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Zhao LR, Sun LH, Wei J, Yu YC. Novel multidisciplinary cooperation model for obstetric medical quality control: A quasi-experimental study. Int J Gynaecol Obstet 2024; 165:806-812. [PMID: 37984372 DOI: 10.1002/ijgo.15259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE To explore the impact of a novel multidisciplinary cooperation model in obstetric medical quality control. METHODS This quasi-experimental study analyzed the quality indicators of full-term pregnant women who underwent vaginal trial labor in Zibo Maternal and Child Health Hospital between July 2021 and June 2022. The pregnant women were divided into two groups based on implementation of novel multidisciplinary cooperation: multidisciplinary and non-multidisciplinary. We compared the rate of labor analgesia, postpartum hemorrhage in vaginal delivery, transfer to cesarean section, and the 5-min Apgar score ≤7 in full-term neonates. RESULTS A total of 3751 pregnant women were enrolled into the study, of whom 2004 were included in the non-multidisciplinary group and 1747 in the multidisciplinary group. The analgesic rate of delivery of the multidisciplinary group was higher than that of the non-multidisciplinary group (P = 0.000). We established that the rate of postpartum bleeding (P = 0.040), transfer cesarean section (P = 0.003) and the incidence of Apgar score ≤7 in 5 min of full-term neonates (P = 0.038) of the multidisciplinary group was lower than that of the non-multidisciplinary group. There was no significant difference in the mean ages (29.40 ± 3.99 vs. 29.90 ± 4.27 years; P = 0.126), mean delivery gestational ages (39.65 ± 0.87 vs. 39.64 ± 1.06; P = 0.221), mean gravidity values (1.93 ± 1.09 vs. 2.00 ± 1.18; P = 0.586) and mean parity (1.40 ± 0.56 vs. 1.42 ± 0.59; P = 0.635) of the women in the two groups. CONCLUSION Multidisciplinary cooperation in delivery management can significantly improve some quality indicators. We established the analgesic rate of delivery can be increased and the rate of postpartum bleeding, transfer cesarean section and the incidence of Apgar score ≤7 in 5 min of full-term neonates can be decreased with the implementation of novel multidisciplinary cooperation.
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Affiliation(s)
- Li-Rong Zhao
- Department of Obstetrics, Zibo Maternal and Child Health Hospital, Zibo, China
| | - Li-Hong Sun
- Department of Obstetrics, Zibo Maternal and Child Health Hospital, Zibo, China
| | - Jing Wei
- Department of Obstetrics, Zibo Maternal and Child Health Hospital, Zibo, China
| | - Ying-Chun Yu
- Department of Obstetrics, Zibo Maternal and Child Health Hospital, Zibo, China
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Liu Y, Lang Z, Peng X, Zhang Z, Fu J, Zhou C. The impact of link quality management on healthcare quality: a comparative study at The Fourth Hospital of Harbin Medical University. Am J Transl Res 2023; 15:5930-5939. [PMID: 37854209 PMCID: PMC10579025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To explore the impact of link quality management on healthcare quality. METHODS In 2021, The Fourth Hospital of Harbin Medical University followed various regulations and systems to manage the quality of hospital links. In 2022, the hospital upgraded and strengthened the quality management of hospital links. We collected and compared data from 2021 and 2022 on several observation indicators, including error rates in medical records, outpatient and inpatient numbers, surgical volumes, adverse event reporting, dispute complaints, inpatient medical records and outpatient prescriptions grading, timely filing rate of medical records, inpatient satisfaction rate, average length of hospital stay, rate of level 3-4 surgeries, admission rate of critically ill patients, workload index, work efficiency index, diagnostic quality index, treatment quality index, antimicrobial drug use rate, staff satisfaction rate, patient satisfaction rate, composite index, and Case Mix Index (CMI). RESULTS In 2021, the error rate of the first page of the general surgery medical records in The Fourth Hospital of Harbin Medical University was 27.91%, while in 2022 it significantly improved to 9.60% (P<0.05). The error rates of the main diagnosis, major surgical operations, other diagnoses, and other surgical operations on the medical records were all significantly different between 2021 and 2022 (all P<0.05). In 2022, the outpatient volume, inpatient volume, surgical volume, and adverse event reporting increased significantly compared to those in 2021, while the number of dispute complaints decreased significantly. The first-grade rate of inpatient medical records, first-grade rate of outpatient prescriptions, timely filing rate of medical records, inpatient satisfaction rate, average length of hospital stay, rate of level 3-4 surgeries, and admission rate of critically ill patients in 2022 were all significantly higher than those in 2021 (all P<0.05). The workload index, work efficiency index, diagnostic quality index, and treatment quality index in 2022 were all significantly higher than those in 2021 (all P<0.05). The outpatient antimicrobial drug use rate, emergency department antimicrobial drug use rate, and inpatient antimicrobial drug use rate in 2022 were significantly lower than those in 2021 (all P<0.05). In 2022, the satisfaction rate of medical staff was 93.57%, which was significantly higher than 81.16% in 2021 (P<0.05). In 2022, the patient satisfaction rate was 91.53%, which was significantly higher than 82.17% in 2021 (P<0.05). In 2022, the composite index and CMI values increased, while the error rate decreased significantly, as compared to those in 2021 (P<0.05). CONCLUSION After upgrading and strengthening the link quality management, The Fourth Hospital of Harbin Medical University has achieved significant improvements in management level, medical quality, technical level, and staff satisfaction.
