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Atri V, Bhatt MT, Chaudhuri S, Mitra A, Maddani SS, Ravindranath S. Family's Perceived Needs and Satisfaction with Intensive Care Services: A Questionnaire-based Prospective Observational Study. Indian J Crit Care Med 2024; 28:483-494. [PMID: 38738197 PMCID: PMC11080099 DOI: 10.5005/jp-journals-10071-24621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/01/2023] [Indexed: 05/14/2024] Open
Abstract
Background Holistic intensive care management involves the treatment of critically ill patients in the intensive care unit (ICU) as well as catering to family psychosocial needs helping in bettering satisfaction/perception of care. There is scarce data in the Indian intensive care setting regarding the same, especially in times of increasing end-of-life practices. Our study aimed to determine the factors impacting family perception/satisfaction with intensive care. Materials and methods A total of 336 family bystanders of patients in ICU with more than 72 hours of stay were surveyed using family satisfaction in the ICU 24 revised (FS-ICU 24R) questionnaire. Results Multivariable logistic regression analysis showed that the significant factors associated with the satisfaction among bystanders of ICU patients were the treatment of patient's physical symptoms like pain/breathlessness (Adjusted OR 3.73, p = 0.003), ICU staff's approach to family's need consideration (Adjusted OR 4.44, p < 0.001), concern and care towards patients' family (Adjusted OR 2.67, p = 0.023). Participation in patient care, ICU waiting room atmosphere, and emotional support are the other factors independently associated with satisfaction with ICU care. Family satisfaction was not associated with the patient's survival (p = 0.331, Chi-square test) or the length of ICU (p = 0.328, Chi-square test) and hospital stay (p = 0.865, Chi-square test). Conclusion Treatment of a patient's physical symptoms like pain, approach to family's needs consideration, and concern/care towards the patient's family are independent factors associated with optimal satisfaction among family members of ICU patients, which even takes precedence over the survival outcomes or length of ICU stay. How to cite this article Atri V, Bhatt MT, Chaudhuri S, Mitra A, Maddani SS, Ravindranath S. Family's Perceived Needs and Satisfaction with Intensive Care Services: A Questionnaire-based Prospective Observational Study. Indian J Crit Care Med 2024;28(5):483-494.
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Affiliation(s)
- Viha Atri
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Margiben Tusharbhai Bhatt
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Souvik Chaudhuri
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Aarohi Mitra
- Department of Community Medicine, B. J. Medical College, Ahmedabad, Gujarat, India
| | - Sagar Shanmukhappa Maddani
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Sunil Ravindranath
- Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
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Aggarwal K, Singh B, Banker H, Stoltzfus MT, Hong J, Anamika F, Nishkamni F, Munjal J, Jain R. Exploring the Ramifications of Delayed Hospital Discharges: Impacts on Patients, Physicians, and Healthcare Systems. Cureus 2024; 16:e61249. [PMID: 38939266 PMCID: PMC11210572 DOI: 10.7759/cureus.61249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/24/2024] [Indexed: 06/29/2024] Open
Abstract
Prolonged hospital stays can significantly impede patients' recovery, negatively affecting anything from physical health via issues like hospital-acquired infections and increased complications due to immobility to psychological health. Several studies investigated the psychosocial impact of prolonged hospital stays, revealing a variety of patient perspectives, such as feeling uncertain and frustrated about their conditions, which can erode their trust in healthcare providers. Delayed discharges not only affect patients but also have multifaceted effects on healthcare providers, potentially reducing physician efficiency and contributing to higher rates of burnout among healthcare professionals. This article investigates the consequences of delayed versus early discharge on physicians, patients, and the overall hospital system. We conducted an extensive search through PubMed and Google Scholar using the keywords "delayed discharge," "hospital discharge," and "bed blocking" to identify all the recent studies highlighting the dynamics of patient discharge. Our results support the hypothesis that reducing delayed discharge rates will not only improve patient outcomes but also have widespread fiscal impacts. This review also outlines measures to reduce delayed discharges, ultimately leading to a significant enhancement in the healthcare system.
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Affiliation(s)
- Kanishk Aggarwal
- Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Bhupinder Singh
- Internal Medicine, Government Medical College, Amritsar, IND
| | - Himanshi Banker
- Medicine and Surgery, Maulana Azad Medical College, Delhi, IND
| | - Mason T Stoltzfus
- Neurosurgery, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
| | - Jinpyo Hong
- Neurosurgery, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
| | - Fnu Anamika
- Internal Medicine, University College of Medical Sciences, Delhi, IND
| | - Fnu Nishkamni
- Internal Medicine, Government Medical College, Jammu, IND
| | - Jaskaran Munjal
- Internal Medicine, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, IND
| | - Rohit Jain
- Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
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Gashaw DG, Alemu ZA, Constanzo F, Belay FT, Tadesse YW, Muñoz C, Rojas JP, Alvarado-Livacic C. COVID-19 patient satisfaction and associated factors in telemedicine and hybrid system. Front Public Health 2024; 12:1384078. [PMID: 38645451 PMCID: PMC11028400 DOI: 10.3389/fpubh.2024.1384078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Background The quality assessment of the home-based isolation and care program (HBIC) relies heavily on patient satisfaction and length of stay. COVID-19 patients who were isolated and received HBIC were monitored through telephone consultations (TC), in-person TC visits, and a self-reporting application. By evaluating patient satisfaction and length of stay in HBIC, healthcare providers could gauge the effectiveness and efficiency of the HBIC program. Methods A cross-sectional study design enrolled 444 HBIC patients who answered a structured questionnaire. A binary logistic regression model assessed the association between independent variables and patient satisfaction. The length of stay in HBIC was analyzed using Cox regression analysis. The data collection started on April (1-30), 2022, in Addis Ababa, Ethiopia. Results The median age was 34, and 247 (55.6%) were females. A greater proportion (313, 70.5%) of the participants had high satisfaction. Higher frequency of calls (>3 calls) (AOR = 2.827, 95% CI = 1.798, 4.443, p = 0.000) and those who were symptomatic (AOR = 2.001, 95% CI = 1.289, 3.106, p = 0.002) were found to be significant factors for high user satisfaction. Higher frequency of calls (>3 calls) (AHR = 0.537, 95% CI = 0.415, 0.696, p = 0.000) and more in-person visits (>1 visit) (AHR = 0.495, 95% CI = 0.322, 0.762, p = 0.001) had greater chances to reduce the length of stay in the COVID-19 HBIC. Conclusion 70.5% of the participants had high satisfaction with the system, and frequent phone call follow-ups on patients' clinical status can significantly improve their satisfaction and length of recovery. An in-person visit is also an invaluable factor in a patient's recovery.
