Dataset Information

Do performance indicators predict regulator ratings of healthcare providers? Cross-sectional study of acute hospitals in England.

ABSTRACT: OBJECTIVE:To determine whether a large set of care performance indicators ('Intelligent Monitoring (IM)') can be used to predict the Care Quality Commission's (CQC) acute hospital trust provider ratings. DESIGN:The IM dataset and first-inspection ratings were used to build linear and ordered logistic regression models for the whole dataset (all trusts). This was repeated for subsets of the trusts, with these models then applied to predict the inspection ratings of the remaining trusts. SETTING:The United Kingdom Department of Health and Social Care's Care Quality Commission is the regulator for all health and social care services in England. We consider their first-inspection cycle of acute hospital trusts (2013-2016). PARTICIPANTS:All 156 English NHS acute hospital trusts. INTERVENTION(S):None. MAIN OUTCOME MEASURE(S):Percentage of correct predictions and weighted kappa. RESULTS:Only 24% of the predicted overall ratings for the test sample were correct and the weighted kappa of 0.01 indicates very poor agreement between predicted and actual ratings. This lack of predictive power is also found for each of the rating domains. CONCLUSION:While hospital inspections draw on a much wider set of information, the poor power of performance indicators to predict subsequent inspection ratings may call into question the validity of indicators, ratings or both. We conclude that a number of changes to the way performance indicators are collected and used could improve their predictive value, and suggest that assessing predictive power should be undertaken prospectively when the sets of indicators are being designed and selected by regulators.

SUBMITTER: Allen T

PROVIDER: S-EPMC7184898 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Do performance indicators predict regulator ratings of healthcare providers? Cross-sectional study of acute hospitals in England.

Allen Thomas T Walshe Kieran K Proudlove Nathan N Sutton Matt M

International journal for quality in health care : journal of the International Society for Quality in Health Care 20200401 2

<h4>Objective</h4>To determine whether a large set of care performance indicators ('Intelligent Monitoring (IM)') can be used to predict the Care Quality Commission's (CQC) acute hospital trust provider ratings.<h4>Design</h4>The IM dataset and first-inspection ratings were used to build linear and ordered logistic regression models for the whole dataset (all trusts). This was repeated for subsets of the trusts, with these models then applied to predict the inspection ratings of the remaining tr ...[more]

PMID: 31725874

Similar Datasets

Project description:Background: Literatures revealed that healthcare-associated infections are still a great concern in many developing countries including in Ethiopia. Despite the development of detailed guidelines for infection control, they remain as a critical challenge for the public health sectors and the knowledge of standard precautions among healthcare workers in many developing countries is low and not properly applied. Hence, the present study tried to determine the level of knowledge about standard precautions among healthcare workers of Amhara region, Ethiopia.Methods: Institutional based cross-sectional study was conducted on a randomly selected public hospitals of Amhara region, Northwest Ethiopia from March 01-April 01/2017. A multistage sampling strategy was utilized to select 795 sampled healthcare workers. Data were collected using pretested self-administered questionnaire. The collected data entered using EpiData Version 3.1 statistical software and analyzed using SPSS version 20 statistical package. After using binary logistic regression, multivariable logistic regression analysis used to form the model. Variables which had statistically significant association with the outcome variable (P < 0.05) were identified as significant in the multivariable logistic regression analysis.Results: Almost half (49.2%) of the study participants were female healthcare workers. Three-fourth (74.3%) of the healthcare workers involved in the current study had good knowledge towards standard precautions. Good knowledge towards standard precautions refers to scoring correct responses to >?60% of knowledge items from the survey. Year of service (AOR: 0.27, 95% CI: 0.16 to 0.44), educational status (AOR: 1.7, 95% CI: 1.13 to 2.56) were among the predictor variables. In addition, physicians were 6.97 times more likely to be knowledgeable (AOR: 6.97, 95% CI 2.42 to 20.12) than laboratory technician/technology counterparts. Study participants working in medical, Gyn/obs, pediatrics wards, and OPD were about 2.23, 4.27, 2.81 and 2.52 times more likely to be knowledgeable than study participants working in surgical ward.Conclusions: Overall, the majority of healthcare workers had good knowledge of standard precautions. But variation in knowledge was detected across healthcare workers by hospital type and ward/units. This may help to design a solution by prioritizing the problem.

