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The 6 dimensions of promising practice for case managed supports to end homelessness: part 2: the 6 dimensions of quality.

https://arctichealth.org/en/permalink/ahliterature129049
Source
Prof Case Manag. 2012 Jan-Feb;17(1):4-12; quiz 13-4
Publication Type
Article
Author
Katrina Milaney
Author Affiliation
Calgary Homeless Foundation, Calgary, Alberta, Canada. kmilaney@calgaryhomeless.com
Source
Prof Case Manag. 2012 Jan-Feb;17(1):4-12; quiz 13-4
Language
English
Publication Type
Article
Keywords
Canada
Case Management - standards - statistics & numerical data
Cooperative Behavior
Delivery of Health Care - organization & administration - standards
Health Services Accessibility
Health services needs and demand
Homeless Persons - statistics & numerical data
Humans
Models, Theoretical
Patient care team
Patient-Centered Care - methods
Physician's Practice Patterns - standards - statistics & numerical data
Professional Competence
Quality of Health Care - standards - statistics & numerical data
Abstract
Homelessness is a social condition increasing in frequency and severity across Canada. Interventions to end and prevent homelessness include effective case management in addition to an affordable housing provision. Little standardization exists for service providers to guide their decision making in developing and maintaining effective case management programs. The purpose of this 2-part article is to articulate dimensions of promising practice for case managers working in a "Housing First" context. Part 1 discusses research processes and findings and Part 2 articulates the 6 dimensions of quality.
Practice settings include community-based organizations that employ and support case managers whose primary role is moving people from homelessness into permanent supportive housing.
Six dimensions of promising practice are critically important to reducing barriers, improving sector collaboration, and ensuring that case managers have appropriate and effective training and support. Dimensions of promising practice are (1) collaboration and cooperation-a true team approach; (2) right matching of services-person-centered; (3) contextual case management-culture and flexibility; (4) the right kind of engagement-relationships and advocacy; (5) coordinated and well-managed system-ethics and communication; and (6) evaluation for success-support and training.
Effective, coordinated case management, in addition to permanent affordable housing has the potential to reduce a person's or family's homelessness permanently. Organizations and professionals working in this context have the opportunity to improve processes, reduce burnout, collaborate and standardize, and, most importantly, efficiently and permanently end someone's homelessness with the help of dimensions of quality for case management.
PubMed ID
22146635 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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The accumulated challenges of long-term care.

https://arctichealth.org/en/permalink/ahliterature146298
Source
Health Aff (Millwood). 2010 Jan-Feb;29(1):29-34
Publication Type
Article
Author
David Barton Smith
Zhanlian Feng
Author Affiliation
Center for Health Equality, School of Public Health, at Drexel University, in Philadelphia, Pennsylvania, USA. david.b.smith@drexel.edu
Source
Health Aff (Millwood). 2010 Jan-Feb;29(1):29-34
Language
English
Publication Type
Article
Keywords
Chronic Disease
Cost Control - methods
Health Policy - trends
Health Services Accessibility - statistics & numerical data - trends
Health Services for the Aged
Health Services, Indigenous - economics - supply & distribution
Healthcare Disparities
Humans
Long-Term Care - methods - organization & administration - standards - trends
Medicaid
Organizational Objectives
Quality of Health Care - standards
United States
Abstract
During the past century, long-term care in the United States has evolved through five cycles of development, each lasting approximately twenty years. Each, focusing on distinct concerns, produced unintended consequences. Each also added a layer to an accumulation of contradictory approaches--a patchwork system now pushed to the breaking point by increasing needs and financial pressures. Future policies must achieve a better synthesis of approaches inherited from the past, while addressing their unintended consequences. Foremost must be assuring access to essential care, delivery of high-quality services in an increasingly deinstitutionalized system, and a reduction in social and economic disparities.
PubMed ID
20048357 View in PubMed
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Source
Scand J Gastroenterol. 2016 Nov;51(11):1326-31
Publication Type
Article
Date
Nov-2016
Author
Palle Bager
Mette Julsgaard
Thea Vestergaard
Lisbet Ambrosius Christensen
Jens Frederik Dahlerup
Source
Scand J Gastroenterol. 2016 Nov;51(11):1326-31
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Adult
Anti-Inflammatory Agents, Non-Steroidal - classification - therapeutic use
Decision Making
Denmark
Female
Humans
Inflammatory Bowel Diseases - drug therapy
Logistic Models
Male
Medication Adherence - statistics & numerical data
Middle Aged
Odds Ratio
Patient satisfaction
Quality of Health Care - standards
Risk factors
Surveys and Questionnaires
Tertiary Care Centers
Young Adult
Abstract
In inflammatory bowel disease (IBD), adherence to both medical treatment and other aspects of care has a substantial impact on the course of the disease. Most studies of medical adherence have reported that 30-45% of patients with IBD were non-adherent. Our study aimed to investigate the different aspects of adherence and to identify predictors of non-adherence, including the quality of care, for outpatients with IBD.
An anonymous electronic questionnaire was used to investigate different aspects of adherence, the quality of care, patient involvement and shared decision making among 377 IBD outpatients.
Three hundred (80%) filled in the questionnaire. The overall adherence rate was 93%. Young age (
PubMed ID
27311071 View in PubMed
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Adolescents' perception of the quality of orthodontic treatment.

