery is of medium quality. Finally, this study recommends that there should be an establishment of health and life insurance for health workers; improved health infrastructures; conducive work environment and working conditions; job security; regular and continuous training of healthcare professionals; and attractive rewards and compensation.

Willingness to Pay to Improve Quality of Public Healthcare Services in Mauritius

Mauritius has a universal free healthcare system, based on the Beveridge model which is financed by taxpayers. There are growing considerations over improving quality of healthcare services. The purpose of the study is to employ a contingency valuation (CV) to investigate the willingness of Mauritians people to pay to improve the quality of public healthcare services and the associated determinants using the double-bounded dichotomous choice model. A drop off survey with a sample size of 974 respondents from the working population is used. The empirical analysis shows that the majority of the sample was willing to pay for improving quality of public healthcare services. Other than the conventional determinants of respondents’ demographic and socioeconomic characteristics, the findings support the assertion that psycho-social constructs such as the Theory of Planned Behaviour, Norm-Activation, Public Good Theory, and Perceived Response Efficacy are found to significantly affect Willingness-to-Pay (WTP). The results of this study might be of use to policymakers to help with both priority setting and fund allocation.

Ways of development of processes of standardization and informatization of the field of healthcare

This article is devoted to the analysis of standardization of informatization of medical care projects. In particular, the task of improving the quality and accessibility of medical services on the basis of a scientifically based methodology of portfolio-oriented management is set. To solve this problem, subtasks have been identified, such as the development of methods for estimating the cost of projects in the field of medical services; the creation of a model for financing healthcare based on the introduction of a system of compulsory state medical insurance; the development of a quality management system for healthcare projects, which includes models and methods for planning, ensuring and controlling the quality of medical services; the development of the foundations of state programs for standardization and informatization of healthcare as the basis of a quality management system. Improving the quality of healthcare is recognized as the main goal of reforming the industry at the present stage. The quality of healthcare is defined as the totality of the results of prevention, diagnosis and treatment of diseases determined by the established requirements based on the achievements of medical science and practice. In the work, based on the analysis of the best world experience, it is shown that the use of the principles of standardization in healthcare provides a high level of medical care, regardless of the patient's place of residence, the level of knowledge of a particular doctor or recommendations of a particular scientific school. The paper proposes the main approaches, methods and components of the standardization system. Using the practical experience of private medical centers an algorithm for creating an electronic medical record, its main functions and possible areas of use are proposed. It is shown that the main difficulty in implementing the standardization of medical care is that this work at the level of public and private clinics is controlled not only by the principle of general standardization and modification, but also by a specific project goal for each medical industry, which should be achieved in a comprehensive and balanced manner.

Web-Based Text Analysis of the Patient Safety Concerns of Various Healthcare Stakeholders

Patient safety is a fundamental aspect of the quality of healthcare and there is a growing interest in improving safety among healthcare stakeholders in many countries. The Korean government recognized that patient safety is a threat to society following several serious adverse events, and so the Ministry of Health and Welfare of the Korean government set up the Patient Safety Act in January 2015. This study analyzed text data on patient safety collected from web-based, user-generated documents related to the legislation to see if they accurately represent the specific concerns of various healthcare stakeholders. We adopted the unsupervised natural language processing method of probabilistic topic modeling and also Latent Dirichlet Allocation. The results showed that text data are useful for inferring the latent concerns of healthcare consumers, providers, government bodies, and researchers as well as changes therein over time.

Impact of Organisational Climate on Nurses’ Commitment at Public Hospitals in Saudi Arabia

