Journal of Healthcare Quality Research最新文献

Introduction and objective

In 2015, the Spanish Society of Hospital Pharmacy (SEFH) launched the Strategic Map for Outpatient Pharmaceutical Care (MAPEX), with the purpose of adapting the activity offered in Hospital Pharmacy outpatient clinics to the new healthcare context.

The aim of the present study was to analyse the evolution of outpatient pharmaceutical care in Hospital Pharmacy Services in Spain in the period 2016-2021 after the implementation and development of the MAPEX initiative.

Material and method

The implementation and development of the project was carried out by a group of experts from SEFH and consisted of five phases: creation of the structure, consensus conference, situation analysis, development of strategic initiatives and evolutionary analysis.

To analyse the evolutionary development, a specific 43-item questionnaire was developed that addressed aspects related to structure, context, integration, processes, outcomes and research and was answered in 2016 and 2021 (in the latter case by adding 3 additional questions).

Results

141 hospitals participated in the status survey in 2016 and 138 in 2021. Significant differences were found in all dimensions analysed. None of the aspects assessed suffered a setback in this period.

The most highly rated aspects at the general level were the improvement of the care model (65.0%) and at the local level, the incorporation of non-face-to-face pharmaceutical care (42.8%). Further progress in the coming years in the expansion and practical application of the methodology proposed in the project was considered a priority.

Conclusions

The implementation and development of the MAPEX initiative has had a positive impact in terms of quality of care for outpatient pharmaceutical care in Hospital Pharmacy services in Spain.

Introduction

Today, primary care professionals’ (PCPs) perspectives on hospital quality are unknown when evaluating hospital quality priorities. The aims of the present study were to identify key healthcare quality attributes from PCPs’ perspective, to validate an instrument that measures PCPs’ experiences of healthcare quality multidimensionally and to define hospital quality priorities based on PCPs’ experiences.

Material and methods

Focus groups with PCPs were conducted to identify quality attributes through a qualitative in-depth analysis. A multicentre study of 18 hospitals was used to quantitatively assess construct, discriminant and criterion validity of the FlaQuM-Quickscan, an instrument that measures ‘Healthcare quality for patients and kin’ (part 1) and ‘Healthcare quality for professionals’ (part 2). To set quality priorities, scores on quality domains were analyzed descriptively and between-hospital variation was examined by evaluating differences in hospitals’ mean scores on the quality domains using one-way Analysis of Variance (ANOVA).

Results

Identified key attributes largely corresponded with Lachman's multidimensional quality model. Including ‘Communication’ as a new quality domain was recommended. The FlaQuM-Quickscan was completed by 550 PCPs. Confirmatory factor analyses showed reasonable to good fit, except for the Root Mean Square Error of Approximation (RMSEA) in part 2. The ‘Equity’ domain scored the highest in parts 1 and 2. Domains ‘Kin-centred care’ and ‘Accessibility and timeliness’ scored the lowest in part 1 and ‘Resilience’ and ‘Partnership and co-production’ in part 2. Significant variation in hospitals’ mean scores was observed for eleven domains in part 1 and sixteen domains in part 2.

Conclusions

The results gained a better understanding of PCPs’ perspective on quality. The FlaQuM-Quickscan is a valid instrument to measure PCPs’ experiences of hospital quality. Identified priorities indicate that hospital management should focus on multifaceted quality strategies, including technical domains, person-and kin-centredness, core values and catalysts.

Background and objective

People with disabilities are one of the groups that usually frequent healthcare centers, so it is essential to attend to their specific needs, especially from the point of view of universal accessibility, safety and healthcare quality.

The aim of the study is to summarize the available evidence on the needs of groups of patients with some type of disability in access, navigation and stay during the reception of healthcare in various health centers and to identify successful solutions.

Materials and methods

A scoping review had been designed, based on a literature review without time limit in three databases (PubMed, WOS, and Embase).

Results

Of the 2562 articles identified, 11 were included. Recommendations for improvement in the design of healthcare services focused on the following aspects: improving access to primary care centers; navigation, signage, and orientation in the hospital environment; elevator design; hospital room bathroom design; meeting the needs of wheelchair users; importance of the participation of the patient with a disability; involvement of stakeholders in the design process; and the need for appropriate policies to ensure accessibility to buildings.

Conclusions

The promotion of artistic programs in healthcare settings and the participation of people with disabilities in the design process of healthcare settings could provide beneficial solutions. More studies are needed, given the scarcity of evidence found, to ensure that care for this group is based on criteria of patient safety, universal accessibility, healthcare quality and humanization.

There was a widespread discontinuation of simulation programs during and after the COVID-19 pandemic. The objective is to explore how to facilitate greater integration of simulation in healthcare organizations.

A literature review was conducted in PubMed, MEDES, IBECS and DOCUMED databases. Twenty-three articles published after the pandemic were selected, categorized in seven themes and critically reviewed.

In order to consistently and fully integrate simulation into the organizational culture it is recommended to prioritize the development of new strategies that enhance the efficiency and safety of healthcare delivery. And also strategies that enhance the satisfaction and well-being of all stakeholders.

Introduction

The application of Lean methodology in the hospital environment can help to improve interprofessional communication and reduce non-value adding activities (waste).

Objective

To determine the effectiveness of the implementation of a visual management tool, in the ability to reduce the number of trips, to determine the location of patients in real time in the process of intra-hospital transfers (ITH) and discharges in a hospital.

Material and methods

Before-after study in a hospital internal medicine unit. Several time wastes due to unnecessary transfers were detected. A multiprofessional group was formed to design a visual management tool for the resolution of these identified problems. The opinion of the professionals on the tool was evaluated and variables of staff displacement and completion of the tool were measured before and after its implementation.

Results

The personnel involved was trained. Completion of the tool improved over time, both in HIT and in discharges, reducing the number of trips.

Conclusions

The application of a visual management tool in care processes, including all the personnel involved is effective and saves waste.