Healthcare Standards Research Articles

Exploring the implementation of national health and social care standards in Ireland: A qualitative descriptive study.

National health and social care standards are complex, quality improvement interventions. Standards typically describe a process and/or outcome of safe, quality, person-centred care according to best evidence. Currently, there are 11 national standards that apply to diverse services in Ireland including residential centres, acute hospitals and rehabilitation and community inpatient healthcare services. A better understanding of contextual factors influencing implementation will inform decision-making when selecting implementation strategies to enhance the implementation of standards. To explore experiences of implementing national health and social care standards and secondly, to identify enablers and barriers to implementation with stakeholders from across multiple levels of the health system. A qualitative descriptive study. We conducted six focus groups and eight individual interviews from October to November 2021 with stakeholders at system level (n = 14), organizational level (n = 14) and individual level (n = 10). Focus groups and interviews were audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis. Six themes were generated; (1) Top-down, bottom-up, a team approach: everybody together, we are all involved, we are all responsible, (2) Support tools: accessible tools and bite-size material pertaining to standards will support us to implement standards, (3) Empower with knowledge: increase awareness and understanding of standards, make them relatable in practice so we can make sense of them, (4) A system-wide malaise: we do not have the bandwidth to implement standards, (5) Follow the leader: we need a lead person at every level to inspire implementation, (6) A bi-directional influence: we know inspections drive quality improvements but we still feel trepidation around inspection outcomes. Key enablers identified related to teamwork, support tools, leadership and inspections. Key barriers related to workforce issues, a lack of awareness of standards and fear of inspection outcomes. Our findings can be incorporated into strategies to support implementation of standards, ultimately for the benefit of service-users. The enablers and barriers described in this study reflect the importance of organizational factors in the implementation of standards. Interdisciplinary teams can infer from these findings, which enablers and barriers apply to their own context. These findings can inform decision-making when selecting strategies that can be effective in supporting the implementation of standards. We have adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines. No patient or public contribution.

Healthcare Diseases Classification Based on Machine Leaning Algorithms: A Review

Researchers have increasingly focused on applying machine learning algorithms to enhance healthcare operations in the past few years. Machine learning has become increasingly popular and has shown to be a viable strategy for raising the standard of healthcare, preventing disease transmission and early disease detection, reducing hospital operational expenses, aiding government healthcare programs, and enhancing healthcare efficiency. This review offers a succinct and well-structured summary of machine learning research that has been done in the field of healthcare. Specifically, the emphasis is placed on the examination of non-communicable illnesses, which pose a significant risk to public health and rank among the primary contributors to global mortality. Moreover, the COVID-19 pandemic, which is among the world's deadliest illnesses and has recently been formally declared a public health emergency, is included. This study aims to assist health sector researchers in choosing appropriate algorithms. After conducting a comprehensive investigation, it was shown that the Decision Tree (DT), Gaussian Naive Bayes (GNB), and Random Forest (RF), algorithms had the highest performance in healthcare classification, achieving a remarkable accuracy rate of 100%. In most tests, the Random Forest (RF) and Support Vector Machine (SVM) demonstrated consistently better performance

Steady undermining of the UK National Health Service underlies industrial action by doctors and other staff.

Erosion of standard of healthcare in the United Kingdom underlies the industrial action taken recently by staff in the publicly provided National Health Service. Underfunding and understaffing, largely as a consequence of neoliberal government "austerity" policies implemented following the 2007-08 banking crisis, together with lack of long-term planning and a drive towards outsourcing, have led to a deterioration in the quality of services. Reduction in bed numbers and neglect of community and social support have compounded problems by making it more difficult both to admit and to discharge patients in a timely fashion. Access to services has been compromised with negative consequences for the sick. Reduction of doctors' real wages together with stress at work, moral injury caused by feelings of not being able to do the best for patients, burnout from the Covid-19 pandemic and uncertainty about the future have led to the longest ever strike action by junior doctors in England.

The TIPS family psychoeducational group work approach in first episode psychosis and related disorders: 25 years of experiences.

