Volume 26, Issue 2 (6-2023)
jha 2023, 26(2): 66-83 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Reddy C O, Kamath R, Nazareth J J J, Lakshmi V, S R, Kamath S et al . Analysis of Quality Indicators in Operation Theatres and Intensive Care Units in a Tertiary Care Hospital in South India. jha 2023; 26 (2) :66-83
URL: http://jha.iums.ac.ir/article-1-4324-en.html
URL: http://jha.iums.ac.ir/article-1-4324-en.html
Chandra Obul Reddy1 
, Rajesh Kamath1 , Jossil Jostna Joseph Nazareth1 , Vani Lakshmi2 , Rithu S3 , Sagarika Kamath4 , Sanjay Kini B 5
, Rajesh Kamath1 , Jossil Jostna Joseph Nazareth1 , Vani Lakshmi2 , Rithu S3 , Sagarika Kamath4 , Sanjay Kini B 5
1- MHA, Prasanna School of Public Health, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
2- Ph.D, Prasanna School of Public Health, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
3- MPH, Prasanna School of Public Health, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
4- MHA, Department of Commerce, Manipal Academy of Higher Education, Manipal, Karnataka, India.
5- MD, Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India. ,sanjay.kb@manipal.edu
2- Ph.D, Prasanna School of Public Health, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
3- MPH, Prasanna School of Public Health, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
4- MHA, Department of Commerce, Manipal Academy of Higher Education, Manipal, Karnataka, India.
5- MD, Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India. ,
Abstract: (1023 Views)
Introduction: In the context of the Sustainable Development Goals (SDGs), the emphasis on quality is increasing. This study aims to analyze quality indicators in the main Operation Theatre (OT) complex and the Intensive Care Unit (ICU) of a tertiary care hospital in Chennai, South India.
Methods: Data were retrospectively collected from January 2018 to December 2019 at a tertiary care hospital in Chennai, India. Given the limitations of the study area, a census methodology was used for data collection. A total of eight quality indicators for the Operation Theatre and nine for the Intensive Care Unit were analyzed. During the two-year period, the maximum number of defaults (departures from the benchmark set by the hospital) was calculated and analyzed using Wilcoxon’s signed rank test..
Results: Among the parameters associated with the OT, the percentages of rescheduling surgeries and unplanned returns to the OT had the highest number of departures from the benchmark. In the ICU, the rate of return within 48 hours and the re-intubation rate exhibited the highest departures from the benchmark. The subsequent one-sided Wilcoxon’s signed rank test confirmed that the average rate of departures for these parameters was not statistically significant.
Conclusion: Although the one-sided Wilcoxon W test confirmed that the departures of the aforementioned parameters were not statistically significant, factors such as lack of awareness among staff members about policies and procedures, insufficient continuous education in terms of quality, absence of clear communication, and staff shortage might be reasons why certain indicators analyzed in this study exceeded the benchmark set by the hospital. Addressing these issues is crucial, as quality is increasingly important in the healthcare industry.
Methods: Data were retrospectively collected from January 2018 to December 2019 at a tertiary care hospital in Chennai, India. Given the limitations of the study area, a census methodology was used for data collection. A total of eight quality indicators for the Operation Theatre and nine for the Intensive Care Unit were analyzed. During the two-year period, the maximum number of defaults (departures from the benchmark set by the hospital) was calculated and analyzed using Wilcoxon’s signed rank test..
Results: Among the parameters associated with the OT, the percentages of rescheduling surgeries and unplanned returns to the OT had the highest number of departures from the benchmark. In the ICU, the rate of return within 48 hours and the re-intubation rate exhibited the highest departures from the benchmark. The subsequent one-sided Wilcoxon’s signed rank test confirmed that the average rate of departures for these parameters was not statistically significant.
Conclusion: Although the one-sided Wilcoxon W test confirmed that the departures of the aforementioned parameters were not statistically significant, factors such as lack of awareness among staff members about policies and procedures, insufficient continuous education in terms of quality, absence of clear communication, and staff shortage might be reasons why certain indicators analyzed in this study exceeded the benchmark set by the hospital. Addressing these issues is crucial, as quality is increasingly important in the healthcare industry.
