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Leché-Martín EA, Saz-Gil MI, Gil-Lacruz AI, Sierra-Berdejo MJ, Gil-Lacruz M. What do families value most about the care home where their older adult relatives live? Front Public Health 2024; 12:1338649. [PMID: 39175896 PMCID: PMC11340505 DOI: 10.3389/fpubh.2024.1338649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 07/16/2024] [Indexed: 08/24/2024] Open
Abstract
Introduction The 2030 Agenda and the principles of Corporate Social Responsibility (CSR) define companies and public authorities as agents for social change sharing objectives such as promotion of health, personal development and social engagement, among others. Care homes for the older adult are an example of organizations that should be particularly aware of these priorities. Since they work with vulnerable groups, collaboration with the families is essential in ensuring residents' wellbeing. Methods The objective of this study is to analyse the factors that condition the satisfaction of relatives of residents in a care home for the older adult located in a rural environment in the province of Huesca (Spain). Results and discussion The 51 relatives interviewed rated the following points very positively: location and accessibility, food service, medical resources, communication with the staff and management team. A high percentage, however, did not know about the channels for volunteer work and institutional involvement. Some psychosocial indicators related to families' interaction and communication with the staff and their potential involvement in the dynamics of the institution have considerable weight in how they explain their satisfaction. These results may lead to new lines of research and intervention that contribute to improving the quality of this type of resources and their commitment to the Sustainable Development Goals (SDGs) and social responsibility.
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Affiliation(s)
| | - María Isabel Saz-Gil
- Departamento de Dirección y Organización de Empresas, Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain
| | - Ana Isabel Gil-Lacruz
- Departamento de Dirección y Organización de Empresas, Escuela de Ingeniería y Arquitectura, Universidad de Zaragoza, Zaragoza, Spain
| | - María José Sierra-Berdejo
- Departamento de Psicología y Sociología, Facultad de Ciencias Sociales y del Trabajo, Universidad de Zaragoza, Zaragoza, Spain
| | - Marta Gil-Lacruz
- Departamento de Psicología y Sociología, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
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Al-Sayedahmed H, Al-Qaaneh A, Al-Tawfiq J, Al-Dossary B, Al-Yami S. Perception of Health Care Professionals Toward Hospital Accreditation at Johns Hopkins Aramco Healthcare. Qual Manag Health Care 2023; 32:238-246. [PMID: 37651601 DOI: 10.1097/qmh.0000000000000405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND AND OBJECTIVES The quality of health care relies on achieving the best quality and patient safety goals, and accreditation plays a fundamental role in achieving these goals through compliance with standards that guide excellence. Accreditation also helps streamline operations and supports evidence-based quality improvement plans. This study aims to evaluate the perception of health care professionals on the accreditation process and its impact on the quality of health care and patient safety. METHODS This is a cross-sectional questionnaire survey distributed via the SuccessFactors website and made accessible to all hospital staff. RESULTS The online questionnaire was completed by 2047 participants, representing 51% of the entire hospital staff at Johns Hopkins Aramco Healthcare (JHAH). Overall analysis indicated a positive perception of accreditation benefits among health care employees (as indicated by participation in accreditation activities and/or preparation for the survey visits) and reflected on patient health care quality and safety dimensions, with an overall Likert median score of 4.0 (interquartile range = 3.7-5.0; P < .05). CONCLUSION The outcomes of our study confirm that JHAH employees perceived a positive impact of accreditation on health care quality improvement and patient safety. Also, the study supports considering accreditation as a fundamental requirement to improve health care system processes. However, it is critical to sustain quality of services over time during accreditation cycles.
