scholarly journals Gynaecological day surgery and quality of care

2002 ◽  
Vol 25 (3) ◽  
pp. 52 ◽  
Author(s):  
Milica Markovic ◽  
Mridula Bandypadhyay ◽  
Trang Vu ◽  
nad Lenore Manderson
Keyword(s):  
Quality Of Care ◽  
Hospital Admission ◽  
Public Hospital ◽  
Telephone Survey ◽  
Day Surgery ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Public And Private ◽  
Alternative Means

The aim of the study was to explore the experiences of Australian public and private patients undergoing gynaecological day surgery in a public hospital. A telephone survey was conducted with 315 women within two days of hospital discharge. The findings indicate that patients generally favour the "in and out" experience of day surgery, with some reservations. Prior to hospital admission, private patients were less likely to have access to multiple sources of information as well as information that they found easy to understand. Alternative means of supporting women recovering from day surgery may be needed for those whose family members and/or friends cannot provide sufficient support following discharge. This study contributes to discussion on setting objective standards to evaluate the health system in the field of day surgery.

scholarly journals 3200 Balancing Cost and Quality of Care in the US and Denmark: Lessons for Nations Transitioning from Volume-Based to Value-Based Care

2019 ◽  
Vol 3 (s1) ◽  
pp. 140-140
Author(s):  
Negin Fouladi ◽  
Margit Malmmose
Keyword(s):  
Decision Making ◽  
Quality Of Care ◽  
Control Strategies ◽  
Decision Makers ◽  
Sources Of Information ◽  
Healthcare Organizations ◽  
Regulatory Oversight ◽  
Physician Practices ◽  
The Us

OBJECTIVES/SPECIFIC AIMS: Promote knowledge translation and evidence-informed decision-making by assessing barriers and facilitators to balancing cost and quality of care within the US state of Maryland and nation of Denmark. METHODS/STUDY POPULATION: Open-ended and semi-structured key-informant interviews were conducted in 2016 and 2017 among high level decision-makers in Maryland (N=21) and the Danish (N=17) healthcare systems, including hospital, local, regional, and cross-organizational administrators and elected officials. The interviews consisted of questions related to: (1) currently practiced and preferred approaches to resource allocation and development and use of quality performance measures, and (2) preferred sources, formats/styles, modes of information, and decision-making strategies based on a shift from volume to quality-driven care. RESULTS/ANTICIPATED RESULTS: Decision-makers in Maryland expressed the need for collaboration in a changing environment, yet increasingly rely on cost and quality outcomes data to drive decisions and note the struggle to identify credible and useful information. Maryland decision-makers also face challenges in regulating utilization and costs without mandated participation of physician practices within the global budget cap model, which is perceived to be a primary driver of healthcare utilization in the hospital sector. Similarly, decision-makers in Denmark conveyed the importance of quantitative data to aid decisions, however, stress collaboration and dialogue as driving factors and important sources of information. Danish decision-makers also express challenges to wide-spread adoption of a quality-driven approach due to unsustained quality assurance regulatory bodies. DISCUSSION/SIGNIFICANCE OF IMPACT: The findings suggest implementation of value-based healthcare is highly driven and influenced by availability of credible data, which may significantly impact development of policies and innovative cost control strategies, and regulatory oversight to promote adoption of quality measures in decision-making. Furthermore, collaboration within and across healthcare organizations remains a key component to health system improvement as it fosters dialogue and sharing of best practices among stakeholders.

scholarly journals Perspectives of Public and Private Primary Healthcare Users in Two Regions of Albania on Non-Clinical Quality of Care

2020 ◽  
Vol 11 ◽  
pp. 215013272097035
Author(s):  
Jonila Gabrani ◽  
Christian Schindler ◽  
Kaspar Wyss
Keyword(s):  
Quality Of Care ◽  
Primary Healthcare ◽  
Outpatient Clinics ◽  
Ageing Population ◽  
Coordination Of Care ◽  
Public And Private ◽  
Clinical Quality ◽  
Private Providers ◽  
Better Than