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Affiliation(s)
- Dagmawit G. Gashaw
- National Public Health Emergency Operation Center, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Freddy Constanzo
- Neurology Unit, Hospital Las Higueras, Talcahuano, Chile
- Medical Program in Adult Neurology, School of Medicine, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Feben T. Belay
- National Training Center, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Carla Muñoz
- Medical Program in Adult Neurology, School of Medicine, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Juan Pablo Rojas
- Medical Program in Adult Neurology, School of Medicine, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Cristobal Alvarado-Livacic
- Medical Program in Adult Neurology, School of Medicine, Universidad Católica de la Santísima Concepción, Concepción, Chile
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Morris EJ, Gray K, Gibbons PJ, Grayson J, Sullivan J, Amorim AB, Burns J, McKay MJ. Evaluating the Use of PROMs in Paediatric Orthopaedic Registries. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1552. [PMID: 37761513 PMCID: PMC10528097 DOI: 10.3390/children10091552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023]
Abstract
Patient-reported outcome measures (PROMs) provide structured information on the patient's health experience and facilitate shared clinical decision-making. Registries that collect PROMs generate essential information about the clinical course and efficacy of interventions. Whilst PROMs are increasingly being used in adult orthopaedic registries, their use in paediatric orthopaedic registries is not well known. The purpose of this systematic review was to identify the frequency and scope of registries that collect PROMs in paediatric orthopaedic patient groups. In July 2023, six databases were systematically searched to identify studies that collected PROMs using a registry amongst patients aged under 18 years with orthopaedic diagnoses. Of 3190 identified articles, 128 unique registries were identified. Three were exclusively paediatric, 27 were majority paediatric, and the remainder included a minority of paediatric patients. One hundred and twenty-eight registries collected 72 different PROMs, and 58% of these PROMs were not validated for a paediatric population. The largest group of orthopaedic registries collected PROMs on knee ligament injuries (21%). There are few reported dedicated orthopaedic registries collecting PROMs in paediatric populations. The majority of PROMs collected amongst paediatric populations by orthopaedic registries are not validated for patients under the age of 18 years. The use of non-validated PROMs by registries greatly impedes their utility and impact. Dedicated orthopaedic registries collecting paediatric-validated PROMs are needed to increase health knowledge, improve decision-making between patients and healthcare providers, and optimise orthopaedic management.
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Affiliation(s)
- Eleanor J. Morris
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
- Sydney Children’s Hospitals Network, The Children’s Hospital at Westmead, Sydney 2145, Australia;
| | - Kelly Gray
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia;
| | - Paul J. Gibbons
- Sydney Children’s Hospitals Network, The Children’s Hospital at Westmead, Sydney 2145, Australia;
| | - Jane Grayson
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
| | - Justin Sullivan
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
| | - Anita B. Amorim
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
| | - Joshua Burns
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
- Sydney Children’s Hospitals Network, Paediatric Gait Analysis Service of New South Wales, Sydney 2145, Australia
| | - Marnee J. McKay
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (E.J.M.); (J.G.); (J.S.); (A.B.A.); (M.J.M.)
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Roustaei Z, Sadeghi N, Azizi A, Eghbalian M, Karsidani SD. The effect of regular nursing rounds on patients' comfort and satisfaction, and violence against nurses in surgical ward. Heliyon 2023; 9:e17708. [PMID: 37539309 PMCID: PMC10395142 DOI: 10.1016/j.heliyon.2023.e17708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/09/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
Background Patients' satisfaction and comfort are known as the quality indicators of nursing care. Nowadays, violence against nurses has an increasing trend. Regular nursing rounds are one of the caring programs that help improve these indicators. This study aimed to examine the effect of regular nursing rounds on patients' comfort, satisfaction, and violence against nurses. Materials and methods This quasi-experimental study was conducted in two groups consisting of 100 patients and 35 nurses in a surgery ward in the northwest of Iran. The satisfaction with nursing care quality questionnaire, Kolcaba's general comfort questionnaire, and work environment violence were used for data collection. In the present study, the control and intervention groups were selected using a simple sampling method. The control group received routine care only; however, the intervention group received a regular nursing round program every 2 h from the second day of their admission for three days. The satisfaction questionnaire and comfort scale were completed on the second and fifth days of admission, and the evaluation of violence against nurses was performed from the second to the fourth day. The results were analyzed using chi-square, Fisher, independent t, and paired t tests. Results Before the intervention, no statistically significant difference was observed between the two groups in terms of demographic and dependent variables (p > 0/05). After the intervention, statistically significant differences were observed among the mean scores of satisfaction with nursing care (p < 0/001), comfort (p < 0.001), and violence against nurses (p = 0.041) between the two study groups, so that in the intervention group, the patients' satisfaction and comfort increased and violence against nurses reduced during the intervention period. Conclusions The use of regular nursing rounds had a positive effect on the study results. Therefore, it is recommended that nurse managers design, implement, encourage, and evaluate regular nursing rounds to improve nursing care.
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Affiliation(s)
- Zohre Roustaei
- Malayer Mehr Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Narges Sadeghi
- Student Research Committee, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azim Azizi
- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mostafa Eghbalian
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
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Temporal convolutional networks and data rebalancing for clinical length of stay and mortality prediction. Sci Rep 2022; 12:21247. [PMID: 36481828 PMCID: PMC9732283 DOI: 10.1038/s41598-022-25472-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
It is critical for hospitals to accurately predict patient length of stay (LOS) and mortality in real-time. We evaluate temporal convolutional networks (TCNs) and data rebalancing methods to predict LOS and mortality. This is a retrospective cohort study utilizing the MIMIC-III database. The MIMIC-Extract pipeline processes 24 hour time-series clinical objective data for 23,944 unique patient records. TCN performance is compared to both baseline and state-of-the-art machine learning models including logistic regression, random forest, gated recurrent unit with decay (GRU-D). Models are evaluated for binary classification tasks (LOS > 3 days, LOS > 7 days, mortality in-hospital, and mortality in-ICU) with and without data rebalancing and analyzed for clinical runtime feasibility. Data is split temporally, and evaluations utilize tenfold cross-validation (stratified splits) followed by simulated prospective hold-out validation. In mortality tasks, TCN outperforms baselines in 6 of 8 metrics (area under receiver operating characteristic, area under precision-recall curve (AUPRC), and F-1 measure for in-hospital mortality; AUPRC, accuracy, and F-1 for in-ICU mortality). In LOS tasks, TCN performs competitively to the GRU-D (best in 6 of 8) and the random forest model (best in 2 of 8). Rebalancing improves predictive power across multiple methods and outcome ratios. The TCN offers strong performance in mortality classification and offers improved computational efficiency on GPU-enabled systems over popular RNN architectures. Dataset rebalancing can improve model predictive power in imbalanced learning. We conclude that temporal convolutional networks should be included in model searches for critical care outcome prediction systems.
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Yusuf M, Kulsum K, Gianty JA. The Correlation between Pre-operative Leukocyte Levels and Length of Stay in Appendicitis Patients after an Appendectomy at Dr. Zainoel Abidin Hospital 2019–2020. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND: Appendicitis is an inflammation of the vermiform appendix. The infectious process and the inflammatory response are associated with increased leukocyte levels. Leukocyte levels can be used as the predictor of severity, treatment selection, and outcome of appendicitis patients that affect the length of hospitalization.
AIM: The aims of the study are to determine the correlation between pre-operative leukocyte levels and the length of stay in appendicitis patients after an appendectomy at Dr. Zainoel Abidin Hospital 2019–2020.
METHODS: The study was an observational analytic study with a cross-sectional design. The sampling technique used is total sampling. The data collected were sourced from medical records and obtained from 47 research subjects.