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Affiliation(s)
- Huda Al-Sayedahmed
- Accreditation Division, Quality and Patient Safety Department (Drs Al-Sayedahmed and Al-Yami and Ms Al-Dossary), Clinical Pharmacy Services Division, Pharmacy Services Department (Dr Al-Qaaneh), Accreditation and Infection Control Division, Quality and Patient Safety Department (Dr Al-Tawfiq), Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; and Department of Genetic Research, Institute for Research and Medical Consultations, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (Dr Al-Qaaneh)
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da Silva Goncalves dos Santos J, de Farias Meirelles B, de Souza da Costa Brum I, Zanchetta M, Xerem B, Braga L, Haiut M, Lanziani R, Musa TH, Cordovil K. First Clinical Nutrition Outpatient Consultation: A Review of Basic Principles in Nutritional Care of Adults with Hematologic Disease. ScientificWorldJournal 2023; 2023:9303798. [PMID: 37780637 PMCID: PMC10539097 DOI: 10.1155/2023/9303798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/11/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Methods A bibliographic survey was carried out between 2020 and 2022 using two databases: PubMed/MEDLINE and Scientific Electronic Library Online (SciELO) and the information source Academic Google, irrespective of language or geography. Results In the first nutrition consultation (FNC), there should be an investigative direction focused on nutritional interventions in the short, medium, and long term. The record in the patient's medical record is relevant for carrying out the consultation, according to the recommendations of the normative councils of medicine and nutrition. The main steps to be followed are the investigation of the presence of food allergies and intolerances; the drugs/nutritional supplements in use; changes in the digestive tract; the presence or absence of picamalacia; and socioeconomic and lifestyle data. In addition, it is necessary to carry out laboratory evaluations, semiological assessment, anthropometric assessment, and assessment of food consumption. In the end, the nutritional approach should be composed of calculation of energy and macronutrient and micronutrient needs, intervention in nutritional status deviations, nutritional guidelines, and nutritional therapeutic planning of return, focusing on adherence to treatment. Conclusion The first nutrition consultation may represent investigative steps that help the clinical nutritionist in the management, allowing a longitudinal and specific nutritional therapeutic planning for patients assisted in large reference centers for hematological disease.
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Affiliation(s)
- Julia da Silva Goncalves dos Santos
- Institute of Hematology Arthur Siqueira Cavalcanti (Hemorio), Rio de Janeiro, RJ, Brazil
- Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | | | - Isabela de Souza da Costa Brum
- Institute of Hematology Arthur Siqueira Cavalcanti (Hemorio), Rio de Janeiro, RJ, Brazil
- Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Mariana Zanchetta
- Institute of Hematology Arthur Siqueira Cavalcanti (Hemorio), Rio de Janeiro, RJ, Brazil
| | - Bruna Xerem
- Institute of Hematology Arthur Siqueira Cavalcanti (Hemorio), Rio de Janeiro, RJ, Brazil
| | - Lucas Braga
- Institute of Hematology Arthur Siqueira Cavalcanti (Hemorio), Rio de Janeiro, RJ, Brazil
| | - Marcia Haiut
- Institute of Hematology Arthur Siqueira Cavalcanti (Hemorio), Rio de Janeiro, RJ, Brazil
| | - Renata Lanziani
- Institute of Hematology Arthur Siqueira Cavalcanti (Hemorio), Rio de Janeiro, RJ, Brazil
| | - Taha Hussein Musa
- Biomedical Research Institute, Darfur University College, Nyala, Sudan
| | - Karen Cordovil
- Institute of Hematology Arthur Siqueira Cavalcanti (Hemorio), Rio de Janeiro, RJ, Brazil
- Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
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ALFadhalah T, Al Mudaf B, Al Salem G, Alghanim HA, Abdelsalam N, El Najjar E, Abdelwahab HM, Elamir H. The Association Between Patient Safety Culture and Accreditation at Primary Care Centers in Kuwait: A Country-Wide Multi-Method Study. Risk Manag Healthc Policy 2022; 15:2155-2169. [DOI: 10.2147/rmhp.s383925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
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Saut AM, Berssaneti FT, Ho LL, Berger S. How do hospitals engage patients and family members in quality management? A grounded theory study of hospitals in Brazil. BMJ Open 2022; 12:e055926. [PMID: 35985775 PMCID: PMC9396118 DOI: 10.1136/bmjopen-2021-055926] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient and family engagement (PFE) is considered an essential element of the transformation of the healthcare system. However, it is characterised by its complexity and a small number of institutions that have implemented the mechanisms of engagement. OBJECTIVE To understand PFE in quality management (QM) in the hospital environment. DESIGN A qualitative approach was guided by the grounded theory based in Straussian perspective. Data were gathered using semistructured interviews. The coding was performed by excerpts, using an inductive approach and the constant comparison technique. SETTING AND PARTICIPANTS A total of seven Brazilian hospitals were selected based on the theoretical sampling technique. RESULTS A total of five categories emerged, namely: patient partner, mechanisms of engagement, internal structure for engagement, maturity of the QM system and openness to change. Externally, three contextual factors can impact the engagement: the local health system, the profile of the community and the change in access to the information. At the centre of the change is the balance in power relations between patients and professionals, the sharing of information from the hospital and a proactive attitude towards improving services. CONCLUSIONS The PFE involves a cultural and process change. Cultural change is represented by 'openness', that is, openness to learn, to listen and to consider new perspectives. The change in processes is in turn characterised by the phrase 'test and venture' because the model to be adopted may be different between hospitals. The patient's perspective allows actions to be driven towards what really matters to them, ensuring quality of service and safety, obtaining a new perspective to understand and solve problems, and stimulating a sense of urgency, more empathy and compassion in professionals.
