Health Care Quality Indicators Research Articles

Healthcare models, quality indicators and quality of care in the management of patients with chronic kidney disease in Spain: results from the CARABELA-CKD initiative

Healthcare models, quality indicators and quality of care in the management of patients with chronic kidney disease in Spain: results from the CARABELA-CKD initiative

Understanding and improving the quality of primary care for people in prison: a mixed-methods study.

People in prison are generally in poorer health than their peers in the community, often living with chronic illness and multimorbidity. Healthcare research in prisons has largely focused on specific problems, such as substance use; less attention has been paid to conditions routinely managed in primary care, such as diabetes or hypertension. It is important to understand how primary care in prisons is currently delivered in the United Kingdom and how it can be improved, in order to reduce health inequalities. To understand the quality of primary care in prison, including gaps and variations in care, in order to recommend how quality of prison health care can be improved. A mixed-methods study with six interlinked work packages. Predominantly the North of England. Between August 2019 and June 2022, we undertook the following work packages: (1) International scoping review of prison healthcare quality indicators. (2) Stakeholder consensus process to identify United Kingdom focused prison healthcare quality indicators. (3) Qualitative interview study with 21 people who had been in prison and 22 prison healthcare staff. (4) Quantitative analysis of anonymised, routinely collected data derived from prison healthcare records (~ 25,000 records across 13 prisons). (5) Stakeholder deliberation process to identify interventions to improve prison health care. (6a) Secondary analysis of the qualitative data set, focusing on mental health and (6b) analysis of the quantitative data set, focusing on health care of three mental health subgroups. Our scoping review found predominantly only papers from the United States of America and of variable rigour with the main finding being that performance measurement is very challenging in the prison healthcare setting. In collaboration with stakeholders, we prioritised, refined and applied a suite of 30 quality indicators across several healthcare domains. We found considerable scope for improvement in several indicators and wide variations in indicator achievement that could not be attributed to differences in prison population characteristics. Examples of indicators with scope for improvement included: diabetes care, medicines reconciliation and epilepsy review and control. Longer length of stay in prison was generally associated with higher achievement than shorter stays. Indicator achievement was generally low compared to that of community general practice. We found some encouraging trends and relatively good performance for a minority of indicators. Our qualitative interviews found that quality of health care is related to factors that exist at several levels but is heavily influenced by organisational factors, such as understaffing, leading to a reactive and sometimes crisis-led service. Our stakeholder deliberations suggested opportunities for improvement, ideally drawing on data to assess and drive improvement. Our mental health work package found that coded mental illness had mixed associations with indicator achievement, while the interviews revealed that mental distress is viewed by many as an inevitable facet of imprisonment. Our analyses of indicator achievement were limited by the quality and coverage of available data. Most study findings are localised to England so international applicability may differ. Marked variations in the quality of primary care in prisons are likely to be attributable to the local organisation and conditions of care delivery. Routinely collected data may offer a credible driver for change. This study is registered at researchregistry.com (Ref: 5098). This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/05/26) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 46. See the NIHR Funding and Awards website for further award information.

Healthcare in police custody: a conceptual framework for measuring and improving quality of care

Abstract Background Individuals in police custody are often in poor (mental) health and can be in need of medical attention. The delivery of primary healthcare in police custody differs from other custodial and non-custodial settings, due to its short-term character and the reliance on custody officers and healthcare professionals to access care. Therefore, medical care for detainees in police custody requires its own standards and indicators to measure the quality of care. We aimed to develop a conceptual framework for (actionable) indicators to measure the quality of care for people detained in short-term police custody settings in the Netherlands. Methods We conducted a scoping review and consulted with experts. The scoping review involved Embase, Medline, PsycINFO, CINAHL, Criminal Justice Abstracts, PiCarta and Cochrane, and was supplemented with grey literature searches. We consulted twenty-seven stakeholders with a wide variety of expertise in the field of healthcare in police custody to discuss and validate the conceptual framework. Results The conceptual framework consists of 14 domains of structures (e.g. staff and facilities), processes (e.g. triage and coordination of care) and outcomes (e.g. effectiveness and satisfaction) that need to be considered when developing quality indicators for the healthcare provision in police custody. The scoping review yielded 68 publications providing information on common health issues and recommendations related to quality assurance or improvement. Conclusions The conceptual framework will guide the development of (actionable) quality indicators, which will be evaluated on relevance and measurability. These are crucial for monitoring care quality and enhancing a learning health systems approach. This study fills a gap in the existing scientific literature by shedding light on the factors contributing to the quality of primary healthcare provision for people detained in short-term custody settings. Key messages • The conceptual framework guides the development of (actionable) quality indicators for healthcare in police custody. • This study contributes to the creation of a learning health system for healthcare in short-term police custody settings.

