Developing And Implementing an Interdisciplinary Quality Program In A Rehabilitation Hospital

To assess the impact of an intervention consisting of a computer-assisted clinical decision support system and performance-based incentives, aiming at improving quality of antenatal and childbirth care. Intervention study in rural primary healthcare (PHC) facilities in Burkina Faso, Ghana and Tanzania. In each country, six intervention and six non-intervention PHC facilities, located in one intervention and one non-intervention rural districts, were selected. Quality was assessed in each facility by health facility surveys, direct observation of antenatal and childbirth care, exit interviews, and reviews of patient records and maternal and child health registers. Findings of pre- and post-intervention and of intervention and non-intervention health facility quality assessments were analysed and assessed for significant (P < 0.05) quality of care differences. Post-intervention quality scores do not show a clear difference to pre-intervention scores and scores at non-intervention facilities. Only a few variables had a statistically significant better post-intervention quality score and when this is the case this is mostly observed in only one study-arm, being pre-/post-intervention or intervention/non-intervention. Post-intervention care shows similar deficiencies in quality of antenatal and childbirth care and in detection, prevention, and management of obstetric complications as at baseline and non-intervention study facilities. Our intervention study did not show a significant improvement in quality of care during the study period. However, the use of new technology seems acceptable and feasible in rural PHC facilities in resource-constrained settings, creating the opportunity to use this technology to improve quality of care.

Keywords: percutaneous coronary intervention; structural heart disease intervention; congential heart disease; adults; congenital heart disease; pediatrics

A mixed-methods study was conducted to determine if adding pharmacy technicians to primary care teams relieved clinicians and nurses of prescribing tasks and improved perceptions of administrative burden and quality of care. A retrospective mixed-methods study using a survey and analysis of electronic health record data was conducted 1 year after deployment of 5 primary care pharmacy technicians in a safety-net group of 11 primary care clinics. Measures included administrative data on pharmacy technician work, survey measures of clinician and nurse ratings of change in administrative burden and impact on patient care, and qualitative responses. Respondants to the survey included 46 physicians, 13 nurse practitioners or physician assistants, and 25 registered nurses (response rate 32%). In 1 year, the 5 pharmacy technicians addressed 43,782 medication items (65% refills, 18% medication problem, 17% prior authorizations). Mean ratings among clinicians and nurses for medication access work on a pain point scale of 1 to 10 decreased from 8.3 to 3.6 (P <.001) pre- and post-deployment of pharmacy technicians. Clinicians and nurses agreed that the pharmacy technicians had a highly beneficial impact on work experience (59%), quality of care (54%), and patient access to medications (63%). Qualitative analysis of open-ended question responses identified 5 main themes: dealing with prior authorizations, communicating with pharmacies, timely medication access for patients, expertise of pharmacy technicians, and reduced task burden and greater efficiency. Pharmacy technicians are an underrecognized asset for team-based primary care, bringing expertise in efficiently managing medication access processes that benefits clinician and nurse work experience, quality of care, and patient access to medications.

In the emerging expanded school mental health (ESMH) field, quality is one of the most, if not the most important, issues to focus on. Program quality is fundamental to effectiveness, and in this era of increased accountability, documenting effectiveness is paramount to the advancement of the field. Although some preliminary evaluation studies have been conducted (e.g., Armbruster, Gerstein, & Fallon, 1997; Nabors & Reynolds, 2000), more information about quality of care and outcomes for youth receiving school mental health services is needed. In this chapter we review ideas for implementing continuous quality improvement (CQI) activities and evaluating the outcomes of expanded school mental health programs. We also discuss challenges to cqi and evaluation and present ideas for future work and research in the field

Cancer caregivers are key stakeholders in the final weeks of life and in bereavement. Research has highlighted end-of-life (EOL) factors important to caregivers, as well as factors contributing to caregiver mental health and bereavement outcomes. There has been limited data on factors predicting caregiver perceptions of quality of EOL care. This study's purpose was to identify modifiable predictors of caregivers' Caregiver Evaluation of Quality of End of Life Care (CEQUEL) scores, with the broader aim of informing clinical interventions to improve caregiver impressions of care and subsequent bereavement adjustment. Study data came from Coping with Cancer I (CwC1). CwC1 investigators interviewed advanced cancer patients and caregivers prior to the patient's death (Wave 1) and reinterviewed caregivers following the death (Wave 2) (N=275 dyads). The authors identified potential Wave 1 predictors of CEQUEL scores and performed a series of linear regression analyses to identify a parsimonious predictive model using corrected Akaike's Information Criterion (AICc) values. In adjusted analyses, caregivers rated quality of care as poorer when patients died in a hospital (B=-1.40, SE=0.40, p=0.001) (B, unstandardized regression coefficient; SE, standard error) or had less than one week of inpatient hospice care (B=-1.98, SE=-0.70, p=0.006). Whole-person physician care and caregiver religiosity were associated with perceived higher quality of care in unadjusted, but not adjusted, analyses. Findings suggest that place of death and hospice length of stay best predict bereaved caregiver evaluations of quality of EOL care. These findings equip health care providers with modifiable targets to improve caregivers' experience of EOL care and subsequent bereavement.

