Quality Of Patient Care Research Articles

The impact of a 5G-based smart nursing information system and associated mobile hardware on clinical nurses’ work stress: a randomized controlled study in a Chinese hospital

BackgroundClinical nurses frequently endure substantial work-related stress, adversely affecting their well-being and potentially compromising patient care quality and safety. The integration of a 5G-based medical private network into smart nursing systems and mobile devices offers a promising solution to reduce this stress. This study evaluates the impact of a Smart Nursing Information System based on a 5G Medical Private Network and its Supporting Mobile Hardware (SNIS-SMH) on mitigating work-related stress among clinical nurses. The goal is to provide a scientific basis for nursing management, reduce error incidents, advance nursing procedures, and enhance productivity.ResultsA total of 226 nurses completed the study. The SNIS-SMH group showed significantly lower total work stress scores (66.16 ± 9.82) compared to the control group (70.65 ± 11.32, P = 0.002). In specific dimensions, the SNIS-SMH group had lower scores for nursing profession and work (14.17 ± 2.37 vs. 15.00 ± 3.06, P = 0.023), workload and time distribution (10.56 ± 2.45 vs. 12.42 ± 2.55, P < 0.001), and patient care (22.55 ± 3.34 vs. 23.70 ± 4.06, P = 0.021). No significant differences were found in the work environment and resource, and management and interpersonal relationships dimensions.ConclusionsThe SNIS-SMH system significantly alleviated work-related stress among clinical nurses, particularly in nursing duties, workload and time distribution, and patient care.

Assessment of automated non-coplanar stereotactic radiosurgery planning in single isocenteric linac-based treatment for brain metastases with respect to planner's experience.

One of the reasons for planning heterogeneity is lack of enough experience and recommendations on the quality of Linac-based stereotactic radiosurgery (SRS). In this study, our goal is to investigate the impact of planner's experience on the quality of Linac-based SRS plans for brain metastases (BMs) with varying levels of complexity. Specifically, to assess the impact of experience on the outcome of an automated noncoplanar treatment planning. A cohort of 120 patients with intracranial SRS plans, with a total of 633 BMs, was examined using VMAT delivery calculated with an available automated plan delivery system. Four planners with different levels of experience, ranging from under 1 year to over 5 years (Expert planner) of SRS planning, generated treatment plans. Dosimetric parameters and plan quality metrics were evaluated including: conformality index, homogeneity index, modulation factor, R50%, total volume of brain receiving 12Gy, 6Gy, and 3Gy (V12Gy, V6Gy, V3Gy) were assessed for each plan and compared with plan which was created by an expert planner with the highest planning experience. Experienced planners consistently produced acceptable plans, while less experienced one required revisions. Single BM cases showed minimal deviations in dosimetric parameters (under 10%) irrespective of planner experience. However, as the number and complexity of BMs increased, differences in plan quality became more pronounced. Moreover, expert planner's plans consistently outperformed others in terms of organs at risk sparing. This difference was particularly pronounced for cases involving the volume of healthy brain tissue. Our study underscores the critical role of planner's experience in the quality of Linac-based SRS plans using an automated planning. By standardizing and enhancing the planning process, the study aims to improve the quality of care for patients with multiple BMs, contributing to more efficient and effective treatments in the field of SRS.

Factors influencing healthcare professionals' moral distress: A descriptive qualitative analysis.

Background: The Measure of Moral Distress - Healthcare Professionals (MMD-HP) is a 27-item survey that quantifies moral distress. The MMD-HP was distributed to healthcare professionals (HPs), and analysis of a free-text response item revealed information-rich descriptions of morally distressing situations. Research question: What are HPs' perceptions of their experiences of morally distressing situations? Research design: A descriptive, qualitative approach explored respondents' free-text responses to the following open-ended response item: "If there are other situations in which you have felt moral distress, please write and score them here." Participants and research context: Eligible participants were HPs (N = 8206) working in a large, multi-site healthcare system located in a major, urban city in the Southeastern United States. Ethical considerations: The Institutional Review Board provided approval for this research. A survey preamble supplied information, and consent was presumed with survey completion. Findings: Three themes were identified from 282 free-text responses: Theme 1: Compromised Quality of Care, Theme 2: Hostile Work Environment, and Theme 3: Ineffective Leadership. Conclusions: This study is unique because it provided in-depth qualitative analysis of morally distressing situations in a free-text response item across a wide array of HPs within multiple settings. Responses revealed that moral distress impacted the quality of patient care and provided descriptions of powerlessness to act.