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Affiliation(s)
- Yi Liu
- Department of Medical, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Zhenyu Lang
- Dean Office, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Xiaoxuan Peng
- Department of Medical, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Zhipeng Zhang
- Department of Medical, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Junwei Fu
- Department of Medical, The Fourth Hospital of Harbin Medical UniversityHarbin 150000, Heilongjiang, China
| | - Chunhe Zhou
- Three Areas of Respiratory Oncology, Harbin Medical University Cancer HospitalHarbin 150000, Heilongjiang, China
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Li P, Cao X, Liu W, Zhao D, Pan S, Sun X, Cai G, Zhou J, Chen X. Peritoneal Dialysis Care in Mainland China: Nationwide Survey. JMIR Public Health Surveill 2023; 9:e39568. [PMID: 36917165 PMCID: PMC10139685 DOI: 10.2196/39568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 11/09/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Peritoneal dialysis (PD) care in mainland China has been progressing in the past 10 years. OBJECTIVE To complement information from the dialysis registry, a large-scale nationwide survey was conducted to investigate the current infrastructure and management of PD care at hospitals of different tiers. METHODS A web-based multiple-choice questionnaire was distributed through the National Center for Nephrology Medical Quality Management and Control to PD centers of secondary and tertiary hospitals in October 2020. The 2-part survey collected the information of PD centers and the clinical management of patients on PD. A total of 788 effective surveys from 746 hospitals were voluntarily returned, and data were extracted and analyzed. RESULTS The effective survey data covered 101,537 patients on PD, with 95% (96,460/101,537) in the tertiary hospitals. The median number of patients per PD center was 60 (IQR 21-152); this number was 32 (IQR 8-65) and 70 (IQR 27-192) for secondary and tertiary hospitals, respectively. There was a discrepancy in the availability of designated physical areas for different functions of PD care between the secondary and tertiary hospitals. The proportion of tertiary hospitals with PD training (P=.01), storage (P=.09), and procedure area (P<.001) was higher compared to secondary hospitals. PD catheter placement was performed in 96% (608/631) of the PD centers in tertiary hospitals, which was significantly higher compared to 86% (99/115) in secondary hospitals (P<.001). Automated PD was available in 55% (347/631) of the tertiary hospitals, which was significantly higher than that in secondary hospitals (37/115, 32%) according to the survey (P<.001). The most commonly performed PD module was continuous ambulatory peritoneal dialysis (772/788, 98%), followed by intermittent peritoneal dialysis (543/788, 69%). The overall reported nocturnal intermittent peritoneal dialysis was 31% (244/788); it was 28% (220/788) for continuous cycling peritoneal dialysis and 15% (118/788) for tidal peritoneal dialysis. Comparisons between the secondary and tertiary hospitals revealed no significant differences in prophylactic antibiotic use for PD catheter placement and therapeutic use for peritonitis. The first peritoneal equilibrium test was conducted in 58% (454/788) of patients at 4-6 weeks after initiation of PD, and 91% (718/788) reported at least one peritoneal equilibrium test per year. Overall, 79% (570/722) and 65% (469/722) of PD centers performed assessment for dialysis adequacy and residual kidney function, respectively; and 87% (685/788) of patients on PD were followed every 1 to 3 months for laboratory and auxiliary examinations. CONCLUSIONS This national survey reflects the current status and disparities of PD center management in mainland China. The study results suggest that the PD care needs to be more conveniently accessible in secondary hospitals, and quality management and staff training in secondary hospitals are still in high demand.