RESULTS: The results showed that both appendicitis patients with leukopenia (<5000 cells/mm3) and normal (5000–10,000 cells/mm3) consist of two subjects which required a short length of hospitalization (<5 days). In the patient with leukocytosis Grade I (≤18,000 cells/mm3), 23 subjects (92%) required a short length of hospitalization and 2 subjects (8%) required a long hospitalization (≥5 days). Meanwhile, patients with leukocytosis Grade II (>18,000 cells/mm3), 8 subjects (40%) required a short length of hospitalization, and 12 subjects (60%) required a long hospitalization . Based on the bivariate analysis using the Chi-square method, obtained p = 0.002 (p < 0.05).
CONCLUSION: There was a correlation between preoperative leukocyte levels and the length of stay in appendicitis patients after an appendectomy at dr. Zainoel Abidin Hospital.
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Wulandari ARC, Rachmawaty R, Ilkafah I, Erfina E. Patient satisfaction towards healthcare quality in Indonesian Public Hospital. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Puppala M, Ezeana CF, Alvarado MVY, Goode KN, Danforth RL, Wong SS, Vassallo ML, Wong ST. A multifaceted study of hospital variables and interventions to improve inpatient satisfaction in a multi-hospital system. Medicine (Baltimore) 2020; 99:e23669. [PMID: 33371105 PMCID: PMC7748194 DOI: 10.1097/md.0000000000023669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/09/2020] [Indexed: 11/27/2022] Open
Abstract
Knowing the areas of service, actions, and parameters that can influence patient perception about a service provided can help hospital executives and healthcare workers to devise improvement plans, leading to higher patient satisfaction. To identify inpatient satisfaction determinants, assess their relationships with hospital variables, and improve patient satisfaction through interventions. We studied the inpatient population of an eight-hospital tertiary medical center in 2015. The satisfaction determinants were based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey answers and included clinical and organizational variables. Interventions began at the end of 2016 included bedside care coordination rounds (BCCR), medications best practices alert (BPA), connect transitions post-discharge calls (CONNECT Transitions) and a framework for provider-patient interactions called AIDET (Acknowledge, Introduce, Duration, Explain, and Thank). Substantial impact upon patient satisfaction was observed after the introduction of these interventions. Three groups were identified: 1. high satisfaction, which correlated with race, surgery, and cancer care; 2. low satisfaction, correlated with elderly, emergency room, intensive care unit, chronic obstructive pulmonary disease, and vascular diseases; and 3. neutral, correlated with hospital-acquired complications, several diagnostic procedures, and medical care delay. Significant improvements in the 3 groups were achieved with interventions that optimize care provider interactions with patients and their families. Based on the HCAHPS-based analysis, we implemented new measures and programs for addressing coordination of care, improving patient safety, reducing the length of stay, and ultimately improving patient satisfaction.
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Affiliation(s)
| | | | | | | | | | - Solomon S.Y. Wong
- Department of Systems Medicine and Bioengineering
- Present address: Baylor University School of Law, Waco, TX
| | - Mark L. Vassallo
- Department of Quality Operations, Houston Methodist Hospital, Houston, Texas
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Bashir S, Nasir M. Tradeoff between efficiency and perceived quality: evidence from patient-level data. Int J Qual Health Care 2020; 32:591-598. [DOI: 10.1093/intqhc/mzaa098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/29/2020] [Accepted: 08/18/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
To estimate technical efficiency scores of District Headquarter Hospitals (DHQHs) for obstetric services and to explore the relationship between the efficiency of DHQHs and the patients’ satisfaction about the quality of services provided.
Design, Setting and Participants
Data from Health Facility Assessment (HFA) survey is used for efficiency measurement. The data on patient’s perceptions and other control variables are taken from Client Exit Interviews part of the HFA survey. Two-stage residual inclusion, Ordered Logistic Regression and Least square dummy variable techniques are used to investigate the relationship between technical efficiency and patients’ satisfaction level.
Main Outcome Measure(s) and Results
The average efficiency score for Pakistan’s DHQHs is 0.52, and not a single hospital is fully efficient. Moreover, the relationship between technical efficiency and patients’ satisfaction is found to be negative and statistically significant indicating that an increase in hospital efficiency tends to decrease patients’ satisfaction. The disaggregated analysis reveals that patients’ satisfaction associated with the healthcare provider attitude and communication is more affected by technical efficiency.
Conclusion
Patients’ satisfaction level is more sensitive to physician’s attitude and communication. This makes sense because the longer the consultation time, the more accurate the diagnosis would be. This, together with a comforting and confident physician, is likely to achieve better patients’ satisfaction.
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Affiliation(s)
- Saima Bashir
- Pakistan Institute of Development Economics Quaid-i-Azam University Campus, Islamabad 44000, Pakistan
| | - Muhammad Nasir
- Pakistan Institute of Development Economics Quaid-i-Azam University Campus, Islamabad 44000, Pakistan
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Affiliation(s)
- John A Martin
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA.
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Kheiry F, Kargarian-Marvasti S, Afrashteh S, Mohammadbeigi A, Daneshi N, Naderi S, Saadat SH. Evaluation of goodness of fit of semiparametric and parametric models in analysis of factors associated with length of stay in neonatal intensive care unit. Clin Exp Pediatr 2020; 63:361-367. [PMID: 32517423 PMCID: PMC7462822 DOI: 10.3345/cep.2019.00437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 01/31/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors. PURPOSE The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018. METHODS This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05. RESULTS The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P<0.05). Parametric models showed better fitness than the Cox model in this study. CONCLUSION Breastfeeding and availability of central venous catheter had protective effects against length of stay, whereas phototherapy, acute renal failure, and mechanical ventilation increased length of stay in NICU. Therefore, the identification of factors associated with NICU length of stay can help establish effective interventions aimed at decreasing the length of stay among infants.
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Affiliation(s)
- Fatemeh Kheiry
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Sima Afrashteh
- Department of Public Health, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Abolfazl Mohammadbeigi
- Department of Epidemiology and Biostatistics, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Nima Daneshi
- Behbahan Faculty of Medical Sciences, Behbahan, Iran
| | - Salma Naderi
- Department of Pediatrics, Faculty of Medicine, Clinical Research Development Centre of Children Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Seyed Hossein Saadat
- Faculty of Medicine, Clinical Research Development Center of Children's Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Medina Victoria DA, Laverde LA, Alviz Conde LK, Galvis JC. Prevalencia de dinapenia (disminución de la fuerza), sarcopenia y posibles biomarcadores en rehabilitación cardíaca. REPERTORIO DE MEDICINA Y CIRUGÍA 2020. [DOI: 10.31260/repertmedcir.01217372.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introducción: la relación entre dinapenia y sarcopenia da como resultado un aumento adicional en el riesgo de morbimortalidad en la población general, con un incremento progresivo de acuerdo con la edad. A partir de los 30 años debido a la disminución de la masa muscular y de la fuerza, se afecta la capacidad de ejercicio, la calidad de vida y el estado de ánimo. Objetivo: determinar la prevalencia de dinapenia y sarcopenia en los pacientes en rehabilitación cardíaca de un hospital colombiano, con mediciones de la fuerza y de los marcadores bioquímicos. Métodos: estudio de corte transversal en mayores de 40 años en rehabilitación cardíaca con controles al menos una vez por semana. La medición de la fuerza se realizó con dinamómetro de mano, la masa muscular con impedanciómetro bipolar y velocidad de la marcha con la prueba de caminata de 6 metros. Se tomaron mediciones de hormona de crecimiento (GH), testosterona libre, somatomedina IGF-1 y cortisol. Resultados: la disminución de la fuerza muscular fue prevalente en hombres (n=15, 19.4%; mujeres n=5, 10%). La prevalencia de dinapenia fue 15,7% y sarcopenia 0%. Los resultados obtenidos fueron GH 0.27 (0.08-1.18), testosterona 5.9 (0.3-8.5), IGF-1 126 (95.5-169) cortisol 13.9 (11.2-18.4). Las patologías más frecuentes de los pacientes del programa fueron infarto del miocardio, angioplastia e implantación de stent. Conclusiones: la prevalencia de dinapenia fue 15.7%. No se encontró diferencia alguna de los marcadores bioquímicos en los pacientes con y sin dinapenia.
