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What is quality in medical care?

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https://www.readbyqxmd.com/read/29665585/-outpatient-emergency-care-for-nursing-home-residents-a-status-quo-from-a-nursing-perspective
#1
Markus Bleckwenn, Linnea Bell, Rieke Schnakenberg, Klaus Weckbecker, Manuela Klaschik
AIM OF THE STUDY: At present about 2 million people need care in Germany, about one third of them live in old people's homes or nursing homes. Outpatient emergency care of nursing home residents is ensured by primary care physicians, the medical emergency service and the emergency services. Emergency care has rarely been examined from the perspective of nurses. Therefore, in our study, we investigated how the nurses perceive medical care in medical emergencies and what suggestions for improvements they have...
April 17, 2018: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29664187/exercise-interventions-and-patient-beliefs-for-people-with-hip-knee-or-hip-and-knee-osteoarthritis-a-mixed-methods-review
#2
REVIEW
Michael Hurley, Kelly Dickson, Rachel Hallett, Robert Grant, Hanan Hauari, Nicola Walsh, Claire Stansfield, Sandy Oliver
BACKGROUND: Chronic peripheral joint pain due to osteoarthritis (OA) is extremely prevalent and a major cause of physical dysfunction and psychosocial distress. Exercise is recommended to reduce joint pain and improve physical function, but the effect of exercise on psychosocial function (health beliefs, depression, anxiety and quality of life) in this population is unknown. OBJECTIVES: To improve our understanding of the complex inter-relationship between pain, psychosocial effects, physical function and exercise...
April 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29649250/what-drives-centralisation-in-cancer-care
#3
Melvin J Kilsdonk, Sabine Siesling, Boukje A C van Dijk, Michel W Wouters, Wim H van Harten
BACKGROUND: To improve quality of care, centralisation of cancer services in high-volume centres has been stimulated. Studies linking specialisation and high (surgical) volumes to better outcomes already appeared in the 1990's. However, actual centralisation was a difficult process in many countries. In this study, factors influencing the centralisation of cancer services in the Netherlands were determined. MATERIAL AND METHODS: Centralisation patterns were studied for three types of cancer that are known to benefit from high surgical caseloads: oesophagus-, pancreas- and bladder cancer...
2018: PloS One
https://www.readbyqxmd.com/read/29643170/treatment-options-in-idiopathic-subglottic-stenosis-protocol-for-a-prospective-international-multicentre-pragmatic-trial
#4
Alexander Gelbard, Yu Shyr, Lynne Berry, Alexander T Hillel, Dale C Ekbom, Eric S Edell, Jan L Kasperbauer, David G Lott, Donald T Donovan, C Gaelyn Garrett, Guri Sandhu, James J Daniero, James L Netterville, Josh S Schindler, Marshall E Smith, Paul C Bryson, Robert R Lorenz, David O Francis
INTRODUCTION: Idiopathic subglottic stenosis (iSGS) is an unexplained progressive obstruction of the upper airway that occurs almost exclusively in adult, Caucasian women. The disease is characterised by mucosal inflammation and localised fibrosis resulting in life-threatening blockage of the upper airway. Because of high recurrence rates, patients with iSGS will frequently require multiple procedures following their initial diagnosis. Both the disease and its therapies profoundly affect patients' ability to breathe, communicate and swallow...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29629923/organizational-processes-and-patient-experiences-in-the-patient-centered-medical-home
#5
Jaya Aysola, Marilyn M Schapira, Hairong Huo, Rachel M Werner
BACKGROUND: There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. OBJECTIVE: Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. RESEARCH DESIGN: We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system...
April 6, 2018: Medical Care
https://www.readbyqxmd.com/read/29611148/what-is-the-current-evidence-of-the-impact-on-quality-of-life-whilst-waiting-for-management-treatment-of-orthopaedic-musculoskeletal-complaints-a-systematic-scoping-review
#6
Joanne Morris, Asterie Twizeyemariya, Karen Grimmer
PURPOSE: To describe quality of life (QoL) outcome measures that are reported in the literature in patients waiting for outpatient orthopaedic/musculoskeletal specialist care and how waiting impacts on QoL in these terms. METHODS: A subset of studies reporting on QoL outcome measures were extracted from literature identified in a recent scoping search of Medline, Embase, Pubmed, NHS Economic Evaluation Database (Prospero registration CRD42016047332). The systematic scoping search examined impacts on patients waiting for orthopaedic specialist care...
