The Quality of Care

Donabedian, Avedis

doi:10.1001/jama.1988.03410120089033

Cited by 4,219 publications

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“…Quality can refer to the technical quality of care to the nontechnical aspect of service delivery such as clients' waiting time and staff attitudes, and to programmatic elements such as policies, infrastructures, access, and management. [11][12][13] In health care and Family Planning Program service, this means offering a range of services that is safe, effective and that satisfy clients' needs and wants.…”

Section: Introductionmentioning

confidence: 99%

Association between quality of family planning services and client's satisfaction level in maternal and child health centers in Port Said city

Nasr

Hassan

2015

JNEP

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Background: Improving quality of care has been a necessary goal for family planning programmes worldwide. Services should be convenient, accessible and acceptable to clients. In addition, it is essential to provide follow-up care to ensure continuity of services and an adequate logistics system to ensure continuity of supplies. Patient satisfaction is reportedly a useful measure to provide a direct indicator of quality in health care. Thus, it is needed to be measured frequently. Aim: To assess the association between quality of family planning services and client's satisfaction level in maternal & child health centers in Port Said city. Subject and Methods: A cross sectional descriptive research design included two main convenient samples were recruited in the study through 5 months, the family planning nurses (20) and clients attending these centers (240). The study was carried out at ten family planning clinics in ten centers representing the five districts of Port Said. Results: Statistically significant difference correlation was found between quality of family planning counseling of nurses practice and their number of received training program, the mean percentage of the client's (95.4%) were satisfied with family planning services. Conclusions: The number of received training program affects quality of family planning counseling of nurse's practice, providers of the services and the provided services affect the client satisfaction.

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Section: Introductionmentioning

confidence: 99%

Association between quality of family planning services and client's satisfaction level in maternal and child health centers in Port Said city

Nasr

Hassan

2015

JNEP

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“…The reasons for cancellation of elective surgical cases which may be patient-initiated or hospital-initiated are multifactorial [11] [12]. These reasons can also be assessed using the Donabedian's quality of care framework [13] which was also used by Leslie RJ et al [8] and presents a relationship between Structure, Process and Patient outcomes. The factors may be categorized into (1) structural factors such as, limited operating rooms and full recovery ward; (2) patient factors such as patient not turning up or not adhering to pre-operative instructions; and (3) process factors such as surgery running late and mechanical faults with theatre equipment.…”

Section: Introductionmentioning

confidence: 99%

Day of Surgery Cancellation in Urology at a Public Tertiary Hospital and a Private Specialist Hospital

Kyei¹,

Mensah²,

Bray³

et al. 2017

OJU

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Background: There is a high variability in the reasons for cancellation of elective urological surgery cases. Case cancellation rate is expected to be high in the Public Health System with perceived inefficiencies compared to private facilities in the same developing economy. Aims and Objectives: This comparative analysis was to determine the case cancellation rate and the reasons for cancellation of elective urological surgeries in a public tertiary hospital and a private specialist hospital in Accra. This is intended to form a basis for interventions aimed at reducing the case cancellation rate. Methods: This was a retrospective analysis of prospectively collected data on Day of Surgery cancelled elective urological cases from September 2014 to October 2015 at the urology unit of the Korle-Bu Teaching Hospital (KBTH), a public Tertiary Hospital and the Trust Specialist Hospital (TSH), a privately managed hospital in Accra. The reasons for case cancellation were categorized into structural factors, patient factors and process factors. Results: There was no significant difference between the case cancellation rate for elective urological cases at KBTH and the TSH which were 20.8% and 17.1% respectively (p = 0.317). For KBTH, the reasons for cancellation of elective urological cases were due to structural factors in 11/117 (9.4%), patient factors in 15/117 (12.8%) and process factors in 91/117 (77.8%) which was due mainly to surgery running late. At the TSH, the reasons were due to structural factors in 1/29 (3.4%), patient factors in 27/29 (93.1%) mainly due to patient not turning up and process factors in 1/29 (3.4%). Conclusion: The case cancellation rate of elective urological surgeries in both the Public Tertiary Hospital and the Private Specialist Hospital were high with no significant difference between the two. However, in the Public Tertiary Hospital, process factors predominated as the cause of these cancellations while patient factors were the predominant cause 23in the privately managed facility. Exposure of theater managers in public facilities to management practices in privately run facilities should be encouraged to help improve the efficiency of the public facilities.

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“…In this study we propose a theoretically-driven approach to study LS adoption. Specifically, we will examine the relationship between state policy and service area factors, hospital characteristics, and hospital LS adoption (20,21), using an adaptation of a well-established framework (Donabedian's three-fold perspective on quality healthcare) (22). Organizational theories provide the scope of hospital structure and process factors that are likely to lead to LS adoption.…”

Section: Introductionmentioning

confidence: 99%

Predictors of language service availability in U.S. hospitals

Schiaffino

Al‐Amin

Schumacher

2014

Int J Health Policy Manag

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Background: Hispanics comprise 17% of the total U.S. population, surpassing African-Americans as the largest minority group. Linguistically, almost 60 million people speak a language other than English. This language diversity can create barriers and additional burden and risk when seeking health services. Patients with Limited English Proficiency (LEP) for example, have been shown to experience a disproportionate risk of poor health outcomes, making the provision of Language Services (LS) in healthcare facilities critical. Research on the determinants of LS adoption has focused more on overall cultural competence and internal managerial decision-making than on measuring LS adoption as a process outcome influenced by contextual or external factors. The current investigation examines the relationship between state policy, service area factors, and hospital characteristics on hospital LS adoption. Methods: We employ a cross-sectional analysis of survey data from a national sample of hospitals in the American Hospital Association (AHA) database for 2011 (N= 4876) to analyze hospital characteristics and outcomes, augmented with additional population data from the American Community Survey (ACS) to estimate language diversity in the hospital service area. Additional data from the National Health Law Program (NHeLP) facilitated the state level Medicaid reimbursement factor. Results: Only 64% of hospitals offered LS. Hospitals that adopted LS were more likely to be not-for-profit, in areas with higher than average language diversity, larger, and urban. Hospitals in above average language diverse counties had more than 2-fold greater odds of adopting LS than less language diverse areas [Adjusted Odds Ratio (AOR): 2.26, P< 0.01]. Further, hospitals with a strategic orientation toward diversity had nearly 2-fold greater odds of adopting LS (AOR: 1.90, P< 0.001). Conclusion: Our findings support the importance of structural and contextual factors as they relate to healthcare delivery. Healthcare organizations must address the needs of the population they serve and align their efforts internally. Current financial incentives do not appear to influence adoption of LS, nor do Medicaid reimbursement funds, thus suggesting that further alignment of incentives. Organizational and system level factors have a place in disparities research and warrant further analysis; additional spatial methods could enhance our understanding of population factors critical to system-level health services research.

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The Quality of Care

Cited by 4,219 publications

References 0 publications

Association between quality of family planning services and client's satisfaction level in maternal and child health centers in Port Said city

Association between quality of family planning services and client's satisfaction level in maternal and child health centers in Port Said city

Day of Surgery Cancellation in Urology at a Public Tertiary Hospital and a Private Specialist Hospital

Predictors of language service availability in U.S. hospitals

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