Academic literature on the topic 'Prehospital care; Quality indicators; Quality improvement'
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Journal articles on the topic "Prehospital care; Quality indicators; Quality improvement"
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Pap, Robin, Craig Lockwood, Matthew Stephenson, and Paul Simpson. "Development and testing of Australian prehospital care quality indicators: study protocol." BMJ Open 10, no. 7 (July 2020): e038310. http://dx.doi.org/10.1136/bmjopen-2020-038310.
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IntroductionHistorically, ambulance services were established to provide rapid transport of patients to hospital. Contemporary prehospital care involves provision of sophisticated ‘mobile healthcare’ to patients across the lifespan presenting with a range of injuries or illnesses of varying acuity. Because of its young age, the paramedicine profession has until recently experienced a lack of research capacity which has led to paucity of a discipline-specific, scientific evidence-base. Therefore, the performance and quality of ambulance services has traditionally been measured using simple, evidence-poor indicators forming a deficient reflection of the true quality of care and providing little direction for quality improvement efforts. This paper reports the study protocol for the development and testing of quality indicators (QIs) for the Australian prehospital care setting.Methods and analysisThis project has three phases. In the first phase, preliminary work in the form of a scoping review was conducted which provided an initial list of QIs. In the subsequent phase, these QIs will be developed by aggregating them and by performing related rapid reviews. The summarised evidence will be used to support an expert consensus process aimed at optimising the clarity and evaluating the validity of proposed QIs. Finally, in the third phase those QIs deemed valid will be tested for acceptability, feasibility and reliability using mixed research methods. Evidence-based indicators can facilitate meaningful measurement of the quality of care provided. This forms the first step to identify unwarranted variation and direction for improvement work. This project will develop and test quality indicators for the Australian prehospital care setting.Ethics and disseminationThis project has been approved by the University of Adelaide Human Research Ethics Committee. Findings will be disseminated by publications in peer-reviewed journals, presentations at appropriate scientific conferences, as well as posts on social media and on the project’s website.
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Ma, Junxiong, Xuejie Dong, Yinzi Jin, and Zhi-Jie Zheng. "Health Care Quality Improvement for ST-Segment Elevation Myocardial Infarction: A Retrospective Study Based on Propensity-Score Matching Analysis." International Journal of Environmental Research and Public Health 18, no. 11 (June 4, 2021): 6045. http://dx.doi.org/10.3390/ijerph18116045.
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Reducing the treatment delay by organizing delivery of care on a regional basis is a priority for improving the quality of ST-segment elevated myocardial infarction (STEMI) care. This study aimed to evaluate the impact of the combined measures on quality metrics of healthcare delivery in Suzhou. The data were collected from the National Chest Pain Center (CPC) Data Reporting Database. 4775 patients were recruited, and after propensity-score matching, 1078 pairs were finally included for analysis. We examined the changes in quality metrics of care including prehospital and in-hospital processes, and clinic outcomes. Quality improvement (QI) implementation improved most process indicators. However, these improvements did not yield decreased in-hospital mortality. The door-to-balloon and the FMC-to-device time decreased from 85.0 and 98.0 min to 78 and 88 min, respectively (p < 0.001). Cases transferred directly via EMS had a greater improvement in most of process indicators. The proportion of patients transferred directly via EMS was 10.3%, much lower than that of self-transported patients at 58.3%. Tertiary hospitals showed greater performance improvement in process indicators than secondary hospitals. The percentage of cases using EMS remained low for suburban areas. The establishment of coordinated STEMI care needs to be accompanied with solving the fragmented situation of the prehospital and hospital care, and patient delay should be addressed, especially in suburban areas and on transferred-in inpatients.
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Howard, Ian, Nicholas Castle, Loua Al Shaikh, and Robert Owen. "Improving the prehospital management of ST elevation myocardial infarction: a national quality improvement initiative." BMJ Open Quality 8, no. 2 (June 2019): e000508. http://dx.doi.org/10.1136/bmjoq-2018-000508.
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ST elevation myocardial infarction (STEMI) is a time-dependent clinical emergency. Early recognition and intervention in the clinical course of STEMI are key to reducing mortality and morbidity. As a result, the benefits of the prehospital management of patients presenting with STEMI are well supported by the literature. Given these benefits, much of the focus on the development of quality and performance measures for Emergency Medical Services has focused on STEMI care. Historically, within Qatar, however, no measures of prehospital STEMI care have previously existed and as such, little is understood regarding the quality of prehospital care delivered to patients with STEMI. The overall aim of this national initiative was to improve the effectiveness of the prehospital care of patients with STEMI, to a minimum compliance of 75%, as measured by four process measures and one bundle measure, over a 12-month period. Initial efforts were aimed at the development of relevant indicators to guide assessment and identifying an appropriate patient cohort to test improvement efforts. Using these measures and criteria, the project team highlighted several areas for potential improvement centred on three key domains within the service: clinical practice, training and clinical equipment/medication. There was significant and sustained improvement across all measures recorded. For the bundle measure, the median proportional compliance increased from 39% pre-improvement activities to 76% post-improvement activities and remained sustained at 12 months post-implementation. The initiative was successful in meeting all of its aims and furthermore showed sustained compliance at 12 months post-implementation, thanks in part to what were designed to be changes that were simple, yet pragmatic, and readily producible at scale. While a formal cost analysis was not conducted, the improvement activities capitalised on existing organisational structures and processes with the resultant cost perceived to be negligible.
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Amaral, Colton B., Daniel C. Ralston, and Torben K. Becker. "Prehospital point-of-care ultrasound: A transformative technology." SAGE Open Medicine 8 (January 2020): 205031212093270. http://dx.doi.org/10.1177/2050312120932706.
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Point-of-care ultrasound at the bedside has evolved into an essential component of emergency patient care. Current evidence supports its use across a wide spectrum of medical and traumatic diseases in a variety of settings. The prehospital use of ultrasound has evolved from a niche technology to impending widespread adoption across emergency medical services systems internationally. Recent technological advances and a growing evidence base support this trend. However, concerns regarding feasibility, education, and quality assurance must be addressed proactively. This topical review describes the history of prehospital ultrasound, initial training needs, ongoing skill maintenance, quality assurance and improvement requirements, available devices, and indications for prehospital ultrasound.
