Quality Improvement Activities Research Articles

COVID-19's Effect on Practice Quality Improvement and Transformation Activities: Practice Survey Results.

The Transforming Clinical Practices Initiative (TCPI) was a 4-year, large-scale, collaborative, peer-based learning initiative for physician practices of all specialties with broad goals to improve the quality of patient care, spend health care dollars more wisely, and assist practices in being ready to succeed under value-based payment (VBP). We investigated whether the COVID-19 pandemic had erased or diminished practice transformation progress made during the TCPI program period, through a follow-up survey of participating practices fielded in October 2021. In October 2021 to April 2022, we surveyed a probability sample of 2207 primary care and specialty practices that participated in the TCPI, receiving 610 responses. We asked about practice characteristics, financial and ownership stability, clinical performance, and quality improvement efforts, both now and prior to COVID-19. The COVID-19 content was part of a larger survey. Responses were weighted to account for sample selection, unknown eligibility status, and nonresponse. We generated weighted univariate descriptive statistics representative of practices with clinicians enrolled in TCPI. These estimated percentages have a 95% confidence interval of about ±5%. Multivariate analysis of unweighted data examined associations between practice characteristics and other variables of interest. For all but one of 13 practice transformation activities engaged in prior to the COVID-19 public health emergency, a majority of practices (at least 52%) reported that the progress on these activities were either not hurt or were helped by their COVID-19 experience. Compared to January 2020, only about 7% of practices reported that their quality of care or clinical performance was worse due to COVID-19, and 32% reported that their quality of care was better. More rural than urban practices reported that half or more of their transformation activities were hurt by COVID-19 (29% and 14%, respectively). Physician-owned practices were more likely to report quality is better today than prior to COVID-19 relative to practices with other ownership types such as hospitals or health systems (43% vs 24%). Most practices have been able to recover from the deep stress of the COVID-19 pandemic and continue their efforts to improve patient care and performance to succeed under VBP. These results suggest a high perceived return on investment in value-readiness support along with emergency financial support in times of crisis, as well as room to continue preparation for any future pandemic and the national movement toward increased VBP, especially in rural settings.

Adoption, acceptance, and use of a decision support tool to promote timely investigations for cancer in primary care.

The complexities of diagnosing cancer in general practice has driven the development of quality improvement (QI) interventions, including clinical decision support (CDS) and auditing tools. Future Health Today (FHT) is a novel QI tool, consisting of CDS at the point-of-care, practice population-level auditing, recall, and the monitoring of QI activities. Explore the acceptability and usability of the FHT cancer module, which flags patients with abnormal test results that may be indicative of undiagnosed cancer. Interviews were conducted with general practitioners (GPs) and general practice nurses (GPNs), from practices participating in a randomized trial evaluating the appropriate follow-up of patients. Clinical Performance Feedback Intervention Theory (CP-FIT) was used to analyse and interpret the data. The majority of practices reported not using the auditing and QI components of the tool, only the CDS which was delivered at the point-of-care. The tool was used primarily by GPs; GPNs did not perceive the clinical recommendations to be within their role. For the CDS, facilitators for use included a good workflow fit, ease of use, low time cost, importance, and perceived knowledge gain. Barriers for use of the CDS included accuracy, competing priorities, and the patient population. The CDS aligned with the clinical workflow of GPs, was considered non-disruptive to the consultation and easy to implement into usual care. By applying the CP-FIT theory, we were able to demonstrate the key drivers for GPs using the tool, and what limited the use by GPNs.

Experiences of Newly Qualified Nurses' Engagement with Quality Improvement in Practice: A Qualitative Follow-Up Study.

