Skip header and navigation

Refine By

875 records – page 1 of 88.

[7 out of 10 satisfied with hospital food--is better, but not good enough].

https://arctichealth.org/en/permalink/ahliterature143873
Source
Lakartidningen. 2010 Mar 31-Apr 13;107(13-14):926; discussion 926-7
Publication Type
Article
Author
Maria Wallhager
Catharina Elmsäter-Svärd
Source
Lakartidningen. 2010 Mar 31-Apr 13;107(13-14):926; discussion 926-7
Language
Swedish
Publication Type
Article
Keywords
Food - standards
Food Handling - standards
Food Service, Hospital - standards
Humans
Patient satisfaction
Sweden
PubMed ID
20432872 View in PubMed
Less detail

30-Day Survival Probabilities as a Quality Indicator for Norwegian Hospitals: Data Management and Analysis.

https://arctichealth.org/en/permalink/ahliterature273361
Source
PLoS One. 2015;10(9):e0136547
Publication Type
Article
Date
2015
Author
Sahar Hassani
Anja Schou Lindman
Doris Tove Kristoffersen
Oliver Tomic
Jon Helgeland
Source
PLoS One. 2015;10(9):e0136547
Date
2015
Language
English
Publication Type
Article
Keywords
Comorbidity
Diagnosis-Related Groups
Episode of Care
Hospital Mortality
Hospital records
Hospitals - standards - statistics & numerical data
Humans
Length of Stay
Norway - epidemiology
Patient Admission - statistics & numerical data
Patient Discharge - statistics & numerical data
Patient transfer
Probability
Quality Improvement
Quality Indicators, Health Care
Survival Analysis
Abstract
The Norwegian Knowledge Centre for the Health Services (NOKC) reports 30-day survival as a quality indicator for Norwegian hospitals. The indicators have been published annually since 2011 on the website of the Norwegian Directorate of Health (www.helsenorge.no), as part of the Norwegian Quality Indicator System authorized by the Ministry of Health. Openness regarding calculation of quality indicators is important, as it provides the opportunity to critically review and discuss the method. The purpose of this article is to describe the data collection, data pre-processing, and data analyses, as carried out by NOKC, for the calculation of 30-day risk-adjusted survival probability as a quality indicator.
Three diagnosis-specific 30-day survival indicators (first time acute myocardial infarction (AMI), stroke and hip fracture) are estimated based on all-cause deaths, occurring in-hospital or out-of-hospital, within 30 days counting from the first day of hospitalization. Furthermore, a hospital-wide (i.e. overall) 30-day survival indicator is calculated. Patient administrative data from all Norwegian hospitals and information from the Norwegian Population Register are retrieved annually, and linked to datasets for previous years. The outcome (alive/death within 30 days) is attributed to every hospital by the fraction of time spent in each hospital. A logistic regression followed by a hierarchical Bayesian analysis is used for the estimation of risk-adjusted survival probabilities. A multiple testing procedure with a false discovery rate of 5% is used to identify hospitals, hospital trusts and regional health authorities with significantly higher/lower survival than the reference. In addition, estimated risk-adjusted survival probabilities are published per hospital, hospital trust and regional health authority. The variation in risk-adjusted survival probabilities across hospitals for AMI shows a decreasing trend over time: estimated survival probabilities for AMI in 2011 varied from 80.6% (in the hospital with lowest estimated survival) to 91.7% (in the hospital with highest estimated survival), whereas it ranged from 83.8% to 91.2% in 2013.
Since 2011, several hospitals and hospital trusts have initiated quality improvement projects, and some of the hospitals have improved the survival over these years. Public reporting of survival/mortality indicators are increasingly being used as quality measures of health care systems. Openness regarding the methods used to calculate the indicators are important, as it provides the opportunity of critically reviewing and discussing the methods in the literature. In this way, the methods employed for establishing the indicators may be improved.
Notes
Cites: PLoS Med. 2010;7(11):e100100421151347
Cites: Med Care. 2010 Dec;48(12):1117-2120978451
Cites: BMC Health Serv Res. 2012;12:36423088745
Cites: Qual Saf Health Care. 2003 Apr;12(2):100-612679505
Cites: Int J Qual Health Care. 2001 Dec;13(6):475-8011769750
Cites: BMJ Open. 2015;5(3):e00674125808167
Cites: BMJ. 2003 Apr 12;326(7393):816-912689983
Cites: Int J Qual Health Care. 2003 Dec;15(6):523-3014660535
Cites: Stat Med. 1994 May 15;13(9):889-9038047743
Cites: Health Care Financ Rev. 1995 Summer;16(4):107-2710151883
Cites: Heart. 1996 Jul;76(1):70-58774332
Cites: Stat Med. 1997 Dec 15;16(23):2645-649421867
Cites: Med Care. 2005 Nov;43(11):1130-916224307
Cites: Circulation. 2006 Jan 24;113(3):456-6216365198
Cites: Am J Epidemiol. 2011 Mar 15;173(6):676-8221330339
PubMed ID
26352600 View in PubMed
Less detail