Beyond Empathy: Examining the Complexities of Outpatient Satisfaction in a Resource-Constrained Setting

Patient satisfaction is a critical indicator of healthcare quality, particularly in resource-constrained settings where efficient and effective care is paramount. This study aimed to explore the multifaceted nature of outpatient satisfaction at a private Indonesian hospital, moving beyond the traditional focus on empathy to understand the interplay of various service quality dimensions. A mixed-methods sequential explanatory design was employed. The quantitative phase involved a survey of 400 outpatients, measuring their satisfaction with five service quality dimensions: tangibles, reliability, responsiveness, empathy, and assurance. Data were analyzed using descriptive statistics, Importance-Performance Analysis (IPA), and gap analysis (suitability index). The qualitative phase utilized in-depth interviews and focus group discussions with patients, staff, and management to provide context and depth to the quantitative findings. While overall patient satisfaction was 82.9%, a gap analysis revealed substantial discrepancies between patient expectations and perceptions across several service quality dimensions. Tangibles, reliability, and responsiveness emerged as key areas requiring improvement. Qualitative findings highlighted extended wait times, inconsistent staff communication, and concerns about the physical environment as significant contributors to patient dissatisfaction. Achieving high levels of patient satisfaction in resource-constrained environments necessitates a comprehensive approach that addresses systemic inefficiencies and communication gaps alongside interpersonal factors like empathy. These findings underscore the need for targeted interventions to optimize resource allocation, streamline processes, and enhance staff communication skills to improve the patient experience.

Integrating Quantitative Data and Qualitative Insights to Understand 30-Day Readmission Rates: A Mixed-Methods Study.

The rate of patients readmitted to hospitals within 30 days of discharge is a critical indicator of healthcare quality. This study explored the factors contributing to 30-day hospital readmission rates nationally and at Arrowhead Regional Medical Center (ARMC) through a mixed-methods research design. Quantitative analysis utilized data from the Centers for Medicare & Medicaid Services (CMS) database, focusing on patient demographics, principal diagnoses, length of stay, and hospital characteristics. Multivariate regression and descriptive statistics were employed to identify predictors of 30-day readmission. The qualitative analysis sought to understand the specific medical conditions and patient profiles linked to higher readmission rates. The findings revealed that older age, specific principal diagnoses (e.g., heart failure, pneumonia, chronic obstructive pulmonary disease (COPD)), and longer initial hospital stays were associated with an increased likelihood of 30-day readmission. Gender disparities and hospital size/type also influenced readmission rates. These results provide valuable insights into the complex interplay of individual patient characteristics and hospital attributes in driving readmissions. The study's mixed-methods approach yielded a comprehensive understanding of the quantitative patterns and qualitative factors contributing to 30-day hospital readmission rates, offering important implications for healthcare quality improvement initiatives.

Key Predictors of Patient Satisfaction and Loyalty in Saudi Healthcare Facilities: A Cross-Sectional Analysis.

Patient satisfaction and loyalty are essential indicators of healthcare quality, directly impacting patient outcomes and the long-term success of healthcare facilities. Despite the growing importance of patient-centered care in Saudi Arabia, there is limited research exploring the factors that influence patient satisfaction and loyalty, particularly in the Riyadh region. This study aims to identify the key factors influencing patient satisfaction and loyalty among Saudi patients attending public and private healthcare facilities in the Riyadh region. The study focuses on how healthcare service quality, communication, and demographic factors contribute to patient satisfaction and loyalty. A cross-sectional study was conducted with a sample of 350 Saudi patients from 10 healthcare facilities in Riyadh. Data were collected using the Patient Satisfaction Questionnaire (PSQ-18) and the Patient Loyalty Questionnaire (PLQ). Descriptive statistics, Pearson correlation, and multiple linear regression were employed to identify predictors of patient satisfaction and loyalty. Significant predictors of patient satisfaction included general satisfaction (β = 0.48, p < 0.001), communication (β = 0.35, p < 0.001), and the frequency of healthcare visits (β = 0.13, p = 0.011). Private healthcare facilities had higher satisfaction (p < 0.001) and loyalty scores (p < 0.001) compared to public facilities. Patient loyalty was strongly predicted by general satisfaction (β = 0.55, p < 0.001) and communication (β = 0.42, p < 0.001). Communication quality and patient satisfaction are key drivers of patient loyalty in Saudi healthcare facilities. Private facilities outperform public ones in patient satisfaction and loyalty. These findings emphasize the need for healthcare providers to enhance communication and service quality to foster patient loyalty. Tailored approaches to meet the diverse needs of patients, particularly in terms of education and visit frequency, are crucial for improving healthcare outcomes in Saudi Arabia.

