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Annals of Oncology : Official Journal... Mar 2022Several commercial and academic autologous chimeric antigen receptor T-cell (CAR-T) products targeting CD19 have been approved in Europe for relapsed/refractory B-cell...
Management of adults and children receiving CAR T-cell therapy: 2021 best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association (EHA).
BACKGROUND
Several commercial and academic autologous chimeric antigen receptor T-cell (CAR-T) products targeting CD19 have been approved in Europe for relapsed/refractory B-cell acute lymphoblastic leukemia, high-grade B-cell lymphoma and mantle cell lymphoma. Products for other diseases such as multiple myeloma and follicular lymphoma are likely to be approved by the European Medicines Agency in the near future.
DESIGN
The European Society for Blood and Marrow Transplantation (EBMT)-Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association collaborated to draft best practice recommendations based on the current literature to support health care professionals in delivering consistent, high-quality care in this rapidly moving field.
RESULTS
Thirty-six CAR-T experts (medical, nursing, pharmacy/laboratory) assembled to draft recommendations to cover all aspects of CAR-T patient care and supply chain management, from patient selection to long-term follow-up, post-authorisation safety surveillance and regulatory issues.
CONCLUSIONS
We provide practical, clinically relevant recommendations on the use of these high-cost, logistically complex therapies for haematologists/oncologists, nurses and other stakeholders including pharmacists and health sector administrators involved in the delivery of CAR-T in the clinic.
Topics: Accreditation; Adult; Bone Marrow; Hematology; Humans; Immunotherapy, Adoptive; Receptors, Antigen, T-Cell; Receptors, Chimeric Antigen
PubMed: 34923107
DOI: 10.1016/j.annonc.2021.12.003 -
BMC Health Services Research Oct 2021Accreditation is viewed as a reputable tool to evaluate and enhance the quality of health care. However, its effect on performance and outcomes remains unclear. This...
BACKGROUND
Accreditation is viewed as a reputable tool to evaluate and enhance the quality of health care. However, its effect on performance and outcomes remains unclear. This review aimed to identify and analyze the evidence on the impact of hospital accreditation.
METHODS
We systematically searched electronic databases (PubMed, CINAHL, PsycINFO, EMBASE, MEDLINE (OvidSP), CDSR, CENTRAL, ScienceDirect, SSCI, RSCI, SciELO, and KCI) and other sources using relevant subject headings. We included peer-reviewed quantitative studies published over the last two decades, irrespective of its design or language. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers independently screened initially identified articles, reviewed the full-text of potentially relevant studies, extracted necessary data, and assessed the methodological quality of the included studies using a validated tool. The accreditation effects were synthesized and categorized thematically into six impact themes.
RESULTS
We screened a total of 17,830 studies, of which 76 empirical studies that examined the impact of accreditation met our inclusion criteria. These studies were methodologically heterogeneous. Apart from the effect of accreditation on healthcare workers and particularly on job stress, our results indicate a consistent positive effect of hospital accreditation on safety culture, process-related performance measures, efficiency, and the patient length of stay, whereas employee satisfaction, patient satisfaction and experience, and 30-day hospital readmission rate were found to be unrelated to accreditation. Paradoxical results regarding the impact of accreditation on mortality rate and healthcare-associated infections hampered drawing firm conclusions on these outcome measures.
CONCLUSION
There is reasonable evidence to support the notion that compliance with accreditation standards has multiple plausible benefits in improving the performance in the hospital setting. Despite inconclusive evidence on causality, introducing hospital accreditation schemes stimulates performance improvement and patient safety. Efforts to incentivize and modernize accreditation are recommended to move towards institutionalization and sustaining the performance gains. PROSPERO registration number CRD42020167863.
Topics: Accreditation; Health Personnel; Hospitals; Humans; Outcome Assessment, Health Care; Patient Satisfaction
PubMed: 34610823
DOI: 10.1186/s12913-021-07097-6 -
American Journal of Pharmaceutical... Jan 2020As practice evolves and scientific advancements are achieved the natural inclination for educators and administrators is to add new content to existing curricula. Often...
