Journal of Healthcare Quality Research最新文献

{"title":"Seguridad del paciente en salud mental: una deuda pendiente","authors":"S. Tomás-Vecina , E. Vicens-Pons , B. Blanquez-Gómez","doi":"10.1016/j.jhqr.2025.101186","DOIUrl":"10.1016/j.jhqr.2025.101186","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101186"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequacy of anticoagulation in patients with nonvalvular atrial fibrillation","authors":"M. Fernández-Pérez,&nbsp;Á. Pereda,&nbsp;M. Gabilondo,&nbsp;C. Pisón","doi":"10.1016/j.jhqr.2026.101194","DOIUrl":"10.1016/j.jhqr.2026.101194","url":null,"abstract":"<div><h3>Objective</h3><div>Fewer benefits are obtained from antithrombotic therapy in nonvalvular atrial fibrillation (NVAF) in routine practice than in clinical trials due to inadequate prescribing. This study aimed to assess the adequacy of anticoagulation therapy in clinical practice in patients with newly diagnosed NVAF.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted to assess treatment adequacy in patients with newly diagnosed NVAF in Alava. The adequacy of direct-acting oral anticoagulant (DOAC) therapy was classified according to the dose specified in the summary of product characteristics. In patients treated with vitamin K antagonists (VKAs), anticoagulation therapy quality was considered good when the time in the therapeutic range (international normalised ratio: 2.0–3.0) was ≥60%. Univariate and multivariate logistic regression analyses were performed to analyse the probability of inadequacy.</div></div><div><h3>Results</h3><div>Overall, 1446 patients with NVAF were included: 408 (28%) were treated with DOACs, and 856 (59%) with VKAs, while 182 (13%) received no anticoagulation therapy. The treatment was considered adequate in 75% of the DOAC group, 33% of the VKA group, and 57% of the no-anticoagulant group. The reason for inadequacy in treated patients was receiving an inappropriate dose of DOACs (25%) or VKAs (67%), while in the untreated group, 78 cases (43%) were classified as inadequate due to lack of anticoagulation with no clinical justification.</div></div><div><h3>Conclusions</h3><div>There is marked variability in the adequacy of anticoagulation in patients with NVAF. Guideline recommendations should be strictly followed to improve treatment adequacy, as it is unacceptable that half of these patients are inadequately anticoagulated.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101194"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Back to basics: Why quality and patient safety tools still matter","authors":"S. Lorenzo Martínez,&nbsp;D. Parés Martínez,&nbsp;C. Natal Ramos","doi":"10.1016/j.jhqr.2026.101198","DOIUrl":"10.1016/j.jhqr.2026.101198","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101198"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance of healthcare-associated infections and antimicrobial use in long-term care facilities in the Community of Madrid","authors":"M. Mosquera-González,&nbsp;M. Alonso-García,&nbsp;S. Jiménez-Bueno,&nbsp;A. Arce-Arnáez","doi":"10.1016/j.jhqr.2026.101191","DOIUrl":"10.1016/j.jhqr.2026.101191","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Healthcare-associated infections (HAIs) in long-term care facilities (LTCFs) represent a significant public health concern. This study aims to estimate the prevalence of HAIs and antimicrobial use in LTCFs in the Community of Madrid (CM), and to assess infection prevention and control (IPC) indicators within the framework of the fourth point prevalence survey of HAIs and Antimicrobial use in European LTCFs (HALT-4).</div></div><div><h3>Materials and methods</h3><div>A descriptive cross-sectional study was conducted between 20th and 30th of May 2024 across nine public LTCFs in the CM. Standardised questionnaires from the HALT-4 protocol were used to collect data on clinical characteristics, risk factors, active HAIs and antimicrobial use. Associations between HAIs, risk factors, IPC indicators and antimicrobial use policies were analysed.