Cross-Sectoral Comparisons of Process Quality Indicators of Health Care Across Residential Regions Using Restricted Mean Survival Time

Background: Practice guidelines recommend patient management based on scientific evidence. Quality indicators gauge adherence to such recommendations and assess health care quality. They are usually defined as adverse event rates, which may not fully capture guideline adherence over time. Methods: For assessing process indicators where compliance to the recommended treatment can be assessed by evaluating a patient's trace in linked routine databases, we propose using restricted mean survival time or restricted mean time lost, which are applicable even in competing risk situations. We demonstrate their application by assessing the compliance of patients with acute myocardial infarction (AMI) to high-power statins over 12 months in Austria’s political districts, using pseudo-observations and employing causal inference methods to achieve regional comparability. Results: We analyzed the compliance of 31,678 AMI patients from Austria’s 116 political districts with index AMI between 2011 and 2015. The results revealed considerable compliance variations across districts but also plausible spatial similarities. Conclusions: Restricted mean survival time and restricted mean time lost provide interpretable estimates of patients’ expected time in compliance (lost), well-suited for risk-adjusted entity comparisons in the presence of (measurable) confounding, censoring, and competing risks.

Areas for Improvement and Barriers Identified in Measuring the Quality of Nursing Care: Perceptions of Patients and Professionals.

Quality indicators in healthcare are essential to raising awareness about the appropriateness of nursing care. However, identifying the key indicators continues to pose a challenge, above all if one wants to include users and professionals. Identify which aspects of nursing care should be measured to assess the results of nursing care and how to do so. Interpretive qualitative exploratory study. The participants were users and professionals of an autonomous regional health service in Spain. The information was collected by means of two focus groups and eight semi-structured interviews conducted between November 2022 and March 2024. The data were analysed thematically using the Braun and Clarke process. The users and professionals agreed on the need to measure emotional skills and attitudes such as empathy, respect, and warmth when dealing with patients. The professionals highlighted workload and inefficiency of the current record system as barriers to adequately reflecting their work. They proposed improvements in the recording tool and the need for more human resources, as well as leadership that is more focused on quality. It is crucial to develop indicators that reflect both the emotional and technical aspects of nursing care. The participation by patients and professionals alike in this design and selection will make it possible to improve the quality of care and advances in the nursing profession. This study was not registered.

Understanding the relative impact of ethnicity and sex on patient experience in cancer care.

247 Background: Patient experience is a key indicator of healthcare quality and outcomes. Research suggests that patient ethnicity and sex have a significant impact on patient experience scores. Therefore, our hospital created a process for continuously monitoring patient experience scores stratified by patient demographic data. In 2021, this process caught what appeared to be a significant drop in some areas of patient experience for non-white female inpatients. This drop prompted an investigation that attempted to better understand the relative impact of ethnicity and sex on patient experience at our hospital. Methods: We conducted a cross-sectional study using 13,560 Press Ganey inpatient experience surveys collected from 11,435 unique patients between 2021 and 2023 at Memorial Sloan Kettering Cancer Center. This investigation analyzed the responses to “likelihood of recommending this hospital to others” using a ordinal logistic regression model including patient ethnicity, sex, language, age, expected mortality on admission, admitting department, insurance, marital status, and length of stay observed to expected ratio. Results: Asian (odds ratio [OR] 0.51, 95% confidence interval [CI] (-0.86,-0.47), p=1.98e-11), female (odds ratio [OR] 0.76, 95% confidence interval [CI] (-0.38,-0.15), p=2.76e-06), and patients admitted to emergency departments female (odds ratio [OR] 0.59, 95% confidence interval [CI] (-0.73,-0.30), p=1.65e-06) reported lower scores than white, male, and patients admitted to medicine. Differences associated with marital status, patient insurance, and patient primary language were insignificant. The largest impact on patient experience was the patient’s expected mortality (odds ratio [OR] 0.30, 95% confidence interval [CI] (-2.20,-0.19), p=1.98e-02). Patients with higher expected mortality were much more likely to give low scores. Non-white patients were also more likely to have high expected mortality when compared to their white counterparts (p = 1.90e-24). Conclusions: Our study suggests that while a patient’s expected mortality on admission has the largest impact on patient experience scores. There are also significant differences in patient experience scores based on ethnicity and sex, but they are relatively small in magnitude. The data suggests that focusing on the intersection of high expected mortality and female patients could be an effective method for improving healthcare quality and outcomes. We recommend additional exploration of end of life care and its interactions with patient experience to better understand optimal methods and times for process improvement projects.

