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A 50-Year Commitment to American Indian and Alaska Native Women.

https://arctichealth.org/en/permalink/ahliterature304709
Source
Obstet Gynecol. 2020 10; 136(4):739-744
Publication Type
Journal Article
Date
10-2020
Author
Alan G Waxman
William H J Haffner
Jean Howe
Kathleen Wilder
Tony Ogburn
Neil Murphy
Eve Espey
J Martin Tucker
Amanda Bruegl
Elaine Locke
Yvonne Malloy
Author Affiliation
University of New Mexico, Albuquerque, New Mexico; the Uniformed Services University of the Health Sciences, Bethesda, Maryland; the Northern Navajo Medical Center, Shiprock, New Mexico; the Mid-Columbia Medical Center, The Dalles, Oregon; the University of Texas Rio Grande Valley, Edinburg, Texas; the Alaska Native Medical Center, Anchorage, Alaska; the University of Mississippi Medical Center, Jackson, Mississippi; the Oregon Health and Science University, Portland, Oregon; and the American College of Obstetricians and Gynecologists, Washington, DC.
Source
Obstet Gynecol. 2020 10; 136(4):739-744
Date
10-2020
Language
English
Publication Type
Journal Article
Keywords
Alaskan Natives
Female
Gynecology
Health Services Accessibility - organization & administration - standards - trends
Healthcare Disparities - ethnology
Humans
Indians, North American
Intersectoral Collaboration
Obstetrics
Program Evaluation
Quality Improvement - organization & administration
Rural Health Services - standards
Surveys and Questionnaires
United States - epidemiology
Urban Health Services - standards
Vulnerable Populations - ethnology
Women's Health Services - organization & administration - standards - trends
Abstract
Since 1970, the American College of Obstetricians and Gynecologists' Committee on American Indian and Alaska Native Women's Health has partnered with the Indian Health Service and health care facilities serving Native American women to improve quality of care in both rural and urban settings. Needs assessments have included formal surveys, expert panels, consensus conferences, and onsite program reviews. Improved care has been achieved through continuing professional education, recruitment of volunteer obstetrician-gynecologists, advocacy, and close collaboration at the local and national levels. The inclusive and multifaceted approach of this program should provide an effective model for collaborations between specialty societies and health care professionals providing primary care services that can reduce health disparities in underserved populations.
PubMed ID
32925622 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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Alberta: evaluation of nursing retention and recruitment programs.

https://arctichealth.org/en/permalink/ahliterature126341
Source
Nurs Leadersh (Tor Ont). 2012 Mar;25 Spec No 2012:130-47
Publication Type
Article
Date
Mar-2012
Author
Arlene Weidner
Carol Graham
Jennifer Smith
Julia Aitken
Jill Odell
Author Affiliation
Research to Action Project, Calgary, AB.
Source
Nurs Leadersh (Tor Ont). 2012 Mar;25 Spec No 2012:130-47
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Alberta
Burnout, Professional - nursing - prevention & control
Data Collection
Delivery of Health Care - organization & administration
Education, Nursing, Graduate - organization & administration
Humans
Inservice Training - organization & administration
Job Satisfaction
Leadership
Mentors
Middle Aged
Nursing Evaluation Research - organization & administration
Nursing Staff, Hospital - organization & administration - supply & distribution
Personnel Selection - statistics & numerical data
Personnel Staffing and Scheduling - organization & administration
Personnel Turnover - statistics & numerical data
Quality Improvement - organization & administration
Retirement
Retrospective Studies
Work Schedule Tolerance
Workplace
Abstract
Retention and recruitment strategies are essential to address nursing workforce supply and ensure the viability of healthcare delivery in Canada. Knowledge transfer between experienced nurses and those new to the profession is also a focus for concern. The Multi-Employer/United Nurses of Alberta Joint Committee attempted to address these issues by introducing a number of retention and recruitment (R&R) initiatives for nurses in Alberta: in total, seven different programs that were introduced to some 24,000 nurses and employers across the province of Alberta in 2001 (the Transitional Graduate Nurse Recruitment Program) and 2007 (the remaining six R&R programs). Approximately 1,600 nurses participated in the seven programs between 2001 and 2009. Of the seven strategies, one supported entry into the workplace, two were pre-retirement strategies and four involved flexible work options. This project entailed a retrospective evaluation of the seven programs and differed from the other Research to Action (RTA) projects because it was solely concerned with evaluation of pre-existing initiatives. All seven programs were launched without a formal evaluation component, and the tracking of local uptake varied throughout the province. The union and various employers faced challenges in implementing these strategies in a timely fashion, as most were designed at the bargaining table during negotiations. As a result, systems, policy and procedural changes had to be developed to support their implementation after they became available.Participants in the programs indicated improvements over time in several areas, including higher levels of satisfaction with work–life balance, hours worked and their current practice and profession. The evaluation found that participation led to perceived improvements in nurses' confidence, greater control over their work environment, decreased stress levels, increased energy and morale and perceived improved ability to provide high-quality care. However, no formal implementation plan had been developed or made available to assist employers with implementation of the programs. The findings highlight the need for more discipline in communicating, implementing and evaluating initiatives such as those evaluated retrospectively in this project. In particular, key performance indicators, baseline data, monitoring mechanisms and an evaluation plan need to be developed prior to implementation.
PubMed ID
22398489 View in PubMed
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Antecedents and characteristics of lean thinking implementation in a Swedish hospital: a case study.

