Improve Healthcare Performance Research Articles

Connecting the Health Care Workforce with the Patient Experience.

This article is one in a series from Press Ganey-a health care performance improvement organization-that will discuss the many facets of the human experience in health care. Using the latest national data, the series will explore the intersections of safety, reliability, experience, and service, and their impact on engagement, work culture, and nurse-sensitive outcomes. Each installment will be designed as a "deep dive" into the most recent thinking and evidence-based approaches to improvement of the patient experience with a particular focus on practical and implementable tactics in each of the above subject areas.

Immersed in scholarly projects: Upskilling our future medical workforce

Introduction: Much has been written about the need for medical students to have research skills. Increasing numbers of medical schools are incorporating compulsory research experiences to increase research literacy. However, little is known about the student perceptions of, and outcomes from, those programs. We aimed to examine medical students' perceptions of a compulsory 6-week scholarly project at a large Australian university. There was a particular focus on comparing students’ perceptions based on their prior research experience. Methods: A cross-sectional study design was used to survey 418 final-year medical students. Responses were analysed using descriptive and bivariate statistics. Results: One hundred and eleven students responded to the survey (27% of the cohort). Fifty-one percent had prior research experience. The majority of respondents perceived they had enhanced their confidence (69%) and research skills (74%), and as a result of this unit, 62% reported enhanced willingness to participate in future research projects. Students produced a variety of outputs in addition to their assessment requirements. Students without prior experience were significantly more likely to report they were suitably challenged and their project had enhanced their skills in interpreting and applying evidence. Conclusion: We found that short (6-week) scholarly projects enhanced final-year medical students’ perceived ability to interpret and apply evidence. Many students also reported an increased willingness to participate in future research activities. As clinician research literacy and engagement are thought to improve healthcare performance and health outcomes, scholarly experiences in the final year of medical school have the potential to enhance graduate enquiry to improve healthcare.

How Nurses Influence the Patient Experience.

This article is one in a series from Press Ganey-a health care performance improvement organization-that will discuss the many facets of the human experience in health care. Using the latest national data, the series will explore the intersections of safety, reliability, experience, and service, and their impact on engagement, work culture, and nurse-sensitive outcomes. Each installment will be designed as a "deep dive" into the most recent thinking and evidence-based approaches to improvement of the patient experience with a particular focus on practical and implementable tactics in each of the above subject areas.

The health service perspective on determinants of success in allied health student research project collaborations: a qualitative study guided by the Consolidated Framework for Implementation Research

BackgroundA research culture in health care organisations is associated with improved healthcare performance. Allied health (AH) students undertake research training as part of their professional degree qualifications. This may include participation in research projects, sometimes undertaken in association with health services. Co-supervision of these projects by health service staff provides research capacity building opportunities and staff-centred outcomes for the individuals involved, as well as improvements in clinical knowledge and practice within the local area. Also, publications from these projects contribute to the wider evidence base. Identification of barriers and facilitators to engagement in, and conduct of, these projects may optimise systems for improved health service outcomes.MethodsThis formative evaluation used the Consolidated Framework for Implementation Research (CFIR) to guide analysis of qualitative data obtained from semi-structured interviews with health service-employed allied health professionals, including clinicians and research fellows, who had supervised students on clinical-related research placements within the previous five years.ResultsEleven AH clinicians described 18 collaborative projects with 24 students from five AH disciplines across four universities. Three health service-employed AH research fellows described their involvement in these and other student research projects. Twenty key determinant constructs were identified and mapped across all five CFIR domains. Facilitators included health service cosmopolitanism, project adaptability and implementation climate (compatibility). Health service-employed research fellows provided readiness for implementation and a facilitator for project execution. The main barriers identified were cost to staff in workload and personal time and aspects related to project complexity. Differing student characteristics affected the relative advantage of collaborative projects in positive and negative manners.ConclusionsThis study describes the facilitators and barriers to the conduct of collaborative AH student research projects. Addressing these determinants when establishing each new project may enable health services to optimise communication, role delineation and project success, and thus ultimately, healthcare performance and patient care.

Learning from Latent Safety Threats Identified During Simulation to Improve Patient Safety.