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Affiliation(s)
- Ping Li
- Department of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Nephrology Institute of the Chinese People's Liberation Army, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xueying Cao
- Department of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Nephrology Institute of the Chinese People's Liberation Army, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Weicen Liu
- Department of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Nephrology Institute of the Chinese People's Liberation Army, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Delong Zhao
- Department of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Nephrology Institute of the Chinese People's Liberation Army, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Sai Pan
- Department of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Nephrology Institute of the Chinese People's Liberation Army, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xuefeng Sun
- Department of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Nephrology Institute of the Chinese People's Liberation Army, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Guangyan Cai
- Department of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Nephrology Institute of the Chinese People's Liberation Army, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jianhui Zhou
- Department of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Nephrology Institute of the Chinese People's Liberation Army, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xiangmei Chen
- Department of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Nephrology Institute of the Chinese People's Liberation Army, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.,Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
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Muacevic A, Adler JR, Young A, Gould E. Call to Action: Creating Resources for Radiology Technologists to Capture Higher Quality Portable Chest X-rays. Cureus 2022; 14:e29197. [PMID: 36507112 PMCID: PMC9731552 DOI: 10.7759/cureus.29197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 12/15/2022] Open
Abstract
Background Patient rotation, foreign body overlying anatomy, and anatomy out of field of view can have detrimental impacts on the diagnostic quality of portable chest x-rays (PCXRs), especially as the number of PCXR imaging increases due to the coronavirus disease 2019 (COVID-19) pandemic. Although preventable, these "quality failures" are common and may lead to interpretative and diagnostic errors for the radiologist. Aims In this study, we present a baseline quality failure rate of PCXR imaging as observed at our institution. We also conduct a focus group highlighting the key issues that lead to the problematic images and discuss potential interventions targeting technologists that can be implemented to address imaging quality failure rate. Materials and methods A total of 500 PCXRs for adult patients admitted to a large university hospital between July 12, 2021, and July 25, 2021, were obtained for evaluation of quality. The PCXRs were evaluated by radiology residents for failures in technical image quality. The images were categorized into various metrics including the degree of rotation and obstruction of anatomical structures. After collecting the data, a focus group involving six managers of the technologist department at our university hospital was conducted to further illuminate the key barriers to quality PCXRs faced at our institution.. Results Out of the 500 PCXRs evaluated, 231 were problematic (46.2%). 43.5% of the problematic films with a repeat PCXR within one week showed that there was a technical problem impacting the ability to detect pathology. Most problematic films also occurred during the night shift (48%). Key issues that lead to poor image quality included improper patient positioning, foreign objects covering anatomy, and variances in technologists' training. Three interventions were proposed to optimize technologist performance that can lower quality failure rates of PCXRs. These include a longitudinal educational curriculum involving didactic sessions, adding nursing support to assist technologists, and adding an extra layer of verification by internal medicine residents before sending the films to the radiologist. The rationale for these interventions is discussed in detail so that a modified version can be implemented in other hospital systems. Conclusion This study illustrates the high baseline error rate in image quality of PCXRs at our institution and demonstrates the need to improve on image quality. Poor image quality negatively impacts the interpretive accuracy of radiologists and therefore leads to wrong diagnoses. Increasing educational resources and support for technologists can lead to higher image quality and radiologist accuracy.