The aim of this paper is to present 25 years of clinical experience with family psychoeducation (FPE) work at Stavanger University Hospital in Norway, highlighting the lessons learned in overcoming implementation barriers in publicly funded specialized mental health care. This retrospective analysis reviews the integration and sustainability of FPE work within the hospital's standard treatment protocols for psychosis, tracing its origins from the Early Treatment and Intervention in Psychosis (TIPS) study (1997-2000) to its current application. The paper examines key strategies for successful implementation, including staff training and resource allocation, as emphasized by international research. Stavanger University Hospital has successfully implemented and maintained both multi- and single-family FPE approaches over the past 25 years. Initially part of the TIPS study, FPE has been integrated into routine clinical practice for treating psychosis and has recently been extended to families of patients with other severe mental disorders. The sustained success at Stavanger University Hospital is attributed to consistent staff training and the prioritization of sufficient resource allocation. The successful and sustainable integration of FPE at Stavanger University Hospital is relatively unique. International guidelines recommend FPE for psychosis, but its implementation remains inconsistent globally, despite over 50 years of supporting evidence. The hospital's experience underscores the critical role of continuous training and dedicated resources in embedding FPE into regular clinical practice. These findings suggest that addressing these areas can significantly enhance the uptake of FPE in other clinical settings. The 25-year experience at Stavanger University Hospital demonstrates that with appropriate training and resources, FPE can be successfully integrated and sustained within standard mental health care practices. This case study provides valuable insights for other institutions aiming to implement FPE and improve treatment outcomes for patients with severe mental disorders.

Experiences of pursuing an intensivist career in regional and rural Australia: An interview study.

The regional and rural intensivist workforce is vital to delivering high standards of healthcare to all Australians. Currently, there is an impending workforce disaster, with higher senior medical officer vacancy rates among regional and rural intensive care units, with these units being staffed by junior doctors who are in earlier stages of their training, which in turn increases supervisory burden. There is a lack of comprehensive literature on the barriers and enablers of training, recruiting and retaining regional and rural intensivists. To address this gap, a qualitative study was conducted, involving 13 in-depth, structured interviews with full-time and part-time intensivists from eight Australian regional and rural hospitals. Content analysis of the interview data resulted in the identification of four major categories: unique practice context, need for a broad generalist skill set, perks and challenges of working in a regional/rural area and workforce implications. The study findings revealed that regional and rural intensive care practice offers positive aspects, including work satisfaction, supportive local teams and an appealing lifestyle. However, these benefits are counterbalanced by challenges such as a heavier burden of on-call work, a higher proportion of junior staff which increase supervisory burden and limited access to subspecialist services. The implications of these findings are noteworthy and can be utilised to inform government policies, hospitals, the College of Intensive Care Medicine and the Australian and New Zealand College of Anaesthetists in developing strategies to enhance the provision of intensive care services and improve workforce planning in regional and rural areas.

The S20 Brazilian Mental Health Report for Building a Just World and a Sustainable Planet: Part II.

This is the second part of the Brazilian S20 mental health report. The mental health working group is dedicated to leveraging scientific insights to foster innovation and propose actionable recommendations for implementation in Brazil and participating countries. In addressing the heightened mental health challenges in a post-pandemic world, strategies should encompass several key elements. This second part of the S20 Brazilian Mental Health Report will delve into some of these elements, including: the impact of climate change on mental health, the influence of environmental factors on neurodevelopmental disorders, the intersection of serious mental illness and precision psychiatry, the co-occurrence of physical and mental disorders, advancements in biomarkers for mental disorders, the utilization of digital health in mental healthcare, the implementation of interventional psychiatry, and the design of innovative mental health systems integrating principles of innovation and human rights. Reassessing the treatment settings for psychiatric patients within general hospitals, where their mental health and physical needs are addressed should be prioritized in mental health policy. As the S20 countries prepare for the future, we need principles that stand to advance innovation, uphold human rights, and strive for the highest standards in mental health care.

