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

Registry studies (RS) get more and more attention in recent years because it can reflect the health care situations of the real world. There are a number of large scale RS for traditional Chinese medicine (TCM). RS are observational studies that can complement randomized controlled trials (RCT). RS have an irreplaceable position in real word study (RWS), especially for small probability events. There are some different characters and qualities in RS. Registries for Evaluating Patient Outcomes: A User's Guide (2nd Edition) was published by the agency for healthcare research and quality (AHRQ) in 2010. It described the details of how to establish, maintain, and evaluate RS, and using 38 RS samples to illustrate the possible problems in undertaking such research. The User's Guide (2nd Edition) provides a reliable reference document for RS. TCM injections post-marketing safety surveillance RS is a national program involving multiple centers in China. This program can further improve RS quality their application in China and is a good illustration of how to follow this guide accurately.
Books ; Drug Therapy ; Drugs, Chinese Herbal ; standards ; therapeutic use ; Humans ; Observational Studies as Topic ; Outcome Assessment (Health Care) ; organization & administration ; standards ; Patient Selection ; Pragmatic Clinical Trials as Topic ; Registries ; standards ; United States ; United States Agency for Healthcare Research and Quality

Patient-reported outcomes (PROs) provide clinical researchers with a good means to assess patient-based outcomes. Yet there are still some problems to pay attention to while using PROs as an effectiveness assessment index, including the selection of an appropriate scale of PRO, quality control in PRO data collection, and the interpretations and application ranges of the PRO results.
Outcome Assessment (Health Care) ; methods ; Patient Satisfaction ; Psychometrics ; Quality Control

PURPOSE: The elderly with UI experienced urine leakage for a long time. The prevalence of UI has increased and it makes costly. Particularly, the elderly were reluctant to visit a hospital or a clinic for the reasons of modesty and poverty. To solve this problem, incontinence intervention programs should be provided at the elderly welfare center. The purpose of this research was to develop Incontinence Intervention Program for the Elderly Women (IIPE) and evaluate in its effect. METHODS: The study design was quasi-experimental with pre and post-test. The study was performed for ten weeks at one elderly welfare center, Seoul, Korea. The subjects were gathered through an official announcement and informed consent was obtained. IIPE, in this study, was consisted of diagnosis, education, exercise and evaluation. The study variables were PFM exercise adherence, pelvic muscle strength, Continence selfefficacy, geriatric depression and incontinence stress. The effects of the IIPE on PFM exercise adherence, pelvic muscle strength, Continence self-efficacy, geriatric depression and incontinence stress were also evaluated. RESULTS: The mean age of the subjects was 75.2 years. The average attendance was 6.2 times. The IIPE improved PFM exercise adherence, intra-vaginal contraction power and CSE significantly. But it was not significant in incontinence stress and geriatric depression. Other important results were that the two-finger test and urine stream interruption were more useful for elderly women with rigid vaginas in teaching and evaluating. CONCLUSION: The Findings suggest that IIPE is effective to the community-residing elderly. Further investigation is needed on a long-term basis with control group.
Aged ; Exercise Therapy/*organization & administration ; Female ; Geriatric Assessment ; Geriatric Nursing/*organization & administration ; Humans ; Korea/epidemiology ; Nursing Assessment ; Nursing Evaluation Research ; *Nursing Homes ; Parity ; Patient Acceptance of Health Care ; Patient Education as Topic/*organization & administration ; Pelvic Floor ; Prevalence ; Program Development ; Program Evaluation ; Questionnaires ; Risk Factors ; Self Efficacy ; Treatment Outcome ; Urinary Incontinence/diagnosis/epidemiology/psychology/*rehabilitation ; Urodynamics

PURPOSE: The purpose of this review is to evaluate the possibility of panoramic radiography as a national oral examination tool. MATERIALS AND METHODS: This report was carried out by review of the literatures. RESULTS: Panoramic radiography has sufficient diagnostic accuracy in dental caries, periodontal diseases, and other lesions. Also, the effective dose of panoramic radiography is lower than traditional full-mouth periapical radiography. CONCLUSION: Panoramic radiography will improve the efficacy of dental examination in national oral examination. However, more studies are required to evaluate the benefit, financial cost, and operation time and also to make selection criteria and quality management program.
Dental Caries ; Diagnosis, Oral ; Mass Screening ; Outcome and Process Assessment (Health Care) ; Patient Selection ; Periodontal Diseases ; Radiation Dosage ; Radiography, Panoramic

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

PURPOSE: Patients usually suffer from pain and discomfort after oral surgery and their consumption of food is severely affected. Accordingly, the patients' quality of life reduce significantly. The aim of this study was to analyze patient satisfaction on the nutritional supplement drinks following periodontal surgery. MATERIALS AND METHODS: Total 90 patients who underwent periodontal surgery were recruited and commercially available nutritional drinks were provided. Group I received two bottles per each meal for 2 days, Group II had one bottle per each meal for 3 days, and Group III had no drinks. The survey for the patient-reported outcome measures (PROMs) were given at the next visit for the removal of sutures. RESULTS: The result of PROMs showed the nutrition drink was easy to intake, appeared to help the healing and can be a satisfying supplement for the meals. CONCLUSION: Nutritional drinks appeared to help the healing after periodontal surgeries and supported the food intake. Also, it was helpful for the patients in nutritional supply and psychological stability.
Eating ; Humans ; Meals ; Outcome Assessment (Health Care)* ; Patient Satisfaction ; Quality of Life ; Surgery, Oral ; Sutures ; Wound Healing

