Academic literature on the topic 'Hospital care Australia Quality control'
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Journal articles on the topic "Hospital care Australia Quality control"
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Chetter, Tamara G. "Statistical process control part 1: a primer for using statistical process control in health care process improvement." Australian Health Review 33, no. 3 (2009): 408. http://dx.doi.org/10.1071/ah090408.
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QUALITY IMPROVEMENT is increasingly important for health care organisations both nation-wide and internationally. There is greater recognition of both the variances in patient care and the gaps between evidence-based research and current practice. At the same time, demand, not only for the quantity of services, but for higher quality services, continues to grow. Realising this, most major hospitals across Australia are initiating the redesign of hospital processes in order to maximise the timeliness and quality of patient care. But changing a process does not always result in an improvement.1,2 For this reason, a key component of any quality improvement effort is the robust measurement, analysis, and interpretation of appropriate clinical outcomes and processes, to ensure beneficial changes occur.
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Cheluvappa, Rajkumar, and Selwyn Selvendran. "Antipodean Perspectives—Aged Care Nursing and the Multifaceted Role of the Aged Care Nurse." Nursing Reports 12, no. 3 (August 30, 2022): 629–36. http://dx.doi.org/10.3390/nursrep12030062.
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Healthy ageing refers to the development and maintenance of the functional ability of ageing individuals. Aged care nurses provide nursing care to elderly individuals and usually work in aged care residential facilities, nursing homes, home care services, and/or hospital departments. The registered nurse working in the aged care sector has several important roles. Key roles cover both therapeutic and preventative paradigms, as discussed in this paper. The aged care nurse is also “tasked with” holistic patient-centred care and the promotion of healthy ageing via advocacy and sociocultural roles. This paper examined, described, and analysed the multifaceted role of an aged care nurse from an Australian perspective. We conducted meticulous searches using PubMed, Google Scholar, government guidelines, authoritative body regulations, quality control guidelines, and government portals pertaining to aged care nursing in Australia. This paper relied upon the information garnered from publications, reports, and guidelines resulting from these searches and analyses. Multiple aspects of healthy ageing and holistic aged care nursing are discussed. The key roles of the aged care nurse are enumerated next, in accordance with the code of conduct from the Nursing and Midwifery Board of Australia (NMBA). The NMBA promotes evidence-based, culturally sensitive, consultative, holistic aged care clinical practice that includes input from care recipients, their decision makers, and/or their health care providers. The difficult issue of loneliness is discussed with strategies to ameliorate aspects of this. Good social networks, community interactions, meaningful friendships, and participation in personalised spiritual/religious practices improve the quality of aged care. The key topic of elder abuse and its forms are discussed apropos of aged care nursing. Healthy ageing is promoted by identifying and reporting elder abuse at the earliest. Current Australian law and recent federal legislation changes pertaining to aged care nursing are discussed next. As a result of these legislation changes, several new quality control imperatives (for aged care organisations/facilities) under the Aged Care Quality and Safety Commission (ACQSC) have been implemented. Residential and flexible aged care providers should now have robust ongoing documentation and a well-developed behaviour support plan (BSP) for each care recipient who currently requires or may require restrictive practices, which must be reported under the new serious incident reporting scheme (SIRS). Various strategies to promote healthy ageing and approaches to communicate effectively with aged care recipients are also discussed. Healthy ageing is promoted when age care recipients are empowered with making their own autonomous choices in “major and minor” aspects of life. Finally, approaches to optimise quality aged care nursing care are discussed. The Roper–Logan–Tierney model is one of the models used to assess and optimise nursing care. This is premised on the capability of an ageing individual to accomplish 12 basic activities of daily living.
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Hill, Anne-Marie, Rachael Moorin, Susan Slatyer, Christina Bryant, Keith Hill, Nicholas Waldron, Samar Aoun, et al. "Evaluating the provision of Further Enabling Care at Home (FECH+) for informal caregivers of older adults discharged home from hospital: protocol for a multicentre randomised controlled trial." BMJ Open 11, no. 6 (June 2021): e046600. http://dx.doi.org/10.1136/bmjopen-2020-046600.
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IntroductionThere are personal and societal benefits from caregiving; however, caregiving can jeopardise caregivers’ health. The Further Enabling Care at Home (FECH+) programme provides structured nurse support, through telephone outreach, to informal caregivers of older adults following discharge from acute hospital care to home. The trial aims to evaluate the efficacy of the FECH+ programme on caregivers’ health-related quality of life (HRQOL) after care recipients’ hospital discharge.Methods and analysisA multisite, parallel-group, randomised controlled trial with blinded baseline and outcome assessment and intention-to-treat analysis, adhering to Consolidated Standards of Reporting Trials guidelines will be conducted. Participants (N=925 dyads) comprising informal home caregiver (18 years or older) and care recipient (70 years or older) will be recruited when the care recipient is discharged from hospital. Caregivers of patients discharged from wards in three hospitals in Australia (one in Western Australia and two in Queensland) are eligible for inclusion. Participants will be randomly assigned to one of the two groups. The intervention group receive the FECH+ programme, which provides structured support and problem-solving for the caregiver after the care recipient’s discharge, in addition to usual care. The control group receives usual care. The programme is delivered by a registered nurse and comprises six 30–45 min telephone support sessions over 6 months. The primary outcome is caregivers’ HRQOL measured using the Assessment of Quality of Life—eight dimensions. Secondary outcomes include caregiver preparedness, strain and distress and use of healthcare services. Changes in HRQOL between groups will be compared using a mixed regression model that accounts for the correlation between repeated measurements.Ethics and disseminationParticipants will provide written informed consent. Ethics approvals have been obtained from Sir Charles Gairdner and Osborne Park Health Care Group, Curtin University, Griffith University, Gold Coast Health Service and government health data linkage services. Findings will be disseminated through presentations, peer-reviewed journals and conferences.Trial registration numberACTRN12620000060943.
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Rhee, Joel, Anne Meller, Karolina Krysinska, Peter Gonski, Vasi Naganathan, Nicholas Zwar, Andrew Hayen, et al. "Advance care planning for patients with advanced illnesses attending hospital outpatient clinics study: a study protocol for a randomised controlled trial." BMJ Open 9, no. 1 (January 2019): e023107. http://dx.doi.org/10.1136/bmjopen-2018-023107.
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IntroductionIt is unclear whether advance care planning (ACP) undertaken with patients living in the community can improve patient care and avoid unwanted interventions and hospital admissions. We have designed a randomised controlled trial (RCT) to examine if ACP undertaken with patients with advanced illnesses attending hospital outpatient clinics can reduce unplanned hospital admissions and improve patient and caregiver well-being.Methods and analysisPragmatic RCT involving patients from subspecialty outpatient clinics at five clinical sites in Sydney, Australia. Participants will be ≥18 years screened as potentially having palliative care needs and at risk of dying in 6–12 months. The patients will be randomised to intervention or control group. Intervention group will undertake ACP discussions facilitated by a trained health professional. The control group will receive written information on ACP, representing the current standard of care. The primary outcome is the number of unplanned hospital admissions at the 6-month follow-up. Secondary outcomes include: (i) patient’s health-related quality-of-life and quality of chronic disease care; (ii) caregiver’s health-related quality-of-life and caregiver burden and (iii) other health outcomes including ambulance usage, emergency department presentations, hospital admissions, resuscitation attempts, intensive care unit admissions, deaths, documentation of patient wishes in patient records and audit of ACP discussions and documents. The staff’s self-reported attitudes and knowledge of ACP will also be measured. The data will be collected using self-report questionnaires, hospital records audit, audit of ACP documentation and data linkage analysis. Semistructured interviews and focus group discussions with patients, caregivers and healthcare professionals will explore the acceptability and feasibility of the intervention.Ethics and disseminationApproved by South-East Sydney Local Health District Human Research Ethics Committee and NSW Population and Health Services Research Ethics Committee. Results will be disseminated via conference presentations, journal publications, seminars and invited talks.Trial registration numberACTRN12617000280303.