Background: Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing services. Consequently, we analyze perceptions of users of primary healthcare as it relates to non-clinical quality of care and the association to sociodemographic characteristics of patients and the type of provider. Methods: A facility-based survey was conducted in 2018 using the World Health Organization responsiveness questionnaire which is based on a 4-point scale along with 8 non-clinical domains of quality of care. The data of 954 patients were analyzed through descriptive statistics and linear mixed regression models. Results: Similar mean values were reported on total scale of the quality of care for private and public providers, also after sociodemographic adjustments. The highest mean score was reported for the domain “communication” (3.75) followed by “dignity” (3.65), while the lowest mean scores were given for “choice” (2.89) and “prompt attention” (3.00). Urban governmental PHC services were rated significantly better than private outpatient clinics in “coordination of care” (2.90 vs 2.12, P < .001). In contrast, private outpatient clinics were judged significantly better than urban PHC clinics in “confidentiality” (3.77 vs 3.38, P = .04) and “quality of basic amenities” (3.70 vs 3.02, P < .001). “Autonomy” was reported as least important attribute of quality. Conclusion: While the perception of non-clinical care quality was found to be high and similar for public and private providers, promptness and coordination of care require attention to meet patient’s expectations on good quality of care. There is a need to raise the awareness on autonomy and the involvement of patients’ aspects concerning their health.

scholarly journals Wisdom of patients: predicting the quality of care using aggregated patient feedback

2017 ◽  
Vol 27 (2) ◽  
pp. 110-118 ◽  
Author(s):  
Alex Griffiths ◽  
Meghan P Leaver
Keyword(s):  
Quality Of Care ◽  
Real Time ◽  
Tracking System ◽  
Predictive Ability ◽  
Positive Association ◽  
High Risk Group ◽  
Care Quality ◽  
Multiple Sources ◽  
Patient Feedback

BackgroundThe Care Quality Commission (CQC) is responsible for ensuring the quality of healthcare in England. To that end, CQC has developed statistical surveillance tools that periodically aggregate large numbers of quantitative performance measures to identify risks to the quality of care and prioritise its limited inspection resource. These tools have, however, failed to successfully identify poor-quality providers. Facing continued budget cuts, CQC is now further reliant on an ‘intelligence-driven’, risk-based approach to prioritising inspections and a new effective tool is required.ObjectiveTo determine whether the near real-time, automated collection and aggregation of multiple sources of patient feedback can provide a collective judgement that effectively identifies risks to the quality of care, and hence can be used to help prioritise inspections.MethodsOur Patient Voice Tracking System combines patient feedback from NHS Choices, Patient Opinion, Facebook and Twitter to form a near real-time collective judgement score for acute hospitals and trusts on any given date. The predictive ability of the collective judgement score is evaluated through a logistic regression analysis of the relationship between the collective judgement score on the start date of 456 hospital and trust-level inspections, and the subsequent inspection outcomes.ResultsAggregating patient feedback increases the volume and diversity of patient-centred insights into the quality of care. There is a positive association between the resulting collective judgement score and subsequent inspection outcomes (OR for being rated ‘Inadequate’ compared with ‘Requires improvement’ 0.35 (95% CI 0.16 to 0.76), Requires improvement/Good OR 0.23 (95% CI 0.12 to 0.44), and Good/Outstanding OR 0.13 (95% CI 0.02 to 0.84), with p<0.05 for all).ConclusionsThe collective judgement score can successfully identify a high-risk group of organisations for inspection, is available in near real time and is available at a more granular level than the majority of existing data sets. The collective judgement score could therefore be used to help prioritise inspections.

scholarly journals Tuberculosis practices among private medical practitioners in Kaski district, Nepal

2013 ◽  
Vol 1 (2) ◽  
pp. 68-75
Author(s):  
AK Nepal ◽  
A Shrestha ◽  
SC Baral ◽  
R Bhattarai ◽  
Y Aryal
Keyword(s):  
Quality Of Care ◽  
Private Sector ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public And Private ◽  
Medical Practitioners ◽  
Sputum Microscopy ◽  
Public And Private Sector

