Computing systems for quality assessment in the operative departments, in anaesthesia and intensive care were developed at the Altona General Hospital, Hamburg. The main goals were to support quality assurance as a tool for the medical staff which they can use actively in their routine work and to reorganize uneconomical forms of clinical data handling. The most important characteristics of the tools presented here are flexibility of the databases and applications, openness to individual configurations and integration of quality assessment, activity audits and clinical routine under the primacy of medical documentation. Research is aimed at new forms of medical documentation, problem-oriented presentation and focusing of clinical data in the context of quality assurance programs.
{"title":"Computing tools for quality assurance.","authors":"C Veit, A Tecklenburg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Computing systems for quality assessment in the operative departments, in anaesthesia and intensive care were developed at the Altona General Hospital, Hamburg. The main goals were to support quality assurance as a tool for the medical staff which they can use actively in their routine work and to reorganize uneconomical forms of clinical data handling. The most important characteristics of the tools presented here are flexibility of the databases and applications, openness to individual configurations and integration of quality assessment, activity audits and clinical routine under the primacy of medical documentation. Research is aimed at new forms of medical documentation, problem-oriented presentation and focusing of clinical data in the context of quality assurance programs.</p>","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 1","pages":"3-8"},"PeriodicalIF":0.0,"publicationDate":"1992-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12743670","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}
U Ruiz, K Acedo, R Buenaventura, J Coll, S Coronado, A Rivero, S Rocillo
A Total Quality Management Programme for the Spanish Health Care System was set in motion in 1986. The first phase of the programme covers three areas: (1) information sources, (2) training, (3) Total Quality activities, through a cascade of four coordinated projects. The first one defines a basic nucleus of patient information and established two national standards: (a) a minimum basic data set, (b) the use of an ICD-9-CM Spanish translation for codification of diagnoses and procedures. The second is an open demonstration project implementing these two standards in National Health Service hospitals and carrying out intensive training on ICD-9-CM codifiers. The third project encompasses two pilot studies on case-mix measurements systems and cost analysis framework. Through the fourth project concepts, methods and tools for Total Quality Management are developed, setting up specific working groups on clinical and organizational indicators for hospitals and primary health care.
{"title":"Implementing total quality management in the Spanish health care system.","authors":"U Ruiz, K Acedo, R Buenaventura, J Coll, S Coronado, A Rivero, S Rocillo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A Total Quality Management Programme for the Spanish Health Care System was set in motion in 1986. The first phase of the programme covers three areas: (1) information sources, (2) training, (3) Total Quality activities, through a cascade of four coordinated projects. The first one defines a basic nucleus of patient information and established two national standards: (a) a minimum basic data set, (b) the use of an ICD-9-CM Spanish translation for codification of diagnoses and procedures. The second is an open demonstration project implementing these two standards in National Health Service hospitals and carrying out intensive training on ICD-9-CM codifiers. The third project encompasses two pilot studies on case-mix measurements systems and cost analysis framework. Through the fourth project concepts, methods and tools for Total Quality Management are developed, setting up specific working groups on clinical and organizational indicators for hospitals and primary health care.</p>","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 1","pages":"43-59"},"PeriodicalIF":0.0,"publicationDate":"1992-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12743672","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}
When quality assurance programmes began to develop actively, 20 or so years ago, information connecting outcome and process was very scanty. However, with the development of the field of health care technology assessment, there is now much information on efficacy that has not been applied in the field to improve quality. At the same time, patient's satisfaction with care is coming to be seen as a valid measure of outcome of care. On the other hand, process measures of quality developed by practitioners working with a particular problem are often of doubtful validity, and could even be harmful. Increasingly, quality assurance programmes will be based on outcomes of care, or on process measures that have been linked clearly to outcome. Informatics can contribute to quality assurance in two ways. One is in the development of information on efficacy and safety of care through data banks, such as those reporting hospital death rates or insurance claims data. The other is to monitor outcomes of care directly. Up until now, technology assessment and quality assurance have developed as largely independent activities. A constructive approach to developing systems of quality assurance would be to incorporate technology assessment as part of the development of guidelines for quality assurance programmes.
