Evaluate Quality Of Care Research Articles

Evaluation of antenatal care quality for preterm birth prevention using an auditable scoring system: A retrospective, descriptive, longitudinal study in Sydney, Australia.

Preterm birth continues to be one of the most significant contributors to perinatal death. This study aims to evaluate the quality of antenatal care provided to women delivering preterm. This was a retrospective, descriptive, longitudinal review of all women who had antenatal care within a single Australian tertiary hospital and delivered spontaneously between 24 and 37 weeks of gestation, using an auditable scoring system assessing potential interventions for prevention of preterm birth. The review was limited to singleton pregnancies without fetal abnormalities delivering between January 2013 and April 2015. The audit tool was developed by reference to established 'best practice' guidance for prediction and prevention of preterm birth based on Royal Australian and New Zealand College of Obstetricians and Gynaecologists guidelines and published literature. Different pathways were assessed for women deemed either low- or high-risk at the outset of antenatal care. A series of 161 pregnancies that delivered preterm (between 24 and 37 weeks' gestation) were reviewed. The quality of antenatal care was scored 'good' in 42.9% and 50% of high-risk and low-risk women, respectively. Care was scored 'adequate', with room for improvement in 51.4% and 45.2% of the two corresponding groups. The main deficiencies in care were recorded evidence of assessment of cervical length (absent in 35% of cases) and failure to screen for bacterial vaginosis in high-risk women. Auditing antenatal care for prevention of preterm birth allows identification of suboptimal practice allowing service improvement and potential intervention for preterm birth prevention.

The relationship between telemedicine tools and physician satisfaction, quality of care, and patient visits during the COVID-19 pandemic

ObjectiveThe objective of our study is to investigate the impacts of telemedicine technology and its specific tools on physicians’ overall satisfaction, quality of care, and percentage of patient visits in ambulatory care settings after the COVID-19 lockdowns. Materials and methodsData for our analysis was sourced from the 2021 annual National Electronic Health Records Survey (NEHRS), which included 1,875 complete questionnaire responses from physicians in the 2021 NEHRS. We used regression models to test the effects of telemedicine on physicians’ overall satisfaction, quality of care, and percentage of patients’ visits. ResultsWe report that telemedicine technology has significant positive effects on physicians’ satisfaction with telemedicine and quality of care evaluation, both at an aggregate level and at the disaggregate levels of individual telemedicine features, and partially significant effects on patients’ telemedicine visits. DiscussionTelemedicine features that contributed significantly to physician satisfaction and quality of care evaluation were telephone, videoconferencing, standalone telemedicine platform, and telemedicine platform integrated with EHR, while only telephone and integrated telemedicine platform contributed significantly to patients’ telemedicine visits. ConclusionFor telemedicine research and practice, this study confirms that telemedicine improves physician satisfaction and quality of care perceptions and will therefore be preferred by physicians. However, telemedicine has a mixed impact on percentage of patient visits, which suggests that providers may have to work harder to regularize telemedicine acceptance among patients in the post-COVID era.

Patients’ satisfaction with services in HIV clinic at a public tertiary health institution in Ogun State, Nigeria: Patients-providers perspectives

Objective: This study assessed HIV patients´ satisfaction, factors associated with patients´ satisfaction and gaps in the quality of health care service delivery in a virology clinic in Ogun State, Nigeria. Methodology: A cross-sectional study design using mixed methods was used for the study. Three hundred and fifty adult HIV patients on HAART for uninterrupted six months were selected by multistage sampling technique. The Chi-square test was used to assess associations between categorical variables. The p-value used was 0.05. The key informants that were interviewed were the clinic manager, the clinic consultant, the adherence counsellor and the clinic pharmacist. Thematic analysis was done on the key informant interviews. Results: The mean satisfaction scores were high for confidentiality (4.24±0.97), overall care (4.17±0.56) and accessibility of care (4.09±0.82). Waiting time (mean of 3.35±0.42 minutes) and hospital environment (mean of 3.97±0.74) had the lowest mean satisfaction scores. Factors associated with satisfaction were patients’ income (p = 0.001), occupation (p = 0.001) and gender (p = 0.007). The key informants identified long waiting times in the clinic, shortage of manpower, inadequate financial support for patients and inadequate technical support for clinic activities as aspects of care for improvement. Conclusion: In this study, patients expressed a high level of satisfaction with the quality of care and the key informants identified challenges that affect optimal care in the clinic. Healthcare quality is a core dimension of health system performance. Continuous patient satisfaction and quality of care evaluations are needed for optimal health system performance.