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Affiliation(s)
- Ana Maria Saut
- Polytechnic School, Production Engineering Department, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Linda Lee Ho
- Polytechnic School, Production Engineering Department, University of Sao Paulo, Sao Paulo, Brazil
| | - Simone Berger
- Polytechnic School, Production Engineering Department, University of Sao Paulo, Sao Paulo, Brazil
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Brouwers J, Seys D, Claessens F, Van Wilder A, Bruyneel L, De Ridder D, Eeckloo K, Vanhaecht K, Kesteloot K. The Cost of a First and Second Hospital-Wide Accreditation in Flanders, Belgium. Int J Qual Health Care 2022; 34:6650077. [PMID: 35880736 DOI: 10.1093/intqhc/mzac062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/07/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hospital accreditation is a popular and widely used quality control and improvement instrument. Despite potential benefits, questions are raised whether it constitutes appropriate use of hospitals' limited financial resources. This study aims to calculate the cost of preparing for and undergoing a first and second accreditation by the Joint Commission International or Qualicor Europe in acute-care hospitals. METHODS All (n=53) acute-care hospitals in Flanders (Belgium) were invited to participate and report on the costs in preparing for and undergoing a first and/or second accreditation cycle. To measure costs, a questionnaire with six domains and 90 questions was developed based on literature review, policy documents and a multidisciplinary expert group. All costs were recalculated to 2020 EUR to correct for inflation and reported as medians with interquartile range (IQR). RESULTS Twenty-five hospitals (47%) participated in the study. Additional investments and direct operational costs for a first accreditation cycle amounted to 879.45 EUR (IQR:794.81) per bed and 3.8 FTE per hospital additional new staff members were recruited for coordination and implementation of the trajectory. A second accreditation survey costed remarkably less with a total cost of extra investments and direct operational cost of 222.88 EUR (IQR: 244.04) per bed and less investment in additional staff (1.50 FTE). Most of the costs were situated in consulting costs and investments in infrastructure. The median total extra cost (direct operational cost and additional investments) amounted to 0.2% of the hospital's operating income for a first accreditation cycle and 0.05% for a second cycle. CONCLUSION A first accreditation cycle requires a strong financial commitment of hospitals, as many costs result from the preparation in the years prior to an accreditation survey. A second survey is less expensive for hospitals, but still requires a considerable effort in terms of budget and staff. Policy makers should be aware of these significant costs as hospitals are operating with public resources and budget is scarce. The identification of these costs is a necessary building block to evaluate cost-effectiveness of accreditation versus other quality improvement systems and the continuation of these accreditation systems and their costs needs further study and a thorough debate.
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Affiliation(s)
- Jonas Brouwers
- Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium & Department of Orthopaedics, University Hospitals Leuven, Belgium
| | - Deborah Seys
- Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium
| | - Fien Claessens
- Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium
| | - Astrid Van Wilder
- Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium
| | - Luk Bruyneel
- Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium
| | - Dirk De Ridder
- Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium & Department of Quality, University Hospitals Leuven, Belgium
| | - Kristof Eeckloo
- Department of Primary Care and Public Health, UGent & Strategic Policy Unit, Ghent University Hospital, Ghent, Belgium
| | - Kris Vanhaecht
- Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium & Department of Quality, University Hospitals Leuven, Belgium
| | - Katrien Kesteloot
- Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium & Financial department, University Hospitals Leuven, Leuven Belgium
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Al-Kalaldeh M, Al-Bdour E, Shosha GA. Patients' Evaluation of the Quality of Emergency Care Services in Jordan: Integration of Patient Centeredness Model. Res Theory Nurs Pract 2021; 36:RTNP-D-21-00037. [PMID: 34848564 DOI: 10.1891/rtnp-d-21-00037] [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: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Accreditation is viewed to enhance the total quality of healthcare. The present study aims at assessing patients' perspectives toward the quality of emergency healthcare services at different hospitals with different characteristics in Jordan. The elements of patients' perception were aligned with the conceptual framework of Patient Centeredness Model. METHODS This descriptive cross-sectional study was carried out in four emergency departments from different healthcare sectors and accreditation statuses in Jordan. Less urgent/nonurgent, alert, and cooperative patients were identified directly after the completion of emergency treatment. The perspectives of patients about the quality of emergency services were evaluated by 10 domains articulated in a validated accident and emergency questionnaire. RESULTS A total of 276 patients were enrolled in the study. Private sector scored higher in all assessment domains in both accredited and nonaccredited hospitals in comparison with the government sector. Accredited government hospitals scored higher in patients' evaluation for "doctor and nurse," "investigations," "pain," and "overall respect of medical staff" domains than nonaccredited government hospitals. The overall experience was significantly different between accredited and nonaccredited government hospitals. IMPLICATIONS FOR PRACTICE Quality of emergency care services should be assessed through various dimensions related to patients' perspectives. Patients' perception toward the quality of emergency health services is evidently enhanced by accreditation especially in the government sector.