{"title":"Developing outcome standards for quality assurance activities.","authors":"D Banta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>When quality assurance programmes began to develop actively, 20 or so years ago, information connecting outcome and process was very scanty. However, with the development of the field of health care technology assessment, there is now much information on efficacy that has not been applied in the field to improve quality. At the same time, patient's satisfaction with care is coming to be seen as a valid measure of outcome of care. On the other hand, process measures of quality developed by practitioners working with a particular problem are often of doubtful validity, and could even be harmful. Increasingly, quality assurance programmes will be based on outcomes of care, or on process measures that have been linked clearly to outcome. Informatics can contribute to quality assurance in two ways. One is in the development of information on efficacy and safety of care through data banks, such as those reporting hospital death rates or insurance claims data. The other is to monitor outcomes of care directly. Up until now, technology assessment and quality assurance have developed as largely independent activities. A constructive approach to developing systems of quality assurance would be to incorporate technology assessment as part of the development of guidelines for quality assurance programmes.</p>","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 1","pages":"25-32"},"PeriodicalIF":0.0,"publicationDate":"1992-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12547213","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}
{"title":"Quality assurance and health informatics.","authors":"E Reerink","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"1992-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12743668","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 : 1992-01-01DOI: 10.1093/OXFORDJOURNALS.INTQHC.A036710
Lucian L. Leape, Lucian L. Leape, R. Park, J. Kahan, Robert H. Brook
The current interest in the development of practice guidelines raises an important question about the effect of expert panel composition on the outcome of the guideline development process. We compared the ratings of appropriateness of indications for carotid endarterectomy produced by two panels: an all-surgical panel and a "balanced" panel composed of four surgeons, two neurologists, and one specialist each from family practice, internal medicine, and radiology. We then compared the effect of the two sets of ratings when used to evaluate 1302 patients who had undergone carotid endarterectomy. The all-surgical panel found more indications "appropriate" (24 versus 14%) and fewer indications "inappropriate" (61 versus 70%) than the balanced panel (p less than 0.01). The all-surgical panel also more often reached agreement. When ratings were applied to patients, 70% were appropriate by the all-surgical criteria versus 38% by the balanced panel, while 19% of the operations were inappropriate by all-surgical criteria, versus 31% by the balanced panel ratings. However, the percentage of procedures judged "inappropriate with agreement" was 15% for all-surgical and 16% for the balanced panel. We conclude that the all-surgical panel was more likely to favor operative treatment for carotid disease than the multispecialty panel, but that concensus judgments of inappropriateness by the two panels were very similar.
{"title":"Group judgments of appropriateness: the effect of panel composition.","authors":"Lucian L. Leape, Lucian L. Leape, R. Park, J. Kahan, Robert H. Brook","doi":"10.1093/OXFORDJOURNALS.INTQHC.A036710","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.INTQHC.A036710","url":null,"abstract":"The current interest in the development of practice guidelines raises an important question about the effect of expert panel composition on the outcome of the guideline development process. We compared the ratings of appropriateness of indications for carotid endarterectomy produced by two panels: an all-surgical panel and a \"balanced\" panel composed of four surgeons, two neurologists, and one specialist each from family practice, internal medicine, and radiology. We then compared the effect of the two sets of ratings when used to evaluate 1302 patients who had undergone carotid endarterectomy. The all-surgical panel found more indications \"appropriate\" (24 versus 14%) and fewer indications \"inappropriate\" (61 versus 70%) than the balanced panel (p less than 0.01). The all-surgical panel also more often reached agreement. When ratings were applied to patients, 70% were appropriate by the all-surgical criteria versus 38% by the balanced panel, while 19% of the operations were inappropriate by all-surgical criteria, versus 31% by the balanced panel ratings. However, the percentage of procedures judged \"inappropriate with agreement\" was 15% for all-surgical and 16% for the balanced panel. We conclude that the all-surgical panel was more likely to favor operative treatment for carotid disease than the multispecialty panel, but that concensus judgments of inappropriateness by the two panels were very similar.","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 2 1","pages":"151-9"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.INTQHC.A036710","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61010518","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 : 1992-01-01DOI: 10.1093/OXFORDJOURNALS.INTQHC.A036694
D. Banta
When quality assurance programmes began to develop actively, 20 or so years ago, information connecting outcome and process was very scanty. However, with the development of the field of health care technology assessment, there is now much information on efficacy that has not been applied in the field to improve quality. At the same time, patient's satisfaction with care is coming to be seen as a valid measure of outcome of care. On the other hand, process measures of quality developed by practitioners working with a particular problem are often of doubtful validity, and could even be harmful. Increasingly, quality assurance programmes will be based on outcomes of care, or on process measures that have been linked clearly to outcome. Informatics can contribute to quality assurance in two ways. One is in the development of information on efficacy and safety of care through data banks, such as those reporting hospital death rates or insurance claims data. The other is to monitor outcomes of care directly. Up until now, technology assessment and quality assurance have developed as largely independent activities. A constructive approach to developing systems of quality assurance would be to incorporate technology assessment as part of the development of guidelines for quality assurance programmes.