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Smith GA, Chirieleison S, Levin J, Atli K, Winkelman R, Tanenbaum JE, Mroz T, Steinmetz M. Impact of length of stay on HCAHPS scores following lumbar spine surgery. J Neurosurg Spine 2020; 31:366-371. [PMID: 31151093 DOI: 10.3171/2019.3.spine181180] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/08/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys, completed by patients following an inpatient stay, are utilized to assess patient satisfaction and quality of the patient experience. HCAHPS results directly impact hospital and provider reimbursements. While recent work has demonstrated that pre- and postoperative factors can affect HCAHPS results following lumbar spine surgery, little is known about how these results are influenced by hospital length of stay (LOS). Here, the authors examined HCAHPS results in patients with LOSs greater or less than expected following lumbar spine surgery to determine whether LOS influences survey scores after these procedures. METHODS The authors conducted a retrospective review of HCAHPS surveys, patient demographics, and outcomes following lumbar spine surgery at a single institution. A total of 391 patients who had undergone lumbar spine surgery and had completed an HCAHPS survey in the period between 2013 and 2015 were included in this analysis. Patients were divided into those with a hospital LOS equal to or less than the expected (LTE-LOS) and those with a hospital LOS longer than expected (GTE-LOS). Expected LOS was based on the University HealthSystem Consortium benchmarks. Nineteen questions from the HCAHPS survey were examined in relation to patient LOS. The primary outcome measure was a comparison of "top-box" ("9-10" or "always or usually") versus "low-box" ("1-8" and "somewhat or never") scores on the HCAHPS questions. Secondary outcomes of interest were whether the comorbid conditions of cancer, chronic renal failure, diabetes, coronary artery disease, hypertension, stroke, or depression occurred differently with respect to LOS. Statistical analysis was performed using Fisher's exact test for the 2 × 2 contingency tables and the chi-square test for categorical variables. RESULTS Two hundred fifty-seven patients had an LTE-LOS, whereas 134 patients had a GTE-LOS. The only statistically significant difference in preoperative characteristics between the patient groups was hypertension, which correlated to a shorter LOS. A GTE-LOS was associated with a decreased likelihood of a top-box score for the HCAHPS survey items on doctor listening and pain control. CONCLUSIONS Here, the authors report a decreased likelihood of top-box responses for some HCAHPS questions following lumbar spine surgery if LOS is prolonged. This study highlights the need to further examine the factors impacting LOS, identify patients at risk for long hospital stays, and improve mechanisms to increase the quality and efficiency of care delivered to this patient population.
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Affiliation(s)
| | | | - Jay Levin
- 2Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Karam Atli
- 2Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Robert Winkelman
- 2Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - Thomas Mroz
- 1Center for Spine Health, Cleveland Clinic Foundation; and
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Bergmann K, Kugler J, Klewer J, Schoenfelder T. Predictors of patient satisfaction after cardiac pacemaker implantation or ICD implantation. J Card Surg 2020; 35:140-145. [DOI: 10.1111/jocs.14333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Katharina Bergmann
- Department of Health Sciences/Public Health, Dresden Medical School Technische Universität Dresden Dresden Germany
| | - Joachim Kugler
- Department of Health Sciences/Public Health, Dresden Medical School Technische Universität Dresden Dresden Germany
| | - Joerg Klewer
- Department of Public Health and Health Care Management University of Applied Sciences Zwickau Zwickau Germany
| | - Tonio Schoenfelder
- Department of Health Sciences/Public Health, Dresden Medical School Technische Universität Dresden Dresden Germany
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16
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Hopkins BS, Patel MR, Yamaguchi JT, Cloney MB, Dahdaleh NS. Predictors of patient satisfaction and survey participation after spine surgery: a retrospective review of 17,853 consecutive spinal patients from a single academic institution. Part 1: Press Ganey. J Neurosurg Spine 2019; 30:382-388. [PMID: 30611140 DOI: 10.3171/2018.8.spine18594] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/29/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVEPress Ganey surveys are common modalities used to assess patient satisfaction scores in an outpatient setting. Despite the existence of data, neurosurgical and orthopedic literature on patient satisfaction following spinal surgery is scarce.METHODSA total of 17,853 patients who underwent spinal procedures at the authors' institution were analyzed retrospectively for Press Ganey survey participation. Appropriate demographic, surgical, comorbidity, and complication data were collected; 1936 patients had patient satisfaction survey data, and further survey metrics were collected for this subset of patients.RESULTSMale patients, patients with urgent/emergency procedures, and patients with longer length of stay (LOS) were less likely to fill out Press Ganey surveys (OR 0.822, p < 0.001; OR 0.781, p = 0.010; and OR 0.983, p < 0.001, respectively). Posterior approach was negatively associated with Press Ganey participation (OR 0.907, p = 0.055). Patients undergoing fusion procedures were more likely to participate in Press Ganey surveys (OR 1.419, p < 0.001). Of the patients who filled out surveys, there were no positive predictors associated with receiving perfect scores on Press Ganey surveys. High Charlson Comorbidity Index (OR 0.959, p = 0.02), increasing elapsed time since surgery or discharge (OR 0.996, p = 0.03), and increasing LOS (OR 0.965, p = 0.009) were all negatively associated with receiving a perfect score. Patients who underwent a posterior-approach procedure compared with other approaches were less likely to report a low Press Ganey score (OR 0.297, p = 0.046). Patient sex and race did not influence the likelihood of receiving perfect or low Press Ganey scores. Finally, the perceived skill of the surgeon was not a significant predictor for perfect (p > 0.99) or low (p = 0.828) Press Ganey scores.CONCLUSIONSPatient participation in Press Ganey surveys strongly correlated with preoperative factors such as procedure approach and type, as well as postoperative factors such as LOS and complications. No factors were associated with an increased likelihood of receiving a perfect Press Ganey score. Similarly, LOS and time elapsed since surgery to survey completion were significant negative predictors of perfect Press Ganey scores. Skill of surgeon, sex, and race did not correlate with a predictive value for Press Ganey outcomes. In addition, overall comorbid disease burden was found to be a significant negative predictor for high patient satisfaction scores. Further study on predictors of patient satisfaction within spine surgery is needed to better assist physicians in improving the surgical experience for patients.