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Turner, Janette, A. Niroshan Siriwardena, Joanne Coster, Richard Jacques, Andy Irving, Annabel Crum, Helen Bell Gorrod, et al. "Developing new ways of measuring the quality and impact of ambulance service care: the PhOEBE mixed-methods research programme." Programme Grants for Applied Research 7, no. 3 (April 2019): 1–90. http://dx.doi.org/10.3310/pgfar07030.
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BackgroundAmbulance service quality measures have focused on response times and a small number of emergency conditions, such as cardiac arrest. These quality measures do not reflect the care for the wide range of problems that ambulance services respond to and the Prehospital Outcomes for Evidence Based Evaluation (PhOEBE) programme sought to address this.ObjectivesThe aim was to develop new ways of measuring the impact of ambulance service care by reviewing and synthesising literature on prehospital ambulance outcome measures and using consensus methods to identify measures for further development; creating a data set linking routinely collected ambulance service, hospital and mortality data; and using the linked data to explore the development of case-mix adjustment models to assess differences or changes in processes and outcomes resulting from ambulance service care.DesignA mixed-methods study using a systematic review and synthesis of performance and outcome measures reported in policy and research literature; qualitative interviews with ambulance service users; a three-stage consensus process to identify candidate indicators; the creation of a data set linking ambulance, hospital and mortality data; and statistical modelling of the linked data set to produce novel case-mix adjustment measures of ambulance service quality.SettingEast Midlands and Yorkshire, England.ParticipantsAmbulance services, patients, public, emergency care clinical academics, commissioners and policy-makers between 2011 and 2015.InterventionsNone.Main outcome measuresAmbulance performance and quality measures.Data sourcesAmbulance call-and-dispatch and electronic patient report forms, Hospital Episode Statistics, accident and emergency and inpatient data, and Office for National Statistics mortality data.ResultsSeventy-two candidate measures were generated from systematic reviews in four categories: (1) ambulance service operations (n = 14), (2) clinical management of patients (n = 20), (3) impact of care on patients (n = 9) and (4) time measures (n = 29). The most common operations measures were call triage accuracy; clinical management was adherence to care protocols, and for patient outcome it was survival measures. Excluding time measures, nine measures were highly prioritised by participants taking part in the consensus event, including measures relating to pain, patient experience, accuracy of dispatch decisions and patient safety. Twenty experts participated in two Delphi rounds to refine and prioritise measures and 20 measures scored ≥ 8/9 points, which indicated good consensus. Eighteen patient and public representatives attending a consensus workshop identified six measures as important: time to definitive care, response time, reduction in pain score, calls correctly prioritised to appropriate levels of response, proportion of patients with a specific condition who are treated in accordance with established guidelines, and survival to hospital discharge for treatable emergency conditions. From this we developed six new potential indicators using the linked data set, of which five were constructed using case-mix-adjusted predictive models: (1) mean change in pain score; (2) proportion of serious emergency conditions correctly identified at the time of the 999 call; (3) response time (unadjusted); (4) proportion of decisions to leave a patient at scene that were potentially inappropriate; (5) proportion of patients transported to the emergency department by 999 emergency ambulance who did not require treatment or investigation(s); and (6) proportion of ambulance patients with a serious emergency condition who survive to admission, and to 7 days post admission. Two indicators (pain score and response times) did not need case-mix adjustment. Among the four adjusted indicators, we found that accuracy of call triage was 61%, rate of potentially inappropriate decisions to leave at home was 5–10%, unnecessary transport to hospital was 1.7–19.2% and survival to hospital admission was 89.5–96.4% depending on Clinical Commissioning Group area. We were unable to complete a fourth objective to test the indicators in use because of delays in obtaining data. An economic analysis using indicators (4) and (5) showed that incorrect decisions resulted in higher costs.LimitationsCreation of a linked data set was complex and time-consuming and data quality was variable. Construction of the indicators was also complex and revealed the effects of other services on outcome, which limits comparisons between services.ConclusionsWe identified and prioritised, through consensus processes, a set of potential ambulance service quality measures that reflected preferences of services and users. Together, these encompass a broad range of domains relevant to the population using the emergency ambulance service. The quality measures can be used to compare ambulance services or regions or measure performance over time if there are improvements in mechanisms for linking data across services.Future workThe new measures can be used to assess different dimensions of ambulance service delivery but current data challenges prohibit routine use. There are opportunities to improve data linkage processes and to further develop, validate and simplify these measures.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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McDonald, Neil, Nicola Little, Rob Grierson, and Erin Weldon. "Sex and Gender Equity in Prehospital Electrocardiogram Acquisition." Prehospital and Disaster Medicine 37, no. 2 (March 9, 2022): 164–70. http://dx.doi.org/10.1017/s1049023x2200036x.
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AbstractIntroduction:Research in cardiac care has identified significant gender-based differences across many outcomes. Women with heart disease are less likely both to be diagnosed and to receive standard care. Gender-based disparities in the prehospital setting are under-researched, but they were found to exist within rates of 12-lead electrocardiogram (ECG) acquisition within one urban Emergency Medical Services (EMS) agency.Study Objective:This study evaluates the quality improvement (QI) initiative that was implemented in that agency to raise overall rates of 12-lead ECG acquisition and reduce the gap in acquisition rates between men and women.Methods:This QI project included two interventions: revised indications for 12-lead acquisition, and training that highlighted sex- and gender-based differences relevant to patient care. To evaluate this project, a retrospective database review identified all patient contacts that potentially involved cardiac assessment over 18 months. The primary outcome was the rate of 12-lead acquisition among patients with qualifying complaints. This was assessed by mean rates of acquisition in before and after periods, as well as segmented regression in an interrupted time series. Secondary outcomes included differences in rates of 12-lead acquisition, both overall and in individual complaint categories, each compared between men/women and before/after the interventions.Results:Among patients with qualifying complaints, the mean rate of 12-lead acquisition in the lead-in period was 22.5% (95% CI, 21.8% - 23.2%) with no discernible trend. The protocol change and training were each associated with a significant absolute level increase in the acquisition rate: 2.09% (95% CI, 0.21% - 4.0%; P = .03) and 3.2% (95% CI, 1.18% - 5.22%; P = .003), respectively. When compared by gender and time period, women received fewer 12-leads than men overall, and more 12-leads were acquired after the interventions than before. There were also significant interactions between gender and period, both overall (2.8%; 95% CI, 1.9% - 3.6%; P < .0001) and in all complaint categories except falls and heart problems.Conclusion:This QI project resulted in an increase in 12-leads acquired. Pre-existing gaps in rates of acquisition between men and women were reduced but did not disappear. On-going research is examining the reasons behind these differences from the perspective of prehospital providers.
