Articles: outcome-assessment-health-care.
-
Multicenter Study
Patient expectations of emergency department care: phase II--a cross-sectional survey.
To explore emergency department (ED) patient expectations regarding staff communication with patients, wait times, the triage process and information management. ⋯ ED patient expectations appear to be similar across all triage levels. Patients value effective communication and short wait times over many other aspects of care. They have expectations for short wait times that are met infrequently and are currently unattainable in many Canadian EDs. Although it may be neither feasible nor desirable to meet all patient expectations, increased focus on wait times and staff communication may increase both ED efficiency and patient satisfaction.
-
Multicenter Study Comparative Study
Operative mortality and procedure volume as predictors of subsequent hospital performance.
Despite growing interest in evidence-based hospital referral for selected surgical procedures, there remains considerable debate about which measures should be used to identify high-quality providers. ⋯ Historical measures of operative mortality or procedure volume identify hospitals likely to have better outcomes in the future. The optimal measure for selecting high-quality providers depends on the procedure.
-
Journal of critical care · Mar 2006
Randomized Controlled Trial Multicenter StudyClinical trial design--effect of prone positioning on clinical outcomes in infants and children with acute respiratory distress syndrome.
This paper describes the methodology of a clinical trial of prone positioning in pediatric patients with acute lung injury (ALI). Nonrandomized studies suggest that prone positioning improves oxygenation in patients with ALI/acute respiratory distress syndrome without the risk of serious iatrogenic injury. It is not known if these improvements in oxygenation result in improvements in clinical outcomes. A clinical trial was needed to answer this question. ⋯ This paper describes the process, multidisciplinary input, and procedures used to support the design of the clinical trial, as well as the challenges faced by the clinical scientists during the conduct of the clinical trial.
-
American heart journal · Mar 2006
Multicenter StudyThe Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER)--evaluating the impact of myocardial infarction on patient outcomes.
More information on the longitudinal care and outcomes of patients after myocardial infarction (MI) is needed to further improve the quality of MI care. The PREMIER study was designed to meet this need. ⋯ PREMIER is a novel registry with detailed insights into patients' sociodemographic, clinical, and health status characteristics, as well as detailed monitoring of their inpatient and outpatient processes of care. Ultimately, PREMIER will describe patients' health status outcomes and identify determinants of these outcomes as an important step toward improving MI care.
-
Bmc Musculoskel Dis · Jan 2006
Multicenter StudyTowards standardized measurement of adverse events in spine surgery: conceptual model and pilot evaluation.
Independent of efficacy, information on safety of surgical procedures is essential for informed choices. We seek to develop standardized methodology for describing the safety of spinal operations and apply these methods to study lumbar surgery. We present a conceptual model for evaluating the safety of spine surgery and describe development of tools to measure principal components of this model: (1) specifying outcome by explicit criteria for adverse event definition, mode of ascertainment, cause, severity, or preventability, and (2) quantitatively measuring predictors such as patient factors, comorbidity, severity of degenerative spine disease, and invasiveness of spine surgery. ⋯ Composite measures of disease severity and surgery invasiveness may allow development of risk-adjusted predictive models for adverse events in spine surgery. Standard measures of adverse events and risk adjustment may also facilitate post-marketing surveillance of spinal devices, effectiveness research, and quality improvement.