Aligning Healthcare Safety and Quality Competencies: Quality and Safety Education for Nurses (QSEN), The Joint Commission, and American Nurses Credentialing Center (ANCC) Magnet® Standards Crosswalk

Improving Patient Care Through Communication

Individuals with serious mental illness often are unable to access consumer- and family-oriented community care, resulting in repeated hospitalizations, incarceration, and homelessness. The "medical home" concept was developed in primary care to provide accessible and accountable services for individuals with chronic medical conditions. Building on the work done in primary care, the authors propose a "mental health home." The model of care incorporates medical home characteristics, such as access to and coordination of services, integration of primary and preventive care, adoption of recovery orientation and evidence-based practices, and family and community outreach. Barriers to and strategies for implementation of mental health homes are discussed.

A New Kind of Homelessness for Individuals With Serious Mental Illness? The Need for a "Mental Health Home"

The dramatic worldwide increase in the prevalence of T2DM is posing a massive health problem in both developed and developing countries. In order to improve quality, patients’ views are important in identifying what is important to them. However, to date, no literature has revealed the comparison of patients’ and healthcare providers’ perceptions on quality of care received by T2DM patients in The Gambia. The study design was a cross-sectional questionnaire survey. Patients with Type 2 diabetes at the Royal Victoria Teaching Hospital and nurses and physicians involved in the care of diabetic patients were recruited as samples in this study. Data were collected using Pouwer’s and Snoek’s (2002) Patients’ Evaluation of the Quality of Diabetes Care (PEQD) scale. Data were analyzed using descriptive statistics including, frequency, standard deviation, numbers, percentages and mean scores to compare the perception of quality of diabetes care between patients and healthcare providers. The t-tests were used to compare the means of the 10 item scores regarding quality of diabetes care. The results revealed that healthcare providers reported the highest endorsement for most aspects of diabetes care. These include availability of prescribed diabetic medications, clarity of information, amount of information, usefulness of information, emotional support, opportunity to ask questions and opportunity to share decisions. Conversely, all these aspects of care were lowly rated among patients. However, the duration of time to wait until the next appointment with the physician and overall quality of diabetes care was highly rated among patients than healthcare providers. In summary, despite the high endorsement for most aspects of care among a substantial proportion of healthcare providers, the overall ratings for all aspects of diabetes care are generally low and therefore depicts that quality of care for T2DM at the Royal Victoria Teaching Hospital is suboptimal. Thus, findings of this study highlights the need to conduct further research to explore into the perceptions of both patients and healthcare providers in order to serve the needs of diabetic patients better and to bridge perception gaps between patients and healthcare providers. Hence, the study demonstrates a significant opportunity to improve quality and organizational efficiency of diabetes care services at the Royal Victoria Teaching Hospital and other health facilities in The Gambia. It will also help the Ministry of Health to formulate and adopt realistic policies and care model for practice in general and for diabetic care in particular.

The quality of care provided for patients in mental health-care facilities remains a challenge for health-care providers in general and for nurses in particular. Identifying the level of quality of care provided for patients in mental health-care facilities as perceived by nurses and patients may help health-care providers improve the quality of care and improve patients' outcomes. The purpose of the study was to assess the perceptions of nurses and patients of the quality of nursing care, and explore the differences in their perceptions of quality of care in mental health-care facilities in Jordan. A cross-sectional study was conducted using two convenience samples of 123 nurses and 150 patients. The nurses completed the Karen-personnel instrument, a self-administered questionnaire; One hundred and fifty patients from several mental health-care facilities in Jordan were interviewed using the Karen-patient instrument. The interviews were structured. Sixtyfour percent of nurses rated the quality of psychiatric nursing care as satisfactory, and 47.6% of patients perceived the quality of nursing care as satisfactory. Male nurses, who attended courses in mental health nursing, chose to work in a psychiatric unit, committed to work in the future in a psychiatric unit, and were providing indirect care have significantly higher perception of quality of psychiatric nursing care than their counterparts. Patients in military hospitals have significantly higher perception of quality of psychiatric nursing care than those in governmental ones (p < .05). To improve the quality of care in psychiatric units, patients and nurses need to be educated about the quality indicators set by Joint Commission international standards related to mental health-care facilities.