The 2004 ACC/AHA Guidelines: a perspective and adaptation for Canada by the Canadian Cardiovascular Society Working Group.

https://arctichealth.org/en/permalink/ahliterature178142
Source
Can J Cardiol. 2004 Sep;20(11):1075-9
Publication Type
Article
Date
Sep-2004
Author
Paul W Armstrong
Peter Bogaty
Christopher E Buller
Paul Dorian
Blair J O'Neill
Author Affiliation
VIGOUR Centre, University of Alberta, Edmonton. paul.armstrong@ualberta.ca
Source
Can J Cardiol. 2004 Sep;20(11):1075-9
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Canada
Defibrillators, Implantable - standards
Electrocardiography
Emergency Medical Services - standards
Emergency Service, Hospital - standards
Female
Guideline Adherence
Humans
Male
Myocardial Infarction - diagnosis - therapy
Myocardial Reperfusion - standards
Severity of Illness Index
Survival Analysis
Treatment Outcome
Abstract
Major changes in acute ST elevation myocardial infarction (STEMI) management prompted a comprehensive rewriting of the American College of Cardiology/American Heart Association Guidelines. The Canadian Cardiovascular Society (CCS) participated in both the writing process and the external review. Subsequently, a Canadian Working Group (CWG), formed under the auspices of the CCS, developed a perspective and adaptation for Canada. Herein, accounting for specific realities of the Canadian cardiovascular health system, is a discussion of the implications for prehospital care and transport, optimal reperfusion therapy and an approach to decision making regarding reperfusion options and invasive therapy following fibrinolytic therapy. Major recent developments regarding indications for implantable cardioverter defibrillator(s) (ICDs) also prompted a review of indications for ICDs and the optimal timing of implantation given the potential for recovery of left ventricular function. At least a 40-day, preferably a 12-week, waiting period was judged to be optimal to evaluate left ventricular function post-STEMI. A recommended algorithm for the insertion of an ICD is provided. Implementation of the new STEMI guidelines has substantial implications for resources, organization and priorities of the Canadian health care system. While on the one hand, the necessary incremental funding to provide tertiary and quaternary care and to support revascularization and device implantation capability is desirable, it is equally or more important to develop enhanced prehospital care, including the capacity for early recognition, risk assessment, fibrinolytic therapy and/or triage to a tertiary care centre as part of an enlightened approach to improving cardiac care.
PubMed ID
15457302 View in PubMed
Less detail

The 2011 outcome from the Swedish Health Care Registry on Heart Disease (SWEDEHEART).

https://arctichealth.org/en/permalink/ahliterature108055
Source
Scand Cardiovasc J. 2013 Jun;47 Suppl 62:1-10
Publication Type
Article
Date
Jun-2013
Author
Jan Harnek
Johan Nilsson
Orjan Friberg
Stefan James
Bo Lagerqvist
Kristina Hambraeus
Asa Cider
Lars Svennberg
Mona From Attebring
Claes Held
Per Johansson
Tomas Jernberg
Author Affiliation
Department of Coronary Heart Disease, Skåne University Hospital, Institution of Clinical Sciences, Lund University, Lund, Sweden. jan.harnek@skane.se
Source
Scand Cardiovasc J. 2013 Jun;47 Suppl 62:1-10
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cardiac Surgical Procedures
Cardiology Service, Hospital - standards
Child
Child, Preschool
Coronary Angiography
Coronary Care Units - standards
Female
Heart Diseases - diagnosis - mortality - therapy
Humans
Infant
Infant, Newborn
Male
Medical Record Linkage
Middle Aged
Outcome and Process Assessment (Health Care) - standards
Percutaneous Coronary Intervention
Quality Improvement - standards
Quality of Health Care - standards
Registries
Secondary Prevention
Sweden - epidemiology
Time Factors
Treatment Outcome
Young Adult
Abstract
The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) collects data to support the improvement of care for heart disease.
SWEDEHEART collects on-line data from consecutive patients treated at any coronary care unit n = (74), followed for secondary prevention, undergoing any coronary angiography, percutaneous coronary intervention, percutaneous valve or cardiac surgery. The registry is governed by an independent steering committee, the software is developed by Uppsala Clinical Research Center and it is funded by The Swedish national health care provider independent of industry support. Approximately 80,000 patients per year enter the database which consists of more than 3 million patients.
Base-line, procedural, complications and discharge data consists of several hundred variables. The data quality is secured by monitoring. Outcomes are validated by linkage to other registries such as the National Cause of Death Register, the National Patient Registry, and the National Registry of Drug prescriptions. Thanks to the unique social security number provided to all citizens follow-up is complete. The 2011 outcomes with special emphasis on patients more than 80 years of age are presented.
SWEDEHEART is a unique complete national registry for heart disease.
PubMed ID
23941732 View in PubMed
Less detail

