scholarly journals The Definition and Scope of Diagnostic Error in the US and How Diagnostic Error is Enabled

2018 ◽  
Vol 3 (1) ◽  
pp. 128-134 ◽  
Author(s):  
Michael Laposata
Keyword(s):  
Patient Outcomes ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Developed Countries ◽  
Diagnostic Error ◽  
Cost Of Care ◽  
Contributing Factors ◽  
The Us ◽  
First Time

Abstract Background The quality of healthcare in the US has been progressively addressed by 3 reports from the National Academy of Medicine, the latest of which, entitled “Improving Diagnosis in Health Care,” was issued in 2015 from a 21-member panel (the author of this report was a member). The report is a review of the longstanding problem of diagnostic error. The infrastructure of healthcare delivery in the US has inadvertently made diagnostic error a major contributor to the high cost of care and preventable poor patient outcomes. Content This review describes the failures in US healthcare delivery that have led to the overwhelming number of deaths attributable to diagnostic error. Each failure is associated with recommendations to eliminate it. The review begins with a description of the scope of the diagnostic error problem and then discusses each of the issues that need to be addressed to reduce the number of misdiagnoses. Summary The problem of diagnostic error in the US is a large one. Some the contributing factors to this large problem can be resolved at a small expense and with modest change; others require a major overhaul of aspects of medical practice. For the first time, Americans have a “to-do list” to reduce our diagnostic error problem and be on par with other developed countries that are recognized as providing less costly care with better patient outcomes.

scholarly journals A review of the utilization of fine needle aspiration in clinical practice and research in Nigeria

CytoJournal ◽  
2011 ◽  
Vol 8 ◽  
pp. 12 ◽  
Author(s):  
Sani Abubakar Malami ◽  
Ochicha Ochicha
Keyword(s):  
Fine Needle Aspiration ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Developed Countries ◽  
Needle Aspiration ◽  
Bibliographic Databases ◽  
Tuberculous Lymphadenitis ◽  
Fine Needle ◽  
Disease Patterns

Background: Research and publications are critical to advancements in the quality of healthcare delivery. This article attempts to highlight the prospects and challenges of fine needle aspiration (FNA) cytology as a tool for research in Nigeria. Materials and Methods: Data available in local and international bibliographic databases for the period 1986–2005 (20 years) were collated and analyzed. Results: The theme of Nigerian FNA-focused studies correlated with the recognized disease patterns in the country which are tuberculous lymphadenitis, breast tumors and Burkitt's lymphoma. The accuracy of FNA in these situations was high and comparable to the experience in developed countries. It was found that the total number of articles published during two contiguous periods (1986–1995 and 1996–2005) had increased from 5 to 18. Also, in majority of cases, the articles were not published in specialized pathology journals. Conclusions: The utilization of FNA is apparently lagging in Nigeria. Given its potential in resource-constrained settings, we are of the opinion that it should be used more often in clinical and translational research.

scholarly journals Association of patients’ perception of quality of healthcare received and colorectal cancer screening uptake: An analysis of two national surveys in the United States

2020 ◽  
Author(s):  
Karan Chawla ◽  
Angesom Kibreab ◽  
Victor & Scott ◽  
Edward L. Lee ◽  
Farshad Aduli ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
The United States ◽  
Crc Screening ◽  
Fair Poor ◽  
National Trends

Objective: It is unknown whether patients’ ratings of the quality of healthcare services they receive truly correlate with the quality of care from their providers. Understanding this association can potentiate improvement in healthcare delivery. We evaluated the association between patients’ ratings of the quality of healthcare services received and uptake of colorectal cancer (CRC) screening. Subject and Methods: We used two iterations of the Health Information National Trends Survey (HINTS) of adults in the United States. HINTS 2007 (4,007 respondents; weighted population=75,397,128) evaluated whether respondents were up-to-date with CRC screening while HINTS 4 cycle 3 (1,562 respondents; weighted population=76,628,000) evaluated whether participants had ever received CRC screening in the past. All included respondents from both surveys were at least 50 years of age, had no history of CRC, and had rated the quality of healthcare services that they had received at their healthcare provider’s office in the previous 12 months. Results: HINTS 2007 data showed that respondents who rated their healthcare as good, or fair/poor were significantly less likely to be up to date with CRC screening compared to those who rated their healthcare as excellent. We found comparable results from analysis of HINTS 4 cycle 3 data with poorer uptake of CRC screening as the healthcare quality ratings of respondents’ reduced. Conclusion: Our study suggested that patients who reported receiving lower quality of healthcare services were less likely to have undergone and be compliant with CRC screening recommendations. It is important to pay close attention to patient feedback surveys in order to improve healthcare delivery.

