Journal of Healthcare Quality Research最新文献

英文中文

Assessing the implementation of a comprehensive quality management system for cross-sectoral psycho-oncology in Germany 评估德国跨部门精神肿瘤学综合质量管理体系的实施情况。

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2024-01-01 DOI: 10.1016/j.jhqr.2023.10.007

L. Derendorf , M. Kusch , S. Stock , C. Lemmen

Introduction

Quality management in healthcare is essential for safe, effective, and patient-centered services. Quality management systems (QMS) monitor and improve healthcare quality. Integrating QMS is crucial for optimal quality of care, but previous studies show gaps in integration. This study aims to assess program adherence to a QMS in cross-sectoral psycho-oncological care and to develop strategies for better integration, ultimately improving healthcare quality.

Materials and methods

The study used a utility analysis to assess the program adherence of a cross-sectoral psycho-oncology care program using a 5-point scale. The evaluation process involved breaking down the program into distinct areas, and used key figures and developed indicators to assess adherence. Descriptive statistics were used.

Results

The study conducted a comprehensive assessment of program adherence in a complex care program, analysing 4460 evaluation cases based on 128 quality indicators. The results showed a score of 4.2 out of 5 points (84%), indicating a highly effective implementation of the QMS. Notably, the study observed successful implementation of top-down elements, while encountering more challenges in integrating bottom-up aspects.

Conclusion

The study demonstrates effective implementation of a comprehensive QMS. Successful integration was observed in areas such as care concept, care management, quality assurance, and IT-based documentation, while challenges remain in quality development and indicators. Active leadership involvement, staff training, data collection, and a learning culture are essential for successful implementation. Future research should assess the impact and cost-effectiveness of QMSs and develop tailored approaches to sustain healthcare professionals’ motivation in quality improvement efforts.

简介:医疗保健中的质量管理对于安全、有效和以患者为中心的服务至关重要。质量管理系统(QMS)监控和提高医疗保健质量。整合质量管理体系对于优化护理质量至关重要，但以往的研究表明，在整合方面存在差距。本研究旨在评估跨部门心理肿瘤护理项目对质量管理体系的依从性，并制定更好整合的策略，最终提高医疗质量。材料和方法:本研究采用效用分析，采用5分制评估跨部门心理肿瘤护理项目的项目依从性。评估过程包括将项目分解为不同的领域，并使用关键数据和开发的指标来评估依从性。采用描述性统计。结果:本研究对一个复杂护理方案的方案依从性进行了综合评估，基于128个质量指标分析了4460个评估案例。结果显示，满分为5分，得分为4.2分(84%)，表明质量管理体系的实施非常有效。值得注意的是，本研究观察到自顶向下元素的成功实施，而在整合自底向上方面遇到了更多的挑战。结论:本研究证明了全面质量管理体系的有效实施。在护理概念、护理管理、质量保证和基于it的文档等领域观察到成功的整合，但在质量开发和指标方面仍然存在挑战。积极的领导参与、员工培训、数据收集和学习文化是成功实施的必要条件。未来的研究应该评估质量管理体系的影响和成本效益，并开发量身定制的方法来维持医疗保健专业人员在质量改进工作中的动机。

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引用次数: 0

Absolute survival as a measure of effectiveness of screening programs 以绝对存活率衡量筛查计划的有效性。

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2023-12-12 DOI: 10.1016/j.jhqr.2023.11.003

M. Caicoya

引用次数: 0

El valor de la persistencia en el modelo de la Medicina 5P en enfermedades crónicas [坚持5P医学模型对慢性病的价值]。

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2023-11-08 DOI: 10.1016/j.jhqr.2023.10.005

J. Borras-Blasco , E. Ramírez-Herráiz , A. Navarro Ruiz

引用次数: 0

The diabetes education material on diabetes for website: Results of a validation process 糖尿病教育资料的糖尿病网站:验证过程的结果

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2023-11-01 DOI: 10.1016/j.jhqr.2023.07.001

L. Velázquez López , R. Achar de la Macorra , E. Colin Ramirez , A.V. Muñoz Torres , I. Pineda del Aguila , P.G. Medina Bravo , M. Klünder Klünder , O.S. Medina Gómez , J. Escobedo de la Peña

Objective

To validate an educational material on diabetes through an expert consensus for its implementation into a web site.

