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Quality and safety in Healthcare

Jihane Sebai
Given the changing needs of the user, the model of public service administration that was once constructed in ignorance of the user and his concerns no longer finds its place. There is therefore mention of a reversal of trends and a modernization of public institutions and structures based on a reflective approach that over-emphasizes the user's place in the system as beneficiary, recipient and partner of the care service. The participation and the viewpoint of the user constitute therefore a very important stake in the improvement of the quality of the care and the evaluation of the health technologies...
September 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Blandine Juillard-Condat, Florence Taboulet
Expiration of patents for biologic drugs allows marketing of biosimilars as copies of reference biologic drugs. The major benefit of biosimilars for health systems relies on the fact that they are likely to bring progress in terms of efficiency and accessibility. Their legal framework is mixed: European for quality, efficiency and safety; national for socio-economic characteristics. At the European level, our analysis highlights a legal and political corpus generally favorable to the development of biosimilars, despite both organizational and structural limits...
July 2018: Journal International de Bioéthique et D'éthique des Sciences
Dorota Raczkiewicz, Jakub Owoc, Jan Krakowiak, Cezary Rzemek, Alfred Owoc, Iwona Bojar
Objective: To examine patient safety culture in primary healthcare centers in Poland. Design: A cross-sectional survey conducted in 2017 using the questionnaire based on the 'Medical Office Survey on Patient Safety Culture' from Agency for Healthcare Research and Quality (AHRQ). Setting: Three hundred thirty-seventy primary healthcare centers in Poland. Participants: Family physician practices in Poland selected from the population of 5400 using systematic random sampling...
February 12, 2019: International Journal for Quality in Health Care
Kerm Henriksen, David Rodrick, Erin N Grace, Marjorie Shofer, P Jeffrey Brady
OBJECTIVES: Despite endorsements for greater use of systems approaches and reports from national consensus bodies calling for closer engineering/health care partnerships to improve care delivery, there has been a scarcity of effort of actually engaging the design and engineering disciplines in patient safety projects. The article describes a grant initiative undertaken by the Agency for of Healthcare Research and Quality that brings these disciplines together to test new ideas that could make health care safer...
February 9, 2019: Journal of Patient Safety
Emma D Quach, Lewis E Kazis, Shibei Zhao, Sarah McDannold, Valerie Clark, Christine W Hartmann
OBJECTIVES: Improving nursing home safety is important to the quality of resident care. Increasing evidence points to the relationship between actual safety and a strong safety climate, i.e., staff agreement about safety norms. This national study focused on Veterans Health Administration nursing homes (Community Living Centers [CLCs]), assessing direct care staff and senior managers' agreement about safety norms. METHODS: We recruited all 134 CLCs to participate in the previously validated CLC Employee Survey of Attitudes about Resident Safety...
February 9, 2019: Journal of Patient Safety
Caterina Offidani, Maria Lodise, Vittorio Gatto, Paola Frati, Stefano D'Errico, Marta Luisa Ciofi Degli Atti, Massimiliano Raponi
INTRODUCTION: Healthcare quality improvements are one of the most important goals to reach a better and safer healthcare system. Reviewing in-hospital mortality data is useful to identify areas for improvement, and to monitor the impact of actions taken to avoid preventable cases, such as those related to healthcare associated infections (HAI). METHODS: In this paper, we present the experience of the Mortality Committee of Bambino Gesù Children Hospital (OPBG)...
February 11, 2019: Current Pharmaceutical Biotechnology
Shefali Haldar, Sonali R Mishra, Maher Khelifi, Ari H Pollack, Wanda Pratt
Healthcare systems worldwide have dedicated several years, special attention, and action toward improving safety for their patients. Although many innovative technological solutions have helped providers reduce medical errors, hospitalized patients lack access to these solutions, and face difficulties in having a proactive role in their safety. In this paper, we examine how patient-peer support can be a valuable resource for patients in the context of hospital safety. Through semi-structured interviews with 30 patients and caregivers at a pediatric and an adult hospital, we identify the potential benefits of incorporating patient-peer support into patient-facing technologies...