As practice evolves and scientific advancements are achieved the natural inclination for educators and administrators is to add new content to existing curricula. Often pre-existing curricula that may be outdated or no longer relevant may go un-checked leading to excessive coursework and program completion times. Faculty may also have emotional or other attachments to certain topics or content and that may serve as an additional or independent barrier to removing extraneous material. To avoid and curtail curricular hoarding of material it may be prudent to periodically engage in reviews of material assessing them for not only adherence to accreditation standards but also in terms of their on-going appropriateness and relevance to contemporary pharmacy practice. These exercises may be especially important today given the rate of information creation and dissemination in the modern digital age.
Topics: Accreditation; Curriculum; Education, Pharmacy; Faculty; Hoarding; Humans; Pharmaceutical Services
PubMed: 32292200
DOI: 10.5688/ajpe847714 -
Bone Marrow Transplantation Feb 2020These updated EBMT guidelines review the clinical evidence, registry activity and mechanisms of action of haematopoietic stem cell transplantation (HSCT) in multiple...
Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases: updated guidelines and recommendations from the EBMT Autoimmune Diseases Working Party (ADWP) and the Joint Accreditation Committee of EBMT and ISCT...
These updated EBMT guidelines review the clinical evidence, registry activity and mechanisms of action of haematopoietic stem cell transplantation (HSCT) in multiple sclerosis (MS) and other immune-mediated neurological diseases and provide recommendations for patient selection, transplant technique, follow-up and future development. The major focus is on autologous HSCT (aHSCT), used in MS for over two decades and currently the fastest growing indication for this treatment in Europe, with increasing evidence to support its use in highly active relapsing remitting MS failing to respond to disease modifying therapies. aHSCT may have a potential role in the treatment of the progressive forms of MS with a significant inflammatory component and other immune-mediated neurological diseases, including chronic inflammatory demyelinating polyneuropathy, neuromyelitis optica, myasthenia gravis and stiff person syndrome. Allogeneic HSCT should only be considered where potential risks are justified. Compared with other immunomodulatory treatments, HSCT is associated with greater short-term risks and requires close interspeciality collaboration between transplant physicians and neurologists with a special interest in these neurological conditions before, during and after treatment in accredited HSCT centres. Other experimental cell therapies are developmental for these diseases and patients should only be treated on clinical trials.
Topics: Accreditation; Autoimmune Diseases; Europe; Hematopoietic Stem Cell Transplantation; Humans; Multiple Sclerosis; Transplantation, Autologous
PubMed: 31558790
DOI: 10.1038/s41409-019-0684-0 -
BMJ Quality & Safety Feb 2020
Topics: Accreditation; Expert Testimony; Humans; Qualitative Research; Surgeons
PubMed: 31519732
DOI: 10.1136/bmjqs-2019-009739 -
International Journal For Quality in... Feb 2023Hospital accreditation is an established quality improvement intervention. Despite a growing body of research, the evidence of effect remains contested. This umbrella... (Review)
Review
Hospital accreditation is an established quality improvement intervention. Despite a growing body of research, the evidence of effect remains contested. This umbrella review synthesizes reviews that examine the impacts of hospital accreditation with regard to health-care quality, highlighting research trends and knowledge gaps. Terms specific to the population: 'hospital' and the intervention: 'accreditation' were used to search seven databases: CINAHL (via EBSCOhost), Embase, Medline (via EBSCOhost), PubMed, Scopus, the Cochrane Database of Systematic Reviews, and the Joanna Briggs Institute (JBI) EBP Database (via Ovid). 2545 references were exported to endnote. After completing a systematic screening process and chain-referencing, 33 reviews were included. Following quality assessment and data extraction, key findings were thematically grouped into the seven health-care quality dimensions. Hospital accreditation has a range of associations with health system and organizational outcomes. Effectiveness, efficiency, patient-centredness, and safety were the most researched quality dimensions. Access, equity, and timeliness were examined in only three reviews. Barriers to robust original studies were reported to have impeded conclusive evidence. The body of research was largely atheoretical, incapable of precisely explaining how or why hospital accreditation may actually influence quality improvement. The impact of hospital accreditation remains poorly understood. Future research should control for all possible variables. Research and accreditation program development should integrate concepts of implementation and behavioural science to investigate the mechanisms through which hospital accreditation may enable quality improvement.