https://arctichealth.org/en/permalink/ahliterature117783
Source
Qual Manag Health Care. 2013 Jan-Mar;22(1):48-61
Publication Type
Article
Author
Waqar Ulhassan
Christer Sandahl
Hugo Westerlund
Peter Henriksson
Marie Bennermo
Ulrica von Thiele Schwarz
Johan Thor
Author Affiliation
Medical Management Centre, Karolinska Institutet, Stockholm, Sweden. waqar.ulhassan@ki.se
Source
Qual Manag Health Care. 2013 Jan-Mar;22(1):48-61
Language
English
Publication Type
Article
Keywords
Cardiology Service, Hospital - organization & administration
Efficiency, Organizational
Emergency Medical Services - organization & administration
Humans
Organizational Case Studies
Personnel, Hospital - utilization
Quality Improvement - organization & administration
Sweden
Abstract
Despite the reported success of Lean in health care settings, it is unclear why and how organizations adopt Lean and how Lean transforms work design and, in turn, affects employees' work. This study investigated a cardiology department's journey to adopt and adapt Lean. The investigation was focused on the rationale and evolution of the Lean adoption to illuminate how a department with a long quality improvement history arrived at the decision to introduce Lean, and how Lean influenced employees' daily work. This is an explanatory single case study based on semistructured interviews, nonparticipant observations, and document studies. Guided by a Lean model, we undertook manifest content analysis of the data. We found that previous improvement efforts may facilitate the introduction of Lean but may be less important when forecasting whether Lean will be sustained over time. Contextual factors seemed to influence both what Lean tools were implemented and how well the changes were sustained. For example, adoption of Lean varied with the degree to which staff saw a need for change. Work redesign and teamwork were found helpful to improve patient care whereas problem solving was found helpful in keeping the staff engaged and sustaining the results over time.
PubMed ID
23271593 View in PubMed
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Application of Lean principles to improve early cardiac care in the emergency department.

