Journal of Healthcare Quality Research最新文献

Introduction and objectives: The principle of patient autonomy in the participation and incorporation of their health data in research projects is a legal and deontological obligation that must be fulfilled. The aim of this study was to know the degree of compliance and adequacy of informed consent in clinical research projects in a university hospital.

Material and methods: Through this cross-sectional study, the adequacy of the way patient data are obtained in the research projects presented to the Research Committee of a university hospital was analyzed. The adequacy of the way patient data were obtained in the research projects, dealing with informed consent and causes of exemption, was described with their frequencies distributions. It was assessed by means of the adjusted odds ratio through a backstep logistic regression model, including the predictable significant variables previously analyzed in the univariant analysis.

Results: A total of 565 protocols were included. The most frequent type of studies assessed were observational retrospectives (49.6%) and end-of-year projects (28.1%). The most frequent way of obtaining the patient data were by means of soliciting exemption of informed consent (48.3%). Obtaining the patient data process was considered appropriated in 51.1% of the projects. Projects with higher adequacy were those solicited by students (OR=4.2; CI_95%=2.0-8.8) and residents OR=3.0; CI_95%=1.2-2.4).

Conclusions: The majority of the projects assessed was retrospective observational studies in which exemption of informed consent was solicited. Projects with higher adequacy were solicited by students and residents.

Objetive: To know the perception of primary care professionals about the frequency with which interventions that should not be done at this level of care are carried out.

Material and methods: Three questionnaires were developed to evaluate 9 interventions in family medicine, 2 in pediatrics and 6 in nursing. The percentage of professionals who stated that they always or almost always carried out these interventions was calculated, considering acceptable percentages of less than 5%. A descriptive analysis of the barriers identified to reduce these interventions was also carried out.

Results: Five of the 9 interventions evaluated in family medicine, 2 in pediatrics, and 4 of the 6 in nursing were always or almost always performed by 5% or more of the professionals. Among the barriers identified to stop doing unnecessary interventions, the first was lack of time in the consultation, followed by lack of training.

Conclusions: The results obtained have made it possible to identify which of the primary care interventions evaluated have the greatest room for improvement, as well as the main barriers to their deimplementation. Surveys of professionals make it possible to assess recommendations that cannot be measured from clinical records. Knowing their perception of their clinical practice can be very useful for designing the intervention plan.

Introduction: Primary health care is essential in a well-designed health system. A way of approaching the quality of an institution or service is evaluating different aspects like accessibility, treatment, satisfaction, and efficiency. The COVID-19 pandemic caused substantial disruptions in health systems. The present work focused on assessing the evolution of the experience of patients. It analyzed its relationship with various factors of the centers and the professionals' quality of life.

Methods: Retrospective quantitative study through a survey carried out in Catalonia evaluating the experience of users in relation to primary health care services. Results from years 2015, 2018, 2021 and 2022 are included in the study.

Results: Users from 370 centers were included in the study. The highest scores were registered in dimensions as environment and information (more than 90%), while accessibility was the worst scored dimension (mean 65.19). Global satisfaction scores were significantly higher in 2015 and 2018 and dropped the following years showing the impact of the COVID-19 pandemics.

Conclusion: The evolution of the patient experience in Catalonia shows a progressive decrease from the first edition in 2015 to the most recent edition in 2022, aggravated by the COVID-19 pandemic. During the pandemic, all the characteristics of primary care were affected, and they are beginning to recover. The resilience that primary care has shown during the pandemic contrasts with a downward valuation of the experience of patients who have used it.