scholarly journals Surgery and trauma care providers' perception of the impact of dual-practice employment on quality of care provided in an Andean country

2017 ◽  
Vol 104 (6) ◽  
pp. 704-709 ◽  
Author(s):  
L. N. LaGrone ◽  
L. N. Isquith-Dicker ◽  
E. Huaman Egoavil ◽  
J. J. Herrera-Matta ◽  
A. K. Fuhs ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Trauma Care ◽  
Care Providers ◽  
Dual Practice ◽  
Andean Country ◽  
The Impact

scholarly journals Online public reactions to frequency of diagnostic errors in US outpatient care

Diagnosis ◽  
2016 ◽  
Vol 3 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Traber Davis Giardina ◽  
Urmimala Sarkar ◽  
Gato Gourley ◽  
Varsha Modi ◽  
Ashley N.D. Meyer ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Diagnostic Errors ◽  
News Article ◽  
Care Providers ◽  
Qualitative Researcher ◽  
Related Quality ◽  
The Impact

AbstractDiagnostic errors pose a significant threat to patient safety but little is known about public perceptions of diagnostic errors. A study published inWe searched the World Wide Web for any news article reporting findings from the study. We then gathered all the online comments made in response to the news articles to evaluate public reaction to the newly reported diagnostic error frequency (n=241). Two coders conducted content analyses of the comments and an experienced qualitative researcher resolved differences.Overall, there were few comments made regarding the frequency of diagnostic errors. However, in response to the media coverage, 44 commenters shared personal experiences of diagnostic errors. Additionally, commentary centered on diagnosis-related quality of care as affected by two emergent categories: (1) US health care providers (n=79; 63 commenters) and (2) US health care reform-related policies, most commonly the Affordable Care Act (ACA) and insurance/reimbursement issues (n=62; 47 commenters).The public appears to have substantial concerns about the impact of the ACA and other reform initiatives on the diagnosis-related quality of care. However, policy discussions on diagnostic errors are largely absent from the current national conversation on improving quality and safety. Because outpatient diagnostic errors have emerged as a major safety concern, researchers and policymakers should consider evaluating the effects of policy and practice changes on diagnostic accuracy.

scholarly journals Protocol: Improving Access to Specialist Nephrology Care Among Rural/Remote Dwellers of Alberta: The Role of Electronic Consultation in Improving Care for Patients With Chronic Kidney Disease

2019 ◽  
Vol 6 ◽  
pp. 205435811987871
Author(s):  
Aminu Bello ◽  
Deenaz Zaidi ◽  
Branko Braam ◽  
Mark Courtney ◽  
Jodi Glassford ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Access To Care ◽  
Care Delivery ◽  
Care Quality ◽  
Care Providers ◽  
Practice Facilitation ◽  
Specialist Care ◽  
Nephrology Care ◽  
The Impact