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Grote V, Unger A, Böttcher E, Muntean M, Puff H, Marktl W, Mur E, Kullich W, Holasek S, Hofmann P, Lackner HK, Goswami N, Moser M. General and Disease-Specific Health Indicator Changes Associated with Inpatient Rehabilitation. J Am Med Dir Assoc 2020; 21:2017.e10-2017.e27. [PMID: 32736990 DOI: 10.1016/j.jamda.2020.05.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilitation, are examined to provide a valid basis for the routine assessment of the quality of medical outcomes. DESIGN An observational study was carried out, placing a focus on general and disease-specific health measurements, to assess representative results of multidisciplinary inpatient rehabilitation. Aspects that were possibly confounding and introduced bias were controlled based on data from a quasi-experimental (waiting) control group. MEASURES Existing data or general health indicators were extracted from medical records. The indicators included blood pressure, resting heart rate, self-assessed health, and pain, as well as more disease-specific indicators of physical function and performance (eg, activities of daily living, walking tests, blood lipids). These are used to identify moderating factors related to health outcomes. SETTING AND PARTICIPANTS A standardized collection of routine data from 16,966 patients [61.5 ± 12.5 years; 7871 (46%) women, 9095 (54%) men] with different medical diagnoses before and after rehabilitation were summarized using a descriptive evaluation in terms of a content and factor analysis. RESULTS Without rehabilitation, general health indicators did not improve independently and remained stable at best [odds ratio (OR) = 0.74], whereas disease-specific indicators improved noticeably after surgery (OR = 3.20). Inpatient rehabilitation was shown to reduce the risk factors associated with certain lifestyles, optimize organ function, and improve well-being in most patients (>70%; cutoff: z-difference >0.20), with a standardized mean difference (SMD) seen in overall medical quality outcome of -0.48 ± 0.37 [pre- vs post-rehabilitation: ηp2 = 0.622; dCohen = -1.22; 95% confidence interval (95% CI) -1.24 to -1.19]. The baseline medical values obtained at the beginning of rehabilitation were influenced by indication, age, and sex (all P < .001); however, these factors have less significant effects on improvements in general health indicators (ηp2 < 0.01). According to the disease-specific results, the greatest improvements were found in older patients (SMD for patients >60 vs ≤60 years: 95% CI 0.08-0.11) and during the early rehabilitation stage (ηp2 = 0.063). CONCLUSIONS AND IMPLICATIONS Compared with those who received no inpatient rehabilitation, patients who received rehabilitation showed greater improvements in 2 independent areas, general and disease-specific health measures, regardless of their diagnosis, age, and sex. Due to the study design and the use of a nonrandomized waiting group, causal conclusions must be drawn with caution. However, the comparability and stability of the presented results strongly support the validity of the observed improvements associated with inpatient rehabilitation.
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Affiliation(s)
- Vincent Grote
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria; Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria.
| | - Alexandra Unger
- University College of Teacher Education Carinthia, Viktor Frankl University College, Klagenfurt, Austria
| | | | | | | | - Wolfgang Marktl
- GAMED & Karl Landsteiner Institut für Traditionelle Medizin, Vienna, Austria
| | - Erich Mur
- Univ.-Klinik Innsbruck & Research Unit f. Orthopädische Physiotherapie (UMIT), Hall in Tirol, Austria
| | - Werner Kullich
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Department for Rehabilitation, Saalfelden, Austria
| | - Sandra Holasek
- Otto Loewi Research Center, Immunology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Peter Hofmann
- Institute of Sports Sciences, Exercise Physiology, Training & Training Therapy Research Group, University of Graz, Graz, Austria
| | - Helmut K Lackner
- Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Nandu Goswami
- Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Maximilian Moser
- Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria; Human Research Institute, Weiz, Austria
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Elgabaly EA, Alshryda S, Alfuqaha H, Lee LH. Simple Step Add-in to Improve Patient Safety: A Technical Note. Cureus 2020; 12:e6592. [PMID: 31929959 PMCID: PMC6948097 DOI: 10.7759/cureus.6592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Human factors and systems factors can affect surgical performance, including the operating room (OR) environment, teamwork and communication, technology and equipment, tasks and workload factors, and organizational variables. Patient safety is a new healthcare discipline that emphasizes the reporting, analysis, and prevention of medical errors that often lead to adverse healthcare events. We are highlighting a potential error and hazardous situation, which may occur due to the difficulty in reading the embossed letters of some ampoules because of the typeface of these ampoules. This problem is particularly important in the ORs, which require special sterile conditions. We are adding a simple step to help in the differentiation between plastic, embossed ampoules. This simple and easy-to-do step makes it possible for accurate and correct identification, without jeopardizing the safety of the patients and health care professionals.
