Journal of Healthcare Quality Research最新文献_第8页

Referentes de seguridad del paciente: del mito a la realidad [患者安全基准：从神话到现实]。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-03-01 DOI: 10.1016/j.jhqr.2024.10.004

Rosa María Añel Rodríguez

引用次数: 0

Analysis of protocol adherence and outcomes of an enhanced recovery program in colorectal surgery after 5 years of implementation 实施5年后结直肠手术强化恢复方案的依从性和结果分析。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-02-01 DOI: 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.

简介：增强恢复计划（ERAS计划）通过减少术后并发症和住院时间彻底改变了外科世界。更严格地遵守治疗方案会带来更好的结果；然而，坚持往往会随着时间的推移而下降。本研究的主要目的是分析ERAS策略的依从率以及ERAS结直肠癌（CRC）计划实施五年后的结果。方法：这是一项描述性观察性研究，比较了两组在大学医院ERAS计划下接受CRC手术的患者。第一组（ERAS）包括在方案实施后立即进行手术的患者（2017年1月至2018年6月），而第二组（ERAS 5）包括实施五年后（2022年1月至2022年6月）进行手术的患者。结果：观察到ERAS策略的依从率增加（ERAS组为88.2%，ERAS 5组为84.2%,p 0.003），医疗保健相关感染（HAIs）（ERAS组为9%，ERAS 5组为25.2%,p 0.001）和手术部位感染（ERAS组为6%，ERAS 5组为18.2%,p 0.002）。其他术后并发症、功能恢复、平均住院时间和再入院率均无差异。结论：在我院实施了5年的CRC ERAS方案后，我们成功地保持了ERAS策略的高依从率。HAIs和手术部位感染显著减少。

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引用次数: 0

Aumento en el porcentaje de asistencia a las consultas externas en el Área Sanitaria de Santiago de Compostela y Barbanza, tras modificar el sistema de gestión de citas [在修改预约管理制度后，圣地亚哥德孔波斯特拉和巴尔班萨保健区门诊就诊的百分比有所增加]。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-01-31 DOI: 10.1016/j.jhqr.2024.12.008

R.A. Montes-Villalba , M.I. Santiago-Pérez , M.J. Purriños-Hermida , J.R. Parada-Jorgal

Objective

To assess whether or not the new appointment management system for hospital outpatient consultations, implementing the use of «mailboxes» (computerized appointment system, based on ideal date), improves adherence to appointments or not.

Method

Before-after study, in which the degree of patient adherence to hospital outpatient appointments is compared, before and after the change in the appointment process (period 2014-2018 vs. year 2022). Statistical analysis was performed with Stata v17.

Results

Adherence to consultations (percentage of consultations performed) remained stable in all years of the period 2014-2018, with an average value of 91%, and increased to 93% in 2022. All characteristics of the consultations were shown to be associated with adherence, but in the multivariate model sex, age group, setting, hospital, functional area and type of activity were significant.

Conclusion

The change made in the appointment management system of hospital outpatient clinics in the Health Area of Santiago de Compostela and Barbanza has proven effective in improving adherence to the consultation. The reduction in the number of absences from consultations reduces waiting lists and improves patient care.

目的：评价医院门诊新预约管理系统实施“邮箱”（基于理想日期的计算机预约系统）是否提高了预约依从性。方法：前后对比研究，比较预约流程变更前后（2014-2018年与2022年）患者对医院门诊预约的依从程度。采用Stata v17进行统计学分析。结果：2014-2018年各年的依从性保持稳定，平均为91%，到2022年增加到93%。咨询的所有特征都显示与依从性有关，但在多变量模型中，性别、年龄组、环境、医院、功能区域和活动类型具有重要意义。结论：圣地亚哥-德孔波斯蒂拉和巴尔班扎卫生区医院门诊预约管理制度的改革对提高会诊依从性是有效的。缺勤人数的减少减少了等候名单，改善了病人护理。

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引用次数: 0

The person-centered medical care in pediatrics: A scoping review 儿科以人为本的医疗护理：范围综述。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-01-18 DOI: 10.1016/j.jhqr.2024.12.009

M.A.M. da Luz , J.O. Mendes

Introduction and objectives

The medicine development demonstrates that the traditional bioethical medical care model is not the most adequate. On the other hand, the person-centered clinical method has been winning more space in the medical practice, since it is a humanized method of care that allows best results. In pediatrics, the patient-centered care works a little bit different, since it requires not only the physician–patient relation, but also the integration of the physician–family–patient relation. Thus, the patient-centered care in the pediatric area is understudied, as well as little practiced. In this context, this review has the objective to exposure the actual scenario of the patient-centered care in pediatrics.