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Ajay K, Poka A, Narayan M. Impact of accreditation on documentation and staff perception in the ophthalmology department of an Indian medical college. Indian J Ophthalmol 2021; 69:337-342. [PMID: 33463587 PMCID: PMC7933869 DOI: 10.4103/ijo.ijo_848_20] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose National Accreditation Board for Hospitals and Healthcare Providers operates the health-care accreditation program in India. Research on impact of accreditation on eye-care centers is scarce. This article was conceptualized to scientifically evaluate the changes in documentation brought about by accreditation and its effects on staff in the Ophthalmology Department of an Indian Medical College. Methods This was conducted as a quasi-experimental study in four steps. First, a point-based evaluation of case sheets in both pre-accreditation and postaccreditation phase, along with statistical analysis of the results, was done. Step two involved analysis of quality indicators and patient safety indices in successive years from inception of data to post-accreditation phase. Step three comprised a survey of staff employing a validated tool, and finally, face-to-face semistructured interviews with designated authorities, including finance departmental head, completed the study. Results A statistically significant difference was seen in scores achieved by the pre and postaccreditation case sheets, with the postphase case sheets achieving 15% increased scores over the prephase case sheets. Quality indicator indices displayed improvements post-accreditation. There was an accompanying increase in quantity of documentation. Financial data analysis showed increased expenditure for accreditation under multiple heads. Staff believed that accreditation led to increased workload but did not express decreased satisfaction and felt that accreditation was eventually beneficial. However, staff believed rewards for improving quality can be enhanced. Conclusion Accreditation increases quality and quantity of documentation, and staff workload. Increased financial costs also ensue.Staff believe that accreditation improves quality, is beneficial, but desire enhanced rewards.
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Affiliation(s)
- K Ajay
- Department of Ophthalmology, P. E. S. Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
| | - Avinash Poka
- Department of Ophthalmology, P. E. S. Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
| | - M Narayan
- Department of Ophthalmology, P. E. S. Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
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Dutra HS, Guirardello EDB. Nursing work environment and accreditation: Is there a relationship? J Nurs Manag 2021; 29:2183-2188. [PMID: 33993587 DOI: 10.1111/jonm.13371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/02/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The association between Magnet recognition and nursing work environment is well established; however, little is known about hospital accreditation and its relationship to the nursing work environment. OBJECTIVE To describe the Brazilian nurses' perceptions of the work environment and their relationship with hospital accreditation. METHODS A cross-sectional survey study was carried out in three Brazilian hospitals. Nurses who delivered direct patient care and worked for at least 6 months were invited to participate. Those who were on vacation or leave for any reason during data collection were excluded. The participants were asked to fill out the personal and professional characterization form and the Brazilian version of the Revised Nursing Work Index. RESULTS The work environment was evaluated as favourable by Brazilian nurses. Linear regression analysis evidenced that hospital accreditation is associated with the nursing work environment, affecting the nurse-physician relationship (OR = 0.266, p < .001), organisational support (OR = 0.256, p < .001), control over the practice setting (OR = 0.229, p < .001) and autonomy (OR = 0.227, p < .001). CONCLUSION The findings suggest that there is a positive influence of hospital accreditation on nurses' perceptions of the work environment concerning autonomy, nurse-physician relationship, control over the practice setting and organisational support. IMPLICATION FOR NURSING MANAGEMENT Nurse managers can apply the recommendations of certification programmes in practice settings to improve the nursing work environment.
