Quality management in general surgery: a review of the literature

Beuran, Mircea; Negoi, Ionuț; Păun, Sorin; Vartic, Mihaela; Stoica, Bogdan; Tănase, I; Negoi, Ruxandra Irina; Hostiuc, Sorin

doi:10.1016/s2221-6189(14)60057-3

Cited by 11 publications

(10 citation statements)

References 19 publications

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“…After adjusting for age, gender, cause of trauma, head injury severity, GCS, and ISS, Trauma Audit and Research Network cases had an odds of death of 3.22 compared to Victoria State Trauma Registry [17] . Another analysis of the Victoria State Trauma Registry found quality indicators associated with mortality: abdominal surgery after 24 h from admission, blunt compound tibial fracture treatment after 8 h, and non-fixation of femoral diaphyseal fracture [18,19] .…”

Section: Discussionmentioning

confidence: 99%

Mortality after acute trauma: Progressive decreasing rather than a trimodal distribution

Negoi

Păun

Hostiuc

et al. 2015

Journal of Acute Disease

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Objective: To characterize the pattern of mortality for major trauma patients. Methods: Retrospective study of major trauma patients admitted in a Level I trauma center, during the latest 5 years was conducted. Selection criteria included (1) injury severity score (ISS) > 16 and (2) in-hospital death. Results: There were 47 patients, with a mean age of 37.2 ± 19.9 years. The mean ISS was 37.6 ± 12.7 and the mean revised trauma score was 4.5 ± 2.2. Computed tomography scan on admission was done in 18 (38%) patients, 20% being hemodynamically unstable (P = 0.001). The diagnostic peritoneal lavage was performed in 10 (22%) cases, 23.3% being hemodynamically unstable (P > 0.05). The mean number of intraabdominal injuries was 3. The need for transfusion was 8.2 ± 6.7 units. The mean time to death was 4.9 days. Early death was secondary to hemorrhagic shock (HS) (ISS = 35.2 ± 15.9, P > 0.05, revised trauma score = 3.74 ± 2.70, P = 0.008) and multiple organ failure (ISS = 36.6 ± 14.1, P > 0.05, revised trauma score = 5.94 ± 1.34, P = 0.008) was the cause for later mortality. Combined liver and splenic injuries were found in 13 cases, with secondary death through HS in 5 and multiple system organ failure (MSOF) in 8 cases. Combined liver, splenic and kidney injuries were found in 5 cases (cause of death: HS 2 cases, MSOF 3 cases). A total of 14 patients had associated head, thorax, abdomen and extremity trauma (cause of death: cerebral trauma 6 cases, MSOF 5 cases, HS 2 cases); 5 patients had thorax and abdomen trauma (cause of death: HS 5 cases); 8 patients had thorax, abdomen and extremity trauma (cause of death: MSOF 5 cases, HS 3 cases); 3 patients had abdomen and extremity trauma (HS 2 cases). We did not find a trimodal time distribution for mortality. Conclusions: The trimodal time distribution of mortality remains a milestone in trauma education and research. Nevertheless, it must be questioned in the modern and very efficient trauma systems, but still very actual for developing trauma care systems. In conclusion, the pattern of mortality due to major trauma seems decreasing continuously with time rather than presenting high peaks of frequency at some moments.

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Section: Discussionmentioning

confidence: 99%

Mortality after acute trauma: Progressive decreasing rather than a trimodal distribution

Negoi

Păun

Hostiuc

et al. 2015

Journal of Acute Disease

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“…Both soft and hard TQM equip the health care system with a suite of tools and methods to facilitate efficient patient routing, to cut down on waste, errors and unnecessary costs, and to improve patient satisfaction (Abdallah and Alkhaldi, 2019). In addition, TQM tools and methods enhance health care operations by designing care that is truly focused on patients: identifying their problems, solving them analytically and implementing continuous quality improvement programs (Beuran et al, 2014). Shazali et al (2013) used primarily soft TQM practices and found that TQM helped to determine patient needs.…”