Project description:ObjectivesThe growth and development of smartphones and eHealth technologies have enabled the potential for extended care hospitals (e-hospitals) in China in order to facilitate the success of a primary healthcare centre (PHC)-based integrated delivery model. Although the adoption of e-hospitals is essential, few studies have directed their research towards understanding the perspectives of healthcare providers. This study aims to identify the current readiness of healthcare providers to adopt e-hospital technologies, determine the factors influencing this adoption and describe the perceived facilitators and barriers in regard to working at e-hospitals.DesignA cross-sectional study conducted in Sichuan, China, between June and September 2019.SettingsInformation was collected from healthcare providers who have more than 3 years of work experience from a tertiary hospital, secondary hospital, PHCs and private hospital.Participants2298 medical professionals were included in this study.Outcome measureThis study included a self-administered questionnaire that was used to assess participants' sociodemographic characteristics, online medical practices, willingness to use e-hospitals and perceived facilitators/barriers to working at e-hospitals. Multivariate regression analysis was performed in order to evaluate the independent factors associated with e-hospital work.ResultsOverall, 86.3% had a positive response towards working at e-hospitals. Age (p<0.05), familiarity with e-hospitals (p<0.001) and prior work practices in online healthcare settings (p<0.001) were associated with participants' readiness to work at e-hospitals. Gender, education level, professional level, the tier of their affiliated hospital and workload were not statistically associated. Healthcare providers who had positive attitudes towards e-hospitals considered improved efficiency, patient satisfaction, communication among physicians, increased reputation and income, and alleviated workload to be advantages of adoption. The participants who were unwilling to work at e-hospitals perceived lack of time, insufficient authenticity/reliability and underdeveloped policies as potential barriers.ConclusionImproving operative proficiency in electronic devices, accommodating to work schedules, increasing familiarity with e-hospitals and regulating practices will improve the readiness of healthcare providers to work at e-hospitals.

Project description:BackgroundIn acute-care hospitals, patients treated in an ICU for surgical reasons or sudden deterioration are treated in an outpatient ward, ICU, and other multiple departments. It is unclear how healthcare providers are initiating advance care planning (ACP) for such patients and assisting them with it. The purpose of this study is to clarify healthcare providers' perceptions of the ACP support provided to patients receiving critical care in acute-care hospitals.MethodsA cross-sectional study was conducted using questionnaires. In this study, 400 acute-care hospitals with ICUs in Japan were randomly selected, and 1490 subjects, including intensivists, surgeons, ICU nurses, surgical floor nurses, and surgical outpatient nurses, participated. Survey items examined whether ICU patients received ACP support, the participants' degree of confidence in providing ACP support, the patients' treatment preferences, and the decision-making process, and whether any discussion was conducted on change of values.ResultsResponses were obtained from 598 participants from 157 hospitals, 41.4% of which reportedly supported ACP provision to ICU patients. The subjects with the highest level of ACP understanding were surgeons (45.8%), and differences in understanding were observed across specialties (P < 0.001). Among the respondents, physicians and nurses expressed high levels of confidence in providing ACP support to patients requiring critical care. However, 15.2% of all the subjects mentioned that they would not attempt to resuscitate the patients. In addition, 25.7% of the participants handed over patients' values to other departments or hospitals, whereas 25.3% handed over the decision-making process.ConclusionsAmong the participating hospitals, 40% provided ACP support to patients receiving critical care. The low number is possibly because support providers lack understanding of the content of patients' ACP or about how to support and use ACP. Second, it is sometimes too late to start providing ACP support after ICU admission. Third, healthcare providers differ in their perception of ACP, widely considered an ambiguous concept. Finally, in acute-care hospitals with different healthcare settings, it is necessary to confirm and integrate the changes in feelings and thoughts of patients.