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Xantus, Gabor Zoltan, Penny Allen, Sharon Norman, and Peter Laszlo Kanizsai. "Mortality benefit of crystalloids administered in 1–6 hours in septic adults in the ED: systematic review with narrative synthesis." Emergency Medicine Journal 38, no. 6 (April 15, 2021): 430–38. http://dx.doi.org/10.1136/emermed-2020-210298.
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BackgroundBased on the 2018 update of the Surviving Sepsis Campaign, the Committee for Quality Improvement of the NHSs of England recommended the instigation of the elements of the ‘Sepsis-6 bundle’ within 1 hour to adult patients screened positive for sepsis. This bundle includes a bolus infusion of 30 mL/kg crystalloids in the ED. Besides the UK, both in the USA and Australia, compliance with similar 1-hour targets became an important quality indicator. However, the supporting evidence may neither be contemporaneous nor necessarily valid for emergency medicine settings.MethodA systematic review was designed and registered at PROSPERO to assess available emergency medicine/prehospital evidence published between 2012 and 2020, investigating the clinical benefits associated with a bolus infusion of a minimum 30 mL/kg crystalloids within 1 hour to adult patients screened positive for sepsis. Due to the small number of papers that addressed this volume of fluids in 1 hour, we expanded the search to include studies looking at 1–6 hours.ResultsSeven full-text articles were identified, which investigated various aspects of the fluid resuscitation in adult sepsis. However, none answered completely to the original research question aimed to determine either the effect of time-to-crystalloids or the optimal fluid volume of resuscitation. Our findings demonstrated that in the USA/UK/Australia/Canada, adult ED septic patients receive 23–43 mL/kg of crystalloids during the first 6 hours of resuscitation without significant differences either in mortality or in adverse effects.ConclusionThis systematic review did not find high-quality evidence supporting the administration of 30 mL/kg crystalloid bolus to adult septic patients within 1 hour of presentation in the ED. Future research must investigate both the benefits and the potential harms of the recommended intervention.
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Pap, Robin, Craig Lockwood, Matthew Stephenson, and Paul Simpson. "Indicators to measure prehospital care quality." JBI Database of Systematic Reviews and Implementation Reports 16, no. 11 (November 2018): 2192–223. http://dx.doi.org/10.11124/jbisrir-2017-003742.
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Dagher, Michel, and Robert J. Lloyd. "Developing EMS Quality Assessment Indicators." Prehospital and Disaster Medicine 7, no. 1 (March 1992): 69–74. http://dx.doi.org/10.1017/s1049023x00039248.
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AbstractAn emergency medical service (EMS) system is part of a broad health care system which no longer can be concerned exclusively with patient transportation. Integration of prehospital and in-hospital emergency care must be achieved to provide quality patient care. This article suggests modifications in the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) 10-Step Model indicators that should help in an evaluation of the issues associated with the diversion of patients from Emergency Departments. The JCAHO model is one that can be used to help integrate prehospital and inhospital care.
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Voskanyan, Yu E. "Epidemiology of Medical Errors and Incidents in Emergency Medicine." Russian Sklifosovsky Journal "Emergency Medical Care" 11, no. 2 (September 8, 2022): 301–16. http://dx.doi.org/10.23934/2223-9022-2022-11-2-301-316.
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Relevance the issues of patient care and quality management have acquired particular relevance in modern healthcare. Improvement in the clinical performance of medical technologies has led to a significant reduction in deaths and complications associated with the disease and side effects of interventions. As a result, the share of additional harm related to the process of providing medical services has become more noticeable. Accurate data regarding the type, frequency and severity of active threats and incidents they cause are needed to reduce the likelihood and severity of additional harm. In this respect, emergency medical care is the subject of special attention and is characterized by the greatest difficulty in terms of obtaining valid and relevant information about deviations associated with health worker performance, equipment operation and patient behavior.The aim of the study was to explore the main epidemiological characteristics of medical errors and incidents associated with the provision of emergency medical care.Material and methods We present a literature review followed by an analytical study of the epidemiology of incidents and active threats (including medical errors) that precede those incidents in various areas of emergency medical care. By an incident, the authors understood an event with a patient that was more related to the process of providing medical care than to the course of the disease or comorbid conditions which led or could lead to causing additional harm. Active threats included events that subsequently became the direct cause of the incident (medical errors and malpractice, mistakes and deviations in patient behavior, emergency situations in the physical environment). By the “mortality from adverse events”, the authors understood the proportion of deaths from adverse events among all hospitalized patients. By the concept of “lethality associated with adverse events”, the authors denoted the proportion of deaths from adverse events among all the patients affected by adverse events. The search for information was carried out for the period of 1995–2021 using the following medical databases: medline; cochrane collaboration; embase; scopus; isi web of science. For analysis, we used prospective and retrospective observational studies of high methodological quality, meta-analyses and systematic reviews. For the statistical evaluation of frequency characteristics, indicators of incidence, prevalence, and incidence density were used. The calculation of generalized frequency indicators for large samples was carried out with a 95% confidence interval.Results The epidemiology of medical errors and incidents depends on the area in which emergency care is provided. For prehospital emergency medical care, there are 12.45 medical errors and 4.50 incidents with consequences for every 100 visits. In emergency departments, one in fourteen patients suffers additional harm which in 10.14% of cases has severe consequences, and in 3.18% of cases leads to unexpected death. In intensive care units, incidents related to the provision of medical care are recorded in every third patient in the amount of 1.55 per 1 patient. Of these, 58.67% of incidents are accompanied by harm, but the fatality associated with the incidents is only 0.77%. The prevalence of patients affected by incidents during the provision of anesthesia for children is almost 2 times higher than for adults (4.79% vs. 2.03%). At the same time, mortality due to anesthesia-related incidents in children is 11 times lower than in adults (0.27% versus 3.09%). The author draws attention to a number of factors contributing to the development of incidents during the provision of emergency medical care. These include environmental complexity, suboptimal configuration of the workspace, technological interface complexity, the effects of acute stress on performers, and organizational vulnerabilities. A special role was assigned to environmental complexity which was studied in detail both in terms of the complexity of the tasks being solved, and in connection with obstacles to solving problems. It was shown that the intensity of the influence of various components of environmental complexity is not the same in different departments providing emergency care. Particular attention was paid to the fact that organizational vulnerabilities reduce the effectiveness of protective mechanisms during the interaction of the human factor with a complex environment.Conclusion The study showed that the provision of emergency medical care is associated with moderately high risks of incidents, including severe and critical consequences for patients. The main factor contributing to the development of incidents is environmental complexity which becomes much harder to counter under the influence of organizational vulnerabilities. Identification and registration of errors and incidents in units providing medical care is difficult due to the short time of contact with patients, the high speed of situation update, and the constant impact of chronic and acute stressors on staff. In this connection, the optimization and improvement of the efficiency of the system for recording errors and incidents in departments providing emergency medical care remains an area for improvement.
