Quality Improvement Of Health Care Services Research Articles

Generating actionable evidence from free-text feedback to improve maternity and acute hospital experiences: A computational text analytics & predictive modelling approach

Abstract Background Patient experience surveys are a key source of evidence for supporting decision-making and quality improvement in healthcare services. These surveys contain two main types of questions: closed and open-ended, asking about patients’ care experiences. Apart from the knowledge obtained from analysing closed-ended questions, invaluable insights can be gleaned from free-text data. Advanced analytics techniques are increasingly used to harness free-text data, yet existing approaches do not offer the rigour required to support formal decision-making through free-text. Methods This study addresses the challenge of effectively and rigorously analysing patients’ free-text feedback to improve maternity and acute hospital services in Ireland. Aspects of healthcare services (i.e. themes) that could be improved were determined using computational text analytics and predictive modelling. Themes extracted from comments were prioritised based on volume, the intensity of negative affect expressed in the texts, and the estimated influence of the themes on overall patient satisfaction. Results Results demonstrate the viability of producing rigorous evidence for prioritising interventions to improve healthcare services based on free-text feedback. Specifically, consistency in advice and support in breastfeeding were among the most important issues for maternity services. For acute hospital services, meals quality and access, A&E waiting time, ward hygiene and communication at discharge were among the most important issues. Women also wanted more emphasis on prior birth experience and complications in future maternity care surveys. Conclusions Advances in computational text modelling enable the extraction of concrete and actionable insights from the analysis of free-text data. This approach also allows decision-makers to prioritise emergent themes and inform actions that will positively impact overall patient satisfaction.

Picture of the employment status of nurses in the world: Scoping review on pros and cons.

Nurses play a vital role in the delivery, quality improvement of healthcare services, and promoting patient health. Therefore, methods of providing nurses are an important issue. This study was conducted to collect evidence on the methods of providing nurses and their advantages and disadvantages by a scoping review method. The Arksey and O'Malley Framework and PRISMA were used in directing the present scoping review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to conduct the review and report on results. The ISI Web of science, PubMed, Scopus, and ProQuest electronic databases were searched for relevant articles published between January 2010 and December 2020 using the keywords and their synonyms. Finally, 19 articles out of 1813 ones to answer the research questions were selected. The results showed that although two general methods are for the employment status of nurses (full-time and part-time nurses), different classification countries are dissimilar from each other. A total of 13 advantages and 20 disadvantages of the part-time pattern and 6 advantages and 4 disadvantages were extracted from the full-time pattern of studies. None of the patterns has precedence over the other. Despite the strengths and weaknesses, each of the full-time or part-time patterns in its position is beneficial. With proper management and planning, it is possible to minimize their weaknesses and benefited from their advantages. Training part-time nurses to maintain and improve their level is a key point in reducing the disadvantages of this pattern.

Clinical governance in general dental practice

Clinical governance as a vital strategy is important for quality improvement in health-care services while protecting staff, patients, and the public. Similarly, such strategies are widely applicable to dental health care and services. In general, clinical governance is a structure in which establishments are responsible for continues improvement of their services using the best standards of care available. The main objective of this study was to conduct an extensive review of literature to identify the efficacy status of clinical governance implementations in general dentistry. A comprehensive review of literature in English language was conducted using PubMed and Emerald databases from 1997 to 2017. Clinical governance, dental services, quality assurance, dental practice, and dental care were used as principal selected keywords. All identified papers were fully assessed and critically evaluated. Evidently, data were very scarce. Eleven relevant articles were selected for data extraction and summary production. Some studies reported a lack of understanding and awareness about how clinical governance can be implemented and how it can influence the dental practice. In response to such concern, others emphasized the importance of professional development through mentorship for successful learning method by dental practitioners. This method has a great potential for improving the quality of dental care and is crucial for the enhancement of dental practice. Excellence in dental clinical practice is best possible by continually improving standards of care through clinical governance. However, supports of dental health educators are immensely required to use mentoring strategies. This would enhance knowledge and confidence in the implementation of clinical governance while dental providers are in clinical practice.