2019: Studies in Health Technology and Informatics
Anne W Snowdon
Health systems worldwide are challenged by the growing costs and demands of delivering high-quality healthcare services that are safe and cost-effective to support health and wellness for populations. This paper proposes a system-level transformation of clinical environment infrastructure to advance quality and strengthen patient safety at sustainable costs. Evidence of the impact and value of the clinically integrated supply chain strategy is emerging in three global health systems: Alberta Health Services (Canada), Mercy (US) and the National Health Service (UK) to inform a strategic roadmap for health system leaders to leverage supply chain infrastructure in clinical environments as a strategic asset to strengthen quality, safety and cost...
October 2018: Healthcare Quarterly
Olivia Skrastins, Stephanie Tsotsos, Hammad Aqeel, Anthony Qiang, Jessica Renton, Jo-Anne Howe, Alda Tee, Jason Moller, Nancy M Salbach
BACKGROUND: Healthcare organizations are partnering with recreation organizations to support the delivery of community-based exercise programs for people with balance and mobility limitations. The value and impact of support strategies provided by healthcare organizations, however, have not been examined. OBJECTIVE: Study objectives were to explore fitness coordinators' and fitness instructors' experiences with implementing a task-oriented community-based exercise program for people with balance and mobility limitations within the context of a healthcare-recreation partnership...
February 10, 2019: Disability and Rehabilitation
Michael Conrad Grant, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Christopher L Wu
Enhanced recovery after surgery (ERAS) protocols for gynecologic (GYN) surgery are increasingly being reported and may be associated with superior outcomes, reduced length of hospital stay, and cost savings. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery, which is a nationwide initiative to disseminate best practices in perioperative care to more than 750 hospitals across five major surgical service lines in a 5-year period...
February 7, 2019: Regional Anesthesia and Pain Medicine
M Mella Laborde, M T Gea Velázquez, G M Ramos Forner, A F Compañ Rosique, M Morales Calderón, J M Aranaz Andrés
OBJECTIVE: Creation and validation of a new in-house synthetic scale to measure patient safety culture. MATERIAL AND METHOD: Cross-sectional and descriptive study in which the results of the assessment of the level of safety culture in health and non-health professionals of a university hospital are collected using a new in-house synthetic scale as a measurement tool. It is called 'Questionnaire on patient safety culture in a Spanish speaking environment'. The construction process was carried out in six phases: Bibliographic search; Validation of the structure and content of the questionnaire by a group of experts in patient safety using a nominal group technique; Assumptions verification and exploratory factor analysis; Pilot test to ensure its compression by a convenience sample of expert professionals; Modification of version 1...
February 4, 2019: Journal of healthcare quality research
Jingping Zhao, Kaida Jiang, Qingwei Li, Yanlei Zhang, Yan Cheng, Ziyi Lin, Jianwei Xuan
OBJECTIVES: This study aimed to analyse 1) the cost-effectiveness of olanzapine orally disintegrating tablet (ODT) compared to olanzapine standard oral tablet (SOT) and 2) the cost-effectiveness of olanzapine-SOT compared to aripiprazole-SOT for patients with schizophrenia in China. METHODS: A microsimulation model was adapted from a healthcare payers' perspective. The model ran over a 1-year time horizon, using quarterly cycles. The costs of adverse events were acquired through a clinical expert panel...
February 7, 2019: Journal of Medical Economics
Adriana van Buijtene, Dona Foster
Background: Over 4 million patients acquire a healthcare-associated infection (HCAI) in Europe every year, indicating possible shortcomings in hospitals converting evidence-based infection prevention and control (IPC) strategies into universal adherence. We present a literature review exploring whether insufficient adherence could be culturally based. Aim: To find empirical evidence if and how specific traits of organisational culture improve adherence to IPC strategies utilising HCAI rates as the marker of system failures or successes...