Access to hand hygiene in eastern Ontario.

https://arctichealth.org/en/permalink/ahliterature147556
Source
Can J Infect Control. 2009;24(3):153-7
Publication Type
Article
Date
2009
Author
Joseph V Vayalumkal
Colette Ouellet
Virginia R Roth
Author Affiliation
Canadian Field Epidemiology Program, Public Health Agency of Canada, Ottawa, ON, Canada.
Source
Can J Infect Control. 2009;24(3):153-7
Date
2009
Language
English
Publication Type
Article
Keywords
Data Collection
Hand Disinfection - standards
Humans
Hygiene
Ontario
Personnel, Hospital - standards
Point-of-Care Systems - standards
Abstract
Hand hygiene compliance improves when alcohol-based hand products (ABHP) are provided at the point-of-care (POC). However, it is not known how many facilities have the infrastructure available to provide easy access to ABHP currently.
To describe the extent to which facilities in the Champlain Infection Control Network (CICN) provide POC access to ABHP.
A survey was conducted of all healthcare facilities in the CICN in October 2007. Sites were asked to complete a one-page questionnaire regarding number and location of ABHP dispensers on one ward in their facilities. The primary outcome measures included: the proportion of facilities providing any POC access to ABHP and the proportion of ABHP dispensers that were at POC, hallways and other areas.
A total of 18 of 59 (31%) long-term care facilities (LTCF) and 14 of 18 (78%) acute-care facilities (ACF) participated in the survey. Intensive care units (ICUs) were present in seven (50%) of the ACF. POC access to ABHP was provided in 44% of LTCF, 50% of ACF and 71% of ICUs surveyed. In LTCF 20% of ABHP dispensers were at the POC compared to 23% in ACF and 42% in ICUs.
Although ABHP is available in these settings, most dispensers are not provided at the POC. Hospitals and LTCF need to increase the number of ABHP dispensers available, with a particular emphasis on placing them at the POC in accordance with provincial guidelines.
PubMed ID
19891168 View in PubMed
Less detail

Access to new cardiovascular therapies in Canadian hospitals: a national survey of the formulary process.

https://arctichealth.org/en/permalink/ahliterature186545
Source
Can J Cardiol. 2003 Feb;19(2):173-9
Publication Type
Article
Date
Feb-2003
Author
Stephen J Shalansky
Roohina Virk
Margaret Ackman
Cynthia Jackevicius
Heather Kertland
Ross Tsuyuki
Karin Humphries
Author Affiliation
Pharmacy Department, St. Paul's Hospital, Vancouver, British Columbia. shalansk@interchange.ubc.ca
Source
Can J Cardiol. 2003 Feb;19(2):173-9
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Antibodies, Monoclonal - economics - therapeutic use
Canada
Cardiovascular Agents - economics - therapeutic use
Dalteparin - economics - therapeutic use
Data Collection
Drug Utilization
Enoxaparin - economics - therapeutic use
Formularies, Hospital - standards
Health Services Accessibility - economics - organization & administration
Hematologic Agents - economics - therapeutic use
Humans
Immunoglobulin Fab Fragments - economics - therapeutic use
Peptides - economics - therapeutic use
Pharmacy and Therapeutics Committee - economics - organization & administration - standards
Ticlopidine - analogs & derivatives - economics - therapeutic use
Tyrosine - analogs & derivatives - economics - therapeutic use
Abstract
Access to new therapies in hospitals depends upon both clinical trial evidence and local Pharmacy and Therapeutics (P&T) committee approval. The process of formulary evaluation by P&T committees is not well-understood.
To describe the formulary decision-making process in Canadian hospitals for cardiovascular medications recently made available on the Canadian market.
Postal survey of hospital pharmacy directors in all Canadian hospitals with more than 50 beds. Target drugs included abciximab, enoxaparin, dalteparin, clopidogrel, eptifibatide and tirofiban.
Of 428 surveys mailed, responses were received from 164 P&T committees representing 350 hospitals for an effective response rate of 82%. While physicians make up the largest proportion of committee membership, pharmacists play an influential role. Information most commonly cited as influencing formulary decisions included published clinical trials (97%), regional guidelines (90%), pharmacoeconomic data (84%), decisions at peer hospitals (73%) and local opinion leaders (60%). However, this information was often not required on formulary applications. Approval timelines varied widely for target medications but there were no regional, hospital or P&T committee characteristics that were independent predictors of early formulary application or approval.
There is wide variability in the time taken for Canadian institutions to adopt new cardiovascular therapies, which is not explained by regional, hospital or P&T committee characteristics. Standardization of the formulary application and evaluation processes, including sharing of information amongst institutions, would lead to broader understanding of the applicable issues, more objectivity and improved efficiency.
PubMed ID
12601443 View in PubMed
Less detail