Evaluating the quality of home care in community health service centres: A machine learning approach.

The aim of the study is to develop a model using a machine learning approach that can effectively identify the quality of home care in communities. A cross-sectional design. In this study, we evaluated the quality of home care in 170 community health service centres between October 2022 and February 2023. The Home Care Service Quality Questionnaire was used to collect information on home care structure, process and outcome quality. Then, an intelligent and comprehensive evaluation model was developed using a convolutional neural network, and its performance was compared with random forest and logistic regression models through various performance indicators. The convolutional neural network model was built upon seven variables, which encompassed the qualification of home nursing staff, developing and practicing emergency plan to cope with different emergency rescues in home environment, being equipped with medication and supplies for first aid according to specific situations, assessing nutrition condition of home patients, allocation of the number of home nursing staff, cases of new pressure ulcers and patient satisfaction rate. Remarkably, the convolutional neural network model demonstrated superior performance, outperforming both the random forest and regression models. The successful development and application of the convolutional neural network model highlight its ability to leverage data from community health service centres for rapid and accurate grading of home care quality. This research points the way to home care quality improvement. The model proposed in this study, coupled with the aforementioned factors, is expected to enhance the accuracy and efficiency of a comprehensive evaluation of home care quality. It will also help managers to take purposeful measures to improve the quality of home care. The reporting of this study (Observational, cross-sectional study) conforms to the STROBE statement. No patient or public contribution. The application of this model has the potential to contribute to the advancement of high-quality home care, particularly in lower-middle-income communities.

E-Health Training of Medical Specialists in Russia

Purpose. The article discusses the improvement of e-Health training of medical specialists in Russia, and the challenges that doctors face when working with different health information systems. 
 Methodology. The study used both qualitative and quantitative data of the online survey conducted during the primary case study. Online survey targeted students of the Department of Medical Informatics and Cybernetics of N.I. Pirogov Russian National Research Medical University and doctors who were receiving initial training under the e-Health advanced training program. The survey aimed to determine systemic challenges and demand for training in various medical information systems. 
 Findings. Research data suggest that in order to bridge the digital gap, educational and training programs should include training versions of medical information systems used in Russian practical healthcare (electronic document flow system, EMIAS, Statistica, Sotsstrakh, Retsipient, etc.). It will enable doctors to enhance their theoretical and practical skills, abilities and knowledge, thus improving the quality of educational and work processes. Practicing health specialists who not only possess the theoretical knowledge, but also actively work in these areas (temporary disability examination, evaluation of medical care quality, work with citizens' appeals, compilation of numerous statistical reports, etc.) should be involved as mentors in the educational process. Simultaneous connection under the same login and password from multiple devices should be restricted to protect personal data and increase the security level of electronic document management systems in Russia.

Antibacterial activities of titanium dioxide (TiO2) nanotube with planar titanium silver (TiAg) to prevent orthopedic implant infection