</div></div><div><h3>Results</h3><div>1076 residents were included. HAIs prevalence was 6.0% (95% CI: 4.6–7.5) including outbreaks-associated infections and 4.1% (95% CI: 2.9–5.3) excluding them. Respiratory tract (36.4%), urinary tract (34.1%) and skin (20.5%) infections were the most frequent, excluding gastrointestinal infection outbreaks. Antimicrobial treatment was administered to 3.8% of residents, primarily via the oral route and for therapeutic purposes. Beta-lactams were the most widely used antimicrobials, and <em>Enterobacteriaceae</em> were the most prevalent microorganisms. Significant associations were found between HAIs and disorientation (prevalence ratio [PR]: 2.0, 95%CI: 1.1–3.8) and reduced mobility (PR: 1.9, 95%CI: 1.0–3.5). Areas of improvement included effective infection surveillance programmes and antimicrobial prescription training.</div></div><div><h3>Conclusions</h3><div>The prevalence of HAIs in the CM was higher than the European average, while antimicrobial use was lower than both national and European averages.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101191"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacto de la frecuentación en la calidad asistencial en un Servicio de Urgencias Pediátricas","authors":"L. de la Sen de la Cruz,&nbsp;A. Palacios Bermejo,&nbsp;S. Amorós Villaverde,&nbsp;M. Escobar Castellanos,&nbsp;C. Ferrero García-Loygorri,&nbsp;A. Rivas García","doi":"10.1016/j.jhqr.2025.101174","DOIUrl":"10.1016/j.jhqr.2025.101174","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Overcrowding in Pediatric Emergency Departments(PED) have a negative impact in waiting times. External factors such as the SARS-CoV-2 pandemic can change the incoming volume of patients. The aim of this study is to quantify the extent to which the quality indicators are impacted by overcrowding and the extent to which the pandemic has impacted them.</div></div><div><h3>Material and methods</h3><div>Retrospective study in the PED of a high complexity hospital. Quality indicators from the PED dashboard are collected weekly for the period 2018-2022, excluding the pandemic year 2020. A univariate and multivariate analysis of the association between the variation of the indicators for every 100 additional emergencies was performed, expressing it using the regression coefficient B and its 95% CI.</div></div><div><h3>Results</h3><div>A median of 1105 emergencies were attended each week(876-1262). The adjusted multivariate analysis showed differences in the indicators for every 100 additional weekly emergencies of: triage delay time(B<!--> <!-->=<!--> <!-->0.23; 95%CI:0.17-0.29.p&lt;<!--> <!-->0.001), delay time in care(B<!--> <!-->=<!--> <!-->1.84; 95%CI:1.58- 2.10.p&lt;<!--> <!-->0.001); percentage of patients under observation(B<!--> <!-->=<!--> <!-->-0.13;95%CI:-0.24--0.02).p<!--> <!-->=<!--> <!-->0.017), percentage of admissions(B<!--> <!-->=<!--> <!-->-0.13;95%CI:-0.23--0.03.p<!--> <!-->=<!--> <!-->0.011), percentage of patients waiting ≥1 hour for admission(B<!--> <!-->=<!--> <!-->0.89;95%CI:0.06-1.73.p<!--> <!-->=<!--> <!-->0.036) and percentage of return visit(B<!--> <!-->=<!--> <!-->0.22;95%CI:0.11-0.34.p&lt;<!--> <!-->0.001).</div><div>The analysis by pre-post pandemic periods showed differences: in the percentage of patients with priority≤3(B<!--> <!-->=<!--> <!-->-3.8;95%CI: -4.7- -2.9.p&lt;<!--> <!-->0.001), length of stay in the PED(B<!--> <!-->=<!--> <!-->0,24;95%CI:0,12-0,36.p&lt;<!--> <!-->0,001), percentage of patients in observation(B<!--> <!-->=<!--> <!-->-2.6;95%CI:-3.2--1.9.p&lt;<!--> <!-->0.001), length of stay in observation(B<!--> <!-->=<!--> <!-->0.68;95%CI:0.51-0.86.p&lt;<!--> <!-->0.001), percentage of admissions(B<!--> <!-->=<!--> <!-->0.8;95%CI;-1.4--0.2.p<!--> <!-->=<!--> <!-->0.006), percentage of patients waiting ≥ 1 hour for admission(B<!--> <!-->=<!--> <!-->30.5;95%CI:26.9-34.p&lt;<!--> <!-->0.001) and percentage of voluntary discharges (B<!--> <!-->=<!--> <!