April 2, 2018: Quality of Life Research
https://www.readbyqxmd.com/read/29591538/quality-measurement-recommendations-relevant-to-clinical-guidelines-in-germany-and-the-united-kingdom-what-can-we-learn-from-each-other
#7
Thomas Petzold, Stefanie Deckert, Paula R Williamson, Jochen Schmitt
We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29581087/improving-health-related-quality-of-life-of-patients-with-an-ostomy-using-a-novel-digital-wearable-device-protocol-for-a-pilot-study
#8
Dara Rouholiman, Jamison G Gamble, Sylvie D Dobrota, Ellen M Encisco, Ashish G Shah, Francisco J Grajales Iii, Larry F Chu
BACKGROUND: Ostomy surgeries involving the placement of an ostomy bag (eg, colostomy, ileostomy, urostomy, etc) have been shown to have a negative impact on health-related quality of life. To date, no studies have been conducted examining what impact, if any, wearable biosensors have on the health-related quality of life of ostomy patients. OBJECTIVE: In the present study, we plan to assess the quality of life of ostomy patients using the Ostom-i alert sensor, a portable, wearable, Bluetooth-linked biosensor that facilitates easier ostomy bag output measurements...
March 26, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29580353/when-hiring-new-trauma-and-surgical-critical-care-fellowship-graduates-what-qualities-are-most-desirable-a-survey-of-trauma-directors-and-trauma-program-administrators
#9
Michael Kalina, Joseph Ferraro, Stephen Cohn
A general surgeon shortage exists and fewer surgical residents specialize in trauma and surgical critical care (TSCC). We conducted a survey of trauma directors and administrators to determine what qualities are most desirable when hiring new TSCC fellowship graduates. METHODS: The survey, entitled "A Survey of Directors of Trauma on Hiring New Attending Trauma Surgeons," was submitted to the Eastern Association for the Surgery of Trauma (EAST) and distributed to the association members in January 2016...
February 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29575924/what-can-we-learn-from-point-of-care-blood-glucose-values-deleted-and-repeated-by-nurses
#10
Dawn Corl, Tom Yin, May Ulibarri, Heather Lien, Tracy Tylee, Jing Chao, Brent E Wisse
BACKGROUND: Hospitals rely on point-of-care (POC) blood glucose (BG) values to guide important decisions related to insulin administration and glycemic control. Evaluation of POC BG in hospitalized patients is associated with measurement and operator errors. Based on a previous quality improvement (QI) project we introduced an option for operators to delete and repeat POC BG values suspected as erroneous. The current project evaluated our experience with deleted POC BG values over a 2-year period...
March 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29566359/does-the-professional-attitude-of-physicians-always-affect-their-professional-behaviour-a-survey-in-tertiary-hospitals-in-nanchang-city-china
#11
Xuan Wang, Xuan Wang, Xin Du, Xin Du, Chenxi Liu, Chenxi Liu, Xinping Zhang, Xinping Zhang
Objective Understanding the effect of professional attitude on professional behaviour is conducive to the development of targeted measures to promote professionalism. The aim of the present study was to explore the effect of professional attitude on professional behaviour. Methods Using a self-reported questionnaire, 212 physicians were surveyed using quota sampling in six tertiary hospitals in Nanchang City. The effect of professional attitude on professional behaviour was analysed through logistic regression analysis...
March 23, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29560060/reduced-computed-tomography-use-in-the-emergency-department-evaluation-of-headache-was-not-followed-by-increased-death-or-missed-diagnosis
#12
Daniel G Miller, Priyanka Vakkalanka, Mark L Moubarek, Sangil Lee, Nicholas M Mohr
Introduction: This study investigated whether a 9.6% decrease in the use of head computed tomography (HCT) for patients presenting to the emergency department (ED) with a chief complaint of headache was followed by an increase in proportions of death or missed intracranial diagnosis during the 22.5-month period following each index ED visit. Methods: We reviewed the electronic medical records of all patients sampled during a quality improvement effort in which the aforementioned decrease in HCT use had been observed...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29548603/-but-perhaps-they-could-reduce-the-suffering-parents-ambivalence-toward-participating-in-forced-peripheral-vein-cannulation-performed-on-their-preschool-aged-children
#13
Edel Jannecke Svendsen, Anne Moen, Reidar Pedersen, Ida Torunn Bjørk
PURPOSE: The purpose of this study was to provide a better understanding of how parents experience the use of restraint during the performance of peripheral vein cannulation (PVC) on their child. DESIGN/METHODS: Qualitative, semi-structured interviews were performed with seven parents and one close relative who had accompanied their 3-5-year-old child while the child resisted the medical procedure of PVC. The analysis was guided by symbolic interactionism and resulted in two themes...