Development and Validation of a Synoptic Operative Report as a Quality Indicator for Thyroid Surgery: A Canadian Study.

Narrative operative reports (NORs) often lack key information that can guide postoperative management of thyroid disease. We aimed to develop and validate a nationally standardized synoptic operative report (SOR) for thyroid surgery. Surgeons were surveyed for their opinions of current operative reporting practices. Reportable elements from thyroidectomy NORs were ranked by thyroid disease specialists and reviewed by a national advisory committee to develop a standardized SOR using the Modified Delphi Method. Six thyroid surgeons piloted the SOR. Completeness and reporting frequencies of SOR elements were compared with pre-pilot NORs using Wilcoxon rank sum, chi-squared, and Fisher's exact analyses. A post-pilot survey assessed provider satisfaction. Among 42 Canadian thyroid surgeons from 9 provinces, 31% expressed dissatisfaction with current reporting practices and 100% expressed interest in a SOR. In total, 109 reportable thyroidectomy elements were collected from 142 NORs and ranked by 46 thyroid disease specialists. Consensus agreed upon a 21-element SOR by a national advisory committee. Among 172 NORs and 170 piloted SORs, SORs had higher median overall completeness (100% [100-100%]) than NORs (65% [47-70%], p < 0.001). SORs improved reporting of cancer-specific elements, including the presence of gross extrathyroidal cancer extension (SOR: 100%, NOR: 43%, p < 0.001) and residual gross disease (SOR: 100%, NOR: 16%, p < 0.001). More than half of users and readers reported improved reporting completeness and impact on patient care with SORs. Implementation of a nationally developed thyroid surgery SOR enhanced completeness, delivery of cancer-specific information, and provider satisfaction, which can improve quality of patient care.

Protocols for ischemic stroke in Flemish hospitals: correlation between availability and content versus adherence.

Stroke is globally one of the leading causes of mortality and disability. Adhering to evidence-based guidelines and protocols can improve quality of care for ischemic stroke patients. We aimed to compare the availability and content of specific protocols versus adherence to these key intervention in clinical daily practice among Flemish hospitals. We selected five key interventions for managing ischemic stroke patients. These key interventions encompassed the measurement of body temperature, glycaemia monitoring, screening of Swallowing function according to the Fever, Sugar and Swallowing protocol (FeSS protocol) and depression and Activities of Daily Living (ADL), (FeSS+ key-interventions). A systematic quantitative and qualitative approach was designed to analyse specific protocols from 24 hospitals. A predefined data extraction matrix for the five FeSS+ key interventions was utilized for data collection. Using this matrix, protocols were scored according to completeness of content, regarding the FeSS+ interventions. These scores were used to calculate a total protocol content score, i.e. a total score for the five FeSS+ interventions and an individual score for each key intervention separately, ranging between 0 and 1, per hospital. A score of zero indicates absence of the FeSS+ interventions in the protocols, while a score of one signifies complete coverage of these interventions. In addition, we assessed the correlation between the availability and content of these protocols in relation to the adherence to interventions documented for 30 patients per hospital. The mean total protocol content score was 0.40±0.20, ranging from 0.64±0.25 for glycaemia management to 0.1±0.28 for ADL screening. With regard to the individual FeSS+ key interventions, we identified a correlation between protocol characteristics and adherence for glycaemia (rs = 0.42, p = 0.04), depression screening (rs = 0.43, p = 0.04) and ADL screening (rs = 0.44, p = 0.03). Total FeSS+-protocol content also correlated with adherence (r = 0.6140, p = 0.0014). Protocol characteristics for the FeSS+ key interventions were variable and rather limited, especially for ADL- and depression screening. The identified relationship between the content of protocols and adherence to interventions underscores the value of defining these activities in hospital documentation to improve stroke care.

Measuring the quality of patient-provider relationships in serious illness: A scoping review.

