Enhancing healthcare quality and outcomes for peritoneal dialysis patients in Thailand: An evaluation of key performance indicators and PDOPPS cohort representativeness.

AIM: To assess whether the peritoneal dialysis (PD) centres included in the Peritoneal Dialysis Outcomes and Practise Patterns Study (PDOPPS) in Thailand are representative of other PD centres in the country, based on 8 key performance indicators (KPIs 1-8). METHODS: A retrospective analysis was conducted comparing PD-related clinical outcomes between PD centres included in the PDOPPS (the PDOPPS group) and those not included (the non-PDOPPS group) from January 2018 to December 2019. Logistic regression analysis was used to identify predictors associated with achieving the target KPIs. RESULTS: Of 181 PD centres, 22 (12%) were included in the PDOPPS. PD centres in the PDOPPS group were larger and tended to serve more PD patients than those in the non-PDOPPS group. However, the process and outcome KPIs (KPIs 1-8) were comparable between the 2 groups. Large hospitals (≥120 beds), providing care to ≥100 PD cases and having experience for >10 years were independent predictors of achieving the peritonitis rate target of <0.5 episodes/year. Most PD centres in Thailand showed weaknesses in off-target haemoglobin levels and culture-negative peritonitis rate. CONCLUSIONS: The PD centres included in Thai PDOPPS were found to be representative of other PD centres in Thailand in terms of clinical outcomes. Thus, Thai PDOPPS findings may apply to the broader PD population in Thailand.

La acreditación de excelencia en Medicina Interna como importante referente histórico de compromiso biomédico / The certification of excellence of Internal Medicine as an important historical benchmark for biomedical commitmen

Introducción: La certificación de la calidad de programas en el posgrado constituye un tema cardinal dentro de los ejes estratégicos de la educación superior a nivel nacional e internacional. Objetivo: Describir las ventajas de la acreditación de la calidad de los programas de las especialidades de posgrado, tomando como ejemplo la de Medicina Interna en Santiago de Cuba. Métodos: Se desarrolló una investigación pedagógica, con enfoque mixto sobre dicha temática, según el subsistema vigente, jerarquizado por la Junta de Acreditación Nacional. Para el proceso de evaluación externa se consideraron las ediciones concluidas 35 y 36 del quinquenio 2014-2019 en Medicina Interna más, las ediciones 37, 38 y 39 en ejecución. Se realizó una minuciosa sistematización de procesos, socialización de experiencias de la autoevaluación y evaluación externa, así como una reflexión histórica acerca de la trascendencia y aspectos conceptuales esenciales de la especialidad. Resultados: Se mostraron fortalezas e impactos fundamentales alcanzados en cada variable del patrón de calidad, lo que demostró reconocido prestigio institucional del programa, eficiencia académica en su ejecución, notable visibilidad del claustro, distinguida gestión en el aseguramiento didáctico y tecnológico, excelente fundamentación teórica y metodológica del currículo junto a una sólida tradición de ambos escenarios laborales. Conclusiones: Propuesta útil de procedimientos organizacionales y de gestión primordiales, que urge generalizar para el mejoramiento continuo de la educación posgraduada, junto a la responsabilidad social universitaria demostrada y lograr que los indicadores de calidad en el rango de excelencia sean sostenibles(AU)

Introduction: The quality certification of postgraduate programs constitutes a cardinal issue within the strategic axes of higher education domestically and worldwide. Objective: To describe the advantages of the quality certification of the programs of the postgraduate specialties, taking as an example the Internal Medicine in Santiago de Cuba. Methods: A pedagogical research was developed with a mixed approach on said subject, according to the current subsystem, ranked by the National Certification Board. For the external evaluation process, we considered the 35th and 36th editions of the 2014-2019 five-year period in Internal Medicine plus, the 37th, 38th and 39th editions in progress. A meticulous systematization of processes, socialization of experiences of self-evaluation and external evaluation was carried out, as well as a historical reflection on the transcendence and essential conceptual aspects of the specialty. Results: The strengths and fundamental impacts achieved in each variable of the quality standard were shown, which demonstrated recognized institutional prestige of the program, academic efficiency in the execution, notable visibility of the faculty, distinguished management in the didactic and technological assurance, excellent theoretical foundation and methodological curriculum together with solid tradition of both work settings. Conclusions: It is a useful proposal of fundamental organizational and management procedures, which is urgent to generalize for the continuous improvement of postgraduate education, together with the demonstrated university social responsibility and to ensure that the quality indicators in the range of excellence are sustainable(AU)