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Hopkins BS, Patel MR, Yamaguchi JT, Cloney MB, Dahdaleh NS. Predictors of patient satisfaction and survey participation after spine surgery: a retrospective review of 17,853 consecutive spinal patients from a single academic institution. Part 2: HCAHPS. J Neurosurg Spine 2019; 30:389-396. [PMID: 30611139 DOI: 10.3171/2018.8.spine181024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 08/27/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVEPatient satisfaction is a new and important metric in the American healthcare system. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a common modality used to assess patient satisfaction in inpatient settings. Despite the existence of data, neurosurgical literature on patient satisfaction following spinal surgery is scarce.METHODSA total of 17,853 patients who underwent spinal procedures at the authors' institution were analyzed retrospectively for HCAHPS survey participation. Appropriate demographic, surgical, comorbidity, and complication data were collected; 1118 patients had patient satisfaction survey data, and further survey metrics were collected for this subset of patients.RESULTSMale patients, patients with urgent/emergency procedures, and patients with a longer length of stay were less likely to complete an HCAHPS survey (OR 0.820, p < 0.001; OR 0.818, p = 0.042; and OR 0.983, p < 0.001, respectively). Posterior approach was negatively associated with HCAHPS survey participation (OR 0.868, p = 0.007). Patients undergoing fusion procedures were more likely to participate in HCAHPS surveys (OR 1.440, p < 0.001). Of the completed HCAHPS surveys, there were no positive predictors associated with perfect scores. High Charlson Comorbidity Index (OR 0.931, p = 0.007), increasing elapsed time since surgery or discharge (OR 0.992, p = 0.004), and increasing length of stay (OR 0.928, p < 0.001) were all negatively associated with a perfect score. Finally, patient sex and race did not influence the likelihood of a perfect or low survey score.CONCLUSIONSParticipation in HCAHPS surveys was correlated with preoperative and postoperative factors. Among these, procedure approach and type, length of stay, and complications seemed to influence participation the most. No factors were associated with an increased likelihood of receiving a perfect score. Similarly, length of stay and time elapsed since surgery to survey completion were significant negative predictors of receiving perfect HCAHPS survey scores. Increasing comorbid burden was also found to be a negative predictor for high scores. Further study on predictors of inpatient satisfaction within spine surgery is needed.
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18
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van der Plas AGM, Oosterveld-Vlug MG, Pasman HR, Schweitzer B, Onwuteaka-Philipsen BD. Continuity of GP care after the last hospitalization for patients who died from cancer, chronic obstructive pulmonary disease or heart failure: a retrospective cohort study using administrative data. Fam Pract 2019; 36:304-309. [PMID: 29982542 DOI: 10.1093/fampra/cmy065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Discharge from hospital to home can be a stressful experience for patients and carers. Contact with the GP is important to ensure continuity of care. OBJECTIVES To investigate timing of contact with the GP and locum after the last hospitalization in the last year of life and to investigate patient and care characteristics related to contact with the GP within 2 days after discharge. METHODS Health insurance data were combined with data from Statistics Netherlands on patients who mainly received care at home in the last 4 months of life. Patients who died from cancer (n = 3014), chronic obstructive pulmonary disease (COPD, n = 195) or heart failure (n = 171) were compared. RESULTS First contact after hospital discharge was within 2 days for 51.7% of patients and within a week for 77.8% of patients. Patients who died from COPD or heart failure had contact less often than patients with cancer. Characteristics related to having contact within 2 days after discharge were older age, cause of death cancer, home death, timing of last hospitalization closer to death and contact with a locum in the week after discharge. CONCLUSION Results may indicate that the GP is likely to visit patients with more care needs sooner. This would be in accordance with the finding that contact with the GP was more likely after a hospitalization closer to death and that contact within 2 days was related to contact with a locum within a week after discharge. Proactive care is necessary. This is a joint responsibility of GPs and medical specialists.
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Affiliation(s)
- Annicka G M van der Plas
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands.,Center for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Mariska G Oosterveld-Vlug
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands.,Center for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - H Roeline Pasman
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands.,Center for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Bart Schweitzer
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands.,Center for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands.,Center for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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Sillero Sillero A, Zabalegui A. Satisfaction of surgical patients with perioperative nursing care in a Spanish tertiary care hospital. SAGE Open Med 2018; 6:2050312118818304. [PMID: 30574305 PMCID: PMC6295759 DOI: 10.1177/2050312118818304] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 11/19/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Although numerous studies have assessed patient satisfaction in diverse settings, in the realm of nursing surgical care, standardization of measurement for patient experience and satisfaction is lacking. Therefore, the aim of this study was to assess the satisfaction of surgical patients with perioperative nursing care. METHOD A descriptive cross-sectional survey was conducted. Sociodemographic characteristics and clinical data were recorded. Patient satisfaction was measured with a modified version of the La Monica-Oberst Patient Satisfaction Scale (LOPSS-12). RESULTS 150 patients (73 women, 49% and 77 men; 51%) completed the survey. The mean age was 63 years (standard deviation, 16 years). The mean overall satisfaction score on the La Monica-Oberst Patient Satisfaction Scale was 3.17 (standard deviation, 0.21). The scale showed adequate content validity (Lawshe's Content Validity Index was 0.76) and moderate reliability (Cronbach's alpha = 0.70). Two variables-patient sex and the presence of comorbidities-were significantly associated with overall satisfaction: men and patients with comorbidities were more satisfied with the care received. Patients with university studies were significantly more likely than patients with less education to consider nurses "impatient," but also considered the nurses' advice to be "useful." Patients with hospital-acquired complications were more likely to perceive nurses to be "more interested in completing tasks than in listening," although they also felt that nurses worked "conscientiously." CONCLUSION Overall, patient satisfaction with perioperative nursing care was good. This study identified several areas of nursing care in need of improvement, particularly the need to spend more time with patients and to keep them better informed about the perioperative process. The modified La Monica-Oberst Patient Satisfaction Scale is suitable for measuring surgical patient satisfaction with perioperative nursing care. The findings presented here may be of value to nursing administrators, educators, and nursing care providers to improve patient satisfaction and to develop strategies to prevent patient dissatisfaction.