Accidental out-of-hospital births in Finland: incidence and geographical distribution 1963-1995.

https://arctichealth.org/en/permalink/ahliterature202145
Source
Acta Obstet Gynecol Scand. 1999 May;78(5):372-8
Publication Type
Article
Date
May-1999
Author
K. Viisainen
M. Gissler
A L Hartikainen
E. Hemminki
Author Affiliation
STAKES (National Research and Development Centre for Welfare and Health), University of Helsinki, Department of Public Health, Finland.
Source
Acta Obstet Gynecol Scand. 1999 May;78(5):372-8
Date
May-1999
Language
English
Publication Type
Article
Keywords
Adult
Birth weight
Delivery Rooms - statistics & numerical data
Delivery, obstetric - statistics & numerical data
Female
Finland
Gestational Age
Hospitals - standards
Hospitals, Maternity - statistics & numerical data
Humans
Incidence
Infant, Newborn
Obstetrics and Gynecology Department, Hospital - statistics & numerical data
Parity
Pregnancy
Prenatal Care
Rural Health Services - statistics & numerical data
Urban Health Services - statistics & numerical data
Abstract
The study aims to describe the incidence and geographical distribution of accidental out-of-hospital births (accidental births) in Finland in relation to the changes in the hospital network, and to compare the perinatal outcomes of accidental births and all hospital births.
Data for the incidence and distribution analyses of accidental births were obtained from the official statistics between 1962 and 1973 and from the national Medical Birth Registry (MBR) in 1992-1993. The infant outcomes were analyzed for the MBR data in 1991-1995.
Between 1963 and 1975 the central hospital network expanded and by 1975 they covered 72% of births. The number of small maternity units has decreased since 1963. The incidence of accidental births decreased between 1963 and 1973, from 1.3 to 0.4 per 1000 births, and rose by the 1990s to 1/1000. In the 1990s the parity adjusted risk of an accidental birth was higher for residents of northern than of southern Finland, OR 2.51 (CI 1.75-3.60), and for residents of rural compared to urban municipalities, OR 3.26 (CI 2.48-4.27). The birthweight adjusted risk for a perinatal death was higher in accidental births than in hospital births, OR 3.11 (CI 1.42-6.84).
A temporal correlation between closing of small hospitals and an increase in accidental birth rates was detected. Due to the poor infant outcomes of accidental births, centralization policies should include measures to their prevention.
PubMed ID
10326879 View in PubMed
Less detail

Accuracy and concordance of nurses in emergency department triage.

https://arctichealth.org/en/permalink/ahliterature171723
Source
Scand J Caring Sci. 2005 Dec;19(4):432-8
Publication Type
Article
Date
Dec-2005
Author
Katarina Göransson
Anna Ehrenberg
Bertil Marklund
Margareta Ehnfors
Author Affiliation
Department of Health Sciences, Orebro University, Sweden. katarina.goransson@hi.oru.se
Source
Scand J Caring Sci. 2005 Dec;19(4):432-8
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Emergency Nursing - standards
Emergency Service, Hospital
Humans
Nursing Staff, Hospital - standards
Observer Variation
Quality of Health Care
Sweden
Triage - classification
Abstract
In the emergency department (ED) Registered Nurses (RNs) often perform triage, i.e. the sorting and prioritizing of patients. The allocation of acuity ratings is commonly based on a triage scale. To date, three reliable 5-level triage scales exist, of which the Canadian Triage and Acuity Scale (CTAS) is one. In Sweden, few studies on ED triage have been conducted and the organization of triage has been found to vary considerably with no common triage scale. The aim of this study was to investigate the accuracy and concordance of emergency nurses acuity ratings of patient scenarios in the ED setting. Totally, 423 RNs from 48 (62%) Swedish EDs each triaged 18 patient scenarios using the CTAS. Of the 7,550 triage ratings, 57.6% were triaged in concordance with the expected outcome and no scenario was triaged into the same triage level by all RNs. Inter-rater agreement for all RNs was kappa = 0.46 (unweighted) and kappa = 0.71 (weighted). The fact that the kappa-values are only moderate to good and the low concordance between the RNs call for further studies, especially from a patient safety perspective.
PubMed ID
16324070 View in PubMed
Less detail

875 records – page 1 of 88.