International journal for quality in health care : journal of the International Society for Quality in Health Care
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Int J Qual Health Care · Apr 2009
ReviewUsing quality indicators to improve hospital care: a review of the literature.
To review the literature concerning strategies for implementing quality indicators in hospital care, and their effectiveness in improving the quality of care. ⋯ Effective strategies to implement quality indicators in daily practice in order to improve hospital care do exist, but there is considerable variation in the methods used and the level of change achieved. Feedback reports combined with another implementation strategy seem to be most effective.
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Int J Qual Health Care · Apr 2009
Comparative StudyComparison of US accredited and non-accredited rural critical access hospitals.
US critical access hospitals play an integral role in rural healthcare. Accreditation may be helpful in assuring that these hospitals provide high-quality care. ⋯ The results indicate that in the setting of critical access hospitals, external accreditation appears to result in modestly better performance.
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The purpose of this study was to determine risk factors of adverse events in five surgical procedures. ⋯ The results of this study suggest that five factors should be routinely monitored for patients undergoing these procedures: age >70 years, type of procedure, duration of operation >2 h, contaminated surgical site and anaemia.
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Int J Qual Health Care · Oct 2008
Interpreting process indicators in trauma care: construct validity versus confounding by indication.
Quality indicators (QIs) are routinely used in health systems, often on the assumption that they provide a valid reflection of the outcome of care. This study investigated the construct validity of 14 trauma QIs through their ability to identify patients at risk of poor outcomes, including increased mortality, longer lengths of stay and greater use of the intensive care unit (ICU). ⋯ The investigated QIs generally demonstrated poor construct validity and limited usefulness in predicting outcomes. Although QIs associated with poor patient outcomes may represent an avenue for further refinement, additional investigation of QIs in comparative trauma systems could provide insight into the utility of these measures at the system level.
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To assess quality of informed consent among patients undergoing procedures and patient's preferences about decision-making. ⋯ Most patients do not remember receiving explanations about risks or alternatives for procedures, and physicians resist attempts to improve informed consent. Tools should be developed to measure the quality of consent. Since patients significantly differ in their preferred mode of decision-making, the informed consent should be patient-specific.