Experiencia en la implementación de sistemas de gestión de calidad para la atención odontológica en un centro docente asistencial universitario / Experience in the implementation of quality management systems for dental care in a university teaching center

RESUMEN: Objetivo: Describir el desarrollo e implementación para el establecimiento, cumplimiento y acreditación como centro de atención abierta, para la atención odontológica de un centro docente asistencial. Metodología: Para alcanzar mayores niveles de calidad sanitaria y lograr satisfacción de pacientes, profesionales, estudiantes, personal auxiliar y administrativo, definimos 8 niveles de acción: orientar trabajo a resultados; realizar actividades centradas en el paciente; desarrollar el liderazgo y coherencia en los objetivos; gestionar por medio de procesos; involucrar a toda la comunidad; incorporar a la gestión el aprendizaje, la innovación y la mejora constante; potenciar alianzas internas y externas y garantizar la responsabilidad social. Resultados: El comité de calidad rediseñó protocolos, realizó mejoras computacionales y administrativas, realizó diálogos con la comunidad, incrementando de 80% a 100% el cumplimiento de los estándares obligatorios (n= 11) y de 70 % a 96 % los globales. Conclusiones: Alcanzar las competencias de planificación, gestión sanitaria y elevar los niveles de calidad en la atención de pacientes de un centro de salud que incluye una Facultad de Odontología, es un desafío continuo en el tiempo que involucra toda la comunidad, requiere especialistas del área, incrementa los costos de operación y conduce a su acreditación como centro de atención abierta.

ABSTRACT: Objective: To describe the development and implementation for the establishment, fulfillment and accreditation as an open-care center, for dental care in a University Teaching Center. Methodology: In order to reach higher levels of health care quality and additionally achieve the satisfaction of patients, professionals, students, auxiliary and administrative staff, the quality committee developed 8 levels of action: 1, orienting the work to results; 2, performing patient-centered activities; 3, developing leadership and coherence in the objectives; 4, managing through processes; 5, involving the entire community; 6, incorporating learning, innovation and constant improvement into management; 7, strengthening internal and external alliances and 8, ensuring social responsibility. Results: After 4 years of work by the quality and review committees, with the redesign of protocols, computer and administrative improvements, evaluation of progress and dialogue with the community, compliance with mandatory quality standards (n=11) was increased from 80% to 100% and compliance with the global standard was increased from 70% to 96% (mandatory + non-mandatory standards). Conclusions: The strategy to achieve planning and management competences in the health system and to raise quality levels of patient care in a health center that includes a dental school is a continuous challenge over time that involves the entire community, requires specialists in the area, increases operating costs and leads to accreditation as an Open.Care Center.

Knowledge and attitudes of Saudi intensive care unit nurses regarding oral care delivery to mechanically ventilated patients with the effect of healthcare quality accreditation.

INTRODUCTION: Ventilator-associated pneumonia is a major morbid outcome among intensive care unit (ICU) patients. Providing oral care for intubated patients is an important task by the ICU nursing staff in reducing the mortality and morbidity. The objectives of this study were to evaluate the attitudes and knowledge of ICU nurses regarding oral care delivery to critically ill patients in Saudi Arabian ICUs. The findings were further correlated to the presence of healthcare quality accreditation of the institution. MATERIALS AND METHODS: The nurses' knowledge, attitudes, and healthcare quality accreditation status of the hospital were recorded. Two hundred fifteen nurses conveniently selected from 10 random hospitals were included in this study from Riyadh city, Saudi Arabia. This is a cross-sectional study in the form of a questionnaire. RESULTS: When comparing the knowledge of the participants to their level of education, there was no statistically significant difference between the two groups of nurses. The majority of the nurses agreed that the oral cavity is difficult to clean and that oral care delivery is a high priority for mechanically ventilated patients. Furthermore, there was no statistically significant difference in the attitudes between nurses working in accredited and nonaccredited hospitals. CONCLUSION: The presence of healthcare quality accreditation did not reflect any significance in attitudes or knowledge of the ICU nurses in regard to mechanically ventilated patients. Factors affecting oral care delivery should be evaluated on the personal and institutional level to achieve better understanding of them.

Overview and experience of hospital quality management in the USA / 中华医院管理杂志

Through nearly 90 years' continuous development and improvement, quality management and accreditation in the American healthcare field has already become an integrated, well-functioned and unique system from which we can learn a lot. This article not only briefly introduces this system in eight aspects, including independent quality management departments, specialized professionals in healthcare quality management, and integrated committee systems of quality improvement, but also explores some good points which we can buy in.