Inpatient Satisfaction on Non-Pharmacological Interventions for Acute Settings: A Systematic Review.

Many patients experience stress and dissatisfaction when they are admitted to acute settings, where they receive short-term and active care for severe injuries, illnesses, or surgeries. Patient satisfaction is a key indicator of healthcare quality that affects patient outcomes, service delivery, and safety. This review aimed at systematically mapping and summarizing the evidence on non-pharmacological interventions that targeted patient satisfaction in inpatient acute settings. Three electronic databases were searched, including PubMed, EBSCO, and ScienceDirect. The inclusion criteria were: (1) studies of non-pharmacological interventions to improve patients' satisfaction and targeting inpatients between the ages of 19 and 65 years old; (2) studies written in English and published in the last 10 years, starting from 2017. The search results were imported and screened for eligibility on Covidence. The data was then extracted, using a tool entered in Covidence's Extraction 2.0. The extraction tool included domains on both intervention impact and delivery processes. A total of 11 articles met the inclusion criteria. Randomized control trials represented the most among the group; seven studies were included given that the others were quasi-experimental studies. Those studies were conducted on the different types of services offered in acute care departments. These studies did not use a standardized questionnaire to evaluate their respective trial outcomes or to implement various adapted or adopted modules of intervention. Of note, the intervention was effective in enhancing patient satisfaction in only some of the studies. Different types of intervention modules have been effective in improving acute care patient satisfaction. However, further studies are needed to evaluate the effectiveness of an intervention among all patients in different acute care departments at the same time.

Hospital Patient Satisfaction With Nursing Care in Saudi Arabia.

Introduction Patient satisfaction is a critical indicator of health care quality, yet research exploring patient satisfaction with nursing care in Saudi Arabia (SA) remains limited. This study investigated patients' satisfaction with nursing care quality during their hospitalization in SA. Material and methods A cross-sectional study was conducted using a convenience sample of 746 patients from five hospitals infive different regions of SA. Data were collected using the Newcastle Satisfaction With Nursing Scale (NSMS), which has been shown to be valid and reliable. Results The average overall patient satisfaction with nursing care was 71.16 ± 13.51 out of 95 (75.96%), indicating a high level of satisfaction with the nursing care the patients received. The highest-scoring items of patient satisfaction were the nurses' manners when carrying out their duties, the amount of privacy the nurses provided and their capability to performtheir jobs. However, the level of satisfaction regarding the frequency of nurse check-ins, time spent with patients, and support provided to patients' relatives indicated areas for potential improvement. Also, patients with primary education who were divorced or married and those admitted to the gynecology ward were more satisfied with nursing care. Conclusion This study's findings indicate that the patients were highly satisfied with the care their nurses provided, although opportunities for improvement in some areas of nursing care were identified. These findings may encourage nurses to be more attentive in meeting their patients' needs according to best nursing practices. It is recommended that hospital administrators prioritize initiatives to enhance the quality of nursing care, thereby improving overall patient satisfaction.

Development of the Patient-Reported Indicator Surveys (PaRIS) conceptual framework to monitor and improve the performance of primary care for people living with chronic conditions

BackgroundThe Organisation for Economic Co-operation and Development (OECD) Patient-Reported Indicator Surveys (PaRIS) initiative aims to support countries in improving care for people living with chronic conditions by collecting information on...