Background: As the burden of chronic kidney disease (CKD) continues to increase, many geographically dispersed Canadians have limited access to specialist nephrology care, which tends to be centralized in major urban areas. As a result, many rural/remote-dwellers in Canada experience poor quality of care and related adverse outcomes. It is imperative to develop alternative care delivery mechanisms to ensure optimal health outcomes for all Canadians. Objective: To investigate the feasibility and effectiveness of electronic consultation (eConsult) as a new model for interactions between specialists and primary care providers (PCPs) to improve access to care for patients with CKD. Design: This is a sequential, mixed methods study that will be conducted in 3 phases. Setting: The study will be conducted across the entire province of Alberta, supported by Alberta Kidney Care (formerly, Northern and Southern Alberta Renal Programs [NARP/SARP]). Patients: Patients suffering from CKD will be included in the study. Measurements: We will assess the barriers and enablers of implementation and adoption of an e-consultation protocol to facilitate access to care for patients with CKD in Alberta with a focus on rural/remote-dwellers with CKD. We will also evaluate the impact of the eConsult system (eg, improved access to specialist care, reduction in care gaps), assess the feasibility of province-wide implementation, and compare eConsult with practice facilitation versus eConsult alone in terms of access to specialist care, quality of care, and related outcomes. Methods: The study will be conducted in 3 phases. In phase 1, we will assess the perceptions of stakeholders (ie, PCPs, nephrologists, patients, policymakers, and other care providers) to improve CKD care delivery, quality, and outcomes in Alberta with focus groups and semistructured interviews. Phase 2 will engage specific family physicians for their input on key factors and logistical issues affecting the feasibility of implementing eConsult for the care of patients with CKD. Phase 3 will provide academic detailing including practice facilitation to clinics in Alberta to assess how eConsult with practice facilitation compares with eConsult alone in terms of access to specialist care, quality of care, and related outcomes. Results: We will assess stakeholder perceptions about potential barriers to and enablers of a new eConsult and decision support system strategy, focusing on elements that are most important for the design of a feasible and implementable intervention. We will develop, pilot test, and assess the impact of the eConsult model in improving access to specialist nephrology care and the feasibility of province-wide implementation. The final phase of the project will address key challenges for optimal care for patients with CKD living in rural, remote, and underserved areas of Alberta, particularly timely referral and disease management as well as the cost-effective benefits of eConsult. Limitations: Lack of high-speed Internet in many rural and remote areas of Alberta may lead to more time spent in completing the eConsult request online versus faxing a referral the traditional way. Allied health care staff (referral coordinators, administrative staff) require training to the eConsult system, and physicians at many remote sites do not have adequate staff to handle eConsult as an added task. Conclusions: Implementation of eConsult can favorably influence referral patterns, access to care, care quality, patient outcomes, and health care costs for people with CKD. Results of this study will inform the optimization of care for rural/remote-dwellers with CKD and will facilitate future partnerships with policymakers and provincial renal programs in Alberta to ensure optimal kidney health for all residents. Trial registration: Not required.

The Impact of Primary Care Dual-Management on Quality of Care

2011 ◽  
Vol 3 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Peter J. Kaboli ◽  
Daniel M. Shivapour ◽  
Michael S. Henderson ◽  
Areef Ishani ◽  
Mary E. Charlton
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Hemoglobin A1c ◽  
Ldl Cholesterol ◽  
Primary Care Providers ◽  
Care Quality ◽  
Care Providers ◽  
Dual Management ◽  
The Impact

Background: Discontinuity is common in US healthcare. Patients access multiple systems of care and in the nation’s largest integrated healthcare system, Veteran’s Administration (VA) patients frequently use non-VA primary care providers. The impact of this “dual-management” on quality is unknown. The authors’ objective was to identify dual-management and associations with markers of care quality for hypertension and associated conditions. Methods: Data was collected via surveys and chart reviews of primary care patients with hypertension from six VA clinics in Iowa and Minnesota. Clinical measures abstracted included the following: goal blood pressure (BP) and use of guideline-concordant therapy, low-density lipoprotein (LDL) cholesterol, hemoglobin A1C, and body mass index (BMI). Dual-management data was obtained through self-report. Results: Of 189 subjects (mean age = 66), 36% were dual-managed by non-VA providers. There was no difference in hypertension quality of care measures by dual-management status. A total of 51% were at BP goal and 58% were on guideline-concordant therapy. Dual-managed patients were more likely to use thiazide diuretics (43% vs 29%; P = .03) and angiotensin receptor blockers (13% vs 3%; P < .01), but less likely to use angiotensin-converting enzyme inhibitors (43% vs 61%; P = .02). There was no difference in LDL cholesterol (97.1 mg/dl vs 100.1 mg/dl; P = .55), hemoglobin A1C (7% vs 6%; P = .74), or BMI (29.8 vs 30.9; P = .40) for dual-managed versus VA managed patients, respectively. Conclusions: Although dual-management may decrease continuity, VA/private sector dual-management did not impact quality of care, though some medication differences were observed. With the high prevalence of dual-management, future work should further address quality and evaluate redundancy of services.