Latent safety threats (LSTs-characteristics of design, processes, or physical environment in health care compromising patient safety) are commonly revealed during simulation-based training. Methods of collecting, analyzing, and classifying LSTs are underdeveloped and not standardized. Building on a large simulation program in one organization, the authors aimed to collect LSTs systematically and develop a taxonomy to classify them. The authors modified the Press Ganey Healthcare Performance Improvement Failure Modes Taxonomy (HPI-FMT), a standardized framework for safety event classification in health care, and used three categories: System, Individual, and Medications. The subcategories were revised to reflect simulation LST content and promote consistent data entry into a spreadsheet. Data visualization software was used to analyze LST data and generate dashboards, graphs, and executive summaries to share across the system that depicted data for individual hospitals and outpatient areas and allowed grouping, comparisons, and trending. Over a year, the researchers identified 1,318 LSTs in 232 simulations across the organization-a rate of 5.7 LSTs/simulation. The top three LST subcategories were Environment/supplies/equipment (System category); Process/structure (System category); and Knowledge or unformed skill/habit (Individual category). Other important LSTs were Missing/malfunctioning supplies/equipment; Unclear or ineffective process or no process; and Unfamiliarity with supplies/equipment. When a repetitive pattern of LSTs was observed (for example, improper dantrolene use during malignant hyperthermia simulations), targeted process improvement or training was implemented. The authors developed, implemented, and refined a systematic method of collecting, analyzing, displaying LSTs, and recommending targeted process improvements or training when LST trends were noted.

Exploring the Human Experience in Health Care.

This is the first article in a new series from Press Ganey-a health care performance improvement organization-that will discuss the many facets of the human experience in health care. Using the latest national data, the series will explore the intersections of safety, reliability, experience, and service, and their impact on engagement, work culture, and nurse-sensitive outcomes. Each installment will be designed as a "deep dive" into the most recent thinking and evidence-based approaches to improvement of the patient experience with a particular focus on practical and implementable tactics in each of the above subject areas.

The value of allied health professional research engagement on healthcare performance: a systematic review

BackgroundExisting evidence suggests that clinician and organisation engagement in research can improve healthcare performance. With the increase in allied health professional (AHP) research activity, it is imperative for healthcare organisations, clinicians, managers, and leaders to understand research engagement specifically within allied health fields. This systematic review aims to examine the value of research engagement by allied health professionals and organisations on healthcare performance.MethodsThis systematic review had a two-stage search strategy. Firstly, the papers from a previous systematic review examining the effect of research engagement in healthcare were screened to identify papers published pre-2012. Secondly, a multi-database search was used to conduct a re-focused update of the previous review, focusing specifically on allied health to identify publications from 2012–2021. Studies which examined the value of allied health research engagement on healthcare performance were included. All stages of the review were conducted by two reviewers independently. Each study was assessed using the appropriate Joanna Briggs Institute critical appraisal tool. A narrative synthesis was completed to analyse the similarities and differences between and within the different study types.ResultsTwenty-two studies were included, comprising of mixed research designs, of which six were ranked as high importance. The findings indicated that AHP research engagement appears related to positive findings in improvements to processes of care. The review also identified the most common mechanisms which may link research engagement with these improvements.DiscussionThis landmark systematic review and narrative synthesis suggests value in AHP research engagement in terms of both processes of care and more tentatively, of healthcare outcomes. While caution is required because of the lack of robust research studies, overall the findings support the agenda for growing AHP research. Recommendations are made to improve transparent reporting of AHP research engagement and to contribute essential evidence of the value of AHP research engagement.Trial registrationThis systematic review protocol was registered with the international prospective register of systematic reviews, PROSPERO (registration number CRD42021253461).