BackgroundOrthopedic implant infection has become a common catastrophic complication after various orthopedic implants, which can lead to prolonged use of antibiotics and even surgical failure. The quality of care (QoC) of orthopedic implant infection is very important.MethodsTitanium dioxide (TiO2) nanotube array with planar TiAg was prepared, and their antibacterial rates were tested. 400 patients hospitalized in the Department of Orthopedics of Wuhan Fourth Hospital from May 2019 to May 2020 were selected as controls (before QoC evaluation system of orthopedics), and 400 patients hospitalized from June 2020 to June 2021 were selected as observation group (after QoC evaluation system of orthopedics).ResultsRegardless of Staphylococcus aureus or Escherichia coli, the antibacterial rate of TiO2 nanotube array with planar TiAg was clearly higher than that of pure iron film on the 10th and 20th days (P < 0.05). The accuracy of hospitalization assessment, disease assessment, adverse event intervention, nursing record filing and nursing satisfaction in observation group were higher as against controls (P < 0.05).ConclusionThe TiO2 nanotube array with planar TiAg has good antibacterial property, which can effectively prevent orthopedic implant infection. The construction of QoC evaluation system for orthopedic specialists can effectively improve the QoC of orthopedic specialists.

Meta-analysis of risk factors for posttraumatic stress disorder in myocardial infarction.

The aim of this study was to identify the risk factors for posttraumatic stress disorder in patients with myocardial infarction. Cohort, case-control, and cross-sectional studies on posttraumatic stress disorder (PTSD) in patients with myocardial infarction were searched from PubMed, Embase, Cochrane Library, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and Technology Journal database. The Newcastle-Ottawa Quality Assessment Scale was used to score the quality of the included literature in the cohort and case-control studies, and the cross-sectional studies were scored using the American Agency for Health Care Quality and Research cross-sectional study quality evaluation criteria. The literature was screened independently by 2 researchers, and if there was no consensus, the inclusion was decided by a third party. The extraction content included first author, publication year, sample size, PTSD assessment tool, PTSD assessment time, PTSD incidence, influencing factors, and study type. Meta-analysis of data was performed using Stata17.0 software. Ten studies were included, including 2 cohort studies, 7 cross-sectional studies, and 1 case-control study, with a total sample size of 2371 patients, including 26 influencing factors. The results of meta-analysis showed that the prevalence of PTSD in patients with myocardial infarction was 21.2%. Statistically significant influencing factors were gender (odd ratio [OR] = 3.124), neuroticism score (OR = 2.069), and age (OR = 0.913). The prevalence of PTSD in patients with myocardial infarction in China is higher than that in other countries. Female and neurotic personality are risk factors for developing PTSD in patients with myocardial infarction, and old age is protective factor for developing PTSD in patients with myocardial infarction. Targeted measures should be taken to prevent and reduce the occurrence and development of PTSD in patients with myocardial infarction in the future.

Importance of Hospital Infection Control.

The increasing demand for healthcare-acquired infection (HAI) control practices and services has intensified the need to evaluate care quality. The World Health Organization (WHO) introduced an infection prevention and control (IPC) framework to mitigate the impact of HAIs, crucial for ensuring patient safety in hospitals. HAIs acquired after hospitalization pose significant challenges due to factors such as compromised immunity, invasive medical procedures, and antibiotic-resistant pathogens, which have dire consequences, including higher mortality rates and increased healthcare costs. Healthcare workers (HCWs) are critical in implementing IPC measures. Infection control programs that include strategies such as hand hygiene, personal protective equipment (PPE), environmental cleaning, and surveillance have become standard. However, challenges such as resistance to change, resource limitations, patient turnover, and variability in patient conditions persist. Strategies to maintain hospital infection control involve rigorous compliance monitoring, staff education, advanced technologies such as artificial intelligence (AI), machine learning (ML), telemedicine, and innovative sanitation methods. The future of hospital infection control may involve increased integration of environmental monitoring, antimicrobial stewardship, and patient participation while leveraging collaboration among healthcare facilities. The review highlights the criticality of hospital infection control and suggests trends and opportunities to strengthen prevention efforts and patient safety.

Performance measurement and user-centeredness in the healthcare sector: Opening the black box adapting the framework of Donabedian.