People affected by serious illness face several threats to their well-being: physical symptoms, psychological distress, disrupted social relations, and spiritual/existential crises. Relationships with clinicians provide a form of structured support that promotes shared decision-making and adaptive stress coping. Measuring relationship quality may improve quality assessment and patient care outcomes. However, researchers and those promoting quality improvement lack clear guidance on measuring this. To identify and assess items from valid measures of patient-provider relationship quality in serious illness settings for guiding quality assessment. Scoping review. We identified peer-reviewed, English-language articles published from 1990 to 2023 in CINAHL, Embase, and PubMed. Eligible articles described the validation of measures assessing healthcare experiences of patient populations characterized by serious illness. We used Clarke et al.'s theory of relationship quality to assess relationship-focused items. From 3868 screened articles, we identified 101 publications describing 47 valid measures used in serious illness settings. Measures assessed patients and other caregivers. We determined that 597 of 2238 items (26.7%) related to relationships. Most measures (n = 46) included items related to engaging the patient as a whole person. Measures evaluated how providers promote information exchange (n = 35), foster therapeutic alliance (n = 35), recognize and respond to emotion (n = 27), and include patients in care-related decisions (n = 23). Few instruments (n = 9) assessed patient self-management and navigation. Measures include items that assess patient-provider relationship quality in serious illness settings. Researchers may consider these for evaluating and improving relationship quality, a patient-centered care and research outcome.

Lipodermatosclerosis: from pathophysiology to treatment.

Lipodermatosclerosis (LDS), also known as sclerosing panniculitis, is a chronic inflammatory condition of the skin and subcutaneous tissue caused by longstanding venous insufficiency. Often misdiagnosed as cellulitis due to overlapping clinical features, it requires accurate diagnosis and a multifaceted management approach. This clinical review explores the epidemiology, pathophysiology, clinical presentation, diagnostic challenges and management strategies for LDS. Acute LDS manifests with erythema and induration similar to cellulitis, while chronic LDS is characterised by fibrosis and skin tightening. Key management strategies include compression therapy, lifestyle modifications and interventions targeting venous insufficiency. Challenges such as delayed diagnosis, poor adherence to therapy and limited evidence for systemic treatments may compromise the quality of patient care. Future directions emphasise novel therapeutic approaches, evaluation of current treatments and the integration of artificial intelligence to enhance diagnostic decisions. Increased clinician awareness and research into the epidemiology, pathogenesis and treatment of LDS remain essential to improve patient outcomes.

Care leaders' moral distress in older adult care: A scoping review.

Moral distress among nurses is well researched and well documented, but there is limited research on the moral distress experienced by care leaders, who serve as intermediaries between patient care nurses and higher levels of administration. Healthcare professionals experience moral distress daily in the context of older adult care. The aim of this scoping review was to evaluate recent literature on moral distress in older adult care with the goal of revealing how care leaders' experiences of moral distress in older adult care have been conceptualized in earlier studies. The research questions were: How is the concept of moral distress as experienced by care leaders in older adult care defined in the existing literature? How is the concept of moral distress conceptualized in the literature? The research has been conducted in accordance with the guidelines set forth by the Finnish National Advisory Board on Research Ethics TENK. We saw that consensus on how moral distress is defined is lacking. Care leaders in older adult care experience substantial moral distress, which could be linked to the duality of their leadership role. Moral distress can be caused by a complex interplay of individual and structural factors and the challenging complex moral issues inherent to older adult care. Moral distress could impact care leaders' emotional health, job performance, overall job satisfaction and result in higher turnover rates, absenteeism, decreased quality of patient care, and increased organizational costs. Addressing moral distress on the individual, team, and organizational levels is crucial for enhancing care leaders' well-being and improving the overall quality of care for older adults. A focus on the identification of strategies whereby care leaders can be supported, exploration of the long-term effects of moral distress on healthcare professionals in general, and the organizational outcomes associated with moral distress should be included in future research.