{"title":"Developing outcome standards for quality assurance activities.","authors":"D. Banta","doi":"10.1093/OXFORDJOURNALS.INTQHC.A036694","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.INTQHC.A036694","url":null,"abstract":"When quality assurance programmes began to develop actively, 20 or so years ago, information connecting outcome and process was very scanty. However, with the development of the field of health care technology assessment, there is now much information on efficacy that has not been applied in the field to improve quality. At the same time, patient's satisfaction with care is coming to be seen as a valid measure of outcome of care. On the other hand, process measures of quality developed by practitioners working with a particular problem are often of doubtful validity, and could even be harmful. Increasingly, quality assurance programmes will be based on outcomes of care, or on process measures that have been linked clearly to outcome. Informatics can contribute to quality assurance in two ways. One is in the development of information on efficacy and safety of care through data banks, such as those reporting hospital death rates or insurance claims data. The other is to monitor outcomes of care directly. Up until now, technology assessment and quality assurance have developed as largely independent activities. A constructive approach to developing systems of quality assurance would be to incorporate technology assessment as part of the development of guidelines for quality assurance programmes.","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 1 1","pages":"25-32"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.INTQHC.A036694","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61010307","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 : 1992-01-01DOI: 10.1093/OXFORDJOURNALS.INTQHC.A036700
F. Perraro, P. Rossi, C. Liva, A. Bulfoni, G. Ganzini, A. Giustinelli, E. Tonutti, P. Sala, P. Santini
An assessment was made on emergency laboratory test ordering at Udine General Hospital (Italy) to investigate the reasons for the excessive number of requested tests. All the orders for emergency laboratory tests during one week in June 1990 were studied. For each test the time of the order was recorded for every day of the week. The most important aspect of our investigation is the distribution of the orders during the day: in fact, test orders reached two peaks, the upper between 7 and 11 a.m., and the lower between 3 and 6 p.m. The analysis of the record cards showed that 42% of the orders were inappropriate. These preliminary findings were very useful in making the consensus on a Quality Assurance program easier, to improve the use of the Emergency Laboratory by doctors and nurses. Some preliminary results in the Emergency Medicine Department confirmed the validity of this program.