Dissertations / Theses on the topic "Prehospital care; Quality indicators; Quality improvement"
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Owen, Robert Campbell. "The development and testing of indicators of prehospital care quality." Thesis, University of Manchester, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.527413.
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Chavez, Maria Magdalena. "Improving Diabetes Care in Family Care Practice: A Quality Improvement Project." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/593612.
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Type 2 diabetes mellitus (T2DM) is a chronic and debilitating disease contributing to the rise in healthcare associated costs in the United States (ADA, 2013a; USDHHS, 2013). T2DM management is complex and requires an ongoing multi-system approach (Goderis et al., 2010). In this quality improvement project, the DNP student led a team in a family care practice setting through a systematic quality improvement process, the PDSA cycle, for the improvement of performance rates of quality indicators including A1C testing, LDL testing, and performance of comprehensive foot examinations. The QI team developed a multi-component intervention to include utilization of an electronic type 2 diabetes mellitus (T2DM) decision support tool. The expected outcome was to increase current performance rates of A1C testing, LDL testing, and comprehensive foot examinations at a family care practice by at least 10% within four weeks of implementing the intervention. A1C testing improved from a pre-intervention median of 70.97% to a post-intervention median of 91.38%, an increase of 20.41%. LDL testing improved from a pre-intervention median of 74.19% to a post-intervention median of 91.38%, an increase of 17.19%. Comprehensive foot examinations improved from a pre-intervention median of 58.06% to a post-intervention median of 84.48%, an increase of 26.42%. While results demonstrate a trend of improvement, the duration of the intervention was insufficient for statistical significance. The QI project served as a first systematic change process for the family care practice and a model for future change processes at the clinic. This project highlights the DNP's role in utilizing evidence-based research and applying a systematic change model for quality improvement in the primacy care practice setting.
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Davila, Claudia Jazmin, and Claudia Jazmin Davila. "A Quality Improvement Project Designed to Increase Diabetes Quality Indicators at a Primary Care Community Health Center." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/621749.
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ABSTRACT Background: Diabetes has become an epidemic in the United States, affecting nearly 30 million people per year (National Center for Chronic Disease Prevention and Health Promotion [NCCDPHP], 2014). Type 2 Diabetes Mellitus (T2DM) disproportionately affects Hispanics. The American Diabetes Association (ADA) has established diabetes care guidelines that focus on improving diabetes care and patient outcomes. Quality improvement (QI) efforts have been developed and proven effective at targeting specific diabetes care indicators. Problem: Wesley Health Center (WHC) has identified deficiencies in select ADA diabetes quality care indicators of ophthalmologist referral, annual foot exam, smoking cessation counseling and pneumococcal vaccines for all patients with T2DM (ADA,2015). Design: A QI project applying the Plan-Do-Study-Act (PDSA) cycle was implemented to improve the select diabetes quality care indicators of ophthalmologist referral, annual foot exam, smoking cessation counseling and pneumococcal vaccines for all patients with T2DM. Setting: WHC, a community health center located in Phoenix, Arizona, services mostly uninsured and underinsured Hispanic patients. Intervention: One PDSA cycle was carried out utilizing the fishbone diagram in an effort to identify root cause of the stated problem. The team of stakeholders identified modifications of the current electronic adult template as a key contributing factor. Workflow process changes that complemented the new modifications to the template were also made. The intervention was carried out for six (6) weeks with weekly stakeholder meetings. Expected Outcome: To improve select ADA diabetes quality care indicators for adult patients with T2DM within six (6) weeks of implementation by at least 10% from baseline. Results: Errors in data querying parameters limited data accuracy and interpretation thus the impact of the intervention was not able to be evaluated. Significance: QI interventions are important to nursing practice because they emphasize the importance of a doctorally prepared Advanced Practice Nurse (APRN) to be able to identify a problem in clinical practice and carry out a QI intervention in an effort to improve patient care and outcomes. A QI intervention provides the DNP prepared APRN an opportunity to synthesize into one project the skills and knowledge learned throughout their DNP program.
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Ueda, Kayo. "Applicability of care quality indicators for women with low-risk pregnancies planning hospital birth: a retrospective study of medical records." Doctoral thesis, Kyoto University, 2021. http://hdl.handle.net/2433/264665.
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京都大学新制・課程博士
博士(社会健康医学)
甲第23384号
社医博第117号
新制||社医||11(附属図書館)
京都大学大学院医学研究科社会健康医学系専攻
(主査)教授 佐藤 俊哉, 教授 滝田 順子, 教授 万代 昌紀
学位規則第4条第1項該当
Doctor of Public Health
Kyoto University
DFAM
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Pap, Robin. "The Development and Testing of Australian Prehospital Care Quality Indicators." Thesis, 2022. https://hdl.handle.net/2440/136518.
