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This study compares responses of physicians and nurses to patient safety culture assessment in the Security Forces Hospital Program Makkah, Saudi Arabia, using the Agency for Healthcare Research and Quality (AHRQ) survey tool and its referenced benchmarking tool. The purpose of this paper is to measure patient safety culture to improve its perception, reaction, and implementation, leading to improvement in care delivery.

This study uses convenience sampling, delivering paper copies. The completed surveys were collected by a designated hospital contact person in QPSD. The total population surveyed was 623: 336 nurses, 174 physicians, 9 pharmacists, and 104 technicians.

Composite-level results compared to AHRQ database hospitals show values below minimum positive in “Staffing” and “Non-Punitive response to error” to have decreased values in nursing answers than physician ones. The average percentage positive concerning “staffing” items is below the average percentage positive of database hospitals; in nursing, it decreases more; it shows a low positive response regarding enough staff, work hours, and crisis mode; the last item shows a more negative response. The average percentage positive concerning “No punitive Response to Error” is below average positive of database hospitals; in nursing, it decreases more, with a low positive response concerning feeling responsible for mistakes.

The approach explained in this paper aims to measure patient safety culture, which can be improved through mentioned recommendations.

Quantitative instruments to assess patient safety culture have been developed recently and a few review articles have been published. Measuring safety culture enables healthcare managers and staff to improve safety behaviours and outcomes for patients and staff. The study aims to determine the AHRQ Hospital Survey on Patient Safety Culture (HSPSC) Portuguese version's validity and reliability.

A missing-value analysis and item analysis was performed to identify problematic items. Reliability analysis, inter-item correlations and inter-scale correlations were done to check internal consistency, composite scores. Inter-correlations were examined to assess construct validity. A confirmatory factor analysis was performed to investigate the observed data's fit to the dimensional structure proposed in the AHRQ HSPSC Portuguese version. To analyse differences between hospitals concerning composites scores, an ANOVA analysis and multiple comparisons were done.

Eight of 12 dimensions had Cronbach's alphas higher than 0.7. The instrument as a whole achieved a high Cronbach's alpha (0.91). Inter-correlations showed that there is no dimension with redundant items, however dimension 10 increased its internal consistency when one item is removed.

This study is the first to evaluate an American patient safety culture survey using Portuguese data. The survey has satisfactory reliability and construct validity.

Although it is widely acknowledged that health care delivery systems are complex adaptive systems, there are gaps in understanding the application of systems engineering approaches to systems analysis and redesign in the health care domain. Commonly employed methods, such as statistical analysis of risk factors and outcomes, are simply not adequate to robustly characterize all system requirements and facilitate reliable design of complex care delivery systems. This is especially apparent in institutional-level systems, such as patient safety programs that must mitigate the risk of infections and other complications that can occur in virtually any setting providing direct and indirect patient care. The case example presented here illustrates the application of various system engineering methods to identify requirements and intervention candidates for a critical patient safety problem known as failure to rescue. Detailed descriptions of the analysis methods and their application are presented along with specific analysis artifacts related to the failure to rescue case study. Given the prevalence of complex systems in health care, this practical and effective approach provides an important example of how systems engineering methods can effectively address the shortcomings in current health care analysis and design, where complex systems are increasingly prevalent.

The purpose of this paper is to discuss strategies for benchmarking patient safety using Lombardy region administrative archives. Patient safety indicators and statistical methods are presented that allow risk adjustment. The analysis benchmarks regional health structures, focusing on two patient safety indicators: failure to rescue; and death in low mortality diagnostic related group.

Data were drawn from a research project promoted by the Italian Agency of Regional Health Services in 2002 to furnish statistical evidence regarding adverse events based on Agency for Healthcare Research and Quality indicators and methods. Hierarchical models for an equitable benchmark analyses are proposed.

Empirical analysis shows that hierarchical approaches, based on comparing health structures within homogenous specialties, disaggregates and moderates failure to rescue variabilities existing between hospitals, especially in oncology, intensive care and general medicine.

The paper proposes using hierarchical models for properly benchmarking health structures, resolving logistic regression drawbacks and limitations.

The paper strengthens the theory that accurate coding supported by software and administrative databases could provide a valuable and economical source for patient safety research.

The paper analyses and suggests strategies for consistent benchmark analyses based on patient safety outcomes, applicable to several situations and different health structure typologies.

This study aimed to examine how Medical Expenditure Panel Survey (MEPS) data have been used to support scientific discoveries in biomedical and health sciences, and provide insight to researchers who are interested in using MEPS regarding collaborations and dissemination of research output.

A bibliometric approach was used to systematically examine the publications that used MEPS data and were indexed by PubMed and Web of Science (WoS). Microsoft Excel and bibliometric tools (WoS and VOSviewer) were utilized for quantitative and bibliometric network analysis. The measures were investigated on the total number of publications by year, research categories, source journals, other datasets/databases co-used with MEPS, funding sources, collaboration patterns, and research topics.

