Background: In 2008, the Department of Health (DOH) issued Administrative Order 2008-0023 that called for an “effective and efficient monitoring system that will link all patient safety initiatives”. However, there are still no explicit and harmonized targets to measure effectiveness and to provide benchmarks that assess whether previous efforts were helpful. Objective: The study aimed to describe the status of patient safety performance measures and indicators on the international patient safety goals (IPSGs) in select hospitals in the Philippines. Methods: Descriptive, cross-sectional design was used to investigate currently used performance measures and indicators. Data collection included administration of a Hospital Patient Safety Indicators Questionnaire (HPSIQ) that summarized the currently used patient safety measures and indicators in the sampled Level 2 and level 3 hospitals and triangulation by review of documents such as hospital databases, protocols on reporting, and manuals for information gathering regarding patient safety. Performance measures were categorized using the Donabedian framework. Core indicators were identified through review of standards that cut across the six IPSGs and evaluation of overarching processes and concepts in patient safety. Results: Forty-one level 2 and 3 hospitals participated in the study. Most performance indicators were process measures (52%), while structure (31%) and outcome measures (17%) accounted for the rest. There is an obvious lack of structural requirements for patient safety in the hospitals included in this study. Less than half the hospitals surveyed implement risk assessment and management consistently. Reporting of events, near- misses, and patient safety data are widely varied among hospitals. Data utilization for quality improvement is not fully established in many of the hospitals. Patient engagement is not integrated in service delivery and performance measurement but is crucial in promoting patient safety. Conclusion Mechanisms to improve hospitals’ capacity to monitor, anticipate, and reduce risk of patient harm during the provision of healthcare should be provided. Having a unified set of definitions and protocols for measurement will facilitate reliable monitoring and improvement. Leadership and governance, both internal (e.g., hospital administrators) and external (e.g., DOH) that recognize a data-driven approach to policymaking and improvement of service delivery are crucial in promoting patient safety
Patient Safety ; Outcome and Process Assessment, Health Care

Health Promotion ; Outcome and Process Assessment (Health Care) ; Workplace

Outcome mapping (OM) is a participant-oriented new method for project planning,monitoring and evaluation.It is based on continuous learning and focuses on changes in behavior,relationship and activities of persons,groups and organizations.The use of OM can help to clarify the roles and assignments of the government,managers,health workers,and other relevant personnel,making full use of the limited social resources and improving the efficiency and quality of health services.We introduce the principle and operation steps of OM with case simulation in health resource integration,to show its application in decision-making.
Decision Making ; Outcome and Process Assessment (Health Care) ; methods ; Planning Techniques

OBJECTIVE: Development of nursing documentation system is the first step as a way to do nursing effectiveness research and proving effectiveness of nursing care on patient outcomes to the other health care professionals as well as the public. METHODS: To develop nursing documentation system using nursing process model, the system incorporated standardized nursing terminologies of North American Nursing Diagnosis Association(NANDA), Nursing Interventions Classification(NIC), and Nursing Outcomes Classification(NOC). The system was developed under the hospital information system by TCP/IP protocol and used Oracle as DBMS under the Windows 98 environment. Power Builder 5.0 was used as a program language. RESULTS: First data model was created and served as the foundation for designing the user interface. And then the system was developed for collecting, storing, and retrieving nursing diagnoses, interventions, and outcomes and comparing the changes in patient outcomes before and after interventions performed. CONCLUSION: By developing nursing information system that includes nursing care sensitive patient outcomes, nurses can involve nursing effectiveness research and know how to improve nursing care quality provided for patients by analyzing patient outcome data. Further evaluation of this system should be followed.
Delivery of Health Care ; Hospital Information Systems ; Humans ; Information Systems* ; Nursing Care ; Nursing Diagnosis ; Nursing Process ; Nursing* ; Outcome Assessment (Health Care)