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Background: The traditional function of ambulance services was to provide rapid transport of patients to hospital. Correspondingly, prehospital care quality has historically been measured using simple and evidence-poor indicators forming a deficient reflection of the true quality of care and providing little direction for quality improvement efforts. Prehospital care is the term used throughout this thesis describing the care and services provided by modern ambulance services. It does not imply that all patients will be transported to a hospital. Modern Australian prehospital care provided by ambulances services involves the delivery of complex mobile healthcare for patients across the lifespan presenting with a range of injuries and illnesses of varying acuity as well as transport or referral to a hospital, transport or referral to other appropriate ongoing care, or discontinuation of care when there is no need for any follow-on healthcare. Measurement of quality is central to quality assurance and quality improvement in healthcare. Measurement starts with the development of quality indicators (QIs) against which performance can be gauged. QIs need to parallel the developments of healthcare systems and services. Thus, the aim of this research was to develop and test prehospital care QIs for the Australian setting. Methods: This is a thesis by publication which presents a research project containing three studies. First, a scoping review was conducted in accordance with JBI methodology to locate, examine, and describe the international literature on indicators used to measure prehospital care quality. Second, a modified RAND/UCLA appropriateness methods (RAM) was undertaken to develop a suite of prehospital care QIs and to assess the QIs for validity. Preparatory work for the expert consensus process included streamlined evidence syntheses guided by the JBI approach for rapid reviews and evidence summaries. Finally, an explanatory sequential mixed methods study was conducted to test the prehospital care QIs for acceptability. Details of the methods utilised in each of the studies are described in the scoping review protocol (manuscript 1), the study protocol (manuscript 3) as well as the methods sections of the other manuscripts. Results: The scoping review identified a total of 17 attributes of prehospital care quality and its findings suggested that quality in this setting is characterised by timely access to appropriate, safe, and effective care, which is responsive to patients’ needs and efficient and equitable to populations. A total of 526 QIs were identified, comprising 283 (53.8%) clinical QIs and 243 (46.2%) organisational/system QIs. QIs relating to out-of-hospital cardiac arrest (OHCA) (n=57; 10.8%) and time intervals (n=75; 14.3%) contributed the most. Most QIs were process indicators (n=386, 73.4%). Systematic preparation of the QIs produced a suite of 111 QIs within a guiding framework and with supporting evidence summaries for consideration by the nine-member expert panel participating in the modified RAM. An additional six QIs were proposed by panel members. Of the 117 QIs, 84 (72%) were rated as valid, including 26 organisational/system QIs across 7 subdomains and 58 clinical QIs within 10 subdomains. Most of the valid QIs were process indicators (n=62; 74%). Structural and outcome QIs were less common (n=13; 15% and n=9; 11%, respectively). Non-exclusively, 18 (21%) QIs described access to healthcare, 21 (25%) detailed elements of safety and 64 (76%) identified aspects contributing to effective prehospital care. With consideration of best available evidence the expert panel did not deem any indicator describing general time intervals, such as response time, as valid. Paramedics and ambulance services managers participating in the initial quantitative survey of the explanatory sequential mixed methods study generally rated the acceptability of the 84 QIs highly. Analysis of qualitative data gathered in the subsequent semi-structured interviews suggested a positive association between acceptability and other key characteristics of QIs. Clarity, scientific validity, practicality, and meaningfulness positively affected acceptability amongst the nine participants. To be acceptable, outcome indicators needed to be attributable to prehospital care. QIs which described time interval targets needed to be specific about time-sensitive interventions. Participants considered the proposed suite of QIs to be reflective of their professional values and qualities, in part explaining the high acceptability ratings. However, participants expressed some scepticism about the use of patient experience and satisfaction as valid QIs to evaluate prehospital care quality. Conclusion: There is growing interest and understanding about the importance of the measurement of prehospital care quality. The validity and acceptability of evaluating timeliness as an indicator of prehospital care quality in specific time-sensitive patients remains self-evident but fixating on response time targets in general cannot comprehensively evaluate modern prehospital care quality. This research systematically developed and tested prehospital care QIs for the Australian setting. Systematically developed QIs possessing key characteristics appear to be more acceptable to prehospital care providers. Before implementation, there may be a need to subject these QIs to further testing.Thesis (Ph.D.) -- University of Adelaide, School of Public Health, 2022
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LAI, SHIN-SHIN, and 賴欣欣. "Investigating Postpartum Care Facility Service Quality Indicators and Improvement Strategies Using AHP and DEMATEL." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/299387.
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博士中華大學
科技管理博士學位學程
106
In recent years, because of the increasing awareness of feminism and changes in family structure, professional postpartum care facilities are gradually replacing lying-in women’s homes as the location of postpartum confinement. Although Taiwan experiences sub-replacement fertility, the number of postpartum care facilities in Taiwan continues to rise annually. Facing fierce competition created by the numerous postpartum care facilities available, postpartum care facilities must elevate their service quality to attract customers. Therefore, this study examined the postpartum care industry by conducting a literature review, collecting expert opinions, and using the five dimensions of the PZB service quality model to devise 20 service quality criteria for assessing postpartum care facilities. Surveys were disseminated to college and university professors, professional nursing scholars, and senior nursing personnel working in postpartum care facilities. Next, analytic hierarchy process (AHP) and decision-making trial and evaluation laboratory (DEMATEL) were employed to determine the order of importance of the postpartum care facility service quality dimensions and criteria as well as the causal relationships between these dimensions and criteria. The study results showed that for postpartum care facility service quality dimensions, the top three dimensions, listed in descending order, were reliability, assurance, and responsiveness. For postpartum care facility service quality criteria, the top five criteria, listed in descending order, were complete records of lying-in women and babies’ health and growth, immediate responses to customers’ problems and needs, favorable brand image, sufficient manpower, and obstetricians and pediatricians able to pay regular visits to perform health checkups on lying-in women and babies. Causal relationship results showed that postpartum care facilities must pay the most attention to and improve the criteria of “reasonable fees,” “favorable communication,” “obstetricians and pediatricians able to pay regular visits to perform health checkups on lying-in women and babies,” and “providing individual consultation.”
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Tshabalala, Myrah Kensetseng. "Quality improvement in primary health care settings in South Africa." Diss., 2002. http://hdl.handle.net/10500/1115.
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This study aimed to explore existing quality improvement activities in primary health care setting in South Africa. Two sets of questionnaires were used to collect data from both patients and nurse managers. Findings indicated that clinics were generally acceptable and affordable to patients, but should operate for longer time-periods, that sorting of patients and long waiting times, coupled with short consultation time-periods, warranted immediate remedial actions. Only five of the fourteen listed quality initiatives were satisfactorily practised. It was concluded that despite many obstacles and difficulties as mentioned by respondents, the issue of quality-improvement in primary health care is receiving attention, but should still be improved to a greater extent.Health Studies
M.A. (Advanced Nursing Sciences)
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Onianwa, Patricia Obiajulu. "An appraisal of continuous quality improvement (CQI) mechanisms and development of quality care indicators amongst clinical nurses in selected teaching hospitals in South-West (SW) Nigeria." Thesis, 2009. http://hdl.handle.net/10413/8173.
