Journal of Healthcare Quality Research最新文献

英文中文

Patient's experience as a tool in analyzing primary care in Catalonia 将患者体验作为分析加泰罗尼亚初级保健的工具。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-03-01 Epub Date: 2024-11-14 DOI: 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.

引言在一个设计完善的医疗系统中，初级医疗保健是必不可少的。衡量机构或服务质量的一种方法是对可及性、治疗、满意度和效率等不同方面进行评估。COVID-19 大流行对医疗系统造成了严重破坏。目前的工作重点是评估患者体验的演变。方法：通过调查进行回顾性定量研究：方法：通过在加泰罗尼亚开展的一项调查进行回顾性定量研究，评估用户在初级医疗保健服务方面的体验。研究结果包括 2015 年、2018 年、2021 年和 2022 年的结果：来自 370 个中心的用户参与了研究。得分最高的维度是环境和信息（超过 90%），而可及性是得分最差的维度（平均 65.19）。全球满意度得分在2015年和2018年明显较高，随后几年有所下降，显示出COVID-19大流行的影响：加泰罗尼亚地区患者体验的演变表明，从2015年的第一版到2022年的最新版，患者体验在COVID-19大流行的影响下逐渐下降。在大流行期间，初级医疗的所有特征都受到了影响，目前正在开始恢复。初级医疗在大流行期间表现出的恢复力与使用过初级医疗的患者对其体验的评价下降形成了鲜明对比。

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引用次数: 0

Optimizing length of hospital stay among inpatients with spinal cord injury: An observational study 脊髓损伤住院患者的最佳住院时间：一项观察性研究。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-03-01 Epub Date: 2024-12-30 DOI: 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.

简介和目的：尽管脊髓损伤后的住院时间（LOS）很重要，但在文献中仍未得到充分的探讨。本研究旨在通过研究创伤性（TSCI）或非创伤性（NTSCI）脊髓损伤患者的康复LOS与功能增益之间的关系来弥合这一差距。方法：我们进行了一项回顾性观察队列研究，使用运动功能独立性测量（mFIM）和脊髓独立性测量（SCIM III）评估康复入院至出院期间的功能增益。结果分析基于美国脊髓损伤协会损伤量表（AIS）的四个神经学类别：C1-C4 AIS A-C；C5-8是a-c；t1 - 5是a-c；线性回归模型估计了康复LOS季度（Q1-Q4）的变化，调整了协变量。结果：我们纳入了2007年至2023年间收治的1036例康复患者（46.3%为TSCI， 53.7%为NTSCI）。TSCI：年龄42.7岁，男性80.2%，男性41.8%，男性90.5岁。NTSCI：年龄55.7%，男性54.2%，男性14.2%，男性69.6。对于TSCI，从第一季度到第二季度（T1-S5-ABC, n=214）和第二季度到第三季度（AIS D, n=129）， mFIM和SCIM III的收益显著增加。对于NTSCI，收益从第二季度增加到第三季度（T1-S5-ABC, n=195），从第一季度增加到第二季度，从第二季度增加到第三季度（AIS D, n=304）。调整后的模型显示，与第一季度（TSCI）相比，第二季度和第三季度的收益有所下降，但与第一季度（NTSCI）相比，第二季度至第四季度的收益均有所增加。从第三季度到第四季度没有观察到显著的收益。结论：我们确定了特定的神经分类和LOS季度产生显著的功能增益。

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引用次数: 0

Percepción de los profesionales de atención primaria sobre la frecuencia con que se realizan intervenciones «que no hay que hacer» [初级保健专业人员对进行“不干预”的频率的看法]。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-03-01 Epub Date: 2024-12-16 DOI: 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.

目的：了解初级保健专业人员对不应在这一级护理中进行干预的频率的看法。材料与方法：采用3份问卷对9项家庭医学干预措施、2项儿科干预措施和6项护理干预措施进行评价。考虑到可接受的小于5%的百分比，计算了表示他们总是或几乎总是执行这些干预措施的专业人员的百分比。还对确定的减少这些干预措施的障碍进行了描述性分析。结果：家庭医学9项干预措施中有5项，儿科2项，护理6项干预措施中有4项总是或几乎总是由5%或更多的专业人员实施。在确定的停止进行不必要干预的障碍中，首先是咨询时间不足，其次是缺乏培训。结论：所获得的结果使我们能够确定哪些初级保健干预措施有最大的改进空间，以及其取消实施的主要障碍。对专业人员的调查使评估无法从临床记录中衡量的建议成为可能。了解他们对临床实践的看法对设计干预计划非常有用。

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引用次数: 0

Acknowledgment to the Journal Reviewers for their contributions 感谢期刊审稿人的贡献

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-03-01 Epub Date: 2025-02-28 DOI: 10.1016/j.jhqr.2025.02.003

引用次数: 0

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 Epub Date: 2024-11-25 DOI: 10.1016/j.jhqr.2024.10.004

Rosa María Añel Rodríguez

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 Epub Date: 2025-01-04 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 Epub Date: 2024-09-12 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

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 Epub Date: 2024-11-27 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

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 Epub Date: 2024-11-13 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

Letter to the Editor on “Loneliness impact on healthcare utilization in primary care: A retrospective study” 致编辑的信，主题为 "孤独感对初级保健中医疗服务利用率的影响：回顾性研究"。

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-01-01 Epub Date: 2024-09-14 DOI: 10.1016/j.jhqr.2024.07.004

M.R. Shen , J.K. Silver

引用次数: 0

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