March 13, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29546884/innovation-implementation-in-the-context-of-hospital-qi-lessons-learned-and-strategies-for-success
#14
Pavani Rangachari
In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care...
2018: Innovation and entrepreneurship in health
https://www.readbyqxmd.com/read/29545325/what-can-patients-tell-us-about-the-quality-and-safety-of-hospital-care-findings-from-a-uk-multicentre-survey-study
#15
Jane K O'Hara, Caroline Reynolds, Sally Moore, Gerry Armitage, Laura Sheard, Claire Marsh, Ian Watt, John Wright, Rebecca Lawton
BACKGROUND: Patient safety measurement remains a global challenge. Patients are an important but neglected source of learning; however, little is known about what patients can add to our understanding of safety. We sought to understand the incidence and nature of patient-reported safety concerns in hospital. METHODS: Feedback about the experience of safety within hospital was gathered from 2471 inpatients as part of a multicentre, waitlist cluster randomised controlled trial of an intervention, undertaken within 33 wards across three English NHS Trusts, between May 2013 and September 2014...
March 15, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29530554/-expectations-of-women-with-endometriosis-what-information-to-deliver-cngof-has-endometriosis-guidelines
#16
A Denouel, A Fauconnier, A Torre
Women with endometriosis often say that the information doctors give them should be improved. Patient support groups can provide missing information but may lack objectivity, or reliability, and may even generate anxiety or even harm their health. Clear unbiased medical information is the ideal. New patients with endometriosis wish to be taken seriously by primary care physicians, and be referred quickly to a specialist without further unnecessary investigation or delay. The diagnosis of endometriosis should ideally be made quickly, and should clearly specify the nature of the disease, its evolution, and its consequences on quality of life, relationships, and fertility...
March 9, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29528720/patient-treatment-and-health-care-utilization-variables-associated-with-adherence-to-metabolic-monitoring-practices-in-children-and-adolescents-taking-second-generation-antipsychotics
#17
Mary Coughlin, Catherine Lindsay Goldie, Joan Tranmer, Sarosh Khalid-Khan, Deborah Tregunno
OBJECTIVE: Children and adolescents with a range of psychiatric disorders are increasingly being prescribed atypical or second-generation antipsychotics (SGAs). While SGAs are effective at treating conduct and behavioural symptoms, they infer significant cardiometabolic risk. This study aims to explore what patient, treatment, and health care utilization variables are associated with adherence to Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) metabolic monitoring guidelines...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29525422/-what-does-the-internet-teach-the-obstetric-patient-about-labor-analgesia
#18
Mariana Alves Weiss, Luiz Dal Sochio Junior, Fernando Bliacheriene, Caitriona Murphy, Vinod Chinappa, Maria Jose Carmona, Clarita B Margarido
BACKGROUND AND OBJECTIVES: The general public increased search on the Internet for health information, including Anesthesiology, justifies the study. The objective of this study was to evaluate the information available to the lay person in Portuguese on the internet about labor analgesia for the Brazilian population. METHOD: Using the term "labor anesthesia", the first 20 sites found on Google in November 2014 were evaluated by two resident physicians and classified as medical and non-medical...
March 7, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29514398/relatives-involvement-in-the-care-of-patients-in-acute-medical-wards-in-two-different-countries-an-ethnographic-study
#19
Shadia Alshahrani, Judy Magarey, Alison Kitson
AIMS: To explore the nature of relatives' involvement in the care of patients in acute medical settings in Australia and Saudi Arabia and to explore the perceptions, attitudes and experiences of nurses. BACKGROUND: There is little known about how relatives respond to being involved in patient care and the impact this has on the quality of care. Equally, little is known about how nurses enable such involvement. Previous studies have focused on settings such as critical care and paediatrics where relatives' involvement as advocates is mostly acknowledged and accepted...
March 7, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29513712/impact-of-universal-medical-insurance-system-on-the-accessibility-of-medical-service-supply-and-affordability-of-patients-in-china
#20
Xiaolei Xiong, Zhiguo Zhang, Jing Ren, Jie Zhang, Xiaoyun Pan, Liang Zhang, Shiwei Gong, Si Jin
BACKGROUND: China's universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China. METHODS: Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS...
2018: PloS One
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