Material and methods

An observational study was carried out in a group of health professionals, for which an educational material was developed for patients with diabetes. Topics included nutrition, physical exercise, control indicators, complications, pharmacological treatment, among others. The language, text and figures were focused on easy comprehension, additionally, a section of didactic activities to be answered by the patient with diabetes at the end of each module was included. To evaluate the educational material by health professionals, an instrument was designed and validated. Once all the educational material was available, each of the modules was sent by e-mail to at least three clinical experts in the assigned topic, as well as the instrument for the evaluation of the module.

Results

Thirty-seven experts were included in the study, 76% rated the educational modules evaluated as highly adequate, while only 24% rated them as adequate. The instrument used obtained a good level of internal consistency, with a Cronbach's alpha coefficient of 0.92. In the dimensions of the instrument, the lowest Cronbach's alpha score was that of “call-to-action”, with a value of 0.71.

Conclusion

The diabetes educational material was rated as highly appropriate by the clinical experts. The developed instrument has an adequate content validity, as well as a good level of internal consistency.

目的通过专家共识，验证糖尿病教育教材在网站上的应用。材料和方法在一组卫生专业人员中进行了一项观察性研究，并为此编写了针对糖尿病患者的教育材料。主题包括营养、体育锻炼、控制指标、并发症、药物治疗等。语言、文本和图表都以易于理解为重点，此外，在每个模块的末尾还包括一节由糖尿病患者回答的教学活动。为了评估卫生专业人员的教育材料，设计并验证了一种工具。一旦所有的教育材料都准备好了，每个模块都通过电子邮件发送给至少三位指定主题的临床专家，以及评估模块的工具。结果37位专家参与了研究，76%的专家认为教育模块是高度适当的，只有24%的专家认为是适当的。所使用的仪器获得了良好的内部一致性，Cronbach's alpha系数为0.92。在该工具的维度中，Cronbach's alpha得分最低的是“call-to-action”，其值为0.71。结论临床专家对该教材评价较高。所研制的仪器具有足够的内容效度和良好的内部一致性。

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引用次数: 0

Second and double victims – Achievements and challenges in ensuring psychological safety of caregivers 第二受害者和双重受害者——确保照顾者心理安全的成就和挑战

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2023-11-01 DOI: 10.1016/j.jhqr.2023.05.001

R. Strametz

引用次数: 0

Journal of Healthcare Quality Research and its first impact factor 《医疗质量研究杂志》及其第一个影响因素。

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2023-11-01 DOI: 10.1016/j.jhqr.2023.09.003

S. Lorenzo, G. Carrasco, D. Parés, J.J. Mira, M.C. Natal, R. Lledó, F. Vazquez, C. Orrego, M. Santiñà, S. Izquierdo, J.C. March, B. Zurita, K. Põlluste

引用次数: 0

Evaluación de la puesta en marcha del Servicio Extendido de Medicina Intensiva en hospital de segundo nivel. Sistema de Alertas Automático de pacientes en riesgo. Experiencia de tres meses 二级医院推广重症医学服务的评估。风险患者自动警报系统。三个月的经验

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2023-11-01 DOI: 10.1016/j.jhqr.2023.06.003

E. Chicote-Álvarez, M. Arlabán-Carpintero, H. Camino-Ferró, M. Feo-González, M. Macías-Pascual, A. Calvo-Martínez

引用次数: 1

Desarrollo y validación de estándares para unidades de calidad de centros sanitarios 卫生中心质量单位标准的制定和验证

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2023-11-01 DOI: 10.1016/j.jhqr.2023.09.009

A. Aloy-Duch , M. Santiñà Vila , F. Ramos-D’Angelo , L. Alonso Calo , M.E. Llaneza-Velasco , B. Fortuny-Organs , A. Apezetxea-Celaya

Objective

In Spain, the Quality Units advise health centres, services and professionals on the methodology of continuous improvement of the quality of care. A system based on good practice standards could provide these units with a tool to improve their results and value their work. The objective was to develop, agree on and validate standards, to properly guide and orient the functions, results and continuous improvement of the Quality Units in health centers.

Material and methods

A qualitative–quantitative, prospective and cross-sectional study was carried out, applying the Metaplan method, the e-Delphi technique and a simulation study. The participants were coordinators of these units, belonging to 14 Spanish Autonomous Communities and distributed in four experts’ panels. They agreed on the standards to be used and evaluated the different types of validity.

