Bmc Health Serv Res
-
Bmc Health Serv Res · Jan 2014
Development of a technical assistance framework for building organizational capacity of health programs in resource-limited settings.
Little information exists on the technical assistance needs of local indigenous organizations charged with managing HIV care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper describes the methods used to adapt the Primary Care Assessment Tool (PCAT) framework, which has successfully strengthened HIV primary care services in the US, into one that could strengthen the capacity of local partners to deliver priority health programs in resource-constrained settings by identifying their specific technical assistance needs. ⋯ A systematic adaptation process has produced a qualitative framework that can inform implementation strategies in support of country led HIV care and treatment programs. The framework, as a well-received iterative process focused on technical assistance, may have broader utility in other global programs.
-
Bmc Health Serv Res · Jan 2014
Observational StudyWorkflow interruptions and mental workload in hospital pediatricians: an observational study.
Pediatricians' workload is increasingly thought to affect pediatricians' quality of work life and patient safety. Workflow interruptions are a frequent stressor in clinical work, impeding clinicians' attention and contributing to clinical malpractice. We aimed to investigate prospective associations of workflow interruptions with multiple dimensions of mental workload in pediatricians during clinical day shifts. ⋯ The findings provide insights into specific pathways between different types of interruptions and pediatricians' mental workload. These findings suggest further research and yield a number of work and organization re-design suggestions for pediatric care.
-
Bmc Health Serv Res · Jan 2014
A short generic patient experience questionnaire: howRwe development and validation.
Patient experience is a key quality outcome for modern health services, but most existing survey methods are long and setting-specific. We identified the need for a short generic questionnaire for tracking patient experience. ⋯ howRwe meets the criteria for a short generic patient experience questionnaire that is suitable for frequent use. In the validation study of PAC patients, it showed good psychometric properties and concurrent, construct and discriminant validity.
-
Bmc Health Serv Res · Jan 2014
Consensus on quality indicators to assess the organisation of palliative cancer and dementia care applicable across national healthcare systems and selected by international experts.
Large numbers of vulnerable patients are in need of palliative cancer and dementia care. However, a wide gap exists between the knowledge of best practices in palliative care and their use in everyday clinical practice. As part of a European policy improvement program, quality indicators (QIs) have been developed to monitor and improve the organisation of palliative care for patients with cancer and those with dementia in various settings in different European countries. ⋯ International experts selected a set of 23 QIs for the organisation of palliative care. Although we particularly focused on the organisation of cancer and dementia palliative care, most QIs are generic and are applicable for other types of diseases as well.
-
Bmc Health Serv Res · Jan 2014
Evaluation of a regional ST-elevation myocardial infarction primary percutaneous coronary intervention program at the Rouge Valley Health System.
ST-elevation myocardial infarction (STEMI) remains the second leading cause of death in Canada. Primary percutaneous coronary intervention (PCI) has been recognized as an effective method for treating STEMI. Improved access to primary PCI can be achieved through the implementation of regional PCI centres, which was the impetus for implementing the PCI program in an east Toronto hospital in 2009. As such, the purpose of this study was to measure the efficacy of this program regional expansion. ⋯ The findings suggest that the partnership between the hospital and its EMS partners should be continued, and paramedic initiated referral should be expanded across Canada and EMS systems where feasible, as this level of coverage does not currently exist nationwide. Investments in regional centres of excellence and the creation of EMS partnerships are needed to enhance access to primary PCI.