Physician Rating Websites in the United States: A systematic review (Preprint)

2021 ◽  
Author(s):  
Meenakshi Bhilwar ◽  
Suzanne A Boren ◽  
Kunal Bhatia
Keyword(s):  
English Language ◽  
Healthcare Delivery ◽  
Healthcare Quality ◽  
Geographic Location ◽  
Quality Of Healthcare ◽  
The United States ◽  
The Us ◽  
Online Ratings ◽  
Physician Rating ◽  
Physician Relationship

BACKGROUND Physician rating websites are gaining popularity, however, data on their usability and influence on healthcare quality is limited. OBJECTIVE to provide an overview of physician rating websites in the US and find answers for the following questions: 1. What are the most commonly studied/rated physician rating websites in the US? 2. Which specialty of physicians/providers are most commonly studied/rated? 3. How many physicians were rated on the studied PRWs? 4. What is the average number of ratings on these websites and are they positive or negative? 5. How does the profile of providers influence their rating? 6. How are PRWs associated with healthcare quality? 7. How PRWs are associated with patient-physician relationship? METHODS A systematic literature search was conducted through Medline for peer-reviewed articles in the English language on studies conducted in the US. RESULTS 33 articles published in peer-reviewed journals were included in the final review. Most of the studies were conducted on surgeons. A significant number of studies observed no correlation of online ratings with gender, geographic location, and years of experience. Additionally, no significant correlation was found between PRWs and healthcare quality. CONCLUSIONS It has been observed that with the current structure of these websites, the reliability of information available on them is rather questionable, and hence more research is required to assess the credibility of these websites along with their cost-effectiveness, effect on the patient-physician relationship, and quality of healthcare delivery.

IMPROVING THE SERVICE QUALITY OF HEALTHCARE IN GHANA: The Role of Locum Nursing

2013 ◽  
Vol 03 (12) ◽  
pp. 01-14
Author(s):  
Keelson, Solomon A. ◽  
Ann Dodor
Keyword(s):  
Service Quality ◽  
Healthcare Delivery ◽  
Sampling Technique ◽  
Research Problem ◽  
Quality Of Healthcare ◽  
Public Hospitals ◽  
Nurse Shortage ◽  
Quality Healthcare ◽  
Hospital Administrators

The study was purposed to consider how encouraging use of locum nursing could aid in managing nurse shortage in the country and consequently improve the service quality of healthcare in Ghana. To be able to address the research problem and achieve the objectives, thirty public hospitals and thirty private hospitals were selected from the three major cities in Ghana to provide data for the study. Also, 250 locum nurses were sampled for information. Nursing Supervisors or Hospital Administrators from the selected hospitals were use as informant for the study. The paper adopted a survey approach, where incidental sampling technique was used to select the hospitals, and the snowball together with incidental sampling methods were used for selecting locum nurses for the study. Mean and standard deviation were the data analysis method used. The findings confirmed that locum practice in Ghana is relatively low. Similarly, the paper also suggested that locum contribute to addressing the issue of nurse shortage in Ghana. At the same time locum nursing was found to contribute to quality healthcare delivery in the country. Appropriate policy directions were recommended.

scholarly journals Interoperability in Healthcare

2017 ◽  
pp. 689-714 ◽  
Author(s):  
Luciana Cardoso ◽  
Fernando Marins ◽  
César Quintas ◽  
Filipe Portela ◽  
Manuel Santos ◽  
...  
Keyword(s):  
Information Systems ◽  
Patient Information ◽  
Swot Analysis ◽  
Medical Information ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
High Availability ◽  
Heterogeneous Information ◽  
Multi Agent

With the advancement of technology, patient information has been being computerized in order to facilitate the work of healthcare professionals and improve the quality of healthcare delivery. However, there are many heterogeneous information systems that need to communicate, sharing information and making it available when and where it is needed. To respond to this requirement the Agency for Integration, Diffusion, and Archiving of medical information (AIDA) was created, a multi-agent and service-based platform that ensures interoperability among healthcare information systems. In order to improve the performance of the platform, beyond the SWOT analysis performed, a system to prevent failures that may occur in the platform database and also in machines where the agents are executed was created. The system has been implemented in the Centro Hospitalar do Porto (one of the major Portuguese hospitals), and it is now possible to define critical workload periods of AIDA, improving high availability and load balancing. This is explored in this chapter.

Management of the deteriorating adult patient: does simulation-based education improve patient safety?

2021 ◽  
pp. 1-8
Author(s):  
Jacqueline Bennion ◽  
Stephanie K Mansell
Keyword(s):  
Human Factors ◽  
Adult Patient ◽  
Patient Outcomes ◽  
Improve Patient Safety ◽  
Low Grade ◽  
Contributing Factors ◽  
Educational Method ◽  
Simulation Based ◽  
The Impact

Failure to recognise the deteriorating patient can cause severe harm and is related to preventable death. Human factors are often identified as contributing factors. Simulation-based education is used to develop clinicians' human factors skills. This article discusses the evidence concerning the efficacy of simulation-based education for improving the recognition and management of the acutely deteriorating adult patient, and the limitations of simulation-based education. Findings demonstrated simulation-based education was the most effective educational method identified for training staff in recognising unwell patients. The evidence demonstrating the impact of simulation-based education on patient outcomes was equivocal. The quality of the evidence was low grade regarding the efficacy of simulation-based education on human factors. Further research is required to confirm the efficacy of simulation-based education for human factors and patient outcomes.