Global research trends on the relationship between IBD and CRC: a bibliometric analysis from 2000 to 2023

ObjectiveThis study aimed to conduct a bibliometric analysis of research articles on the relationship between inflammatory bowel disease (IBD) and colorectal cancer (CRC) using CiteSpace to summarize the current research status, hotspots, and trends in this field and present the results visually.MethodResearch articles on the relationship between IBD and CRC published from 2000 to 2023 and in English were selected from the Web of Science Core Collection (Woscc) database. The articles were downloaded as “full record and references”. CiteSpace was used to conduct cooperative, cluster, co-citation, and burst analyses.ResultsThe literature search revealed 4244 articles; of which, 5 duplicates were removed, resulting in the inclusion of 4239 articles in this study. The United States of America had the highest number of publications, with Mayo Clinic and Harvard University being the most active institutions, and Bas Oldenburg being the most active author. Collaboration among core authors was inadequate. JA Eaden was the most cited author, and CRC was the most common keyword. Burst analysis indicated that Sun Yat-sen University might be one of the institutions with a large contribution to this research field in the future. Cluster analysis showed that earlier research focused more on microsatellite instability, whereas “gut microbiota” and “oxidative stress” are considered current research hotspots and trends.ConclusionAt present, the primary focus areas of research are “gut microbiota” and “oxidative stress”. With the improvement of healthcare policies and standards, regular endoscopic monitoring of patients with IBD has become an indispensable diagnostic and therapeutic practice. More drugs will be developed to reduce the risk of progression from IBD to CRC. The findings of this study provide valuable insights into the relationship between IBD and CRC for researchers in the same field.

Education has a significant effect on the performance of implementing nurses in hospitals

Introduction: Higher education typically gives nurses a more profound knowledge of healthcare practices and recent developments and enhances nurses' analytical and problem-solving abilities, enabling them to provide more effective care. Aim: Knowing education significantly affects the performance of implementing nurses in hospitals. Methods: The research design is qualitative analytical descriptive research with a cross-sectional approach. The population is all nurses working in the internal care room, and as many as 50 responses using the sampling technique are total sampling. Results: Showing the chi-square test with the level of meaning (α) = 0.05, obtained p value = 0.003, education significantly influences the implementing nurse's performance. Conclusion: Education significantly influences the performance of implementing nurses, and continuing education can be an effective strategy for improving the standard of health care in hospitals. Nurses with higher education tend to have better clinical knowledge and skills, enabling them to provide higher-quality care.

Expert opinions on improving coercion data collection across Europe: a concept mapping study.

Coercion is frequently used in mental health practice. Since it overrides some patients' fundamental human rights, adequate use of coercion requires legal and ethical justifications. Having internationally standardised datasets to benchmark and monitor coercion reduction programs is desirable. However, only a few countries have specific, open, publicly accessible registries for this issue. This study aims to assemble expert opinions regarding strategies that might be feasible for promoting, developing, and implementing an integrated and differentiated coercion data collection system in Europe at national and international levels. A concept mapping methodology was followed, involving 59 experts from 27 countries in generating, sorting and rating strategies regarding relevance and feasibility. The experts were all researchers and/or practitioner members of an EU-COST-Action focused on coercion reduction Fostering and Strengthening Approaches to Reducing Coercion in European Mental Health Services (FOSTREN). A hierarchical cluster analysis revealed a conceptual map of 41 strategies organized in seven clusters. These clusters fit into two higher-order domains: "Advancing Global Health Research: Collaboration, Accessibility, and Technological Innovations/Advancing International Research" and "Strategies for Comprehensive Healthcare Data Integration, Standardization, and Collaboration." Regarding the action with the higher priority, relevance was generally rated higher than feasibility. No differences could be found regarding the two domains regarding the relevance rating or feasibility of the respective strategies in those domains. The following strategies were rated as most relevant: "Collection of reliable data", "Implementation of nationwide register, including data on coercive measures", and "Equal understanding of different coercive measures". In analysing the differences in strategies between countries and their health prosperity, the overall rating did not differ substantially between the groups. The strategy rated as most relevant was the collection of reliable data in the nationwide health register, ensuring that countries share a standard understanding/definition of different coercive measures. Respondents did not consider the feasibility of establishing a shared European database for coercive measures to be high, nor did they envision the unification of mental health legislation in the future. There is some consensus on the most suitable strategies that can be adopted to enable international benchmarking of coercion in mental health settings.

From Synthesis to Solutions: Hydrogels' Impact on the Biomedical Landscape.