{"title":"Inappropriate emergency test ordering in a general hospital: preliminary reports.","authors":"F. Perraro, P. Rossi, C. Liva, A. Bulfoni, G. Ganzini, A. Giustinelli, E. Tonutti, P. Sala, P. Santini","doi":"10.1093/OXFORDJOURNALS.INTQHC.A036700","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.INTQHC.A036700","url":null,"abstract":"An assessment was made on emergency laboratory test ordering at Udine General Hospital (Italy) to investigate the reasons for the excessive number of requested tests. All the orders for emergency laboratory tests during one week in June 1990 were studied. For each test the time of the order was recorded for every day of the week. The most important aspect of our investigation is the distribution of the orders during the day: in fact, test orders reached two peaks, the upper between 7 and 11 a.m., and the lower between 3 and 6 p.m. The analysis of the record cards showed that 42% of the orders were inappropriate. These preliminary findings were very useful in making the consensus on a Quality Assurance program easier, to improve the use of the Emergency Laboratory by doctors and nurses. Some preliminary results in the Emergency Medicine Department confirmed the validity of this program.","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 1 1","pages":"77-81"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.INTQHC.A036700","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61010421","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 : 1992-01-01DOI: 10.1093/OXFORDJOURNALS.INTQHC.A036696
M. A. Gogorcena, M. Castillo, J. Casajuana, F. Jove
Appropriate access to health care is one of the components of Primary Health Care (PHC) and it can be a good quality indicator. We present in this paper the results of 1 year of follow-up of an appointment system applied in 29 PHC centers in the Balearic Islands, Spain; the program was set up by the National Institute of Health. Telephonic appointment proportion increased from the first weeks, stabilizing at about 70%. The number of calls that it is necessary to make in order to get an appointment at peak time is now 1.5 and only 1 throughout the rest of the day. To determine changes in the waiting time and visit time, and the user opinion of the system, an enquiry was made to a sample of patients 1 month before, and 1 month, 6 months and 1 year after the program started. The waiting time is now less than 15 min for most of the people interviewed, in contrast with the previous situation when the waiting time was more than 30 min. The visit time is longer now and more than two thirds of the people think that care is better or much better than prior to the start of the program. These results have been verified in the waiting room (11.2 min mean waiting time and 7.2 min mean visit time). We conclude that we have achieved the goals of the appointment system program in all the centers covered by our department.
{"title":"Accessibility to primary health care centers: experience and evaluation of an appointment system program.","authors":"M. A. Gogorcena, M. Castillo, J. Casajuana, F. Jove","doi":"10.1093/OXFORDJOURNALS.INTQHC.A036696","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.INTQHC.A036696","url":null,"abstract":"Appropriate access to health care is one of the components of Primary Health Care (PHC) and it can be a good quality indicator. We present in this paper the results of 1 year of follow-up of an appointment system applied in 29 PHC centers in the Balearic Islands, Spain; the program was set up by the National Institute of Health. Telephonic appointment proportion increased from the first weeks, stabilizing at about 70%. The number of calls that it is necessary to make in order to get an appointment at peak time is now 1.5 and only 1 throughout the rest of the day. To determine changes in the waiting time and visit time, and the user opinion of the system, an enquiry was made to a sample of patients 1 month before, and 1 month, 6 months and 1 year after the program started. The waiting time is now less than 15 min for most of the people interviewed, in contrast with the previous situation when the waiting time was more than 30 min. The visit time is longer now and more than two thirds of the people think that care is better or much better than prior to the start of the program. These results have been verified in the waiting room (11.2 min mean waiting time and 7.2 min mean visit time). We conclude that we have achieved the goals of the appointment system program in all the centers covered by our department.","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 1 1","pages":"33-41"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.INTQHC.A036696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61010327","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 : 1992-01-01DOI: 10.1093/OXFORDJOURNALS.INTQHC.A036704
B. Mijnheer
Since a radiotherapy department is a clinical and technical entity, quality assurance (QA) is a team effort. This is necessary for the treatment of a patient with the required high degree of accuracy and precision. The physical and technical aspects of QA programmes performed in radiotherapy institutions have been reviewed in this paper. Firstly, the accuracy required in radiotherapy has been discussed. An increasing amount of clinical evidence indicates that an accuracy of 3.5% in the dose value at the specification point and an accuracy of less than 5 mm in the position of the field with respect to the target volume in the patient is required. Secondly, various aspects of QA programmes related to beam characteristics of treatment machines, treatment planning and treatment verification have been elucidated. It is recommended that international organizations formulate minimum and ideal QA programmes for this purpose. Finally, some recent developments in the field of treatment verification concerning portal imaging and in vivo dosimetry, partly sponsored by the CEC/AIM programme, have been illustrated in more detail. The latter project concerns the further development of an on-line electronic portal imaging device for checking the correct position of the target volume with respect to the radiation beam.