Distributed cross-learning for equitable federated models - privacy-preserving prediction on data from five California hospitals

Quality improvement, clinical research, and patient care can be supported by medical predictive analytics. Predictive models can be improved by integrating more patient records from different healthcare centers (horizontal) or integrating parts of information of a patient from different centers (vertical). We introduce Distributed Cross-Learning for Equitable Federated models (D-CLEF), which incorporates horizontally- or vertically-partitioned data without disseminating patient-level records, to protect patients’ privacy. We compared D-CLEF with centralized/siloed/federated learning in horizontal or vertical scenarios. Using data of more than 15,000 patients with COVID-19 from five University of California (UC) Health medical centers, surgical data from UC San Diego, and heart disease data from Edinburgh, UK, D-CLEF performed close to the centralized solution, outperforming the siloed ones, and equivalent to the federated learning counterparts, but with increased synchronization time. Here, we show that D-CLEF presents a promising accelerator for healthcare systems to collaborate without submitting their patient data outside their own systems.

Evaluating the Impact of Big Data Analytics in Rural-Based Hospitals.

While the healthcare landscape continues to evolve, rural-based hospitals face unique challenges in providing quality patient care amidst resource constraints and geographical isolation. This study evaluates the impact of big data analytics in rural-based hospitals in relation to service delivery and shaping future policies. Evaluating the impact of big data analytics in rural-based hospitals will assist in discovering the benefits and challenges pertinent to this hospital. The study employs a positivist paradigm to quantitatively analyze collected data from rural-based hospital professionals from the Information Technology (IT) departments. Through a comprehensive evaluation of big data analytics, this study seeks to provide valuable insights into the feasibility, infrastructure, policies, development, benefits and challenges associated with incorporating big data analytics into rural-based hospitals for day-to-day operations. The findings are expected to contribute to the ongoing discourse on healthcare innovation, particularly in rural-based hospitals and inform strategies for optimizing the implementation and use of big data analytics to improve patient care, decision-making, operations and healthcare sustainability in rural-based hospitals.

A Study to Assess the Practical Challenges Faced by Nursing Staff Towards Care of Critically Ill Obese Patients in the Adult Intensive Care Unit of a Tertiary Care Teaching Hospital of Jaipur, Rajasthan

Obesity is a rising global health challenge, particularly in critical care settings where nursing staff face unique difficulties in managing critically ill obese patients. This study assesses the practical challenges encountered by nursing staff in the Adult Intensive Care Unit (ICU) of a tertiary care teaching hospital in Jaipur, Rajasthan. Employing a descriptive cross-sectional research design, the study identifies physical, emotional, and logistical challenges, alongside resource inadequacies and training gaps. Results indicate significant physical strain, emotional stress, and resource deficits, emphasizing the need for specialized bariatric equipment, training, and systemic administrative support. The findings inform actionable strategies to enhance patient care quality and improve nurses' well-being. Keywords: Obesity, Intensive Care Unit, Nursing Challenges, Bariatric Care, Critical Care, Resource Allocation

OPTIMIZATION OF HUMAN RESOURCES IN GYNECOLOGY: FACTORS INFLUENCING THE TURNOVER OF YOUNG SPECIALISTS

Introduction: There is a shortage of medical personnel all over the world and this trend is only increasing every year. Trends in leaving the medical profession in the modern world are caused by various factors, including the aging of the population, emotional burnout, lack of support and equipment with innovative tackle, and an increase in workload that took place during the coronavirus pandemic. All the above leads to difficulties in retaining medical personnel, respectively, to a decrease in the quality of patient care and pronounced financial difficulties for medical institutions. It is no secret that all over the world, as well as in Kazakhstan, steps are being taken to solve these problems, including ongoing changes in the education system and the use of the latest digital technologies, telemedicine. The purpose of the study: is to evaluate the factors influencing the desire to leave work among young gynecologists. Materials and methods: A cross–sectional study was conducted, in which a telephone interview was conducted with 36 young gynecologists who completed their studies at the expense of a state grant from three to eight years ago. The group of respondents is conditionally divided into those who no longer work in their specialty or are going to change their profession or migrate (15 people – group 1) and those who continue to work in their specialty and will work soon (21 people — group 2). Data processing was carried out using the data analysis package of the Microsoft® Office Excel 365 spreadsheet processor, SPSS IBM Statistics version 26.0 for Windows. Results: Dissatisfaction with the protection of the rights of medical workers increased the chance to leave the profession by 10 times (95% CI:2.1-48.5, p=0.003), stress increased the chance to leave by 5.5 times 95% CI: 1.3-23.7, p=0.018), difficulties with purchasing preferential housing by 5.5 times (95% CI: 1.3-23.7), dissatisfaction with wages increased the chance of leaving the profession by 5.3 times (95% CI:1.2-24.7). These same factors had statistically significant correlations with the desire to leave the profession. The imperfection of the system of financing medical services, the difficulties of working with it and unfair fines, according to respondents, influenced the reluctance to work in public medical institutions. Conclusion: During the interviewing of young obstetrician-gynecologists, a rather unfavorable tendency towards the desire to leave practical healthcare was revealed. Almost a third does not work or does not want to work in the practical healthcare of the Republic of Kazakhstan, while more than half works in the private sector or prefers to go to the private sector. Factors that can be considered when planning personnel policy in medicine for decision makers have been identified.