-->0,3;95%CI:0,1-0,6.p<!--> <!-->=<!--> <!-->0,013).</div></div><div><h3>Conclusion</h3><div>Overcrowding impacts the quality of care in our center, increasing the waiting times for triage, care and admission, and increasing the proportion of visit return.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101174"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Administrative Processes in a Trauma Centre: Lean and Pareto Approach","authors":"R. Harsvardhan,&nbsp;A. Jain,&nbsp;S. Singh,&nbsp;M. Suhaib,&nbsp;S. Bose","doi":"10.1016/j.jhqr.2025.101172","DOIUrl":"10.1016/j.jhqr.2025.101172","url":null,"abstract":"<div><h3>Background</h3><div>The Central Control Room (CCR) of hospital plays a pivotal role in the hospital operations by overseeing, coordinating and resolving real-time administrative and operational challenges. Trauma centres operate in high-pressure environment and frequently encounter inefficiently designed workflows that impacts service delivery. Pareto analysis and Gemba Walk, based on Lean Management and Total Quality Management approach, focuses on direct observation by identify high-priority issues and real-time problem solving.</div></div><div><h3>Methods</h3><div>An interventional study was conducted over seven months (April–October 2024) at a trauma centre. In Phase I (April–June), all complaints reported in CCR were registered, categorized and analysed using Pareto analysis to identify the most frequent and high-impact issues. In Phase II (July), Gemba Walk by multidisciplinary team was introduced. During Phase III (August–October 2024), complaints were re-evaluated using Pareto analysis to measure the impact of the intervention.</div></div><div><h3>Interventions</h3><div>Introduction of structured complaint tracking using Pareto charts, followed by Gemba Walks involving operations, nursing, engineering, and housekeeping teams to address issues at the point of occurrence.</div></div><div><h3>Results</h3><div>Pareto analysis done in pre-intervention phase revealed that 69.88% of issues stemmed from 28.6% of the complaints. After targeted Gemba Walk introduction, the post-intervention analysis showed that while 67.77% of issues were still from 28.6% of complaints, however, nature of the problems was different.</div></div><div><h3>Conclusion</h3><div>Integration of Pareto analysis and Gemba Walk proved to be an effective approach for identifying and resolving key operational challenges in trauma centre. Findings highlight the importance of structured quality improvement approach in enhancing hospital efficiency.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101172"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Análisis de las hospitalizaciones potencialmente evitables en las enfermedades crónicas","authors":"F.M. Escandell Rico ,&nbsp;L. Pérez Fernández","doi":"10.1016/j.jhqr.2025.101168","DOIUrl":"10.1016/j.jhqr.2025.101168","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze indicators of potentially avoidable hospitalizations obtained through the minimum basic data set for chronic disease management and improving the quality of care.</div></div><div><h3>Method</h3><div>A descriptive retrospective study evaluating gender differences included hospital discharge records from 342 hospitals in the National Health System. The indicators and axes of analysis were from 2021, and the information included the following general data: total discharges, mean stay, mean age, and mortality rate. Four groups of indicators of potentially avoidable hospitalizations were analyzed: diabetes and its complications, cardiovascular disease and hypertension, respiratory and pulmonary diseases, and other acute and chronic conditions.</div></div><div><h3>Results</h3><div>Women have a higher risk of mortality in congestive heart failure (RR<!--> <!-->=<!--> <!-->1.35) and diabetes with acute complications. Men have higher mortality rates in respiratory diseases such as COPD and asthma. In acute conditions, there are no significant differences in mortality, but in chronic conditions, women have a higher risk. In diabetes, women have higher mortality from acute complications (RR<!