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Abdel-Latif, Mohamed E., Gen Nowak, Barbara Bajuk, Kathryn Glass, and David Harley. "Variation in hospital mortality in an Australian neonatal intensive care unit network." Archives of Disease in Childhood - Fetal and Neonatal Edition 103, no. 4 (October 26, 2017): F331—F336. http://dx.doi.org/10.1136/archdischild-2017-313222.
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BackgroundStudying centre-to-centre (CTC) variation in mortality rates is important because inferences about quality of care can be made permitting changes in practice to improve outcomes. However, comparisons between hospitals can be misleading unless there is adjustment for population characteristics and severity of illness.ObjectiveWe sought to report the risk-adjusted CTC variation in mortality among preterm infants born <32 weeks and admitted to all eight tertiary neonatal intensive care units (NICUs) in the New South Wales and the Australian Capital Territory Neonatal Network (NICUS), Australia.MethodsWe analysed routinely collected prospective data for births between 2007 and 2014. Adjusted mortality rates for each NICU were produced using a multiple logistic regression model. Output from this model was used to construct funnel plots.ResultsA total of 7212 live born infants <32 weeks gestation were admitted consecutively to network NICUs during the study period. NICUs differed in their patient populations and severity of illness.The overall unadjusted hospital mortality rate for the network was 7.9% (n=572 deaths). This varied from 5.3% in hospital E to 10.4% in hospital C. Adjusted mortality rates showed little CTC variation. No hospital reached the +99.8% control limit level on adjusted funnel plots.ConclusionCharacteristics of infants admitted to NICUs differ, and comparing unadjusted mortality rates should be avoided. Logistic regression-derived risk-adjusted mortality rates plotted on funnel plots provide a powerful visual graphical tool for presenting quality performance data. CTC variation is readily identified, permitting hospitals to appraise their practices and start timely intervention.
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Long, R., J. Luzuriaga, C. Biondi, A. Woods, P. Jackson, C. Anderiesz, C. Giles, and H. Zorbas. "Collection and Reporting of System-Wide Cancer Treatment Activity Data As Part of the Stage, Treatment and Recurrence (STaR) Project." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 74s. http://dx.doi.org/10.1200/jgo.18.61400.
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Background: The need for high quality, comprehensive national data on the treatments applied to cancers is widely recognized within the Australian cancer control community. The analysis and reporting of cancer treatment data will greatly enhance our ability to better understand cancer care activity and outcomes - and in particular the treatments being applied across population groups. Aim: To collect and report national data on cancer treatments, as part of Cancer Australia's Stage, Treatment and Recurrence (STaR) project. The linking of this data with national data on stage at diagnosis, survival and recurrence, will help inform policy and practice and ultimately improve cancer outcomes. Methods: Cancer Australia developed a dataset of selected surgical procedures for the treatment of the top five incidence cancers (prostate, breast, colorectal, lung, and melanoma). A dataset of key selected radiotherapy, and systemic therapies for the treatment of all cancer types was also developed. Data for reporting system-wide treatment activity were extracted from existing national health administrative datasets, including: the Pharmaceutical Benefits Scheme (PBS), the Medicare Benefits Schedule (MBS) and the National Hospital Morbidity Database (NHMD). The scope of the analysis was selected surgical procedures, radiotherapy procedures, or pharmaceutical agents administered with the general intent to change the outcome of the cancer and/or provide symptom relief/ palliative care. Results: The data reported provide a high-level national system-wide overview of cancer treatments applied, including: • More than 1 million radiotherapy services were provided for all cancers combined in Australia (as indicated by MBS reimbursement claims data) for the years 2013 to 2015 inclusive; • The number of people receiving systemic anticancer therapies in Australia for all cancers combined (as indicated by PBS reimbursement claims data) increased from 198,756 in 2012 to 247,939 in 2016; and • The number of hospital separations recorded in the NHMD (i.e., episodes of admitted patient care) for patients with a principal diagnosis of cancer undergoing surgery for the treatment of the top five high incidence cancers in Australia increased from 53,516 in 2010 to 57,651 in 2015. Conclusion: National cancer treatment data were successfully collected and reported. Australia is one of very few countries in the world to collect and report national system-wide treatment data with a specific focus on cancer. These data will be linked to cancer incidence, stage at diagnosis, survival and recurrence data to help inform for population-level reporting of cancer outcomes.
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McDerby, Nicole, Sam Kosari, Kasia Bail, Alison Shield, Gregory Peterson, and Mark Naunton. "Residential Aged Care Pharmacist: An Australian Pilot Trial Exploring the Impact on Quality Use of Medicines Indicators." Medicines 7, no. 4 (April 20, 2020): 20. http://dx.doi.org/10.3390/medicines7040020.
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Background: This pilot study aimed to assess whether an on-site pharmacist could influence indicators of quality use of medicines in residential aged care. Methods: A pharmacist was embedded in a residential aged care home for six months. A similar control site received usual care. Polypharmacy, drug burden index, antipsychotic and benzodiazepine use, hospital admission rates and length of stay, and emergency department presentation rates were outcomes used to indicate medication use quality. Data were extracted from participating resident health records. Results: Fifty-eight residents at the study site and 39 residents at the control site were included in the analysis. There was a reduction in the proportion of residents at the study site who had at least one hospital admission at follow-up (28% to 12%, p < 0.01), but no significant difference in other outcomes. Conclusions: This pilot study suggests that a residential care pharmacist may positively influence indicators of medication use quality in aged care; however, further research is needed to expand on these findings.
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Conway, Jane, Sophie Dilworth, Carolyn Hullick, Jacqueline Hewitt, Catherine Turner, and Isabel Higgins. "A multi-organisation aged care emergency service for acute care management of older residents in aged care facilities." Australian Health Review 39, no. 5 (2015): 514. http://dx.doi.org/10.1071/ah15049.
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This case study describes a multi-organisation aged care emergency (ACE) service. The service was designed to enable point-of-care assessment and management for older people in residential aged care facilities (RACFs). Design of the ACE service involved consultation and engagement of multiple key stakeholders. The ACE service was implemented in a large geographical region of a single Medicare Local (ML) in New South Wales, Australia. The service was developed over several phases. A case control pilot evaluation of one emergency department (ED) and four RACFs revealed a 16% reduction in presentations to the ED as well as reductions in admission to the hospital following ED presentation. Following initial pilot work, the ACE service transitioned across another five EDs and 85 RACFs in the local health district. The service has now been implemented in a further 10 sites (six metropolitan and four rural EDs) across New South Wales. Ongoing evaluation of the implementation continues to show positive outcomes. The ACE service offers a model shown to reduce ED presentations and admissions from RACFs, and provide quality care with a focus on the needs of the older person.
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Gough, K., and M. Krishnasamy. "Variation in the Quality of Experiences of Cancer Care at Five Large Metropolitan Health Services in Australia: Implications for Performance Measurement and Improvement." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 90s. http://dx.doi.org/10.1200/jgo.18.32400.
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Background: Using insights gained from the National Health Service in England, an alliance of organizations committed to cancer control in Australia conducted a large-scale survey aimed at better understanding the quality of cancer care. Aims: To understand sources of variation in the quality of patients' experiences of cancer care; and to identify patients with the largest potential to benefit from strategic quality improvement initiatives. Methods: The Victorian Comprehensive Cancer Centre commissioned a cross-sectional survey of adult cancer patients treated as day cases or inpatients at five partner health services in 2015. Data comprised responses to the National Health Service (NHS) Cancer Patient Experiences Survey, ICD-10-AM codes and postcodes. Some survey items were modified to suit the Australian population based on advice from local experts and consumers. Aspects of care covered by the survey included: timeliness and experience of diagnosis; treatment decision-making; provision of support information; experience of operations, hospital doctors, ward nurses, hospital care and home care and support; experience of care as a day or outpatient; follow-up care with general practitioners; and overall cancer care. Consistent with NHS methodology, cancer care questions were recoded to binary variables reflecting more or less positive experiences and cancer type was defined based on ICD-10-AM codes. Postcodes were converted to an index of relative socioeconomic advantage and disadvantage using an Australian standard. Proportions were used to summarize the characteristics of patients who had more and less positive experiences of cancer care; then, logistic regression was used to model the probability of having less positive experiences. Age, gender, language spoken at home, socioeconomic group and cancer type were included in the models. Univariate models were used to calculate unadjusted odds ratios. Multivariate models were used to calculate the odds ratios of less positive experiences adjusting for patient characteristics and cancer type. Results: A total of 2526 patients completed the survey (response rate: 41%). As a general rule, and consistent with findings from the NHS, a substantial majority of patients (80% or more) reported positively on many aspects of care. Even so, more often than not aggregated data obscured striking disparities between patients diagnosed with different types of cancers. Overall, patients diagnosed with pancreatic cancer fared the worst; more than half reported less favorably on multiple aspects of care. Variation in perceptions of care was not as pronounced for different age groups, genders and language groups and we identified little variation between socioeconomic groups. Conclusion: At the very least, cancer system performance should be appraised by cancer type. Aggregation may conceal gross inequities and thwart attempts to identify those patients most likely to benefit from targeted service improvements.