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Affiliation(s)
- Elham A Elgabaly
- Pediatric Radiology, Al Jalila Children Specialty Hospital, Dubai, ARE
| | - Sattar Alshryda
- Pediatric Orthopedics, Al Jalila Children Specialty Hospital, Dubai, ARE
| | | | - Ling Hong Lee
- Pediatric Orthopedics, Sunderland Royal Hospital, Sunderland, GBR
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Yu D, Zhao Q. Effect Of Surgical Safety Checklists On Gastric Cancer Outcomes: A Single-Center Retrospective Study. Cancer Manag Res 2019; 11:8845-8853. [PMID: 31632144 PMCID: PMC6790110 DOI: 10.2147/cmar.s218686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/17/2019] [Indexed: 12/30/2022] Open
Abstract
Aims Surgery is the primary treatment option for patients with gastric cancer, however the rate of postoperative complications are still high. The implementation of surgical safety checklists (SSCs) has been shown to reduce morbidity and mortality. This study aimed to evaluate the effect of SSCs on the clinical outcomes of gastric cancer. Methods A total of 881 gastric cancer patients who underwent D2 gastrectomy from May 2009 to April 2011 in a large teaching hospital in China were included in this retrospective study. Patients were matched and divided into the control group (SSC nonimplementation) and intervention group (SSC implementation). The outcomes including intraoperative condition, postoperative complications, and prognosis were then compared between the groups. Results The control group comprised 414 patients (47.0%), and the intervention group included 467 patients (53.0%). Patients in the intervention group had a significantly shorter length of postoperative stay (P < 0.001). Operation time, blood loss, blood transfusion, and hospital charges were comparable between the two groups (all P > 0.05). SSC was not associated with postoperative complications (all P > 0.05). Overall survival was also comparable between patients in the two groups (P > 0.05). Conclusion The implementation of an SSC was associated with a decreased length of postoperative stay in gastric cancer patients following D2 gastrectomy but did not significantly affect the other outcomes.
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Affiliation(s)
- Deliang Yu
- Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, Air Force Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
| | - Qingchuan Zhao
- Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, Air Force Military Medical University, Xi'an, Shaanxi 710032, People's Republic of China
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Asif M, Jameel A, Sahito N, Hwang J, Hussain A, Manzoor F. Can Leadership Enhance Patient Satisfaction? Assessing the Role of Administrative and Medical Quality. Int J Environ Res Public Health 2019; 16:ijerph16173212. [PMID: 31484308 PMCID: PMC6747509 DOI: 10.3390/ijerph16173212] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 12/03/2022]
Abstract
This paper aimed to investigate the relationships between participative leadership (PL), administrative quality (AQ), medical quality (MQ), and patient satisfaction (PS) using the Malcolm Baldrige National Quality Award Healthcare Criteria (MBNQA) criteria. The study further examined the intervening influence of administrative quality and medical quality on the relationship between participative leadership and patient satisfaction. The data was obtained from 123 public sector hospitals in Pakistan. We employed confirmatory factor analysis (CFA) and structural equation modeling (SEM) techniques to test the structural model. From the study results, we found significant and positive relationships between participative, administrative quality, medical quality, and patient satisfaction. In addition, our research found administrative quality and medical quality as potential mediators on PL-PS relation. Adopting participative leadership as an exogenous factor, and both administrative and medical quality as potential mediators of patient satisfaction, provided new insights into MBNQA criteria.
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Affiliation(s)
- Muhammad Asif
- School of Public Affairs, Zijingang Campus, Zhejiang University, Hangzhou 310058, China.
| | - Arif Jameel
- School of Public Affairs, Zijingang Campus, Zhejiang University, Hangzhou 310058, China.
| | - Noman Sahito
- Department of City & Regional Planning, Mehran University of Engineering & Technology, Jamshoro 76062, Pakistan.
| | - Jinsoo Hwang
- The College of Hospitality and Tourism Management, Sejong University, 98 Gunja-Dong, Gwanjin-Gu, Seoul 143-747, Korea.
| | - Abid Hussain
- School of Public Affairs, Zijingang Campus, Zhejiang University, Hangzhou 310058, China.
| | - Faiza Manzoor
- Department of Agricultural Economics and Management, School of Management, Zhejiang University, Hangzhou 310029, China.