Background: Nurses represent most healthcare professionals. They work in different healthcare organisations and play a vital role in improving the quality of healthcare. Consequently, it is essential to study the factors that influence nurses' organisational commitments. The purpose of this study is to explore the impact of organisational climate and nurses' commitment in Saudi Arabian public hospitals and to explore the correlation between hospital climate and nurses' commitment. Methods: a quantitative cross-sectional method conducted at the Al-Zulfi General Hospital, Riyadh; King Abdul-Aziz Hospital, Makkah; and King Fahd Central Hospital, Jazan. The Data was collected from 343 participants by using electronic questionnaire in English distributed for the period between 01/03/2021 to 01/04/2021. The questionnaire is composed of three parts: demographic data, a three-component model (TCM) of employee commitment, and an organisational climate questionnaire (OCQ). The sample size was calculated based on the Steven K. Thompson equation. The data were analysed using analysis of variance (ANOVA) and t-tests to identify the differences in organisational commitment and organisational climate among participants’ characteristics. Correlation analysis was used to identify the relationship between organisational commitment and organisational climate. Results: The results demonstrated a significant positive moderate correlation between nurses’ commitment and hospital climate, where r = 0.580 and P < 0.001. We found that organisational commitment was observed as significantly correlated with gender, nationalities and hospital; also, organisational climate was perceived as significantly correlated with gender, nationalities, marital status, years of experience and hospitals with a p-value < 0.05. It is evident that improving organisational climate leads to an increase in nurses’ commitment. Conclusion: Improving the organisational climate could help to promote nurse retention and enhance nursing commitment. The current study recommends that nurse managers pay careful attention to the organisational environment to increase organisational commitment, which can contribute to positive attitudes and appreciation for the organisation.

Preventing Non-attendance in Outpatient Appointments: Predictive Model Development, Validation, and Clinical Assessment

Background: Non-attendance to scheduled hospital outpatient appointments may compromise healthcare resource planning, which ultimately reduces the quality of healthcare provision by delaying assessments and increasing waiting lists. We developed a model for predicting non-attendance and assessed the effectiveness of an intervention for reducing non-attendance based on the model.Methods: Candidate models were built using retrospective data from appointments scheduled between January 1, 2015, and November 30, 2018, in the dermatology and pneumology outpatient services of the Hospital Municipal de Badalona (Spain). The predictive capacity of the selected model was then validated prospectively with appointments scheduled between January 7 and February 8, 2019. The effectiveness of selective phone call reminders to patients at high risk of non-attendance according to the model was assessed on all consecutive patients with at least one appointment scheduled between February 25 and April 19, 2019. Patients identified by the model as high risk of non-attendance were randomly assigned to either a control (no intervention) or intervention group, the last receiving phone call reminders one week before the appointment.Results: Models were trained and selected using 33,329 appointments in the dermatology service and 21,050 in the pneumology service. Average results for specificity and balanced accuracy for the prediction of non-attendance were 79.90% and 73.49% for dermatology, and 71.38% and 64.61% for pneumology outpatient services. The prospective validation showed a specificity of 78.34% (95%CI 71.07, 84.51) and balanced accuracy of 70.45% for dermatology; and 69.83% (95%CI 60.61, 78.00) for pneumology, respectively. The effectiveness of the intervention was assessed on 1,311 individuals identified as high risk of non-attendance according to the selected model. Overall, the intervention resulted in a significant reduction in the non-attendance rate to both the dermatology and pneumology services, with a decrease of 50.61% (p<0.001) and 39.33% (p=0.048), respectively.Conclusions: The risk of non-attendance can be adequately estimated using patient information stored in medical records. The patient stratification according to the non-attendance risk allows prioritizing interventions, such as phone call reminders, to effectively reduce non-attendance rates.

Building Culturally Competent Compassion in Nurses Caring for Vulnerable Populations

Objective: To understand the process of building culturally competent compassion in nurses who care for vulnerable populations. Method: This is a qualitative study of a “single case study” type, developed with 18 nurses who worked in an emergency care unit in the city of Belo Horizonte, Brazil, between October 2020 and January 2021. Data collection was performed through individual online or one-to-one interviews, following a semi-structured script. Data were treated following thematic content analysis, proposed by Bardin. All ethical precepts were taken into account. Results: After data analysis, the following categories were created: a) Looking within: the recognition of cultural identity; b) Paths to be taken: from the gap to cultural knowledge; c) Attentive listening as essential nursing care; d) Culturally competent compassion as an infinite opportunity for growth. Final considerations: Culturally competent compassion is a subjective, complex, and essential construct in holistic nursing care. When implemented successfully, we gain a significant improvement in the quality of healthcare provided to patients and their families as well as a decrease in social inequality, and the protection of human rights.