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Young, Jane M., Phyllis N. Butow, Jennifer Walsh, Ivana Durcinoska, Timothy A. Dobbins, Laura Rodwell, James D. Harrison, et al. "Multicenter Randomized Trial of Centralized Nurse-Led Telephone-Based Care Coordination to Improve Outcomes After Surgical Resection for Colorectal Cancer: The CONNECT Intervention." Journal of Clinical Oncology 31, no. 28 (October 1, 2013): 3585–91. http://dx.doi.org/10.1200/jco.2012.48.1036.
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Purpose To investigate the effectiveness of a centralized, nurse-delivered telephone-based service to improve care coordination and patient-reported outcomes after surgery for colorectal cancer. Patients and Methods Patients with a newly diagnosed colorectal cancer were randomly assigned to the CONNECT intervention or usual care. Intervention-group patients received standardized calls from the centrally based nurse 3 and 10 days and 1, 3, and 6 months after discharge from hospital. Unmet supportive care needs, experience of care coordination, unplanned readmissions, emergency department presentations, distress, and quality of life (QOL) were assessed by questionnaire at 1, 3, and 6 months. Results Of 775 patients treated at 23 public and private hospitals in Australia, 387 were randomly assigned to the intervention group and 369 to the control group. There were no significant differences between groups in unmet supportive care needs, but these were consistently low in both groups at both follow-up time points. There were no differences between the groups in emergency department presentations (10.8% v 13.8%; P = .2) or unplanned hospital readmissions (8.6% v 10.5%; P = .4) at 1 month. By 6 months, 25.6% of intervention-group patients had reported an unplanned readmission compared with 27.9% of controls (P = .5). There were no significant differences in experience of care coordination, distress, or QOL between groups at any follow-up time point. Conclusion This trial failed to demonstrate substantial benefit of a centralized system to provide standardized, telephone follow-up for postoperative patients with colorectal cancer. Future interventions could investigate a more tailored approach.
Dissertations / Theses on the topic "Hospital care Australia Quality control"
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Mussett, Janis. "An analysis of quality practices and business outcomes in Western Australian hospitals." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2000. https://ro.ecu.edu.au/theses/1651.
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This study aimed at identifying aspects of health care organisational management and activities that produced the highest level of quality care. A Literature review was conducted to determine the most successful quality activities currently used in a wide variety of industries. Using the findings of this review a questionnaire and interview questions were designed to identify factors associated with successful quality activities I health care organisations. Four Western Australian hospitals that were believed to have effective quality activities were randomly selected as a hospital from each of the following categories. A private hospital accredited by the Australian Council on Health Care Standards. A country hospital that had 100% patient satisfaction and a city hospital with above 96% patient satisfaction assessed by the State wide Government Patient Satisfaction with Care Survey. A hospital that the Health Department of Western Australia considered had best practice in Quality Activities. Each of these hospitals was matched with a control hospital. Data was collected through direct observation of a questionnaire and interviews with people in predetermined health service employment positions and the completion of one randomly selected supplier interview for each of the eight health services studied. The questionnaire was supplied to a range of staff members and interviews were conducted with these employees and hospital goods or service suppliers. Data was analysed using qualitative evaluation, frequency distribution and a factor analysis. Results obtained in this study identified that the most important factors required to produce the most profitable and highest quality of health care were a culture of caring, providing employees with enough time to complete their work and having effective organisation wide communication. A Quality Care Model for use in Health Services was created based on the research findings. When used this model of quality activities should provide customer satisfaction and a high standard of cost effective health care service.
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Patterson, Jan. "Consumers and complaints systems in health care /." Title page, contents and summary only, 1996. http://web4.library.adelaide.edu.au/theses/09PH/09php3174.pdf.
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Finnie, Carol Jean. "The components of a quality assurance program for smaller hospitals." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24662.
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The components of a quality assurance program for smaller hospitals in British Columbia have been defined. These components have been defined by a comparison of the normative standards as determined in the literature and by a survey of administrators. Sixteen administrators of predominantly acute-care, accredited, 20-50-bed hospitals in B.C. were surveyed. Twelve of these administrators were surveyed twice.
A new requirement for accreditation was introduced by the Canadian Council on Hospital Accreditation (C.C.H.A.) called the Quality Assurance Standard (1985). This Standard required that quality assurance (QA) programs be established in every department or service in the hospital. The Standard does not give a clear description of the QA functions for each individual department in a smaller hospital. An important and relevant list of specific functions for a QA program were identified at various C.C.H.A. seminars held across Canada in late 1983 and early 1984.
The literature review indicated that there were a number of controversial issues affecting the implementation of the QA Standard. In spite of many methodological problems associated with quality measurement and assurance, most hospitals will adopt a quality assurance model. The first survey asked the administrators to define the purpose, goals and objectives of a QA program. They were also asked to determine the QA functions for four areas: hospital board, dietary, nursing and pharmacy. Administrators were asked to identify who in the hospital is primarily responsible for the overall QA program and for the QA program in four areas; the problems and benefits encountered when trying to implement a QA program; and their opinion of the new QA requirements for accreditation.
The second survey asked the administrators to assign a priority to those functions identified in Round I. The empirical findings were then compared with the normative standards.
With some exceptions, the empirical data were consistent with the normative standards. The empirical findings shows that there are problems related to implementing a QA program but at the same time there are a number of benefits related to the program.
The priority ratings of the functions indicated areas of high or low importance to the administrator. It is likely that these priority ratings are useful for planning when alternatives must be considered during this time of fiscal restraint. Government policies along with the strong voluntary support of accreditation programs make it vitally important that suitable models for implementing QA are developed. The Doll model is suggested as a basis for implementing QA. Further areas for research are presented.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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Theunissen, Dirkie Petra. "Improving service quality and operations at a South African private healthcare clinic through the implimentation of lean principles." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1020654.
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Although open to debate, it is something of an undisputed fact and has been since the days of Florence Nightingale, that hospital management is frustrated with recurring problems - many of them due to broken processes. Hospitals are places of phenomenal healing and heroic care. However, as with any human-led endeavour, there are problems. (Grunden (2009)) A first time use of the word ‘lean’ generally begs some explaination as it is not a commonly used word. The simplest way to explain the word is by way of the introduction of the concept known as ‘lean management’. Lean management is a methodology which allows hospitals to advance the quality of patient care by reducing errors and waiting times. Lean is a system of reinforcement of hospital business for the long term thereby reducing costs and risk. Kanban (2009) states that lean is a toolset; a management system and a viewpoint that can change the way hospitals are structured and managed. Lean helps managers to comprehend and identify broken systems and to improve these in small parts, while employees aid in finding solutions for broken systems. This proposal analyses the effect lean tools have had within Arwyp Medical Centre in Kempton Park, South Africa.
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Theunissen, Dirkie Petra Stephanie. "Improving service quality and operations at a South African private healthcare clinic through the implimentation of lean principles." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/d1019943.