PURPOSE: The purpose of this study is to judge the quality of clinical skills assessment in Busan-Gyeongnam Consortium. METHODS: Fourth grade medical school students (n=350 in 2012 and n=419 in 2013) in the Busan-Gyeongnam Consortium were included in the study. The examination was consisted of 6 clinical performance examination (CPX) and 6 objective structured clinical examination (OSCE) stations. The students were divided into groups to take the exam in 4 sites during 3 days. The overall reliability was estimated by Cronbach alpha coefficient across the stations and the case reliability was by alpha across checklist items. Analysis of variance and between-group variation were used to evaluate the variation of examinee performance across different days and sites. RESULTS: The mean total CPX/OSCE score was 67.0 points. The overall alpha across-stations was 0.66 in 2012 and 0.61 in 2013. The alpha across-items within a station was 0.54 to 0.86 in CPX, 0.51 to 0.92 in OSCE. There was no significant increase in scores between the different days. The mean scores over sites were different in 30 out of 48 stations but between-group variances were under 30%, except 2 cases. CONCLUSION: The overall reliability was below 0.70 and standardization of exam sites was unclear. To improve the quality of exam, case development, item design, training of standardized patients and assessors, and standardization of sites are necessary. Above of all, we need to develop the well-organized matrix to measure the quality of the exam.
Checklist ; Clinical Competence* ; Humans ; Outcome and Process Assessment (Health Care) ; Psychometrics ; Schools, Medical

Patient-centered questionnaires, as widely used tools for the diagnosis of erectile dysfunction (ED) and the assessment of ED treatment efficacy, are increasing in number and kinds. This review focuses on a few effective and most commonly used ED-related questionnaires, including the International Index of Erectile Function (IIEF), Sexual Health Inventory for Men (SHIM), Erectile Function Domain of the IIEF (IIEF-EF), Erection Hardness Grading Scale (EHGS), Self-Esteem and Relationship Questionnaire (SEAR), Erection Dysfunction Inventory of Treatment Satisfaction (EDITS), Quality of Erection Questionnaire (QEQ), Treatment Satisfaction Scale (TSS), Psychological and Interpersonal Relationship Scales (PAIRS), and Sexual Experience Questionnaire (SEX-Q). The objectives, contents and characteristics of these questionnaires are explained and discussed.
Erectile Dysfunction ; diagnosis ; drug therapy ; psychology ; Humans ; Male ; Outcome and Process Assessment (Health Care) ; Surveys and Questionnaires

PURPOSE: This study aimed to examine the effects of simulation-based education on nursing knowledge, anxiety, and clinical performance ability in nursing students before their first clinical practice. METHODS: Third-year university students who had not yet entered their first clinical practice were recruited to participate in the study. Nineteen students formed the experimental group and participated in simulation-based education for 7 sessions. The 19 students in the control group were provided with clinical practice orientation in the form of traditional lectures. Outcome measures assessed nursing knowledge, clinical practice anxiety, and clinical performance ability. Data were collected before and immediately after the simulation-based education and after six weeks of clinical practice. RESULTS: Nursing knowledge and clinical anxiety were not statistically significant between the groups. However, there was a significant improvement in the clinical performance abilities of the experimental group. Among the subcategories, the ability to apply the nursing process and the ability to educate and cooperate were shown to maintain significant differences from the control group by the end of the six weeks of clinical practice. CONCLUSION: The simulation prior to nursing students’ first clinical practice could be useful to improve clinical performance ability. Nursing educators should consider building programs to reduce anxiety and improve performance ability through simulations.
Anxiety ; Clinical Competence ; Education ; Humans ; Lectures ; Nursing Process ; Nursing ; Outcome Assessment (Health Care) ; Students, Nursing

OBJECTIVES: The objective of this study is to find out what nurses wrote in narrative nursing notes. METHODS: Forty-six patients' nursing notes were analyzed based on the nursing process. Eight patterns were extracted depending on the different combinations of the nursing process components. RESULTS: Of the 8 patterns, assessment only pattern was the most frequent comprising 45.8% and assessment or diagnosis-intervention-outcome patterns accounted for 25.9% of the total nursing phrases. The content of nursing notes was also classified into 15 categories. Out of these 15 categories, nursing outcomes were recorded more frequently in nursing care mainly driven by doctor's order such as diseases related symptom management, insomnia care, respiratory care and pain control than in independent nursing care such as education and emotional care. According to the survey on nurses' attitude toward nursing record, nurses did not document nursing outcome as much as they reported they did. The main reasons for this discrepancy were insufficient time for recording and lack of knowledge about why, how and what to evaluate. CONCLUSION: Even though there is room for improvement, nursing notes can be used a source for nursing contribution to patient outcomes.
Education ; Humans ; Nursing Care ; Nursing Process* ; Nursing Records* ; Nursing* ; Outcome Assessment (Health Care) ; Sleep Initiation and Maintenance Disorders ; Thoracic Surgery*