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Affiliation(s)
- Herica Silva Dutra
- School of Nursing, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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El-Shal A, Cubi-Molla P, Jofre-Bonet M. Accreditation as a quality-improving policy tool: family planning, maternal health, and child health in Egypt. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:115-139. [PMID: 33219440 PMCID: PMC7822797 DOI: 10.1007/s10198-020-01240-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 10/15/2020] [Indexed: 06/02/2023]
Abstract
Accreditation of healthcare providers has been established in many high-income countries and some low- and middle-income countries as a tool to improve the quality of health care. However, the available evidence on the effectiveness of this approach is limited and of questionable quality, especially in low- and middle-income countries. We exploit the interventions introduced under Egypt's health sector reform program between 2000 and 2014 to estimate the effect of health facility accreditation on family planning, maternal health, and child health outcomes. We use difference-in-differences fixed-effects and propensity score matching difference-in-differences models. To do so, we spatially link women to their nearest mapped health facilities using their global positioning system coordinates. We find that accreditation had multiple positive effects, especially on delivery care and child morbidity prevalence. The effects appear to weaken over time though. Our findings suggest that facility accreditation can be effective in improving family planning, antenatal care, delivery care, and child health, but stress the need to study how the effects can be sustained.
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Affiliation(s)
- Amira El-Shal
- Department of Economics, Faculty of Economics and Political Science, Cairo University, Giza, Egypt.
| | - Patricia Cubi-Molla
- Office of Health Economics, London, UK
- Department of Economics, City, University of London, London, UK
| | - Mireia Jofre-Bonet
- Office of Health Economics, London, UK
- Department of Economics, City, University of London, London, UK
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Miranda AC, Santana JCC, Yamamura CLK, Rosa JM, Tambourgi EB, Ho LL, Berssaneti FT. Application of neural network to simulate the behavior of hospitalizations and their costs under the effects of various polluting gases in the city of São Paulo. AIR QUALITY, ATMOSPHERE, & HEALTH 2021; 14:2091-2099. [PMID: 34745381 PMCID: PMC8556003 DOI: 10.1007/s11869-021-01077-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/11/2021] [Indexed: 05/13/2023]
Abstract
This work aims to obtain an artificial neural network to simulate hospitalizations for respiratory diseases influenced by pollutant gaseous such as CO, PM10, PM2.5, NO2, O3, and SO2 emitted from 2011 to 2017, in the city of São Paulo. The hospitalization costs were also be calculated. MLP and RBF neural networks have been tested by varying the number of neurons in the hidden layer and the type of equation of the output function. The following pollutants and its concentration range were collected considering the supervision of Alto Tiete station set, in several neighborhoods in the city of São Paulo, from in the period 2011 to 2017: 28-63 µg/m3 of PM2.5, 52-110 µg/m3 of PM10, 49-135 µg/m3 of O3, 0.8-2.6 ppm CO, 41-98 µg/m3 of NO2, and 3-16 µg/m3 of SO2. Results showed that a RBF neural network with 6 input neurons, 13 hidden layer neurons, and 1 output neuron, using BFGS algorithm and a Gaussian function to neuronal activation, was the best fitted to the experimental datasets. So, knowing the monthly concentration of gaseous pollutions was possible to predict the hospitalization of 1464 to 3483 ± 510 patients, with costs between 570,447 and 1,357,151 ± 198,171 USD per month. This way, it is possible to use this neural network to predict the costs of hospitalizing patients for respiratory diseases and to contribute to the decision-making of how much the government should spend on health care.
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Affiliation(s)
- Amanda Carvalho Miranda
- Department of Pharmaceutical Sciences, Nine July University, São Paulo, Brazil
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
| | - José Carlos Curvelo Santana
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
- Department of Management Engineering, Federal University of ABC, University Mall, São Bernardo do Campo, 09606-045 Brazil
| | - Charles Lincoln Kenji Yamamura
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
| | - Jorge Marcos Rosa
- School of Textile Technology of SENAI, Rua Correia de Andrade, 232 Brás, São Paulo, SP 03008-020 Brazil
- School of Chemical Engineering, State University of Campinas, Barão Geraldo, Campinas, SP 13083-970 Brazil
| | - Elias Basile Tambourgi
- School of Chemical Engineering, State University of Campinas, Barão Geraldo, Campinas, SP 13083-970 Brazil
| | - Linda Lee Ho
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
| | - Fernando Tobal Berssaneti
- Department of Production Engineering, Polytechnic School, University of São Paulo, Av. Prof. Luciano Gualberto, 1380, Butantã, São Paulo, SP 05508-010 Brazil
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Melo E, Balsanelli AP, Neves VR, Bohomol E. Patient safety culture according to nursing professionals of an accredited hospital. ACTA ACUST UNITED AC 2020; 41:e20190288. [PMID: 33237218 DOI: 10.1590/1983-1447.2020.20190288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 05/28/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the perception of the nursing team regarding the patient safety culture of an accredited hospital and to identify the differences between shifts, professional category and units. METHOD Cross-sectional study, conducted in a private hospital in the city of São Paulo, SP, Brazil, with application of the Survey on Patient Safety Culture Hospital to 497 nursing professionals. Descriptive analysis, instrument consistency and generalized linear mixed model were performed. RESULTS The organizational learning and continuous improvement dimension was considered a strong area (77%) and the personal adequacy (47%), shift / shift change and transfer (47%) and non-punitive response to errors (25%) dimensions were considered. fragile. Differences in perception were found between the professional categories in two dimensions; between shifts in six and between units in seven dimensions. CONCLUSION The nursing team identified weaknesses in the patient safety culture in the hospital, with the need to standardize the improvement processes.