The framework of Donabedian is widely applied to performance assessment at the healthcare system level. Donabedian categorised the care quality measurement around three dimensions, namely structure, process, and outcomes. The first dimension concerns the inputs; the second one, the combinations of factors and inputs; the last one, the effectiveness in terms of patients' health status. Donabedian early included in the last dimension the patient satisfaction. Nevertheless, nowadays, outcomes are generally measured through hard endpoints, such as re-admissions and mortality indicators. Recently, the Patient-Reported Outcome Measures (PROMs) have been included among the outcome measures within the Donabedian framework. How to move the concept of patient-centeredness to a macro level, including the patient point of view in care quality measurement, evaluation, and improvement? This paper integrates the Donabedian structure-process-outcome framework, by incorporating in the proper dimension the patient-indicators, namely the abovementioned PROMs and Patient-Reported Experience Measures (PREMs). While PROMs are clearly measures of outcome, PREMs can be collocated in the process dimension, since they can be useful for mapping processes and care pathways, in a lean perspective, as well as in the outcome dimension, because inherently linked to outcome, and enablers of patient-centeredness.

Effective coverage of newborn postnatal care in Ethiopia: Measuring inequality and spatial distribution of quality-adjusted coverage.

Neonatal health is a significant global public health concern, and the first two days of life are crucial for newborn survival. Most studies on newborn postnatal care have focused on crude coverage measures, which limit the evaluation of care quality. However, evidence suggests a shift towards emphasising effective coverage, which incorporates the quality of care when measuring intervention coverage. This research aimed to assess the effective coverage of newborn postnatal care in Ethiopia while also examining its inequalities and spatial distribution. The study used secondary data from the 2016 Ethiopian Demographic and Health Survey, which was a cross-sectional community-based study. A total weighted sample of 4169 women was used for analyses. We calculated crude coverage, which is the proportion who received a postnatal check within 48 hours of birth and quality-adjusted coverage (effective coverage), which is the proportion who received a postnatal check within 48 hours of birth and reported receipt of 6 or more contents of care provided by health care providers. Concentration index and concentration curves were used to estimate the socioeconomic-related inequalities in quality-adjusted newborn postnatal care. The spatial statistic was analysed by using Arc-GIS. The crude coverage of newborn postnatal care was found to be 13.2%, while the effective coverage was 9%. High-quality postnatal care was disproportionately concentrated among the rich. A spatial variation was found in quality-adjusted coverage of newborn postnatal care across regions. The findings suggest that there is a significant gap in the coverage and quality of postnatal care for newborns across regions in Ethiopia. The low rates of coverage and effective coverage, combined with the concentration of high-quality care among the rich and the spatial variation across regions, highlight the need for targeted interventions and policies to address the inequalities in access to high-quality postnatal care for newborns.

Perspectives of cardiac rehabilitation in patients who had a stroke: a protocol for a qualitative study review

IntroductionStroke has a high incidence and disability rate, and its recurrence and readmission rates are rising, making it the second-leading cause of mortality in the globe. Cardiac rehabilitation is a...

Regional Experience in Improving the Quality and Cost-Effectiveness of Medical Care for Children with Acute Respiratory Pathology in the Rostov Region

One of the priorities of the modern world medical community is the continuous comprehensive improvement of medical care quality. Evaluation of medical care quality and material costs level for the management of patients with acute respiratory pathology (ARP) was performed in one city medical facility, as well as cost-effectiveness analysis of the project “Improvement of medical care quality for children of the Rostov region”. The first step of this study was retrospective audit of source medical records (n = 154) of Children’s hospital via the adapted World Health Organization questionnaire “Evaluation of in-patient care quality for children” recommended for Europe and revised in 2015. Inclusion criteria: hospitalization of patients with acute conditions; outcome — recovery with no complications; presence of one of the clinical manifestations (acute nasopharyngitis, acute non-obstructive bronchitis, acute obstructive bronchitis, acute obstructive laryngitis, acute community-acquired pneumonia). The cost-effectiveness evaluation was performed considering the direct treatment costs and the coefficient of economic costs per patient (CECPP). Analysis of the study’s first stage has revealed defects in medical care quality, significant and irrational material costs of the medical facility at all stages of medical and diagnostic care for children with ARP. CECPP peak indicators came under notice in all observation groups due to high expenses on medications and specifically those not included in clinical practice guidelines, vast amount of unreasonable hospitalizations and diagnostic procedures, expenses on physical therapy (PT), etc. Analysis of the study’s second stage medical records (n = 146) of patients with ARP took place after the initial audit followed by quarterly monitoring and hospital staff training (endpoint — 12 months). Significant improvements in the health care quality and cost-effectiveness for children with ARP have been shown.

