Bmc Health Serv Res
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Bmc Health Serv Res · Jan 2013
Improving the quality of palliative and terminal care in the hospital by a network of palliative care nurse champions: the study protocol of the PalTeC-H project.
The quality of care of patients dying in the hospital is often judged as insufficient. This article describes the protocol of a study to assess the quality of care of the dying patient and the contribution of an intervention targeted on staff nurses of inpatient wards of a large university hospital in the Netherlands. ⋯ With this study we aim to improve the understanding of and attention for patients' needs, and the quality of care in the dying phase in the hospital and measure the impact of a quality improvement intervention targeted at nurses.
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Bmc Health Serv Res · Jan 2013
Barriers and enablers to implementing multiple stroke guideline recommendations: a qualitative study.
Translating evidence into practice is an important final step in the process of evidence-based practice. Medical record audits can be used to examine how well practice compares with published evidence, and identify evidence-practice gaps. After providing audit feedback to professionals, local barriers to practice change can be identified and targetted with focussed behaviour change interventions. This study aimed to identify barriers and enablers to implementing multiple stroke guideline recommendations at one Australian stroke unit. ⋯ Findings add to current knowledge about barriers to change and implementation of multiple guideline recommendations. Major challenges included sexuality education and depression screening. Limited knowledge and skills was a common barrier. Knowledge about specific interventions was needed before implementation could commence, and to maintain treatment fidelity. The provision of detailed online intervention protocols and manuals may help clinicians to overcome the knowledge barrier.
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Bmc Health Serv Res · Jan 2013
Applicability of a previously validated readmission predictive index in medical patients in Singapore: a retrospective study.
Hospital readmissions are serious and costly events, and readmission rates are considered to be an indicator of quality in health care management. Several models to identify patients at risk of unplanned readmissions have been developed in Western countries, but little is known about their performance in other countries. This paper reports the possible utility of one such model developed in Canada, the LACE index, in patients in a tertiary hospital in Singapore. ⋯ The use of the LACE index may have significant application in identifying medical patients at high risk of readmission and visits to the Emergency Department in Singapore.
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Bmc Health Serv Res · Jan 2013
High and low-risk specialties experience with the U.S. medical malpractice system.
"High-liability risk specialties" tend to be the focus of medical malpractice system research and debate, but concerns and fears are not limited to this group. The objective of this study was to examine whether "high-liability risk" medical specialties have a different experience with the malpractice system than "low-liability risk" specialties. ⋯ Malpractice risk exists for all specialties. Variability in indemnity costs are found in both high- and low-liability risk specialties. Differences in the reasons for which claims are initiated for high- and low-liability risk specialties likely necessitate different risk management solutions.
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Bmc Health Serv Res · Jan 2013
The impact of economic factors on migration considerations among Icelandic specialist doctors: a cross-sectional study.
Globalization has facilitated the employability of doctors almost anywhere in the world. In recent years, the migration of doctors seems to have increased. However, we lack studies on doctors' migration from developed countries. Because the economic recession experienced by many countries might have affected the migration of doctors, research on this topic is important for the retention of doctors. Iceland was hit hard by the economic recession in 2008. Therefore, we want to explore how many specialist doctors in Iceland have considered migrating and whether economic factors at work and in private life, such as extensive cost-containment initiatives at work and worries about personal finances, are related to doctors' migration considerations. ⋯ Economic factors affect whether specialist doctors in Iceland consider migration. More studies on the effect of economic recession on migration by doctors are needed.