ABSTRACT
INTRODUCTION: Application of Quality Function Deployment (QFD) methodology can be used to identify the requirements that determine patient perception of health care quality. The objective was to identify patient requirements in a Hemodialysis unit using QFD. MATERIAL AND METHODS: Setting was Hemodialysis unit at the Infanta Sofia Hospital (Madrid). Matrix analysis based on the QFD method was performed from the qualitative approaches of the patient satisfaction. This was expressed by the Donabedian quality measurement model with a focus group for qualitative data. RESULTS: The analysis of the matrix revealed the characteristics of the process which have a major influence on the service quality, related to patient satisfaction, this were recorded for future designs, services and improvements of the process, through a reliable healthcare monitoring service. CONCLUSIONS: QFD allows understanding patients requirements and to include them for continuous improvement of quality in services.
Subject(s)
Needs Assessment/standards , Patient Satisfaction , Quality of Health Care , Renal Dialysis/standards , Focus Groups , Hemodialysis Units, Hospital , Hospitals, University , Humans , Quality Improvement , Renal Dialysis/psychology , SpainABSTRACT
OBJECTIVE: To determine the level of health of individuals living in 1987 in Sector 7 of the Autonomous Community of Madrid (ACM). DESIGN: Crossover analysis of the mortality among residents of Sector 7 of the ACM in 1987. SETTING: The Madrid districts, Centro, Chamberí and Latina, which compose Sector 7 of the ACM. POPULATION UNDER STUDY: The 5,460 deaths of Sector 7 residents registered in 1987. MEASUREMENTS AND MAIN RESULTS: The mortality rates (both overall and broken down according to C.I.E. 9th causes), the mortality rates of those under 70 and the rates of years of life potentially lost were standardised by the direct method. The following results were obtained: 1. The mortality rates standardised according to age in the Centro district (7.82 per thousand) were significantly higher (p < 0.001) than those of the other Sector 7 districts (Chamberí and Latina were both at 6.25 per thousand) and of the ACM as a whole (6.63 per thousand). 2. The mortality rates, standardised by age for the population under 70 in the Centro district, were significantly higher (p < 0.001) than those of the other Sector 7 districts (Chamberí, 3.1 per thousand and Latina, 2.63 per thousand) and of the ACM as a whole (2.88 per thousand). CONCLUSIONS: Analysing mortality by Health Area reveals differences in communities' health levels. These findings will assist more rational planning of the distribution of resources.
Subject(s)
Mortality , Urban Population/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Cause of Death , Child , Child, Preschool , Humans , Infant , Middle Aged , Spain/epidemiologyABSTRACT
The development and systematic use of microserological techniques have allowed to identify the etiology of a higher number of respiratory diseases, that could hardly have been considered some years ago and that now are known to play a more common role in clinical practice than usually thought. In the present study, the clinical, radiological and epidemiological features of seven patients are reported; they were seen in our health center during a 16 month period and the diagnosis of Chlamydia psittaci pneumonia was made by serological studies. All patients were treated with erithromycin, with favorable clinical and radiological outcome. Psittacosis is a condition that should be considered as a cause of community acquired pneumonia even in the absence of suggestive epidemiological background.
Subject(s)
Psittacosis , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Psittacosis/complications , Psittacosis/diagnostic imaging , RadiographyABSTRACT
The clinical features and diagnostic evaluation of six patients affected by prolymphocytic leukemia (PLL), are described. Some of the cases deviate from a relatively uniform and aggressive clinical course of the disease entity. An actuarial survival analysis of 60 cases gathered from the literature and the authors' experience indicate that the cases showing the most prolongated evolution may reach 30% of the total. The different aggressiveness in the clinical course of these patients does not depend on the efficiency of the therapies applied. The percentage of prolymphocytes (PL) in peripheral blood throughout the clinical course was variable and not depending on the treatments used. This fact, in conjunction with (1) the presence of cellular types deviated from the typical PL and detected both at optical and ultrastructural levels and (2) the existence of cases of PL with minimal splenomegaly and leukocyte counts of less than 50 X 10(9)/liter, could lead to an underdiagnosis of PLL and hinder the actual cognition of the natural medical history of the disease.