Nurse education plays an essential role in preparing future nurses to engage with quality improvement (QI) initiatives in their organisations and improve patient care. However, frontline nurses continue to report that a lack of QI knowledge hinders their abilities to engage in improvement work. In the UK, student nurses are now trained in QI within their degree to enable them to contribute to improvements once qualified. This qualitative follow-up study investigated the sustainability of QI engagement in nurses who undertook QI training and a QI project during their degree and explored the factors influencing their engagement in QI once qualified. This paper followed the COREQ criteria to report upon 10 semi-structured interviews undertaken with registered nurses and focuses on their experiences of QI engagement post-registration. The data were investigated using an inductive thematic analysis and Nvivo 14. Five themes emerged: transition to a newly qualified nurse, QI knowledge decline, influencing factors (hierarchy, leadership, COVID-19 pandemic, data access and location), and skill transferability. This study showed that qualified nurses can sustain their QI knowledge and remain engaged with QI where they experience positive QI leadership and were exposed to ongoing QI activity in their preceptorship year. However, a lack of QI opportunities and a culture which does not consider QI a responsibility of new nurses is seen to hinder engagement. Educational institutions and practice partners require careful collaboration to assess and develop ongoing QI learning activities that support new nurses to engage in QI.

Influence of process shifts in case of Six Sigma-based Bayesian control charts

While traditional control charts play an important role in quality assurance activities, the work on such techniques evolved over the years particularly for early detection of process shifts. Many advanced level control charts have been proposed in the literature to even detect small shifts in the process as early as possible. In order to make use of the prior beliefs and likelihood of the observed data behavior, Bayesian control charts for parameter of the posterior distribution have been proposed by various authors. The Six Sigma-based control charts ensure smaller process variations by enforcing quality improvement activities and as a result, such processes would produce higher quality products with only 3.4 defects per million opportunities (DPMO) even after allowing a shift in the process up to ± 1.5 times of process standard deviation. In this paper, an attempt has been made to develop Six Sigma-based Bayesian control charts. The proposed control charts incorporate various shift (or no-shift) combinations to prior and observed data behaviors to study their influence on the posterior parameter. Illustrative examples are also given for understanding the proposed approach. The performance evaluation and comparisons are also presented. The paper ends with a discussion and concluding remarks.

Access of Low-Resource Areas to ASCO Quality Initiatives: Initial Experience and Lessons Learned.

With the aim of improving the quality of cancer care globally, ASCO began to offer its quality improvement programs to interested international oncology practices. In this manuscript, we describe the experiences with ASCO quality initiatives in low- and middle-income countries (LMICs). The experience acquired from different practices in Latin America and Africa was reviewed and various action steps were summarized. Encountered challenges and implemented solutions to mitigate these challenges were identified to list as lessons learned for oncology practices in LMICs or low-resource settings to use in their future quality improvement initiatives and providing a proactive approach for those practices considering starting quality improvement programs. Having programs tailored to LMICs may facilitate the participation of more practices and help them take advantage of these programs to enhance patient care. The preliminary data and learning are promising and demonstrate that participation in quality improvement activities can have a positive effect. Although this early experience is encouraging, each country and resource-limited practice will have its own unique challenges as highlighted in this article. Having more practices participate will further enhance the knowledge base, build experience in addressing challenges, and enable oncology patients to reap the benefits worldwide.

Towards the new primary care reform in Greece: a focus on patients' expectations, views and perceptions from rural healthcare centres.

Patient perception of quality of care is an essential component in evaluating healthcare delivery. This article reports data from primary health care (PHC) centers before Greece's most recent PHC reform. The study was undertaken to offer some baseline information about patient experience, support the decision-making processes taking place, and provide valuable input for future policy-making comparisons in Greece. The research was conducted across the 16 PHC centers of Epirus, a region of north-western Greece, from June to September 2017, with 532 patients rating the importance of different aspects of three main healthcare domains (clinical behavior, support and services, and organization of care) of PHC provision. The Greek version of the European Task Force on Patient Evaluations of General Practice (EUROPEP) questionnaire was implemented for research purposes. Univariate comparisons were performed for patients with and without chronic disease, using Pearson's χ2 test for categorical data. Study findings support that the organization of care domain is of highest importance and priority, with clinical behavior and support and services following closely. Among recruited patients, on average, only 2.1% of patients with a chronic disease were satisfied (rated 4 or 5 on the Likert scale) with the organization of care aspects under consideration, compared to 18.4% of patients without a chronic disease. Furthermore, only 4% of patients with a chronic disease were satisfied with the aspects examined in the clinical behavior domain, compared to 27% of patients without a chronic disease. Finally, 18% of sampled patients with a chronic disease reported being satisfied with the quality of support and services provided, compared to 38% of patients without a chronic disease. It is necessary to back up available past information to afterwards estimate reform imprinting on expectations and perceptions. The items and aspects of EUROPEP, in line with the new tasks of the personal doctor within the PHC system that patients perceive as most essential, can be used to prioritize quality improvement activities to strengthen PHC delivery in Greece. Communication skills, practices, and behavioral change skills seem to need more attention for an efficient PHC model.