This review aims to examine the hydrogel structure concisely, approaches to hydrogel synthesis, and the most recent progressions in hydrogel technology along with its multifaceted applications within the domain of biomedicine, emphasizing its capacity to transform the delivery of drugs, tissue engineering, and diagnostics. This review employs an organized search of the literature to gather and evaluate state-of-the-art examines on hydrogel uses for biomedicine, synthesizing significant developments and breakthroughs to provide a holistic comprehension of their developing role and possible impact. The review's findings emphasize the revolutionary potential of recent advances in hydrogel uses within biomedicine, which includes improved drug delivery, cutting-edge tissue engineering, and recognized diagnostics. In summary, this scholarly article explores the intricacies of hydrogel structure, methodologies for hydrogel synthesis, and notable breakthroughs in the biomedical utilization of hydrogels. Given the extraordinary potential of hydrogels to transform diagnostic and therapeutic methodologies, this article emphasizes the growing significance of hydrogels in biomedicine and the critical need for further investigation into this subject matter. Consequently, hydrogels can pave the way for enhanced healthcare standards.

Visualization of Effectiveness: The Use of a Set of Colored Cleaning Wipes for Visible Disinfection of Ultrasound Probes

The German health authorities’ guidelines for medical devices in 2012 highlighted the importance of cleaning ultrasound probes, emphasizing their validation and reliability. In addition to automated and validated options, alternative manual methods such as wipe disinfection have gained traction due to their independence from additional hardware. The study examines the effectiveness of a manual cleaning process using wipes, addressing concerns raised by the Robert Koch Institute regarding the lack of validation for wipe disinfection of semi-critical devices. The EQUINOS colored wipe disinfection kit identified wetting gaps in all cleanings across four probes tested. The results indicate significant challenges in ensuring complete surface wetting, particularly in complex device parts such as clip-on areas and fixtures for additional biopsy attachments, suggesting that manual methods alone may not adequately mitigate the risk of infection transmission (p value < 0.0001). The study concludes that while manual disinfection methods are a commonly used alternative to automated reprocessing, there is a critical need for enhanced training and potentially the development of more effective manual disinfection techniques or colored wipes to ensure patient safety and compliance with healthcare hygiene standards.

Practical challenges for mental health services among Rohingya refugee in Bangladesh

Rohingya Muslims have been forcefully displaced from their mother land, Rakhaine State, Myanmar to Bangladesh, a country with about 170 million population with a treatment gap of more than 90% for standard mental health care. Due to the experienced trauma and displacement, high prevalence of depression, anxiety and post-traumatic tress disorders has been identified among Rohingya refugees in addition to the enduring mental health burden of Bangladesh. Very little has been known regarding the practical challenges of mental health services among Rohingya refugees in Bangladesh. In this commentary, we aimed to highlight the practical challenges for mental health services in Rohingya camps in Bangladesh along with our speculative ways forward based on available evidence, work experience, and informal communications. We highlighted the available mental health services, several major challenges including awareness, perception and belief towards mental health, language and cultural barriers, dearth of skilled service providers, inadequate services for severe mental illness, dearth of mental health services for children, inadequate provision of supervision and ‘Care for Caregivers’ program, and privacy and confidentiality of the clients. Although significant improvements have been made in the mental health field in the emergency crisis sector in Cox's Bazar over the past years, concentrated efforts are urgently required to actualize proposed solutions in this paper.

Prison systems must embrace disability rights as a human rights imperative.

For decades, India has been a staunch supporter of the human rights regime. However, lately, its positive role has been jeopardised by glaring instances of human rights violations against prisoners, especially those with disabilities. Since the edifice of the Convention on the Rights of Persons with Disabilities and the subsequent Rights of Persons with Disabilities Act emphasises non-discrimination and reasonable accommodation, our policies, laws, and procedures need to be aligned with the human rights model of disability. We offer insights into the current challenges and propose disability-inclusive prison reforms, advocating for data disaggregation, legislative amendments, accessibility measures, and decision-making autonomy support. Upholding ethical healthcare standards is vital. Adhering to human rights principles and legal mandates in policymaking is crucial to combat systemic injustices and ensure equitable access to justice for all.

A short report on the current landscape of Artificial Intelligence (AI) in vascular surgery in Pakistan.

