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Value-based healthcare for social insurance medicine: key enablers for adoption in practice.
BMJ Open Qual
December 2024
Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
Background: Driven by rising retirement age and increasing prevalence of chronic diseases impacting work participation, there is an increasing need for quality and efficiency improvement in social insurance medicine (SIM). SIM provides guidance to individuals facing long-term work disability, assess their functional abilities and eligibility for long-term disability benefits. Value-based healthcare (VBHC) targets quality and efficiency improvements in healthcare by placing a priority on improving patient value.
View Article and Find Full Text PDFA Multianalyte Machine Learning Model to Detect Wrong Blood in Complete Blood Count Tube Errors in a Pediatric Setting.
Clin Chem
January 2025
Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Background: Multianalyte machine learning (ML) models can potentially identify previously undetectable wrong blood in tube (WBIT) errors, improving upon current single-analyte delta check methodology. However, WBIT detection model performance has not been assessed in a real-world, low-prevalence context. To estimate real-world positive predictive values, we propose a methodology to assess WBIT detection models by evaluating the impact of missing data and by using a "low prevalence" validation data set.
View Article and Find Full Text PDFAdvancing Quality and Safety Culture in Healthcare: Insights From the Evaluation of an Improvement Science Program for Nurses and Midwives.
J Adv Nurs
January 2025
Professor of Person Centred Healthcare, South Western Sydney Nursing & Midwifery Research Alliance, The Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia.
Aims: This paper presents the outcomes and insights gained from the implementation of an Improvement Science program tailored for nursing and midwifery staff within a large local health district in New South Wales. The programme aimed to enhance frontline clinicians' confidence and capability in quality improvement, ultimately improving patient outcomes and safety culture.
Design: Through an explanatory sequential mixed-methods evaluation study, we assessed the programme's effectiveness in building capacity, sustaining practice changes and fostering a culture of continuous improvement.
Pain and Dyspnea During Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Documentation Audit 2019-2020.
J Clin Med
January 2025
Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3199, Australia.
Patient-reported outcome measures (PROMs) assess the severity and impact of both pain and dyspnea in those with acute exacerbations of chronic obstructive pulmonary disease (COPD), but their frequency of use in clinical practice is unknown. This study aimed to determine the point prevalence of pain and dyspnea assessment in patients hospitalized with an acute exacerbation of COPD and the measurement tools applied for this purpose in clinical practice. Clinical notes and observation charts of patients admitted with acute exacerbations of COPD to a metropolitan hospital in 2019 and 2020 were retrospectively audited to identify the point prevalence of pain and dyspnea assessment, the PROMs applied, and their associated focal periods.
View Article and Find Full Text PDFTherapeutic Consequences and Prognostic Impact of Multimorbidity in Heart Failure: Time to Act.
J Clin Med
December 2024
Department of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary.
: In heart failure (HF) with reduced ejection fraction (HFrEF), the early diagnosis and proper treatment of comorbidities (CMs) are of fundamental relevance. Our aim was to assess the prevalence of CMs among real-world patients requiring hospitalisation for HFrEF and to investigate the effect of CMs on the implementation of guideline-directed medical therapy (GDMT) and on all-cause mortality (ACM). : The data of a consecutive HFrEF patient cohort hospitalised for HF between 2021 and 2024 were analysed retrospectively.
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