Designing, delivering and evaluating a specialty specific quality improvement course for the rheumatology multidisciplinary team

Abstract Objectives Quality improvement (QI) methodology aims to drive improvement in healthcare using a systematic approach. QI is an integral part of healthcare professional training curricula. However, many members of the rheumatology community have not accessed formal QI methodology training, including those expected to supervise QI activity. The BSR QI practical methodology workshop was created to address this knowledge gap in a specialty-specific course designed and delivered by, and for, the multidisciplinary team. Methods Course design centred on the Institute for Healthcare Improvement approach, ‘Model for improvement’, adapting materials from the well-established Trainees Improving Patient Safety through QI (TIPSQI) initiative. The course was delivered online (2021) and face-to-face (2022). Kolbs’ four stage experiential learning cycle informed course design utilising rheumatology-specific cases and facilitated breakout rooms to teach QI tools. Kirkpatrick’s four-stage model was used to design the course evaluation. Data from surveys completed before, immediately after, and six months’ following the courses were used to evaluate the course. Results Baseline knowledge of specific QI tools was limited. Post course evaluation demonstrated increased confidence to use and teach tools. Sustained confidence to contribute to and lead QI activity was reported. Course satisfaction was high; 100% of delegates would recommend the course to colleagues. Conclusion This successful, rheumatology specific QI course led to improved delegate knowledge of QI methodology and confidence in leading and teaching QI initiatives. It has contributed to building momentum in a growing rheumatology QI community of practice and to embedding a sustainable culture of improvement across the rheumatology community.

Building Capacity of Community Health Centers to Improve the Provision of Postpartum Care Services Through Data-Driven Health Information Technology and Innovation.

Maternal morbidity and mortality remain significant challenges in the United States, with substantial burden during the postpartum period. The Centers for Disease Control and Prevention, in partnership with the National Association of Community Health Centers, began an initiative to build capacity in Federally Qualified Health Centers to (1) improve the infrastructure for perinatal care measures and (2) use perinatal care measures to identify and address gaps in postpartum care. Two partner health center-controlled networks implemented strategies to integrate evidence-based recommendations into the clinic workflow and used data-driven health information technology (HIT) systems to improve data standardization for quality improvement of postpartum care services. Ten measures were created to capture recommended care and services. To support measure capture, a data cleaning algorithm was created to prioritize defining pregnancy episodes and delivery dates and address data inconsistencies. Quality improvement activities targeted postpartum care delivery tailored to patients and care teams. Data limitations, including inconsistencies in electronic health record documentation and data extraction practices, underscored the complexity of integrating HIT solutions into postpartum care workflows. Despite challenges, the project demonstrated continuous quality improvement to support data quality for perinatal care measures. Future solutions emphasize the need for standardized data elements, collaborative care team engagement, and iterative HIT implementation strategies to enhance perinatal care quality. Our findings highlight the potential of HIT-driven interventions to improve postpartum care within health centers, with a focus on the importance of addressing data interoperability and documentation challenges to optimize and monitor initiatives to improve postpartum health outcomes.