OBJECTIVETo calculate the actual expenditures in a county of Dehong prefecture, Yunnan province, China by using the method of National AIDS Spending Assessment (NASA) in 2010.

METHODSData were collected through NASA data collection form based on adapted NASA classification in the county of Dehong prefecture from October to December, 2011, and complemented by semi-structured interview with 16 well trained programmatic and financial representatives in 8 spending units. Data were entered in Resource Tracking Software (RTS) V 2009.3.0, and SPSS 13.0 was used for data processing and analysis.

RESULTSThe NASA estimations showed that the county spent a total of ¥16 235 954 on HIV/AIDS in 2010. Public funds constituted 96.3% of the total expenditure (¥15 630 937), followed by Global Fund which accounted for 3.0% (¥484 585) and private sources which accounted for 0.7% (¥120 432). Findings based on NASA categories showed that AIDS spendings were mainly on 4 areas, and expenditure on Care & Treatment was ¥12 401 382 (76.4% of total expenditure), followed by Prevention which accounted for 14.3% (¥2 325 707), Program Management & Administration which accounted for 7.8% (¥1 268 523) and human resources which accounted for 1.5% (¥240 342). The most beneficial population group was People Living with HIV (PLHIV), accounting for 84.7% of total expenditure. (¥13 753 428), followed by 4.8% for high risk population, including female sex workers and their partners (¥297 333), injection drug users and their partners (¥293 143), men having sex with men and their partners (¥185 136) and 1.5% (¥241 429) for the general population.

CONCLUSIONThe local funds for HIV/AIDS in this county was insufficient. The local government should increase corresponding funds based on central government funding. Care and treatment was the first spending priority in the county and the investment of prevention services needs to be increased. Prevention and treatment and care should be combined to ensure the effectiveness of comprehensive prevention and treatment of AIDS.

Acquired Immunodeficiency Syndrome ; economics ; prevention & control ; China ; Financing, Government ; economics ; Health Expenditures ; Humans ; Outcome and Process Assessment (Health Care) ; Surveys and Questionnaires

PURPOSE: This study was performed to investigate the preventable death rate (PDR) in Daegu, South Korea, and to assess both its affecting- and preventable-factors to improve the treatment of regional trauma patients. METHODS: All cases of traumatic death that occurred between January 2012 and December 2012 in five hospitals in Daegu were analyzed retrospectively by a panel review. Cases were classified into preventable (P) and non-preventable deaths (NP). We determined the affecting factors of trauma deaths and preventable factors during trauma care. RESULTS: The PDR was 25.2%. Significant differences by mode of arrival, day of injury, cause of death, and time of emergency department (ED) arrival were observed between P and NP groups. According to the logistic regression analysis, preventability was associated with patients transferred from other hospitals, ED arrival at night and dawn, and non-head injuries. A total of 145 preventable factors were discovered in 59 preventable trauma deaths. When we categorized by location, the ED was the most common, with 71 cases, followed by 57 prehospital preventable factors. When we classified the preventable factors by process, 76.8% were process-related and 23.4% were structure-related. CONCLUSION: Our study is valuable to build an adequate trauma system in Daegu as it provides the baseline quality control data. Efforts to mediate the preventable factors were revealed in this study, and continuous reviews to calculate and track the PDR are needed to evaluate the local trauma system and establish a system specific to Daegu.
Cause of Death ; Daegu* ; Emergency Service, Hospital ; Humans ; Korea* ; Logistic Models ; Mortality* ; Outcome and Process Assessment (Health Care) ; Quality Control ; Retrospective Studies