Section: Soft and Hard Tqm And Patient Satisfactionmentioning

confidence: 99%

“…TQM in health care is a philosophy that aims to achieve an overall performance standard and improve the efficiency and effectiveness of health care provision (Gadolin and Andersson, 2017). It is a systematic approach focused on meeting patient expectations, identifying problems and analytically addressing them and performing continuous quality improvement (Beuran et al , 2014).…”

Section: Introductionmentioning

confidence: 99%

The influence of soft and hard TQM on quality performance and patient satisfaction in health care: investigating direct and indirect effects

Alkhaldi

Abdallah

2021

JHOM

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PurposeThe present study conceptualizes total quality management (TQM) in terms of soft and hard aspects and examines their effects on quality performance and patient satisfaction. The indirect effects of soft and hard TQM on patient satisfaction through quality performance are also investigated.Design/methodology/approachA multi-item questionnaire was prepared to gather primary data from a sample of 312 medical employees in private hospitals in Jordan. The measurement model was evaluated for validity and reliability and determined to be acceptable. Structural equation modeling (SEM) was applied to test the research hypotheses.FindingsThe results revealed that soft TQM has a strong positive effect on quality performance and patient satisfaction. Hard TQM was found to positively affect quality performance but to a lesser extent compared to soft TQM. The effect of hard TQM on patient satisfaction, meanwhile, was not significant. Quality performance positively mediated the relationship between TQM – both soft and hard – and patient satisfaction.Originality/valueThis study is one of the first to conceptualize TQM in terms of soft and hard aspects in a health care context. It offers valuable insights for managers of private hospitals looking to enhance quality performance and patient satisfaction. The results reveal that soft TQM is the primary driver of quality performance and patient satisfaction in the health care context, which is in stark contrast to the manufacturing sector.

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“…4 Dada a concepção de qualidade ser dinâmica e potencialmente mutável no cotidiano organizacional, o desenvolvimento e o aprimoramento de ações gerenciais relacionadas à sua avaliação fazem-se necessárias, até mesmo para a sobrevivência das organizações no mundo globalizado hodierno. 5 Nessa perspectiva, a avaliação da qualidade em saúde, que teve sua gênese na área hospitalar, é considerada recurso indispensável para o controle e o avanço de melhorias dos serviços. 6 Isso porque a qualidade pode ser ferramenta para mediar o processo avaliativo cíclico e sistemático entre os resultados obtidos das realidades avaliadas, seguido de tomadas de decisão em prol de melhorias contínuas.…”

Section: Introductionunclassified

Hospital Accreditation: Implications of the Waiver of the Search for the Certification

Cervilheri¹,

Oliveira²,

Ferreira³

et al. 2017

REME: Revista Mineira De Enfermagem

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Estudo descritivo-exploratório, de abordagem qualitativa, com o objetivo de analisar as percepções de trabalhadores sobre a desistência de busca da certificação pela acreditação hospitalar. Participaram 10 profissionais de um hospital privado do Sul do Brasil, que em fevereiro de 2016 responderam à entrevista semiestruturada, norteada pela questão: "fale-me como se deu o processo de desistência deste hospital em aderir à acreditação". Nos depoimentos transcritos empregou-se a técnica de análise de conteúdo, na modalidade temática, da qual emergiram três categorias: desistência de busca da certificação de acreditação-motivos referidos por trabalhadores; sentimentos oriundos da desistência de busca pela certificação de acreditação e; desistência versus adiamento: diferença clara para os trabalhadores. Concluiu-se que a desistência ocorreu por déficit de suporte da alta direção atrelado à limitação de ordem estrutural. Esses fatos provocaram sentimentos negativos nos trabalhadores, mas apesar disso referiram que a motivação para a retomada da busca da certificação permanece.

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Quality management in general surgery: a review of the literature

Cited by 11 publications

References 19 publications

Mortality after acute trauma: Progressive decreasing rather than a trimodal distribution

Mortality after acute trauma: Progressive decreasing rather than a trimodal distribution

The influence of soft and hard TQM on quality performance and patient satisfaction in health care: investigating direct and indirect effects

Hospital Accreditation: Implications of the Waiver of the Search for the Certification

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