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Zhuang M, Fan W, Xie P, Yuan ST, Liu QH, Zhao C. Evaluation of the safety and quality of day-case cataract surgery based on 4151 cases. Int J Ophthalmol 2019; 12:291-295. [PMID: 30809487 PMCID: PMC6376245 DOI: 10.18240/ijo.2019.02.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 10/15/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the safety, quality and prospects of day-case cataract surgery performed in a Jiangsu public tertiary hospital. METHODS The general and clinical data for patients who underwent day-case cataract surgery between August 1, 2014 and December 31, 2016 at this hospital were collected. The incidences of intraoperative and postoperative complications, preoperative and postoperative best-corrected visual acuities (BCVAs), delayed discharge rate, rate of unplanned re-admission to hospital, and patient satisfaction were analyzed. RESULTS A total of 4151 patients received cataract phacoemulsification surgery to correct age-related, congenital, traumatic, or complicated cataracts. Of these, age-related cataracts were the most frequently occurring. Patient age ranged from 18 to 101y and the vast majority of patients were between 60 and 80 years old. Of the 4151 patients, 64.73% (2687/4151) had a systemic disease. The number of patients increased over the years, with the average number of patients per month being 90.4, 124.83, and 183.42 in 2014, 2015 and 2016, respectively. The average preoperative BCVA was 0.102±0.057 and average postoperative BCVAs at 1d, 1wk, and 1mo post-surgery were 0.453±0.264, 0.657±0.285, and 0.734±0.244, respectively. For intraoperative complications, 4.12% (171/4151) had posterior capsule rupture, 0.79% (33/4151) had iris or ciliary body injury, and 0.048% (2/4151) had suprachoroidal hemorrhage. For postoperative complications, 4.38% (182/4151) had cornea edema, 7.78% (323/4151) had intraocular hypertension, 0.096% (4/4151) had IOL toxicity syndrome, 0.28% (12/4151) had retained lens cortex, and 0.048% (2/4151) had hyphema. The delayed discharge rate was 0.82% (44/4151) and the unplanned re-admission to the hospital was 0 (0/4151). The patient satisfaction rate was 91.42% (3795/4151). CONCLUSION Day-case cataract surgery is safe and effective with good prospects for development.
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Affiliation(s)
- Min Zhuang
- Department of Ophthalmology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- Department of Ophthalmology, the Fourth Affiliated Hospital of Nantong University (Yancheng No.1 People's Hospital), Yancheng 224000, Jiangsu Province, China
| | - Wen Fan
- Department of Ophthalmology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Ping Xie
- Department of Ophthalmology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Song-Tao Yuan
- Department of Ophthalmology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Qing-Huai Liu
- Department of Ophthalmology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Chen Zhao
- Department of Ophthalmology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- Eye Institute, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200000, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200000, China
- Key Laboratory of Myopia of State Health Ministry (Fudan University), Shanghai 200000, China
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10
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Abstract
BACKGROUND Although second opinions are rather restricted to the surgical disciplines, they have become more and more important to the health system in the last 20 years. The demand has been triggered by rising health costs and the economization of the field. The Internet has also made a considerable contribution to the demand for patient-initiated second opinions. Given these developments, it is surprising that second opinions have not become more important in the field of psychiatry. This article highlights the special situation of second opinions in psychiatry, discusses possible barriers to the adoption of second opinions in psychiatry, and the potential for greater use of second opinions in this field. OBJECTIVE In psychiatry, second opinions have been neglected by the typical drivers of innovations in health care, including insurers and other commercial drivers as well as psychiatrists and patients themselves. This review identifies current barriers to widespread adoption of second opinions in psychiatric practice, discusses the benefits of second opinions that have been demonstrated in other disciplines, and outlines the potential gains to be realized through use of second opinions in psychiatry. METHODS Literature in the area was reviewed through a search of the main medical databases. This literature review was supported by in-depth interviews with health care personnel and insurers. CONCLUSIONS Second opinions are rarely obtained in psychiatry and there is little literature on this subject. The stigmatization of psychiatric disorders and patients and the uniqueness of the patient-doctor relationship in psychiatry, especially in psychotherapeutic care, may pose considerable obstacles to the use of second opinions in this field. In addition, more stakeholders, such as social workers, government agencies and regulators, health care and disability insurers, and social security agencies, are involved in the mental health compared with the somatic health sector, which may make it more difficult to achieve a coordinated approach in psychiatric care. However, we have found no convincingly good reason why second opinions have not been at least discussed in psychiatry. Psychiatry could benefit from ongoing discussions concerning the outcomes of second opinions in other medical disciplines.