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Aim: This study appraised the CQI mechanisms and processes in the clinical nursing divisions of five selected teaching hospitals located in South-West Nigeria and developed quality care indicators to measure and monitor quality of care amongst clinical based nurses in these teaching hospitals.
Background: Studies have been done on evaluation of quality care to determine what good care is; whether the care nurses give is proper and effective, and whether the care provided is good quality. Several authors have asserted that evaluating the quality of nursing care is an essential part of professional accountability. Literature also suggests that in providing high quality care, it is important that nurses develop appropriate evaluative measurement tools to ensure professional aspect of nursing.
Conversely, it is a concern that in the clinical nursing division of some teaching hospitals in SW Nigeria, CQI mechanisms/processes (such as a structured auditing, monitoring and measuring quality of nursing care, established systems of continuing professional learning/ In-service Education Unit) were not more evident, particularly when these teaching hospitals were supposed to be seen as models for providing quality care services. It was not certain what CQI activities were present in similar hospitals, and if such activities were present, there was uncertainty as to how these activities were performed. In addition, the type of instrument/tools available for nursing care measurement was uncertain. There is a paucity of published evidence relating to the quality of nursing care measurement in the teaching hospitals in SW Nigeria. Gaps identified in the study would form the basis for future training and education of nurses involved in care-giving to promote quality care. Findings from the study provided evidenced-based scientific rationale for practice in relation to quality nursing care measurement in the health care institutions, thus adding to the body of knowledge of quality improvement. The methodology employed in the study is an action research; with a mixed method-Sequential explanatory incorporated. Quantitative data was collected and analysed, followed by the collection and analyses of qualitative data. The study was done in five cycles which included a survey that elicited responses from the participants on general knowledge and perceptions about CQI. Cycle two included generating promising solutions and an action plan. In cycle three, established quality-care indicators were analysed, developed and thereafter, the newly adapted instrument for nursing care measurement was tested for applicability to settings. Participants reflected on the testing of the new tool in the fourth cycle and lastly, implementation/testing outcomes were evaluated in the fifth cycle. Conclusion: Established quality-care indicators were adapted in each of the five hospital settings for quality nursing care measurement. The newly adapted quality care indicators were tested for applicability on two acute-care wards in three of the five participating hospitals. The results of the study could be used in Nigeria and elsewhere as a means to protect the rights of the patient; by measuring and monitoring the quality of nursing care.Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2009.
Books on the topic "Prehospital care; Quality indicators; Quality improvement"
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Canadian Council on Health Services Accreditation. Performance indicators project: Phase I, pilot test project. Ottawa, Ont: Canadian Council on Health Services Accreditation, 2000.
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Dunton, Nancy. Sustained improvement in nursing quality: Hospital performance on NDNQI indicators, 2007-2008. Edited by American Nurses Association. Silver Spring, Md: American Nurses Association, 2009.
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Dunton, Nancy. Sustained improvement in nursing quality: Hospital performance on NDNQI indicators, 2007-2008. Edited by American Nurses Association. Silver Spring, Md: American Nurses Association, 2009.
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Nancy, Dunton, Montalvo Isis, and American Nurses Association, eds. Sustained improvement in nursing quality: Hospital performance on NDNQI indicators, 2007-2008. Silver Spring, Md: American Nurses Association, 2009.
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Nancy, Dunton, Montalvo Isis, and American Nurses Association, eds. Sustained improvement in nursing quality: Hospital performance on NDNQI indicators, 2007-2008. Silver Spring, Md: American Nurses Association, 2009.
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Ogrinc, Gregory S. Fundamentals of health care improvement: A guide to improving your patients' care. Oak Brook Terrace, Ill: Joint Commission Resources, 2008.
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Ogrinc, Gregory S. Fundamentals of health care improvement: A guide to improving your patient's care. 2nd ed. Oak Brook Terrace, Ill: Joint Commission, 2012.
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Samantha, Chao, ed. The state of quality improvement and implementation research: Expert views, workshop summary. Washington, D.C: National Academies Press, 2007.
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Basics of health care performance improvement: A Six Sigma approach. Burlington, Mass: Jones & Bartlett Learning, 2012.
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Lighter, Donald E. Advanced performance improvement in health care: Principles and methods. Sudbury, Mass: Jones and Bartlett Publishers, 2011.
Find full textBook chapters on the topic "Prehospital care; Quality indicators; Quality improvement"
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Plebani, Mario, Ada Aita, and Laura Sciacovelli. "Patient Safety in Laboratory Medicine." In Textbook of Patient Safety and Clinical Risk Management, 325–38. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-59403-9_24.
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AbstractLaboratory medicine in the healthcare system has recently been recognized as a fundamental service in the clinical decision-making process. Therefore, the notion of patient safety in laboratory medicine must be recognized as the assurance that harm to patients will be avoided, safe care outcomes will be enhanced through error prevention, and the total testing process (TTP) will be continuously improved.Although the goal for patient safety is zero errors, and although laboratory professionals have made numerous efforts to reduce errors in the last few decades, current research into laboratory-related diagnostic errors highlights that: (a) errors occur at every step of the TTP, mainly affecting phases at clinical interfaces; (b) despite the improvement strategies adopted, analytical quality remains a challenge; (c) errors are linked not only to clinical chemistry tests, but also to new, increasingly complex diagnostic testing.Medical laboratories must therefore implement effective quality assurance tools to identify and prevent errors in order to guarantee the reliability of laboratory information. Accreditation in compliance with the International Standard ISO 15189 represents the first step, establishing processes with excellence requirements and greater expectations of staff competency. Another important step in preventing errors and ensuring patient safety is the development of specific educational and training programs addressed to all professionals involved in the process, in which both technical and administrative skills are integrated. A wide variety of information is provided by a robust quality management system and consensus-approved Quality Indicators (QI) that identify undesirable events, evaluate the risk to the patient, and call for corrective and preventive actions. However, the effectiveness of the system depends on the careful analysis of data collected and on staff awareness of the importance of laboratory medicine to the healthcare process. The main task of the new generation of laboratory professionals should be to gain experience in “clinical laboratory stewardship.” In order to safeguard patients, laboratory professionals must assist clinicians in selecting the right test for the right patient at the right time and facilitate the interpretation of laboratory information.
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Hillman, Ken, Michael Sugrue, and Thomas Sweeney. "Organization, Documentation, and Continuous Quality Improvement." In Prehospital Trauma Care. Informa Healthcare, 2001. http://dx.doi.org/10.1201/9780203908624.ch11.
