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Aims and objectives To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers. Background In 2011, an ongoing project on a new model of family medicine practic...
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Aims and objectives To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers. Background In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians’ working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full‐time equivalents. This was an example of a personalised team approach to managing chronic patients. Methods We included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 ( N ?=?66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data. Results There were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty‐six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator “Examination of diabetic foot once per year” was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit. Conclusions Characteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients. Relevance to clinical practice The quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements.
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Patient-centered care is considered to be one of the essential pillars of a modern healthcare system. Thus, quality assessment based on patients' perceptions, views and experiences in their journey through the healthcare system is...
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Patient-centered care is considered to be one of the essential pillars of a modern healthcare system. Thus, quality assessment based on patients' perceptions, views and experiences in their journey through the healthcare system is recognized as one of the key principles for quality improvement initiatives. Measuring patient satisfaction can be confounded by expectations and prior experiences, which can be at least partly overcome by evaluating patient-perceived healthcare quality (PPHQ). Understanding the principal constituents of PPHQ may aid healthcare professionals and decision makers in the healthcare management process and help in creating instruments to meaningfully measure patient feedback. Herein, we aimed to analyze the primary determinants of PPHQ and their interactions, with a focus on patient experiences and healthcare accessibility, using the example of Lithuanian primary healthcare. For this purpose, we conducted a cross-sectional representative telephone survey that included a total of 1033 respondents (48% male) who had encountered primary healthcare during last 3 years. Survey questions consisted of sociodemographic characteristics, patient perceptions of healthcare service provision, patient experiences, self-reported health status and overall PPHQ ranked with a 5-point Likert scale as the primary outcome. The classification-regression tree (CRT) technique was used to analyze the relationship between different explanatory variables and PPHQ, as well as their relative importance and interactions. The majority of respondents (89%) evaluated PPHQ as acceptable or good. CRT analysis identified staff behavior, organizational accessibility and financial accessibility as the most important factors affecting PPHQ. Importantly, the latter factors surpassed the effect of other known PPHQ determinants, such as sociodemographic characteristics or health status. Further analysis has revealed that the relative importance of staff behavior, including understanding, attention and empathy, increased when more problems with organizational accessibility were encountered. In conclusion, our study suggests that PPHQ in primary healthcare may primarily be determined by organizational and financial accessibility and staff behavior, which may also act as an important mediating factor.
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Older people, people with disabilities and their carers will benefit from a $26 million allocation to expand and support Home and Community Care services in Queensland, the Australian Government Minister for Ageing, Christopher Py...
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Older people, people with disabilities and their carers will benefit from a $26 million allocation to expand and support Home and Community Care services in Queensland, the Australian Government Minister for Ageing, Christopher Pyne, and the Queensland Minister for Communities, Warren Pitt, said has announced. The funds will be used for program development and enhanced service delivery throughout the state. In particular, they will fund services that provide assistance to special-needs groups, such as people with continence management problems, people with dementia, people from culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islanders. "Home and Community Care is a central element of the Australian Government's vision for a world-class aged-care system that delivers high-quality, affordable and accessible care", Mr Pyne said.
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Quality indicators are vital for monitoring the transformation of institution-based mental health services towards the provision of person-centered mental healthcare. While several mental healthcare quality indicators have been id...
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Quality indicators are vital for monitoring the transformation of institution-based mental health services towards the provision of person-centered mental healthcare. While several mental healthcare quality indicators have been identified as relevant and valid, their actual usability and utility for routine monitoring healthcare quality over time is significantly determined by the availability and trustworthiness of the underlying data. In this feasibility study, quality indicators that have been systematically identified for use in the Danube region countries of Bulgaria, the Czech Republic, Hungary, and Serbia were measured on the basis of existing mental healthcare data in the four countries. Data were collected retrospectively by means of the best available, most standardized, trustworthy, and up-to-date data in each country. Out of 21 proposed quality indicators, 18 could be measured in Hungary, 17 could be measured in Bulgaria and in the Czech Republic, and 8 could be measured in Serbia. The results demonstrate that a majority of quality indicators can be measured in most of the countries by means of already existing data, thereby demonstrating the feasibility of quality measurement and regular quality monitoring. However, data availability and usability are scattered across countries and care sectors, which leads to variations in the quality of the quality indicators themselves. Making the planning and outputs of national mental healthcare reforms more transparent and evidence-based requires (trans-)national standardization of healthcare quality data, their routine availability and standardized assessment, and the regular reporting of quality indicators.