Materials and methods

This is a scoping review carried out from the standards of Jonna Briggs Institute (JBI). The database PubMed, Science Direct and BVS were used to search studies between 2012 until 2024. The research was performed with the descriptors “Medicine”, “Shared Decision Making”, “Pediatrics”, “Physician–Patient Relations” and “Patient-Centered Care”.

Results

The research identified 27,272 articles, along with 79 met the criteria and were included. Each article was analyzed and allocated in the four pillars of the patient-centered care, which was described and related with the pediatric clinic.

Conclusions

The patient-centered care brings benefits to medical care, especially in the pediatric area. Among them, stands out the increased adherence to treatment, the lowest rates of medical errors, the greater integration of the interprofessional team, the more individual and patient-sensitive investigation, as well as the respect of beliefs and desires, making the results obtained better.

前言与目的：医学发展表明，传统的生物伦理医疗模式已经不是最合适的。另一方面，以人为本的临床方法在医疗实践中赢得了更多的空间，因为它是一种人性化的护理方法，可以获得最佳效果。在儿科，以患者为中心的护理工作略有不同，因为它不仅需要医患关系，还需要医患家庭关系的整合。因此，以患者为中心的护理在儿科领域的研究不足，以及很少的实践。在此背景下，本综述的目的是揭示儿科以患者为中心的护理的实际情况。材料和方法：这是根据Jonna Briggs研究所（JBI）的标准进行的范围审查。数据库PubMed， Science Direct和BVS用于检索2012年至2024年之间的研究。研究以“医学”、“共同决策”、“儿科”、“医患关系”和“以患者为中心的护理”等描述符进行。结果：共发现27,272篇文章，其中79篇符合标准并被纳入。每篇文章被分析和分配在以患者为中心的护理的四个支柱，这是描述和相关的儿科诊所。结论：以患者为中心的护理为医疗服务带来了效益，特别是在儿科领域。其中，治疗依从性的提高、医疗错误率的降低、跨专业团队的融合程度的提高、个性化和患者敏感性的调查以及对信仰和愿望的尊重，使得获得的结果更好。

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引用次数: 0

Explorando la voz de los pacientes: mapeo de su experiencia tras ser atendidos en un área integrada de salud [探索病人的声音：绘制他们在综合健康领域护理后的经历]。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-01-16 DOI: 10.1016/j.jhqr.2024.12.006

J. López-Picazo Ferrer, J.M. Marín Martínez, I. Vidal-Abarca Gutiérrez, M. López Ibáñez

Background and aim

Measuring patient-reported experience measures (PREMs) is essential for the continuous improvement of quality. This study aims to assess the quality perceived by patients in the key care processes of an integrated health area measuring PREM elements, with the goal of identifying opportunities for improvement.

Methods

The research was conducted in the first half of 2023 within a Spanish integrated health area, analysing five key healthcare processes: Primary Care, Emergency Services, Hospitalisation, Consultations, and Surgery. To assess perceived quality, PREM elements such as accessibility, information, and professionalism were measured using the Net Promoter Score (NPS). The Lot Quality Assurance Sampling (LQAS) method was employed to identify specific areas for improvement by detecting rejected lots and optimising sample sizes.

Results

Although the perceived quality was generally high, with good or excellent NPS scores, significant variability was observed between processes. A total of 104 rejected lots (21%) were identified across the processes evaluated. The highest number of rejections occurred in and Emergency Services (67%), with notable issues in accessibility and information.

Conclusions

The study underscores the need for targeted interventions in accessibility and information to enhance the patient experience, particularly in Primary Care and Emergency Services. The measurement of PREM elements using NPS, in conjunction with the LQAS method, proves to be an effective tool for identifying and prioritising areas for improvement, especially when applied on a regular basis.

背景与目的：测量患者报告体验测量（PREMs）对于持续提高质量至关重要。本研究旨在评估病患在综合医疗领域的关键照护过程中所感受到的品质，以找出改善的机会。方法：该研究于2023年上半年在西班牙综合卫生领域进行，分析了五个关键的卫生保健流程：初级保健、紧急服务、住院、咨询和手术。为了评估感知质量，使用净推荐值（NPS）来测量PREM元素，如可访问性、信息和专业性。采用批次质量保证抽样（LQAS）方法，通过检测拒收批次和优化样本量来确定需要改进的特定区域。结果：虽然感知质量普遍较高，具有良好或优秀的NPS评分，但在过程之间观察到显著的差异。在整个评估过程中，共有104个不合格批次（21%）被确定。拒绝人数最多的是急救服务部门（67%），在可及性和信息方面存在明显问题。结论：该研究强调需要在可及性和信息方面采取有针对性的干预措施，以改善患者体验，特别是在初级保健和急诊服务方面。使用NPS测量PREM元素，结合LQAS方法，证明是识别和优先考虑需要改进的领域的有效工具，特别是在定期应用时。

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引用次数: 0

Humanización y calidad de vida profesional en el cuidado oncohematológico y radioterápico: un estudio descriptivo en un hospital universitario [人性化与肿瘤血液学和放疗护理的职业生活质量：一所大学医院的描述性研究]。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-01-10 DOI: 10.1016/j.jhqr.2024.12.007

A. Gutiérrez Delgado , C.J. Gómez Martín , C. Martín-Arriscado Arroba , G. González Monterrubio , S. Pérez García , A. Jariego Gómez

Objective

To evaluate levels of humanization, professional quality of life, resilience, communication skills, and the use of silence among healthcare professionals in these areas.