A total of 1,953 eligible publications were included in this study with the numbers growing significantly over time. MEPS data were primarily used in healthcare services, public environmental and occupational health research. The journals that published the most papers using MEPS were all in the healthcare research area. Twenty-four other databases were found to be used along with MEPS. Over 3,200 researchers from 1,074 institutions in 25 countries have contributed to the publications. Research funding was supported from federal, private, local, and international agencies. Three clusters of research topics were identified among 235 key terms extracted from titles and abstracts.

Our results illustrated the broad landscape of the research efforts that MEPS data have supported and substantiated the value of AHRQ's effort of providing MEPS to the public.

The purpose of this paper is to identify and describe hospital quality indicators, classifying them according to Donabedian’s structure, process and outcome model and in specific domains (quality, safety, infection and mortality) in two care divisions: inpatient and emergency services.

A systematic review identified hospital clinical indicators. Two independent investigators evaluated 70 articles/documents located in electronic databases and nine documents from the grey literature, 35 were included in the systematic review.

In total, 248 hospital-based indicators were classified as infection, safety, quality and mortality domains. Only 10.2 percent were identified in more than one article/document and 47 percent showed how they were calculated/obtained. Although there are scientific papers on developing, validating and hospital indicator assessment, most indicators were obtained from technical reports, government publications or health professional associations.

This review identified several hospital structure, process and outcome quality indicators, which are used by different national and international groups in both research and clinical practice. Comparing performance between healthcare organizations was difficult. Common clinical care standard indicators used by different networks, programs and institutions are essential to hospital quality benchmarking.

To the authors’ knowledge, this is the first systematic review to identify and describe hospital quality indicators after a comprehensive search in MEDLINE/PubMed, etc., and the grey literature, aiming to identify as many indicators as possible. Few studies evaluate the indicators, and most are found only in the grey literature, and have been published mostly by government agencies. Documents published in scientific journals usually refer to a specific indicator or to constructing an indicator. However, indicators most commonly found are not supported by reliability or validity studies.

Purpose – The numbers of health care transparency initiatives are increasing. Despite the growing availability of quality data, there seems to be a shortage of evidence about the effects and effectiveness of such initiatives. The aim of this systematic review is to document the effects of transparency, defined as the public release of quality performance data, on hospital care outcomes.

Design/methodology/approach – Through a review of the literature, we chose 46 keywords to use in our searches and focused on empirical studies published in English between 2010 and 2015. The use of combinations of these keywords in searches of four databases (PubMed, Scopus, Web of Science, and the Cochrane Library) generated 13,849 publications. The removal of duplicates and exclusion of studies that were not empirical or not relevant to transparency and quality resulted in 39 studies to be reviewed.

Findings – Our review of the literature confirmed the growth of health care transparency efforts, led by the United States, and found mixed results regarding the effects of transparency on hospital care outcomes. For example, mortality, the most frequently researched performance measure (n = 15), exhibited this mixed pattern by having studies showing a reduction (n = 4), increase (n = 1), mixed findings (n = 4), and no significant relationship (n = 6) as a result of public release. We also found a limited number of articles related to unintended consequences of public reporting. When compared with earlier systematic reviews, there seems to be a trend in the reduction of unintended consequences. Therefore, we recommend exploration of this potential trend in future studies empirically.

Practical Implications – The research findings summarized in this systematic review can be used to understand the results of existing transparency efforts and to develop future transparency initiatives that may better enhance hospital quality performance.

Originality/value – This is the latest and most comprehensive systematic review summarizing the effects of transparency of quality metrics on hospital care outcomes.

This paper aims to assess a pediatric media health effects’ toolkit from a health literacy perspective. A secondary aim is to highlight the collaborative role of an embedded librarian.

The authors assessed ten items from the toolkit in several formats (text, survey and video) using the following health literacy assessment tools: the Simple Measure of Gobbledygook, the Suitability Assessment of Materials, the Patient Education Materials Assessment Tool for Printed Materials and the Patient Education Materials Assessment Tool for Audio/Visual Materials.

Both the toolkit’s readability scores and understandability scores provided a deeper understanding of where improvements to the toolkit need to be made. The review process also highlighted issues with the assessment tools themselves that prevent them from providing a complete analysis of each materials’ readability and suitability.

This initial assessment of the toolkit will serve as the backbone for additional formative research, revisions and pilot tests, which will be conducted for the toolkit to become a viable, available and usable tool for pediatricians and health-care providers. The insight gleaned from this study serves as an example, for other institutions across fields, of the importance of having professionals, such as librarians, become well-versed in health literacy and offer guidance and insight for the development of health-focused patient materials.

This project provides further insight into the evolving role of the embedded librarian. As gatekeepers of information with the responsibility of vetting sources, informing the creation of content, and developing resources, the integration of health literacy knowledge is imperative for librarians to further the work of their institutions and aid in the progression of their field.