Global journal on quality and safety in healthcare最新文献

Introduction: Value-based healthcare (VBHC) is supplanting the traditional volume-based healthcare paradigm in healthcare systems. In the healthcare industry, value creation focuses on the health outcomes that individuals and institutions achieve while maintaining an optimal cost-benefit ratio. This scoping review aimed to determine the essential components and results of VBHC implementation.

Methods: A scoping review was conducted using the patient, intervention, and outcome model. PubMed (Medline), Web of Science, and Embase databases were searched using a combination of keywords. The search results were then subjected to a step-by-step screening protocol to identify the related studies and extract data.

Results: The initial database search identified 3055 studies. After removing duplicates, 1920 studies were eligible for title/abstract screening. Abstract/title screening identified 268 studies, of which 115 studies were selected for full-text screening. Fifteen studies were selected for the scoping review after full-text screening. Analysis revealed that 73% of studies reported improved interdisciplinary collaboration, 67% demonstrated enhanced patient-centered care approaches, and 60% showed measurable cost reductions. Key implementation factors included strong leadership (identified in 87% of studies), patient involvement (reported in 80% of studies), and integrated care units (implemented in 73% of studies). All studies agreed on the importance of VBHC in improving patient care quality and reducing costs.

Conclusion: VBHC can help improve the overall healthcare experience. The VBHC model is a promising strategy to enhance healthcare effectiveness and long-term viability; however, successful implementation requires careful attention to organizational factors and stakeholder engagement.

A robust data management system is crucial for healthcare entities to get value from the exponential volume of generated and stored data. Given the impact of data on the decision-making process at the individual, organizational, and institutional levels, appropriate management of data should be considered a priority. Data management is referred to as the activities and processes that are directly related to the actual management of data, whereas data governance is a strategic framework concerned with managing rules, responsibilities, processes, and practices of managing the data. Data management can turn this data classification framework into executable policies and procedures. The main aim of this article is to formulate a proposal or road map for data classification methodology, with a primary focus on the first step of data classification, which is categorizing different types of data collected and released from various ecosystems within the Egyptian healthcare system.

Introduction: Reorganizing the hospital discharge process to enhance patient experience and reduce avoidable readmissions and costs is an ongoing challenge. At Al Hada Armed Forces Hospital (Taif, Saudi Arabia), we identified a significant issue with the effectiveness and efficiency of our discharge process, with a noticeable effect on patient experience on the basis of Press Ganey surveys (discharge domain). The aim of this project was to improve the efficiency and effectiveness of the discharge process and to enhance patient health outcomes and experience.

Methods: In this quality improvement initiative, we used Lean methodology and the Re-Engineered Discharge (RED) toolkit to improve the effectiveness of patient discharge processes and the quality of after-hospital care plans. We implemented a multicomponent, evidence-based intervention via three plan-do-check-act cycles, and pre-implementation and postimplementation findings were compared.

Results: Along the duration of this project (Feb 2022 - Oct 2023), the median discharge cycle time was reduced from 235.5 to 82.5 minutes, and the discharge process cycle efficiency improved from 36% to 60%. The average patient discharge experience satisfaction score increased from 84.16% to 88.25% (p < 0.001), with improvements in noted for "speed of discharge process" and "instructions for care at home" (p = 0.001 and p < 0.001, respectively); in addition, patient experience for the "extent felt ready discharge" rose from the 76th to the 95th percentile. There was a decrease in the average hospital readmission rate for targeted patients within 30 days (from 3.9% to 2.0%) as well as the median percentage of patients visiting the emergency department within 7 days of discharge (from 9.6% to 6.1%). Decreased hospital readmissions were associated with improved operational efficiency in terms of reduced direct bed costs.

Conclusion: Implementing Lean methodology and the RED toolkit enhanced the effectiveness and efficiency of the discharge process, with a substantial positive effect on the overall patient discharge experience, while reducing hospital readmission rates within 30 days and ED visits within 7 days after discharge.

Introduction: As healthcare organizations strive to improve the quality and safety of their services, there is growing recognition of the importance of fostering a patient safety culture to enhance patient safety and improve patient care outcomes. This study aims to evaluate healthcare professionals' perceptions of patient safety culture in accredited vs nonaccredited hospitals within a network of 68 hospitals in Brazil.

Methods: This cross-sectional, multicenter study included 68 hospitals from a private network. The Hospital Survey on Patient Safety Culture (HSOPSC) was administered across all participating hospitals in September 2022. Hospitals that had been formally recognized for their quality and safety standards were compared with nonaccredited hospitals. Scores for various dimensions of patient safety culture were compared between groups. A logistic regression model was applied to assess the association between the frequency of event reporting in the past 12 months and participant characteristics.

Results: A total of 31,919 healthcare professionals responded to the survey. Compared with nonaccredited hospitals, accredited hospitals reported higher scores in communication openness (3% higher, p = 0.04), frequency of events reported (4% higher, p = 0.02), and overall perception of patient safety (4% higher, p = 0.02). Accreditation was associated with a reduced likelihood of event underreporting (odds ratio = 0.80; 95% CI, 0.74-0.87), and physicians were more likely to underreport compared with nursing staff.

Conclusion: Although accreditation enhances patient safety culture, its effect may be more limited in healthcare networks with robust quality management systems already in place. To drive meaningful improvements, policymakers should go beyond accreditation and prioritize the reinforcement of ongoing institutional safety initiatives. Particular attention should be given to persistent challenges, such as fostering a nonpunitive approach to errors and addressing underreporting of adverse events. A graphical abstract is provided in the supplemental material.