Abstract:
BACKGROUND:The aim of this umbrella review was to summarize the research evidence on programs to improve the transition between ambulatory and hospital care. METHODS:The MEDLINE database and the Cochrane library were searched. Systematic reviews of randomized controlled trials published between January 2000 and September 2018 in English or German were included. Studies were eligible if an assessment or coordination intervention had been evaluated and if patients had been transferred between hospital (defined as internal medicine, surgery, or unspecified hospital setting) and home (defined as any permanent residence). Risk of bias was assessed using the AMSTAR criteria. Results are presented descriptively and in table format. RESULTS:Thirty-nine systematic reviews comprising 492 different studies were included. More than half of these studies were conducted in the United States, the United Kingdom, Canada, and Australia. All studies evaluated strategies to improve discharge management (introduced after patients' arrival at the hospital); no study assessed strategies to improve admission management (initiated in primary care before patients' transition to hospital). The reviews included focused on a specific patient group, a specific intervention type, or a specific outcome. Overall, interventions focusing on elderly patients and high-intensity interventions seemed to be most effective. An overview of classifications of care transition strategies is provided. CONCLUSIONS:Future research should focus on hospital admission management programs.
journal_name
Qual Manag Health Carejournal_title
Quality management in health careauthors
Straßner C,Hoffmann M,Forstner J,Roth C,Szecsenyi J,Wensing Mdoi
10.1097/QMH.0000000000000244subject
Has Abstractpub_date
2020-04-01 00:00:00pages
67-75issue
2eissn
1063-8628issn
1550-5154pii
00019514-202004000-00003journal_volume
29pub_type
杂志文章abstract::A variety of approaches are available to monitor and quantify the frequency of medical errors and the harm associated with them. The University HealthSystem Consortium Patient Safety Net provides a categorical, rank-ordered approach for designating harm associated with medical errors but does not lend itself to routin...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3181fa074e
更新日期:2010-10-01 00:00:00
abstract::Patient flow improvement strategies have been effective in reducing emergency department (ED) crowding, but little guidance is available on the implementation process. By using a qualitative research design, our objective was to identify common facilitators and barriers to the implementation of patient flow improvemen...
journal_title:Quality management in health care
pub_type: 杂志文章,多中心研究
doi:10.1097/QMH.0b013e318222a3b0
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Although organizational context can affect the implementation of quality initiatives, we know less about the influence of contextual conditions on quality outcomes. We examined organizational features of primary care clinics that achieved greatest performance improvements after implementing Lean redesigns. ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000198
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:This article explores and describes key processes facilitating the integration of neophyte graduate nurses into safe and effective organizational systems and processes as part of a hospital's overall local clinical governance and clinical risk management (CRM) program. METHODS:This study was undertaken usin...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000316994.02039.80
更新日期:2008-04-01 00:00:00
abstract::This article reviews studies of the effects of medical organization structure on quality and cost conducted over the past three decades. Topics of inquiry have proceeded from the organizational to the individual provider level and from the inpatient to the ambulatory level. The article presents the findings of these s...
journal_title:Quality management in health care
pub_type: 杂志文章,评审
doi:10.1097/00019514-199503040-00002
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Metformin is recommended as initial therapy for most patients with type 2 diabetes mellitus. Its most serious adverse effect, lactic acidosis, is a rare entity with a high mortality rate. Despite well-publicized contraindications, metformin is inappropriately prescribed to many hospitalized patients. OBJECT...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31826d1ef9
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:We explored the associations between opioid dose and multiple measures of pain. STUDY DESIGN AND MEASURES:Thirty-two consecutive patients admitted solely for an acute exacerbation of cancer-related pain or for surgery were followed for their entire hospital stay (115 days of pain). For each hospital day, we ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000009
更新日期:2013-10-01 00:00:00
abstract::While data collection is fundamental to any scientifically based effort, health care improvement teams often report that it is one of the most frustrating aspects of their work. Groups that do succeed in gathering some data can also sometimes find that the data they have worked so hard to obtain does not really help t...
journal_title:Quality management in health care
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract::The past decade has been marked by extensive change in the organization of health care delivery systems (the "supply side" of health care). There has been relatively less change in the nature of the health care consumer (the "demand side" of health care). The emergence of the Internet as a consumer health care technol...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200008020-00009
更新日期:2000-01-01 00:00:00
abstract::A control chart can be an effective way to display process data over time. It can differentiate common cause variation from special cause variation through the application of several probability-based interpretation rules. In addition, a control chart can be helpful in evaluating the effectiveness of a change. There a...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200109030-00003
更新日期:2001-04-01 00:00:00
abstract:INTRODUCTION:Real-time location systems (RTLS) and Lean management approaches have been employed to improve patient flow in clinical settings. This study explored the feasibility of using these methodologies in an outpatient resident ophthalmology clinic. METHODS:Patients, providers, and staff in Wilmer Eye Institute ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000075
更新日期:2015-10-01 00:00:00
abstract::The purpose of this study was to elucidate conditions at all system levels in a specific health care service to develop practices for identification of children as relatives. An interactive research approach with the intention to create mutual learning between practice and research was used. The participating health c...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000181
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To determine whether employees working for a transformational leader perceive their leader as more effective than do those working for a transactional leader. To assess whether employees in private hospitals are more likely to perceive their leaders as transformational than are employees in public hospitals....