IMPROVING OPHTHALMIC CARE QUALITY AND ACCESSIBILITY THROUGH PATIENT-CENTERED APPROACHES AND STAFF TRAINING IN KAZAKHSTAN: A LITERATURE REVIEW

Introduction. The primary goal of treating vitreoretinal pathology is to preserve visual functions, which significantly impacts the patient’s quality of life. Subjective testing of patients with vitreoretinal pathology is particularly relevant in determining appropriate management strategies. This study focuses on exploring modern organizational tools to enhance the quality and accessibility of ophthalmic care. Purpose of the review. To explore modern organizational tools to improve the quality and accessibility of ophthalmic care for the population. Materials and Methods. Publicly available articles were reviewed using scientific publication databases and specialized search engines, including PubMed, Mendeley, Scopus, Web of Science, and Google Scholar. The study emphasizes the evaluation of patient satisfaction and quality of care in ophthalmology through surveys, applicable across all levels of healthcare facilities. Results. The findings highlight the importance of regular monitoring by medical personnel to assess their knowledge levels in theoretical and practical aspects of preventive measures and surgical treatments for macular holes. Early diagnostic measures are also essential to improve access to specialized ophthalmic care. The value of using monitoring questionnaires to enhance interactions between ophthalmologists and patients has been well established. Conclusion. The study highlights the necessity of developing and implementing adapted specialized questionnaires for residents of Kazakhstan to improve patient satisfaction and care quality. Introducing these tools in medical institutions can significantly enhance ophthalmic care accessibility and outcomes.

Protocol for a scoping review to explore governance for national hip fracture clinical audits

Background Hip Fractures are serious injuries leading to increased morbidity and mortality. The global incidence of hip fracture is rising. National hip fracture audits facilitate improvements in patient outcomes and care quality. There is a wealth of literature regarding hip fracture care, evidence-based standards, use of registry/clinical audit data for improvement, benchmarking and outcomes. There is however a gap in the literature for describing how to establish the governance for a national hip fracture audit. Objective This scoping review aims to identify the core governance components for national clinical audits (NCAs) of hip fractures. Methods The Joanna Briggs Institute guidance will be used in conducting the review and Preferred Reporting Items for Systematic Reviews extensions for Scoping Reviews (PRISMA-ScR) guidance for scoping reviews will be followed. has been used. Articles published in English, between 1988–2024 and indexed in MEDLINE (Ovid), Embase (Elsevier) and CINAHL (EBSCOHost) will be included in this review. Two reviewers will independently screen the articles, with any disagreements resolved by a third reviewer. Data extraction will be conducted by two reviewers and shared with external stakeholders to ascertain whether there is documentation or reports that were missed and preliminary analysis will be shared to validate the data we have extracted. The results will be disseminated widely through publication in an international peer reviewed journal and through the Global Fragility Fracture Network (FFN) Hip Fracture Audit Special Interest Group. Conclusions By identifying the core components for the governance of NCAs for hip fracture it is hoped that application of these components will support the existing NCAs for hip fracture to enhance their current governance and aid in the establishment of NCAs in the future.