FACTORS ASSOCIATED WITH THE ASSESSMENT ON HEALTH CARE QUALITY AT COMMUNE HEALTH CENTERS IN THUA THIEN HUE PROVINCE

Background: Patient satisfaction is an important indicator of healthcare quality. Better satisfaction is associated with greater adherence to treatment and better health outcomes. Primary care is considered the basic structure of many healthcare systems. Evaluation of healthcare provision is essential in the ongoing assessment and consequent quality improvement of healthcare services. Objective: To describe and analyze the determinants associated with patient assessment and satisfaction in primary care. Methods: The survey was conducted with 519 households and 209 patients at 18 commune health centers. The questionnaire included sociodemographic variables, health status, and use and satisfaction with primary care services. We undertook descriptive analyses, bivariate correlations to study the relationship between levels of satisfaction and the explanatory variables for demographics, health status and health services for households and patients. Results: The majority of households and patients were satisfied with the health care services at primary health care facilities. Satisfaction of waiting time, communication and counseling by healthcare providers was high. We found significant associations between the level of satisfaction and owning health insurance card, the first contact point assigned at CHCs, the severity of illness episodes, and health condition of participants. Conclusions: The results provide evidence on factors that should be taken into account in the planning and development of health policies with respect to the quality and delivery of primary care services in order to enhancing the satisfaction of clients. Key words: consumer satisfaction, patient satisfaction, primary care, quality indicators

Patient partnership in quality improvement of healthcare services: Patients’ inputs and challenges faced

This research focuses on the perception of patients who participated in Continuous Quality Improvement Committees (CIC) regarding their contribution, lessons learned, and challenges encountered. The committees are engaged in a care partnership approach where patients are recognized for their experiential knowledge and treated as full members of the clinical team. Based on patient interviews, we conclude tha experience. They identify themselves as real partners in the care process and are grateful for the opportunity to improve the care provided to other patients by using their own experience and by brin relationship, particularly in terms of communication. They also become better acquainted with the complexity of the health system and its organization. However, their participation in CICs raised two challenges. The availability, as their professional schedules did not always allow them to participate in meetings. The second was their frustration with the slow decision-making process and implementation of necessary measures for quality improvement of healthcare and services. This study highlights the contribution of successful patient participation to quality of care improvement.

Managing healthcare technology in quality management framework

Healthcare services available these days deploy high technology to satisfy both internal and external customers by continuously improving various quality parameters. Quality improvement in healthcare services is a complex and multidimensional task. Although various quality management tools are routinely deployed for identifying quality issues in healthcare delivery, there is absence of an integrated approach, which can identify and analyse issues, provide solutions to resolve those issues and develop a project management framework to implement and evaluate those solutions. This study introduces an integrated and uniform quality management framework for healthcare services. This study uses the Logical Framework Analysis (LFA) to improve the performance of healthcare services. LFA has three major steps problem identification, solution derivation and formation of a planning matrix for implementation and evaluation. LFA has been applied in a case study environment to three acute healthcare services (Operating Room (OR) utilisation, Accident and Emergency (A&E) and intensive care) in order to demonstrate its effectiveness.

Integrated approach to healthcare quality management: a case study

PurposeThe purpose of the paper is to develop an integrated quality management model, which identifies problems, suggests solutions, develops a framework for implementation and helps evaluate performance of health care services dynamically.Design/methodology/approachThis paper uses logical framework analysis (LFA), a matrix approach to project planning for managing quality. This has been applied to three acute healthcare services (Operating room utilization, Accident and emergency, and Intensive care) in order to demonstrate its effectiveness.FindingsThe paper finds that LFA is an effective method of quality management of hospital‐based healthcare services.Research limitations/implicationsThis paper shows LFA application in three service processes in one hospital. However, ideally this is required to be tested in several hospitals and other services as well.Practical implicationsIn the paper the proposed model can be practised in hospital‐based healthcare services for improving performance.Originality/valueThe paper shows that quality improvement in healthcare services is a complex and multi‐dimensional task. Although various quality management tools are routinely deployed for identifying quality issues in health care delivery and corrective measures are taken for superior performance, there is an absence of an integrated approach, which can identify and analyze issues, provide solutions to resolve those issues, develop a project management framework (planning, monitoring, and evaluating) to implement those solutions in order to improve process performance. This study introduces an integrated and uniform quality management tool. It integrates operations with organizational strategies.

Innovation management using logical framework in hospital-based healthcare units

Innovation is part and parcel of any service in today's environment, so as to remain competitive. Quality improvement in healthcare services is a complex, multi-dimensional task. This study proposes innovation management in healthcare services using a logical framework. A problem tree and an objective tree are developed to identify and mitigate issues and concerns. A logical framework is formulated to develop a plan for implementation and monitoring strategies, potentially creating an environment for continuous quality improvement in a specific unit. We recommend logical framework as a valuable model for innovation management in healthcare services. Copyright © 2006 Inderscience Enterprises Ltd.