journal_title:Quality management in health care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00019514-200410000-00009
更新日期:2004-10-01 00:00:00
abstract::Handover communication improvement initiatives typically employ a "one size fits all" approach. A human factors perspective has the potential to guide how to tailor interventions to roles, levels of experience, settings, and types of patients. We conducted ethnographic observations of sign-outs by attending and reside...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000114
更新日期:2016-10-01 00:00:00
abstract:CONTEXT:Residents often fail to escalate narcotics to ensure pain relief in patients with cancer because of fear of overdose. A computer simulation of patients in pain may provide a way to improve management without fear of harm. We developed a pain care simulation to train residents. STUDY DESIGN/MEASURES: Thirty-one ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000326722.70708.0d
更新日期:2008-07-01 00:00:00
abstract::Many hospitals are unable to successfully implement "evidence-based practices" at the unit level. For example, consistent implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs) is often difficult. This problem has been broadly characterized as "change implem...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31827dea7d
更新日期:2013-01-01 00:00:00
abstract::Quality indicators and a quality-monitoring system developed for use in the regulatory survey process offer a quality improvement tool for nursing home staff. The systematic use of resident assessment data can aid in the identification of quality of care problems and the determination of the nature of those problems. ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199604030-00008
更新日期:1996-04-01 00:00:00
abstract::Several recent reports show that many physicians feel discontented and unhappy with their work situation. This could in part be due to a decline in status, loss of influence on health care organization, reduced wages etc. It is important to find ways to better understand their experiences of working life to get more f...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200401000-00008
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVES:To describe health care staff members' usage and documentation in a Swedish quality registry focusing on a preventive care process regarding the risk area of malnutrition among persons with dementia. The preventive care process includes risk assessment, analysis of underlying causes, planning and performing ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000116
更新日期:2017-01-01 00:00:00
abstract::Like many organizations, Continental Rehabilitation Hospital of San Diego designs and communicates templates and targets for desired changes in behaviors and tracks results. It recognizes and celebrates successes and struggles with its failures. A recent case example demonstrates the importance of generating immediate...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199706010-00007
更新日期:1997-10-01 00:00:00
abstract::To see the world systematically through the practice of systems thinking means to see the relationship in the phenomena we experience. The systems view is not just another way of improving an object, a process, or even services. It should not be viewed as a method that is focused only on "quality." The intrinsic value...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199807010-00004
更新日期:1998-10-01 00:00:00
abstract::In a previous article (M. K. Hart, Qual Manag Health Care. 2003;12(1):5-19), the authors presented risk-adjusted control charts applicable for attributes data. The present article discusses a similar class of control charts applicable for variables data that are often skewed. The key feature of these charts is their a...
journal_title:Quality management in health care
pub_type: 评论,杂志文章
doi:10.1097/00019514-200404000-00003
更新日期:2004-04-01 00:00:00
abstract::The U.S. Healthcare Fellowship in Quality Management at Hahnemann University was developed by a managed health care organization and health science university in order to train physicians in the theory and practice of quality management and clinical outcomes measurement. This article describes in detail the program co...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract::Pay for performance cannot consist of a one-size-fits-all approach. Variation in quality and cost of care is best measured using a single "value" (quality/cost) score that is decomposed into component cost and quality for every health care encounter type. Economic incentives must be enough to focus the provider's atte...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200501000-00004
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:The multifaceted nature of the transition of care from the triage unit to labor and delivery has historically led to confusion, delays, and errors in care. This study evaluated the effect of standardization of roles and communication on improving this transition. METHODS:A multidisciplinary team was assemble...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000191
更新日期:2018-10-01 00:00:00
abstract::Academic medical centers and clinicians have been slow to embrace continuous quality improvement. The Mount Sinai Medical Center in New York has created a new Department of Health Policy that combines an academic research mission with an administrative mission to demonstrate improving quality of care. This article dis...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199604040-00006
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:Implementing change in a health care organization poses structural and cultural challenges. DESIGN:We developed a survey derived from an existing organizational change model and distributed it to the target population of an impending change initiative. RESULTS:The respondents (59.2% response rate) indicated...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000061
更新日期:2015-07-01 00:00:00
abstract::Recently, many have begun to explore the possibility of using analytical methods associated with continuous quality improvement in the efforts to improve health care. Central to this paradigm is the proposition that such analytical methods can be used to identify and react to variations in the processes and outcomes o...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract::This article proposes a new class of control charts that may be used for monitoring and improving the quality of care. Unlike conventional control charts that rely on observed performance data, these charts use risk-adjusted data in addition to the observed data. The resulting time-ordered charts are capable of reduci...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200301000-00004
更新日期:2003-01-01 00:00:00
abstract::In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to co...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e318231a84f
更新日期:2011-10-01 00:00:00