Impact of administrative decision-making on the performance of health facilities in Medina, Saudi Arabia

Enhancing the administration of primary healthcare facilities might be a significant step toward achieving the quality improvement goal. The purpose of this research was to determine whether or not improvements in healthcare performance lead to improvements in the overall quality of decision-making in Medina, Saudi Arabia. In order to determine the impact that increased information security has on the quality of decision-making, the researcher used the use of a questionnaire. Our findings revealed a high level of the quality, accepting and implementing and timeliness and administrative decision-making, and this suggests that health facilities have a high degree of competence to make administrative choices in all three of their dimensions. In addition, we mentioned a high level of performance of health facilities, and this suggests that the health facilities that were investigated had a high level of performance. We found that administrative decision-making had a statistically significant influence on the performance of healthcare facilities, and we found that for every 1% rise in the level of administrative decision-making, the performance of healthcare facilities improved by 0.853%.

Typology, Severity, and Outcomes of Adverse Events Related to Angiographic Equipment-A Ten-Year Analysis of the FDA MAUDE Database.

Purpose: Angiographic equipment is a key component of healthcare infrastructure, used for endovascular procedures throughout the body. The literature on adverse events related to this technology is limited. The purpose of this study was to analyze adverse events related to angiographic devices from the US Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database. Methods: MAUDE data on angiographic imaging equipment from July 2011 to July 2021 were extracted. Qualitative content analysis was performed, a typology of adverse events was derived, and this was used to classify the data. Outcomes were assessed using the Healthcare Performance Improvement (HPI) and Society of Interventional Radiology (SIR) adverse event classifications. Results: There were 651 adverse events reported. Most were near misses (67%), followed by precursor safety events (20.5%), serious safety events (11.2%), and unclassifiable (1.2%). Events impacted patients (42.1%), staff (3.2%), both (1.2%), or neither (53.5%). The most common events associated with patient harm were intra-procedure system shut down, foot pedal malfunction, table movement malfunction, image quality deterioration, patient falls, and fluid damage to system. Overall, 34 (5.2%) events were associated with patient death; 18 during the procedure and 5 during patient transport to another angiographic suite/hospital due to critical failure of equipment. Conclusion: Adverse events related to angiographic equipment are rare; however, serious adverse events and deaths have been reported. This study has defined a typology of the most common adverse events associated with patient and staff harm. Increased understanding of these failures may lead to improved product design, user training, and departmental contingency planning.

Healthcare performance improvement through lean management and industry 4.0

PurposeThis paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studiesDesign/methodology/approachThis briefing is prepared by an independent writer who adds their own impartial comments and places the articles in contextFindingsThe statistical results indicated that Industry 4.0 technologies lead to improved healthcare operational performance. Lean practices showed a weaker correlation with operational performance.Originality/valueThe briefing saves busy executives, strategists and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format

Audit and feedback in cardio- and cerebrovascular setting: Toward a path of high reliability in Italian healthcare.

Adopting audit and feedback (A&F) strategies could be a suitable healthcare intervention to fulfill the challenge of monitoring and improving clinical guidelines in evidence-based medicine. Indeed, A&F is used to encourage professionals to better adhere to standard guidelines to improve healthcare performance. Briefly, an audit is an inspection of professional practice in comparison to professional standards or targets whose results are subsequently communicated to professionals in a structured manner. Although A&F strategies have been adopted in several time-dependent settings, such as for acute myocardial infarction (AMI) and stroke, interest of audits in rehabilitation care is also emerging. Recently, the Italian Ministry of Health has funded a national network project called EASY-NET, whose main objective is to evaluate the effectiveness of A&F strategies to improve healthcare practice and equity in various clinical and organizational settings in seven Italian regions. Last but not the least of these regions is the Sicily, represented within the project by the IRCCS Centro Neurolesi Bonino-Pulejo of Messina as the work package 7 (WP7). The EASY-NET WP7 is focused on the effectiveness of A&F strategies in both AMI and ischemic stroke setting, from acute to rehabilitation process of care. In this study, we described the study protocol, including the study design and methodology, providing a detailed description of the new model of A&F based on telemedicine, and discussing the possible challenges of this project.