Обзор нормативных документов, регламентирующих оказание медицинской помощи пациентам с хроническим гнойным средним отитом

Current regulatory documents of national importance that directly regulate medical care for chronic suppurative otitis media include the Federal Law "Basics of Health Protection of the Citizens in the Russian Federation", seven orders of the Ministry of Health and its predecessors, and Clinical Guidelines of the National Medical Association of Otolaryngologists. From general to specific according to the legal hierarchy, each document determines the regulations, routing, amount, and quality of medical care down to the smallest detail in various conditions and age groups. Chronic suppurative otitis media is a group of diseases that are expensive to treat and associated with a high risk of early and delayed complications. Therefore, many documents (which often conflict with each other) are dedicated to medical care standardization. Despite the outdatedness and, often, the difficulty of practical implementation of some recommendations specified in the regulatory documents, all of them are mandatory for implementation throughout the Russian Federation. KEYWORDS: chronic suppurative otitis media, standard, clinical guidelines, procedure for providing medical care, evaluation of medical care quality. FOR CITATION: Komarov M.V., Dvoryanchikov V.V. Legal documents regulating medical care for chronic suppurative otitis media. Russian Medical Inquiry. 2023;7(8):529–536 (in Russ.). DOI: 10.32364/2587-6821-2023-7-8-9.

TRANSLATION AND CULTURAL ADAPTATION OF THE PREFERENCES FOR EVERYDAY LIVING INVENTORY INTO KOREAN

Abstract Valid and reliable measures are necessary to provide person-centered care tailored to the individual. However, there are no such measures in Korean nursing home settings. Therefore, the purpose of this study was to translate and culturally adapt the Preferences for Everyday Living Inventory (PELI); test face validity; and finalize a Korean version of PELI (PELI-K). The translation and cultural adaptation were done according to guidelines of the International Society for Pharmacoeconomics and Outcomes. After translating, cognitively capable Korean older adults (n=10) reviewed the PELI items and completed a questionnaire. Face validity was assessed by three questions regarding grammar and wording, understandability, and cultural relevance using a 4-point Likert scale: 1 (strongly disagree) to 4 (strongly agree). Higher scores indicate better validity. The mean (±SD) age of participants was 67 (±2.50) years. The mean score of appropriateness for grammar and wording was 2.70 (±.82); understandability was 3.70 (±.48); and cultural relevance was 3.70 (±.67). Participants found the Korean version of PELI easy to understand and interpret, and culturally relevant. However, some translations have room for improvement in rephrasing sentences and using alternative wording. Based on cognitive debriefing results and several suggestions from participants, necessary changes were made before creating a final version of PELI-K. These findings suggest that PELI was successfully translated and culturally adapted to Korean. Implementing PELI-K in Korean nursing home settings will help with eliciting individual preferences and incorporating them into care delivery. Next steps can evaluate care quality improvement and increased residents’ satisfaction.

A 360 Evaluation of Neonatal Care Quality at a Level II Neonatal Intensive Care Unit when Delivered Using a Hybrid Telemedicine Service.

