Pub Date : 2025-03-01DOI: 10.1016/j.jhqr.2024.11.003
A. McCaskill , A. Gasch-Gallen , J. Montero-Marco
Objective
This quasi-experimental, non-randomized study described the process of implementing ISO 7101 subclause 8.10.5 Health literacy in specialty consultations, then determined the effects of implementation on patient general health literacy scores and perceptions of quality of care.
Method
Implementation steps were outlined, nurses were trained and used a standardized health literacy checklist with patients. The HLS19-Q12 was used to calculate patients’ general health literacy scores pre- and post-implementation of subclause 8.10.5. Paired samples t-test and Wilcoxon signed-rank test determined relationships between implementation, health literacy score, and quality of care perceived.
Results
Mean general health literacy scores increased post-implementation from 66.35 to 76.29, as did the mean score of perception of quality of care received (M = 3.87 to M = 3.99). Wilcoxon test for both variables was significant (P < .001), and effect size was large (d ≥ 0.8).
Conclusions
Implementation of ISO 7101, subclause 8.10.5 Health literacy had a positive, statistically significant impact on patient general health literacy scores and perceptions of quality of care. This is valuable information for healthcare management decision makers as they implement new standards and seek to improve patient health outcomes.
{"title":"Results of the process of implementation of ISO 7101 subclause 8.10.5 Health literacy in specialty consultations","authors":"A. McCaskill , A. Gasch-Gallen , J. Montero-Marco","doi":"10.1016/j.jhqr.2024.11.003","DOIUrl":"10.1016/j.jhqr.2024.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>This quasi-experimental, non-randomized study described the process of implementing ISO 7101 subclause 8.10.5 Health literacy in specialty consultations, then determined the effects of implementation on patient general health literacy scores and perceptions of quality of care.</div></div><div><h3>Method</h3><div>Implementation steps were outlined, nurses were trained and used a standardized health literacy checklist with patients. The HLS<sub>19</sub>-Q12 was used to calculate patients’ general health literacy scores pre- and post-implementation of subclause 8.10.5. Paired samples <em>t</em>-test and Wilcoxon signed-rank test determined relationships between implementation, health literacy score, and quality of care perceived.</div></div><div><h3>Results</h3><div>Mean general health literacy scores increased post-implementation from 66.35 to 76.29, as did the mean score of perception of quality of care received (<em>M</em> <!-->=<!--> <!-->3.87 to <em>M</em> <!-->=<!--> <!-->3.99). Wilcoxon test for both variables was significant (<em>P</em> <!--><<!--> <!-->.001), and effect size was large (<em>d</em> <!-->≥<!--> <!-->0.8).</div></div><div><h3>Conclusions</h3><div>Implementation of ISO 7101, subclause 8.10.5 Health literacy had a positive, statistically significant impact on patient general health literacy scores and perceptions of quality of care. This is valuable information for healthcare management decision makers as they implement new standards and seek to improve patient health outcomes.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Pages 116-125"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910876","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}
Pub Date : 2025-03-01DOI: 10.1016/j.jhqr.2024.12.003
Vicente Ortún
Governance and management, two terms that are barely understood, are precisely defined, and measured. They explain a very important part of the difference between countries, systems, and organizations. Also, in healthcare. The article devotes much attention to the indicators that address the quality of the rules of the game of society, its institutions, showing how the judgment about one or another form of social organization depends on more than one dimension. The good Spanish health system, with a poor prognosis due to its sclerosis of supply and flight to the private sector, needs to be depoliticized and debureaucratized so that the solvency of the health response provides the majority vote necessary for the sustainability of the welfare state. The entire text uses real examples and lands in the Spanish reality, finally distinguishing between what we can influence as citizens and what we as professionals are responsible for.
{"title":"Calidad de las organizaciones y del sistema: no es lo mismo","authors":"Vicente Ortún","doi":"10.1016/j.jhqr.2024.12.003","DOIUrl":"10.1016/j.jhqr.2024.12.003","url":null,"abstract":"<div><div>Governance and management, two terms that are barely understood, are precisely defined, and measured. They explain a very important part of the difference between countries, systems, and organizations. Also, in healthcare. The article devotes much attention to the indicators that address the quality of the rules of the game of society, its institutions, showing how the judgment about one or another form of social organization depends on more than one dimension. The good Spanish health system, with a poor prognosis due to its sclerosis of supply and flight to the private sector, needs to be depoliticized and debureaucratized so that the solvency of the health response provides the majority vote necessary for the sustainability of the welfare state. The entire text uses real examples and lands in the Spanish reality, finally distinguishing between what we can influence as citizens and what we as professionals are responsible for.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Pages 126-133"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060561","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}
Pub Date : 2025-03-01DOI: 10.1016/j.jhqr.2024.10.002
A. Iruela , I. Moral , G. Gálvez , L.M. Jimenez , R. Manzanera
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.