Experiences of hospital allied health professionals in collaborative student research projects: a qualitative study

BackgroundActive engagement in research by healthcare organisations and clinicians is associated with improvements in healthcare performance. Barriers to research engagement by clinician allied health (AH) professionals include competing priorities from high clinical workloads, lack of research skills and confidence, and lack of supportive research relationships. Collaboration with universities on joint clinical research projects is well recognised as a means of building health service research capacity. Research projects undertaken by students as part of their qualifying degree represent one such opportunity. However, there are few reports evaluating these collaborations from the health service perspective.MethodsA qualitative study using semi-structured interviews and thematic analysis to explore the experiences of AH professionals in the co-supervision of students completing research placements as part of their professional degree course.ResultsFourteen health service employees from six allied health disciplines described collaborations on research projects with 24 students from four different universities. Student placements and projects varied widely in length of placement, extent of collaboration, supervision structure and study design. Three overarching themes were identified in the AH professional co-supervision experience: 1) Professional growth; 2) Mismatch with expectations; and 3) Focus on the student. Project outcomes were categorised from the health system perspective. These were 1) Healthcare performance improvements, including local increases in staff clinical practice knowledge and wider contributions to the evidence base; 2) Research capacity gains within the health service, including research knowledge and skill development, collaborative linkages and opportunity for future research; and 3) Staff-centred outcomes including increased job satisfaction.ConclusionsThis study demonstrates the potential for AH professional supervision of students on research placements to contribute to healthcare performance improvements and research capacity gains within health services, alongside providing personal benefits for the AH professionals involved. Early consultation with a health service-employed research specialist may support health professional and student learning, team collaboration and project coordination for these student projects.

Improving healthcare operations with IT deployment: a critical assessment of literature and a framework for future research

In this paper, we critically assess the contribution of the operations management literature in creating pragmatic knowledge regarding how IT deployment can improve healthcare performance. A systematic literature review is conducted, and the following issues limiting knowledge generation have been identified: 1) IT deployment and healthcare performance are often conceptualised as black boxes; 2) existing theories are used inadequately, and emerging theories are lacking, which restricts the identification of the underlying mechanisms in the IT-performance relation; and 3) contextual factors are often overlooked. We develop a framework, arguing that to overcome these limitations, future studies require the following: 1) conceptualise IT in terms of its functionalities; 2) explain the reason(s) for selecting the performance attribute(s); 3) identify the mechanisms of the relationship of IT-performance by investigating and theorising the consequences of IT deployment on service operations; and 4) consider the contextual factors while explaining the IT-performance relation.

Governance in Primary Care Systems: Experiences and Lessons from Urban, Rural, and Remote Settings in the Philippines

Objectives. Workforce shortages, policy fragmentation, and administrative fragmentation have broadened health inequities in the absence of an effective primary care system in the Philippines. While a central component within the health system, the role of governance in strengthening primary care systems remains underexplored. Therefore, this study aims to: 1) examine governance challenges encountered upon strengthening primary care systems; and 2) provide experience-based recommendations for improving primary care services in the Philippines. Methods. Data on governance issues were obtained from participant observation and regular meetings facilitated over one year. Conducted across urban, rural, and remote settings, the present study outlines experience-near insights throughout a hierarchy of system implementers—from those in positions of authority to frontline workers. These insights were thematically analyzed and organized following the Health System Dynamics Framework. Results. This study identified six governance challenges: 1) establishing a health information system; 2) engaging leaders, healthcare staff, and communities; 3) assuring efficient financing; 4) assuring health workforce sufficiency; 5) addressing legal challenges; and 6) planning evaluation and monitoring. To address these challenges, this study forwards systemic solutions to advance effective governance and improve healthcare performance. Conclusion. A renewed approach to strengthening primary care systems is fundamental to achieving universal healthcare. This entails good governance that develops strategies, equips people with tools for proper implementation, and provides data for evidence-based policies. The experiences outlined in the present study envisions guiding policymakers toward improving health outcomes in a devolved setting.

Confronting Barriers to Improving Healthcare Performance in Canada.

Is substantive transformation of healthcare delivery in canada a fool's paradise? Since this idiom refers to a state of happiness unconnected to underlying truths, it may be an apt descriptor given the many problems with the provinces' and territories' delivery of healthcare. Some of these problems cause harm, such as hospital-acquired infections, while others are simply wasteful, such as unnecessary tests or imaging. Moreover, meaningful transformation of healthcare delivery has been elusive and divisive in provinces and territories for decades (Martin et al. 2018; McIntosh et al. 2010; Ontario Ministry of Finance 2012).