An alternative and augmentative communication (AAC) device replaces or supplements a person’s natural speech. Speech-Language Pathologists (SLPs) collaborate with a team of healthcare professionals in the process of identification and use of the right AAC device for a person with complex communication needs (CCN). In the Philippines, occupational therapists (OTs) and SLPs are more likely to collaborate in the treatment of their clients due to their interprofessional education (IPE) experience. However, most Filipino SLPs do not engage in interprofessional collaboration (IPC) when rendering AAC services. Thus, there is a need to identify existing literature that tackles collaborative practices to raise the quality of service and care. Hence, this study aimed to identify and discuss existing literature that documented IPE and IPC strategies between OTs and SLPs in the field of AAC. The structure of this literature review was guided and adapted from the topics outlined in the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Literature archived in two databases (Pubmed and Scopus) were reviewed. Two articles out of five studies were included in this review. Strategies found were “case based learning approach” for post-graduate students and the “Beyond Access model” in supporting practitioners. In conclusion, there is a dearth of literature on IPC practices among OTs and SLPs in the field of AAC. There is a need to report IPE and IPC efforts in the Philippines to provide applicable strategies to the local healthcare landscape.

&lt;p&gt;This study sought to establish therapy-related constraints in delivering Speech and Language Therapy (SLT) services to children with CP in Kibera slums. The study was guided by the four-level model of the healthcare system and adopted a descriptive survey research design. The target population included caregivers of children with CP, speech therapists (in training), occupational therapists, and other healthcare providers offering speech services, a total of 51 participants. Purposive sampling was used to select study participants, and the entire study population served as the sample size. Data was collected through questionnaires for caregivers and interviews with speech therapists (in training), occupational therapists, and other healthcare providers offering speech services. The study ensured validity through professional reviews and a pilot study conducted at a similar institution within the Lang’ata constituency in Nairobi County. Reliability was determined using Cronbach’s Alpha to assess the consistency of research instruments. Qualitative data from interviews were analyzed thematically, while quantitative data from the questionnaires were analyzed using descriptive statistics, including frequency counts, percentages, and tables utilizing SPSS. The study revealed that a significant percentage of caregivers were discontented with the way the therapist treated their children with cerebral palsy, which not only resulted to inconsistent therapy attendance, but also poor cooperation with the speech therapists. In addition, inadequacy of available speech therapists, low quality of services provided, limited speech therapy resources and monetary constraints were cited as obstacles to seeking speech therapy services despite some care centres offering subsidized or free services. The study concluded that addressing these therapy-related constraints is essential to providing effective care and delivery of speech and language therapy services to children with CP. The study recommended that the government should prioritize the recruitment of speech and language therapists in underserved areas, particularly in slum communities and collaborate with NGOs to conduct disability awareness campaigns in Kibra in order to combat stigmatization and ensure that community members are well-informed about the available services for children with CP.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0747/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

BackgroundInterprofessional education (IPE) is a key strategy for enhancing collaboration and patient safety. While evidence for student populations is abundant, studies focusing on licensed physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs) remain limited. In contemporary rehabilitation practice, continuous IPE is increasingly important to address professional burnout and the growing complexity of patient needs.ObjectiveThis scoping review aimed to systematically map and synthesize the educational formats, content domains, and reported outcomes of IPE programs specifically targeting licensed PTs, OTs, and SLPs.MethodsFollowing Joanna Briggs Institute and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we searched the PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Educational Resources Information Center databases through December 31, 2025. The eligibility criteria were based on the population, concept, and context framework, including peer-reviewed, English-language studies of licensed PTs, OTs, and SLPs (population) participating in structured IPE interventions (concept) within clinical or community settings (context). Studies focusing solely on students or prelicensure trainees were excluded. Following the screening of 3234 records by independent pairs of reviewers, 9 studies were ultimately selected for inclusion. Methodological quality was appraised using Joanna Briggs Institute critical appraisal checklists and the Mixed Methods Appraisal Tool. Data were synthesized using an evidence gap map to visualize research density across domains relative to established competency frameworks.ResultsA total of 9 studies from Australia, the United States, Canada, and the Philippines were included, with sample sizes ranging from 8 to 197. Most used single-group pre-post or mixed methods designs; notably, no randomized controlled trials were identified. Methodological quality was generally high, though limited by the lack of control groups. Systematic mapping identified 7 educational formats, with lectures and discussions being the most dominant across all competency domains. Primary content domains included communication and role clarification. Specific successful interventions included pharmacist-led medication safety workshops and the Kawa model for team building. While participants reported immediate improvements in role understanding and collaborative confidence, simulation-based training showed inconsistent effects on long-term clinical behavior. A substantial evidence gap was identified in experiential learning approaches targeting collaborative leadership.ConclusionsThis scoping review adds a novel perspective by focusing exclusively on licensed rehabilitation professionals (PTs, OTs, and SLPs), highlighting learning needs distinct from those of prelicensure students. It brings to the field a clearer understanding of a potential “leadership gap” and the current overreliance on didactic methods for experienced clinicians. Real-world implications suggest the need for health care institutions to transition toward systematic, practice-integrated IPE models that incorporate objective behavioral assessments. By addressing identified gaps in collaborative leadership and team functioning through longitudinal programs, health care institutions may contribute to more resilient team cultures, ultimately improving patient safety and the quality of rehabilitation care.

When Team Conflicts Threaten Quality of Care: A Study of Health Care Professionals' Experiences and Perceptions.