INDICADORES DE QUALIDADE EM TERAPIA NUTRICIONAL (IQTN) NA AVALIAÇÃO DO CUIDADO NUTRICIONAL EM UNIDADES HOSPITALARES DO BRASIL: UMA REVISÃO DE LITERATURA

Malnutrition is understood as an imbalance caused by low nutrient intake or increased nutritional needs, in the hospital environment, malnutrition has a direct influence on the clinical course of the patient and is often neglected, resulting in complications such as: infections, delayed healing and prolonged duration of treatment. Hospitalization time. In these cases, nutritional therapy (NT) is used and, along with the implementation, adverse events may prevent the effective implementation of nt. in this context, the use of quality indicators in nutritional therapy (IQTN) are applied, aiming to ensure the effectiveness of daily routines associated with nutritional management. Thus, this work aims to verify the use of the iqtn tool in the evaluation of nutritional care in hospital units in Brazil. the present study is a bibliographical review of the literature, built from scientific articles in the medline database (pubmed), portal periódicos capes and latin american literature in health sciences (lilacs) using the descriptors “Protein-Energy Malnutrition”, “Quality Indicators in Health Care”, “Nutritional Therapy”. Articles that did not correspond to the topic of interest and those published in the last 11 years were excluded. After cataloging, 08 articles were added that demonstrated the implementation of IQTN in the evaluation of nutritional care in services provided in hospitals in Brazil. most studies present indicators in accordance with the proposed goals, but it is worth mentioning that there is a significant prevalence of malnutrition in all the studies selected in this research, however those that have greater adequacy in indices related to nutritional assessment and prescription x calorie and protein infusion has a better prognosis for hospitalized patients. Therefore, the implementation of the IQTN tool becomes necessary in hospital units, as through this method it is possible to assess the compliance of nutritional care in order to minimize risks and intercurrences.

Evaluation of Fall Risk in Hemodialysis Patients within the Scope of Quality Improvements: A Comparison of Two Assessment Scales

Introduction: Patient falls are one of the most important quality indicators in healthcare. Aim: It was aimed to compare two tools used to evaluate fall risk in hemodialysis patients. Method: The mean age of the patients was 58.72 ± 14.49 years and 62% were male. The mean duration of treatment was 4.98 ± 4.71 years. Within the last year, 33% of the patients had a history of falling. The patients' fall risk was assessed using the Itaki Fall Risk Scale and Dialysis Fall Risk Index. The relationship between patients' age, gender, duration of hemodialysis treatment, and the status of having a chronic disease and falls were examined. Results: According to the Itaki Scale, 57% were in the ''high-risk'' group. According to the Dialysis Fall Risk Index, 64% were in the "very high risk" group. The mean Itaki Fall Risk Scale score was 4.75 ± 3.92, and the mean of the Dialysis Fall Risk Index was 7.59 ± 1.92. According to the cut-of score, the sensitivity and specifiity of the Itaki Fall Risk Scale were 97% and 99.6%, and the Dialysis Fall Risk Index was 93.9% and 99.6%. The positive and negative predictive value were 56.1% and 97.7%, respectively for the Itaki Fall Risk Scale. These points were 51.6% and 100% for the Dialysis Fall Risk Index. Conclusion: Both scales were effctive in improving care quality in hemodialysis centers. Itaki Scale may be preferred due to its ease of use and patient compliance.

Diabetes treatment satisfaction among a multi-ethnic Aotearoa New Zealand population with uncontrolled type 2 diabetes mellitus.

To assess whether diabetes treatment satisfaction differs by ethnicity among participants with insufficient glycaemic control of type 2 diabetes mellitus in a clinical trial involving additional oral diabetes medications. Patient satisfaction is used as an indicator of healthcare quality. However, data on patients' diabetes treatment satisfaction in the context of insufficient glycaemic control is limited. Individuals with type 2 diabetes and an HbA1c of 58-110mmol/mol (7.5-12.5%) were recruited across Aotearoa New Zealand to participate in an 8-month randomised crossover study of vildagliptin and pioglitazone as add-on therapy to metformin and/or sulfonylurea. Participants completed the Diabetes Treatment Satisfaction Questionnaire (DTSQ) at baseline pre-randomisation. Treatment satisfaction scores were compared between ethnic groups and other characteristics using the analysis of variance and linear regression. Perceived hyper- and hypoglycaemia were summarised separately. Between February 2019 and March 2020, 346 participants (41% women, 32% Pacific peoples, 23% Māori, 26% European) completed the DTSQ. Mean (SD) age was 57.5 (10.9) years, diabetes duration was 9 (6.3) years and HbA1c was 75 (12)mmol/mol (9.0[3.2]%). At study entry, 40% were receiving monotherapy for diabetes. Treatment satisfaction was rated highly, with a score of 29(6) (interquartile range 25-33). Pacific peoples and older people reported greater treatment satisfaction than other groups (p<0.001). Diabetes treatment satisfaction was high, particularly among Pacific peoples, despite suboptimal glycaemic control and insufficient glucose-lowering therapy.