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"Organization, Documentation, and Continuous Quality Improvement." In Prehospital Trauma Care, 193–204. CRC Press, 2001. http://dx.doi.org/10.1201/b14021-17.
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Lee, Katherine, and Zara Cooper. "Models of Care Delivery and Quality Measurement." In Surgical Palliative Care, 19–33. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190858360.003.0003.
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Two main models of care delivery have emerged for palliative care delivery to surgical patients: the consultative model, which relies on triggers for palliative care consultations, and the integrative model, which delivers palliative care alongside standard treatments. While both these models have shown success among nonsurgical populations, only a few studies have examined their utilization among surgical patients. Even though these models provide palliative care delivery to patients, indicators of quality are also necessary to ensure that palliative delivery improves quality of care. However, the most relevant and important indicators of quality for surgical palliative care remain undefined. Presently, there is no national surgical quality improvement program for palliative care, hindering attempts to measure quality and improve performance. However, the surgical specialties can adapt and learn from related specialties, such as critical care, geriatrics, oncology, and palliative and hospice medicine, to develop quality indicators for surgical palliative care. Capitalizing on existing quality structures, such as the American College of Surgeons quality improvement programs, can also help ensure integration of quality improvement efforts into standard practice.
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Neubeck, Lis, María Teresa Lira, Ercole Vellone, Donna Fitzsimons, Lisa Dullaghan, and Julie Sanders. "Delivering high-quality cardiovascular care." In ESC Textbook of Cardiovascular Nursing, edited by Catriona Jennings, Felicity Astin, Donna Fitzsimons, Ekaterini Lambrinou, Lis Neubeck, and David R. Thompson, 29–54. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198849315.003.0002.
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The World Health Organization provides a framework that identifies the core elements of high-quality care which should be safe, effective, timely, equitable, efficient, and people centred. Nurses need to understand the fundamentals of high-quality professional practices and the metrics used to evaluate key performance indicators. Nurses have a central role to play in advocating for and delivering high-quality care across the continuum as the largest healthcare workforce worldwide. The use of patient-reported outcome measures and patient-reported experience measures helps to bring the patient voice into high-quality care. Quality management includes planning, control, and improvement. Measurement and audit are important tools to drive up the quality of care. It is imperative that nurses develop cultural competence. Understanding the barriers to high-quality care can help to develop effective interdisciplinary solutions to ensure that patient well-being is preserved.
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Mukherjee, Joia S. "Monitoring, Evaluation, and Quality Improvement in Global Health." In An Introduction to Global Health Delivery, 245–68. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780197607251.003.0011.
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Quality data are necessary to make good decisions in health delivery, for both individuals and populations. Data can be used to improve care and achieve equity. However, the collection of health data has been weak in most impoverished countries, where health data are compiled in stacks of poorly organized paper records. Efforts to streamline and improve health information discussed in this chapter include patient-held booklets, demographic health surveys, and the use of common indicators. This chapter also focuses on the evolution of medical records, including electronic systems. The use of data for monitoring, evaluation, and quality improvement is explained. Finally, this chapter reviews the use of frameworks—such as logic models and log frames—for program planning, evaluation, and improvement.
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Ruffin, T. Ray. "Reflections and Understanding of Quality Management in Healthcare." In Optimizing Health Literacy for Improved Clinical Practices, 153–74. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-4074-8.ch009.
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Healthcare organizations (HCOs) leadership must be involved with patient safety inventiveness and healthcare strategy. Leadership is essential to implementing and sustaining continuous performance quality improvement for patient-centered care. Quality management is of extreme significance to the United States (U.S.) healthcare industry and patients. Included are an introduction and background of the U.S. healthcare systems as well as the joint commission and government mandates. One of the primary focuses of the chapter is to enhance health literacy by developing a robust lexicon of fundamental healthcare terms and concepts. Healthcare reforms such as Patient Protection and Affordable Care Act (PPACA) are explored. The quality of healthcare delivery, involuntary reporting, patient safety indicators (PSIs), prevention quality indicators (PQIs), and inpatient quality indicators (IQIs) are explained. The chapter culminates with a discussion focusing on transformational leadership and the strategies for quality management implementation, along with a conclusion.
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Metelmann, Bibiana, and Camilla Metelmann. "M-Health in Prehospital Emergency Medicine." In Virtual and Mobile Healthcare, 843–58. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-5225-9863-3.ch041.
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Prehospital emergency medicine strives to treat (potentially) life-threatening conditions as early as possible and thus reduce preventable disabilities and deaths. MHealth enables the transfer of knowledge to the emergency site. The purpose of this chapter is to display different approaches. Knowledge can be brought to the emergency site e.g. by smart phone applications allowing retrieval of data or by real-time communication with a remote medical expert. High definition video communication in real time offers the highest amount of mHealth communication currently available in prehospital emergency medicine. Projects, using such a video communication are discussed. In the European Union funded project LiveCity a special video camera was developed and tested. After having encountered simulated emergency scenarios, emergency doctors and paramedics rated the video connection as helpful, an improvement of the quality of patient care and could imagine working with such a video consultation. MHealth has huge potential for the application in prehospital emergency medicine.
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Metelmann, Bibiana, and Camilla Metelmann. "M-Health in Prehospital Emergency Medicine." In Advances in Healthcare Information Systems and Administration, 197–212. IGI Global, 2016. http://dx.doi.org/10.4018/978-1-4666-9861-1.ch010.
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Prehospital emergency medicine strives to treat (potentially) life-threatening conditions as early as possible and thus reduce preventable disabilities and deaths. MHealth enables the transfer of knowledge to the emergency site. The purpose of this chapter is to display different approaches. Knowledge can be brought to the emergency site e.g. by smart phone applications allowing retrieval of data or by real-time communication with a remote medical expert. High definition video communication in real time offers the highest amount of mHealth communication currently available in prehospital emergency medicine. Projects, using such a video communication are discussed. In the European Union funded project LiveCity a special video camera was developed and tested. After having encountered simulated emergency scenarios, emergency doctors and paramedics rated the video connection as helpful, an improvement of the quality of patient care and could imagine working with such a video consultation. MHealth has huge potential for the application in prehospital emergency medicine.