INTRODUCTION: Although the evidences suggest that more than one third tuberculosis (TB) cases are being managed in private sector, the quality of care in private sector is major concern. However, the information regarding the private practices were lacking. Therefore the study was conducted to gain insights on current practices of TB management at private sectors. MATERIALS AND METHODS: A descriptive cross sectional study, applying quantitative method, was conducted at two cities of Kaski among all private practitioners, private pharmacies and private laboratories through self administered questionnaire and structured interview schedule. RESULTS: Nearly one fourth of the TB suspects in the district were found to have consulted private providers with about 20.0% of the total smear positive cases diagnosed in private laboratories. Beside sputum microscopy, Private Medical Practitioners (PMPs) were also found to prefer other tests like X-ray, culture for TB diagnosis. Similarly, PMPs’ varying prescription of anti TB drugs beyond National TB Programme (NTP) recommendation along with their weak recording and case holding were noteworthy, and the cost of TB treatment seemed higher in private sector. Only one third of private institution had their staff trained in TB. Except some informal linkage, no collaboration between public and private sector was noted. CONCLUSIONS: Private sector was managing many TB cases in the district. However, their practice of TB management was not much satisfactory. Therefore NTP should take effective measures for Public Private Mix and to make them aware of the standards through training and orientation in order to improve the quality of care. DOI: http://dx.doi.org/10.3126/ijim.v1i2.7085 Int J Infect Microbiol 2012;1(1):68-75

scholarly journals The choice between surgical scrubbing and sterile covering before or after induction of anaesthesia: A prospective study

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1019
Author(s):  
Irene Sellbrandt ◽  
Metha Brattwall ◽  
Pether Jildenstål ◽  
Margareta Warrén Stomberg ◽  
Jan G. Jakobsson
Keyword(s):  
Quality Of Care ◽  
Hernia Repair ◽  
Day Surgery ◽  
Randomised Study ◽  
Post Surgery ◽  
A Prospective Study ◽  
Induction Of Anaesthesia ◽  
The Impact ◽  
Open Hernia Repair

Background: Day surgery is increasing, and safe and effective logistics are sought. One part of the in-theatre logistics commonly discussed is whether surgical scrub and sterile covering should be done before or after induction of anaesthesia. The aim of the present study was to compare the impact of surgical scrub and sterile covering before vs. after the induction of anaesthesia in male patients scheduled for open hernia repair.    Methods: This is a prospective randomised study. Sixty ASA 1-3 patients scheduled for open hernia repair were randomised to surgical scrub and sterile covering before or after induction of anaesthesia; group “awake” and group “anaesthetised”, respectively. Patients and theatre nurses were asked about their experiences and willingness to have the same logistics on further potential surgeries, through a survey provided before post-surgery. Duration of anaesthesia, surgery, theatre time, recovery room stay and time to discharge was studied. Results: There was no difference in the patients’ assessment of quality of care, and only one patient in the awake group would prefer to be anaesthetised on a future procedure. All nurses found pre-anaesthesia scrubbing acceptable as routine. The duration of anaesthesia was shorter and doses of propofol and remifentanil were reduced by 10 and 13%, respectively, in the awake group. Time in recovery area was significantly reduced in the awake group (p<0.05), but time to discharge was not different. Conclusion: Surgical scrub and sterile covering before the induction of anaesthesia can be done safely and without jeopardising patients’ quality of care.

scholarly journals Quality of Care for Diabetic Patients in a Large Urban Public Hospital

Diabetes Care ◽  
2003 ◽  
Vol 26 (3) ◽  
pp. 563-568 ◽  
Author(s):  
P. Suwattee ◽  
J. C. Lynch ◽  
M. L. Pendergrass
Keyword(s):  
Quality Of Care ◽  
Public Hospital ◽  
Diabetic Patients
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