Project description:OBJECTIVE:To estimate obesity prevalence among healthcare professionals in England and compare prevalence with those working outside of the health services. DESIGN:Cross-sectional study based on data from 5?years (2008-2012) of the nationally representative Health Survey for England. SETTING:England. PARTICIPANTS:20?103 adults aged 17-65 years indicating they were economically active at the time of survey classified into four occupational groups: nurses (n=422), other healthcare professionals (n=412), unregistered care workers (n=736) and individuals employed in non-health-related occupations (n=18?533). OUTCOME MEASURE:Prevalence of obesity defined as body mass index ?30.0 with 95% CIs and weighted to reflect the population. RESULTS:Obesity prevalence was high across all occupational groups including: among nurses (25.1%, 95%?CI 20.9% to 29.4%); other healthcare professionals (14.4%,?95% CI 11.0% to 17.8%); non-health-related occupations (23.5%,?95% CI 22.9% to 24.1%); and unregistered care workers who had the highest prevalence of obesity (31.9%, 95% CI 28.4% to 35.3%). A logistic regression model adjusted for sociodemographic composition and survey year indicated that, compared with nurses, the odds of being obese were significantly lower for other healthcare professionals (adjusted OR (aOR) 0.52, 95% CI 0.37 to 0.75) and higher for unregistered care workers (aOR 1.46,?95% CI 1.11 to 1.93). There was no significant difference in obesity prevalence between nurses and people working in non-health-related occupations (aOR 0.94,?95% CI 0.74 to 1.18). CONCLUSIONS:High obesity prevalence among nurses and unregistered care workers is concerning as it increases the risks of musculoskeletal conditions and mental health conditions that are the main causes of sickness absence in health services. Further research is required to better understand the reasons for high obesity prevalence among healthcare professionals in England to inform interventions to support individuals to achieve and maintain a healthy weight.

Project description:ObjectivesHealth system reforms in England are opening broad areas of clinical practice to new providers of care. As part of these reforms, new entrants--including private companies--have been allowed into the primary care market under 'alternative provider of medical services' contracting mechanisms since 2004. The characteristics and performance of general practices working under new alternative provider contracts are not well described. We sought to compare the quality of care provided by new entrant providers to that provided by the traditional model of general practice.DesignOpen cohort study of English general practices. We used linear regression in cross-sectional and time series analyses, adjusting for practice and population characteristics, to compare quality in practices using alternative provider contracts to traditional practices. We created regression models using practice fixed effects to estimate the impact of practices changing to the new contract type.SettingThe English National Health Service.ParticipantsAll general practices open from 2008/2009 to 2012/2013.Main outcome measuresSeventeen established quality indicators--covering clinical effectiveness, efficiency, access and patient experience.ResultsIn total, 4.1% (347 of 8300) of general practices in England were run by alternative contract providers. These practices tended to be smaller, and serve younger, more diverse and more deprived populations than traditional providers. Practices run by alternative providers performed worse than traditional providers on 15 of 17 indicators after adjusting for practice and population characteristics (p?<?0.01 for all). Switching to a new alternative provider contract did not result in improved performance.ConclusionsThe introduction of new alternative providers to deliver primary care services in England has not led to improvements in quality and may have resulted in worse care. Regulators should ensure that new entrants to clinical provider markets are performing to adequate standards and at least as well as traditional providers.

Project description:BackgroundInternationally, people in prison should receive a standard of healthcare provision equivalent to people living in the community. Yet efforts to assess the quality of healthcare through the use of quality indicators or performance measures have been much more widely reported in the community than in the prison setting. This review aims to provide an overview of research undertaken to develop quality indicators suitable for prison healthcare.MethodsAn international scoping review of articles published in English was conducted between 2004 and 2021. Searches of six electronic databases (MEDLINE, CINAHL, Scopus, Embase, PsycInfo and Criminal Justice Abstracts) were supplemented with journal searches, author searches and forwards and backwards citation tracking.ResultsTwelve articles were included in the review, all of which were from the United States. Quality indicator selection processes varied in rigour, and there was no evidence of patient involvement in consultation activities. Selected indicators predominantly measured healthcare processes rather than health outcomes or healthcare structure. Difficulties identified in developing performance measures for the prison setting included resource constraints, data system functionality, and the comparability of the prison population to the non-incarcerated population.ConclusionsSelecting performance measures for healthcare that are evidence-based, relevant to the population and feasible requires rigorous and transparent processes. Balanced sets of indicators for prison healthcare need to reflect prison population trends, be operable within data systems and be aligned with equivalence principles. More effort needs to be made to meaningfully engage people with lived experience in stakeholder consultations on prison healthcare quality. Monitoring healthcare structure, processes and outcomes in prison settings will provide evidence to improve care quality with the aim of reducing health inequalities experienced by people living in prison.