--> <!-->=<!--> <!-->1.42), while men face a higher risk of chronic complications.</div></div><div><h3>Conclusions</h3><div>The study reveals variations in mortality and hospitalization associated with cardiovascular and respiratory diseases, and diabetes, with significant differences by gender. Women have higher mortality from acute complications of diabetes, while men have higher mortality from chronic diseases. These findings support the need for a personalized approach to treatment and prevention, considering the specificities of each gender.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101168"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"30 años de la Ley de Prevención de Riesgos Laborales en España: avances y retos en las organizaciones sanitarias","authors":"M. López-Gobernado ,&nbsp;J. Hernández Bartolomé ,&nbsp;D. Villalba Gil","doi":"10.1016/j.jhqr.2025.101181","DOIUrl":"10.1016/j.jhqr.2025.101181","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101181"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio multicéntrico de validez del Sistema Centralizado de Triaje Pediátrico","authors":"M.C. Miguez-Navarro ,&nbsp;G. Guerrero-Márquez ,&nbsp;P. Storch De Gracia Calvo ,&nbsp;S. Herranz López ,&nbsp;M.A. de la Fuente de la Hoz ,&nbsp;M.I. Sainz de la Maza Giménez ,&nbsp;Grupo de Triaje Pediátrico-STPED","doi":"10.1016/j.jhqr.2025.101173","DOIUrl":"10.1016/j.jhqr.2025.101173","url":null,"abstract":"<div><h3>Introduction</h3><div>This study was conducted to determine the indirect validity of the Sistema Centralizado de Triaje Pediátrico (STPED) –the computer version of the Sistema de Triaje Pediátrico del Hospital Gregorio Marañón (TRIPED-GM)– in eight pediatric emergency departments of the Community of Madrid.</div></div><div><h3>Patients and methods</h3><div>It is a retrospective observational multicenter study. A sample of patients (&lt;18 years) attending triaje from October 2021 to October 2022, for any reason, was randomly selected. The validity of STPED was assessed by analyzing the association between priority level (1 [maximum]- 5 [minimum]) and use of resources utilization (number of complementary tests, procedures, or treatments; need for observation or admissions; mean length of stay [LOS]) with a regression model. A subgroup analysis of secondary and tertiary hospitals was performed. The R software version</div><div>4.3.3 was used.</div></div><div><h3>Results</h3><div>A total of 542 patients were analyzed. For each unit increase in priority, the probability of performing a complementary test, procedure or receiving treatment increased 1.83-fold (Incidence Rate Ratio: 1.83; 95% confidence interval (CI): 1.66-2.02; <em>p</em> <!-->&lt;<!--> <!-->0.001), the need for observation, 6 (Odds Ratio: 6.07; 95% CI: 4.10-9.22; <em>p</em> <!-->&lt;<!--> <!-->0.001) and the need for admission, almost 5 (Odds Ratio: 4.93; 95% CI: 2.97-8.43; <em>p</em> <!-->&lt;<!--> <!-->0.001). The LOS increased by 69<!--> <!-->minutes (beta: 69; 95% CI: 44-95; <em>p</em> <!-->&lt;<!--> <!-->0.001). The relationship between resource use and priority was higher in tertiary hospitals.</div></div><div><h3>Conclusions</h3><div>The results confirm the indirect validity of STPED, especially in tertiary hospitals. Studies in other regions are needed to ratify these findings.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101173"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Habilidades no técnicas en cuidados intensivos. Importantes, pero aún desconocidas","authors":"E. Chicote-Álvarez,&nbsp;E. Cervantes-Marrodán,&nbsp;A. Sáenz-Pinillos,&nbsp;M. Macías-Pascual,&nbsp;A. Calvo-Martínez","doi":"10.1016/j.jhqr.2025.101162","DOIUrl":"10.1016/j.jhqr.2025.101162","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 1","pages":"Article 101162"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}