In 2013, the Section of Neonatal and Perinatal Medicine at the University of Oklahoma's Children's Hospital began providing advanced care to a regional level II neonatal intensive care unit (NICU), using a hybrid telemedicine program. This project compares health care providers' and parents' assessments of health care quality using this program. This is a prospective, anonymous, nonrandomized survey of health care providers and parents of neonates using our hybrid telemedicine services. Physicians, neonatal nurse practitioners (NNPs), nurses, and parents completed pencil-and-paper surveys based on their participatory roles. Institutional Review Board approval was obtained at OU Medical Center and Comanche County Memorial Hospital. Surveys consisted of 5-point Likert's scale questions. Descriptive statistics compared the level of agreement with each question across participant groups. A service quality (SQ) composite score was created by summing responses from six SQ questions. Between-group analysis was done on the SQ score using the Mann-Whitney U-test. Nine physicians, 10 NNPs, 12 nurses, and 40 parents completed the survey. Providers agreed (90%) that telemedicine can effectively deliver advanced neonatal care; the care patients receive is comparable to direct patient care (87%); telemedicine enhanced overall patient care quality (90%); providers can effectively interact with each other and families using telemedicine (90.3%), and overall telemedicine experience was good (90%). In total, 61% of providers reported telemedicine improves physician-patient interaction. Parents of newborns agreed that they were well informed about telemedicine use for their child's care (88%), were able to communicate routinely with neonatologists (85%), and were comfortable with their child's physical examinations (93%). Provider's versus family's (SQ) score was not significantly different. All survey participants, including neonatologists, NNPs, nurses, and patient families, reported high levels of satisfaction with the hybrid telemedicine model developed and implemented at this institution which may be comparable to in-person direct patient care. · Implementation of a hybrid telemedicine system provides an alternative to the transfer of newborns needing advanced care to tertiary care facilities.. · In this study, both health care providers and patient family members were satisfied with the quality of care using hybrid telemedicine.. · In this study, families of newborns could fully participate in their child's care using the hybrid telemedicine system..

Evaluation of the hospital care quality perceived by patients with immune-mediated inflammatory diseases from the pharmacy service. SACVINFA study.

Immune-mediated inflammatory diseases (IMIDs) are a group of chronic and highly disabling diseases. The objective is to evaluate the satisfaction with the health care received by patients with the most prevalent IMIDs in Spain: inflammatory bowel disease (IBD), psoriasis (Ps) psoriatic arthritis (PsA), rheumatoid arthritis (RA) and spondyloarthropathies (SpAs), and to determine the factors that influence patient satisfaction. This was an observational, cross-sectional, multicentre study in a real-world evidence context conducted in the Pharmacy Service in four hospital centres of the Community of Madrid that belong to the National Health System. The study included adult patients diagnosed with an IMID who had attended the Pharmacy Service at least three times. The patients were grouped according to the main IMID. Health care satisfaction was evaluated using the chronic patient experience assessment (IEXPAC) questionnaire. The responses to IEXPAC are grouped into three factors: productive interactions, new relational model and patient self-management, with a total score from 0 (worst) to 10 (best experience). Health-related quality of life (HRQoL) was also evaluated using the EQ-5D-5L questionnaire, and pharmacological adherence was evaluated through the Morisky-Green test. A total of 578 patients were analysed (IBD=25.3%; Ps=19.7%; SpAs=18.7%; RA=18.5%; PsA=17.8%). The mean age (SD) was 49.8 (12.3) years and 50.7% were male. The average score (SD) for the total IEXPAC sample was 6.6 (1.9). RA was the IMID with the lowest score, at 5.83 (2.0), significantly lower than the scores of Ps (SD) [7.01 (1.7); p=0.003], IBD [6.83 (1, 9); p=0.012] and SpAs [6.80 (1.6); p=0.001]. Productive interactions (SD) [8.5 (1.8)] and patient self-management (SD) [7.3 (2.3)] were the factors with the highest scores, and the new relational model had the lowest score (SD) [3.2 (2.7)]. Male gender, a longer time interval between medication administrations and a higher HRQoL were correlated with better patient satisfaction. Current biological therapy (according to the Anatomical Chemical classification system) also had a significant influence; patients treated with tumour necrosis factor inhibitors and interleukin inhibitors showed greater satisfaction than those treated with selective immunosuppressants. The IEXPAC results show high general satisfaction with care quality reported by patients with IMIDs treated in the Pharmacy Service. However, there are areas of improvement in care quality specially health professional-patient communication, such as increasing access to information, and promoting and facilitating relationships with patients in similar conditions.