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Affiliation(s)
- Eliana Melo
- Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Enfermagem, Departamento de Administração em Serviços de Saúde e Enfermagem, São Paulo, São Paulo, Brasil
| | - Alexandre Pazetto Balsanelli
- Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Enfermagem, Departamento de Administração em Serviços de Saúde e Enfermagem, São Paulo, São Paulo, Brasil
| | - Vanessa Ribeiro Neves
- Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Enfermagem, Departamento de Administração em Serviços de Saúde e Enfermagem, São Paulo, São Paulo, Brasil
| | - Elena Bohomol
- Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Enfermagem, Departamento de Administração em Serviços de Saúde e Enfermagem, São Paulo, São Paulo, Brasil
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Kakemam E, Rajabi MR, Raeissi P, Ehlers LH. Attitudes Towards Accreditation and Quality Improvement Activities Among Hospital Employees in Iran: A Quantitative Study. J Multidiscip Healthc 2020; 13:799-807. [PMID: 32884279 PMCID: PMC7431451 DOI: 10.2147/jmdh.s263811] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/22/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose The hospital accreditation system in Iran is relatively young, having been introduced in 2012. Therefore, there is a real need for research on the status and impact of hospital accreditation in Iran. The purpose of this study was to evaluate and compare attitudes towards accreditation and quality improvement activities among hospital employees, specifically the attitudes towards the impact of accreditation on the quality of healthcare and its benefits in Iran. Materials and Methods A cross-sectional survey was carried out at 23 teaching hospitals in three metropolises in Iran, all of which successfully passed national accreditation surveys. Some 1213 hospital managers, administrative staff, nurses, and para-clinical staff participated in the survey. The main outcome measures were quality results, and the activities related to quality improvement include senior managers' commitment and support, strategic quality planning, education and training, rewards and recognition, quality management, use of data, the involvement of professionals in accreditation, and accreditation benefits. The questionnaire was applied using a 5-point Likert scale ranging from 1 “strongly disagree” to 5 “strongly agree”. One-way analysis of variance (ANOVA) was used to compare mean values between respondent groups. Results Among nurses and managers, there was low support for accreditation and even less among para-clinical staff who fail to see accreditation having a positive impact on healthcare quality. Also, nurses' attitudes toward the accreditation benefits were more positive compared with the two other groups. Staff stated that the main reasons for low support were a lack of education and training to act upon the accreditation survey results and a lack of management visibility and support for quality improvement. Conclusion Improving quality through means of hospital accreditation is a complex process with high demands for management and employees. Questionnaires on employees’ attitudes and perceptions of the impact of accreditation and quality improvement-related activities in the hospitals can provide valuable information on the current problems of a hospital accreditation program.
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Affiliation(s)
- Edris Kakemam
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pouran Raeissi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Lars Holger Ehlers
- Danish Center for Healthcare Improvements, Institute of Business and Management, Faculty of Social Sciences, Aalborg University, Aalborg, Denmark
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14
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A Smart Grid System for Reducing Energy Consumption and Energy Cost in Buildings in São Paulo, Brazil. ENERGIES 2020. [DOI: 10.3390/en13153874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The National Electric Energy Agency (ANEEL) of Brazil, in a bid to encourage energy-conscious energy consumption, has proposed a new sustainable energy tariff modality (the White Tariff) based on off-peak usage. This study aims to compare and contrast situations in which the White Tariff alone is used, and where it is combined with power generation from a generator set or a photovoltaic cell energy system to reduce energy costs. Furthermore, economic, environmental, and social advantages are outlined in the project summaries. Interviews and documentary analyses were conducted in a technology park that uses only the White Tariff and in condominiums that combine the White Tariff with a generator set or a photovoltaic cell system. The data generated was fed into the database of the Horosazonal software to obtain an overview of these companies. Results show that the company adopting the White Tariff alone achieved 19% and US$14,684 in annual savings. However, when the White Tariff is combined with a generator set, the smart grid project proved to be more efficient over time as it obtained an annual benefit of US$35,832 and 62.38% savings. In contrast, the smart grid project combining a photovoltaic cell energy system with the White Tariff achieved an annual benefit of US$52,712, with 68.31% savings and was 1.3 to 5.3 times more profitable than other projects, demonstrating that it was the best smart grip project studied. Furthermore, opting for the White Tariff produced advantages such as a reduction in energy consumption expenses, contributing to a reduction in power outages and blackouts, reduction in greenhouse gas emissions and boosting the company image within society. This study shows that energy-conscious consumption combined with the use of renewable energy sources is environmentally and economically advantageous and can provide future generations with a healthier environment in which people can make use of natural resources in a sustainable manner that is sustainable for planet earth.