January 2019: Journal of Infection Prevention
Anita A Vashi, Barbara Lerner, Tracy H Urech, Steven M Asch, Martin P Charns
BACKGROUND: The goal of Lean Enterprise Transformation (LET) is to go beyond simply using Lean tools and instead embed Lean principles and practices in the system so that it becomes a fundamental, collective mindset of the entire enterprise. The Veterans Engineering Resource Center (VERC) launched the Veterans Affairs (VA) LET pilot program to improve quality, safety, and the Veteran's experience. A national evaluation will examine the pilot program sites' implementation processes, outcomes and impacts, and abilities to improve LET adoption and sustainment...
February 4, 2019: BMC Health Services Research
Diana M Layne, Lynne S Nemeth, Martina Mueller, Mary Martin
Behaviors that undermine a culture of safety within hospitals threaten overall wellbeing of healthcare workers as well as patient outcomes. Existing evidence suggests negative behaviors adversely influence patient outcomes, employee satisfaction, retention, productivity, absenteeism, and employee engagement. Our objective was to examine the presence of negative behaviors within a healthcare system and the influence of negative behaviors among healthcare workers on perceptions of patient safety culture. Using a cross-sectional design, the negative behaviors in healthcare survey (NBHC) and selected composites of the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPS) were combined within an electronic survey which was administered to physicians, clinical and managerial staff...
February 1, 2019: Healthcare (Basel, Switzerland)
J A Carrasco-Peralta, M Herrera-Usagre, V Reyes-Alcázar, A Torres-Olivera
BACKGROUND: Healthcare accreditation seeks to promote the organisational change in healthcare organisations from an approach that values the level of progress achieved through a validated reference framework. The aim of this paper is to analyse the role played by accreditation through the experience perceived by health professionals during the process of self-assessment and external evaluation, taking into account three dimensions of analysis: focus on the patient, internal organisation and leadership, and impact on the clinical aspects of healthcare...
January 31, 2019: Journal of healthcare quality research
Elisa G Liberati, Carolyn Tarrant, Janet Willars, Tim Draycott, Cathy Winter, Sarah Chew, Mary Dixon-Woods
Maternity care continues to be associated with avoidable harm that can result in serious disability and profound anguish for women, their children, and their families, and in high costs for healthcare systems. As in other areas of healthcare, improvement efforts have typically focused either on implementing and evaluating specific interventions, or on identifying the contextual features that may be generative of safety (e.g. structures, processes, behaviour, practices, and values), but the dialogue between these two approaches has remained limited...
January 24, 2019: Social Science & Medicine
Jan Schjøtt, Olav Spigset
WHAT IS KNOWN AND OBJECTIVE: Appraisal of drug information centres (DICs) is mainly by word of mouth communication and surveys of overall user satisfaction. Efforts to study the impact of this type of informatics and decision support systematically are generally lacking within the healthcare system. COMMENT: Scandinavian DICs question-answering databases are relevant sources for identifying recurring problems in pharmacotherapy, including drug safety questions, and for re-use of previous answers...
February 1, 2019: Journal of Clinical Pharmacy and Therapeutics
David B Bekelman, Christopher E Knoepke, Carolyn Turvey
OBJECTIVE: In seriously ill cardiac patients, several psychotherapy efficacy studies demonstrate little to no reduction in depression or improvement in quality of life, and little is known about how to improve psychotherapies to best address the range of patient needs. An interpersonal and behavioral activation psychotherapy was a key component of the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) multisite randomized clinical trial. Although depressive symptoms did improve in the CASA trial, questions remain about how best to tailor psychotherapies to the needs of seriously ill patient populations...
January 31, 2019: Palliative & Supportive Care
Tara Dimopoulos-Bick, Regina Osten, Chris Shipway, Lyndal Trevena, Tammy Hoffmann
The aim of this study was to identify potential implementation interventions to increase the uptake of shared decision making (SDM) in clinical practice in New South Wales (NSW) Health. The Agency for Clinical Innovation hosted a full-day SDM masterclass in May 2017 and 53 attendees completed a survey to identify barriers to implementing SDM. The Theoretical Domains Framework, COM-B ('capability', 'opportunity', motivation' and 'behaviour') Model and Behaviour Change Wheel were used to conduct a theoretical analysis of the barriers and identify potential interventions to increase the uptake of SDM...
January 31, 2019: Australian Health Review: a Publication of the Australian Hospital Association
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