Social and clinical vulnerability in stroke and STEMI management during the COVID-19 pandemic: a registry-based study.

Objective: This study aims to evaluate whether the first wave of the COVID-19 pandemic resulted in a deterioration in the quality of care for socially and/or clinically vulnerable stroke and ST-segment elevation myocardial infarction (STEMI) patients.

Design: Two cohorts of STEMI and stroke patients in the Aquitaine neurocardiovascular registry.

Setting: Six emergency medical services, 30 emergency units, 14 hospitalisation units and 11 catheterisation laboratories in the Aquitaine region in France.

Evaluating a Public Health Information Service According to Users' Socioeconomic Position and Health Status: Protocol for a Cross-Sectional Study.

Background: The increasing use of information technology in the field of health is supposed to promote users' empowerment but can also reinforce social inequalities. Some health authorities in various countries have developed mechanisms to offer accurate and relevant information to health care system users, often through health websites. However, the evaluation of these sociotechnical tools is inadequate, particularly with respect to differences and inequalities in use by social groups.

Social determinants associated with psychological distress in children and adolescents during and after the first COVID-19-related lockdown in France: results from the CONFEADO study.

Background: This study aimed to analyze the parental socio-demographic characteristics of children and adolescents aged 9 to 18 years old, as well as the living and housing conditions associated with the psychological distress in these two sub-populations during and after France's first national COVID-19-related lockdown in spring 2020.

Methods: We used data from the cross-sectional, observational, web-based study CONFEADO, which collected data on children and adolescents' living and housing conditions and socio-demographic characteristics as well as those of their parents. It also collected data on children's and adolescents' health behaviors and psychological distress.

Factors associated with the time from the first call to emergency medical services to puncture for mechanical thrombectomy for ischaemic stroke patients in Gironde, France, in 2017 and 2018.

Background And Purpose: When an ischaemic stroke due to a large vessel occlusion occurs, the sooner Mechanical Thrombectomy (MT) is performed, the better the functional prognosis. However, the organisation of care does not systematically allow rapid access to MT. The aim of our study was to determine the clinical and organisational factors associated with the time to access to MT.

Alert on elongated in-hospital acute stroke management delays. An Aquitain cohort study.

The objectives were to analyze changes from 2012 to 2017 in different management times of stroke patients included in the Aquitaine stroke Observatory (ObA2). The studied times (onset-to-needle time-ONT, onset-to-door time-ODT, door-to-imaging time-DIT, door-to-needle time-DNT and imaging-to-needle time-INT) were described as median, interquartile ranges and proportion of patients within the recommended median time goals (ODT under 4hours, DIT within 20min; for thrombolyzed patients, DIT under 20min and a ONT under 4:30) to be compared with an objective of 50% of patients within said time goal. Globally, ODT was 160min, with 43.

Effects of healthcare system transformations spurred by the COVID-19 pandemic on management of stroke and STEMI: a registry-based cohort study in France.

Objective: To assess the impact of changes in use of care and implementation of hospital reorganisations spurred by the COVID-19 pandemic (first wave) on the acute management times of patients who had a stroke and ST-segment elevation myocardial infarction (STEMI).

Design: Two cohorts of patients who had an STEMI and stroke in the Aquitaine Cardio-Neuro-Vascular (CNV) registry.

Setting: 6 emergency medical services, 30 emergency units (EUs), 14 hospitalisation units and 11 cathlabs in the Aquitaine region.

[Linking Interventional Cardiology clinical registry data with French hospital administrative data: Development and validation of deterministic record linkage].

Background: To recreate the in-hospital healthcare pathway for patients treated with coronary angiography or percutaneous coronary intervention, we linked the interventional cardiology registry (ACIRA) and the pseudonymized French hospital medical information system database (PMSI) in the Aquitaine region. The objective of this study was to develop and validate a deterministic merging algorithm between these exhaustive and complementary databases.

Methods: After a pre-treatment phase of the databases to standardize the 11 identified linking variables, a deterministic linking algorithm was developed on ACIRA hospital stays between December 2011 and December 2014 in nine interventional cardiology centers as well as the data from the consolidated PMSI databases of the Aquitaine region from 2011 to 2014.

Post-stroke pathway analysis and link with one year sequelae in a French cohort of stroke patients: the PAPASePA protocol study.

Background: Stroke is a health problem with serious consequences, both in terms of mortality, and after-effects affecting patient quality of life. Stroke requires both urgent and chronic management involving the entire health care system. Although large variability in the management of stroke patients have been noticed, knowledge of the diversity and the scalability of post-stroke pathways, whether it is the care pathway or the life pathway, is currently not sufficient.

Improving the safety climate in hospitals by a vignette-based analysis of adverse events: a cluster randomised study.

Objective: To assess the impact of a vignette-based analysis of adverse events (AEs) on the safety climate (SC) of care units.

Design: Prospective, open, cluster (a unit) randomised controlled trial.

Setting: Eighteen acute care units of seven hospitals in France.

Organizational and managerial factors associated with clinical practice guideline adherence: a simulation-based study in 36 French hospital wards.

Objectives: To identify managerial and organizational characteristics of multi-specialty medicine wards and individual characteristics of health professionals that are most strongly associated with clinical practice guidelines (CPG) adherence.

Design: Cross-sectional stratified cluster sample design.

Setting: Data were gathered from 36 randomly selected multi-specialty medicine wards.

Validation of the Behavioural Observation Scale 3 for the evaluation of pain in adults.

Background: Many behavioural scales are available to assess pain but none are suitable for a quick evaluation of non-sedated and non-geriatric adults. The Behavioural Observation Scale 3 (BOS-3) is short, composed of five items. This study examined its feasibility and diagnostic performances.

Design and validation of a questionnaire to assess organizational culture in French hospital wards.

Background: Although many organizational culture questionnaires have been developed, there is a lack of any validated multidimensional questionnaire assessing organizational culture at hospital ward level and adapted to health care context. Facing the lack of an appropriate tool, a multidisciplinary team designed and validated a dimensional organizational culture questionnaire for healthcare settings to be administered at ward level.

Methods: A database of organizational culture items and themes was created after extensive literature review.

[Assessment of the announcement procedure in 29 cancer-accredited hospitals in the Aquitaine region: the EVADA project].

Introduction: An announcement procedure is mandatory to obtain accreditation to treat cancer patients. Health care professionals in the Aquitaine region evaluated the organization of this announcement procedure in their institutions and the patients' perception, in order to initiate actions to improve the structure and traceability of this procedure.

Method: Self-assessment approach based on a retrospective study plan comprising three concomitant steps: organizational audit, medical records audit and patient experience survey.

Validation of the French version of the Hospital Survey on Patient Safety Culture questionnaire.

Objective: To assess the psychometric properties of the French version of the Hospital Survey on Patient Safety Culture questionnaire (HSOPSC) and study the hierarchical structure of the measured dimensions.

Design: Cross-sectional survey of the safety culture.

Setting: 18 acute care units of seven hospitals in South-western France.

[Combined quantitative and qualitative methods to identify local facilitators of and barriers to physician's adherence to clinical practice guidelines].

Background: The effectiveness of Clinical Practice Guideline (CPG) implementation interventions could be improved by their adaptation to facilitators of and barriers to practice change in each setting. Very few is known about these local factors in French hospitals. Our objectives were to identify the facilitator factors of and barriers to physician's adherence to CPG in internal medicine wards in France and to determine the factors most strongly statistically associated to CPG adherence.