Evidence-based organization and patient safety strategies in European hospitals
Suñol Sala, Rosa (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Wagner, Cordula (Amsterdam University Medical Center (UMC))
Arah, Onyebuchi A.. (University of California, Los Angeles (UCLA))
Shaw, Charles D. (University of New South Wales)
Kristensen, Solvejg (Aalborg Universitet)
Thompson, Caroline A. (University of California, Los Angeles (UCLA))
Dersarkissian, Maral (University of California, Los Angeles (UCLA))
Bartels, Paul (Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA)
Pfaff, Holger (Aalborg Universitet)
Secanell, Mariona (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Mora, Núria (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Vlcek, Frantisek (University of Cologne)
Kutaj-Wasikowska, Halina (Czech Accreditation Committee)
Kutryba, Basia (Czech Accreditation Committee)
Michel, Philippe (Polish Society for Quality Promotion in Health Care)
Groene, Oliver (Lyon University, Hospital Network)
Klazinga, N. (DUQuE Project Consortium)
Kringos, D. S. (DUQuE Project Consortium)
Lombarts, M. J. M. H. (DUQuE Project Consortium)
Plochg, T. (DUQuE Project Consortium)
Lopez, M. A. (DUQuE Project Consortium)
Vallejo, P. (DUQuE Project Consortium)
Saillour-Glenisson, F. (DUQuE Project Consortium)
Car, M. (DUQuE Project Consortium)
Jones, S. (DUQuE Project Consortium)
Klaus, E. (DUQuE Project Consortium)
Bottaro, S. (DUQuE Project Consortium)
Garel, Pascal (DUQuE Project Consortium)
Saluvan, M. (DUQuE Project Consortium)
Bruneau, Charles (DUQuE Project Consortium)
Depaigne-Loth, A. (DUQuE Project Consortium)
Hammer, A. (DUQuE Project Consortium)
Ommen, O. (DUQuE Project Consortium)
Pfaff, Holger (DUQuE Project Consortium)
Botje, Daan (DUQuE Project Consortium)
Escoval, Ana (DUQuE Project Consortium)
Lívio, A. (DUQuE Project Consortium)
Eiras, M. (DUQuE Project Consortium)
Franca, M. (DUQuE Project Consortium)
Leite, I. (DUQuE Project Consortium)
Almeman, F. (DUQuE Project Consortium)
Kus, H. (DUQuE Project Consortium)
Ozturk, K. (DUQuE Project Consortium)
Mannion, Russell (DUQuE Project Consortium)
Wang, A. (DUQuE Project Consortium)
Thompson, A. (DUQuE Project Consortium)

Data:	2014
Resum:	To explore how European hospitals have implemented patient safety strategies (PSS) and evidence-based organization of care pathway (EBOP) recommendations and examine the extent to which implementation varies between countries and hospitals. Mixed-method multilevel cross-sectional design in seven countries as part of the European Union-funded project 'Deepening our Understanding of Quality improvement in Europe' (DUQuE). Seventy-four acute care hospitals with 292 departments managing acute myocardial infarction (AMI), hip fracture, stroke, and obstetric deliveries. Five multi-item composite measures-one generic measure for PSS and four pathway-specific measures for EBOP. Potassium chloride had only been removed from general medication stocks in 9. 4-30. 5% of different pathways wards and patients were adequately identified with wristband in 43. 0-59. 7%. Although 86. 3% of areas treating AMI patients had immediate access to a specialist physician, only 56. 0% had arrangements for patients to receive thrombolysis within 30 min of arrival at the hospital. A substantial amount of the total variance observed was due to between-hospital differences in the same country for PSS (65. 9%). In EBOP, between-country differences play also an important role (10. 1% in AMI to 57. 1% in hip fracture). There were substantial gaps between evidence and practice of PSS and EBOP in a sample of European hospitals and variations due to country differences are more important in EBOP than in PSS, but less important than within-country variations. Agencies supporting the implementation of PSS and EBOP should closely re-examine the effectiveness of their current strategies.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Patient safety ; Quality improvement ; Quality management ; Practice variations ; Appropriate healthcare ; Hospital care ; Effectiveness
Publicat a:	International journal for quality in health care, Vol. 26 (february 2014) , p. 47-55, ISSN 1464-3677

DOI: 10.1093/intqhc/mzu016
PMID: 24578501

9 p, 143.7 KB

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