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[20 years emergency surgery of abdominal organs in Moscow].

https://arctichealth.org/en/permalink/ahliterature104248
Source
Khirurgiia (Mosk). 2014;(5):7-16
Publication Type
Article
Date
2014
Author
A S Ermolov
A N Smoliar
I A Shliakhovskii
M G Khramenkov
Source
Khirurgiia (Mosk). 2014;(5):7-16
Date
2014
Language
Russian
Publication Type
Article
Keywords
Abdomen, Acute - classification - epidemiology - surgery
Anniversaries and Special Events
Emergency Medical Services - statistics & numerical data
Humans
Intensive Care - methods - organization & administration
Moscow - epidemiology
Outcome and Process Assessment (Health Care) - statistics & numerical data
Quality Improvement - statistics & numerical data - trends
Surgery Department, Hospital - statistics & numerical data
Abstract
The analysis of emergency surgical care in medical institution of Moscow for the last 20 years is presented in the article. There were 912 156 patients with acute appendicitis, strangulated hernia, perforated gastro-duodenal ulcer, gastro-duodenal bleeding, acute cholecystitis, acute pancreatitis, acute intestinal obstruction on treatment during this period. It was observed reduction overall and postoperative mortality. It was concluded that positive results are caused by development of material and technical base, transition on clock mode of diagnostic units, increase of patients? number hospitalized in department of intensive care for operation training and after it, using of modern diagnostic and therapeutic methods, edit documents regulating of health facilities activity according to medicine development.
PubMed ID
24874218 View in PubMed
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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
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PubMed ID
26352600 View in PubMed
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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
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[About standardization of specialized medical care].

https://arctichealth.org/en/permalink/ahliterature291369
Source
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2016 May-Jun; 24(3):156-9
Publication Type
Journal Article
Author
I V Uspenkaia
A A Nizov
E V Manukhina
Source
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2016 May-Jun; 24(3):156-9
Language
Russian
Publication Type
Journal Article
Keywords
Delivery of Health Care, Integrated - organization & administration - standards
Health Care Reform
Hospitalization
Humans
Medicine - methods - standards
Program Development
Quality Improvement - organization & administration
Russia
Specialization - standards
Abstract
The article presents materials of studying of such important problem of health care as standardization of specialized medical care provided in conditions of hospital and modernization of regional health care. The issues of standardization of specialized medical care are considered in medical, economic and social aspects. The implementation of medical standards was determined as one of main tasks of the regional program of modernization of health care. The program was developed with direct involvement of the authors of article. The comparative analysis of classes of diseases and nosologic forms on main indices of hospitalized morbidity and lethality was used for substantiation of priority of implementing medical standards in the region. The questionnaire survey was carried out on sampling of 510 patients of hospitals. The sociological questionnaire survey was applied to sampling of 8732 patients comprised by system of mandatory medical insurance. Such an approach determined reliability of derived results. The expertise of medical standards was implemented by 124 experienced and competent physicians participating in implementation of medical standards. The results of expertise confirmed expediency of implementation of medical standards. Kepy following shortcomings were established: inadequate financing; lacking of modern equipment and analysis techniques in hospitals, etc. The article presents evidences of effectiveness of process of standardization of specialized of medical care provided in hospital conditions. The basis of such an assumption was reliable increasing of level of satisfaction of quality of its organization and achievement of planned indices of "road map" in the section of increasing of salary of medical workers and decreasing of mortality of population because of controllable causes.
PubMed ID
29553232 View in PubMed
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Accreditation and improvement in process quality of care: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature274471
Source
Int J Qual Health Care. 2015 Oct;27(5):336-43
Publication Type
Article
Date
Oct-2015
Author
Søren Bie Bogh
Anne Mette Falstie-Jensen
Paul Bartels
Erik Hollnagel
Søren Paaske Johnsen
Source
Int J Qual Health Care. 2015 Oct;27(5):336-43
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Accreditation - statistics & numerical data
Denmark
Follow-Up Studies
Guideline Adherence - statistics & numerical data
Heart Failure - therapy
Hospital Bed Capacity
Hospitals, Public - statistics & numerical data
Humans
Peptic Ulcer - therapy
Practice Guidelines as Topic
Quality Improvement - statistics & numerical data
Quality Indicators, Health Care - statistics & numerical data
Residence Characteristics
Stroke - therapy
Abstract
To examine whether performance measures improve more in accredited hospitals than in non-accredited hospital.
A historical follow-up study was performed using process of care data from all public Danish hospitals in order to examine the development over time in performance measures according to participation in accreditation programs.
All patients admitted for acute stroke, heart failure or ulcer at Danish hospitals.
Hospital accreditation by either The Joint Commission International or The Health Quality Service.
The primary outcome was a change in opportunity-based composite score and the secondary outcome was a change in all-or-none scores, both measures were based on the individual processes of care. These processes included seven processes related to stroke, six processes to heart failure, four to bleeding ulcer and four to perforated ulcer.
A total of 27 273 patients were included. The overall opportunity-based composite score improved for both non-accredited and accredited hospitals (13.7% [95% CI 10.6; 16.8] and 9.9% [95% 5.4; 14.4], respectively), but the improvements were significantly higher for non-accredited hospitals (absolute difference: 3.8% [95% 0.8; 8.3]). No significant differences were found at disease level. The overall all-or-none score increased significantly for non-accredited hospitals, but not for accredited hospitals. The absolute difference between improvements in the all-or-none score at non-accredited and accredited hospitals was not significant (3.2% [95% -3.6:9.9]).
Participating in accreditation was not associated with larger improvement in performance measures for acute stroke, heart failure or ulcer.
PubMed ID
26239473 View in PubMed
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Achieving optimal prescribing: what can physicians do?