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Although open to debate, it is something of an undisputed fact and has been since the days of Florence Nightingale, that hospital management is frustrated with recurring problems - many of them due to broken processes. Hospitals are places of phenomenal healing and heroic care. However, as with any human-led endeavour, there are problems. (Grunden (2009)). A first time use of the word ‘lean’ generally begs some explaination as it is not a commonly used word. The simplest way to explain the word is by way of the introduction of the concept known as ‘lean management’. Lean management is a methodology which allows hospitals to advance the quality of patient care by reducing errors and waiting times. Lean is a system of reinforcement of hospital business for the long term thereby reducing costs and risk. Kanban (2009) states that lean is a toolset; a management system and a viewpoint that can change the way hospitals are structured and managed. Lean helps managers to comprehend and identify broken systems and to improve these in small parts, while employees aid in finding solutions for broken systems. This proposal analyses the effect lean tools have had within Arwyp Medical Centre in Kempton Park, South Africa.
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Al-Awa, Bahjat. "Impact of hospital accreditation on patients' safety and quality indicators." Doctoral thesis, Universite Libre de Bruxelles, 2011. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209917.
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Ecole de Santé Publique Université Libre de Bruxelles
Academic Year 2010-2011
Al-Awa, Bahjat
Impact of Hospital Accreditation on Patients' Safety and Quality Indicators
Dissertation Summary
I.\
Doctorat en Sciences
info:eu-repo/semantics/nonPublished
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Badrick, Tony Cecil. "Implementing total quality management in Australian health care organizations." Thesis, Queensland University of Technology, 1997.
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Eckermann, Simon Economics Australian School of Business UNSW. "Hospital performance including quality: creating economic incentives consistent with evidence-based medicine." Awarded by:University of New South Wales. School of Economics, 2004. http://handle.unsw.edu.au/1959.4/22011.
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This thesis addresses questions of how to incorporate quality of care, represented by disutility-bearing effects such as mortality, morbidity and re-admission, in measuring relative performance of public hospitals. Currently, case-mix funding and performance, measured with costs per case-mix adjusted separation, hold hospitals accountable for costs, but not effects, of care, creating economic incentives for quality of care minimising cost per admission. To allow an appropriate trade-off between the value and cost of quality of care a correspondence is demonstrated between maximising net benefit and minimising costs plus decision makers??? value of disutility events, where effects of care can be represented by disutility events and hospitals face a common comparator. Applying this correspondence to performance measurement, frontier methods specifying disutility events as inputs are illustrated to have distinct advantages over output specifications, allowing estimation of: 1. economic efficiency conditional on the value of avoiding disutility events. 2. technical, scale and congestion sources of net benefit efficiency; 3. best practice peers over potential decision makers??? value of quality; and 4. industry shadow price of avoiding disutility events. The accountability this performance measurement framework provides for effects and cost of quality of care are also illustrated as the basis for moving from case-mix funding towards a funding mechanism based on maximising net benefit. Links to evidence-based medicine in health technology assessment are emphasised in illustrating application of the correspondence to comparison of multiple strategies in the cost-disutility plane, where radial properties as shown to provide distinct advantages over comparison in the cost-effectiveness plane. The identified performance measurement and funding framework allows policy makers to create economic incentives consistent with evidence-based medicine in practice, while avoiding incentives for cream-skimming and cost-shifting. The linear nature of the net benefit correspondence theorem allows simple inclusion of multiple effects of quality, whether expressed as not meeting a standard, functional limitation or disutility directly. In applying the net benefit correspondence theorem to hospitals a clinical activity level is suggested, to allow correspondence conditions to be robustly satisfied in identification of effects with decision analytic methods, adjustment for within DRG risk factors and data linkage to effects beyond separation.
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Luke, Gary Joseph. "An assessment of the service quality expectations and perceptions of the patients of Awali Hospital in the Kingdom of Bahrain." Thesis, Rhodes University, 2008. http://hdl.handle.net/10962/d1003850.
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The quality of service from a hospital is the number one factor that will either turn a customer/patient away or make one for life. More and more hospitals are competing for greater shares in the market and customer-driven quality management is becoming the preferred method for improving their performance. Awali hospital is a private hospital in the Kingdom of Bahrain. It is a small 35-bed hospital that offers private medical services to the public. The hospital was originally built to serve the Bahrain Petroleum Company (Bapco) refinery workers but later opened its doors to the public. With the introduction of private patients came higher expectations of quality and higher demands on the overall services. A number of service quality shortfalls were identified over the years but never identified quantitatively by a patient evaluation survey. An English and Arabic version of the questionnaire based on SERVQUAL (Zeithaml, Parasuraman and Berry, 1988) was developed and placed in Awali hospital to test these service quality shortfalls. This study intends to evaluate these areas by answering questions about the relevant areas of service provided by the hospital. It measured patient satisfaction by looking at human aspects of service (responsiveness, reliability, empathy and assurance) with only one factor of the instrument being devoted to the non-human aspect of care rendered (tangibles). The SERVQUAL instrument has five dimensions that were measured by 21 pairs of item statements. One statement from each pair reflects perceptions, the other expectations. Measurement was accomplished by subtracting expectation from perceptions resulting in a service quality score. Positive or zero scores would reflect ideal or adequate service quality offered by the hospital. A negative score would be indicative of a service experience that did not meet customer expectations. Using the SERVQUAL questionnaire provided, quantifiable reasoning to the research questions in each dimension could be obtained so that precision, objectivity and rigour replaced hunches, experience and intuition as a means of investigating problem areas. Customers were first asked to supply some additional demographic information, for example gender, number of hospital visits, nationality, patient type (Bapco worker, general practitioner referred or private) and type of visit (inpatient, outpatient or both). They werethen asked to rate the hospital service on a 7-point Likert scale ranging from Strongly Agree (7) to Strongly Disagree (1). At the end of the questionnaire was space to write open comments. In total 600 paper questionnaires were distributed in the hospital, 300 English and 300 Arabic. Another 150 electronic questionnaires via emails were sent to refinery workers. Of the total 750 questionnaires distributed 162 were returned of which 156 (or 21.6%) could be statistically analysed. The empirical data results showed that the perception scores were significantly different at the p < 0.05 level from expectation scores. All the service quality differences (SQ=P-E) were negatively scored. This indicated that patients were not satisfied in all five dimensions of services offered by the hospital. Of the five dimensions responsiveness had the largest difference with assurance and reliability following with no significant differences between them. The demographic information revealed some interesting differences between the groups. Of all the demographic groups the most significant differences were between groups, “patient types” and “types of visit”, which showed differences between private patients and refinery workers and patients who used the hospital only as an outpatient and patients who used both services, outpatient and inpatient. In terms of the managerial implications, it was recommended that Awali hospital look to closing Gaps 1-4 of the SERVQUAL gap model which would result in closing the consumer gap, Gap 5. A process model for continuous measurement and improvement of service quality was recommended that looks at asking questions about how the hospital is performing. By adopting some of the recommendations identified in the research questions, Awali hospital could improve their quality of service, and as a consequence, their customer satisfaction and loyalty.
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Baker, Melanie Jane. "The application of evidence based practice in the acute care hospital setting: A grounded theory study of the perspective of nurses in Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2020. https://ro.ecu.edu.au/theses/2377.
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Evidence based practice (EBP) in nursing is an important part of care provision, both in Australia and globally. The experience of applying evidence in practice presents many challenges for nurses. This study focused on the application of EBP in the acute care hospital setting. Grounded Theory methodology was used and 21 semi-structured recorded interviews with Registered Nurses from two acute care hospitals were conducted. Data were analysed using the constant comparative method.
A substantive theory was developed, Traversing the EBP Conundrum, as the process used to manage the core issue: The Challenge of Applying EBP. Time Constraints, Nurses’ Inherent Traits, and The Organisation Talking the Talk but not Walking the Walk, were conditions affecting the nurses’ daily practice. These conditions resulted in a discrepancy between the ideal mandated by the nursing profession and organisations, and the reality of working in a context of Consideration for Quality and Safety. In applying the process, nurses were found to Survive the Conundrum: Navigating Alternative Pathways; by Getting Lost in the Bush: Going Their Own Way; by Scaling New Heights Working Over and Above to Optimise Outcomes.