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15
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Effects of Air Pollution on Human Health and Costs: Current Situation in São Paulo, Brazil. SUSTAINABILITY 2020. [DOI: 10.3390/su12124875] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study focused on verifying whether the emission of air pollutants in São Paulo increases the costs and number of hospitalizations for respiratory diseases in Brazil. Data on pollutant emissions, hospitalizations, and hospital costs were collected from 2008 to 2017 and correlated with air quality standards. The results showed that the concentration of particulate matter increased each year during the study period and was highly correlated with hospitalizations due to respiratory diseases. Ozone (O3) was within the quality standard throughout the study period but registered an increase in the mean and a positive correlation with hospitalizations due to respiratory diseases. The carbon monoxide (CO), sulfur dioxide (SO2), and nitrogen dioxide (NO2) levels were within the quality standards throughout the study period with a decrease in the last years studied, but showed a positive correlation with hospitalizations due to respiratory diseases. The pollutant emissions and hospitalizations due to respiratory diseases had an inverse relationship with the monthly rainfall curve for São Paulo, which indicates that rainfall tended to reduce pollutant emissions and consequently hospitalizations due to inhalation of these pollutants. Because costs are directly associated with hospitalizations, both increased during the study period—302,000 hospitalizations at an average cost of 368 USD resulted in a total cost of 111 million USD. To reduce these costs, Brazil should implement stricter policies to improve the air quality of its major cities and develop a viable alternative to diesel vehicles.
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16
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Costa DGD, Moura GMSSD, Pasin SS, Costa FGD, Magalhães AMMD. Patient experience in co-production of care: perceptions about patient safety protocols. Rev Lat Am Enfermagem 2020; 28:e3272. [PMID: 32491126 PMCID: PMC7266629 DOI: 10.1590/1518-8345.3352.3272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 02/14/2020] [Indexed: 12/28/2022] Open
Abstract
Objective: to analyze the experience of the patient during hospitalization, focusing on
the co-production of care related to patient safety protocols. Method: qualitative study, whose data were collected through the triangulation of
multiple sources: document analysis, observation of 10 professionals in the
provision of care and 24 interviews with patient-families from 12 clinical
and surgical inpatient units of a hospital. Thematic analysis was carried
out, based on the concept of co-production. Results: safety protocols according to the experience of the patient portrayed the
role of patient-families as co-producers of safe care. It was found an
alignment between perceptions of the patients, institutional definitions and
basic national and international patient safety protocols. However, these
protocols are not always followed by professionals. Conclusion: co-production was perceived in the protocols for safe surgery and prevention
of injuries resulting from falls. In patient identification, hand hygiene
and medication process, it was found that co-production depends on the
proactive behavior of patient-families, as it is not encouraged by
professionals. The research contributes with subsidies to leverage the
participation of the patient as an agent of their safety, highlighting the
co-production of health care as a valuable resource for advancing patient
safety.
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17
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Tashayoei N, Raeissi P, Nasiripour AA. Challenges of implementation of hospital accreditation in Iran: an exploratory factor analysis. J Egypt Public Health Assoc 2020; 95:5. [PMID: 32813055 PMCID: PMC7364711 DOI: 10.1186/s42506-019-0033-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/29/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Today, accreditation is considered as the most commonly used health assessment approach. Considering the importance and application of the process of this approach in the hospital, this study aimed to investigate the challenges of implementation of hospital accreditation in Iran using exploratory factor analysis. METHODS A cross-sectional study design was carried out from July to December 2017, consisting of 200 managers in the seven hospitals accredited by the MOH in Tehran, Iran. Samples were selected through the purposive sampling method, and data were collected using a structured questionnaire in which validity and reliability were confirmed. Likert's five-choice range was used for the rating of items. Exploratory factor analysis was used to categorize the identified challenges and extract the mathematical model on them. RESULTS Exploratory factor analysis identified six dimensions (implementation, evaluation, content, structural, psychological, and managerial) with 40 items using a 5-point Likert scale. Each dimension accounted for greater than 63.20% of the total variance. The scale had strong content validity (indices = 0.84). Each dimension of Cronbach's alpha ranged from 0.74 to 0.94. Implementation, evaluation, content, structural, psychological, and managerial components also formed the final identified areas. CONCLUSION The present study showed that there were major challenges in the path to successful deployment of Iranian hospital accreditation, requiring serious action by managers and policymakers in this field.