https://arctichealth.org/en/permalink/ahliterature121612
Source
Can Fam Physician. 2012 Aug;58(8):820-1
Publication Type
Article
Date
Aug-2012
Author
Samuel Shortt
Ingrid Sketris
Author Affiliation
Office for Knowledge Transfer, Canadian Medical Association, Ottawa ON. sam.shortt@cma.ca
Source
Can Fam Physician. 2012 Aug;58(8):820-1
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Canada
Drug Costs
Humans
Inappropriate Prescribing - adverse effects - economics - prevention & control
Medication Errors - adverse effects - economics - prevention & control
Patient Safety
Physician's Practice Patterns - economics - standards
Physician's Role
Quality Improvement
Notes
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PubMed ID
22893327 View in PubMed
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Acting on audit & feedback: a qualitative instrumental case study in mental health services in Norway.

https://arctichealth.org/en/permalink/ahliterature295007
Source
BMC Health Serv Res. 2018 01 31; 18(1):71
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Date
01-31-2018
Author
Monica Stolt Pedersen
Anne Landheim
Merete Møller
Lars Lien
Author Affiliation
Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.B. 104, 2340, Brumunddal, Norway. monica.stolt.pedersen@sykehuset-innlandet.no.
Source
BMC Health Serv Res. 2018 01 31; 18(1):71
Date
01-31-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Benchmarking
Evidence-Based Practice
Feedback
Health Personnel
Humans
Medical Audit
Mental Disorders - rehabilitation - therapy
Mental Health Services - organization & administration - standards
Norway
Organizational Case Studies
Qualitative Research
Quality Improvement
Abstract
The National Guideline for Assessment, Treatment and Social Rehabilitation of Persons with Concurrent Substance Use and Mental Health Disorders, launched in 2012, is to be implemented in mental health services in Norway. Audit and feedback (A&F) is commonly used as the starting point of an implementation process. It aims to measure the research-practice gap, but its effect varies greatly. Less is known of how audit and feedback is used in natural settings. The aim of this study was to describe and investigate what is discussed and thematised when Quality Improvement (QI) teams in a District Psychiatric Centre (DPC) work to complete an action form as part of an A&F cycle in 2014.
This was an instrumental multiple case study involving four units in a DPC in Norway. We used open non-participant observation of QI team meetings in their natural setting, a total of seven teams and eleven meetings.
The discussions provided health professionals with insight into their own and their colleagues' practices. They revealed insufficient knowledge of substance-related disorders and experienced unclear role expectations. We found differences in how professional groups sought answers to questions of clinical practice and that they were concerned about whether new tasks fitted in with their routine ways of working.
Acting on A&F provided an opportunity to discuss practice in general, enhancing awareness of good practice. There was a general need for arenas to relate to practice and QI team meetings after A&F may well be a suitable arena for this. Self-assessment audits seem valuable, particular in areas where no benchmarked data exists, and there is a demand for implementation of new guidelines that might change routines and develop new roles. QI teams could benefit from having a unit leader present at meetings. Nurses and social educators and others turn to psychiatrists or psychologists for answers to clinical and organisational questions beyond guidelines, and show less confidence or routine in seeking research-based information. There is a general need to emphasise training in evidence-based practice and information seeking behaviour for all professional groups.
Notes
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PubMed ID
29386020 View in PubMed
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Active ambulatory care management supported by short message services and mobile phone technology in patients with arterial hypertension.

