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1.
Factors impacting on the activation and approach times of helicopter emergency medical services in four Alpine countries
Iztok Tomazin, Miljana Vegnuti, John Ellerton, Oliver Reisten, Guenther Sumann, Janko Kersnik, 2012, izvirni znanstveni članek

Opis: Background: The outcome of severely injured or ill patients can be time dependent. Short activation and approach times for emergency medical service (EMS) units are widely recognized to be important quality indicators. The use of a helicopter emergency medical service (HEMS) can significantly shorten rescue missions especially in mountainous areas. We aimed to analyze the HEMS characteristics that influence the activation and approach times. Methods: In a multi-centre retrospective study, we analyzed 6121 rescue missions from nineHEMS bases situated in mountainous regions of four European countries. Results: We found large differences in mean activation and approach times among HEMS bases. The shortest mean activation time was 2.9 minutes; the longest 17.0 minutes. The shortest mean approach time was 10.4 minutes; the longest 45.0 minutes. Short times are linked (p < 0.001) to the following conditions: helicopter operator is not state owned; HEMS is integrated in EMS; all crew members are at the same location; doctors come from state or private health institutions; organization performing HEMS is privately owned; helicopters are only for HEMS; operation area is around 10.000 km2; HEMS activation is by a dispatching centre of regional government who is in charge of making decisions; there is only one intermediator in the emergency call; helicopter is equipped with hoist or fixed line; HEMS has more than one base with helicopters, and one team per base; closest neighboring base is 90 km away; HEMS is about 20 years old and has more than 650 missions per year; and modern helicopters are used. Conclusions: An improvement in HEMS activation and approach times is possible. We found 17 factors associated with shorter times.
Ključne besede: emergency medical services, air ambulances, emergency helicopters, quality of health care, activation and approach time
Objavljeno: 29.06.2017; Ogledov: 439; Prenosov: 51
.pdf Celotno besedilo (1,22 MB)
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2.
Patient safety culture in Slovenian out-of-hours primary care clinics
Zalika Klemenc-Ketiš, Ellen Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik, 2017, izvirni znanstveni članek

Opis: Introduction: Patient safety culture is a concept which describes how leader and staff interaction, attitudes, routines and practices protect patients from adverse events in healthcare. We aimed to investigate patient safety culture in Slovenian out-of-hours health care (OOHC) clinics, and determine the possible factors that might be associated with it. Methods: This was a cross-sectional study, which took place in Slovenian OOHC, as part of the international study entitled Patient Safety Culture in European Out-of-Hours Services (SAFE-EUR-OOH). All the OOHC clinics in Slovenia (N=60) were invited to participate, and 37 agreed to do so; 438 employees from these clinics were invited to participate. We used the Slovenian version of the Safety Attitudes Questionnaire % an ambulatory version (SAQAV) to measure the climate of safety. Results: Out of 438 invited participants, 250 answered the questionnaire (57.1% response rate). The mean overall score % standard deviation of the SAQ was 56.6%16.0 points, of Perceptions of Management 53.6%19.6 points, of Job Satisfaction 48.5%18.3 points, of Safety Climate 59.1%22.1 points, of Teamwork Climate 72.7%16.6, and of Communication 51.5%23.4 points. Employees working in the Ravne na Koroškem region, employees with variable work shifts, and those with full-time jobs scored significantly higher on the SAQ-A V. Conclusion: The safety culture in Slovenian OOHC clinics needs improvement. The variations in the safety culture factor scores in Slovenian OOHC clinics point to the need to eliminate variations and improve working conditions in Slovenian OOHC clinics.
Ključne besede: safety culture, out-of-hours medical care, primary health care, Slovenia
Objavljeno: 03.11.2017; Ogledov: 297; Prenosov: 63
.pdf Celotno besedilo (397,20 KB)
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3.
Variations in patient safety climate and perceived quality of collaboration between professions in out-of-hours care
Zalika Klemenc-Ketiš, Ellen Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik, 2017, izvirni znanstveni članek

Opis: Purpose: To get an overview of health care workers perceptions of patient safety climates and the quality of collaboration in Slovenian out-of-hours health care (OOHC) between professional groups. Materials and methods: This was a cross-sectional study carried out in all (60) Slovenian OOHC clinics; 37 (61.7%) agreed to participate with 438 employees. The questionnaire consisted of the Slovenian version of the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). Results: The study sample consisted of 175 (70.0%) physicians, nurse practitioners, and practice nurses. Practice nurses reported the highest patient safety climate scores in all dimensions. Total mean (standard deviation) SAQ-AV score was 60.9+-15.2. Scores for quality of collaboration between different professional groups were high. The highest mean scores were reported by nurse practitioners on collaboration with practice nurses (4.4+-0.6). The lowest mean scores were reported by practice nurses on collaboration with nurse practitioners (3.8+-0.9). Conclusion: Due to large variations in Slovenian OOHC clinics with regard to how health care workers from different professional backgrounds perceive safety culture, more attention should be devoted to improving the team collaboration in OOHC. A clearer description of professional team roles should be provided.
Ključne besede: primary health care, out-of-hours medical care, patient care management
Objavljeno: 27.11.2017; Ogledov: 280; Prenosov: 76
.pdf Celotno besedilo (169,11 KB)
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4.
An overview of medical malpractice law in the United States including legislative and the health care industry's responses to increased claims
Thomas Allan Heller, 2017, pregledni znanstveni članek

Opis: Medical Malpractice claims are frequently asserted in the United States. At various time and places, an extraordinarily high number of claims and payouts led to what some have called medical malpractice crises. Consequently, in some geographical locations physicians either could not purchase malpractice insurance as carriers withdrew from the market, or, insurance became increasingly expensive and the overall costs associated with the delivery of health care continued to rise. Other undesirable consequences of these crises included a shortage of qualified physicians in certain parts of the country. Many of the states responded to these problems legislatively through a long series of tort reform measures. The health care industry itself has evolved in numerous ways. In particular, many health care providers have turned away from traditional private insurance models to self-insured models such as captives. Further, the industry has continued to consolidate, with fewer, but larger hospitals and clinics, and with an increasing number of physicians employed directly by hospitals and large clinics. The results of all of these changes have had mixed results.
Ključne besede: medical malpractice, defensive medicine, medical malpractice crises, tort reform, consolidation of health care industry, group captives
Objavljeno: 09.10.2018; Ogledov: 140; Prenosov: 12
.pdf Celotno besedilo (488,42 KB)
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