Quality Improvement In Health Care Organizations Research Articles

Nurses’ knowledge of Diagnostic-Therapeutic Care Pathways (DTCP): A cross-sectional study

Introduction: Management by processes and clinical care pathways are now fundamental and indispensable requirements for quality improvement in healthcare organisations. The basic idea is to design a system that allows for continuous improvement in the way in which the key player in healthcare, i.e. the patient, is managed. If this were to happen, the best experiences to date tell us, it would definitively improve outcomes, efficiency and appropriateness. Moreover, patients perceive and appreciate this difference, allowing health professionals to operate at their best. Objective: To assess the knowledge and application of the DTCPs by the nursing staff. Materials and methods: The cross-sectional study took place in the period between June and September 2019 at the Operative Units of digestive surgery, hepatobiliary surgery, breast surgery and gynaecological surgery of the “Fondazione Policlinico Gemelli IRCCS in Rome”. A questionnaire was administered only to permanent nurses. Results: A total of 64 questionnaires were administered of which 27 were correctly completed (response rate 42.1%) and considered valid for analysis. The sample of respondents was predominantly female (74.07%), 81.48% held a Bachelor’s degree and 40.74% held a Master’s degree. 55.56% knew what DTCPs were, but there was no in-depth knowledge of them in the sample. In fact, 55.56% knew whether there were active DTCPs in their region; 7.41% that nurses cannot participate in DTCPs and only 11.11% that nurses cannot participate in the review of individual DTCPs, while 59.26% were aware of the professional figures involved in the drafting and review of DTCPs. 25.93% knew what the diagnostic phase was based on and 14.81% that there were no active memoranda of understanding with public or private facilities in the diagnostic phase. Finally, only 25.93% were aware that the user could not be used in the evaluation of the outcome. Conclusions: Although the interviewees were familiar with clinical care pathways, for most of them there had never been active involvement, they agreed on user involvement instead.

Patients Satisfaction with the Quality of Service in Clinical Pathology Laboratory in Jos University Teaching Hospital (JUTH)

Background: Clients satisfaction have gained increasing attention as meaningful and important sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations. However, there only very few published studies reporting of the improvement resulting from feedback information of patient surveys, and in most cases, these studies are not in line with their findings. The patients become the main strategy for the main strategy for the organization of health services. This is the era of patients centre care. The study attempts to evaluate patients satisfaction with quality of service offered by clinical pathology Department in JUTH. Materials and methods: 150 Subjects were recruited after consent by random sampling through an inquiry conducted anonymously during the months of January and May 2017. The age range is between eighteen to seventy years. The inquiry was in form of questionnaire with the following questions: accessibility to the laboratory, cleanliness of the laboratory, patients-staff interpersonal relationship, waiting time and turn around time (TAT), labeled 1,2,3,4,5 respectively. Classification of the calculation results of questionnaires was carried out in three categories, namely good service quality, service quality is good enough, and the quality of service quality, service quality is good enough, and the quality of service is not good. Results: This study showed very high overall satisfaction of patients on service in clinical pathology laboratory (80.4%). The levers of cleanliness, communication level and TAT have the highest satisfaction with 99%, 95% and 93% respectively. Those with good enough falls into the category of accessibility and time taken with 52% and 63% respectively. The overall degree of satisfaction is 80.4%. Conclusion: The patients satisfaction in the lever of cleanness, communication, and TAT was the highest (good quality service) and the lowest of the levers ......

The Development of Conceptual Frameworks in Assessing Continuous Quality Improvement in Healthcare Organizations the Proposal from Asiquas

The Development of Conceptual Frameworks in Assessing Continuous Quality Improvement in Healthcare Organizations the Proposal from Asiquas

Health care services satisfaction and associated factors among people living with HIV/AIDS at Kibuye referral hospital, Rwanda

Background: Patient satisfaction surveys have gained great attention as meaningful parameters for evaluating quality improvement in healthcare organizations. At Kibuye referral hospital, healthcare utilization and health care services for people living with HIV/AIDS (PLWHA) has been low, as attested by poor adherence to medication and weakening of patients due the disease progression. The main objective of this study was to assess healthcare services satisfaction and associated factors among people living with HIV/AIDS Kibuye referral hospital, Rwanda. Methods: An institutional-based cross-sectional design was used to select 277 study participants who were interviewed by use of a structured questionnaire, and the data analyzed quantitatively. Two focus group discussions (FGDs) were performed, after which the interviews were transcribed in verbatim and analyzed thematically.Results: The overall level of PLWHA satisfaction was 95.0%. In multivariate analysis, social class and age were found to be the main predictors of PLWHA satisfaction (AOR=10.218, 95% CI=1.39, 74.88, p=0.002) and (AOR=0.39, CI=0.121 to 1.186, p=0.005), respectively. Qualitative study outcome showed that health care service delivery at Kibuye referral hospital is measured by a number of factors, including timeliness of health care service delivery, meeting needs of clients and paying attention in provision of health care services.Conclusions: The level of patient satisfaction was found to be high. When individual was of high-class status in the society, and were above 20 years of age, his or her satisfaction increased. The study recommends that PLWAs are treated equally so as to improve service delivery, particularly among people living HIV/AIDS.

Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study

To assess the utility of using external databases for quality improvement (QI) evaluations in the context of an innovative QI collaborative aimed to reduce three infections and improve patient safety across the cardiac surgery service line. We compared changes in each outcome between 15 intervention hospitals (infection reduction protocols plus safety culture intervention)and 52 propensity score-matched hospitals(feedback only). Improvement trends in several outcomes among the intervention hospitals were not statistically different from those in comparison hospitals. Using external databases such as those of professional societies may permit comparative effectiveness assessment by providing concurrent comparison groups, additional outcome measures and longer follow-up. This can better inform evaluation of continuous QI in healthcare organizations.