Comparing program supervision with an external RADAR evaluation of quality of care in integrated community case management for childhood illnesses in Mali

ABSTRACT Background Many countries have adopted integrated community case management (iCCM) to reduce mortality among children under five years from common childhood illnesses. The 2016–2020 Malian Red Cross iCCM program trained 441 Community Health Workers (CHWs) to treat malaria, pneumonia, diarrhea, and malnutrition for children under five years of age in six districts. Implementation strength and quality of care (QoC) were assessed through the program’s supervision function, using the Malian Ministry of Health’s system. Objective This paper compares methods and results of program supervision data and an independent evaluation to assess the effectiveness of program implementation and supervision and inform program improvement. It also presents the benefits and limitations of each method. Method An independent QoC evaluation was conducted using tools developed by the Real Accountability: Data Analysis for Results (RADAR) project, hereafter referred to as the RADAR evaluation. RADAR evaluation data collected in July and August 2018 were compared with program supervision data collected mostly between May and December 2018. Results The RADAR evaluation provided detailed findings on correct assessment, classification, and treatment per illness, medication type, and dosage. Program supervision combined the findings for all illnesses, medication type, and dosage due to limitations in the data collection process. Six indicators were comparable between both methods. Findings were similar for temperature and mid-upper arm circumference measurements but diverged between program supervision and the RADAR evaluation, respectively, on correct classification for all illnesses (87.1% vs. 65.3%), correct treatment for all illnesses (69.5% vs. 39.8%), correct respiratory rate counting (88.5% vs. 54.7%), and administering the first dose by CHW (75.4% vs. 65.0%). Findings from the RADAR evaluation guided improvements in program supervision. Conclusions A robust program supervision system can serve as a credible method to assess QoC. However, a rigorous independent QoC evaluation provides a valuable benchmark to gauge the effectiveness of the supervisory process.

Construction and Empirical Study of Nursing Quality Evaluation Index System of Hepatobiliary Surgery Based on ERAS Concept

Objective To study the index system of enhanced recovery after surgery (ERAS) nursing evaluation, as a basis for the quality evaluation of hepatobiliary care, continue to improve the quality of hepatobiliary care. Methods The 300 cases of hepatobiliary surgical diseases treated in our hospital from January 2019 to December 2020 were randomly selected as the subjects of this study. Through clinical trials, two groups of subjects were used, one for the ERAS care group and the traditional care group. Through the questionnaire survey and access to the relevant research data, statistical data analysis was performed using the SPSS 22.0 software. Metrics were analyzed as descriptive by mean, standard deviation, and coefficient of variation. The Visual Analogue Score (VAS) Hepatobiliary Surgery Nursing Service evaluation form, service evaluation form, postoperative incidence of adverse reaction rate, patient satisfaction, and readmission rate questionnaire were established from the aspects of structural quality and process quality. An index system of hepatobiliary surgery nursing quality evaluation based on the ERAS concept was constructed. Results This study compared the degree of VAS pain through postoperative care. The ERAS care group scored significantly lower than in the traditional care group. Nursing patients based on ERAS are very satisfied with the quality of care services. By comparing patient postoperative adverse reactions, satisfaction, and readmission rates, the ERAS care group was significantly better than the traditional care group. It can be seen that a good nursing quality evaluation index system can truly and objectively reflect the level of nursing quality and promote the hospital to further improve the medical quality. Conclusion The research on the construction of nursing quality evaluation index system of hepatobiliary surgery based on ERAS concept provides a more scientific evaluation standard for nursing quality evaluation of hepatobiliary surgery ERAS, creates conditions for digital and intelligent management of nursing quality, and provides a basis for formulating a unified nursing quality evaluation index system of hepatobiliary surgery. It is of practical significance to improve the nursing quality of ERAS in hepatobiliary surgery.