https://arctichealth.org/en/permalink/ahliterature130918
Source
CJEM. 2011 Sep;13(5):325-32
Publication Type
Article
Date
Sep-2011
Author
Zoë Piggott
Erin Weldon
Trevor Strome
Alecs Chochinov
Author Affiliation
Royal College Emergency Medicine Residency Program, University of Manitoba, Winnipeg, MB, Canada. zoepiggott@gmail.com
Source
CJEM. 2011 Sep;13(5):325-32
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - diagnosis - therapy
Efficiency, Organizational - standards
Electrocardiography - statistics & numerical data
Emergency Service, Hospital - organization & administration
Health Services Research
Humans
Manitoba
Organizational Culture
Outcome and Process Assessment (Health Care) - organization & administration
Quality Improvement - organization & administration - standards
Triage - organization & administration
Abstract
To achieve our goal of excellent emergency cardiac care, our institution embarked on a Lean process improvement initiative. We sought to examine and quantify the outcome of this project on the care of suspected acute coronary syndrome (ACS) patients in our emergency department (ED).
Front-line ED staff participated in several rapid improvement events, using Lean principles and techniques such as waste elimination, supply chain streamlining, and standard work to increase the value of the early care provided to patients with suspected ACS. A chart review was also conducted. To evaluate our success, proportions of care milestones (first electrocardiogram [ECG], ECG interpretation, physician assessment, and acetylsalicylic acid [ASA] administration) meeting target times were chosen as outcome metrics in this before-and-after study.
The proportion of cases with 12-lead ECGs completed within 10 minutes of patient triage increased by 37.4% (p
PubMed ID
21955414 View in PubMed
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Are data from national quality registries used in quality improvement at Swedish hospital clinics?

https://arctichealth.org/en/permalink/ahliterature293047
Source
Int J Qual Health Care. 2017 Nov 01; 29(7):909-915
Publication Type
Journal Article
Date
Nov-01-2017
Author
Mio Fredriksson
Christina Halford
Ann Catrine Eldh
Tobias Dahlström
Sofie Vengberg
Lars Wallin
Ulrika Winblad
Author Affiliation
Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22 Uppsala, Sweden.
Source
Int J Qual Health Care. 2017 Nov 01; 29(7):909-915
Date
Nov-01-2017
Language
English
Publication Type
Journal Article
Keywords
Data Accuracy
Databases as Topic - utilization
Gallstones - surgery
Hospitals - standards
Humans
Lung Neoplasms
Quality Improvement - organization & administration
Registries - standards - statistics & numerical data
Stroke
Surveys and Questionnaires
Sweden
Abstract
To investigate the use of data from national quality registries (NQRs) in local quality improvement as well as purported key factors for effective clinical use in Sweden.
Comparative descriptive: a web survey of all Swedish hospitals participating in three NQRs with different levels of development (certification level).
Heads of the clinics and physician(s) at clinics participating in the Swedish Stroke Register (Riksstroke), the Swedish National Registry of Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks) and the Swedish Lung Cancer Registry (NLCR).
Individual and unit level use of NQRs in local quality improvement, and perceptions on data quality, organizational conditions and user motivation.
Riksstroke data were reported as most extensively used at individual and unit levels (x¯ 17.97 of 24 and x¯ 27.06 of 35). Data quality and usefulness was considered high for the two most developed NQRs (x¯ 19.86 for Riksstroke and x¯ 19.89 for GallRiks of 25). Organizational conditions were estimated at the same level for Riksstroke and GallRiks (x¯ 12.90 and x¯ 13.28 of 20) while the least developed registry, the NLCR, had lower estimates (x¯ 10.32). In Riksstroke, the managers requested registry data more often (x¯ 15.17 of 20).
While there were significant differences between registries in key factors such as management interest, use of NQR data in local quality improvement seems rather prevalent, at least for Riksstroke. The link between the registry's level of development and factors important for routinization of innovations such as NQRs needs investigation.
PubMed ID
29077930 View in PubMed
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Assessing the status of thoracic surgical research and quality improvement programs: a survey of the members of the Canadian Association of Thoracic Surgeons.