Risk Management and Patient Safety; The National Safety and Quality Health Service (NSQHS) Standards

Purpose: The research aims at modifying two Standards of the National Safety and Quality Health Service (NSQHS) framework for UAE healthcare institutions which include both Clinical Governance and Medication Safety standards. This adaptation process is crucial for linking these standards to UAE regulations and healthcare infrastructure because of substantial cultural as well as legal technological and organizational differences between Australia and the UAE. Healthcare facilities in UAE will receive upgraded patient safety and quality of care through standards adaptations which reflect their specific operational needs. Methodology: The analysis methodically evaluates healthcare systems in Australia and UAE by involving their governance structures along with their combination of diverse cultures and system capabilities. A structured framework development method guides standard alignment with the UAE’s regulatory framework and adds suitable leadership strategies for diverse patient populations. The study delves into technology adoption mainly through artificial intelligence (AI) and digital health tools which enhance clinical decision-making ability and patient information retrieval. This analysis determines the implementation feasibility of electronic prescribing and medication tracking frameworks which will support the Medication Safety Standard within the UAE context due to its advanced technology infrastructure. Findings: A comprehensive governance framework requires development in order to achieve compatibility between the Clinical Governance Standard and UAE healthcare framework standards and employee population diversity. A combination of healthcare analytics with AI capabilities leads to substantial improvements in governance decision processes and patient care programs and quality assessment activities. The standard needs effective solutions to address regulatory matching requirements and cultural adaptation needs in order to function properly. Tests show that implementing electronic prescribing systems with nation-wide medication reconciliation programs will improve provider accountability and healthcare professional communication while decreasing medication errors. Adequate technology infrastructure within the UAE promotes these initiatives though the healthcare systems experiences impedance because of technical inconsistencies and regulatory barriers across regions. Unique Contribution to Theory, Practice and Policy: The UAE requires the development of a specific Clinical Governance Framework to fulfill legal requirements and address multicultural patient needs in the nation. Healthcare institutions must use AI and digital health technology to create data-driven decisions and enhance governance operation and quality assessment systems. It is crucial to establish nation-wide medication reconciliation standards across all healthcare facilities so care management remains consistent while minimizing medication errors in the UAE. The adoption of electronic prescribing systems and medication tracking platforms will boost healthcare provider communication by advancing patient protection measures. More research needs to be performed about AI and machine learning integration to expand the range of NSQHS standards and their application in UAE healthcare facilities.

THE IMPACT OF ARTIFICIAL INTELLIGENCE ON THE STANDARDIZATION AND IMPROVEMENT OF NURSING CARE

Background. The rapid advancement of artificial intelligence technologies and their implementation in medical practice create new opportunities for enhancing the quality of patient care. In the context of growing healthcare service demands and a shortage of qualified personnel, artificial intelligence plays a crucial role in optimizing nursing processes, improving diagnostic accuracy and forecasting, as well as increasing the efficiency of healthcare staff. Research objective. To examine nurses’ perceptions of artificial intelligence technologies and their readiness to integrate artificial intelligence into nursing practice in order to enhance the efficiency of patient care and optimize work processes. Materials and methods. An analysis of publications on the research topic was conducted using sources such as PubMed, Google Scholar, Web of Science, and Scopus. The results of a literature review are presented, focused on studying the use and understanding of artificial intelligence among nurses. Research results. A literature review has demonstrated that artificial intelligence holds significant potential to transform healthcare by enhancing diagnostic accuracy, personalizing treatment, improving administrative efficiency, and optimizing healthcare staff coordination. Artificial intelligence contributes to the automation of routine tasks, supports clinical decisionmaking, predicts outcomes, improves patient monitoring, and reduces workload and burnout risk among nurses. However, the implementation of artificial intelligence in medical practice requires enhanced education and training for healthcare personnel to overcome acceptance barriers, address ethical considerations, and ensure data security. Conclusion. Artificial intelligence has a significant impact on healthcare by improving the quality of care and optimizing workflows. Nurses play a crucial role in its integration, which requires enhancing their knowledge and training. Studies indicate the need for developing educational programs to improve nurses’ competencies in using artificial intelligence, ensuring more effective and safer implementation of technologies into practice.