PURPOSE: Quality indicators of the National Endoscopy Quality Improvement Program (NEQIP) and outcome measures of endoscopy in the National Cancer Screening Program (NCSP) in Korea are not clear. We evaluated the quality indicators of the revised NEQIP and outcome measures of endoscopy at different types of healthcare facilities participating in the NCSP. MATERIALS AND METHODS: This study was conducted between March and August 2018 in primary, secondary, and tertiary healthcare facilities that perform endoscopy as a part of the NCSP. Representative endoscopists completed a questionnaire for quality indicators of the NEQIP and provided data on outcome measures for endoscopy. RESULTS: Quality indicators of the NEQIP were mostly acceptable. However, the quality indicators for annual volume of esophagogastroduodenoscopy (EGD) and colonoscopy, training for endoscopy quality improvement by endoscopy nursing staff, colonoscopy reports, documentation of pathologic lesions, quality of endoscopy reprocessing areas, and completion of endoscopy reprocessing education programs were suboptimal. For outcome measures of EGD, the number of photo-documentations and total procedure time were higher at tertiary healthcare facilities than at other facilities (p<0.001 and p=0.023, respectively). For the outcome measures of colonoscopy, colonoscopy completion rate and waiting times for colonoscopy were significantly higher at tertiary healthcare facilities than at other facilities (both p<0.001). CONCLUSION: Outcome measures of endoscopy should be included as quality indicators of NCSP. However, universal outcome measures for all types of healthcare facilities should be established because performance levels of some outcome measures differ among individual healthcare facility types.
Colonoscopy ; Delivery of Health Care ; Early Detection of Cancer ; Education ; Endoscopy ; Endoscopy, Digestive System ; Gastroscopy ; Humans ; Korea ; Mass Screening ; Nursing Staff ; Outcome Assessment (Health Care) ; Quality Improvement ; Tertiary Healthcare

OBJECTIVE: To explore the application and the effect of early recognition of deteriorating patient program in department of cardiac surgery. METHODS: We used the early recognition of deteriorating patient program in the cardiac surgery groups, including cardiac surgeons, nurses in ward, ICU and operation rooms of the cardiac surgery department, and compared the satisfaction of nurses and doctors, handover time, handover score of critical patients, and rate of unplanned ICU admission before and after the intervention. RESULTS: After using the early recognition of deteriorating patient program, the satisfaction of doctors and nurses was increased, the handover time was lowered 0.56 min/time (t=2.22, P<0.05), the handover score of critical patients enhanced by 19.59 points (t=30.57, P<0.001), the rate of unplanned ICU readmission after the operation reduced by 4.8% (χ2=4.14, P<0.05). CONCLUSION Early recognition of deteriorating patient program can improve the safety of cardiac patients, enhance the self-confidence of nurses and work efficiency.
Cardiology Service, Hospital ; organization & administration ; Critical Illness ; Humans ; Intensive Care Units ; Outcome and Process Assessment, Health Care ; Patient Handoff ; Surgery Department, Hospital ; organization & administration

Nowadays, there is a trend of HIV prevalence transmitting from high-risk group to average-risk group in China. Rural China is the weak link of HIV prevention, and rural areas of Henan province which is one of the most high-risk regions in China have more than 60% of the AIDS patients in the province. Thus, improving the HIV awareness and implementing health education become the top-priority of HIV/AIDS control and prevention. A multistage sampling was designed to draw 1129 people living with HIV/AIDS (PLWHAs) and 1168 non-PLWHAs in 4 prevalence counties of Henan province. A health promoting and social-psychological support model was constructed to improve the health knowledge of participants. Chi-square tests and unconditional logistic regression were performed to determine the intervention effect and influencing factors. All groups had misunderstandings towards the basic medical knowledge and the AIDS transmission mode. Before the intervention, 59.3% of the HIV/AIDS patients and 74.6% of the healthy people had negative attitudes towards the disease. There was statistically significant difference in the improvement of knowledge, attitude and action with regards to HIV prevention before and after intervention (P<0.05). PLWHAs who were males (OR=1.731) and had higher education level (OR=1.910) were found to have better HIV/AIDS health knowledge, whereas older PLWHAs (OR=0.961) were less likely to have better HIV/AIDS health knowledge. However, the intervention effect was associated with the expertise of doctors and supervisors, the content and methods of education, and participants' education level. It was concluded that health education of HIV/AIDS which positively influences the awareness and attitude of HIV prevention is popular in rural areas, therefore, a systematic and long-term program of HIV control and prevention is urgently needed in rural areas.
Acquired Immunodeficiency Syndrome ; prevention & control ; Adult ; Aged ; China ; Female ; Humans ; Male ; Middle Aged ; Outcome and Process Assessment (Health Care) ; Patient Education as Topic ; methods ; standards ; Rural Population