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11
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Zhao S, He L, Feng C, He X. Improvements in medical quality and patient safety through implementation of a case bundle management strategy in a large outpatient blood collection center. Medicine (Baltimore) 2018; 97:e10990. [PMID: 29851856 PMCID: PMC6393060 DOI: 10.1097/md.0000000000010990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Laboratory errors in blood collection center (BCC) are most common in the preanalytical phase. It is, therefore, of vital importance for administrators to take measures to improve healthcare quality and patient safety.In 2015, a case bundle management strategy was applied in a large outpatient BCC to improve its medical quality and patient safety.Unqualified blood sampling, complications, patient waiting time, largest number of patients waiting during peak hours, patient complaints, and patient satisfaction were compared over the period from 2014 to 2016.The strategy reduced unqualified blood sampling, complications, patient waiting time, largest number of patients waiting during peak hours, and patient complaints, while improving patient satisfaction.This strategy was effective in improving BCC healthcare quality and patient safety.
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12
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Abstract
OBJECTIVES To seek the ways of how to optimize medical equipment quality control, and improve the implementation effect of quality control for improving the quality of the medical equipment and clinical diagnosis and treatment. METHODS Analysis the new problems of quality control, combined with quality control testing data, adverse events of medical equipments, and practical work of clinical diagnosis and treatment. RESULTS Medical equipment quality control need to solve specific problems pertinently, and optimize from implementation of comprehensive quality control management system, establish standardized evaluation system and carry out research on new technologies of quality control, and so on. CONCLUSIONS To solve the new problems promptly and to optimize related work can effectively improve the effect of quality control.
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Affiliation(s)
- Xiaoxi Zheng
- Department of Medical Engineering, Wuhan General Hospital of PLA, Wuhan, 430070
| | - Ni Liu
- Department of Medical Engineering, Wuhan General Hospital of PLA, Wuhan, 430070
| | - Wei Wang
- Department of Medical Engineering, Wuhan General Hospital of PLA, Wuhan, 430070
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13
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Zhong J. [Discussion on Medical Equipment Maintenance Based on Outsourcing Service]. Zhongguo Yi Liao Qi Xie Za Zhi 2017; 41:231-232. [PMID: 29862776 DOI: 10.3969/j.issn.1671-7104.2017.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Based on the idea of outsourcing service, a set of maintenance outsourcing scheme was constructed from outsourcing type, pricing strategy and benchmarking management. Through outsourcing services, it would reduce maintenance costs, improve the medical quality, and improve patient satisfaction.
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Affiliation(s)
- Jianping Zhong
- Huadong Hospital Affiliated to Fudan University, Shanghai, 200040
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14
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Teng Z, Shen Y, Li J, Lin Z, Chen M, Wang M, Li M, Dong H, Huang L. Construction and Quality Analysis of Transgenic Rehmannia glutinosa Containing TMV and CMV Coat Protein. Molecules 2016; 21:E1134. [PMID: 27618888 DOI: 10.3390/molecules21091134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/23/2016] [Accepted: 08/24/2016] [Indexed: 11/17/2022] Open
Abstract
Plant viruses, especially tobacco mosaic virus (TMV) and cucumber mosaic virus (CMV) are serious threats to Rehmannia glutinosa which is a "top grade" herb in China. In the present study, TMV- and CMV-resistant Rehmannia glutinosa Libosch. plants were constructed by transforming the protein (CP) genes of TMV and CMV into Rehmannia glutinosa via a modified procedure of Agrobacterium tumefaciens-mediated transformation. Integration and expression of TMV CP and CMV CP transgenes in 2 lines, LBA-1 and LBA-2, were confirmed by PCR, Southern blot and RT-PCR. Both LBA-1 and LBA-2 were resistant to infection of homologous TMV and CMV strains. The quality of transgenic Rehmanniae Radix was evaluated based on fingerprint analysis and components quantitative analysis comparing with control root tubes. These results showed that chemical composition of transgenic Rehmanniae Radix were similar to non-transgenic ones, which demonstrated that the medical quality and biosafety of transgenic Rehmanniae Radix were equivalent to non-transgenic material when consumed as traditional Chinese medicinal (TCM).