Advancing competitive position in healthcare: a hybrid metaheuristic nutrition decision support system

In the highly competitive environment of healthcare industry, managers incorporate patient centered care as a major component in the healthcare mission. Management information systems have gained increasing attention to develop effective plans for patient centered care, and quality improvement in healthcare organizations. Consumers are becoming actively involved in their health, which is great for patient engagement, but to meet this demand, healthcare providers need to make significant changes. Information technology and artificial intelligence can significantly improve workflows for healthcare professionals, and support the development of new services to meet changing consumer demands while maintaining costs. In this study, we aimed to build a decision support system including Genetic algorithm and Simulated Annealing metaheuristic machine learning methods for nutritionists to regulate a hospitals’ nutrition cycle and provide the best possible diet menu solutions while decreasing costs. Our main reason of using hybrid metaheuristic machine learning methods is to obtain a better quality solution on the problem dealt with study. Experimental results showed that; the proposed system is a novel, smart, cost-effective, flexible and machine learning based decision support system for nutritionist and healthcare managers.

Data transparency at the point of care: Results of patient and visitor interviews.

Abstract Feedback on their performance is driving quality improvement in healthcare organizations. In this study, the researchers explore patient and visitor perceptions about the role data play in engaging them in their care, investigate which measures the patients and visitors find most useful, and assess their understanding of diverse processes, system performance, and patient outcome measures and alternative methods of presenting those data. This was a cross-sectional, mixed methods study that included consulting the Patient and Family Advisory Council (PFAC) and conducting structured interviews with a convenience sample of patients and visitors not associated with the PFAC from 12 inpatient units across one healthcare system. The PFAC evaluated the graphic representations used to report 22 possible measures internally and suggest any changes needed to best communicate process, system performance, and patient outcomes data to patients and their visitors during their hospital stay. Although the PFAC was very supportive of efforts for greater data transparency on patient-care units, it did not support displaying unit grades, levels of nursing specialty certification, or RN education levels, so these measures were excluded from this study. The PFAC recommended that the graphs be simplified as much as possible, including displaying just 1 year of monthly data. The PFAC requested that all axes be clearly labeled and that more standardization be provided and that the y-axes be extended on all graphs to avoid the appearance of high rates of safety issues. This study demonstrated that patients and visitors have positive opinions about increasing data transparency around both patient experience and safety data at the point of care but find safety measures less useful and more difficult to understand relative to patient experience measures.

Performance and quality improvement in healthcare organizations

Organizational studies of healthcare are focused on the contribution of organizational solutions to improved performance.The corporatization and customer satisfaction research have led healthcare organizations to reflect on the concept of quality. Not only the quality of the service but also the relationships with patients and all operations of the organization.It is important to implement appropriate assessment systems that affect, in an integrated way, customer satisfaction, health-staff contribution, and the performance of the entire organization.

Patient Satisfaction Survey as a Tool Towards Quality Improvement

Over the past 20 years, patient satisfaction surveys have gained increasing attention as meaningful and essential sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations. However, there are very few published studies reporting of the improvements resulting from feedback information of patient satisfaction surveys, and in most cases, these studies are contradictory in their findings. This article investigates in-depth a number of research studies that critically discuss the relationship of dependent and independent influential attributes towards overall patient satisfaction in addition to its impact on the quality improvement process of healthcare organizations.

Pseudoinnovation: the development and spread of healthcare quality improvement methodologies

Over the last two decades, we have seen the successive rise and fall of a number of concepts, ideas or methods in healthcare quality improvement (QI). Paradoxically, the content of many of these QI methodologies is very similar, though their presentation often seeks to differentiate or distinguish them. This paper sets out to explore the processes by which new QI methodologies are developed and disseminated and the impact this has on the effectiveness of QI programmes in healthcare organizations. It draws on both a bibliometric analysis of the QI literature over the period from 1988 to 2007 and a review of the literature on the effectiveness of QI programmes and their evaluation. The repeated presentation of an essentially similar set of QI ideas and methods under different names and terminologies is a process of 'pseudoinnovation', which may be driven by both the incentives for QI methodology developers and the demands and expectations of those responsible for QI in healthcare organizations. We argue that this process has important disbenefits because QI programmes need sustained and long-term investment and support in order to bring about significant improvements. The repeated redesign of QI programmes may have damaged or limited their effectiveness in many healthcare organizations. A more sceptical and scientifically rigorous approach to the development, evaluation and dissemination of QI methodologies is needed, in which a combination of theoretical, empirical and experiential evidence is used to guide and plan their uptake. Our expectations of the evidence base for QI methodologies should be on a par with our expectations in relation to other forms of healthcare interventions.

Effective quality improvement: some necessary conditions

In the previous article in this series, the authors discussed the growing importance of quality improvement in healthcare organisations, outlined some of the approaches that have been used, and considered some of the factors that make healthcare organisations a particularly challenging setting for managers introducing quality improvement interventions. This article considers some of the core conditions that are necessary for successful quality improvement in health care, regardless of the approach used.

What is quality and how is it achieved? Practitioners’ views versus quality models

Background:Quality improvement in healthcare organisations requires structural reorganisation and systems reform, and also the development of an appropriate organisational “culture”. Beliefs and attitudes that are thought by experts to be...

A very public failure: lessons for quality improvement in healthcare organisations from the Bristol Royal Infirmary: Table 1

A very public failure: lessons for quality improvement in healthcare organisations from the Bristol Royal Infirmary: Table 1