Bmc Health Serv Res
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Bmc Health Serv Res · Jan 2008
Comparative StudyComparative indicators for cancer network management in England: availability, characteristics and presentation.
In 2000, the national cancer plan for England created 34 cancer networks, new organisational structures to coordinate services across populations varying between a half and three million people. We investigated the availability of data sets reflecting measures of structure, process and outcome that could be used to support network management. ⋯ While not as yet used together in practice, comparative indicators are available within the National Health Service in England for use in performance assessment by cancer networks.
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Bmc Health Serv Res · Jan 2008
Is theatre utilization a valid performance indicator for NHS operating theatres?
Utilization is used as the principal marker of theatre performance in the NHS. This study investigated its validity as: a managerial tool, an inter-Trust indicator of efficient theatre use and as a marker of service performance for surgeons. ⋯ Theatre utilization broadly reflects the surgical volume successfully admitted and operated on elective lists. At extreme values it can expose administrative process failure within individual Trusts but probably lacks specificity for meaningful use as an inter-Trust theatre performance indicator. Unadjusted utilization rates fail to reflect the service performance of surgeons, as their ability to influence it is small.
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Bmc Health Serv Res · Jan 2008
Insights about the process and impact of implementing nursing guidelines on delivery of care in hospitals and community settings.
Little is known about the impact of implementing nursing-oriented best practice guidelines on the delivery of patient care in either hospital or community settings. ⋯ Implementation of nursing best practice guidelines can result in improved practice and patient outcomes across diverse settings yet many indicators remained unchanged. Mobilization of the nursing workforce to actively implement guidelines and to monitor the delivery of their care is important so that patients may learn about and receive recommended healthcare.
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Bmc Health Serv Res · Jan 2008
Perceived barriers to the regionalization of adult critical care in the United States: a qualitative preliminary study.
Regionalization of adult critical care services may improve outcomes for critically ill patients. We sought to develop a framework for understanding clinician attitudes toward regionalization and potential barriers to developing a tiered, regionalized system of care in the United States. ⋯ Regionalization efforts will be met with significant conceptual and structural barriers. These data provide a foundation for future research and can be used to inform policy decisions regarding the design and implementation of a regionalized system of critical care.
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Bmc Health Serv Res · Jan 2008
The impact of adverse events in the intensive care unit on hospital mortality and length of stay.
Adverse events (AEs) are patient injuries caused by medical care. Previous studies have reported increased mortality rates and prolonged hospital length of stay in patients having an AE. However, these studies have not adequately accounted for potential biases which might influence these associations. We performed this study to measure the independent influence of intensive care unit (ICU) based AEs on in-hospital mortality and hospital length of stay. ⋯ The impact of AEs on hospital length of stay was clinically relevant. Larger studies are needed to conclusively measure the association between preventable AEs and patient outcomes.