Methods

Observational, cross-sectional, and descriptive study conducted in a referral hospital. Data were collected from 152 healthcare professionals through questionnaires assessing professional quality of life (ProQOL), resilience (CD-RISC), humanization (HUMAS), communication skills (EHC-PS), and the use of silence (Q-SPS).

Results

The median age of the professionals was 42 years. They showed moderate levels of compassion satisfaction and resilience (means = 23.47 and 29.96) but low levels of humanization (mean = 66.09). Emotional exhaustion was significant among physicians (mean = 19.19, P=.022), while radiotherapy technicians excelled in empathy (mean = 27.33). Significant correlations were observed between compassion satisfaction and optimism (Rho = 0.2017, P=.0127), and between productive silence and communication skills (Rho = 0.3131, P=.0001).

Conclusions

Strengthening emotional and communication competencies is essential. Interventions should focus on reducing compassion fatigue and enhancing the well-being of healthcare professionals, improving care quality for oncohematology and radiotherapy patients.

目的：评价这些地区医疗保健专业人员的人性化水平、职业生活质量、恢复力、沟通技巧和沉默的使用。方法：在一家转诊医院进行观察性、横断面和描述性研究。从152名医疗保健专业人员中收集数据，通过问卷评估专业生活质量（ProQOL）、恢复力（CD-RISC）、人性化（HUMAS）、沟通技巧（EHC-PS）和沉默使用（Q-SPS）。结果：专业人员的中位年龄为42岁。他们表现出中等水平的同情满意度和弹性（均值分别为23.47和29.96），但低水平的人性化（均值为66.09）。医师的情绪耗竭表现显著（平均=19.19，P= 0.022），而放疗技师的共情表现较好（平均=27.33）。同情满意度与乐观情绪之间存在显著相关（Rho=0.2017， P= 0.0127），生产性沉默与沟通技巧之间存在显著相关（Rho=0.3131， P= 0.0001）。结论：加强情感和沟通能力是必要的。干预措施应侧重于减少同情疲劳和提高卫生保健专业人员的福祉，提高肿瘤血液学和放疗患者的护理质量。

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引用次数: 0

Continuing the journey: A new chapter for the Journal of Healthcare Quality Research 继续旅程：医疗保健质量研究杂志的新篇章

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-01-01 DOI: 10.1016/j.jhqr.2024.12.002

S. Lorenzo, G.C. Gómez, D. Parés, C. Natal, R. Lledó, J.J. Mira, F. Vázquez, S. Izquierdo, K. Polluste, M. Santiñá, B. Zurita

引用次数: 0

Aprendiendo de nuestros errores: notificación de eventos pediátricos a través del SiNASP en Galicia [从错误中学习：加利西亚通过 SiNASP 通报儿科事件]。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-01-01 DOI: 10.1016/j.jhqr.2024.08.002

S. Rujido Freire , P. Viaño Nogueira , M.J. Pérez Taboada , R. Bugarín González , A. Rodríguez Núñez

引用次数: 0

Informational and educational needs of caregivers of neurologic inpatients in rehabilitation treatment: A qualitative exploratory study 接受康复治疗的神经科住院患者的护理人员对信息和教育的需求：定性探索性研究。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-01-01 DOI: 10.1016/j.jhqr.2024.09.005

M. Ottonello , C. Pistarini , S. Ruvolo , S. Costa , V. Navarra , C. Murianni , E. Cristallo , S. Maiello , M.R. Tritto , M.G. Pagliarulo , M.R. Manera

Introduction

The aim of the present study was to identify information and educational needs of neurological inpatients during residential rehabilitation from the caregivers’ perspective. On top of that, it was important to acknowledge the conceptual framework underlying the complexity of needs, for the development in future research of an early identification of caregiver's information needs assessment tool. This preliminary study will allow to define the dimensions on which to measure caregiver needs and the quality of care provided to the patients and their families.

Material and methods

Focus groups of family caregivers of inpatients admitted to the Neurorehabilitation Units by the ICS Maugeri Institutes were conducted to explore the caregivers needs. All focus groups were tape-recorded and contemporaneous notes made. The tapes were transcribed and thematic analysis was used to develop categories of needs. To ensure consistency between groups, a semi-structured schedule was used to guide the focus groups.