This study raises questions regarding the quality and safety of patient care, as well as the wellbeing of nurses, and the ideal of EBP which is mandated by professional bodies. The findings lead to recommendations including: further research into the reality of EBP for nurses and its impact upon patient outcomes, safety, nurses job satisfaction and nurse retention; consideration by the professional body as to how realistic professional and organisational expectations of EBP are in nursing; and a review of decision making by leaders in relationship to EBP, therefore quality and safety.
Books on the topic "Hospital care Australia Quality control"
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L, Rowland Beatrice, ed. Hospital quality assurance manual. Rockville, Md: Aspen Publishers, 1989.
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Coe, Charles P. The elements of quality in pharmaceutical care. Bethesda, MD: ASHP, 1992.
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R, Dichter Jeffrey, and Dichter Jeffrey R, eds. The hospitalist program management guide. 2nd ed. Marblehead, MA: HCPro, Inc., 2008.
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Erkert, Thomas. Qualitätssicherung im Krankenhauswesen: Übertragbarkeit nordamerikanischer Ansätze auf die Bundesrepublik Deutschland. Konstanz: Hartung-Gorre, 1991.
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Williams, Kenneth J. Medical care quality and the public trust. Ottawa: Canadian Hospital Association, 1987.
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Forgia, Gerard M. La. Hospital performance in Brazil: The search for excellence. Washington, D.C: World Bank, 2008.
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Forgia, Gerard M. La. Hospital performance in Brazil: The search for excellence. Washington, D.C: World Bank, 2008.
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Bullas, Sheila. Managing hospital quality and cost: Using patient-based information. Harlow: Longman, 1994.
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Health care quality: The path forward : hearing before the Committee on Finance, United States Senate, One Hundred Thirteenth Congress, first session, June 26, 2013. Washington: U.S. Government Printing Office, 2013.
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Greeley, Hugh P. Streamlining quality monitoring. Marblehead, MA: Opus Communications, 1995.
Find full textBook chapters on the topic "Hospital care Australia Quality control"
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Manachi, Maha, Eyad Chatty, Seham Sulaiman, and Zahera Fahed. "General Oncology Care in Syria." In Cancer in the Arab World, 265–84. Singapore: Springer Singapore, 2022. http://dx.doi.org/10.1007/978-981-16-7945-2_17.
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AbstractThe first entity dedicated to cancer was established named “Nuclear Medical Center” with a single radiotherapy unit in 1969. Since then, the concept of oncology has rapidly progressed with the establishment of a division of oncology in the University of Damascus, School of Medicine with six staff members at that time. In 2001, a National Cancer Registry was established with the help of the World Health Organization. Many civil societies related to cancer awareness, early detection, and care of patients bloomed, first being the Syrian Cancer Society.Now cancer diagnosis and treatment facilities are spread all over the county but mainly concentrated in Damascus, Lattakia, and Aleppo. All three main government related medical entities that are the Ministry of Higher Education, Ministry of Health, and the Medical Corps are involved in the process with the help of the private sector also. This progress of course was slowed due to the bloody aggression that engulfed Syria for 10 years of conflict. However, it did not halt the country’s goals and achievements.In 2006, Nuclear Medicine Centre was developed into a comprehensive institution for cancer, Al Bairouni University Hospital (ABUH) to provide free standard of care treatment for all citizens. The Syrian National Committee for cancer control (SNCCC) was established in June 2019 with a mission of strategic planning for better cancer management in collaboration with all stakeholders aiming to raise cancer services to the best possible standard in the post-war era. The chapters’ focus is to discuss cancer care services being provided in the country and future challenges that need to be addressed for high quality oncology care services in Syria.
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Kharfan-Dabaja, Mohamed A. "The Infusion Center." In The Comprehensive Cancer Center, 35–40. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-82052-7_5.
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AbstractAvailability of more effective supportive therapies coupled with emergence of novel antineoplastic agents has facilitated administration of cancer treatments outside the hospital setting. Cancer treatments typically require multiple visits. Accordingly, it can be exhausting for patients and their caregivers who are already under a lot of stress including physical, emotional and financial strain, among others. Infusion centers allow providers to help patients better manage and control their disease and associated symptoms by providing a continuity of care throughout their medical need, enhancing continuity of care and improving compliance. Here, we described the major components required for successful operation of a cancer infusion center. The ultimate goal is to offer a patient-centered experience that improves the overall quality of delivered care at a sustainable cost.
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Orosz, Péter, Ágnes Vadász, Dániel Sándor Veres, Zsolt Berentei, István Gubucz, Sándor Nardai, Balázs Kis, and István Szikora. "Living with a Brain AVM: A Quality of Life Assessment." In Acta Neurochirurgica Supplement, 71–76. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63453-7_10.
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AbstractBackground and purpose: Brain arteriovenous malformations (AVM) are uncommon vascular lesions with the risk of hemorrhage, epileptic seizures, neurological deficits, and headache. Comparing the risks of the natural history and that of preventive treatment, a recent study has found observation more beneficial than treatment for unruptured AVMs. This study, however, did not consider the long-term impact of carrying a brain AVM on everyday activities. In this study we analyzed the Quality Of Life (QOL) of patients with untreated AVMs, a measure increasingly used in clinical trials to asses this kind of impact.Methods: We enrolled 36 patients with unruptured, untreated brain AVM from our hospital database and measured their QOL retrospectively using the EQ-5D-5L questionnaire. As a control group we used the results of the Research Report, a nationwide study based on the quality of life of 5534 healthy Hungarians in 2002. Due to the low number of cases, statistical analysis could not be made.Results: Headache proved to be the most common AVM-related sign in our cohort (40%, n = 17), with a female predominance; neurological deficit was detected in 33% (n = 14), while epileptic seizures occurred in 26% (n = 11), more commonly affecting male subjects. Anxiety and discomfort seemed to be the most prevalent influencing factors on QOL, especially in the youngest age group (18–34 years). Female subjects showed a greater dependence than men in all age groups, though males had a more significant impairment in their usual activities. Older patients were affected more significantly in their self-care and usual activities compared with the younger population.Conclusions: Untreated AVMs have a significant negative impact on patients carrying unruptured brain AVMs, as proved by QOL assessment. Beside neurological deficits, this impact should also be considered in the therapeutic decision.
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Grosso, Dolores, Mahmoud Aljurf, and Usama Gergis. "Building a Comprehensive Cancer Center: Overall Structure." In The Comprehensive Cancer Center, 3–13. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-82052-7_2.
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AbstractAccording to the World Health Organization (WHO), cancer is the second leading cause of death globally, accounting for approximately 9.6 million deaths [1]. The WHO recommends that each nation has a national cancer control program (NCCP) to reduce the incidence of cancer and deaths related to cancer, as well as to improve the quality of life of cancer patients [2]. Comprehensive cancer centers form the backbone of a NCCP and are charged with developing innovative approaches to cancer prevention, diagnosis, and treatment [3]. This is accomplished through basic and clinical research, the provision of patient care, the training of new clinicians and scientists, and community outreach and education. Most comprehensive cancer centers are affiliated with university medical centers, but their cancer care initiatives may involve partnering outside the institution with other comprehensive cancer centers, community leaders, or members of industry [3]. When affiliated with a university medical center, cancer center executives must work in concert with their counterparts at the hospital, patient practice, medical school, and allied health science leaders resulting in an overlapping, often complicated reporting structure. Comprehensive cancer centers and the departments in the center receive funding for their services from various sources, including national and local grants, institutional funds, private donations, and industry [4].
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Wickramasinghe, Nilmini, and Steve L. Goldberg. "Accountable Care and Evidence-Based Decision Making." In Handbook of Research on Healthcare Administration and Management, 567–76. IGI Global, 2017. http://dx.doi.org/10.4018/978-1-5225-0920-2.ch034.
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In today's cost challenged healthcare environment accountable care and evidence-based decision making have become important considerations. Contemporaneous to this is the fact that the superior management of diabetes has become a global priority especially given the exponential increase in the number of diabetes patients as well as the financial implications of treating this silent epidemic. Thus, this research focuses on trying to address these respective yet critical issues by examining the possibility of using a mobile web-based reporting system that taps into existing widely available resources to monitor and manage gestational diabetes. To test this solution, we adopted a randomized control trial with two-arm cross over applied to a not-for profit hospital in Victoria, Australia. From the perspective of practice, we have uncovered far reaching implications for hospital management's cost vs. quality care to patients. In particular, it appears that the adoption of smartphones to support many aspects of care and patient-clinician interactions is prudent.