Results

The 204 standards proposed by the scientific committee were reduced to 157 with Metaplan, to 110 with e-Delphi, and to 96 with the committee's final review (87.3% consensus, content validity). The construct validity showed a Cronbach's alpha > 0.7 (P < .001); the validity of content was reaffirmed in the simulation workshop (80% “understood” each other, P < .001; and there was “documentary evidence” in 84%, P < .001); face validity was accepted (75% “related to quality dimensions”, P < .001); and the validity of the criteria was verified with a sensitivity of 84.2%, a specificity of 98.3%, and a kappa index of 0.84.

Conclusions

Valid standards have been developed for Quality Units in health centers.

目标在西班牙，质量单位就不断提高护理质量的方法向卫生中心、服务机构和专业人员提供建议。一个以良好做法标准为基础的系统可以为这些单位提供一个工具，以改进其成果并重视其工作。目标是制定、商定和验证标准，正确指导和定位卫生中心质量单位的职能、结果和持续改进。材料和方法采用Metaplan方法、e-Delphi技术和模拟研究，进行了定性-定量、前瞻性和横断面研究。与会者是这些单位的协调员，这些单位属于14个西班牙自治区，分布在四个专家小组中。他们商定了要使用的标准，并评估了不同类型的有效性。结果科学委员会提出的204项标准在Metaplan中减少到157项，在e-Delphi中减少到110项，在委员会最终审查中减少到96项（87.3%的一致性，内容有效性）。构念有效性显示Cronbachα>；0.7（P＜.001）；模拟研讨会重申了内容的有效性（80%的人相互“理解”，P<；.001；84%的人有“书面证据”，P&<；.001）；面部有效性被接受（75%“与质量维度相关”，P<；.001）；验证了该标准的有效性，灵敏度为84.2%，特异性为98.3%，kappa指数为0.84。结论为卫生中心质量单位制定了有效的标准。

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引用次数: 0

Retos e iniciativas en la prevención de las infecciones relacionadas con la asistencia sanitaria: estudio de consenso de expertos 预防与卫生保健有关的感染的挑战和倡议：专家共识研究

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2023-11-01 DOI: 10.1016/j.jhqr.2023.10.001

S. Tomás-Vecina , M.J. Reyes-Ramos , Grupo de Expertos Infection-Hub

Introduction

The objective of the project was to identify new strategies, agreed upon by experts, that help reduce the prevalence of Health Care Related Infections (HAIs) given the increase in their prevalence as a result of the pandemic and improve patient safety.

Material and methods

The project was developed in three phases. The first two are framed in a sequential explanatory mixed model. Phase 1 consisted of a quantitative study (anonymous survey) to find out the perception of healthcare professionals about HAIs, risk factors, preventive measures, protocols, disinfection products and approaches. Phase 2 consisted of a qualitative exploratory study in which a panel of 15 experts analyzed the results, using focus group techniques, integrating both phases through the elaboration of metainferences. Phase 3 consisted of a qualitative descriptive study where, through nominal group techniques, agreed proposals for strategies to prevent HAIs were prepared.

Results

The panel of experts defined a total of 51 proposals for new strategies: 15 in hand hygiene, 13 in surface cleaning, 13 in the use of devices, and 10 in HAI prevention training. Of all of them, 13 were agreed upon as preferable (medium-high viability and high impact) and 7 as recommendable (low viability and high impact).

Conclusions

In the prevention of HAIs, experts recommend applying different strategies simultaneously, which include innovative, technological and humanization aspects, both in data collection, intervention and training, prioritizing those with the greatest impact. and feasibility.

引言该项目的目标是确定经专家同意的新策略，以帮助降低医疗保健相关感染（HAI）的流行率，并提高患者的安全性。材料和方法该项目分三个阶段开发。前两个是在一个顺序解释混合模型中构建的。第一阶段包括一项定量研究（匿名调查），以了解医疗保健专业人员对HAI、风险因素、预防措施、方案、消毒产品和方法的看法。第二阶段是一项定性探索性研究，由15名专家组成的小组使用焦点小组技术分析了结果，通过阐述元推理将两个阶段结合起来。第3阶段包括一项定性描述性研究，通过名义小组技术，制定了预防HAI的商定策略建议。结果专家组共确定了51项新策略建议：手部卫生15项，表面清洁13项，器械使用13项，HAI预防培训10项。结论在HAI的预防中，专家建议同时采用不同的策略，包括数据收集、干预和培训方面的创新、技术和人性化，优先考虑那些影响最大的人。以及可行性。

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引用次数: 0

El metaverso de atención a la cronicidad 关注时间的元诗句

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2023-11-01 DOI: 10.1016/j.jhqr.2023.06.001

R. Qanneta

引用次数: 0

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Journal of Healthcare Quality Research

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