{"title":"Patient's experience as a tool in analyzing primary care in Catalonia","authors":"A. Iruela , I. Moral , G. Gálvez , L.M. Jimenez , R. Manzanera","doi":"10.1016/j.jhqr.2024.10.002","DOIUrl":"10.1016/j.jhqr.2024.10.002","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Pages 72-78"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640026","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}
Pub Date : 2025-03-01DOI: 10.1016/j.jhqr.2024.11.001
A. García-Rudolph , E.A. Devilleneuve , M.A. Wright , D. Sanchez-Pinsach , E. Opisso
Introduction and objectives
Despite the importance of length of stay (LOS) following spinal cord injury, it remains underexplored in the literature. This study aims to bridge this gap by investigating the association between rehabilitation LOS and functional gains among patients with traumatic (TSCI) or non-traumatic (NTSCI) spinal cord injuries.
Methods
We conducted a retrospective observational cohort study assessing functional gains using the motor Functional Independence Measure (mFIM) and the Spinal Cord Independence Measure (SCIM III) from rehabilitation admission to discharge. Outcomes were analyzed across four neurological categories based on the American Spinal Injury Association Impairment Scale (AIS): C1-C4 AIS A-C; C5-8 AIS A-C; T1-S5 AIS A-C; and AIS D. Linear regression models estimated changes across rehabilitation LOS quarters (Q1–Q4), adjusting for covariates.
Results
We included 1036 patients admitted for rehabilitation between 2007 and 2023 (46.3% TSCI, 53.7% NTSCI).
TSCI: age 42.7, 80.2% male, 41.8% AIS A, LOS 90.5.
NTSCI: age 55.7, 54.2% male, 14.2% AIS A, LOS 69.6.
For TSCI, mFIM and SCIM III gains increased significantly from Q1 to Q2 (T1-S5-ABC, n = 214) and Q2 to Q3 (AIS D, n = 129). For NTSCI, gains increased from Q2 to Q3 (T1-S5-ABC, n = 195) and from Q1 to Q2 as well as from Q2 to Q3 (AIS D, n = 304). Adjusted models showed decreasing gains for Q2 and Q3 vs. Q1 (TSCI) but increasing gains for Q2–Q4 vs. Q1 (NTSCI) for both measures. No significant gains were observed from Q3 to Q4.
Conclusions
We identified specific neurological categories and LOS quarters yielding to significant functional gains.
{"title":"Optimizing length of hospital stay among inpatients with spinal cord injury: An observational study","authors":"A. García-Rudolph , E.A. Devilleneuve , M.A. Wright , D. Sanchez-Pinsach , E. Opisso","doi":"10.1016/j.jhqr.2024.11.001","DOIUrl":"10.1016/j.jhqr.2024.11.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Despite the importance of length of stay (LOS) following spinal cord injury, it remains underexplored in the literature. This study aims to bridge this gap by investigating the association between rehabilitation LOS and functional gains among patients with traumatic (TSCI) or non-traumatic (NTSCI) spinal cord injuries.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational cohort study assessing functional gains using the motor Functional Independence Measure (mFIM) and the Spinal Cord Independence Measure (SCIM III) from rehabilitation admission to discharge. Outcomes were analyzed across four neurological categories based on the American Spinal Injury Association Impairment Scale (AIS): C1-C4 AIS A-C; C5-8 AIS A-C; T1-S5 AIS A-C; and AIS D. Linear regression models estimated changes across rehabilitation LOS quarters (Q1–Q4), adjusting for covariates.</div></div><div><h3>Results</h3><div>We included 1036 patients admitted for rehabilitation between 2007 and 2023 (46.3% TSCI, 53.7% NTSCI).</div><div>TSCI: age 42.7, 80.2% male, 41.8% AIS A, LOS 90.5.</div><div>NTSCI: age 55.7, 54.2% male, 14.2% AIS A, LOS 69.6.</div><div>For TSCI, mFIM and SCIM III gains increased significantly from Q1 to Q2 (T1-S5-ABC, <em>n</em> <!-->=<!--> <!-->214) and Q2 to Q3 (AIS D, <em>n</em> <!-->=<!--> <!-->129). For NTSCI, gains increased from Q2 to Q3 (T1-S5-ABC, <em>n</em> <!-->=<!--> <!-->195) and from Q1 to Q2 as well as from Q2 to Q3 (AIS D, <em>n</em> <!-->=<!--> <!-->304). Adjusted models showed decreasing gains for Q2 and Q3 vs. Q1 (TSCI) but increasing gains for Q2–Q4 vs. Q1 (NTSCI) for both measures. No significant gains were observed from Q3 to Q4.</div></div><div><h3>Conclusions</h3><div>We identified specific neurological categories and LOS quarters yielding to significant functional gains.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Pages 79-88"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910874","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}
Pub Date : 2025-03-01DOI: 10.1016/j.jhqr.2024.12.005
J.M. Aranaz Andrés , M.A. Espinel Ruiz , F. Roldan Moll , Miembros de la Comisión de Seguridad del Paciente del Hospital Ramón y Cajal
Introduction
The culture of patient safety is reflected in the behavior of individuals within a healthcare organization, based on knowledge, beliefs, and values aimed at minimizing the harm that patients might suffer. Assessing the perception of safety culture helps in developing and implementing improvement actions.