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Affiliation(s)
| | - Adelaida Zabalegui
- Department of Nursing Research and Education, Hospital Clinic of Barcelona, Barcelona, Spain
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20
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Improta G, Balato G, Romano M, Ponsiglione AM, Raiola E, Russo MA, Cuccaro P, Santillo LC, Cesarelli M. Improving performances of the knee replacement surgery process by applying DMAIC principles. J Eval Clin Pract 2017; 23:1401-1407. [PMID: 28948662 PMCID: PMC6585639 DOI: 10.1111/jep.12810] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 07/13/2017] [Indexed: 12/21/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The work is a part of a project about the application of the Lean Six Sigma to improve health care processes. A previously published work regarding the hip replacement surgery has shown promising results. Here, we propose an application of the DMAIC (Define, Measure, Analyse, Improve, and Control) cycle to improve quality and reduce costs related to the prosthetic knee replacement surgery by decreasing patients' length of hospital stay (LOS) METHODS: The DMAIC cycle has been adopted to decrease the patients' LOS. The University Hospital "Federico II" of Naples, one of the most important university hospitals in Southern Italy, participated in this study. Data on 148 patients who underwent prosthetic knee replacement between 2010 and 2013 were used. Process mapping, statistical measures, brainstorming activities, and comparative analysis were performed to identify factors influencing LOS and improvement strategies. RESULTS The study allowed the identification of variables influencing the prolongation of the LOS and the implementation of corrective actions to improve the process of care. The adopted actions reduced the LOS by 42%, from a mean value of 14.2 to 8.3 days (standard deviation also decreased from 5.2 to 2.3 days). CONCLUSIONS The DMAIC approach has proven to be a helpful strategy ensuring a significant decreasing of the LOS. Furthermore, through its implementation, a significant reduction of the average costs of hospital stay can be achieved. Such a versatile approach could be applied to improve a wide range of health care processes.
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Affiliation(s)
- Giovanni Improta
- Department of Chemical Engineering, Materials and Industrial Production, University of Naples "Federico II", Naples, Italy
| | - Giovanni Balato
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Maria Romano
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,S. Maugeri' Foundation, Scientific Institute of Telese Terme (BN), IRCCS Telese, Terme, Italy
| | | | - Eliana Raiola
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | | | | | - Liberatina Carmela Santillo
- Department of Chemical Engineering, Materials and Industrial Production, University of Naples "Federico II", Naples, Italy
| | - Mario Cesarelli
- S. Maugeri' Foundation, Scientific Institute of Telese Terme (BN), IRCCS Telese, Terme, Italy.,Department of Electrical and Information Technology Engineering, University of Naples "Federico II", Naples, Italy
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21
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Alaloul F, Williams K, Myers J, Jones KD, Sullivan K, Logsdon MC. Contextual Factors Impacting a Pain Management Intervention. J Nurs Scholarsh 2017; 49:504-512. [DOI: 10.1111/jnu.12319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Fawwaz Alaloul
- Iota Zeta, Assistant Professor, School of Nursing; Health Sciences Campus; K-Wing Louisville KY USA
| | - Kimberly Williams
- Acute Pain Service Charge Nurse; University of Louisville Hospital; Louisville KY USA
| | - John Myers
- Associate Professor, Department of Pediatrics; School of Medicine, Health Sciences Campus; Louisville KY USA
| | | | - Katelyn Sullivan
- Student, School of Nursing; Health Sciences Campus; Louisville KY USA
| | - M. Cynthia Logsdon
- Alpha and Iota Gamma, Professor, School of Nursing, University of Louisville; Associate Chief of Nursing for Research, University of Louisville Hospital; James Graham Brown Cancer Center; Louisville KY USA
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22
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Gómez de Terreros Guardiola M, Lozano Oyola JF, Avilés Carvajal I, Martínez Cervantes RJ. [Development and pilot study of a questionnaire to assess child and teenager satisfaction with their stay in hospital]. GACETA SANITARIA 2016; 31:492-498. [PMID: 27914749 DOI: 10.1016/j.gaceta.2016.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/16/2016] [Accepted: 09/19/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To develop an instrument to assess the satisfaction of children and teenagers with their stay in hospital. METHODS A qualitative analysis of hospitalisation satisfaction dimensions based on the feedback of hospitalised children and teenagers; a content validation study by a group of experts of the items generated for the different satisfaction dimensions; and a pilot study to assess the usefulness of the questionnaire with a sample of 84 children and teenagers hospitalised in Andalusia. RESULTS After successive refinements, a short questionnaire was obtained which took between 5 and 15minutes to complete. All items presented positive item-total correlations (r>0.18). The questionnaire showed an internal consistency index of 0.779 (Cronbach's alpha) and significant rank differences (Mann-Whitney U test; p<0.001) with medium size effects (η2>0.151) in three satisfaction dimensions compared between hospitals. DISCUSSION A short, easy-to-answer questionnaire was developed that is reliable regarding its internal consistency and sensitive to differences in hospital satisfaction dimensions. Once validated, it will be used to assess the satisfaction of children and teenagers with their hospital stay, in addition to being a potential indicator of quality of care.
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Affiliation(s)
| | - José Francisco Lozano Oyola
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Facultad de Psicología, Universidad de Sevilla, Sevilla, España
| | - Isabel Avilés Carvajal
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Facultad de Psicología, Universidad de Sevilla, Sevilla, España.
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Batbaatar E, Dorjdagva J, Luvsannyam A, Savino MM, Amenta P. Determinants of patient satisfaction: a systematic review. Perspect Public Health 2016; 137:89-101. [PMID: 27004489 DOI: 10.1177/1757913916634136] [Citation(s) in RCA: 356] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM A large number of studies have addressed the detection of patient satisfaction determinants, and the results are still inconclusive. Furthermore, it is known that contradicting evidence exists across patient satisfaction studies. This article is the second part of a two-part series of research with a goal to review a current conceptual framework of patient satisfaction for further operationalisation procedures. The aim of this work was to systematically identify and review evidence regarding determinants of patient satisfaction between 1980 and 2014, and to seek the reasons for contradicting results in relationships between determinants and patient satisfaction in the literature to design a further robust measurement system for patient satisfaction. METHOD This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search was conducted in PubMed, CINAHL, and Scopus in October 2014. Studies published in full in peer reviewed journals between January 1980 and August 2014 and in the English language were included. We included 109 articles for the synthesis. RESULTS We found several number of determinants of patient satisfaction investigated in a wide diversity of studies. However, study results were varied due to no globally accepted formulation of patient satisfaction and measurement system. CONCLUSIONS Health care service quality indicators were the most influential determinants of patient satisfaction across the studies. Among them, health providers' interpersonal care quality was the essential determinant of patient satisfaction. Sociodemographic characteristics were the most varied in the review. The strength and directions of associations with patient satisfaction were found inconsistent. Therefore, person-related characteristics should be considered to be the potential determinants and confounders simultaneously. The selected studies were not able to show all potential characteristics which may have had effects on satisfaction. There is a need for more studies on how cultural, behavioural, and socio-demographic differences affect patient satisfaction, using a standardised questionnaire.