Health professional regulation and provision of quality health services; cross sectional analysis of private health care providers in Wajir County, Kenya

Background: Health professional regulatory bodies oversee and enforce standards in healthcare to safeguard patient safety and prevent harm. However, international consistency in these regulations remains limited. The Kenya health sector relies on various bodies to enforce standards among professionals and institutions, albeit constrained by financial and human resources that hinder effective oversight. This study aimed to assess how regulatory practices- such as licensing, training oversight, inspection of practice, and quality assurance mechanisms- affect the quality of healthcare provided by private providers. Methods: The study targeted 108 healthcare providers from 36 private health facilities, primarily nurses and clinical officers. A sample of 86 participants was drawn using purposive sampling. The data were collected using a structured questionnaire. Results: The licensing of health professionals, training, inspection of practice, and quality assurance mechanisms collectively influenced 47.9% of the variation in service quality. Statistical analysis revealed significant associations between licensing (p=0.003), practice inspections (p=0.01), quality assurance (p=0.001), and service quality. Conclusions: Regulatory bodies play a crucial role in ensuring healthcare standards; however, their effectiveness hinges on tailored strategies that address local challenges and foster collaborative efforts towards sustainable quality improvement in healthcare services. Routine inspections, conducted in a supportive manner, are likely to ensure ongoing adherence to standards. Moreover, adequate resource allocation for regulatory compliance and continuous quality improvement activities, including the formation of internal quality improvement (QI) teams and the maintenance of regular QI meetings and assessments, was deemed essential.

Improving medication safety in a Latin American hospital: Examination of medication errors and the role of pharmacists.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Prospective medication order review by a clinical pharmacist is uncommon in many South and Central American countries. Voluntary error reporting and analysis are similarly uncommon. This paper describes the results of pharmacist prospective order review, medication error reporting, and quality improvement activities in a Latin American hospital. On January 1, 2020, the hospital initiated prospective review of all medication orders in both the hospital and clinic setting by pharmacists. Health professionals were encouraged to report errors identified to the hospital's voluntary reporting program. Data collected included the medication name and dose, stage of the medication use process, error severity, and error cause. Error reports were periodically reviewed by pharmacy staff. In the 402,100 orders reviewed, errors were found in 605 inpatient orders and 405 clinic orders (0.25%). Most errors were identified before they reached the patient (69.9% of inpatient errors and 81.0% of clinic errors). The prescribing phase was associated with the highest proportion of errors (50.8% of inpatient errors and 41.7% of clinic errors). The most common reasons for prescribing errors were confusing orders and wrong doses. Analgesics (22.7%) and antibiotics (21.3%) were the medication classes most frequently identified. After aggregated review, pharmacists generated 19 clinical alerts leading to system changes and staff education. This study demonstrates the impact of prospective order review by pharmacists on patient safety. In addition to preventing errors from reaching the patient, voluntary error reporting and evaluation led to system changes intended to reduce the likelihood that similar errors would occur again.

Pharmacotherapy profile for mothers with schizophrenia and bipolar affective disorder in a psychiatric mother–baby unit