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Jan, Farooq. "Hospital infection control measures." In Quality Hospital Care, 146. Jaypee Brothers Medical Publishers (P) Ltd., 2013. http://dx.doi.org/10.5005/jp/books/11807_16.
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Siesling, Sabine, Freddie Bray, Roberto Zanetti, Tomohiro Matsuda, Anna Gavin, Adri Voogd, Betsy Kohler, and Ryan McCabe. "Cancer Registries." In Breast cancer: Global quality care, edited by Isabelle Soerjomataram, Claudia Allemani, Adri Voogd, and Sabine Siesling, 17–24. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198839248.003.0002.
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Abstract: Cancer registries provide insight into the burden of cancer by systematically recording data on new (pre)malignancies and/or in-situ tumours within a specific region, area, or treatment setting (e.g. hospital-based care). An understanding of the burden for a patient group at the population level is given by indicators such as incidence, survival, treatment modalities and timing, and prevalence. Mortality data are often obtained through national or regional death registries. Registries play a vital role in research into the causes of cancer, both by providing data on patterns and trends, and in different types of epidemiological studies (in particular, in their ability to follow up groups of persons exposed to a potential hazard). They comprise an essential element in the planning and monitoring of cancer control strategies as well as for identifying priorities in public health. Increasingly, registries in developed countries have begun to gather more data on treatments and outcomes (such as recurrences), which can be used for monitoring quality of care, guideline adherence, and outcome research.
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Gould, Jane M. "Hospital-Based Playrooms, Classrooms, and Pet Therapy." In Handbook of Pediatric Infection Prevention and Control, 199–230. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190697174.003.0009.
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A unique feature of most pediatric healthcare facilities is that they provide opportunities for both inpatients and outpatients to participate in play with developmentally appropriate toys during their medical care. Reasons for play in hospitalized pediatric patients may include providing mechanisms to educate children about their particular medical conditions, providing stress reduction during frightening procedures, assisting in the development of coping strategies, and attempting to maintain a sense of normalcy during long hospitalizations. Although toys and playroom environments provide a vital psychosocial and quality-of-life function, however, they are also known to contribute to the transmission of infectious agents. This chapter provides guidance on minimizing transmission of pathogens in hospital-based playrooms and classrooms: pathogens that are commonly found in pediatric healthcare facilities. This chapter also discusses the transmission challenges with pet therapy programs for children, and suggests approaches for safe implementation of these programs. Sample policies are included.
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Santos, Milton, Luís Bastião, Carlos Costa, Augusto Silva, and Nelson Rocha. "Clinical Data Mining in Small Hospital PACS." In Information Systems and Technologies for Enhancing Health and Social Care, 236–51. IGI Global, 2013. http://dx.doi.org/10.4018/978-1-4666-3667-5.ch016.
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Technological developments in the medical imaging acquisition and storage process have triggered the use of PACS (Picture Archiving and Communication Systems) with gradually larger archives. Nowadays, there is data stored in the DICOM (Digital Imaging and Communication in Medicine) file that is not searchable using the traditional PACS database. However, it may represent an important source of information for continuous professional practice improvement. The use of DICOM Data Mining tools has been a valuable asset to analyze the information stored in the DICOM file and can result in gathering important data for the professional practice improvement. These tools can also contribute to the PACS information audit and facilitate access to relevant clinical data within programs for quality continuous improvement. By allowing the construction of multiple views over data repository in a flexible and quickly way and with the possibility to export data for further statistical analysis, Dicoogle permits the identification of data and process inconsistencies that can contribute to radiology department improvement, such as in dose surveillance and patient safety programs and image quality control initiatives. However, the assessment of relevant data for practice improvement must take into account several factors related to the informational environment, professional reality, and healthcare goals and mission. This chapter describes a method to examine and perform studies over a medical imaging repository. Moreover, a case study of a small hospital where the obtained results are discussed is shown.
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Nemecek, Romina, Patrick Huber, Sophie Schur, Eva Masel, Stefanie Porkert, Barbara Hofer, Herbert Watzke, Christoph Zielinski, and Michael Binder. "Telemedically Augmented Palliative Care." In Healthcare Ethics and Training, 1228–46. IGI Global, 2017. http://dx.doi.org/10.4018/978-1-5225-2237-9.ch058.
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Patients with advanced cancer have a substantial symptom burden, which deteriorates their quality of life. Palliative care improves well-being of patients and their family caregivers. Within the scope of a controlled pilot study, a user-friendly telepresence system is developed, which enables patients and family caregivers to send a direct request to a palliative care team. Additionally, a specially tailored database is developed, which contains up to date patient information. Twenty patients with advanced non-small cell lung cancer are consecutively assigned in a control and an intervention group. The intervention group receives the telemedically augmented care, whereas the control group receives standard care. The primary goal of this chapter is to determine the usability and feasibility; the secondary goal is the assessment of the intervention's impact on quality of life and the number of unscheduled hospital admissions. To sum up, telemedically supported ambulatory palliative care may synergistically help to improve safety and quality of life.
Conference papers on the topic "Hospital care Australia Quality control"
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Chien, T. W., Agnes L. F. Chan, and Henry W. C. Leung. "Using statistical process control chart techniques to ensure quality of care in pharmacy department of a hospital." In 2011 IEEE International Conference on Quality and Reliability (ICQR). IEEE, 2011. http://dx.doi.org/10.1109/icqr.2011.6031724.
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Yan, Mian, Ting Qu, Congdong Li, and Suxiu Xu. "Impacts of health information technology on health care quality in hospital-related settings: A systematic review." In 2018 IEEE 15th International Conference on Networking, Sensing and Control (ICNSC). IEEE, 2018. http://dx.doi.org/10.1109/icnsc.2018.8361316.
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Xia, Henian, Nathan Keeney, Brian J. Daley, Adam Petrie, and Xiaopeng Zhao. "Prediction of ICU In-Hospital Mortality Using Artificial Neural Networks." In ASME 2013 Dynamic Systems and Control Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/dscc2013-3768.
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This work aims to predict in-hospital mortality in the open-source Physionet ICU database from features extracted from the time series of physiological variables using neural network models and other machine learning techniques. We developed an effective and efficient greedy algorithm for feature selection, reducing the number of potential features from 205 to a best subset of only 47. The average of five trials of 10-fold cross validation shows an accuracy of (86.23±0.14)%, a sensitivity of (50.29±0.22)%, a specificity of (92.01 ± 0.21)%, a positive prediction value of (50.29±0.50)%, a negative prediction value of (92.01±0.00)%, and a Lemeshow score of 119.55±9.87. By calibrating the predicted mortality probability using an optimization approach, we can improve the Lemeshow score to 27.51±4.38. The developed model has the potential for application in ICU machines to improve the quality of care and to evaluate the effect of treatment or drugs.
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Eltai, Nahla Omer, Lubna Abu Rub, Hana A. Mohamed, Asma A. Al Thani, Hamda Qotba, and Hadi M. Yassine. "Testing Air Quality of Primary Health Care Centers in Qatar." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0125.