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Affiliation(s)
- Enkhjargal Batbaatar
- Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; Faculty of Economy and Business Sciences, University of Sannio, Benevento, Italy
| | - Javkhlanbayar Dorjdagva
- Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; The Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Ariunbat Luvsannyam
- Department of Business Management, Ulaanbaatar University, Ulaanbaatar, Mongolia
| | | | - Pietro Amenta
- Faculty of Economy and Business Sciences, University of Sannio, Benevento, Italy
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24
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Slater JK, Braverman MT, Meath T. Patient satisfaction with a hospital’s arts-enhanced environment as a predictor of the likelihood of recommending the hospital. Arts Health 2016. [DOI: 10.1080/17533015.2016.1185448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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25
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Shirk JD, Tan HJ, Hu JC, Saigal CS, Litwin MS. Patient experience and quality of urologic cancer surgery in US hospitals. Cancer 2016; 122:2571-8. [DOI: 10.1002/cncr.30081] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/30/2015] [Accepted: 01/04/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Joseph D. Shirk
- Department of Urology, David Geffen School of Medicine; University of California at Los Angeles; Los Angeles California
| | - Hung-Jui Tan
- Department of Urology, David Geffen School of Medicine; University of California at Los Angeles; Los Angeles California
- VA/University of California at Los Angeles Robert Wood Johnson Clinical Scholars Program; Los Angeles California
| | - Jim C. Hu
- Department of Urology; Weill Cornell School of Medicine; New York New York
| | - Christopher S. Saigal
- Department of Urology, David Geffen School of Medicine; University of California at Los Angeles; Los Angeles California
| | - Mark S. Litwin
- Department of Urology, David Geffen School of Medicine; University of California at Los Angeles; Los Angeles California
- Department of Health Policy and Management; University of California at Los Angeles Fielding School of Public Health; Los Angeles California
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26
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Yavas U, Babakus E, Westbrook KW, Grant CC, Deitz GD, Rafalski E. An Investigation of Service Quality—Willingness to Recommend Relationship across Patient and Hospital Characteristics. JOURNAL OF HEALTH MANAGEMENT 2016. [DOI: 10.1177/0972063415625508] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigates onto which dimensions of service quality have more impact on patients’ overall quality perceptions of a hospital and seeks to determine the nature of relationship between service quality and patients’ willingness to recommend a hospital to their friends and family. The study also uncovers if the levels of service quality and recommendation behaviours and the relationship between service quality and recommendation behaviour exhibit similar patterns among male versus female, black versus white patients and small/medium versus large hospitals. Data gathered via mail questionnaires and phone interviews from a large sample of the patients of a hospital system in the Southern United States serve as the study setting. Results are presented and their implications are discussed. Avenues for future research are offered.
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Affiliation(s)
- Ugur Yavas
- Professor of Marketing and Advisory Board Faculty Fellow, Department of Management and Marketing, East Tennessee State University, Johnson City, TN, United States
| | - Emin Babakus
- Professor of Marketing and George Johnson Research Fellow, Department of Marketing & Supply Chain Management, The University of Memphis, Memphis, TN, United States
| | - Kevin W. Westbrook
- Professor of Marketing, McAfee School of Business Administration, Union University, Germantown, TN, United States
| | | | - George D. Deitz
- Associate Professor of Marketing, Department of Marketing & Supply Chain Management, The University of Memphis, Memphis, TN, United States
| | - Ed Rafalski
- Affiliate Research Professor, School of Public Health, University of Memphis, Memphis, TN, United States
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Molina KL, Moura GMSSD. A satisfação dos pacientes segundo a forma de internação em hospital universitário. ACTA PAUL ENFERM 2016. [DOI: 10.1590/1982-0194201600004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Analisar a satisfação dos pacientes de acordo com a forma de internação em hospital universitário. Métodos Estudo transversal realizado com 366 pacientes com mais de 18 anos, internados em unidades clínicas e cirúrgicas no período de janeiro a junho de 2014, cujo desfecho tenha sido a alta entre 15 e 30 dias. Teste Mann-Whitney foi realizado para analisar amostras independentes para comparação entre os grupos. Resultados Estiveram satisfeitos e muito satisfeitos com o atendimento recebido 99,4% dos pacientes internados pela emergência e 98,4% dos internados pela admissão, apresentando médias de satisfação de 5,66 e 5,55, respectivamente. A média de satisfação foi mais elevada em todos os atributos para o grupo da emergência. A comparação entre grupos dos atributos da equipe de Enfermagem e satisfação geral não demonstrou significância estatística. Conclusão O elevado nível de satisfação dos pacientes com o serviço de saúde evidenciou a qualidade assistencial prestada no hospital universitário, na perspectiva do paciente. Destacou-se igual e elevada avaliação da satisfação com enfermagem entre os grupos.
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28
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Bowers J, Cheyne H. Reducing the length of postnatal hospital stay: implications for cost and quality of care. BMC Health Serv Res 2016; 16:16. [PMID: 26772389 PMCID: PMC4714454 DOI: 10.1186/s12913-015-1214-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 12/07/2015] [Indexed: 12/04/2022] Open
Abstract
Background UK health services are under pressure to make cost savings while maintaining quality of care. Typically reducing the length of time patients stay in hospital and increasing bed occupancy are advocated to achieve service efficiency. Around 800,000 women give birth in the UK each year making maternity care a high volume, high cost service. Although average length of stay on the postnatal ward has fallen substantially over the years there is pressure to make still further reductions. This paper explores and discusses the possible cost savings of further reductions in length of stay, the consequences for postnatal services in the community, and the impact on quality of care. Method We draw on a range of pre-existing data sources including, national level routinely collected data, workforce planning data and data from national surveys of women’s experience. Simulation and a financial model were used to estimate excess demand, work intensity and bed occupancy to explore the quantitative, organisational consequences of reducing the length of stay. These data are discussed in relation to findings of national surveys to draw inferences about potential impacts on cost and quality of care. Discursive analysis Reducing the length of time women spend in hospital after birth implies that staff and bed numbers can be reduced. However, the cost savings may be reduced if quality and access to services are maintained. Admission and discharge procedures are relatively fixed and involve high cost, trained staff time. Furthermore, it is important to retain a sufficient bed contingency capacity to ensure a reasonable level of service. If quality of care is maintained, staffing and bed capacity cannot be simply reduced proportionately: reducing average length of stay on a typical postnatal ward by six hours or 17 % would reduce costs by just 8 %. This might still be a significant saving over a high volume service however, earlier discharge results in more women and babies with significant care needs at home. Quality and safety of care would also require corresponding increases in community based postnatal care. Simply reducing staffing in proportion to the length of stay increases the workload for each staff member resulting in poorer quality of care and increased staff stress. Conclusions Many policy debates, such as that about the length of postnatal hospital-stay, demand consideration of multiple dimensions. This paper demonstrates how diverse data sources and techniques can be integrated to provide a more holistic analysis. Our study suggests that while earlier discharge from the postnatal ward may achievable, it may not generate all of the anticipated cost savings. Some useful savings may be realised but if staff and bed capacity are simply reduced in proportion to the length of stay, care quality may be compromised.
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Affiliation(s)
- John Bowers
- Stirling Management School, University of Stirling, Stirling, FK9 4LA, UK
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professions Research Unit, Stirling University Innovation Park, Unit 13 Scion House, Stirling, FK9 4NF, UK.
