No abstract available.
Colonoscopy ; England ; Quality Indicators, Health Care

No abstract available.
Colonoscopy ; England ; Quality Indicators, Health Care

The hospital readmission rate has been widely used as an indicator of the quality of hospital care in many countries. However, the transferrability of this indicator that has been developed in a different health care system can be questioned. We reviewed what should be considered when using the risk-standardized readmission rate (RSRR) as a generic quality indicator in the Korean setting. We addressed the relationship between RSRR and the quality of hospital care, methodological aspects of RSRR, and use of RSRR for external purposes. These issues can influence the validity of the readmission rate as a generic quality indicator. Therefore RSRR should be used with care and further studies are needed to enhance the validity of the readmission rate indicator.
Delivery of Health Care ; Patient Readmission ; Quality Indicators, Health Care

BACKGROUND/AIMS: The colonoscopic withdrawal time has been proposed as a quality indicator for colonoscopy, and this is based on the recent evidence that the Colon withdrawal time is associated with adenoma detection rate. In this study, we examined the difference of the polyp detection rates between practicing endoscopists, and we analysed certain factors that might lead to such differences, and particularly the colonoscopic withdrawal time. METHODS: We retrospectively evaluated the colonoscopic procedures that were performed by 7 second-year GI fellows at Hanyang University Guri Hospital. A total of 1,515 colonoscopies were assessed for the polyp detection rate, the insertion time, the withdrawal time, bowel preparation, the size of the detected polyps and the location of polyps. RESULTS: The median withdrawal time for the case with no polyps removed was 3.6 to 7.1 minutes. There was a strong positive correlation between the colonoscopic withdrawal times and the polyp detection rates (p<0.001). Furthermore, a longer withdrawal time resulted in discovering a higher percentage of small polyps. On comparing groups, the group of colonoscopists with a withdrawal time longer than 6 minutes had a higher rate of detecting polyps (30.7% vs 18.4%, p<0.001). CONCLUSIONS: There is wide range of polyp detection rates among practicing colonoscopists and there is strong positive correlation between the colonoscopic withdrawal times and the rate of detecting polyps. A long enough withdrawal time, perhaps 7 minutes, is needed to raise the rate of detecting polyps during colonoscopy.
Adenoma ; Colon ; Colonoscopy ; Polyps ; Quality Indicators, Health Care ; Retrospective Studies

Child ; China ; Humans ; Pediatrics ; Quality Indicators, Health Care ; Research

PURPOSE: This study aimed at developing integrated clinical performance indicators(CPIs) through the analysis of quality improvement(QI) activities of a hospital and literature review about performance measures. METHOD: The CPIs were developed through the following three stages; 1)Identifying preliminary CPIs 2)A staff validity test in preliminary CPIs 3)Developing final CPIs. RESULT: One hundred twenty-three preliminary CPIs were developed through QI activities of the target hospital for 8 years and literature review. The results of the validity test for the preliminary CPIs supported ninety-one items. Sixty-two CPIs were selected through integration, reclassification and renaming. Then, eighteen items were deleted on account of an imprecise calculation method. Finally, forty-four CPIs were confirmed. They consisted of twenty-six items at the hospital level and eighteen items at the department level. CONCLUSION: CPIs can be used as criteria to evaluate the performance of healthcare organizations, and to decide the quality of healthcare for customers. This study may contribute to establishing an integrated system between QI activities and performance measurement of healthcare organizations.
*Quality Indicators, Health Care ; *Quality Assurance, Health Care ; Middle Aged ; Korea ; Humans ; Hospitals/*standards ; Adult

In Singapore, chronic care is provided by both ambulatory primary care clinics and specialist clinics in hospitals. In 2005, the National Healthcare Group (NHG) embarked to build a diabetes registry to enhance the continuity of care for patients with diabetes and facilitate greater efficiency in outcome measurement. This Chronic Disease Management System (CDMS) links administrative and key clinical data of patients with diabetes mellitus across the healthcare cluster. At the point of patient care, clinicians view a summary of each patient's chronic disease records, consolidated chart with physical parameters, laboratory investigation results and the "patient reminders" listing the clinical decision support prompts when key laboratory and screening tests are due for each patient. The CDMS provides reports of clinical outcomes in a systematic and efficient manner for quality improvement and evidenced-based population management. These include process indicators consisting of the rates of glycated haemoglobin (HbA1c), low-density lipoprotein-cholesterol (LDL-c) and nephropathy tests; and intermediate outcome indicators of the proportion of patients with poor HbA1c (>9%) and optimal LDL-c (<2.6 mmol/L) control. From January 2007 to December 2008, the rates of the 3 process indicators were relatively unchanged and that of HbA1c and LDL-c tests were high. There was gradual improvement in the proportion of patients achieving target level of LDL-c in both primary care clinics and hospitals. Fewer patients at primary care clinics had poorly-controlled HbA1c. As a tool for chronic care delivery, the NHG diabetes registry has made clinical monitoring and outcome management for patients with diabetes mellitus more efficient.
Diabetes Mellitus ; Humans ; Program Development ; Quality Indicators, Health Care ; Quality of Health Care ; Registries ; Singapore

PURPOSE: This study was designed to develop quality outcome indicators for nursing homes and community-based home care that would contribute to an appropriate evaluation and improvement of quality of long term care in Korea. METHODS: The preliminary quality indicators of long term care were developed from a literature review and clinical expert panel. A content validity testing was done using a panel of experts who were selected from academic and clinical field of long-term care. The final quality indicators were confirmed after application in four nursing homes and four home care agencies to test clinical validity. RESULTS: The preliminary quality indicators consisted of 3 domains and 19 indicators. The final quality indicators were composed of 4 domains and 17 indicators. CONCLUSION: This study demonstrated the feasibility of outcome quality indicators in long term care. These quality indicators can be effectively used to evaluate the quality of nursing home and home care and to improve the quality of care in the Korean long-term care system.
Home Care Agencies ; Home Care Services ; Long-Term Care ; Nursing Homes ; Quality Indicators, Health Care

Assessment of mental health service refers to the process of using the indicator system and methods to reflect the quality or performance of mental health. Mental health evaluation can effectively promote the development of mental health system and service quality. Scientific and comprehensive indicator system is key to assessment. After long-term practice and exploration, there have been many successful assessment schemes in foreign countries, which may be used in establishing the assessment system and screening indicators in China.
China ; Health Status Indicators ; Humans ; Mental Disorders ; rehabilitation ; Mental Health Services ; standards ; Quality Indicators, Health Care ; Surveys and Questionnaires

The payment system such as national long term care insurance for the elderly and per diem rate for geriatric hospitals introduced in 2008 has greatly changed the Korean medical system for the elderly. Therefore, today it would be inevitable to discuss quality assessment of healthcare services provided by nursing facilities and geriatric hospitals in order to effectively establish and operate the introduced systems. Under these circumstances, in an effort to provide elderly people with high-quality medical services with limited resources, it is believed that the quality indicators need to include the following: (1) provision and management of medical services for major health problems; (2) assessment of quality of life for residents; (3) assessment of ADL and rehabilitation services so as to maintain and improve functions; (4) assessment of convenience of living facilities; and (5) assessment of rate of potential avoidable hospitalization in acute care hospitals. Moreover, along with an effort to define roles of nursing facilities and geriatric hospitals, it would be necessary to set up the feasible stepwise strategy through discussions with relevant institutions.
Activities of Daily Living ; Aged ; Delivery of Health Care ; Hospitalization ; Humans ; Insurance, Long-Term Care ; Quality Indicators, Health Care ; Quality of Life