Topics: Humans; Accreditation; Hospitals; Quality Improvement; Quality of Health Care; Review Literature as Topic
PubMed: 36738157
DOI: 10.1093/intqhc/mzad007 -
The Journal of the American Osteopathic... Oct 2019
Topics: Accreditation; Internship and Residency; Workload
PubMed: 31566691
DOI: 10.7556/jaoa.2019.111 -
Journal of Echocardiography Mar 2020The echocardiogram is the second most used diagnostic tool for cardiovascular patient care. Qualified sonographers are needed to consistently produce high-quality...
BACKGROUND
The echocardiogram is the second most used diagnostic tool for cardiovascular patient care. Qualified sonographers are needed to consistently produce high-quality echocardiograms to provide high-quality patient care.
METHODS
Our department uses the three major management tools to assure sonographers are qualified. (1) ASE guidelines and standards. (2) Sonographer registry system and (3) quality improvement (QI) program with the accreditation of Echo Lab. QI measures are done quarterly assessing the appropriate use criteria for echocardiography, interpreter and sonographer variability, timeliness and completeness and correlations. The variabilities are assessed along ASE guidelines and standards.
RESULTS
QI measures are mainly done by Medical Director and Technical Director. Medical Director and Technical Director discuss with individual interpreter and sonographer after QI measures are done each quarter as the feedback. Through the feedback improving the individual sonographer skills and understanding of Echo result. Our Echo Lab is accredited by Intersocietal Accreditation Commission (IAC). Accredited Echo Labs have to follow the IAC standards for echocardiography which includes those QI measures. Every sonographer in our lab is registered and complied for CME requirement to update their knowledge and skills. Twice a year QI meeting will be held and discuss about those QI measures and make consensus as Echo Lab.
CONCLUSIONS
Registered sonographer with systematic quality checking system of their work will be achieved improving the high-quality echocardiogram and leading to the high-quality patient care.
Topics: Accreditation; Allied Health Personnel; Cardiovascular Diseases; Clinical Competence; Echocardiography; Humans; Quality Improvement
PubMed: 31190291
DOI: 10.1007/s12574-019-00430-3 -
Langenbeck's Archives of Surgery Nov 2019A key measure to maintain and improve the quality of healthcare is the formal accreditation of provider units. The European Society of Endocrine Surgeons (ESES)... (Review)
Review
BACKGROUND/PURPOSE
A key measure to maintain and improve the quality of healthcare is the formal accreditation of provider units. The European Society of Endocrine Surgeons (ESES) therefore proposes a system of accreditation for endocrine surgical centers in Europe to supplement existing measures that promote high standards in the practice in endocrine surgery.
METHODS
A working group analyzed the current healthcare situation in the field of endocrine surgery in Europe. Two surveys were distributed to ESES members to acquire information about the structure, staffing, caseload, specifications, and technology available to endocrine surgery units. Further data were sought on tracer diagnoses for quality standards, training provision, and research activity. Existing accreditation models related to endocrine surgery were included in the analysis.
RESULTS
The analysis of existing accreditation models, available evidence, and survey results suggests that a majority of ESES members aspire to a two-level model (termed competence and reference centers), sub-divided into those providing neck endocrine surgery and those providing endocrine surgery. Criteria for minimum caseload, number and certification of staff, unit structure, on-site collaborating disciplines, research activities, and training capacity for competence center accreditation are proposed. Lastly, quality indicators for distinct tracer diagnoses are defined.
CONCLUSIONS
Differing healthcare structures, existing accreditation models, training models, and varied case volumes across Europe are barriers to the conception and implementation of a pan-European accreditation model. However, there is consensus on accepted standards required for accrediting an ESES competence center. These will serve as a basis for first-stage accreditation of endocrine surgery units.
Topics: Accreditation; Child; Endocrine Surgical Procedures; Germany; Hospital Units; Humans; Quality Assurance, Health Care
PubMed: 31494716
DOI: 10.1007/s00423-019-01820-y -
American Journal of Public Health Feb 2021
Topics: Accreditation; Humans; Public Health; Public Health Administration
PubMed: 33439711
DOI: 10.2105/AJPH.2020.306076