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Concepts of quality of care: national survey of five self-regulating health professions in Canada.

https://arctichealth.org/en/permalink/ahliterature103850
Source
Qual Assur Health Care. 1990;2(1):89-109
Publication Type
Article
Date
1990
Author
C. Fooks
M. Rachlis
C. Kushner
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Source
Qual Assur Health Care. 1990;2(1):89-109
Date
1990
Language
English
Publication Type
Article
Keywords
Canada
Clinical Medicine - standards
Data Collection
Dentistry - standards
Health Occupations - standards
Humans
Licensure
Medical Audit - statistics & numerical data
Nursing - standards
Optometry - standards
Organizations
Pharmacy - standards
Quality Assurance, Health Care - statistics & numerical data
Abstract
Discussions of quality assurance mechanisms for health professions are increasing in Canada. In their roles of protecting the public from incompetent or unsafe health care, and enhancing the quality of care provided by practitioners, provincial licensing organizations are taking an interest in quality assurance programmes. The paper reports the results from a national survey of five self-regulating health professions (dentistry, medicine, nursing, optometry and pharmacy) in Canada. The study found two types of activities in place--a complaints programme and a routine audit programme. Both programmes use a similar approach to identifying poor performers within a health profession. The paper discusses the results of the study, the advantages and disadvantages of the approach used, and suggests a second approach to quality assurance which could be used in conjunction with current activities.
PubMed ID
2103875 View in PubMed
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Discrepancies between the assessed urgency and the actual time taken to obtain a consultation with an internist.

https://arctichealth.org/en/permalink/ahliterature204936
Source
Scand J Prim Health Care. 1998 Jun;16(2):81-4
Publication Type
Article
Date
Jun-1998
Author
A T Vehviläinen
I J Vohlonen
E A Kumpusalo
J K Takala
Author Affiliation
Department of Community Health and General Practice, University of Kuopio, Finland.
Source
Scand J Prim Health Care. 1998 Jun;16(2):81-4
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Emergencies
Female
Finland
Humans
Internal Medicine - statistics & numerical data
Male
Outcome and Process Assessment (Health Care)
Patient Admission - statistics & numerical data
Quality Assurance, Health Care - statistics & numerical data
Referral and Consultation - statistics & numerical data
Retrospective Studies
Waiting Lists
Abstract
To compare postreferral waiting times to hospital in internal medicine with the urgency of the cases as assessed by a panel of doctors.
Retrospective evaluation of referrals to three hospitals during 1 week.
Referrals to internal medicine departments of Kuopio University Hospital, Kajaani central hospital and Pieksämäki regional hospital in Finland.
Two specialists in internal medicine working in university hospital and four specialists in general practice, two of whom were private sector general practitioners (GPs), the other two being public health centre chief physicians.
Postreferral waiting times, assessment of the urgency of the referral by a panel of doctors, and the reliability of this assessment.
Mean delay to specialist consultation was 36 days. There were no significant differences between the assessors in their opinions regarding the degree of urgency of referrals. Interobserver agreement between assessors was moderate or substantial (kappa values 0.46-0.62) and intraobserver agreement varied from moderate to almost perfect (kappa values were between 0.57 and 0.88). However, of those patients who were assessed to require examination by a consultant within 1 week only 34% actually saw the specialist within that time. Of those patients who were assessed to be require the treatments within 8-30 days, 48% were examined by a specialist within that time.
It is possible to reliably assess the urgency of referrals to internal medicine departments. There is a need to improve the referral process for those patients requiring consultation with a hospital specialist within 30 days.
PubMed ID
9689684 View in PubMed
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A simple on-line information system for quality assessment.

https://arctichealth.org/en/permalink/ahliterature25172
Source
Med Care. 1990 Jul;28(7):567-72
Publication Type
Article
Date
Jul-1990
Author
C W Janssen
A. Viste
E. Glück
Author Affiliation
Department of Surgery, University of Bergen, Norway.
Source
Med Care. 1990 Jul;28(7):567-72
Date
Jul-1990
Language
English
Publication Type
Article
Keywords
Aged
Data Interpretation, Statistical
Female
Hospital Information Systems
Humans
Length of Stay - statistics & numerical data
Male
Norway
Online Systems
Outcome and Process Assessment (Health Care) - methods
Postoperative Complications - epidemiology
Quality Assurance, Health Care - statistics & numerical data
Stomach Neoplasms - complications - surgery
Surgical Procedures, Operative - standards
Thrombophlebitis - epidemiology
Abstract
Many aspects of medicine would be well served by a simple method to assess the outcome of care in specified groups of patients. This study examined charts of patients with stomach cancer on a surgical service. Two digits were added to the ICD-9 number in the routine discharge data; one for the nature and severity of case and the other for the outcome of care. The digits were designed for on-line registration at discharge. Information was also obtained on resource consumption in the various groups of patients. Most of the variables had to be evaluated implicitly as there were no explicit judgement criteria and few empiric data available for comparison. Implicit evaluation of the results was significant and prompted steps for improving care. With current systems, the information obtained from traditional hospital statistics is limited and partly misleading. By slight modification, however, hospital statistics may provide valuable information for assessing quality of care and resource allocation during hospitalization.
PubMed ID
2366598 View in PubMed
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