https://arctichealth.org/en/permalink/ahliterature133410
Source
J Surg Educ. 2011 Jul-Aug;68(4):258-65
Publication Type
Article
Author
Jelena Ivanovic
Donna E Maziak
Sebastien Gilbert
Farid M Shamji
R Sudhir Sundaresan
Tim Ramsay
Andrew J E Seely
Author Affiliation
Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa Hospital, Ottawa, Canada.
Source
J Surg Educ. 2011 Jul-Aug;68(4):258-65
Language
English
Publication Type
Article
Keywords
Canada
Databases, Factual
Female
Health Care Surveys
Humans
Male
Needs Assessment
Pilot Projects
Professional Practice - standards
Program Evaluation
Quality Assurance, Health Care
Quality Improvement - organization & administration
Questionnaires
Research - standards - trends
Societies, Medical
Thoracic Surgery - standards - trends
Abstract
Assessing the degree of involvement and participation in thoracic surgical research as well as surgical quality improvement conducted across Canadian institutions is difficult as no common data collection system and no prior studies exist. As a pilot investigation, we designed and conducted a membership survey of the Canadian Association of Thoracic Surgeons (CATS) to evaluate the extent of participation in research and quality improvement processes among thoracic surgeons.
A 45-item needs assessment survey was mailed to all national members of CATS (n = 86) in August 2009. Questions primarily focused on clinical research programs and research activity, research funding, database use and interest, and other methods of quality monitoring.
The 49 completed surveys represented a 57.0% response rate and 28 institutions across Canada. Research in basic and clinical science is conducted by 17.0% and 80.9% of the respondents, respectively. The annual budget of research funds is most commonly between $5000 and $50,000. A total of 72.0% (n = 18) of institutions do not have a formal surgery quality assessment program and 92.3% (n = 24) do not participate in a national or international thoracic surgery database. Ten institutions (38.6%) have a local thoracic surgery database for quality monitoring. Other systems of monitoring surgical quality include formal morbidity and mortality rounds (69.2%; n = 8 institutions), formal evaluation of surgical wait times (73.1%; n = 19 institutions), and patient satisfaction surveys (71.4%; n = 10 institutions). Overall, 97.8% of surgeons would be willing to share data on morbidity and mortality with other centers, and 73.1% have a high or very high level of interest in participating in a national thoracic surgery quality database.
A high level of interest and participation exists in thoracic surgery research. However, more robust quality improvement processes are needed for thoracic surgical oncology services. A national thoracic surgery quality improvement database offers a potential means to improve practice effectiveness, standardize surgical outcomes, and promote thoracic research across Canada.
PubMed ID
21708361 View in PubMed
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Can improved quality of care explain the success of orthogeriatric units? A population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature277031
Source
Age Ageing. 2016 Jan;45(1):66-71
Publication Type
Article
Date
Jan-2016
Author
Pia Kjær Kristensen
Theis Muncholm Thillemann
Kjeld Søballe
Søren Paaske Johnsen
Source
Age Ageing. 2016 Jan;45(1):66-71
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Delivery of Health Care, Integrated - organization & administration - standards
Denmark
Female
Fracture Fixation - adverse effects - mortality - standards
Geriatrics - organization & administration - standards
Hip Fractures - diagnosis - mortality - surgery
Humans
Length of Stay
Linear Models
Logistic Models
Male
Multivariate Analysis
Odds Ratio
Orthopedics - organization & administration - standards
Patient Admission
Process Assessment (Health Care) - organization & administration - standards
Prospective Studies
Quality Improvement - organization & administration - standards
Quality Indicators, Health Care - organization & administration - standards
Registries
Risk factors
Time Factors
Time-to-Treatment
Treatment Outcome
Abstract
admission to orthogeriatric units improves clinical outcomes for patients with hip fracture; however, little is known about the underlying mechanisms.
to compare quality of in-hospital care, 30-day mortality, time to surgery (TTS) and length of hospital stay (LOS) among patients with hip fracture admitted to orthogeriatric and ordinary orthopaedic units, respectively.
population-based cohort study.
using prospectively collected data from the Danish Multidisciplinary Hip Fracture Registry, we identified 11,461 patients aged =65 years admitted with a hip fracture between 1 March 2010 and 30 November 2011. The patients were divided into two groups: (i) those treated at an orthogeriatric unit, where the geriatrician is an integrated part of the multidisciplinary team, and (ii) those treated at an ordinary orthopaedic unit, where geriatric or medical consultant service are available on request. Outcome measures were the quality of care as reflected by six process performance measures, 30-day mortality, the TTS and the LOS. Data were analysed using log-binomial, linear and logistic regression controlling for potential confounders.
admittance to orthogeriatric units was associated with a higher chance for fulfilling five out of six process performance measures. Patients who were admitted to an orthogeriatric unit experienced a lower 30-day mortality (adjusted odds ratio (aOR) 0.69; 95% CI 0.54-0.88), whereas the LOS (adjusted relative time (aRT) of 1.18; 95% CI 0.92-1.52) and the TTS (aRT 1.06; 95% CI 0.89-1.26) were similar.
admittance to an orthogeriatric unit was associated with improved quality of care and lower 30-day mortality among patients with hip fracture.
PubMed ID
26582757 View in PubMed
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The challenges of making care safer: leadership and system transformation.