https://arctichealth.org/en/permalink/ahliterature29729
Source
Scand J Caring Sci. 2005 Jun;19(2):95-101
Publication Type
Article
Date
Jun-2005
Author
Bodil Wilde Larsson
Kurt Bergström
Author Affiliation
Division for Health and Care, Karlstad University, Karlstad, Sweden. bodil.wilde@kau.se
Source
Scand J Caring Sci. 2005 Jun;19(2):95-101
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Psychology
Adult
Attitude to Health
Bias (epidemiology)
Child
Cross-Sectional Studies
Decision Making
Female
Health Care Surveys
Health services needs and demand
Humans
Male
Models, Psychological
Orthodontics - standards - statistics & numerical data
Outcome Assessment (Health Care)
Patient Compliance - psychology
Patient Participation - psychology
Quality of Health Care - standards
Questionnaires
Sweden
Total Quality Management - organization & administration
Urban health
Abstract
The aim was to describe quality of care from a patient perspective among adolescents receiving orthodontic treatment and to assess the relationship between quality of care and outcome-related aspects. The research design was cross-sectional. The sample consisted of 151 young people (mean age 17.1 years, SD: 2.2; 53% girls and 47% boys) receiving orthodontic treatment in the Stockholm region in Sweden (response rate 75%). Data were collected using the Quality from the Patient's Perspective questionnaire. The highest quality of care perceptions were noted on items dealing with receiving the best possible orthodontic treatment and being treated with respect. Less favourable perceptions of the quality of care were found regarding the opportunity to participate in the decisions related to the orthodontic treatment. In order to improve the quality of care a more active involvement of these patients in the decision-making process is suggested. The item 'I received the best possible orthodontic treatment' noted the highest subjective importance rating. The youngest participants reported the most favourable scores and the oldest the least. The majority (74%) reported that they were 'completely satisfied' with the result of the orthodontic treatment. However, 52% claimed that they had not followed all of the advice obtained during the treatment period, and 29% indicated some or more hesitation about attending the same dentist for future treatment.
PubMed ID
15877634 View in PubMed
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Analysis of the moral habitability of the nursing work environment.

https://arctichealth.org/en/permalink/ahliterature179129
Source
J Adv Nurs. 2004 Aug;47(4):356-64
Publication Type
Article
Date
Aug-2004
Author
Elizabeth H Peter
Amy V Macfarlane
Linda L O'Brien-Pallas
Author Affiliation
Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada. elizabeth.peter@utoronto.ca
Source
J Adv Nurs. 2004 Aug;47(4):356-64
Date
Aug-2004
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Ethics, Nursing
Feminism
Focus Groups
Humans
Interprofessional Relations
Morals
Professional Practice - ethics - standards
Quality of Health Care - standards
Workplace - organization & administration - standards
Abstract
Following health reform, nurses have experienced the tremendous stress of heavy workloads, long hours and difficult professional responsibilities. In recognition of these problems, a study was conducted that examined the impact of the working environment on the health of nurses. After conducting focus groups across Canada with nurses and others well acquainted with nursing issues, it became clear that the difficult work environments described had significant ethical implications.
The aim of this paper is to report the findings of research that examined the moral habitability of the nursing working environment.
A secondary analysis was conducted using the theoretical work of Margaret Urban Walker. Moral practices and responsibilities from Walker's perspective cannot be extricated from other social roles, practices and divisions of labour. Moral-social orders, such as work environments in this research, must be made transparent to examine their moral habitability. Morally habitable environments are those in which differently situated people experience their responsibilities as intelligible and coherent. They also foster recognition, cooperation and shared benefits.
Four overarching categories were developed through the analysis of the data: (1) oppressive work environments; (2) incoherent moral understandings; (3) moral suffering and (4) moral influence and resistance. The findings clearly indicate that participants perceived the work environment to be morally uninhabitable. The social and spatial positioning of nurses left them vulnerable to being overburdened by and unsure of their responsibilities. Nevertheless, nurses found meaningful ways to resist and to influence the moral environment.
We recommend that nurses develop strong moral identities, make visible the inseparability of their proximity to patients and moral accountability, and further identify what forms of collective action are most effective in improving the moral habitability of their work environments.
Notes
Comment In: J Adv Nurs. 2004 Aug;47(4):364-515271153
PubMed ID
15271152 View in PubMed
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[An analysis of the efficacy of orthodontic care for the population of Moscow based on data from an expert commission on quality].

https://arctichealth.org/en/permalink/ahliterature204471
Source
Stomatologiia (Mosk). 1998;77(4):63
Publication Type
Article
Date
1998

An exploration of the phenomenon of formal care from the perspective of middle-aged heart failure patients.