AbstractBackgroundPharmacotherapy treatment is used to manage women with schizophrenia and bipolar affective disorder admitted to a mother–baby unit (MBU).AimThe aims of this study were (1) to examine prescribing practices for women with schizophrenia and bipolar affective disorder in an MBU, (2) to assess alignment with the Mental health care in the perinatal period: Australian clinical practice guideline and (3) to examine the classes of typical and atypical antipsychotics prescribed to mothers with schizophrenia.MethodA retrospective audit of women with schizophrenia and bipolar affective disorder admitted to a psychiatric MBU, located in Queensland, Australia, was conducted from March 2017–July 2019. The exclusion criteria included women admitted with depression, anxiety, personality disorders, and postpartum psychosis. Pharmacotherapy treatment details were extracted at commencement of admission, mid‐way through admission, and discharge. Descriptive statistics were completed. This project was exempt due to the local policy requirements that constitute research by the Gold Coast Hospital and Health Service Human Research Ethics Committee (Reference no: EX/2023/QGC/102306). The justification for this exemption was as follows: the study was deemed a quality improvement activity and complied with Chapter 2.3 of the National Statement of Ethical Conduct in Research and involved only routinely collected data.ResultsOf the 53 mothers included in the study, 29 (55%) had schizophrenia and 24 (45%) had bipolar affective disorder. In addition, 97% of women with schizophrenia received atypical antipsychotics. Five women (21%) with bipolar affective disorder (mean age = 31.60 years, standard deviation = 6.19 years) were prescribed sodium valproate, with four women given contraception. Sodium valproate or lamotrigine were prescribed to four women (67%) with bipolar affective disorder whilst breastfeeding. Of mothers prescribed lithium, 92% did not breastfeed. Overall, 44% of women involuntarily admitted received antipsychotic depot medication compared with 38% of voluntary patients. Results are discussed in relation to the national guidelines.ConclusionThis is the first naturalistic study to examine the pharmacotherapy management of postpartum women admitted to a psychiatric MBU with schizophrenia and bipolar affective disorder. The study highlights that prescribing patterns across three time points during admission were generally in alignment with Australian national guidelines.

Evaluating Customer Quality, Satisfaction, And Loyalty In B2B Relations: Insights From PT Telkom Witel Yogyakarta

The main objective of this research is to examine how service quality and brand awareness affect customer satisfaction and loyalty in the business-to-business (B2B) technology services industry. Data was collected through interviews with four respondents with different backgrounds in Yogyakarta and analyzed using the content analysis method. This study shows that service quality has a positive impact on customer satisfaction, customer satisfaction has a positive impact on customer loyalty, and brand awareness has a positive impact on the relationship between service quality and customer satisfaction. The findings will help company managers in the B2B technology services industry to use these insights to improve customer satisfaction through service quality improvement actions.

SQUIRE-SIM (Standards for Quality Improvement Reporting Excellence for SIMulation): Publication Guidelines for Simulation-Based Quality Improvement Projects.

With increased incorporation of simulation-based methodologies into quality improvement activities, standards for reporting on simulation-specific elements in healthcare improvement research are needed. We followed established consensus process methodology to iteratively create simulation-based extensions for SQUIRE 2.0 reporting guidelines. Initial steps involved forming a steering committee, defining the scope, and conducting premeeting activities with an expert panel of simulation and quality improvement researchers. Recommendations from the expert panel were brought to a consensus meeting where existing guidelines were reviewed and recommendations made. Steering Committee members reviewed all recommendations, reconciled differences, and made final recommendations, which were piloted by experienced simulation and quality improvement researchers. Fifteen Steering Committee members, 59 experts in simulation and quality improvement research, and 86 consensus meeting attendees reviewed SQUIRE 2.0 reporting guidelines and ultimately recommended simulation-based reporting guidelines for 22 of the 41 (54%) SQUIRE 2.0 guidelines. Those items for which simulation-based extensions were identified were: Notes to Authors, 1 (Title), 2a (Abstract), 2b (Abstract), 4 (Introduction: Available knowledge), 5 (Introduction: Rationale), 7 and 8a & b (Methods: Context and intervention), 9a (Methods - Study of the intervention), 9b (Methods - Study of the intervention), 10a (Methods - Measures), 10b (Methods-Measures), 10c (Methods-Measures), 11b (Methods- Analysis), 12 (Methods - Ethical considerations), 13a (Results), 13e (Results), 14b (Discussion - Summary), 15a-e (Discussion - Interpretation), 16a (Discussion - Limitations), 16b (Discussion - Limitations), 17c (Discussion - Conclusions), and 17d (Discussion - Conclusions). We created simulation-based extensions to SQUIRE 2.0 reporting guidelines to improve the quality and standardization of reporting on simulation-specific elements of healthcare improvement research.

The Integration of Quality Improvement and Health Care Simulation: A Scoping Review.