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Background: Poor indoor air quality results in significant adverse effects on human health. In particular, the hospital atmospheric environment requires high air quality to protect patients and health care workers against airborne disease including nosocomial infections. Monitoring and surveillance programs of air pollutants and communicable diseases are essential as they provide information on the effectiveness of occupational hygiene and hazard control, and beneficial in assessing risks to community and environment. Objectives: This study aims to identify, monitor and report the level of air borne bacteria at four PHCC canters in Doha. Methodology: Four primary Health Centers (HC) were selected for testing air quality namely, Qatar University HC (North of Doha), AlRayan HC (West of Doha), Um Ghualina HC (Centre of Doha) and Old airport HC (South of Doha). Three sublocations were tested in each health center including a triage room, lobby and outdoor sample; each centre was visited once a month. Two sampling methods were used in this study: Anderson impactor (viable method) and filtration method (non-viable method). Anderson six stages impactor (TISCH Environmental, USA) was used to collect airborne bacteria on nutrient agar plates. Then the samples were incubated at 37 o C for 24 - 48 hours. The average colony- forming units (CFU) of bacteria was calculated per cubic meter of air (CFU/m3 ). On the other hand, the SKC Button Sampler (SKC Inc. PA, USA) was used to collect the airborne bacteria using cellulose ester filters. The collected isolates will be identified by sequencing 16srRNA (Miseq) later. Preliminary results: According to our preliminary results, the smallest average number of bacteria in the air was detected in QU HC, 3.2 (CFU/m3 ). While the highest average number was 44.7 CFU/m3 detected in Old Airport HC. Al-Rayyan HC and Om Ghuilina HC exhibited 30 and 20 CFU/m3 sequentially. Conclusions: Our preliminary results depicted that the occupancy pattern, size, and age of the building affect the number of bacteria in the air. However, more samples will be collected for better statistical sample size and analysis. .In addition, the captured airborne bacteria will be identified by 16s r RNA sequencing later.
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Aulia, Destanul, Heru Santosa, and Ida Yustina. "Implementation of Integrated Nursing Models toward Patient Satisfaction in Mitra Medika Amplas Hospital, Medan, North Sumatra." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.22.
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ABSTRACT Background: The patient’s statement of the nurse’s poor and needy performance reflects dissatisfaction. Communities need patient-focused services, and the success of nursing care is determined mainly by choice of nursing care delivery models. This study aimed to determine implementation of integrated nursing models toward patient satisfaction in Mitra Medika Amplas Hospital, Medan, North Sumatra. Subject dan Method: This was a quasi-experiment with two group comparison conducted at Mitra Medika Amplas Hospital, Medan, Indonesia. A sample of 77 patients was selected by consecutive sampling. The data were collected by questionnare and analyzed by t-test. Result: The results showed that the level of satisfaction in the intervention group stated that 60 people were satisfied (78%) while the control group stated that 4 people were satisfied (5%). It was statistically significant (p<0,05). Conclusion: The level of patient satisfaction based on the dimensions of tangible quality, empathy, reliability, responsiveness and assurance was higher in the intervention group than in the control group. Keywords: integrated model, patient focused services Correspondence: Deli, Universitas Sumatera Utara Medan. Jl. Dr. T. Mansur No.9, Padang Bulan, Medan, North Sumatra 20222. Email: delitheo.theo@yahoo.com. Mobile: 085361880118 DOI: https://doi.org/10.26911/the7thicph.04.22
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Elkefi, Safa, Onur Asan, and Tina W F Yen. "Using Human factors approach to evaluate patient-centered cancer care." In 13th International Conference on Applied Human Factors and Ergonomics (AHFE 2022). AHFE International, 2022. http://dx.doi.org/10.54941/ahfe1002186.
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Patient-centered care (PCC) approaches are critical for the delivery of high-quality care in cancer care where the therapeutic alliance between patients and the oncologists is frequent over extended periods of time. The concept of patient-centered care has received increased attention since the publication of the 2001 Institute of Medicine (IOM) report Crossing the Quality Chasm. In this study, we create and evaluate a new framework for patient-centered care in cancer using human factors approaches. Many initiatives focused on developing technologies that help foster PCC by increasing patients’ access to information and facilitating self-monitoring and patient convenience. This paper makes an important contribution to the literature by historically examining the evolution of the definitions of care approaches from disease-centered care focusing on curing the diseases to patient-centered care satisfying patients’ needs to person-centered care. Instead of treating people like victims of diseases, this model recognizes their need for more than one professional to support them emphasizing their capabilities and potential to improve their own health by themselves. It also provides a different and complementary way to the visit-oriented approach furnishing more accessible and continuous care over time, Our contribution also covers summarizing the existing measures adopted to measure its components and finally suggests a socio-technical framework based on the human factors approach to measuring PCC effectiveness. Our approach to measuring PCC is grounded in the conceptual framework we are suggesting that evaluates the effectiveness of patient-centered care based on a socio-technical perspective. We link the cognitive perception of patients towards PCC (Cognitive Sensory Input) to their exposure to external factors (Exposure) that may affect their (Cognition) behavior. A holistic approach recognizing health care as a dynamic socio-technical system in which sub-elements interact with each other remains necessary to better understand the system and its constraints in cancer care. We use a case study to emphasize the importance and need of such a human factors-based framework in providing a better quality of care and improving health outcomes. Achieving high-quality care is a complex pursuit in any setting especially for cancer care and improving the patient journey requires an integrated system of care and productive interactions among many system levels. By understanding the work system components, the design and integration of tasks, technology, and clinical processes can be reviewed to better support the respective needs of individuals while optimizing system performance. A supportive work environment and a highly engaged workforce are highly correlated with improved quality of patient-centered care and hospital performance. At the population level, case managers, navigators, quality officers, and administrators may track outcomes across patients.This framework can help organize clinical interventions that aim to control cancer patients’ behavior from a patient-centered perspective. It can also help technology designers by giving them insight into how patient-centeredness in the design of health informatics can impact cancer patients’ behavior. In addition, patient-centered designs can enhance technology acceptance among cancer patients making it easier to adopt technology for follow-up reasons by involving human factors and ergonomics principles in order to ensure successful results.
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Marlina, Devi, Didik Gunawan Tamtomo, and RB Soemanto. "Factors Affecting the Quality of Life in Patients with Type 2 Diabetes Mellitus in Surakarta, Central Java." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.05.39.
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ABSTRACT Background: Previous studies have shown that better glycemic control in type 2 diabetes mellitus (DM) is associated with fewer physical symptoms and better well being. The purpose of this study was to determine factors affecting the quality of life in patients with type 2 diabetes mellitus in Surakarta, Central Java. Subjects and Method: A cross-sectional study was conducted at Dr. Moewardi hospital, Surakarta, Central Java, from February to March 2020. A sample of 200 patients with type 2 DM aged ≥18 years was selected by simple random sampling. The dependent variable was quality of life. The independent variables were self-care, family support, peer support, length of disease, body mass index (BMI), and education. The data were collected by questionnaire and analyzed by a multiple logistic regression run on Stata 13. Results: Quality of life in type 2 DM patients increased with good self care (OR= 14.34; 95% CI= 1.47 to 140.06; p= 0.022), strong family support (OR= 21.52; 95% CI= 2.98 to 155.44; p=0.002), strong peer support (OR= 31.03; 95% CI= 3.14 to 306.78; p=0.003), length of disease <6 years (OR= 0.05; 95% CI= 0.01 to 0.45; p= 0.007), normal BMI (OR= 0.08; 95%= 0.01 to 0.60; p= 0.014), and education ≥Senior high school (OR= 11.76; 95% CI= 2.05 to 67.41; p= 0.006). Conclusion: Quality of life in type 2 DM patients increases with good self care, strong family support, strong peer support, length of disease <6 years, normal BMI, and education ≥Senior high school. Keywords: quality of life, type 2 diabetes mellitus Correspondence: Devi Marlina. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: devimarlinaaa94@gmail.com. Mobile:+6281340983044 DOI: https://doi.org/10.26911/the7thicph.05.39
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Barra, Alexandre Almeida, Ana Silvia Diniz Makluf, Elyonara Mello Figueiredo, Danielle Aparecida Gomes Pereira, and Cristóvão Pinheiro Barros. "INFLUENCE OF PHYSICAL ACTIVITY ON QUALITY OF LIFE OF BREAST CANCER PATIENTS." In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1095.