Ethical and Legal Implications of Healthcare Worker Shortages

The chronic shortage of healthcare workers presents significant ethical and legal challenges, particularly regarding the quality of patient care and safety. This paper explores the implications of healthcare worker shortages, focusing on their impact on labor cost, compromised patient care, increased medical errors, and rising malpractice claims. Healthcare institutions face legal risks when they fail to meet mandated staffing ratios, which can result in penalties, fines, and lawsuits. Furthermore, overworked staff, often subject to extended hours and excessive workloads, raise concerns about labor law violations, including non-compliance with mandatory rest periods and fair overtime compensation. The increased reliance on contract workers to fill staffing gaps also introduces legal challenges related to contract disputes, working conditions, and patient safety. Addressing these shortages is critical to preventing further harm to patients and mitigating legal liabilities for healthcare systems. This paper proposes a set of solutions, including legal mandates for minimum staffing ratios in critical care areas and incentives for recruitment and retention in underserved regions. These measures aim to reduce turnover, protect patient safety, and minimize legal risks. A holistic approach to workforce planning and policy reform is necessary to sustain safe staffing levels and ensure ethical standards of care are maintained across the healthcare system. Ultimately, addressing healthcare worker shortages is both a legal requirement and an ethical imperative to safeguard the future of patient care and the well-being of healthcare professionals.

Analysis of quality criteria in endoscopic retrograde cholangiopancreatography in a tertiary care center.

There is a growing concern about ensuring quality in patient care, particularly in high-risk procedures such as Endoscopic Retrograde Cholangiopancreatography (ERCP). We present the results of the evaluation of our performance in ERCP based on the quality measures proposed by the European Society of Gastrointestinal Endoscopy (ESGE) in 2018. This study aims to serve as an internal audit and the first of its kind in our center.

The integration of hospital pharmacists into primary care settings in Shenzhen, China: a qualitative study

BackgroundIntegrating hospital pharmacists into primary care settings can enhance the quality of patient care. However, the challenges vary across countries. China has piloted such collaborations between hospital pharmacists and primary care practitioners in recent years, but research on this subject is limited. This study aims to examine the integration of hospital pharmacists into primary care settings in Shenzhen, China, and identify the perceived barriers and facilitators.MethodsFrom May 1 to November 30, 2022, a qualitative study gathered key informant interviews and on-site observations at three community health centers (CHCs) in Shenzhen. Two researchers collected the data, and all interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic approach.ResultsSeventeen key informants were recruited (eight hospital pharmacists, six GPs, and three health administrators), most of whom were women (n = 11). Hospital pharmacists mainly conduct medication reviews and consultations in clinics or pharmacies of CHCs and engage in home visits with GPs in a few cases. Barriers to their integration include pharmacists’ inadequate competency, a lack of patient recognition, GPs’ resistance, and insufficient technological support. Patient needs, incentive systems, administrative leadership, social media use, and colocation were identified as facilitators of integration.ConclusionWhile unique opportunities may exist for primary care settings to improve patient care by integrating hospital pharmacists, it is essential to address the barriers stemming from individuals and the health system. Efforts should focus on the targeted training of pharmacists’ practical skills, strategic campaigns to raise awareness among the public and healthcare providers, and policy-led efforts to foster technological progress.

Association of race and ethnicity with quality of care among head and neck cancer patients in California.

There are significant racial disparities in head and neck cancer (HNC) outcomes. Racial differences in survival may be explained by differential access to high-quality care. The goal of this study was to evaluate the association of race and ethnicity with the quality of the treating hospital, and receipt of guideline-compliant care among HNC patients. Retrospective cohort study of data from the California Cancer Registry dataset linked with discharge records and hospital characteristics. The study cohort included adult patients with HNC diagnosed between January 1, 2010, and December 31, 2019. Outcome measures included the quality of treating hospital, and NCCN guideline-compliant care. Black (OR 0.76, 95% CI 0.67 to 0.85) and Hispanic (OR 0.68, 95% CI 0.63 to 0.74) patients were less likely to be treated in top-quality hospitals compared with non-Hispanic White patients, after adjusting for demographic, and clinical factors. This association disappeared for Black patients, but persisted for Hispanic patients, after additionally adjusting for socioeconomic status and insurance status. Black patients with advanced-stage disease were less likely to be treated with dual-modality therapy (OR 0.82, 95% CI 0.70 to 0.96), however, this association disappeared after adjusting for demographic, and clinical factors, and hospital quality. There are significant racial and ethnic disparities in quality of care for patients with HNC. Our findings suggest that differential access to high-quality care may account for some of the racial disparities in HNC survival, and highlight the need for continued investigation into the drivers of racial disparities in HNC outcomes.