1.Description of core performance measures and indicators of patient safety used by select government and private hospitals in the Philippines
Diana R. Tamondong-Lachica ; Lynn Crisanta R. Panganiban ; Generoso D. Roberto ; Charissa Rosamond D. Calacday ; Agnes D. Mejia
Acta Medica Philippina 2024;58(1):15-24
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
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Outcome and Process Assessment, Health Care
2.Assessment of panoramic radiography as a national oral examination tool: review of the literature.
Imaging Science in Dentistry 2011;41(1):1-6
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
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Diagnosis, Oral
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Mass Screening
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Outcome and Process Assessment (Health Care)
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Patient Selection
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Periodontal Diseases
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Radiation Dosage
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Radiography, Panoramic
4.Early recognition of deteriorating patient program in department of cardiac surgery.
Chunxiang QIN ; Ping MAO ; Peng XIAO ; Sainan ZENG ; Jianfei XIE ; Siqing DING
Journal of Central South University(Medical Sciences) 2014;39(3):307-312
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
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organization & administration
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Critical Illness
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Humans
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Intensive Care Units
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Outcome and Process Assessment, Health Care
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Patient Handoff
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Surgery Department, Hospital
;
organization & administration
5.Outcome mapping for decision-making in health system.
Journal of Zhejiang University. Medical sciences 2014;43(2):245-251
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
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Outcome and Process Assessment (Health Care)
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methods
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Planning Techniques
6.Impact evaluation of HIV/AIDS education in rural Henan province of China.
Ben-yan LV ; Yuan-xi XIANG ; Rui ZHAO ; Zhan-chun FENG ; Shu-ying LIANG ; Yu-ming WANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2013;33(6):905-911
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
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prevention & control
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Adult
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Aged
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China
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Female
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Humans
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Male
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Middle Aged
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Outcome and Process Assessment (Health Care)
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Patient Education as Topic
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methods
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standards
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Rural Population
7.Noninfectious Complications of Peritoneal Dialysis in Korean Children: A 26-Year Single-Center Study.
Ji Eun KIM ; Se Jin PARK ; Ji Young OH ; Ji Hong KIM ; Jae Seung LEE ; Pyung Kil KIM ; Jae Il SHIN
Yonsei Medical Journal 2015;56(5):1359-1364
PURPOSE: The aim of this study was to investigate noninfectious complications of peritoneal dialysis (PD), including mechanical and metabolic complications, at a single center in Korea. MATERIALS AND METHODS: We analyzed data from 60 PD patients aged < or =18 years (40 boys and 20 girls) during the period between 1986 and 2012. The collected data included gender, age, causes of PD, incidence of noninfectious complications, and treatment for the complications. RESULTS: The mean duration of PD therapy was 28.7+/-42.1 months (range 1-240 months). The most common cause of end-stage renal disease was glomerular disease (43.3%). There were no statistically significant differences between patients with and without mechanical complications regarding gender, age at the start of PD, and total duration of PD. Outflow failure was the most common catheter-related complication (14.3%), followed by leakage (10.0%) and hernia (8.6%). Metabolic complications, such as hyperglycemia and hypokalemia, were observed in three of 16 patients. The frequency of noninfectious complications of PD in our study was comparable with those in previous pediatric studies. PD was switched to hemodialysis (HD) in only three patients. CONCLUSION: Our results indicate that noninfectious complications of PD are common, though they hardly lead to catheter removal or HD in pediatric patients on PD.
Adolescent
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Asian Continental Ancestry Group
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Catheterization/*adverse effects
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Child
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Child, Preschool
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Device Removal
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Female
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Humans
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Incidence
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Kidney Failure, Chronic/*therapy
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Male
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*Outcome and Process Assessment (Health Care)
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Peritoneal Dialysis/*adverse effects/instrumentation/*methods
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Renal Dialysis/adverse effects
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Republic of Korea
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Treatment Outcome
8.Development of Nursing Information System for the Analysis of Nursing Intervention Effects on Patient Outcomes.
Journal of Korean Society of Medical Informatics 2005;11(4):371-382
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
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Hospital Information Systems
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Humans
;
Information Systems*
;
Nursing Care
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Nursing Diagnosis
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Nursing Process
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Nursing*
;
Outcome Assessment (Health Care)
9.Experience of clinical skills assessment in the Busan-Gyeongnam Consortium.
Beesung KAM ; Young Rim OH ; Sang Hwa LEE ; Hye Rin ROH ; Jong Ryeal HAHM ; Sun Ju IM
Korean Journal of Medical Education 2013;25(4):327-336
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
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Clinical Competence*
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Humans
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Outcome and Process Assessment (Health Care)
;
Psychometrics
;
Schools, Medical
10.Questionnaires on the diagnosis and treatment of erectile dysfunction.
Yi-Ming YUAN ; Su ZHOU ; Kai ZHANG
National Journal of Andrology 2008;14(12):1121-1125
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
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diagnosis
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drug therapy
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psychology
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Humans
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Male
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Outcome and Process Assessment (Health Care)
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Surveys and Questionnaires