Journal of Healthcare Quality Research最新文献

Introduction and objectives: Assessing quality of care from the patient's perspective is key to improving health services. In university podiatry, this perspective has been little explored, despite its relevance for guiding person-centred teaching and clinical practice. The aim of this study was to describe patients' care experience in a university podiatry clinic and to identify the factors associated with their perceived satisfaction.

Patients and methods: Qualitative exploratory-descriptive study conducted at the University Podiatry Clinic of the University of A Coruña (Spain). Thirty-one adult patients participated, selected through purposive theoretical sampling. Individual semi-structured interviews were carried out and complemented with field notes. Data were analysed using Colaizzi's method within a phenomenological framework, until theoretical saturation was reached.

Results: The care experience was structured around six thematic axes: clinical aspects, interpersonal care, infrastructures, accessibility, characteristics of the centre and clinical experience. Patients reported high perceived satisfaction, highlighting the warmth of the interpersonal care, the clarity of communication and the confidence derived from clinical supervision. The free-of-charge nature of the service and its university setting were valued as added-value elements. The main areas for improvement were the waiting time for the first appointment in the orthopodiatry service and continuity of care between academic terms.

Conclusions: University podiatry care is perceived as approachable, effective and technically adequate. The educational model, combined with high-quality interpersonal care, shapes a highly valued care experience and provides useful insights for defining quality standards in university clinical settings.

Introduction: Patient safety is an essential and transversal element in health care, encompassing multiple and varied elements, including the use of simulation as a training tool for professionals.

Objective: The main objective was to evaluate the feasibility, impact, and satisfaction with an in situ simulation program in a pediatric intensive care unit.

Methods: Prospective, longitudinal, observational study in a level III PICU was carried out during 5 months. Standardized simulations were realized during the working day in the own unit. Demographic participants data, unit́s workload, assessment of non-technical skills (TEAM scale), latent system errors identified and staff satisfaction were recorded.

Results: A total 45 healthcare professionals participated in 13 simulation cases, performing between 1 and 4 simulations per person. The average duration of the simulations was 50minutes (SD 10.5). The average of the TEAM scale was 7,8 (1) and the overall satisfaction of the staff was 4,4 (0.5) points on a Likert scale of 1 to 5. A total of 14 latent system errors were identified: organizational deficiencies (3, 21.4%), problems with material or consumables (3, 21.4%) and training gaps (8, 57.2%).

Conclusions: It́s possible to carry out a in situ simulation program during working hours with good acceptance by the staff. This tool allows identifying latent errors in the system and non-technical skills training.

Introduction and objectives: Clinical pathways (CPs) are structured care plans designed to improve the quality of healthcare. In July 2020, we initiated a CP for patients admitted from the Emergency Department with a pacemaker indication.

Material and method: This study was conducted in a tertiary care hospital. It followed a pre-post design to evaluate outcomes after the implementation of the CP. Under this model, patients without contraindications for early intervention were included in the CP and managed by the Arrhythmia Unit, while the rest were treated according to standard care practices. Data from 2019, prior to the introduction of the CP, served as a baseline and were compared with data from 2022, when the CP was fully integrated.

Results: Between 2019 and 2022, 851 patients with pacemaker indications were admitted from the Emergency Department. The mean age was 78.35±9.5 years, and 380 were women. There was a significant reduction in hospital stay, from 6.52±2.21 days in 2019 to 5.01±2.77 days in 2022 (p<0.01). No differences were detected in mortality rate or 30-day readmissions before and after program initiation. Patients who could not be included in the CP did not experience an unjustified delay in time to intervention.

Conclusions: The implementation of a CP for patients admitted from the Emergency Department with pacemaker indications was associated with a significant reduction in hospital stay duration, without observing differences in clinical outcomes compared to patients not included in the CP.

Objective: To describe the implementation of Health Care Quality Standards (HCQS) to evaluate quality of care and its impact on the culture of continuous improvement in the outpatient centres of an Occupational Mutual Insurance Company (OMIC) collaborating with the Spanish Social Security.

Methods: Fifty HCQS were selected from the Joint Commission model and the Departament de Salut of the Government of Catalonia, both used as gold-standard references, and were adapted to the OMIC context. As an implementation strategy, 20 HCQS were initially deployed. Compliance values were rescaled and weighted, and the system was refined through training sessions prior to implementation in 2022, building on a 2021 pilot test. A multidisciplinary focus group rated the intensity of the actions undertaken for each HCQS and the magnitude of the resulting improvements.

Results: The mean HCQS score in outpatient centres increased progressively from 8.2 in 2021 to 8.5 in 2022, 8.8 in 2023 and 8.9 in 2024 (0-10 scale). HCQS were grouped into those consistently at high levels, those that improved and those that worsened. A significant correlation (Spearman's r=0.70; p<0.05) was observed between the intensity of actions and the degree of improvement. Overall HCQS values were similar to those obtained in the Catalan Primary Care accreditation model.

Conclusions: After four years, the HCQS model for OMIC outpatient centres has proved feasible, flexible and well accepted by professionals, and useful for structuring the evaluation of quality of care.

Background: Reliable healthcare data is fundamental to patient safety, clinical decision-making, and health system efficiency. However, human error in monitoring and evaluation (M&E) systems remains a key barrier to data quality. This study investigated how healthcare workers' social skills, specifically communication, teamwork, and change catalyst abilities, influence four core dimensions of data quality: accuracy, completeness, timeliness, and consistency.

Methods: A cross-sectional study was conducted between August and October 2024 in eight Tanzanian regional referral hospitals. From a sampling frame of 2650 healthcare professionals involved in routine data entry, 336 were randomly selected to complete a validated self-administered questionnaire (Cronbach's α=0.94). Data were analyzed using descriptive statistics and multiple linear regression (SPSS v27) to determine associations between social skills and data quality indicators.

Results: Communication was positively associated with accuracy (β=.247, p<.001), consistency (β=.366, p<.001), and timeliness (β=.509, p<.001), but not with completeness. Change catalyst skills significantly improved accuracy (β=.580), consistency (β=.520), and timeliness (β=.370), all p<.001, but showed no effect on completeness. Teamwork positively influenced consistency (β=.184, p<.001) and completeness (β=.282, p=.002), but was unrelated to accuracy and negatively associated with timeliness (β=-.223, p<.001).

Conclusion: Strengthening communication and change catalyst abilities among healthcare workers can improve key aspects of data quality. Tailored training in these areas, along with process-mapping to streamline teamwork, may support more accurate and timely health data management.