Qual Saf Health Care
-
Qual Saf Health Care · Dec 2010
A patient-centred instrument for assessment of quality of breast cancer care: results of a pilot questionnaire.
In several breast cancer research environments, there was a need to develop a questionnaire that would (1) provide data on how breast cancer patients experience healthcare services, (2) address issues corresponding with patients' needs and expectations and (3) produce useful data for quality assessment and improvement projects aimed at breast cancer care. This article describes the first part of the quantitative process of item selection, instrument construction and optimisation based on the results of a pilot questionnaire. ⋯ In this study, the number of items to be included in the self-administered questionnaire was reduced. The resulting set of items that determines patients' perceptions on quality of breast cancer care is easy to complete and enables anonymous responses. Further research can be aimed at establishing the reliability of the current questionnaire.
-
Qual Saf Health Care · Dec 2010
Pneumococcal vaccination process improvement in an acute care setting.
Despite the availability of the pneumococcal vaccine since 1977, the vaccine is greatly underutilised. Centers for Medicare and Medicaid Services, The Joint Commission and Healthy People 2010 have all listed the administration of the pneumococcal vaccine before hospital discharge as a standard of care and a quality initiative in the 21st century. SSM St Mary's Health Center chartered a multidisciplinary team to address a disappointing pneumococcal vaccination rate of 34.7% in the first quarter of 2005. ⋯ Utilising Plan-Do-Study-Act allows for continual improvement of the vaccination process. Multiple cycles are necessary to achieve standardisation and optimal process flow.
-
Qual Saf Health Care · Dec 2010
ReviewQuality assessment of clinical practice guidelines in perioperative care: a systematic appraisal.
Surgical care is an important burden in healthcare, and the complications and harm related to surgery are of special concern. Clinical practice guidelines in perioperative care should provide the opportunity to minimise these risks and improve surgical outcomes, but their quality has not yet been evaluated systematically. ⋯ The quality of guidelines for perioperative care is moderate. Measures should be taken to guarantee that CPGs are based on the best available evidence and rigorously developed and reported. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.
-
Qual Saf Health Care · Dec 2010
Acute care practices relevant to quality end-of-life care: a survey of Pennsylvania hospitals.
Improving end-of-life care in the hospital is a national priority. ⋯ There is low penetration of hospital practices relevant to quality end-of-life care in Pennsylvania acute care hospitals. Our results may serve to inform the development of future benchmark goals. It is critical to establish a strong evidence base for the practices most associated with improved end-of-life care outcomes and to develop quality measures for end-of-life care to complement existing hospital quality measures that primarily focus on life extension.
-
Qual Saf Health Care · Dec 2010
The impact of shift patterns on junior doctors' perceptions of fatigue, training, work/life balance and the role of social support.
The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. ⋯ The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.