Examining the knowledge level of nurses regarding aseptic non touch technique in nurses: a cross-sectional study

BackgroundHealthcare-associated infections (HAIs) are important indicators of healthcare quality. The aseptic non touch technique (ANTT), a standardised aseptic technique, is a crucial preventative measure against HAIs. However, there is insufficient evidence currently available regarding ANTT awareness and proficiency among nurses. This study aimed to investigate the status of ANTT proficiency in a cohort of nurses and analyse the associated risk factors, with the ultimate goal of providing a reference for promoting the application of ANTT in clinical practice.MethodsThe study population was sampled from nurses working in a tertiary hospital in Zhejiang Province, China, in January 2024. A cross-sectional survey was conducted using a self-designed questionnaire to assess ANTT knowledge. Multivariate linear regression analysis was used to analyse the risk factors influencing ANTT knowledge in nurses.ResultsA total of 458 nurses were included in this study. The cohort had an overall score of 49.7% correct responses on the ANTT knowledge questionnaire, with a mean score of 12.4 ± 2.4 out of 25, and 30.1% of the nurses felt that they did not need training related to ANTT. Multivariate linear regression analysis indicated that professional title, educational level, and the need for ANTT training were independently associated with ANTT knowledge in nurses. Nurses with Master’s degrees and associated chief nurses were observed to have higher levels of ANTT knowledge compared to the rest.ConclusionsANTT knowledge is insufficient among nurses in China, and its importance is not widely recognised. Continuous efforts are required to strengthen this knowledge. Constructing sustained, multiform, and stratified training programmes may represent an effective method to strengthen ANTT knowledge among nurses and promote its clinical use.

COVID-19 Inpatient Caseloads in General Hospitals Did Not Affect Quality Indicator Compliance Rates in Israel.

Early in the global COVID-19 pandemic, a concern was raised that potentially high volumes of COVID-19 inpatients in general hospitals might compromise the hospitals' capabilities to maintain high-quality care for routine patients and, thereby, to comply with indicators specifying quality of care. The objective of this study is to evaluate the impact of the surges of COVID-19 inpatients into general hospitals in Israel on the compliance rates for selected quality indicators reported by these hospitals within the Israeli National Program for Quality Indicators (NPQI). Compliance rate data were collected from the quality indicators reports made to the NPQI by participating hospitals. COVID-19 inpatient volume data were obtained from the Ministry of Health Digital Technologies and Data Division. Both datasets were analyzed on a week-by-week basis and plotted one alongside the other on a time scale. Association of each quality indicator's compliance rate with the number of COVID-19 inpatients was tested by Pearson's correlation analysis. The study included data from July 1, 2019 through June 30, 2022, spanning the duration of the COVID-19 pandemic in Israel. Five quality indicators included in the study were: Surgical repair of femoral neck fracture within 48h of admission; Assessment of cerebral ischemic event risk for patients with atrial fibrillation; Duplex carotid ultrasound within 72h of emergency department admission for patients with suspected transient ischemic attack; Antibiotic prophylaxis for caesarean sections; and Percutaneous coronary intervention within 90min for patients presenting with ST-elevation myocardial infarction. Compliance rates for five quality indicators, representing different aspects of routine health care, remained steady - even at times with high volumes of COVID-19 inpatients in general hospitals. This lack of effect was prominent throughout the analyzed period, i.e., general hospitals maintained similar compliance rates for all quality indicators both during the surges of COVID-19 patients and between these periods. Statistical analysis showed no correlation between the quality indicators' compliance rates and the number of COVID-19 inpatients. Our findings indicate that high volumes of COVID-19 inpatients in general hospitals did not affect the hospitals' capability to comply with routine health care quality indicators. The results of our study imply that general hospitals in Israel were able to withstand the challenges associated with the care of COVID-19 inpatients while preserving high quality of care for routine patients.