Materials and methods
A descriptive study conducted in two phases. A patient safety culture questionnaire measuring three dimensions of the safety culture was administered, and improvement actions were developed based on the results.
Results
300 responses were obtained, with a response rate of 10.2%. 70% were women, 40% were physicians, and 38% were nurses. 37% reported having worked at the hospital for more than 20 years. The management support for patient safety dimension received 33% (CI: 29.5-35.7) of positive responses and 27% (CI: 24.3-30.2) of negative responses. The patient safety perception dimension received 67% (CI: 63.8-70.01) of positive responses and 20% (CI: 17.4-22.8) of negative responses. The supervisor/department head support for patient safety dimension received 61% (CI: 57.4-63.9) of positive responses and 19% (CI: 16.3-21.5) of negative responses.
After presenting the results to the management team, improvement actions were proposed, which led to greater commitment from the management team to patient safety, increased presence during patient safety rounds, and greater visibility of patient safety-related information available on the intranet.
Conclusions
A low perception of management support was detected, allowing for improvements in this dimension.
{"title":"Percepción de la cultura de seguridad del paciente en un hospital de alta complejidad de Madrid y acciones de mejora","authors":"J.M. Aranaz Andrés , M.A. Espinel Ruiz , F. Roldan Moll , Miembros de la Comisión de Seguridad del Paciente del Hospital Ramón y Cajal","doi":"10.1016/j.jhqr.2024.12.005","DOIUrl":"10.1016/j.jhqr.2024.12.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The culture of patient safety is reflected in the behavior of individuals within a healthcare organization, based on knowledge, beliefs, and values aimed at minimizing the harm that patients might suffer. Assessing the perception of safety culture helps in developing and implementing improvement actions.</div></div><div><h3>Materials and methods</h3><div>A descriptive study conducted in two phases. A patient safety culture questionnaire measuring three dimensions of the safety culture was administered, and improvement actions were developed based on the results.</div></div><div><h3>Results</h3><div>300 responses were obtained, with a response rate of 10.2%. 70% were women, 40% were physicians, and 38% were nurses. 37% reported having worked at the hospital for more than 20<!--> <!-->years. The management support for patient safety dimension received 33% (CI: 29.5-35.7) of positive responses and 27% (CI: 24.3-30.2) of negative responses. The patient safety perception dimension received 67% (CI: 63.8-70.01) of positive responses and 20% (CI: 17.4-22.8) of negative responses. The supervisor/department head support for patient safety dimension received 61% (CI: 57.4-63.9) of positive responses and 19% (CI: 16.3-21.5) of negative responses.</div><div>After presenting the results to the management team, improvement actions were proposed, which led to greater commitment from the management team to patient safety, increased presence during patient safety rounds, and greater visibility of patient safety-related information available on the intranet.</div></div><div><h3>Conclusions</h3><div>A low perception of management support was detected, allowing for improvements in this dimension.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Pages 97-106"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060373","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}
Pub Date : 2025-03-01DOI: 10.1016/j.jhqr.2024.11.002
J.E. Calle Urra , A. Jimeno Almazán , A. Más Castillo , T. Ramón Esparza , C. Arellano Morata , J.J. López-Picazo Ferrer
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.