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Sanclemente-Ansó C, Salazar A, Bosch X, Capdevila C, Giménez-Requena A, Rosón-Hernández B, Corbella X. Perception of quality of care of patients with potentially severe diseases evaluated at a distinct quick diagnostic delivery model: a cross-sectional study. BMC Health Serv Res 2015; 15:434. [PMID: 26420244 PMCID: PMC4589195 DOI: 10.1186/s12913-015-1070-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 09/17/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Although hospital-based outpatient quick diagnosis units (QDU) are an increasingly recognized cost-effective alternative to hospitalization for the diagnosis of potentially serious diseases, patient perception of their quality of care has not been evaluated well enough. This cross-sectional study analyzed the perceived quality of care of a QDU of a public third-level university hospital in Barcelona. METHODS One hundred sixty-two consecutive patients aged ≥ 18 years attending the QDU over a 9-month period were invited to participate. A validated questionnaire distributed by the QDU attending physician and completed at the end of the first and last QDU visit evaluated perceived quality of care using six subscales. RESULTS Response rate was 98 %. Perceived care in all subscales was high. Waiting times were rated as 'short'/'very short' or 'better'/'much better' than expected by 69-89 % of respondents and physical environment as 'better'/'much better' than expected by 94-96 %. As to accessibility, only 3 % reported not finding the Unit easily and 7 % said that frequent travels to hospital for visits and investigations were uncomfortable. Perception of patient-physician encounter was high, with 90-94 % choosing the positive extreme ends of the clinical information and personal interaction subscales items. Mean score of willingness to recommend the Unit using an analogue scale where 0 was 'never' and 10 'without a doubt' was 9.5 (0.70). On multivariate linear regression, age >65 years was an independent predictor of clinical information, personal interaction, and recommendation, while age 18-44 years was associated with lower scores in these subscales. No schooling predicted higher clinical information and recommendation scores, while university education had remarkable negative influence on them. Having ≥4 QDU visits was associated with lower time to diagnosis and recommendation scores and malignancy was a negative predictor of time to diagnosis, clinical information, and recommendation. DISCUSSION It is worthy of note that the questionnaire evaluated patient perception and opinions of healthcare quality including recommendation rather than simply satisfaction. It has been argued that perception of quality of care is a more valuable approach than satisfaction. In addition to embracing an affective dimension, satisfaction appears more dependent on patient expectations than is perception of quality. CONCLUSIONS While appreciating that completing the questionnaire immediately after the visit and its distribution by the QDU physician may have affected the results, scores of perceived quality of care including recommendation were high. There were, however, significant differences in several subscales associated with age, education, number of QDU visits, and diagnosis of malignant vs. benign condition.
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Affiliation(s)
- Carmen Sanclemente-Ansó
- Department of Internal Medicine, Bellvitge University Hospital, University of Barcelona, Biomedical Research Institute (IDIBELL), Consultas Externas, Area de Gestión Administrativa, c/Feixa Llarga s/n, 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Albert Salazar
- Emergency Department, Bellvitge University Hospital, Department of Medicine, University of Barcelona, Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Xavier Bosch
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c/Villarroel 170, 08036, Barcelona, Spain.
| | - Cristina Capdevila
- Emergency Department, Bellvitge University Hospital, Department of Medicine, University of Barcelona, Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Amparo Giménez-Requena
- Department of Quality, Bellvitge University Hospital, University of Barcelona, Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Beatriz Rosón-Hernández
- Department of Internal Medicine, Bellvitge University Hospital, University of Barcelona, Biomedical Research Institute (IDIBELL), Consultas Externas, Area de Gestión Administrativa, c/Feixa Llarga s/n, 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Xavier Corbella
- Department of Internal Medicine, Bellvitge University Hospital, University of Barcelona, Biomedical Research Institute (IDIBELL), Consultas Externas, Area de Gestión Administrativa, c/Feixa Llarga s/n, 08907-L'Hospitalet de Llobregat, Barcelona, Spain. .,Global Institute of Public Health and Health Policy, School of Medicine, International University of Catalonia, Barcelona, Spain.
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Negarandeh R, Hooshmand Bahabadi A, Aliheydari Mamaghani J. Impact of Regular Nursing Rounds on Patient Satisfaction with Nursing Care. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 8:282-5. [DOI: 10.1016/j.anr.2014.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 04/24/2014] [Accepted: 06/23/2014] [Indexed: 10/24/2022] Open
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Jackson KL, Glasgow RE, Mone MC, Sheng X, Mulvihill SJ, Scaife CL. Does travel distance influence length of stay in elective pancreatic surgery? HPB (Oxford) 2014; 16:543-9. [PMID: 24245982 PMCID: PMC4048076 DOI: 10.1111/hpb.12180] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 07/28/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Length of stay (LoS) following elective surgery is being reported as an outcomes quality measure. Regional referral centres may care for patients travelling significant distances. The effect of travel distance on LoS in pancreatic surgery patients was examined. METHODS National Surgical Quality Improvement Program data on pancreatic surgery patients, operated during the period from 2005 to 2011, were reviewed. Demographics, surgical variables and distance travelled were analysed relative to LoS. The LoS was log-transformed in general linear models to achieve normality. RESULTS Of the 243 patients, 53% were male. The mean ± standard deviation (SD) age of the total patient sample was 60.6 ± 14 years. The mean ± SD distance travelled was 203 ± 319 miles (326.7 ± 513.4 km) [median: 132 miles (212.4 km); range: 3-3006 miles (4.8-4837.7 km)], and the mean ± SD LoS was 10.5 ± 7 days (range: 1-46 days). Univariate analysis showed a near significant increase in LoS with increased distance travelled (P = 0.05). Significant variables related to LoS were: age (P = 0.002); relative value units (P < 0.001), and preoperative American Society of Anesthesiologists class (P = 0.005). In a general linear model, for every 100 miles (160.9 km) travelled there is an associated 2% increase in LoS (P = 0.031). When the distance travelled is increased by 500 miles (804.7 km), LoS increases by 10.5%. CONCLUSIONS Increased travel distance from a patient's home to the hospital was independently associated with an increase in LoS. If LoS is a reportable quality measure in pancreatic surgery, travel distance should be considered in risk adjustments.
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Affiliation(s)
| | - Robert E Glasgow
- Department of Surgery, University of UtahSalt Lake City, UT, USA
| | - Mary C Mone
- Department of Surgery, University of UtahSalt Lake City, UT, USA
| | - Xiaoming Sheng
- Department of Paediatrics, University of UtahSalt Lake City, UT, USA
| | - Sean J Mulvihill
- Department of Surgery, University of UtahSalt Lake City, UT, USA
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Rocha ESB, Ventura CAA, de Godoy S, Mendes IAC, Trevizan MA. Ethical issues in hospital clients' satisfaction: a Brazilian perspective. Nurs Ethics 2014; 22:188-93. [PMID: 24878574 DOI: 10.1177/0969733014533235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Health institutions can be considered as complex organizations because they need to be prepared to receive and satisfy patients. This clientele differs from other organizations because the use of hospital services is not a matter of choice. Another motive for this difference is that, most often, the patients do not determine what services and products they will use during their stay. Although they are the clients, usually, health professionals decide which service or product they will consume. Hence, nursing care delivery based on competence, efficiency and ethics represents a challenge. OBJECTIVE This critical reflection is meant to draw attention to the relevance of the ethical aspects of nurses' actions involving patients' satisfaction with nursing care. RESEARCH DESIGN This paper highlights the responsibility of nurses to develop ethical actions in their commitment to manage and provide care with quality, commitment and efficiency. FINDINGS AND DISCUSSION Possibilities of actions needed emerged from this discussion, such as the provision of reliable and updated information to clients, respect for standards, routines of care, exams and others, as well as clients' education, in order to further their involvement and participation in decisions concerning the care planned for them. CONCLUSION The adoption of this paradigm entails a change in the performance of nurses' management and care roles, which may have to observe attitudes previously disregarded in most services provided.
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