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Introduction: Breast cancer is the most common neoplasm among women. As a consequence of the increased number of cancer diagnoses, and concomitant mortality reductions for most types of cancer many patients live with physical and psychosocial problems associated with the disease and its treatment that may compromise their quality of life (QoL). Exercise has been recommended as part of standard care for patients with cancer to help prevent and manage physical and psychosocial problems and improve QoL. Objectives: The objective of the current study was to compare the impact of physical activity practice in women with breast cancer, through indicators of quality of life. Methods: This is a randomized study with breast cancer patients in a large general hospital in southeastern Brazil. The questionnaires were applied regarding function and quality of life (EORTC QLQ-C30 and BR-23). Patients were randomly allocated into two groups: control, without intervention and treatment group, with the practice of physical exercises and nutritional orientation. Physical activity was performed for three hours/week through active-assisted exercises of flexion, abduction, extension, and rotation of upper limbs and treadmill walking at a speed tolerated by the patient. After six months of participation, all patients were reassessed, with blindness of the investigator. Results: The study did not reveal statistical difference in the constructs cited (p>0.05) between the control group and the treatment group regarding “Global Health Status” “Functional Scale” and “Scale of Symptoms “, however the patients in physical activity presented better mood and confidence being more adapted to face the challenge of the disease. Conclusions: The practice of physical activity showed no benefit in improving quality of life and functional capacity in patients with breast cancer in the evaluation by questionnaires in a short period established, however, showed favorable trends for improvement in successive evaluations.
Reports on the topic "Hospital care Australia Quality control"
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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James-Scott, Alisha, Rachel Savoy, Donna Lynch-Smith, and tracy McClinton. Impact of Central Line Bundle Care on Reduction of Central Line Associated-Infections: A Scoping Review. University of Tennessee Health Science Center, November 2021. http://dx.doi.org/10.21007/con.dnp.2021.0014.
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Purpose/Background Central venous catheters (CVC) are typical for critically ill patients in the intensive care unit (ICU). Due to the invasiveness of this procedure, there is a high risk for central line-associated bloodstream infection (CLABSI). These infections have been known to increase mortality and morbidity, medical costs, and reduce hospital reimbursements. Evidenced-based interventions were grouped to assemble a central line bundle to decrease the number of CLABSIs and improve patient outcomes. This scoping review will evaluate the literature and examine the association between reduced CLABSI rates and central line bundle care implementation or current use. Methods A literature review was completed of nine critically appraised articles from the years 2010-2021. The association of the use of central line bundles and CLABSI rates was examined. These relationships were investigated to determine if the adherence to a central line bundle directly reduced the number of CLABSI rates in critically ill adult patients. A summary evaluation table was composed to determine the associations related to the implementation or current central line bundle care use. Results Of the study sample (N=9), all but one demonstrated a significant decrease in CLABSI rates when a central line bundle was in place. A trend towards reducing CLABSI was noted in the remaining article, a randomized controlled study, but the results were not significantly different. In all the other studies, a meta-analysis, randomized controlled trial, control trial, cohort or case-control studies, and quality improvement project, there was a significant improvement in CLABSI rates when utilizing a central line bundle. The extensive use of different levels of evidence provided an excellent synopsis that implementing a central line bundle care would directly affect decreasing CLABSI rates. Implications for Nursing Practice Results provided in this scoping review afforded the authors a diverse level of evidence that using a central line bundle has a direct outcome on reducing CLABSI rates. This practice can be implemented within the hospital setting as suggested by the literature review to prevent or reduce CLABSI rates. Implementing a standard central line bundle care hospital-wide helps avoid this hospital-acquired infection.
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Uhl, Stacey, Shazia Mehmood Siddique, Liam McKeever, Aaron Bloschichak, Kristen D’Anci, Brian Leas, Nikhil K. Mull, and Amy Y. Tsou. Malnutrition in Hospitalized Adults: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), October 2021. http://dx.doi.org/10.23970/ahrqepccer249.
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Objectives. To review the association between malnutrition and clinical outcomes among hospitalized patients, evaluate effectiveness of measurement tools for malnutrition on clinical outcomes, and assess effectiveness of hospital-initiated interventions for patients diagnosed with malnutrition. Data sources. We searched electronic databases (Embase®, MEDLINE®, PubMed®, and the Cochrane Library) from January 1, 2000, to June 3, 2021. We hand-searched reference lists of relevant studies and searched for unpublished studies in ClinicalTrials.gov. Review methods. Using predefined criteria and dual review, we selected (1) existing systematic reviews (SRs) to assess the association between malnutrition and clinical outcomes, (2) randomized and non-randomized studies to evaluate the effectiveness of malnutrition tools on clinical outcomes, and (3) randomized controlled trials (RCTs) to assess effectiveness of hospital-initiated treatments for malnutrition. Clinical outcomes of interest included mortality, length of stay, 30-day readmission, quality of life, functional status, activities of daily living, hospital acquired conditions, wound healing, and discharge disposition. When appropriate, we conducted meta-analysis to quantitatively summarize study findings; otherwise, data were narratively synthesized. When available, we used pooled estimates from existing SRs to determine the association between malnutrition and clinical outcomes, and assessed the strength of evidence. Results. Six existing SRs (including 43 unique studies) provided evidence on the association between malnutrition and clinical outcomes. Low to moderate strength of evidence (SOE) showed an association between malnutrition and increased hospital mortality and prolonged hospital length of stay. This association was observed across patients hospitalized for an acute medical event requiring intensive care unit care, heart failure, and cirrhosis. Literature searches found no studies that met inclusion criteria and assessed effectiveness of measurement tools. The primary reason studies did not meet inclusion criteria is because they lacked an appropriate control group. Moderate SOE from 11 RCTs found that hospital-initiated malnutrition interventions likely reduce mortality compared with usual care among hospitalized patients diagnosed with malnutrition. Low SOE indicated that hospital-initiated malnutrition interventions may also improve quality of life compared to usual care. Conclusions. Evidence shows an association between malnutrition and increased mortality and prolonged length of hospital stay among hospitalized patients identified as malnourished. However, the strength of this association varied depending on patient population and tool used to identify malnutrition. Evidence indicates malnutrition-focused hospital-initiated interventions likely reduce mortality and may improve quality of life compared to usual care among patients diagnosed with malnutrition. Research is needed to assess the clinical utility of measurement tools for malnutrition.
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Hajarizadeh, Behzad, Jennifer MacLachlan, Benjamin Cowie, and Gregory J. Dore. Population-level interventions to improve the health outcomes of people living with hepatitis B: an Evidence Check brokered by the Sax Institute for the NSW Ministry of Health, 2022. The Sax Institute, August 2022. http://dx.doi.org/10.57022/pxwj3682.
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Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.
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Egypt: Expand access to postabortion care. Population Council, 2000. http://dx.doi.org/10.31899/rh2000.1023.
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The Population Council has supported a series of studies to improve the quality of postabortion care (PAC) in Egypt. A 1994 pilot study in two Egyptian hospitals showed that upgrading PAC and training physicians in manual vacuum aspiration (MVA), infection control, and counseling led to significant improvements in the care of postabortion patients. The 1997 study, conducted by the Egyptian Fertility Care Society with support from the Population Council, sought to institutionalize improved postabortion medical care and counseling procedures in ten hospitals. Five senior physicians from each hospital attended a five-day training course in MVA, infection control, and family planning (FP) counseling. The physicians then supervised four months of on-the-job training of doctors and nurses at the ten hospitals. A case management protocol, including emergency medical treatment, pain control, and FP counseling, was also introduced. As reported in this brief, training providers and introducing a case management protocol led to improved PAC at ten government and teaching hospitals in Egypt.
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The PLHA-friendly achievement checklist: A self-assessment tool for hospitals and other medical institutions caring for people living with HIV/AIDS (PLHA). Population Council, 2003. http://dx.doi.org/10.31899/hiv2003.1005.
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The Population Council/Horizons (New Delhi and Washington, DC) and the Society for Service to Urban Poverty (New Delhi) are conducting an operations research study in three New Delhi hospitals. The study, entitled “Improving the hospital environment for HIV-positive clients in India,” is endorsed by the National AIDS Control Organization (NACO) of India. The main objective is to assess factors that affect the quality and type of care received by the general patient population, with special emphasis on patients with HIV. Another objective is to assess and address factors that affect staff safety with respect to infectious diseases. As part of the study, a practical checklist was developed that can be used by managers and others to identify institutional strengths, pinpoint problems, and set goals for improvement of services for people living with HIV/AIDS (PLHA) and staff safety. The PLHA-friendly Achievement Checklist is intended as a self-assessment tool for managers to use in gauging how well their facility reaches, serves, and treats HIV-positive patients. NACO plans to distribute the checklist to all government medical facilities throughout India.