Project description:In Ethiopia Long-acting contraception method utilization was found low (22.7%) among female healthcare providers. However, there is no study has been conducted on the utilization long-acting contraception methods among female healthcare providers in the study area. These studies addressed important variables such as socio-demography and individual factors that might affect the use of long-acting contraceptive methods among female healthcare providers. We assessed the utilization of long-acting contraceptive methods and associated factors among healthcare providers in South Wollo Zone public hospitals, Amhara Region, Ethiopia, in 2021.An institutional-based cross-sectional study was conducted among 354 female healthcare workers in the South Wollo Zone hospitals from March to April, 2021. The participants were selected using a systematic random sampling technique. The data were collected using self-administered questionnaires entered into Epi-data version 4.1 and exported to SPSS version 25 for analysis. Bi-variable and multi-variable logistic regression analyses were performed. The adjusted odds ratio (AOR), along with a 95% confidence interval (CI), was estimated to measure the association. The significance level was set at a P- value under 0.05. The current utilization of long-acting contraceptive methods among female healthcare providers was found to be 33.6% [95%, CI 29-39)]. Discussion with a partner [AOR = 2.277,95% CI, (1.026-5.055)], method shift/switched [AOR = 4.302,95% CI, (2.285-8.102)], knowledge of the respondent [AOR = 1.887,95% CI, (1.020-3.491)], and ever birth [AOR = 15.670,95% CI, (5.065-48.49)] were significant factors toward the utilization of long-acting contraceptive methods. The current utilization of long-acting contraceptive methods was found to be low. Therefore, encouraging partner discussions through a targeted information education communication intervention strategy should be intensified to improve long-acting contraceptive methods utilization.

Project description:Background: Simulation education can benefit healthcare providers (HCPs) by providing opportunities to practice complex neonatal-resuscitation tasks in low-stake environments. To our knowledge, no study investigated the role of growth mindset on longitudinal performance on neonatal resuscitation before and after simulation-based training. Objectives: This study examines whether 1) the RETAIN digital/table-top simulators facilitate HCPs' neonatal resuscitation knowledge gain, retention, and transfer and 2) growth mindset moderates HCPs' longitudinal performance in neonatal resuscitation. Methods: Participants were n = 50 HCPs in a tertiary perinatal center in Edmonton, Canada. This longitudinal study was conducted in three stages including 1) a pretest and a mindset survey, immediately followed by a posttest using the RETAIN digital simulator from April to August 2019; 2) a 2-month delayed posttest using the same RETAIN neonatal resuscitation digital simulator from June to October 2019; and 3) a 5-month delayed posttest using the low-fidelity table-top neonatal resuscitation digital simulator from September 2019 to January 2020. Three General Linear Mixed Model (GLMM) repeated-measure analyses investigated HCPs' performance on neonatal resuscitation over time and the moderating effect of growth mindset on the association between test time points and task performance. Results: Compared with their pretest performance, HCPs effectively improved their neonatal resuscitation knowledge after the RETAIN digital simulation-based training on the immediate posttest (Est = 1.88, p < 0.05), retained their knowledge on the 2-month delayed posttest (Est = 1.36, p < 0.05), and transferred their knowledge to the table-top simulator after 5 months (Est = 2.01, p < 0.05). Although growth mindset did not moderate the performance gain from the pretest to the immediate posttest, it moderated the relationship between HCPs' pretest and long-term knowledge retention (i.e., the interaction effect of mindset and the 2-month posttest was significant: Est = 0.97, p < 0.05). The more they endorsed a growth mindset, the better the HCPs performed on the posttest, but only when they were tested after 2 months. Conclusions: Digital simulators for neonatal resuscitation training can effectively facilitate HCPs' knowledge gain, maintenance, and transfer. Besides, growth mindset shows a positive moderating effect on the longitudinal performance improvement in simulation-based training. Future research can be conducted to implement growth-mindset interventions promoting more effective delivery of technology-enhanced, simulation-based training and assessment.

Dataset Information

Do performance indicators predict regulator ratings of healthcare providers? Cross-sectional study of acute hospitals in England.

Publications

Do performance indicators predict regulator ratings of healthcare providers? Cross-sectional study of acute hospitals in England.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets