Iskanje po katalogu digitalne knjižnice

Opis: Background and purpose: The use of quality registers has increased rapidly in Sweden and they are identified as beneficial for health care competitiveness. A quality register is a structured gathering of patient information, to improve health care. However, the introduction of quality registers in health care organisations presupposes that employees know how to use them in quality improvement. Disconnections, or knowledge gaps, concerning quality registers hamper the possibilities to take advantage of them. Taking departure in professional health care educations, the purpose with the paper is to identify and explore knowledge gaps concerning quality registers. A second purpose is to propose actions to bridge the gaps. Methodology/Approach: In 2012 50 semi-structured telephone interviews were completed and the material analysed in the search for knowledge gaps. Results: Five knowledge gaps were found. Some professional health care educations teach improvement knowledge, but they have difficulties integrating quality registers as a resource in teaching. Quality registers do not sufficiently cooperate with professional health care educations and county councils do not generally include learning of quality registers in clinical placements/practicums. Conclusion: Professional health care educations need forums where they can collaborate with others to jointly explore how learning of quality registers can be integrated. There are promising approaches.
Ključne besede: quality registers, quality improvement, health care
Objavljeno v DKUM: 22.01.2018; Ogledov: 603; Prenosov: 104
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Opis: Background: Several tools have been developed to measure safety attitudes of health care providers, out of which the Safety Attitudes Questionnaire (SAQ) is regarded as one of the most appropriate ones. In 2007, it was adapted to outpatient (primary health care) settings and in 2014 it was tested in out-of-hours health care settings in Norway. The purpose of this study was to translate the English version of the SAQ-Ambulatory Version (SAQ-AV) to Slovenian language; to test its reliability; and to explore its factor structure. Methods: This was a cross-sectional study that took place in Slovenian out-of-hours primary care clinics in March- May 2015 as a part of an international study entitled Patient Safety Culture in European Out-of-hours services. The questionnaire consisted of the Slovenian version of the SAQ-AV. The link to the questionnaire was emailed to health care workers in the out-of-hours clinics. A total of 438 participants were invited. We performed exploratory factor analysis. Results: Out of 438 invited participants, 250 answered the questionnaire (response rate 57.1%). Exploratory factor analysis put forward five factors: 1) Perceptions of management, 2) Job satisfaction, 3) Safety climate, 4) Teamwork climate, and 5) Communication. Cronbach's alpha of the whole SAQ-AV was 0.922. Cronbach's alpha of the five factors ranged from 0.587 to 0.791. Mean total score of the SAQ-AV was 56.6 +- 16.0 points. The factor with the highest average score was Teamwork climate and the factor with the lowest average was Job satisfaction. Conclusions: Based on the results in our study, we cannot state that the SAQ-AV is a reliable tool for measuring safety culture in the Slovenian out-of-hours care setting. Our study also showed that there might be other safety culture factors in out-of-hours care not recognised before. We therefore recommend larger studies aiming to identify an alternative factor structure.
Ključne besede: patient safety, quality assurance, health care
Objavljeno v DKUM: 28.06.2017; Ogledov: 1100; Prenosov: 137
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Opis: Background: Medical processes are often obstructed by administrative ones. The main issue in administrative processes is uneven workload resulting in an increased possibility of human errors. The system approach assures that medical and administrative processes are integrated. According to research reports and best practices, discrete event simulation is a proper method to implement the system approach. Methods: A detailed analysis of the administrative processes was performed using interviews, UML diagrams and flowcharts. Based on the data gathered from the information system and measurements on the site, the distribution of patient arrivals and service times were modelled. The aim of discrete event simulation models was to replicate the behaviour of the existing system (separate administration) and to simulate the changes proposed (joint administration). Results: Average utilizations of administrative personnel in 100 simulation runs for specific clinical departments are: 83.8 % at the Department of Rheumatology, 61.9 % at the Department of Hypertension, and 47.2 % at the Veteransć Medical Unit. Should joint administration be applied, the average utilization of administrative personnel would be 74.3%. Conclusions: Discrete event simulation proved that joint administration would contribute to a more even workload distribution among administrative personnel, higher quality of service and easier human resource management. The presented approach can be efficiently applied to large-scale systems e.g. organizational changes of processes in Specialist Outpatient Clinics.
Ključne besede: health care, discrete event simulation, quality of service
Objavljeno v DKUM: 27.03.2017; Ogledov: 838; Prenosov: 127
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