{"title":"QUALITY ASSURANCE IN RADIOTHERAPY: PHYSICAL AND TECENICAL ASPECTS","authors":"B. Mijnheer","doi":"10.1093/OXFORDJOURNALS.INTQHC.A036704","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.INTQHC.A036704","url":null,"abstract":"Since a radiotherapy department is a clinical and technical entity, quality assurance (QA) is a team effort. This is necessary for the treatment of a patient with the required high degree of accuracy and precision. The physical and technical aspects of QA programmes performed in radiotherapy institutions have been reviewed in this paper. Firstly, the accuracy required in radiotherapy has been discussed. An increasing amount of clinical evidence indicates that an accuracy of 3.5% in the dose value at the specification point and an accuracy of less than 5 mm in the position of the field with respect to the target volume in the patient is required. Secondly, various aspects of QA programmes related to beam characteristics of treatment machines, treatment planning and treatment verification have been elucidated. It is recommended that international organizations formulate minimum and ideal QA programmes for this purpose. Finally, some recent developments in the field of treatment verification concerning portal imaging and in vivo dosimetry, partly sponsored by the CEC/AIM programme, have been illustrated in more detail. The latter project concerns the further development of an on-line electronic portal imaging device for checking the correct position of the target volume with respect to the radiation beam.","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 1","pages":"9-18"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.INTQHC.A036704","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61010436","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 : 1992-01-01DOI: 10.1093/OXFORDJOURNALS.INTQHC.A036708
Elina Hemminki, Juha Teperi, Kristiina Tuominen
Data for the Finnish medical birth register (established 1987) are collected by local hospital personnel as a part of their routine work. The purpose of this study was to study the need of personnel for feedback and the impact of feedback on later data quality. Furthermore, we studied whether such feedback tends to modify extreme cesarean section rates. Data on attitudes towards the birth register and on the need for feedback of data providers were collected through interviews and observations. In March 1988, an information package describing births, birth procedures and infant outcomes in each hospital compared with other hospitals was sent to a random stratified sample of 26 hospitals out of a total of 53. Opinions of the package were obtained by questionnaire from 104 physicians and nurses (82% response rate). Most hospital personnel, especially physicians, had negative attitudes towards the birth register. Comparison of the hospitals which had received feedback with other hospitals in terms of quality of data furnished in 1987 and 1988 suggested that feedback may improve the technical quality of data. There was no evidence, however, that feedback caused hospitals to change their practices in regard to cesarean sections.
{"title":"Need for and influence of feedback from the Finnish birth register to data providers.","authors":"Elina Hemminki, Juha Teperi, Kristiina Tuominen","doi":"10.1093/OXFORDJOURNALS.INTQHC.A036708","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.INTQHC.A036708","url":null,"abstract":"Data for the Finnish medical birth register (established 1987) are collected by local hospital personnel as a part of their routine work. The purpose of this study was to study the need of personnel for feedback and the impact of feedback on later data quality. Furthermore, we studied whether such feedback tends to modify extreme cesarean section rates. Data on attitudes towards the birth register and on the need for feedback of data providers were collected through interviews and observations. In March 1988, an information package describing births, birth procedures and infant outcomes in each hospital compared with other hospitals was sent to a random stratified sample of 26 hospitals out of a total of 53. Opinions of the package were obtained by questionnaire from 104 physicians and nurses (82% response rate). Most hospital personnel, especially physicians, had negative attitudes towards the birth register. Comparison of the hospitals which had received feedback with other hospitals in terms of quality of data furnished in 1987 and 1988 suggested that feedback may improve the technical quality of data. There was no evidence, however, that feedback caused hospitals to change their practices in regard to cesarean sections.","PeriodicalId":77341,"journal":{"name":"Quality assurance in health care : the official journal of the International Society for Quality Assurance in Health Care","volume":"4 2 1","pages":"133-9"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.INTQHC.A036708","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61010490","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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