Evaluation of a collaborative ambulatory orthopedic care program for patients with hip and knee osteoarthritis: a comparative observational cohort study

The utility of website-based quality improvement tools for health professionals: a systematic review

As technology continues to advance, it is important to understand how website-based tools can support quality improvement. Website-based tools refer to resources such as toolkits that users can access and use autonomously through a dedicated website. This review examined how website-based tools can support healthcare professionals with quality improvement, including the optimal processes used to develop tools and the elements of an effective tool. A systematic search of seven databases was conducted to include articles published between January 2012 and January 2024. Articles were included if they were peer reviewed, written in English, based in health settings, and reported the development or evaluation of a quality improvement website-based tool for professionals. A narrative synthesis was conducted using NVivo. Risk of bias was assessed using the Mixed Methods Appraisal Tool. All papers were independently screened and coded by two authors using a six-phase conceptual framework by Braun and Clarke. Eighteen studies met the inclusion criteria. Themes identified were tool development processes, quality improvement mechanisms and barriers and facilitators to tool usage. Digitalizing existing quality improvement processes (n = 7), identifying gaps in practice (n = 6), and contributing to professional development (n = 3) were common quality improvement aims. Tools were associated with the reported enhancement of accuracy and efficiency in clinical tasks, improvement in adherence to guidelines, facilitation of reflective practice, and provision of tailored feedback for continuous quality improvement. Common features were educational resources (n = 7) and assisting the user to assess current practices against standards/recommendations (n = 6), which supported professionals in achieving better clinical outcomes, increased professional satisfaction and streamlined workflow in various settings. Studies reported facilitators to tool usage including relevance to practice, accessibility, and facilitating multidisciplinary action, making these tools practical and time-efficient for healthcare. However, barriers such as being time consuming, irrelevant to practice, difficult to use, and lack of organizational engagement were reported. Almost all tools were co-developed with stakeholders. The co-design approaches varied, reflecting different levels of stakeholder engagement and adoption of co-design methodologies. It is noted that the quality of included studies was low. These findings offer valuable insights for future development of quality improvement website-based tools in healthcare. Recommendations include ensuring tools are co-developed with healthcare professionals, focusing on practical usability and addressing common barriers to enhance engagement and effectiveness in improving healthcare quality. Randomized controlled trials are warranted to provide objective evidence of tool efficacy.

Analysis of the Effect of the Communication Ability of Nurses in Outpatient Infusion Room on the Treatment Experience of Patients and Their Families

Objective

To observe the effect of nursing communication ability in outpatient infusion room on the treatment experience of outpatients and their families and analyze whether improving nurses' communication skills can reduce the incidence of doctor-patient disputes.

Methods

According to the results of the communication ability survey, the outpatient nurses in our hospital are divided into groups A (score < 65), B (65 ≤ score < 80), C (80 ≤ score < 95), and D (score ≥ 95). Taking outpatients and their families in our hospital from September 2019 to December 2020 as the research objects, they were divided into corresponding groups according to the nurses who served them. Finally, there were 73 cases in group A, 85 in group B, 92 in group C, and 65 in group D. The mental toughness scale (Connor-Davidson Resilience Scale Chinese (CD-RISC)) scores and Herth Hope Index (HHI) scores of the four groups of patients were compared, and the correlation between nurse communication scores and CD-RISC scores and HHI scores was analyzed. The incidence of negative events (patient-nurse disputes, complaints, etc.) and the results of nursing satisfaction surveys during the visits of the four study groups were also counted.

Results

The four groups of CD-RISC and HHI total scores were ranked from highest to lowest as groups D, C, B, and A, respectively (P < 0.05). There was a positive correlation between the resilience dimension scores of the family members' CD-RISC and the toughness, strength, optimism dimension scores of the HHI and the nurses' communication dimension scores (r = 0.191-0.472, P < 0.05). Besides, the incidence of negative events was higher in group A than in the other three groups, while the satisfaction with care was lower than in the other three groups (P < 0.05).

Conclusion

Improving nurses' communication skills in infusion room nursing quality management can improve the mental toughness and hope level of patients' accompanying family members, which is conducive to controlling their emotions and avoiding the occurrence of dispute incidents.