Tingkat Kepuasan Pasien Terhadap Pelayanan Kefarmasian di Apotek Parviz Kota Palangka Raya

Pharmaceutical services involve direct and responsible care for patients related to pharmaceutical preparations, aiming to achieve definite results that enhance patients' quality of life. One indicator of healthcare quality is measuring user satisfaction. Apotek Parviz provides pharmaceutical services to the surrounding community, offering dual healthcare services—doctor diagnosis and pharmaceutical care—thus improving the health and quality of life for residents of Palangka Raya City. This study aims to determine patient satisfaction levels with pharmaceutical services at Apotek Parviz in Palangka Raya City, based on five dimensions: tangibility, reliability, responsiveness, assurance, and empathy. This descriptive study used a questionnaire with a sample size of 86 respondents selected through accidental sampling. The research results showed that the satisfaction percentages for each dimension were: 87.43% for tangibility, 81.16% for reliability, 83.25% for responsiveness, 84.49% for assurance, and 83.25% for empathy. The overall average satisfaction across the five dimensions, according to the Likert scale, was 84.18%, indicating that patients are very satisfied with the pharmaceutical services at Apotek Parviz in Palangka Raya City.

Physician Burnout during Covid-19 Pandemic in Pediatric Emergency Rooms of Low-Middle Income Country, Pakistan

Abstract: Background: Burnout can adversely affect the mental health, quality of life and quality of work of healthcare workers. Objective: We aimed to assess the burnout rate among physicians working in pediatric emergency rooms during COVID-19 pandemic, in public sector hospitals of Pakistan. Materials and Methods: It is a descriptive study performed in March 2021. We included all physicians working in the pediatric emergency departments of 9 public sector hospitals of Sindh, Pakistan, excluding those who didn’t give consent. The participants were sent an online questionnaire based survey, comprising of Copenhagen Burnout Inventory (CBI) tool along with three added COVID-19 specific questions. It was disseminated electronically. Data was analyzed using SPSS ver22. Result: A total of n=249 physicians filled the forms out of 320, giving a response rate of 77.8%. Majority 187 (75.1%) were females. Most of the physicians were females n=187 (75.1%) and worked primarily in emergency department n=186 (74.7%). The Copenhagen Burnout Inventory (CBI) score revealed that 88 (35.3%) of the physicians had burnout (Score &gt; 50). The most common component was Personal burnout in 122 (48.9%). Physicians working in emergency department, full time shifts and at junior designations had higher rates of burnout (P value &lt;0.05). Conclusion: Burnout is a significant problem in pediatric emergency departments, specifically during the COVID-19 pandemic. Timely training and provision of supplies along with safety, security and alleviation of fear are important strategies to overcome burnout. Keywords: Burnout, Emergency departments, COVID-19, Pediatric emergency, Mental health, Health care professionals, Pandemic, Healthcare Quality indicators.

Efficiency and intrinsic quality in healthcare: blending radial and non-radial measures of efficiency with a flashpoint of long-term health policy

PurposeEfficiency and quality are primary factors for the survival of health systems. The evaluation of the efficiency of the healthcare system is a crucial component of promoting long-term health policy actions. Healthcare capacity indicators provide a basis for evaluating and comparing the performance of different healthcare organizations. Intrinsic quality indicators are Donabedian (1980)’s structural and process elements of quality of healthcare. This study aims to integrate capacity and intrinsic quality indicators of healthcare while measuring the efficiency of provinces by using radial and non-radial efficiency measurement techniques.Design/methodology/approachEfficiency analysis performed in Turkey from 2015 to 2020 by performing input-oriented radial, nonradial, and super-efficiency estimates for 81 provinces of Turkey by incorporating capacity and intrinsic quality indicators into the different model specifications.FindingsRadial and nonradial efficiency results have an increasing trend over the study years obtained from the efficiency models showing high average scores obtained from the models that include intrinsic quality of care indicators. Statistically significant mean rank differences are observed between different radial efficiency models for all study years (p < 0.001). Negative and moderate level correlations were observed between radial efficiency results and quality of care indicators (r < 0.70).Originality/valueUnder long-term centralized health policies, increases in efficiency result in decreased intrinsic quality of care indicators. A better synthesis of health system capacity and intrinsic healthcare quality indicators is necessary to generate evidence-based health systems.