Quality of Care for Patients With Diabetes and Mulitmorbidity Registered at Nurse Practitioner-Led Clinics

2017 ◽  
Vol 50 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Roberta Heale ◽  
Elizabeth Wenghofer ◽  
Susan James ◽  
Marie-Luce Garceau
Keyword(s):  
Quality Of Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Diabetes Care ◽  
Primary Care Providers ◽  
Organizational Characteristics ◽  
Care Providers ◽  
Patients With Diabetes ◽  
The Impact

Background Nurse Practitioner-Led Clinics are a new model of primary healthcare in Ontario. Nurse Practitioner-Led Clinics are distinctive in that nurse practitioners are the primary care providers working with an interprofessional team. There have been no evaluations of the quality of care within the Nurse Practitioner-Led Clinic model. Purpose Evaluation of the Nurse Practitioner-Led Clinic model, specifically for complex clinical presentations, will provide insights that may be used to inform improvements to the delivery of care in the Nurse Practitioner-Led Clinics. The aim of this study was to evaluate the extent to which diabetes care was complete and to determine the impact of organizational tools, including electronic medical record tracking, diabetes care template, and referral to community programs, on the completeness of care for patients with diabetes and multimorbidity at Nurse Practitioner-Led Clinics. Methods An audit of 30 charts was conducted at five different Nurse Practitioner-Led Clinics (n = 150) for patients with diabetes and at least one other chronic condition. Indicators included patient and organizational characteristics as well as diabetes care items taken from diabetes clinical guidelines. Results Overall, care for patients with diabetes and multimorbidity in Nurse Practitioner-Led Clinics was complete. However, there were no significant associations between patient or organizational characteristics and the extent to which diabetes care was complete.

A study of deficiencies in teamwork skills among Jordan caregivers

2018 ◽  
Vol 31 (4) ◽  
pp. 350-360 ◽  
Author(s):  
Omar Al-Araidah ◽  
Nader Al Theeb ◽  
Mariam Bader ◽  
Nabeel Mandahawi
Keyword(s):  
Quality Of Care ◽  
Leadership Skills ◽  
Training Needs ◽  
Care Providers ◽  
Content Type ◽  
Team Members ◽  
Low Levels ◽  
Teamwork Skills ◽  
The Impact

Purpose The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire. Design/methodology/approach A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members. Surveyed care providers included physicians, nursing and anesthesiologists operating in emergency departments, surgical operating rooms and intensive care units from various hospitals. Findings With a response rate of 78.8 percent, statistical analysis of collected data of opposing staff members revealed low levels of satisfaction (40.7-48 percent opposing), lack of awareness on the impact of teamwork on quality of care (15.6-22.1 percent opposing), low levels of involvement of top management (27.1-57.3 percent opposing), lack of training (52.5-69.8 percent opposing), lack of leadership skills (29.8-60 percent opposing), lack of communication (22.3-62.1 percent opposing), lack of employee involvement (37.6-50.8 percent opposing) and lack of collaboration among team members (28.6-50 percent opposing). Among the many, results illustrate the need for improving leadership skills of team leaders, improving communication and involving team members in decision making. Originality/value Several studies investigated relationships between teamwork skills and quality of care in many countries. To the authors’ knowledge, no local study investigated the deficiencies of teamwork skills among Jordan caregivers and its impact on quality of care. The study provides the ground for management at Jordan hospitals and to healthcare academic departments to tailor training courses to improve teamwork skills of caregivers. Data of this study are collected from the society who is working in the field of healthcare. As the results of this are produced from a real data, it is expected that applying the recommendations will impact the society positively by enhancing the patients’ satisfaction.

Provider Payment and Incentives

2011 ◽  
pp. 623-648 ◽  
Author(s):  
Jon B. Christianson ◽  
Douglas Conrad
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Financial Incentives ◽  
Empirical Literature ◽  
Care Providers ◽  
Payment Incentives ◽  
Provider Payment ◽  
The Impact

The design of incentives and the evaluation of their impact are examined in the research literature at many different levels. This article provides a background and a conceptual framework relating to the effects of payment incentives on the behavior of health care providers. It then summarizes the empirical literature on the effect of financial incentives in health care. The article offers a conceptual model of the provider's choice of the quantity and quality of output as a means of organizing our thinking about the effects of specific provider payment incentives. This article addresses the effect of general provider payment incentives on the amount and type of care provided; the evidence that general payment incentives have indirectly affected quality of care; and the impact of payment incentive programs that attempt specifically to reward providers for improving quality of care, or for achieving specific benchmark levels of quality.