Impact of Health Information Technologies on the Quality of Healthcare Deliveries

2021 ◽  
Vol 6 (1) ◽  
pp. 30-44
Author(s):  
Patricia Whitley ◽  
Hossain Shahriar ◽  
Sweta Sneha
Keyword(s):  
Patient Care ◽  
Health Information ◽  
Medical Errors ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Well Being ◽  
Quality Of Healthcare ◽  
Quality Healthcare ◽  
The Impact

Through a literary review of recent research, this paper examines the mixed impact of health information technology (HIT) on patient care, medical errors, and the quality of healthcare delivery in selected hospital settings such as emergency departments. Specific technologies examined include the electronic health record (EHR), medical devices, artificial intelligence, and robotics. The paper identifies that some healthcare technologies are increasingly valuable in reducing medical errors, improving healthcare quality, and in producing better patient-centered outcomes. It also determines that technologies have complicated the delivery of quality patient care, increased the incidences of clinician burnout, and made receiving quality healthcare in America's hospital systems possibly less sure. The paper concludes with some suggestions for improving HIT's implementations and confirms the need for further evaluation of the impact of HIT in increasing patient safety and clinician well-being.

An Android-Enabled PHR-based System for the Provision of Homecare Services

2013 ◽  
Vol 3 (2) ◽  
pp. 1-18 ◽  
Author(s):  
Vassiliki Koufi ◽  
Flora Malamateniou ◽  
George Vassilacopoulos
Keyword(s):  
Healthcare Professionals ◽  
Point Of Care ◽  
Treatment Plan ◽  
Personal Health Record ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Appropriate Treatment ◽  
Treatment Plans ◽  
The Continuum

Homecare is an important component of the continuum of care as it provides the potential to improve quality of life and quality of healthcare delivery while containing costs. Personal Health Record (PHR) systems are intended to reach patients outside of care settings and influence their behaviors thus allowing for more effective homecare services. To this end, these systems need to evolve well beyond providing a consolidated patient record, in ways that make it more widely applicable and valuable to health systems. The development of applications on top of PHR systems can allow them to function as a platform for both patients and healthcare professionals to exchange information and interact with the health system. This paper presents a prototype PHR-based system that aims at supporting chronic disease management at any point of care or decision making through familiar environments such as Google’s Android. In particular, it assists healthcare professionals in assessing an individual’s condition and in forming the appropriate treatment plan for him/her while it provides individuals with step-to-step guidance to their treatment plans.

scholarly journals Leveraging massive open online courses to expand quality of healthcare education to health practitioners in Rwanda

2019 ◽  
Vol 8 (4) ◽  
pp. e000532 ◽  
Author(s):  
Kirstin Woody Scott ◽  
Theophile Dushime ◽  
Vincent Rusanganwa ◽  
Liana Woskie ◽  
Clint Attebery ◽  
...  
Keyword(s):  
Patient Safety ◽  
Global Health ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Lessons Learned ◽  
Online Course ◽  
Massive Open Online ◽  
District Hospitals

Improving the quality of healthcare delivery is increasingly a global health priority. However, quality improvement training opportunities that provide theoretical foundations and basic skills for patient safety and other quality initiatives have been limited or historically out of reach, especially in low-and-middle income countries (LMICs). To address this gap, the Harvard Initiative on Global Health Quality (HIGHQ) created and launched a massive open online course (MOOC) in 2014 focused on patient safety and quality of care using the edX platform. More than 30 000 students from across 195 countries registered for the online course. This paper summarises an innovative educational partnership between the course team and one of these countries, Rwanda, to develop a blended-learning model to bolster participation in this new course among Rwandan healthcare professionals. Although a small country, Rwanda was among the top performing countries for attracting course registrants and was the leading country for the proportion of enrollees who ultimately completed the course. Further, half (21 of 42) of Rwanda’s district hospitals opted to appoint a PH555x course facilitator at their site to help lead regular meetings and discussions about the course content at their facility. The majority of Rwandan enrollees were health professionals (63%) and 81% reported that PH555x was their first experience taking an online course. Among those participating in the ‘flipped’ component at hospital sites, 94% reported that the course helped them to think of specific ways to improve healthcare quality at their facility. In this paper, we describe this innovative public–private educational model, challenges to implementation and lessons learned that may be helpful for future MOOC developers who wish to augment learning opportunities among healthcare professionals in LMICs.

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