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The Sierra Leone government is considering a health care plan that would combine a national insurance scheme with totally free care for the neediest groups, including children and pregnant/lactating women.
"We will probably have ...
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The Sierra Leone government is considering a health care plan that would combine a national insurance scheme with totally free care for the neediest groups, including children and pregnant/lactating women.
"We will probably have a hybrid of both", Health Minister Soccoh Kabia said. "Sierra Leone has some of the highest infant, child and maternal mortality rates in the world. But Kabia said the most recent demographic survey shows progress on these fronts. "We have a ways to go but we are making progress. We will not rest until our [women] and children stop dying."
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The Gillard Government will introduce landmark legislation to secure better hospital services across Australia through fundamental reforms to the health system. For the first time, the Commonwealth Government will take majority fu...
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The Gillard Government will introduce landmark legislation to secure better hospital services across Australia through fundamental reforms to the health system. For the first time, the Commonwealth Government will take majority funding responsibility for public hospitals and full responsibility for primary care. This change in funding arrangements provides the foundation for major reform of Australia's health and hospitals system. Australia's health system has suffered from inadequate funding arrangements and unclear accountability for too long.
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Thousands of people have flooded Ghana's hospitals since a scheme to make affordable healthcare available for all was launched last year, but many patients are still going untreated because of administrative hiccups and overstretc...
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Thousands of people have flooded Ghana's hospitals since a scheme to make affordable healthcare available for all was launched last year, but many patients are still going untreated because of administrative hiccups and overstretched resources. Under the National Health Insurance Scheme (NHIS) launched in 2004 by the government of President John Kufuor, adults were supposed to receive unlimited treatment for an annual fee of 75,000 cedis (US$9). Children would be seen free of charge if both of their parents were registered.
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Variations in clinical outcomes, such as mortality rates and complications, between men and women have been reported in cardiovascular disease for many years. However, whether these are the result of divergent underlying biology, ...
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Variations in clinical outcomes, such as mortality rates and complications, between men and women have been reported in cardiovascular disease for many years. However, whether these are the result of divergent underlying biology, which we often refer to as a difference, or whether they are the consequence of inadequate or inappropriate treatment, which we would refer to as a disparity, remains unclear. Even the definitions of these 2 words are not universally agreed upon, and they are often used interchangeably. However, the distinction is important to inform the solutions clinical leaders and policymakers might put into place.
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A government initiative to share knowledge and improve quality and performance in the health sector is striking the right note with health experts just months after it was launched. Figures show 12,448 people made 23,127 visits to...
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A government initiative to share knowledge and improve quality and performance in the health sector is striking the right note with health experts just months after it was launched. Figures show 12,448 people made 23,127 visits to the website of the Health Improvement and Innovation Resource Centre (HIIRC) between 1 July and 31 December 2010. The website can be found at www.hiirc.org.nz "Those numbers are really encouraging for such a new site," says HIIRC spokesperson Gary Tonkin, a senior project manager in the Ministry of Health's Sector Capability and Implementation Directorate.
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Purpose - Healthcare providers differ in their readiness and maturity levels regarding quality and quality management systems applications. The purpose of this paper is to serve as a useful quantitative quality maturity-level asse...
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Purpose - Healthcare providers differ in their readiness and maturity levels regarding quality and quality management systems applications. The purpose of this paper is to serve as a useful quantitative quality maturity-level assessment tool for healthcare organizations. Design/methodology/approach - The model proposes five quality maturity levels (chaotic, primitive, structured, mature and proficient) based on six quality drivers: top management, people, operations, culture, quality focus and accreditation. Findings - Healthcare managers can apply the model to identify the status quo, quality shortcomings and evaluating ongoing progress. Practical implications - The model has been incorporated in an interactive Excel worksheet that visually displays the quality maturity-level risk meter. The tool has been applied successfully to local hospitals. Originality/value - The proposed six quality driver scales appear to measure healthcare provider maturity levels on a single quality meter.
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