Qual Saf Health Care
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Qual Saf Health Care · Dec 2007
Exploring users' experiences of accessing out-of-hours primary medical care services.
Since 2000, out-of-hours primary medical care services in the UK have undergone major changes in the organisation and delivery of services in response to recommendations by the Carson Review and more recently, through the new General Medical Services Contract (GMS2). People calling their general practice in the evening or at weekends are redirected to the out-of-hours service which may offer telephone advice, a home visit or a visit to a treatment centre. Little is known about users' experiences under the new arrangements. ⋯ Service users need clear information on how current out-of-hours services operate and how it should be used. Problems with triaging need to be addressed, users should be kept informed of any delays, and care needs to be taken to ensure that the new arrangements do not alienate older people or individuals with complex health needs.
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Qual Saf Health Care · Dec 2007
European Surveillance of Antimicrobial Consumption (ESAC): quality indicators for outpatient antibiotic use in Europe.
Indicators to measure the quality of healthcare are increasingly used by healthcare professionals and policy makers. In the context of increasing antimicrobial resistance, this study aimed to develop valid drug-specific quality indicators for outpatient antibiotic use in Europe, derived from European Surveillance of Antimicrobial Consumption (ESAC) data. ⋯ 12 of the proposed ESAC-based quality indicators for outpatient antibiotic use in Europe have face validity and are potentially applicable. These indicators could be used to better describe antibiotic use in ambulatory care and assess the quality of national antibiotic prescribing patterns in Europe.
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Qual Saf Health Care · Dec 2007
Randomized Controlled TrialImpact of short evidence summaries in discharge letters on adherence of practitioners to discharge medication. A cluster-randomised controlled trial.
International concern about quality of medical care has led to intensive study of interventions to ensure care is consistent with best evidence. Simple, inexpensive, feasible and effective interventions remain limited. ⋯ The one-sentence evidence summary is a simple, inexpensive, well-accepted intervention that may improve primary care practitioners' adherence to evidence-based consultant recommendations.
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Qual Saf Health Care · Dec 2007
Comparative StudyComparison of patients' assessments of the quality of stroke care with audit findings.
To determine the extent of correlation between stroke patients' experiences of hospital care with the quality of services assessed in a national audit. ⋯ Better organised stroke care is associated with more positive patient experiences. Examining areas of disparity between patients' and clinicians' reports is important for understanding the complex nature of healthcare and for identifying areas for quality improvement. Future evaluations of the quality of stroke services should include a validated patient experience survey in addition to audit of clinical records.
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Qual Saf Health Care · Oct 2007
Multicenter StudyIntensivist physician staffing and the process of care in academic medical centres.
Although intensivist physician staffing is associated with improved outcomes in critical care, little is known about the mechanism leading to this observation. ⋯ High intensity physician staffing is associated with increased use of evidence-based quality indicators in patients receiving mechanical ventilation.