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Berler, Alexander, Sotiris Pavlopoulos, and Dimitris Koutsouris. "Key Performance Indicators and Information Flow." In Clinical Knowledge Management, 116–38. IGI Global, 2005. http://dx.doi.org/10.4018/978-1-59140-300-5.ch007.
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It is paradoxical that, although several major technological discoveries such as Magnetic Resonance Imaging and Nuclear Medicine and Digital Radiology, which facilitate improvement in patient care, have been satisfactorily embraced by the medical community, this has not been the case with Healthcare Informatics. Thus, it can be argued that issues such as Data Management, Data Modeling, and Knowledge Management have a long way to go before reaching the maturity level that other technologies have achieved in the medical sector. This chapter proposes to explore trends and best practices regarding knowledge management from the viewpoint of performance management, based upon the use of Key Performance Indicators in healthcare systems. By assessing both balanced scorecards and quality assurance techniques in healthcare, it is possible to foresee an electronic healthcare record centered approach which drives information flow at all levels of the day-to-day process of delivering effective and managed care, and which finally moves towards information assessment and knowledge discovery.
Conference papers on the topic "Prehospital care; Quality indicators; Quality improvement"
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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.
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Zilidou, Vasiliki, and Panagiotis Bamidis. "EXERGAMING AND EXERDANCING ENHANCE THE WELL-BEING OF OLDER ADULTS." In INTERNATIONAL SCIENTIFIC CONGRESS “APPLIED SPORTS SCIENCES”. Scientific Publishing House NSA Press, 2022. http://dx.doi.org/10.37393/icass2022/59.
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ABSTRACT The digital age and advances in technology are introducing a new attitude to medical care, bringing about significant technologies such as exergames, enhancing the promotion of active and healthy aging. This study aimed to investigate possible differences in perceived quality of life factors between older adults participating in traditional dance and physical training using new technologies, comparing them with sedentary people (control group). The study involved 84 women, with an average age of 67.6 years from Day Care Centers of the Municipality of Thessaloniki, Greece. The program duration was six months (24 weeks) with a frequency of twice a week and each session lasted 75 minutes. An evaluation was performed both before and after the end of the interventions with specialized tools that assess the physical status and functional capacity of the individuals, as well as questionnaires that assess the quality of life indicators. Regarding the usability of the systems, integrated the System Usability Scale (SUS). Statistical analysis was performed with the statistical package SPSS 26. According to the results, the intervention groups compared to the initial measurement showed a statistically significant improvement in variables that assess strength, balance, aerobic capacity, gait to avoid falls, stress, depression, and quality of life in general, in comparison with the control group (p ≤ .05). The SUS scores ranged around 80 for both systems, so it seems that the practical implementation of the programs has the potential to provide the expected results. In conclusion, these innovative technological solutions in collaboration with expert health professionals, can improve the quality of life of older adults, remain autonomous and independent, but at the same time active members of society for a long time.
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Gencheva, Nezabravka. "PHYSIOTHERAPY FOR COLON CANCER IN THE EARLY POSTOPERATIVE PERIOD - A CASE REPORT." In INTERNATIONAL SCIENTIFIC CONGRESS “APPLIED SPORTS SCIENCES”. Scientific Publishing House NSA Press, 2022. http://dx.doi.org/10.37393/icass2022/146.
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АBSTRACT Introduction: The Physiotherapy (PT) is an important part of cancer treatment and could be recovery PT, maintenance PT and palliative PT. The aim of the study is to investigate the impact of early postoperative PT on the functional and mental recovery of a 57-year-old patient with colon cancer. Research methods: On the second and seventh postoperative day, we applied a Quality of Recovery-40 (QoR-15) questionnaire, Cumulated Ambulation Score (CAS) and Hospital Anxiety and Depression Scale (HADS) and а 6 min walk-test – on the third and seventh postoperative day. The special PT is used to improve the respiratory function, to alleviate the unpleasant sensations of the gastrointestinal tract, to reduce pain, to restore mobility through training in painless sitting, standing up, and walking, as well as to reduce anxiety and to overcome depressive symptoms. Results: Applied PT in the early postoperative period in severe abdominal surgery for colon cancer prevented postoperative complications. The results show a significant improvement in the studied indicators and good quality of recovery; patient’s independence in standing up, sitting, and walking; pain relief; reduced anxiety and depressive moods. Conclusion: The application of early PT is an important part of patient’s post-surgical care. It helps for optimal recovery and prepares him for the next additional therapies such as chemotherapy, radiation therapy, etc.
Reports on the topic "Prehospital care; Quality indicators; Quality improvement"
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Monitoring of macro-level family planning quality of care indicators. Population Council, 1998. http://dx.doi.org/10.31899/rh1998.1045.
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The success of population development in Indonesia can be seen partly from success in reducing population growth. Population growth has declined from 2.32 percent (1971–80) to 1.98 percent (1980–90), and then to 1.66 percent (1990–95). The continued slowing of population growth is expected to bring expanded opportunities for economic development and improved quality of life. The success of family planning (FP) programs cannot be judged solely on reduction of population growth but should also be judged in terms of quality of care (QOC) and success in helping women achieve their reproductive goals. The Indonesian National Family Planning Coordinating Board (BKKBN) has acknowledged the need for improved QOC and continuous quality improvement to increase satisfaction among clients. At the national level, there is a need to monitor quality of contraceptive services to ensure efficient use of government resources and evaluate the extent to which the Indonesian FP program has provided information and services of adequate quality. In this report, the value of five selected macro-level QOC indicators is discussed to highlight potential usefulness to program planners and managers in their efforts to improve quality of FP care.
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Community participation in health, family planning and development activities: A review of international experiences. Population Council, 1996. http://dx.doi.org/10.31899/rh1996.1010.
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The family planning (FP)/maternal and child health (MCH) program in Bangladesh has achieved success in the recent past, mostly through a large-scale government service-delivery system with support and cooperation from donors and nongovernmental organizations. There is concern about the financial and social sustainability of the program. Other issues include achievement of replacement-level fertility within a stipulated period and improvement of MCH-FP service quality. It is widely believed that most of the concerns will be taken care of with effective community participation. Before activating community initiatives, it is worth carrying out action research. A literature review was completed from July to October 1996 to identify a range of models used for increasing community participation and experiences in terms of implementation, management, financing, monitoring and evaluation, and sustainability in both rural and urban areas. Attempts were also made to identify a set of indicators to assess the level of community participation in these programs. This report documents the results of the review.