Application Effect Analysis of Operating Room Detailed Nursing Based on Medical Big Data in Patients Undergoing Gastrointestinal Tumor Surgery.

With the continuous development of internet information computing, the continuous improvement of medical and health systems, and the continuous increase of medical big data, traditional operating room care also needs to be further optimized. Medical big data is a forum data set for medical industry healthcare, electronic medical record information, clinical case record information, medical financial data, remote patient monitoring data, clinical decision support data, medical insurance data set, online consulting platform, and so on. Gastrointestinal tumors are currently one of the largest malignant tumors. Compared with ordinary patients, the presence of fear, depression, irritability, and other unhealthy emotions in patients with gastrointestinal tumors will reduce the therapeutic effect. Without careful care, the use of chemotherapy and other treatments makes patients vulnerable to various side effects. This article aims to study the use of medical big data intelligent algorithms to perform detailed care for patients during gastrointestinal tumor surgery and analyze the effects of care. This paper proposes an improved DNN algorithm; the DNN algorithm is to use several weight coefficient matrices and bias vectors to perform a series of linear operations and activation operations with the input value vector, starting from the input layer, backward calculation layer by layer, until the operation reaches the output layer, and the output result is obtained. This algorithm is used to study the theory, use mathematical formulas for method calculation and model design, and use the model to carry out detailed nursing experiments in the relevant operating room. The results of the experiment show that patients who have performed detailed care have a 27.2% improvement in treatment and rehabilitation effects than those who have not, and the level of detailed care has an obvious positive relationship with the rate of condition conversion. In the end, the hospital's detailed care quality evaluation index, which is QEI, increases by 1 point, which can increase the rate of condition conversion by 0.4.

P161 Implementation of Outcome Measurement – Case Finnish IBD register

Abstract Background Inflammatory bowel diseases (IBD) are becoming increasingly common. In Finland, during 2020, in total of 54 000 patients were diagnosed with IBD, and over 2000 new diagnoses are made every year. The Finnish university hospitals in collaboration with BCB Medical Ltd have built disease-specific registers to support and monitor the quality and effectiveness of health care. The IBD register (IBDR) collects data on the effectiveness of IBD treatments and their follow-up, where e.g. disease severity, treatment and outcomes are profoundly monitored. As combination, IBDR, MyHealth service, and IBD Symptom Diary enables patients’ health, functional status, experience and QoL monitoring to reach the health care goals. The service supports patient treatment pathway and makes designing more personalized treatments for IBD possible. Methods The IBDR is a web-based system integrated with electronic health record (EHR) systems, through which patient data is captured. Nationally convergent register allows for peer review of treatment outcomes. To complement registers’ clinical data, PROMs are collected with online MyHealth service to enable automatic, recurring data collection directly from the patient. The first questionnaire is activated 14 days before the visit, whereas new questionnaire is sent to the patient two months after visit, and then at time points according to the disease activity index calculated from the questionnaire. The disease activity is reflecting the severity of the IBD symptoms[1]. Captured measures are immediately available for clinician review. Results MyHealth for IBD is actively used in four Finnish university hospitals and two central hospitals with some inter-regional variation. By November 2021, the questionnaires were answered 31 506 times since the beginning of the implementation in 2019. The response rate is yearly increasing (Figure 1). Distribution of disease activity index among IBD patients in Tampere University Hospital is shown in Figure 2. Conclusion IBDR enables the evaluation and comparison of patient care quality, which is not accessible through EHR systems alone. Our electronic data collection model brings out the patients’ voice and saves resources since cyclic questionnaires are automatically send to patients, and answers are immediately reached by clinician. In future, international comparison and monitoring of treatment outcomes will be emphasized. As MyHealth deployment proceeds across hospitals, the availability of the patient reported outcomes data will increase. International research and peer development will continue to be an essential part of our activities. Reference 1. Puolanne A-M et al. Dig Dis Sci (2017) 62:3123–3130.