{"title":"Percepción de los profesionales de atención primaria sobre la frecuencia con que se realizan intervenciones «que no hay que hacer»","authors":"J.E. Calle Urra , A. Jimeno Almazán , A. Más Castillo , T. Ramón Esparza , C. Arellano Morata , J.J. López-Picazo Ferrer","doi":"10.1016/j.jhqr.2024.11.002","DOIUrl":"10.1016/j.jhqr.2024.11.002","url":null,"abstract":"<div><h3>Objetive</h3><div>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.</div></div><div><h3>Material and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div><div>Among the barriers identified to stop doing unnecessary interventions, the first was lack of time in the consultation, followed by lack of training.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Pages 89-96"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847679","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}
Pub Date : 2025-03-01DOI: 10.1016/j.jhqr.2025.02.003
{"title":"Acknowledgment to the Journal Reviewers for their contributions","authors":"","doi":"10.1016/j.jhqr.2025.02.003","DOIUrl":"10.1016/j.jhqr.2025.02.003","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Page 137"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.jhqr.2024.10.004
Rosa María Añel Rodríguez
{"title":"Referentes de seguridad del paciente: del mito a la realidad","authors":"Rosa María Añel Rodríguez","doi":"10.1016/j.jhqr.2024.10.004","DOIUrl":"10.1016/j.jhqr.2024.10.004","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 2","pages":"Pages 65-67"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733320","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jhqr.2024.12.010
J. Bel Diaz, M. Barbero Mielgo, A. Pérez Garnelo, R. Guzmán Carranza, J. García Fernández
Introduction
Enhanced recovery program (ERAS program) have revolutionized the world of surgery by reducing postoperative complications and hospital stays. Greater adherence to the protocol results in better outcomes; however, adherence often declines over time. The main objective of this study is to analyze the adherence rate to ERAS strategies and the outcomes of an ERAS colorectal (CRC) program five years after its implementation.
Methodology
This is a descriptive observational study comparing two groups of patients undergoing scheduled CRC surgery under an ERAS program at University Hospital. The first group (ERAS) includes patients operated on during the period immediately following the implementation of the protocol (January 2017–June 2018), while the second group (ERAS 5) includes patients operated on five years after the implementation (January 2022–June 2022).
Results
An increase in the adherence rate to ERAS strategies was observed (88.2% in ERAS vs. 84.2% in ERAS 5, p 0.003), as well as a reduction in healthcare-associated infections (HAIs) (9% in ERAS vs. 25.2% in ERAS 5, p 0.001) and surgical site infections (6% in ERAS vs. 18.2% in ERAS 5, p 0.002). No differences were found in other postoperative complications, functional recovery, average length of stay, and readmission rates.
Conclusions
After five years of implementing an ERAS protocol for CRC in our hospital, we have managed to maintain a high adherence rate to ERAS strategies. There has been a significant reduction in HAIs and surgical site infections.
{"title":"Analysis of protocol adherence and outcomes of an enhanced recovery program in colorectal surgery after 5 years of implementation","authors":"J. Bel Diaz, M. Barbero Mielgo, A. Pérez Garnelo, R. Guzmán Carranza, J. García Fernández","doi":"10.1016/j.jhqr.2024.12.010","DOIUrl":"10.1016/j.jhqr.2024.12.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Enhanced recovery program (ERAS program) have revolutionized the world of surgery by reducing postoperative complications and hospital stays. Greater adherence to the protocol results in better outcomes; however, adherence often declines over time. The main objective of this study is to analyze the adherence rate to ERAS strategies and the outcomes of an ERAS colorectal (CRC) program five years after its implementation.</div></div><div><h3>Methodology</h3><div>This is a descriptive observational study comparing two groups of patients undergoing scheduled CRC surgery under an ERAS program at University Hospital. The first group (ERAS) includes patients operated on during the period immediately following the implementation of the protocol (January 2017–June 2018), while the second group (ERAS 5) includes patients operated on five years after the implementation (January 2022–June 2022).</div></div><div><h3>Results</h3><div>An increase in the adherence rate to ERAS strategies was observed (88.2% in ERAS vs. 84.2% in ERAS 5, <em>p</em> 0.003), as well as a reduction in healthcare-associated infections (HAIs) (9% in ERAS vs. 25.2% in ERAS 5, <em>p</em> 0.001) and surgical site infections (6% in ERAS vs. 18.2% in ERAS 5, <em>p</em> 0.002). No differences were found in other postoperative complications, functional recovery, average length of stay, and readmission rates.</div></div><div><h3>Conclusions</h3><div>After five years of implementing an ERAS protocol for CRC in our hospital, we have managed to maintain a high adherence rate to ERAS strategies. There has been a significant reduction in HAIs and surgical site infections.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"40 3","pages":"Article 101111"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081449","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}
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