https://arctichealth.org/en/permalink/ahliterature120508
Source
J Am Soc Hypertens. 2012 Sep-Oct;6(5):346-55
Publication Type
Article
Author
Anton R Kiselev
Vladimir I Gridnev
Vladimir A Shvartz
Olga M Posnenkova
Pavel Ya Dovgalevsky
Author Affiliation
Centre of New Cardiological Informational Technologies, Saratov Research Institute of Cardiology, Saratov, Russia. antonkis@list.ru
Source
J Am Soc Hypertens. 2012 Sep-Oct;6(5):346-55
Language
English
Publication Type
Article
Keywords
Adult
Ambulatory Care - methods - standards
Blood Pressure Monitoring, Ambulatory - methods - standards
Cellular Phone
Comparative Effectiveness Research
Disease Management
Female
Health Care Surveys
Humans
Hypertension - diagnosis - therapy
Male
Medication Therapy Management
Middle Aged
Outcome and Process Assessment (Health Care)
Patient Care Management - organization & administration
Quality Improvement
Russia
Text Messaging
Abstract
The use of short message services and mobile phone technology for ambulatory care management is the most accessible and most inexpensive way to transition from traditional ambulatory care management to active ambulatory care management in patients with arterial hypertension (AH). The aim of this study was to compare the clinical efficacy of active ambulatory care management supported by short message services and mobile phone technology with traditional ambulatory care management in AH patients. The study included 97 hypertensive patients under active ambulatory care management and 102 patients under traditional ambulatory care management. Blood pressure levels, body mass, and smoking history of patients were analyzed in the study. The duration of study was 1 year. In the active ambulatory care management group, 36% of patients were withdrawn from the study within a year. At the end of the year, 77% of patients from the active care management group had achieved the goal blood pressure level. That was more than 5 times higher than that in the traditional ambulatory care management group (P
PubMed ID
22995803 View in PubMed
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Adding quality to day centre activities for people with psychiatric disabilities: Staff perceptions of an intervention.

https://arctichealth.org/en/permalink/ahliterature273214
Source
Scand J Occup Ther. 2016;23(1):13-22
Publication Type
Article
Date
2016
Author
Mona Eklund
Christel Leufstadius
Source
Scand J Occup Ther. 2016;23(1):13-22
Date
2016
Language
English
Publication Type
Article
Keywords
Adult Day Care Centers - organization & administration - standards
Community Mental Health Centers - organization & administration
Disabled Persons - rehabilitation
Focus Groups
Humans
Mental Disorders - rehabilitation
Narration
Occupational Therapy - organization & administration
Personal Satisfaction
Power (Psychology)
Quality Improvement
Surveys and Questionnaires
Sweden
Abstract
To evaluate an intervention aimed at enriching day centres for people with psychiatric disabilities by exploring staff experiences from developing and implementing the intervention.
Each staff group developed a tailor-made intervention plan, following a manual, for how to enrich the day centre. They received supervision and support from the research team. The study was based on focus-group interviews with a total of 13 staff members at four day centres. Narrative analysis with a thematic approach was used. A first round resulted in one narrative per centre. These centre-specific narratives were then integrated into a common narrative that covered all the data.
A core theme emerged: User involvement permeated the implementation process and created empowerment. It embraced four themes forming a timeline: "Mix of excitement, worries and hope", "Confirmation and development through dialogue, feedback and guidance", "The art of integrating new activities and strategies with the old", and "Empowerment-engendered future aspirations".
The users' involvement and empowerment were central for the staff in accomplishing the desired changes in services, as were their own reflections and learning. A possible factor that may have contributed to the positive outcomes was that those who were central in developing the plan were the same as those who implemented it.
PubMed ID
26206294 View in PubMed
Less detail
Source
Sarcoidosis Vasc Diffuse Lung Dis. 2015;32 Suppl 1:3
Publication Type
Article
Date
2015

429 records – page 1 of 43.