Quality improvement (QI) and simulation employ complementary approaches to improve the care provided to patients. There is a significant opportunity to leverage these disciplines, yet little is known about how they are utilized in concert. The purpose of this study is to explore how QI and simulation have been used together in health care. This scoping review includes studies published between 2015 and 2021 in 4 databases: CINAHL, Embase, PubMed, and Scopus. The search yielded 921 unique articles.18 articles met the inclusion criteria and specifically described QI and simulation collaborative projects. Of the 18 articles, 28% focused on improvements in patient care, 17% on educational interventions, 17% on the identification of latent safety threats (LSTs) that could have an impact on clinical care, 11% on the creation of new processes, 11% on checklist creation, and 6% on both LST identification and educational intervention. The review revealed that 61% of the included studies demonstrated a concurrent integration of simulation and QI activities, while 33% used a sequential approach. There is a paucity of studies detailing the robust and synergistic use of QI and simulation. The findings of this review suggest a positive impact on patient safety when QI and simulation are used in tandem. The systematic integration of these disciplines and the use of established reporting guidelines can promote patient safety in practice and in the literature.

Asian Neonatal Network Collaboration (AsianNeo): a study protocol for international collaborative comparisons of health services and outcomes to improve quality of care for sick newborn infants in Asia – survey, cohort and quality improvement studies

IntroductionReducing neonatal deaths in premature infants in low- and middle-income countries is key to reducing global neonatal mortality. International neonatal networks, along with patient registries of premature infants, have contributed...

Medical Quality Improvement Activity in the Medical Crisis

Quality improvement activities are especially important in middle to small-sized hospitals as well as in large hospitals. Hospital accreditation would play a crucial role in the re-establishment of the healthcare delivery system, which is now nearly collapsed in Korea. To achieve all these goals, it is also important to educate prospective medical personnel at college on the concepts of quality improvement and patient safety.

Accuracy assessment of patient safety incident (PSI) codes and present-on-admission (POA) indicators: a cross-sectional analysis using the Patient Safety Incidents Inquiry (PSII) in Korea

BackgroundAmong the various methods used, administrative data collected for claims and billing purposes, such as diagnosis codes and present-on-admission (POA) indicators, can easily be employed to assess patient safety status. However, it is crucial that administrative data be accurate to generate valid estimates of adverse event (AE) occurrence. Thus, we aimed to evaluate the accuracy of diagnosis codes and POA indicators in patients with confirmed AEs in the hospital admission setting.MethodsWe analysed the diagnosis codes of 1,032 confirmed AE cases and 6,754 non-AE cases from the 2019 Patient Safety Incidents Inquiry, which was designed as a cross-sectional study, to determine their alignment with the Korean Patient Safety Incidents (PSIs) Code Classification System. The unit of analysis was the individual case rather than the patient, because two or more AEs may occur in one patient. We examined whether the primary and secondary diagnostic codes had PSIs codes matching the AE type and checked each PSI code for whether the POA indicator had an ‘N’ tag. We reviewed the presence of PSI codes in patients without identified AEs and calculated the correlation between the AE incidence rate and PSI code and POA indicator accuracy across 15 hospitals.ResultsNinety (8.7%) of the AE cases had PSI codes with an ‘N’ tag on the POA indicator compared to 294 (4.4%) of the non-AE cases. Infection- (20.4%) and surgery/procedure-related AEs (13.6%) had relatively higher instances of correctly tagged PSI codes. We did not identify any PSI codes for diagnosis-related incidents. While we noted significant differences in AE incidence rates, PSI code accuracy, and POA indicator accuracy among the hospitals, the correlations between these variables were not statistically significant.ConclusionCurrently, PSI codes and POA indicators in South Korea appear to have low validity. To use administrative data in medical quality improvement activities such as monitoring patient safety levels, improving the accuracy of administrative data should be a priority. Possible strategies include targeted education on PSI codes and POA indicators and introduction of new evaluation indicators regarding the accuracy of administrative data.

