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PloS One 2019Hospitals under financial pressure may struggle to maintain quality and patient safety and have worse patient outcomes relative to well-resourced hospitals. Poor...
BACKGROUND
Hospitals under financial pressure may struggle to maintain quality and patient safety and have worse patient outcomes relative to well-resourced hospitals. Poor predictive validity may explain why previous studies on the association between finances and quality/safety have been equivocal. This manuscript employs principal component analysis to produce robust measures of both financial status and quality/safety of care, to assess our a priori hypothesis: hospital financial performance is associated with the provision of quality care, as measured by quality and safety processes, patient outcomes, and patient centered care.
METHODS
This 2014 cross-sectional study investigated hospital financial condition and hospital quality and safety at acute care hospitals. The hospital financial data from the Centers for Medicare and Medicaid Services (CMS) cost report were used to develop a composite financial performance score using principal component analysis. Hospital quality and patient safety were measured with a composite quality/safety performance score derived from principal component analysis, utilizing a range of established quality and safety indicators including: risk-standardized inpatient mortality, 30-day mortality, 30-day readmissions for select conditions, patient safety indicators from inpatient admissions, process of care chart reviews, CMS value-based purchasing total performance score and patient experience of care surveys. The correlation between the composite financial performance score and the composite quality/safety performance score was calculated using linear regression adjusting for hospital characteristics.
RESULTS
Among the 108 New York State acute care facilities for which data were available, there is a clear relationship between hospital financial performance and hospital quality/safety performance score (standardized correlation coefficient 0.34, p<0.001). The composite financial performance score is also positively associated with the CMS Value Based Purchasing Total Performance Score (standardized correlation coefficient 0.277, p = 0.002); while it is negatively associated with 30 day readmission for all outcomes (standardized correlation coefficient -0.236, p = 0.013), 30-day readmission for congestive heart failure (standardized correlation coefficient -0.23, p = 0.018), 30 day readmission for pneumonia (standardized correlation coefficient -0.209, p = 0.033), and a decrease in 30-day mortality for acute myocardial infarction (standardized correlation coefficient -0.211, p = 0.027). Used alone, operating margin and total margin are poor predictors of quality and safety outcomes.
CONCLUSIONS
Strong financial performance is associated with improved patient reported experience of care, the strongest component distinguishing quality and safety. These findings suggest that financially stable hospitals are better able to maintain highly reliable systems and provide ongoing resources for quality improvement.
Topics: Cross-Sectional Studies; Decision Trees; Economics, Hospital; Hospital Mortality; Humans; New York; Patient Care; Patient Readmission; Patient Safety; Principal Component Analysis; Quality of Health Care
PubMed: 31419227
DOI: 10.1371/journal.pone.0219124 -
CJEM Dec 2022
Topics: Humans; Patient Safety; Organizational Culture
PubMed: 36472810
DOI: 10.1007/s43678-022-00426-6 -
BMJ Quality & Safety Apr 2020
Topics: Humans; Patient Safety; Quality Assurance, Health Care; Reference Standards; Safety Management
PubMed: 32066571
DOI: 10.1136/bmjqs-2019-009731 -
Journal of Patient Safety Mar 2021The aims of the study were to evaluate and to quantify the effects of patient and family involvement (PFI) interventions on patient safety by synthesizing the available... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aims of the study were to evaluate and to quantify the effects of patient and family involvement (PFI) interventions on patient safety by synthesizing the available global data.
METHODS
Four databases were searched to identify relevant studies that have assessed the impact of PFI on patient safety up to March 2019. Reference lists of potential selected articles were also used to identify additional relevant studies. Effect sizes (ESs) were calculated using random and fixed effects models. Statistical heterogeneity was measured using the I2 test.
RESULTS
Twenty-two studies met the review criteria. The meta-analysis showed that PFI were beneficial in significantly reducing adverse events (ES = -0.240, P < 0.001), decreasing the length of hospital stay (ES = -0.122, P < 0.001), increasing patient safety experiences (ES = 0.630, P = 0.007), and improving patient satisfaction (ES = 0.268, P = 0.004). However, the PFI interventions did not significantly enhance the perception of patient safety (ES = 0.205, P = 0.09) or the quality of life (ES = 0.057, P = 0.61). Moreover, moderate-to-high heterogeneity was found for all impacts except adverse events (I2 = 0%) and length of hospital stay (I2 = 35%). A funnel plot indicated a low degree of publication bias for the adverse event outcome.
CONCLUSIONS
The synthesized evidence in this review demonstrates the benefits of PFI for promoting patient safety. However, further studies should extend the research scope to fill the existing gaps for both the type of PFI interventions and the patient safety outcomes.
Topics: Adult; Humans; Middle Aged; Patient Safety; Prospective Studies; Quality of Life; Young Adult
PubMed: 33208637
DOI: 10.1097/PTS.0000000000000714 -
BMJ Quality & Safety Nov 2021
Review
Topics: Humans; Patient Safety; Quality Improvement
PubMed: 34039748
DOI: 10.1136/bmjqs-2020-012538 -
British Journal of Nursing (Mark Allen... Nov 2023, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient safety and health quality reports.
, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient safety and health quality reports.
Topics: Humans; Patient Safety; State Medicine; Schools; United Kingdom
PubMed: 37938984
DOI: 10.12968/bjon.2023.32.20.1012 -
Journal of Patient Safety Mar 2021Existing patient safety culture assessment tools are mostly developed in western countries and may not be suitable for Chinese primary health care institutions. Primary...
BACKGROUND
Existing patient safety culture assessment tools are mostly developed in western countries and may not be suitable for Chinese primary health care institutions. Primary care plays an important role in China's medical system, and a targeted tool for its patient safety culture is urgently needed.
OBJECTIVE
The aim of the study was to develop a dependable instrument to assess the patient safety culture in Chinese primary health care institutions.
METHODS
Three phases were undertaken to develop the scale. The first phase developed a pilot scale by literature review, focus groups, and 2-round Delphi expert consultation. The second phase conducted a pilot survey. The third phase carried out a formal survey to test reliability and validity, involving 369 participants from 9 primary health care institutions.
RESULTS
The final scale included 32 items under 7 dimensions. For reliability, the Cronbach α coefficients among dimensions varied from 0.754 to 0.926, and the Cronbach α for the scale was 0.940. For content validity, the corrected item-level content validity varied between 0.64 and 1, the scale-level content validity index/universal agreement was 0.625, and the scale-level content validity index/average was 0.93. For construct validity, the Spearman correlations of dimension-total score varied between 0.129 and 0.851, all Spearman correlations of the dimension-total score were greater than that of interdimensions and the Spearman correlations of item-total score ranged from 0.042 to 0.775. The results of the confirmatory factor analysis indicated that the model fitted well.
CONCLUSIONS
The Patient Safety Culture Scale for Chinese primary health care institutions demonstrated good reliability and acceptable validity; thus, it can be used as an assessment instrument for patient safety culture in Chinese primary health care institutions.
Topics: China; Humans; Patient Safety; Primary Health Care; Psychometrics; Reproducibility of Results; Safety Management; Surveys and Questionnaires
PubMed: 32404850
DOI: 10.1097/PTS.0000000000000733 -
Studies in Health Technology and... Jun 2022The fourth industrial revolution is based on cyber-physical systems and the connectivity of devices. It is currently unclear what the consequences are for patient safety...
The fourth industrial revolution is based on cyber-physical systems and the connectivity of devices. It is currently unclear what the consequences are for patient safety as existing digital health technologies become ubiquitous with increasing pace and interact in unforeseen ways. In this paper, we describe the output from a workshop focused on identifying the patient safety challenges associated with emerging digital health technologies. We discuss six challenges identified in the workshop and present recommendations to address the patient safety concerns posed by them. A key implication of considering the challenges and opportunities for Patient Safety Informatics is the interdisciplinary contribution required to study digital health technologies within their embedded context. The principles underlying our recommendations are those of proactive and systems approaches that relate the social, technical and regulatory facets underpinning patient safety informatics theory and practice.
Topics: Humans; Interdisciplinary Studies; Medical Informatics; Patient Safety
PubMed: 35673036
DOI: 10.3233/SHTI220097 -
BMJ Open Quality May 2024Patient safety is crucial in dentistry, yet it has received delayed recognition compared with other healthcare fields. This literature review assesses the current state... (Review)
Review
BACKGROUND
Patient safety is crucial in dentistry, yet it has received delayed recognition compared with other healthcare fields. This literature review assesses the current state of patient safety in dentistry, investigates the reasons for the delay, and offers recommendations for enhancing patient safety in dental practices, dental schools, and hospitals.
METHODS
The review incorporates a thorough analysis of existing literature on patient safety in dentistry. Various sources, including research articles, guidelines and reports, were reviewed to gather insights into patient safety definitions, challenges and best practices specific to dentistry.
RESULTS
The review underscores the importance of prioritising patient safety in dentistry at all levels of healthcare. It identifies key definitions and factors contributing to the delayed focus on patient safety in the field. Additionally, it emphasises the significance of establishing a patient safety culture and discusses approaches such as safety plans, incident management systems, blame-free cultures and ethical frameworks to enhance patient safety.
CONCLUSION
Patient safety is vital in dentistry to ensure high-quality care and patient well-being. The review emphasises the importance of prioritising patient safety in dental practices, dental schools and hospitals. Through the implementation of recommended strategies and best practices, dental organisations can cultivate a patient safety culture, enhance communication, mitigate risks and continually improve patient safety outcomes. The dissemination of knowledge and the active involvement of all stakeholders are crucial for promoting patient safety and establishing a safe dental healthcare system.
Topics: Humans; Patient Safety; Dentistry
PubMed: 38719522
DOI: 10.1136/bmjoq-2023-002502 -
Anaesthesia Nov 2021
Topics: Disaster Planning; Fires; Guidelines as Topic; Intensive Care Units; Patient Safety; Rescue Work; Safety Management
PubMed: 34309007
DOI: 10.1111/anae.15547