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Affiliation(s)
- Narges Tashayoei
- Department of Health Services Management, School of Medical Sciences, Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Pouran Raeissi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Amir Ashkan Nasiripour
- Department of Health Services Management, School of Medical Sciences, Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran
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18
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K.S. S, Barkur G, G. S. Impact of accreditation on performance of healthcare organizations. INTERNATIONAL JOURNAL OF QUALITY AND SERVICE SCIENCES 2020. [DOI: 10.1108/ijqss-10-2018-0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to review the accreditation research in specific to its effect on the performance of healthcare organizations.
Design/methodology/approach
A comprehensive search and analysis of literature on the effect of healthcare accreditation were conducted between June 2017 and May 2018. The study identified 62 empirical research studies that examined the effect of healthcare accreditation programmes. Study particulars such as year of publication, objectives, focus of the study, research settings and key findings were recorded. A content analysis was performed to identify the frequency of the main themes in the literature. Knowledge gaps needing further examination were identified.
Findings
Majority of the accreditation impact studies were carried out in the developed nations (n = 49). The thematic categories, that is the impact on “patient safety and healthcare quality” (n = 26), “healthcare professionals’ views” (n = 28) and “clinical process and outcomes” (n = 17) were addressed more times. Whereas the other two thematic categories “organizational performance” and “consumers’ views or satisfaction,” each was examined less than 10 instances. This review reveals mixed views on effect of healthcare accreditation. The varied quality of studies and the availability of a few studies on consumers’ perception of accreditation effectiveness were the important limiting factors of this review.
Originality/value
The findings are valuable to healthcare managers and hospital administrators in accreditation decisions, whereas findings are of value to researchers and academicians in terms of gaps identified for future research studies pertaining to the impact of healthcare accreditation. Future studies need to consider holistic theoretical frameworks for assessing the effect of accreditation on performance of healthcare organizations to achieve precise results.
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Greenfield D, Lawrence SA, Kellner A, Townsend K, Wilkinson A. Health service accreditation stimulating change in clinical care and human resource management processes: A study of 311 Australian hospitals. Health Policy 2019; 123:661-665. [PMID: 31076201 DOI: 10.1016/j.healthpol.2019.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/07/2019] [Accepted: 04/24/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to establish whether longitudinal participation in an accreditation program is translated into improvement in continuity of quality patient care and human resource management (HRM) processes outcomes. MATERIALS AND METHODS This was a secondary data analysis of accreditation panel data from acute hospitals participating in the Australian Council on Healthcare Standards' Evaluation and Quality Improvement Program (EQuIP). EQuIP criteria data from 311 hospitals were collected by external surveyors across 2003-2006 (Time 1) and 2007-2010 (Time 2). Mandatory accreditation criteria ratings at Time 1 were used to determine hospital performance group membership (1 = below moderate, 2 = moderate, 3 = above moderate). Analysis was undertaken of ratings across continuity of quality patient care and HRM process criteria, at Time 1 and 2. RESULTS Continuity of quality patient care and HRM processes improved across time in the three performance groups. Lower performing hospitals improved at a greater rate than moderate and higher performing hospitals. The groupings and performance order did not change over time. CONCLUSIONS An accreditation program is an external driver that facilitates continual and systemic quality improvement changes to sub-systems with an organisation.
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Affiliation(s)
- David Greenfield
- Australian Institute of Health Service Management, University of Tasmania, NSW, Australia.
| | - S A Lawrence
- Centre for Work, Organisation and Wellbeing, Griffith University, QLD, Australia
| | - A Kellner
- Centre for Work, Organisation and Wellbeing, Griffith University, QLD, Australia
| | - K Townsend
- Centre for Work, Organisation and Wellbeing, Griffith University, QLD, Australia
| | - A Wilkinson
- Centre for Work, Organisation and Wellbeing, Griffith University, QLD, Australia
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