https://arctichealth.org/en/permalink/ahliterature121834
Source
Healthc Q. 2012;15 Spec No:8-11
Publication Type
Article
Date
2012

Challenges of standardized continuous quality improvement programs in community pharmacies: the case of SafetyNET-Rx.

https://arctichealth.org/en/permalink/ahliterature126130
Source
Res Social Adm Pharm. 2012 Nov-Dec;8(6):499-508
Publication Type
Article
Author
Todd A Boyle
Neil J MacKinnon
Thomas Mahaffey
Kellie Duggan
Natalie Dow
Author Affiliation
Gerald Schwartz School of Business, St. Francis Xavier University, Antigonish, NS, Canada. tboyle@stfx.ca
Source
Res Social Adm Pharm. 2012 Nov-Dec;8(6):499-508
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Community Pharmacy Services - organization & administration - standards
Guideline Adherence
Humans
Interviews as Topic
Learning
Medication Errors - prevention & control
Nova Scotia
Organizational Objectives
Patient Safety - standards
Pharmacists - organization & administration - psychology
Pharmacists' Aides - organization & administration - psychology
Practice Guidelines as Topic
Program Development
Program Evaluation
Qualitative Research
Quality Assurance, Health Care - organization & administration - standards
Quality Improvement - organization & administration - standards
Quality Indicators, Health Care - organization & administration - standards
Time Factors
Abstract
Research on continuous quality improvement (CQI) in community pharmacies lags in comparison to service, manufacturing, and various health care sectors. As a result, very little is known about the challenges community pharmacies face when implementing CQI programs in general, let alone the challenges of implementing a standardized and technologically sophisticated one.
This research identifies the initial challenges of implementing a standardized CQI program in community pharmacies and how such challenges were addressed by pharmacy staff.
Through qualitative interviews, a multisite study of the SafetyNET-Rx CQI program involving community pharmacies in Nova Scotia, Canada, was performed to identify such challenges. Interviews were conducted with the CQI facilitator (ie, staff pharmacist or technician) in 55 community pharmacies that adopted the SafetyNET-Rx program. Of these 55 pharmacies, 25 were part of large national corporate chains, 22 were part of banner chains, and 8 were independent pharmacies. A total of 10 different corporate chains and banners were represented among the 55 pharmacies. Thematic content analysis using well-established coding procedures was used to explore the interview data and elicit the key challenges faced.
Six major challenges were identified, specifically finding time to report, having all pharmacy staff involved in quality-related event (QRE) reporting, reporting apprehensiveness, changing staff relationships, meeting to discuss QREs, and accepting the online technology. Challenges were addressed in a number of ways including developing a manual-online hybrid reporting system, managers paying staff to meet after hours, and pharmacy managers showing visible commitment to QRE reporting and learning.
This research identifies key challenges to implementing CQI programs in community pharmacies and also provides a starting point for future research relating to how the challenges of QRE reporting and learning in community pharmacies change over time.
PubMed ID
22421196 View in PubMed
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93 records – page 1 of 10.