https://arctichealth.org/en/permalink/ahliterature81280
Source
Eur J Cardiovasc Nurs. 2007 Jun;6(2):121-9
Publication Type
Article
Date
Jun-2007
Author
Nordgren Lena
Asp Margareta
Fagerberg Ingegerd
Author Affiliation
Department of Caring and Public Health Sciences, Mälardalen University, 631 05 Eskilstuna, Sweden. lena.nordgren@mdh.se
Source
Eur J Cardiovasc Nurs. 2007 Jun;6(2):121-9
Date
Jun-2007
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Aged
Attitude to Health
Decision Making
Empathy
Female
Health services needs and demand
Heart Failure, Congestive - prevention & control - psychology
Humans
Male
Middle Aged
Morale
Narration
Nursing Methodology Research
Patient-Centered Care
Power (Psychology)
Professional Role - psychology
Professional-Patient Relations
Quality of Health Care - standards
Questionnaires
Self Concept
Severity of Illness Index
Social Support
Sweden
Abstract
BACKGROUND: Despite a considerable amount of research into heart failure there remains a divergence between the care available and patient's needs. The predominant biomedical perspective is more focused on the disease rather than the patient. In order to deliver formal care appropriate to the needs of middle-aged patients with moderate-severe HF it is imperative to gain the perspective of the individual patient. AIMS: The aim of the current study was to explore and understand the phenomenon: Formal care as experienced from the perspective of middle-aged patients living with HF. METHODS: The study was performed using a lifeworld perspective. Data was collected in seven unstructured interviews with middle-aged people living with moderate-severe HF. Data was analysed using a phenomenological approach. RESULTS: Formal care, as experienced by middle-aged patients living with moderate to severe HF, means hope to once again be able to have access to life. However, the meaning of formal care is ambiguous, which signifies that care means both health and suffering at the same time. The essence's meaning constituents are: dependency of care, surrender to care and unclear participation. CONCLUSION: The experience of formal care means both well-being and suffering at the same time. Patients' suffering in relation to formal care can be reduced if formal carers act from an ethical patient perspective point of view and if carers regard patients' lived experiences.
PubMed ID
16877043 View in PubMed
Less detail

An integrated system-wide strategy for quality improvement in cancer surgery.

https://arctichealth.org/en/permalink/ahliterature165790
Source
Br J Surg. 2007 Jan;94(1):3-5
Publication Type
Article
Date
Jan-2007
Author
B. Langer
H. Stern
Author Affiliation
Surgical Oncology Program, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario M5G 2L7, Canada. Bernard.langer@cancercare.on.ca
Source
Br J Surg. 2007 Jan;94(1):3-5
Date
Jan-2007
Language
English
Publication Type
Article
Keywords
Colorectal Neoplasms - surgery
Health Policy
Humans
Neoplasms - surgery
Ontario
Pancreatic Neoplasms - surgery
Practice Guidelines as Topic - standards
Quality of Health Care - standards
PubMed ID
17205507 View in PubMed
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An observational study: associations between nurse-reported hospital characteristics and estimated 30-day survival probabilities.

https://arctichealth.org/en/permalink/ahliterature274520
Source
BMJ Qual Saf. 2014 Sep;23(9):757-64
Publication Type
Article
Date
Sep-2014
Author
Christine Tvedt
Ingeborg Strømseng Sjetne
Jon Helgeland
Geir Bukholm
Source
BMJ Qual Saf. 2014 Sep;23(9):757-64
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Hospital Mortality
Hospitals - standards
Humans
Norway
Nursing Staff, Hospital
Patient Discharge - statistics & numerical data
Patient Safety - standards
Probability
Quality Assurance, Health Care - methods
Quality of Health Care - standards
Abstract
There is a growing body of evidence for associations between the work environment and patient outcomes. A good work environment may maximise healthcare workers' efforts to avoid failures and to facilitate quality care that is focused on patient safety. Several studies use nurse-reported quality measures, but it is uncertain whether these outcomes are correlated with clinical outcomes. The aim of this study was to determine the correlations between hospital-aggregated, nurse-assessed quality and safety, and estimated probabilities for 30-day survival in and out of hospital.
In a multicentre study involving almost all Norwegian hospitals with more than 85 beds (sample size=30, information about nurses' perceptions of organisational characteristics were collected. Subscales from this survey were used to describe properties of the organisations: quality system, patient safety management, nurse-physician relationship, staffing adequacy, quality of nursing and patient safety. The average scores for these organisational characteristics were aggregated to hospital level, and merged with estimated probabilities for 30-day survival in and out of hospital (survival probabilities) from a national database. In this observational, ecological study, the relationships between the organisational characteristics (independent variables) and clinical outcomes (survival probabilities) were examined.
Survival probabilities were correlated with nurse-assessed quality of nursing. Furthermore, the subjective perception of staffing adequacy was correlated with overall survival.
This study showed that perceived staffing adequacy and nurses' assessments of quality of nursing were correlated with survival probabilities. It is suggested that the way nurses characterise the microsystems they belong to, also reflects the general performance of hospitals.
Notes
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PubMed ID
24728887 View in PubMed
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218 records – page 1 of 22.