Healthcare professionals and further engagement in research

British Journal of Neuroscience NursingVol. 17, No. 5 EditorialHealthcare professionals and further engagement in researchAlison McLoughlinAlison McLoughlinSearch for more papers by this authorAlison McLoughlinPublished Online:25 Oct 2021https://doi.org/10.12968/bjnn.2021.17.5.176AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Boaz A, Hanney S, Jones T, Soper B. Does the engagement of clinicians and organisations in research improve healthcare performance: a three-stage review. BMJ Open. 2015;5(12):e009415. https://doi.org/10.1136/bmjopen-2015-009415 Crossref, Google ScholarDimova S, Prideaux R, Ball S, et al. Enabling NHS Staff to contribute to research: reflecting on current practice and informing future opportunities. RAND Europe. 2018. www.rand.org/pubs/research_reports/RR2679.html (accessed 20 September 2021) Google ScholarDepartment of Health and Social Care. Developing the role of the clinical academic researcher in the nursing, midwifery and allied health professions. 2021. www.gov.uk/government/publications/developing-the-role-of-the-clinical-academic-researcher-in-the-nursing-midwifery-and-allied-health-professions (accessed 20 September 2021) Google ScholarGibbs CL, Lowton K. The role of the clinical research nurse. Nurs Stand. 2012;26(27):37–40. https://doi.org/10.7748/ns2012.03.26.27.37.c8986 Crossref, Google ScholarJones D, Keenan A. The rise and rise of NMAHPs in UK clinical research. Future Healthc J. 2021;8(2). https://doi.org/10.7861/fhj.2021-0098 Crossref, Google ScholarJonker L, Fisher SJ, Dagnan D. Patients admitted to more research-active hospitals have more confidence in staff and are better informed about their condition and medication: Results from a retrospective cross-sectional study. J Eval Clin Pract. 2020;26(1):203–208. https://doi.org/10.1111/jep.13118 Crossref, Google ScholarNational Institute for Health Research. CQC Inspections to give more exposure to clinical research taking place in the NHS. 2018. www.nihr.ac.uk/news/cqc-inspections-to-give-more-exposure-to-clinical-research-taking-place-in-nhs-trusts/11185 (accessed 20 September 2021) Google ScholarOzdemir BA, Karthikesalingam A, Sinha S et al. Research activity and the association with mortality. PLoS One. 2015;10(2):e0118253. https://doi.org/10.1371/journal.pone.0118253 Crossref, Google ScholarRoyal College of Physicians. Delivering research for all: expectations and aspirations for the NHS in England. 2019. www.rcplondon.ac.uk/guidelines-policy/delivering-research-all-expectations-and-aspirations-nhs-england (accessed 20 September 2021) Google ScholarScala E, Price C, Day J. An integrative review of engaging clinical nurses in nursing research. J Nurs Scholarsh. 2016;48(4):423–430. https://doi.org/10.1111/jnu.12223 Crossref, Google ScholarTrusson D, Rowley E, Bramley L. A mixed-methods study of challenges and benefits of clinical academic careers for nurses, midwives and allied health professionals. BMJ Open. 2019;9(10):e030595. https://doi.org/10.1136/bmjopen-2019-030595 Crossref, Google ScholarWestwood G, Richardson A, Latter S, Macleod Clark J, Fader M. Building clinical academic leadership capacity: sustainability through partnership. J Res Nurs. 2018;23(4):346–357. https://doi.org/10.1177/1744987117748348 Crossref, Google Scholar FiguresReferencesRelatedDetails 2 October 2021Volume 17Issue 5ISSN (print): 1747-0307ISSN (online): 2052-2800 Metrics History Published online 25 October 2021 Published in print 2 October 2021 Information© MA Healthcare LimitedPDF download

Improving healthcare performance through Activity‐Based Costing and Time‐Driven Activity‐Based Costing