The Effect of Management Support, Team Work, and Monitoring & Evaluation Process on Implementing the Patients Identification

Background: One of the efforts to fulfill patient safety targets is identifying patients correctly. Identification carried out incorrectly will have fatal consequences, triggering other errors. An important paradigm for reducing misidentification requires more than two patient identifiers. Objective: The study aims to analyze the influence of management support, team work, monitoring and evaluation process on implementing the patients’ identification among nurses at Wisma Rini Pringsewu Hospital. Method: We conduct the cross-sectional study to examine the causalities of independent variable with dependent variable. Result: Management support has a direct effect on the implementation of patient identification. Management support also has an indirect effect on the implementation of patient identification, through monitoring and evaluation. Meanwhile, monitoring and evaluation can have a direct influence on the implementation of patient identification. Team work influences the implementation of patient identification, but the influence is small, so monitoring and evaluation is needed so that team work works well. Meanwhile, team work is formed due to the contribution of management support. Implication: Create monitoring and evaluation policies related to the implementation of quality improvement and patient safety activities

Advancing Medical Quality and Patient Safety through Full Staff Engagement in Quality Management

<p>亞東醫院隨著品安發展趨勢與各式品管活動之演進，從全面推動單位品質架構、建置自動化指標監測機制、鼓勵品質改善活動等，持續活絡院內醫品病安持續改善之動力與投入，落實考量病人的需求與整合納入病人的偏好，導入各式資訊及通訊技術，不斷地優化與智能化醫療服務流程與增進醫護團隊醫療決策輔助之深度，且以區域聯盟醫院共同精進之理念，與合作醫院建立品質提升夥伴關係，共同促進與提升醫療品質與改善病人安全。</p> <p> </p><p>As Far Eastern Memorial Hospital progresses with the evolving trends in safety and quality development and various quality management activities, it has fully committed to promoting a comprehensive department quality framework, establishing automated monitoring mechanisms for indicators, and encouraging quality improvement activities. These efforts are designed to sustain the momentum and investment in continuous improvements in medical quality and patient safety within the hospital. By integrating patient needs and preferences and by incorporating various information and communication technologies, the hospital continually optimizes the intelligence of medical service processes and enhances to depth of medical decision-making for healthcare teams. Additionally, with a philosophy of shared improvement with regional alliance hospitals, Far Eastern Memorial Hospital has established quality enhancement partnerships with collaborating institutions to jointly advance medical quality and enhance patient safety.</p> <p> </p>

Using interRAI Assessment for Research: Developing a National Research Agenda in Aotearoa New Zealand

interRAI provides a suite of standardized, validated instruments used to assess health and psychosocial well-being, and to inform person-centered care planning. Data obtained from these standardized tools can also be used at a population level for research and to inform policy, and interRAI is currently used in more than 40 countries globally. We present a brief overview of the use of interRAI internationally within research and policy settings, and then introduce how interRAI is used within the universal public health system in Aotearoa New Zealand (NZ), including considerations relating to Māori, the Indigenous people of NZ. In NZ, improvement in interRAI data utilization for research purposes was called for from aged care, health providers, and researchers, to better use these data for quality improvement and health advancement for New Zealanders. A national research network has been established, providing a medium for researchers to form relationships and collaborate on interRAI research with a goal of translating routinely collected interRAI data to improve clinical care, patient experience, service development, and quality improvement. In 2023, the network members met (hybrid: in-person and online) and identified research priorities. These were collated and developed into a national interRAI research agenda by the NZ interRAI Research Network Working Group. Research priorities included reviewing the interRAI assessment processes, improving methods for data linkage to national data sets, exploring how Indigenous Data Sovereignty can be upheld, as well as a variety of clinically focused research topics. Implications for Practice, Policy, and Research: This appears to be the first time national interRAI research priorities have been formally identified. Priorities identified have the potential to inform quality and clinical improvement activities and are likely of international relevance. The methodology described to cocreate the research priorities will also be of wider significance for those looking to do so in other countries.