This study focuses on the current applications, potential, and challenges to Artificial Intelligence (AI) integration in vascular surgery with specific emphasis on its relevance in Pakistan. Despite the benefits of AI in vascular surgery, there is a substantial gap in its adoption in Pakistan compared to global standards. In our context with limited resources and a scarcity of vascular surgeons, AI can serve as a promising solution. It can enhance healthcare accessibility, improve diagnostic accuracy, and alleviate the workload on vascular surgeons. However, hurdles including the absence of a comprehensive vascular surgery database, a shortage of AI experts, and potential algorithmic biases pose significant challenges to AI implementation. Despite these obstacles, the study underscores the imperative for continued research, collaborative efforts, and investments to unlock the full potential of AI and elevate vascular healthcare standards in Pakistan.

Analysis of the Use of Hospital Management Information Systems with Jobs to be Done to Increase Innovation Simplifying Administrative Processes at CHP Hospitals

The Hospital Management Information System (HMIS) must be developed and implemented in every hospital, in accordance with Minister of Health Regulation Number 82 of 2013, to provide the best service to the Indonesian public, the quality of hospital services must be continuously improved. The management of patient information, data, data processing, and all activities related to a good hospital depend heavily on this. It is important to understand how the implementation of the Hospital Management Information System can improve healthcare service standards in Indonesia after its implementation. Thirty-two samples were used in this study, and SEM-PLS data were analyzed using the Jobs To Be Done approach. The findings indicate that human, organizational structure, and system usage within the Hospital Management Information System (HMIS) can enhance healthcare technology innovation by simplifying administration in hospital services.

Troubling Trends in Health Misinformation Related to Gender-Affirming Care.

Amidst the misinformation climate about trans people and their health care that dominates policy and social discourse, autonomy-based rationales for gender-affirming care for trans and nonbinary youth are being called into question. In this commentary, which responds to "What Is the Aim of Pediatric 'Gender-Affirming' Care?," by Moti Gorin, we contextualize the virulent ideas circulating in misinformation campaigns that have become weaponized for unprecedented legal interference into standard health care. We conclude that the current legal justifications for upending gender-affirming care gloss over how this health care field meets conventional evidentiary standards and aligns protocols with most other fields of medicine. Refusal to offer gender-affirming care is more harmful than centralizing trans and nonbinary people's health autonomy.

Excellent Medical Quality and Patient Safety are the Mission and Responsibility of Health Care: Assessment of the Eff and Signifi of Mission Three in Medical Centers

<p>醫學中心「任務三：卓越的醫療品質與病人安全」，以2023年參與醫學中心評鑑之14家參與醫學中心為研究對象，凸顯臺灣醫療機構在追求高品質醫療與病人安全方面的成就。各醫院積極建立管理架構與組織策略，包括成立委員會與小組，推動改善活動。領導系統的強化與主管參與教育訓練促進了品質與安全的執行。教育訓練持續進行與精進，提升醫護人員的意識。品管中心主導和品管圈的推動，促進全院性的參與。內省回饋機制推動根本原因分析與改善措施的落實。資訊科技的應用提高了效率與準確性。大量資源投入於品質與安全活動，並普遍應用資訊智慧化與科技支援。醫院間的分享與合作提升了區域醫療水準。我們臺灣醫療機構通過建構組織架構、推動教育訓練、建置內省回饋機制等方式，持續加強品質文化，提供卓越品質與病安的健康照護，並促進整個區域醫療水準的提升。</p> <p> </p><p>Mission Three: Excellent Medical Quality and Patient Safety- highlights the achievements of 14 competitive medical centers in Taiwan in pursuing high-quality health care and patient safety in 2023. Each hospital actively established management frameworks and organizational strategies, including committees and groups, to promote improvement activities. Strengthening leadership systems and supervisor participation in education and training aided the execution of quality and safety measures. Continuous education and training enhanced the awareness of health-care personnel. The leadership of the Quality Control Center and the promotion of quality control circles fostered participation across the hospital. The introspective feedback mechanism promoted root cause analysis and the implementation of improvement measures. The application of information technology improved efficiency and accuracy. Medical centers invested substantial resources in quality and safety activities, with widespread use of information intelligence and technological support. Sharing and collaboration among hospitals elevated regional health-care standards. Through the construction of organizational frameworks, promotion of education and training, and establishment of introspective feedback mechanisms, Taiwanese medical institutions continuously strengthen their culture of quality, thereby providing excellent health-care quality and patient safety while promoting the enhancement of regional health-care standards.</p> <p> </p>

Bangladeshi Atherosclerosis Biobank and Hub: The BANGABANDHU Study.