Improving healthcare performance has become a need for resource optimisation in a field where they are scarce. Activity-Based Costing (ABC) has been applied for more than 30 years to allocate costs and provide information for decision-making. This paper seeks to review previous literature in the health field that analysed this cost system and its new version, TDABC (Time-Driven Activity-Based Costing). Five hundred ninety articles published from 1989 to 2019 were retrieved from Scopus and Medline. The review includes descriptive, relational and content analyses. Results show that the interest in applying these cost systems is growing, especially in journals focusing on the financial aspects of health, policy and planning, and radiology. However, there is a difference in the application of ABC and TDABC. ABC is more related to efficiency and more used in laboratories. In contrast, TDABC is primarily used in hospitals and addressing the value of health rather than cost-effectiveness. On the other hand, the findings suggest that TDABC present greater opportunities for publication compared with ABC. Its progression is higher and gets more citations. The current article contributes to broadening the field's vision and encourages authors for further research.

A qualitative study exploring contributors to the success of a community of practice in rehabilitation

BackgroundCommunities of Practice (CoPs) focus on learning, knowledge sharing, and creation, and research indicates they can improve healthcare performance. This article describes the development of a CoP that focused on synthesizing and adapting evidence in Physical Medicine and Rehabilitation (PM&R). This study aimed to investigate the CoP members’ experiences and perceived barriers and enablers of CoP success in the early phase of a CoP.MethodsPhysical therapists and a physician (n = 10) volunteered for a CoP that synthesized literature of PM&R evidence. CoP members participated in education and training on critical appraisal and knowledge synthesis, practiced critical appraisal skills, and summarized literature. Three months after CoP initiation, semi-structured interviews were conducted to understand the CoP members’ experiences and reflections. Members also completed an online survey that included the Evidence-Based Practice Confidence scale (EPIC), questions related to CoP activities, and demographics before CoP initiation. We utilized the Capability, Opportunity, and Motivation Model of Behaviour (COM-B) to explore how these experiences related to the behavioral adaptation and participation.ResultsTen themes related to the potential contributors to CoP success and failure were identified. These included project management, technological solutions, efficacy, organizational support, interaction, the bigger picture, self-development, time, and motivation.ConclusionsContributors to CoP success may include clearly articulated project goals and participant expectations, education and training, reliable technology solutions, organizational support, face-to-face communication, and good project management. Importantly, CoP members need time to participate in activities.

Healthcare Performance Improvement, is it possible to do at a distance?

Healthcare Performance Improvement, is it possible to do at a distance?

The Impact of Upgrade towards Comprehensive Electronic Medical Record System on Hospital Performance: A Single Tertiary Care Center Experience in Saudi Arabia

In line with the global trend, hospitals in the Kingdom of Saudi Arabia, including tertiary medical care centers, have increasingly adopted comprehensive electronic medical record (EMR) systems in the past twenty years. However, knowledge of these systems and the extent of their impact on performance is still limited in the Kingdom due to the lack of studies researching in this field. Accordingly, this study aims to investigate the impact of implementing a comprehensive EMR system in King Abdullah Medical City (KAMC) on hospital performance and to test the assumed hypotheses which propose that implementing a comprehensive EMR significantly improves the clinical effectiveness, patient-centeredness, patients’ safety and production efficiency in an advanced tertiary care setting in Saudi Arabia. To achieve this, a quantitative cross-sectional survey was conducted, using a valid questionnaire, on a random representative sample of 150 participants from healthcare professionals working in KAMC who experienced the upgrade towards the comprehensive EMR. The data collected was analyzed and the results showed the existence of statistically significant relationships between the implementation of comprehensive EMR as an independent variable and the four investigated dependent variables which are clinical effectiveness, patient-centeredness, patients’ safety and production efficiency in an advanced tertiary care setting in Saudi Arabia at significance level p=0.000 < 0.05. The study concluded the necessity of implementing comprehensive EMR to the point where tertiary care hospitals should pay attention to the application of such advanced electronic system because of their role in improving health care performance. Eventually, the study recommends the need to build an integrated EMR system at the level of the Kingdom that ensures the safe exchange of information between hospitals and health national centers which would enhance the provision of more distinguished health service for each patient, increase administrative efficiency and reduce the use of traditional means of recording like paper.