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Bian YN, Shi J, She JJ, Wu J, Gao JM. Application of traditional indexes and adverse events in the ophthalmologic perioperative medical quality evaluation during 2010-2012. Int J Ophthalmol 2015; 8:1051-5. [PMID: 26558225 DOI: 10.3980/j.issn.2222-3959.2015.05.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 03/07/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the medical quality of ophthalmologic perioperative period during 2010-2012 in our hospital. METHODS The relevant data of perioperative period were collected in our hospital during 2010-2012, and the medical quality of perioperative period was evaluated by using the traditional evaluation indexes and adverse events. Whereby, the traditional indicators include vision changes, improving of intraocular pressure, diagnostic accordance rate before and after operation, cure improvement rate, successful rescue rate, and incidence of surgical complications, etc. Adverse events are associated with ophthalmologic perioperative events including pressure sores, postoperative wound infection, drug adverse events, and equipment related adverse events. RESULTS There were 1483, 1662 and 1931 ophthalmic operations in our hospital in the year 2010, 2011 and 2012, respectively. From traditional index analysis, the proportions of vision improvement for each year were 96.43%, 96.76% and 97.32%, respectively; the rates of intraocular pressure improvement were 87.50%, 85.72% and 90.17%, respectively (P <0.05); the diagnostic accordance rates before and after operation were 99.86%, 99.94% and 99.90%, respectively; cure improvement rates were 99.73%, 99.93% and 99.84%, respectively; the successful rescue rates were 82.98%, 81.46% and 76.66%, respectively; the complications incidence rates were 18.44%, 17.52% and 17.97%, respectively. The negative factor analysis results showed that: among all the patients of ophthalmic surgeries in our hospital during 2010 and 2012, only one case of postoperative wound infection was found in 2011, and also only one case of tumbling in 2010. The adverse drug events for each year were 1 case (0.07%), 2 cases (0.12%), and 4 cases (0.21%), respectively; the medical device adverse events for each year were 3 cases (0.20%), 5 cases (0.30%), and 6 cases (0.31%), respectively. Noticeably, only one case with postoperative infection of endophthalmitis was found in 2011. Moreover, no pulmonary infection or pulmonary embolism occurred during the three years. The perioperative adverse event rates for each year were 0.34% (5/1483), 0.48% (8/1662) and 0.52% (10/1931), respectively. Though incidence was rising during the three years period, no statistical significance was observed (P>0.05). It is the same case with drugs and medical devices adverse events (P >0.05). CONCLUSION Traditional indicators reflect an excellent operation of the perioperative ophthalmologic quality, whereas adverse events analysis indicates some underlying problems. Compared with the traditional indexes for medical quality evaluation, the index of adverse events is more reasonable and easier to make an objective evaluation for medical quality of ophthalmologic perioperation, facilitating further refine analysis. Reasonable application of the adverse events indicators helps hospital to make the detailed quality control measures.
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Affiliation(s)
- Yong-Na Bian
- The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Jian Shi
- The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Jun-Jun She
- The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Jie Wu
- The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Jian-Min Gao
- Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
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Hatoun J, Suen W, Liu C, Shea S, Patts G, Weinberg J, Eng J. Elucidating Reasons for Resident Underutilization of Electronic Adverse Event Reporting. Am J Med Qual 2015; 31:308-14. [PMID: 25753451 DOI: 10.1177/1062860615574504] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Reasons for resident underutilization of adverse event (AE) reporting systems are unclear, particularly given frequent resident exposure to AEs and near misses (NMs). Residents at an academic medical center were surveyed about AEs/NMs, barriers to reporting, patient safety climate, and educational interventions. A total of 350 of 527 eligible residents (66%) completed the survey; 77% of respondents reported involvement in an AE/NM, though only 43% had used the reporting system. Top barriers to reporting were not knowing what or how to report. Surgeons reported more than other residents (surgery, 61%; medical, 38%; hospital-based, 15%; P < .01), yet more often felt that systems were unlikely to change after reporting (surgery, 49%; medical, 28%; hospital-based. 18%; P < .01). Residents preferred discussions with supervisors (52%) and department-led conferences (46%) to increased reporting. Efforts to increase resident reporting should address common barriers to reporting as well as department-specific differences in resident knowledge, perceptions of system effectiveness, and educational preferences.
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Affiliation(s)
| | - Winnie Suen
- Boston University School of Medicine, Boston, MA Virginia Commonwealth University School of Medicine, Richmond, VA
| | | | - Sandy Shea
- Committee of Interns and Residents, Boston, MA
| | - Gregory Patts
- Boston University School of Public Health, Boston, MA
| | | | - Jessica Eng
- University of California-San Francisco, CA San Francisco VA Medical Center, San Francisco, CA
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