Results

In the analysis of the statements extracted from the transcripts we defined five main themes of information needs expressed from caregivers: education, hospital care organization, legal and social care management and emotional or psychological support.

Conclusion

The results provided the identification of the domains essential for the development of a questionnaire that measures the complexity of the caregiver's information needs during residential rehabilitation. The caregivers’ statements expressed in the focus groups allowed to identify five main kinds of needs. Moreover, some suggestions and ideas to improve the information and education materials to satisfy these needs emerged from caregivers and health professionals during team meetings.

简介本研究旨在从护理人员的角度出发，确定神经系统住院患者在住院康复期间的信息和教育需求。此外，确认需求复杂性背后的概念框架也很重要，以便在今后的研究中开发出一种早期识别护理人员信息需求的评估工具。这项初步研究将有助于确定衡量照顾者需求和为患者及其家属提供的护理质量的维度：为了解护理人员的需求，ICS 毛杰里研究所对神经康复科住院患者的家庭护理人员进行了焦点小组讨论。所有焦点小组都进行了录音，并做了同期记录。对录音带进行了转录，并采用主题分析法对需求进行分类。为确保各小组之间的一致性，采用了半结构化时间表来指导焦点小组的工作：结果：在分析从录音誊本中提取的陈述时，我们确定了护理人员所表达的信息需求的五大主题：教育、医院护理组织、法律和社会护理管理以及情感或心理支持：结论：研究结果为编制一份调查问卷提供了重要依据，该问卷可衡量护理人员在住院康复期间对信息需求的复杂程度。根据护理人员在焦点小组中的发言，可以确定五种主要需求。此外，在小组会议期间，护理人员和保健专业人员还提出了一些建议和想法，以改进信息和教育材料，满足这些需求。

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引用次数: 0

Results of a qualitative semi-structured interview study with hospital nursing staff to improve incident reporting systems in Estonia 一项定性半结构化访谈研究的结果与医院护理人员改善事故报告系统在爱沙尼亚。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-01-01 DOI: 10.1016/j.jhqr.2024.10.003

E. Uibu , K. Binsol , K. Põlluste , M. Lember , M. Kangasniemi

Objective

Nurses and their leaders are known for actively using incident reporting systems. However, information sharing about lessons learned from incidents has rarely been reported in previous studies. This study aimed to describe nurses’ and nursing managers’ experiences with incident reporting system information sharing and their perceptions of patient safety development needs.

Material and methods

Semi-structured individual and group interviews were conducted with nursing staff in Estonia (n = 26). Collected data was analyzed using the inductive content analysis method. The COREQ checklist was used for study report.

Results

Nursing staff considered information sharing of lessons learned crucial. First, it was necessary to raise patient safety awareness among employees. Second, the importance of learning from mistakes to protect themselves from legal consequences and improve public trust was highlighted. Nursing staff had traditional ways of sharing information about lessons learned. However, because of the lack of organized strategies, nurses resorted to private discussions or self-initiated investigations. Nursing staff reported a need to develop patient safety by supporting nurses’ patient safety competencies and training, and to establish the use of a reporting system in daily care. The precondition was a positive patient safety culture, which would be improved by open communication among nursing staff and sufficient resources.

Conclusions

Information sharing from safety incident reports should rely on organized strategies to avoid self-initiated practices and misinformation. Awareness of the complexity of implementing patient safety initiatives and adequate responsiveness from hospital executives can help establish practices supporting staff to feel secure when discussing safety issues.

目的：护士及其领导以积极使用事件报告系统而闻名。然而，在以往的研究中，很少有关于从事件中吸取教训的信息共享的报道。本研究旨在描述护士和护理管理者在事件报告系统信息共享方面的经验，以及他们对患者安全发展需求的看法。材料和方法：对爱沙尼亚的护理人员进行半结构化的个人和小组访谈（n=26）。采用归纳内容分析法对收集到的数据进行分析。研究报告采用COREQ检查表。结果：护理人员认为经验教训的信息共享至关重要。首先，有必要提高员工的患者安全意识。其次，强调了从错误中吸取教训以保护自己免受法律后果和提高公众信任的重要性。护理人员有分享经验教训信息的传统方式。然而，由于缺乏有组织的策略，护士诉诸于私下讨论或自我发起的调查。护理人员报告说，需要通过支持护士的患者安全能力和培训来发展患者安全，并在日常护理中建立使用报告系统。前提条件是积极的患者安全文化，通过护理人员之间的开放沟通和充足的资源可以改善患者安全文化。结论：安全事故报告中的信息共享应该依赖于有组织的策略，以避免自发的做法和错误的信息。认识到实施患者安全举措的复杂性以及医院管理人员的充分响应，可以帮助建立实践，支持员工在讨论安全问题时感到安全。

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引用次数: 0