Genetic factors contribute significantly to the risk of ischaemic heart disease (IHD), which is the leading cause of mortality in Bangladesh. The BANGABANDHU (Bangladeshi Atherosclerosis Biobank AND Hub) study will allow a hypothesis-free genome-wide association study (GWAS) to identify genetic risk factors associated with ischaemic heart disease patients undergoing coronary artery bypass graft (CABG) surgery in Bangladesh. This is a multi-centre population-based case-control study aimed to evaluate 1500 (Fifteen Hundred) adult (≥18 years of age) people divided into 2 study groups: Case/Proband (750 IHD patients undergoing CABG surgery) and Control (750 healthy people). Spouses or family members are preferred as healthy control subjects due to their shared geographic location and similar environmental exposure. This will be the first largest DNA repository of CABG patients in Bangladesh, and identifying novel gene loci among CABG patients might help to discover novel therapeutic targets for Bangladeshi IHD patients. Further, identifying and comparing novel gene loci among CABG patients with other ancestry might help devise national guidelines for treating coronary artery disease. Promising current study results will encourage Bangladeshi researchers and pharmaceutical companies to conduct further studies into the genetic basis of Bangladeshi complex coronary artery disease, which might identify novel genes for therapeutic targets for Bangladeshi patients and strengthen the healthcare standards in Bangladesh.

Clinical needs and preferences for AI-based explanations in clinical simulation training

ABSTRACT Medical training is a key element in maintaining and improving today's healthcare standards. Given the nature of medical work, students must master not only theory but also develop their hands-on abilities and skills in clinical practice. Medical simulators play an increasing role in supporting the active learning of these students due to their ability to present a large variety of tasks allowing students to train and experiment indefinitely without causing any patient harm. While the criticality of explainable AI systems has been extensively discussed in the literature, the medical training context presents unique user needs for explanations. In this paper, we explore the potential gap of current limitations within simulation-based training, and the role Artificial Intelligence (AI) holds in supporting the needs of medical students in training. Through contextual inquiries and interviews with clinicians in training (N = 9) and subsequent validation with medical experts (N = 4), we obtain an understanding of the shortcomings in current simulation-based training and offer recommendations for future AI-driven training. Our results stress the need for continuous and actionable feedback that resembles the interaction between clinical supervisor and resident in real-world training scenarios while adjusting training material to the residents' skills and prior performance.

Standardization in the health care system and interaction of participants during therapeutical and diagnostic process (literature review)

Standardization in the health care is necessary at all levels, in the field of structure, process, results, which positively affects the quality of medical care. Today, the issues of interaction between participants in the treatment and diagnostic process, both at the level of a medical institution and at the level of the health care system as a whole, have not been fully considered. The purpose of the study: based on the data of current reports and regulatory legal acts on standardization in the health care system, to scientifically substantiate the need to propose mechanisms for improving this process within the framework of effective interaction between participants in the treatment and diagnostic process. This manuscript presents data from scientific publications of such databases as Web of Science, Scopus, The Cochrane Library, MedLine, CyberLeninka, RSCI, etc., as well as official documents related to the regulatory framework governing the standardization process in health care system. As a result of the analysis of scientific publications, official documents of legal regulation; procedures and standards for the provision of medical care; clinical guidelines; medical and economic standards regarding various aspects of standardization in the health care system, data were obtained regarding the current state of the standardization process in health care; provisions were formulated on the need for improvement in this area within the framework of the interaction of participants in the diagnostic and treatment process. The main features of standardization in health care are analyzed and there is a scientific justification for the need to introduce measures to improve it. The development of the most optimal standardization mechanisms in the health care system in the future can significantly improve the quality of management in the health care system and social, medical, economic efficiency.