International journal of health care quality assurance
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Int J Health Care Qual Assur · Jan 2014
Clinical decision support system (CDSS)--effects on care quality.
Despite their efficacy, some recommended therapies are underused. The purpose of this paper is to describe clinical decision support system (CDSS) development and its impact on clinical guideline adherence. ⋯ This paper describes and evaluates an intervention that successfully increased guideline adherence, which improved healthcare quality when the intervention CICU was compared to the control group.
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Int J Health Care Qual Assur · Jan 2014
Differences in quality of life between pediatric sickle cell patients who used hydroxyurea and those who did not.
The purpose of this paper is to examine the differences in quality of life (QoL) between two groups of pediatric sickle cell patients: those who used hydroxyurea and those who chose not to use the medication to treat sickle cell disease. ⋯ This paper proved a need to study the differences in QoL between those pediatric patients who used hydroxyurea and those who did not use the medication.
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Int J Health Care Qual Assur · Jan 2014
European registry for quality improvement in cataract surgery.
A project aimed at creating a multi-national database for cataract and refractive surgery was initiated in 2008. The database was intended for learning and clinical improvement, not supervision. The project was co-funded by the European Union, under the Executive Agency for Health and Consumers and the European Society of Cataract and Refractive Surgeons (ESCRS) and supported by 11 national societies for cataract and refractive surgery. The purpose of this article is to describe the setup of the database and the ensuing achievements within cataract surgery after four years. ⋯ A European quality registry with data input from surgeons and clinics in 16 European countries has been established. Close to one million surgeries have been entered into the system during the first four years. Evidence-based guidelines have been published based on data in the registry. The system is used for benchmarking by both experienced surgeons and trainees.
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Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. ⋯ Healthcare managers are adopting business practices that improve efficiency and productivity while ensuring their healthcare mission and guaranteeing that customer values are achieved. Shared understanding about complex goals (e.g. reducing waste and enhancing customer value) at the front-end is crucial for implementing successful lean practices. In particular, this study shows that nursing practices, which are both labour intensive and technology enabled, are good candidates for lean practice.
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Int J Health Care Qual Assur · Jan 2014
Developing a hospital quality improvement initiative in Lesotho.
Hospital-based quality improvement (QI) programs are becoming increasingly common in developing countries as a sustainable method of strengthening health systems. The aim of this paper is to present the results and lessons learned from a QI program in a large, rural, district hospital in Lesotho, Southern Africa. ⋯ The design and early implementation of QI programs should focus on easily achievable, locally-relevant improvement projects. It was found that early successes helped to fuel further QI gains and the authors believe that the work building sustainable QI skill sets within hospital staff could be useful in the future when attempting to tackle larger national-level quality of care indicators. The findings add to the existing evidence suggesting that an increased use of locally-relevant quality improvement programming could help strengthen health care systems in low resource settings.