Surgeons’ and Trauma Care Physicians’ Perception of the Impact of the Globalization of Medical Education on Quality of Care in Lima, Peru

JAMA Surgery ◽  
2017 ◽  
Vol 152 (3) ◽  
pp. 251 ◽  
Author(s):  
Lacey N. LaGrone ◽  
Leah N. Isquith-Dicker ◽  
Eduardo Huaman Egoavil ◽  
Manuel J. A. Rodriguez Castro ◽  
Alfredo Allagual ◽  
...  
Keyword(s):  
Medical Education ◽  
Quality Of Care ◽  
Trauma Care ◽  
The Impact

scholarly journals Who needs patient satisfaction surveys? Perspectives of Polish doctors, nurses, and patients

2015 ◽  
Vol 125 (2) ◽  
pp. 72-76
Author(s):  
Ludmiła Marcinowicz ◽  
Renata Sierżantowicz ◽  
Agnieszka Dudzik ◽  
Jolanta Sawicka-Powierza ◽  
Zbysław Grajek ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Quality Of Health Care ◽  
Care Delivery ◽  
Care Providers ◽  
The Impact ◽  
Satisfaction Surveys

Abstract Introduction. Patient satisfaction surveys are still popular tools for obtaining feedback on the quality of health care. Nonetheless, there is a paucity of data to indicate whether health care providers even want patients to assess the quality of care delivered. Neither it is certain whether patients are interested in participating in such surveys. Aim. To present and compare the perspectives of doctors, nurses, and patients on the validity of health care customer satisfaction surveys. Material and methods. A cross-sectional survey design was used. The questionnaires were administered to doctors, nurses and patients in three hospitals of different sizes (small, medium, and large), all in the north-east of Poland. Each sample group was given 200 questionnaires; responses were received from 95 doctors (47.5%), 190 nurses (95%), and 182 patients (91%), and included in the final analyses. Results. Most respondents (doctors - 64.2%; nurses - 61.6%; patients - 87.4%) answered ‘Yes’ to the question ‘Do you think that patients should evaluate the quality of health care?’ Analysis of data allowed to identify the following main reasons why patients should evaluate the quality of health care: 1. to enhance the quality of care; 2. to recognise patients as evaluators; 3. to motivate providers to work more efficiently; and 4. to emphasise the impact of evaluation on a core value, i.e. health. Doctors and nurses outlined reasons why they did not advocate conducting patient satisfaction surveys: satisfaction surveys are redundant; negative evaluations; unwillingness to be evaluated by patients; satisfaction surveys hamper effective work with patients; surveys are not objective; survey results are not communicated to providers. Conclusions. Patient satisfaction surveys are desirable tools for evaluating the quality of health care delivery despite the fact that they frequently raise concerns amongst providers and patients. There is, therefore, a definite need for providers to experience the benefits of measuring patient satisfaction. Another important practical implication is that patients need to be convinced that their opinions do matter and contribute to improving the quality of services.

scholarly journals Too few staff, too many patients: a qualitative study of the impact on obstetric care providers and on quality of care in Malawi

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Susan Bradley ◽  
Francis Kamwendo ◽  
Effie Chipeta ◽  
Wanangwa Chimwaza ◽  
Helen de Pinho ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Qualitative Study ◽  
Obstetric Care ◽  
Care Providers ◽  
Obstetric Care Providers ◽  
The Impact

The reciprocity of the quality of care providers' occupational life of and the quality of care: A cycle model

2013 ◽  
Author(s):  
Marco Ferrara ◽  
Sara Viotti ◽  
Daniela Converso ◽  
Valentina Trotta ◽  
Gloria Guidetti ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Care Providers ◽  
Cycle Model ◽  
Occupational Life
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