Bmc Health Serv Res
-
Bmc Health Serv Res · Jan 2012
The effectiveness of a multidisciplinary QI activity for accidental fall prevention: staff compliance is critical.
Accidental falls among inpatients are a substantial cause of hospital injury. A number of successful experimental studies on fall prevention have shown the importance and efficacy of multifactorial intervention, though success rates vary. However, the importance of staff compliance with these effective, but often time-consuming, multifactorial interventions has not been fully investigated in a routine clinical setting. The purpose of this observational study was to describe the effectiveness of a multidisciplinary quality improvement (QI) activity for accidental fall prevention, with particular focus on staff compliance in a non-experimental clinical setting. ⋯ In our study we observed a substantial decrease in patient fall rates and an increase of staff compliance with a newly implemented falls prevention program. A systematized QI approach that closely involves, encourages, and educates healthcare staff at multiple levels is effective.
-
Bmc Health Serv Res · Jan 2012
Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination Database.
Little is known about the effects of professional staffing on cancer surgical outcomes. The present study aimed to investigate the association between cancer surgical outcomes and physician/nurse staffing in relation to hospital volume. ⋯ Well-staffed hospitals confer a benefit for cancer surgical patients regarding reduced FTR, irrespective of hospital volume. These results suggest that consolidation of surgical centers linked with migration of medical professionals may improve the quality of cancer surgical management.
-
Bmc Health Serv Res · Jan 2012
Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System.
While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. ⋯ Older age, male gender, higher chronic comorbidity and higher severity measured by the Risk Mortality Index were associated with higher mortality, but the time to surgery was not.
-
Bmc Health Serv Res · Jan 2012
Implementation of ICD-10 in Canada: how has it impacted coded hospital discharge data?
The purpose of this study was to assess whether or not the change in coding classification had an impact on diagnosis and comorbidity coding in hospital discharge data across Canadian provinces. ⋯ In conclusion, implementation of ICD-10-CA in Canadian provinces did not substantially change coding practices, but there was some coding variation in the average number of diagnoses per hospital visit across provinces.
-
Bmc Health Serv Res · Jan 2012
National Essential Medicines List and policy practice: a case study of China's health care reform.
In 2009, China implemented the national essential medicines system by enacting the National Essential Medicines List 2009. According to the policy of this system, primary health care institutions can only stock and use essential medicines on the prescribed List. Meanwhile, each province can choose to make its own list of supplemented medicines. The goal of the study is to provide suggestions for emerging problems and identify future policy-making trends. ⋯ The structure and selection of the National Essential Medicines List 2009 are relatively reasonable. The main problems, however, include the excessive and non-scientific selection of medicines on the supplemented medicines list. The function of the provincial lists of supplemented medicines has not been achieved, which has influenced the effectiveness of the national essential medicines system in China.