Type of Study: Research |
Subject:
Health Services Management
Received: 2023/04/3 | Accepted: 2023/06/20 | Published: 2023/12/18
Received: 2023/04/3 | Accepted: 2023/06/20 | Published: 2023/12/18
References
1. Wang Q, Yang L, Chen J, Tu X, Sun Q, Li H. Quality of care in public county hospitals: A cross-sectional study for stroke, pneumonia, and heart failure care in Eastern China. Int J Environ Res Public Health. 2022 Jul 27;19(15):9144. [DOI:10.3390/ijerph19159144]
2. Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 2018;6(11):e1196-252. [DOI:10.1016/S2214-109X(18)30386-3]
3. Das J, Woskie L, Rajbhandari R, Abbasi K, Jha A. Rethinking assumptions about delivery of healthcare: implications for universal health coverage. BMJ. 2018;361:k1716. [DOI:10.1136/bmj.k1716]
4. Lancet T. Putting quality and people at the center of health systems. Lancet. 2018;392(10150):795. DOI: 10.1016/S0140-6736(18)32064-6 [DOI:10.1016/S0140-6736(18)32064-6]
5. Karaca A, Durna Z. Patient satisfaction with the quality of nursing care. Nurs Open. 2019;6(2):535-545. [DOI:10.1002/nop2.237]
6. Quentin W, Partanen VM, Brownwood I, Klazinga N. Improving healthcare quality in Europe: Characteristics, effectiveness and implementation of different strategies. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2019. (Health Policy Series, No. 53).
7. Báo ACP, Amestoy SC, Moura GMSS de, Trindade L de L. Quality indicators: tools for the management of best practices in Health. Rev Bras Enferm. 2019;72(2):360-6. [DOI:10.1590/0034-7167-2018-0479]
8. Jeve YB. Raising quality whilst reducing cost in health care: A retrospective cohort study. Int J Health Plann Manage. 2018;33(1):e228-37. [DOI:10.1002/hpm.2454]
9. David SN, Valas S. National Accreditation Board for Hospitals and Healthcare Providers (NABH) standards: A review. Curr Med Issues. 2017;15(3):231-6. [DOI:10.4103/cmi.cmi_51_17]
10. Tadia VK, Monalisa, Dubey S. Accreditation is not a one-time process: Quality Assessment of Intensive Care Unit during Post-NABH Accreditation Period in a tertiary care hospital. Int J Res Found Hosp Healthc Adm. 2017;5(1):29-41. [DOI:10.5005/jp-journals-10035-1073]
11. International Society for Quality in Health Care. Available from: https://isqua.org/resources-blog/blog/healthcare-quality-and-safety-in-india-current-scenario.html. Accessed May 11, 2021.
12. National Accreditation Board for Hospitals & Healthcare Providers (NABH). Available from: https://nabh.co/introduction.aspx. Accessed Aug 3, 2022.
13. Udeh C, Udeh B, Rahman N, Canfield C, Campbell J, Hata JS. Telemedicine/Virtual ICU: Where are we and where are we going? Methodist Debakey Cardiovasc J. 2018;14(2):126-33. [DOI:10.14797/mdcj-14-2-126]
14. Kumpf O, Nothacker M, Dubb R, Kaltwasser A, Brinkmann A, Greim CA, et al. Qualitätssicherung in der Intensivmedizin: Peer Reviews und Qualitätsindikatoren. Anästhesiol Intensivmed Notfallmed Schmerzther. 2021 Jan;56(1):12-27. [DOI:10.1055/a-1130-4950]
15. Kashyap R, Vashistha K, Saini C, Dutt T, Raman D, Bansal V, et al. Critical care practice in India: Results of the intensive care unit need assessment survey (ININ2018). World J Crit Care Med. 2020 Jun 5;9:31-42. [DOI:10.5492/wjccm.v9.i2.31]
16. Munta K, Gopal P, Amte R. Quality indicators compliance survey in Indian Intensive Care Units. Indian J Crit Care Med. 2017 Apr 1;21:187. [DOI:10.4103/ijccm.IJCCM_164_15]
17. Ghebreyesus TA. How could health care be anything other than high quality? Lancet Glob Health. 2018 Nov;6(11):e1140-1. [DOI:10.1016/S2214-109X(18)30394-2]
18. Voeten SC, Wouters MWJM, Würdemann FS, Krijnen P, Schipper IB, Hegeman JH. Textbook process as a composite quality indicator for in-hospital hip fracture care. Arch Osteoporos. 2021;16(1):63. [DOI:10.1007/s11657-021-00909-6]
19. Gudivada KK, Krishna B, Sriram S. Evaluation of quality indicators in an Indian Intensive Care Unit using "CHITRA" Database. Indian J Crit Care Med. 2017 Dec;21(12):841-6. [DOI:10.4103/ijccm.IJCCM_303_17]
20. National Accreditation Board for Hospitals and Healthcare Providers. Available from: https://nabh.co/Images/PDF/AyurvedaAnnexure_2Edition.pdf. Accessed Aug 9, 2022.
21. Mahajan HK, Dhanerwa R, Chauhan PR, Gupta A. A comparative study of Key Quality Performance Indicators in anaesthesia and surgery, between the years 2013 and 2014, in Operation Theatre at Indian Spinal Injuries Centre, New Delhi. J Med Sci Clin Res. 2017;05(02):17269-17277. [DOI:10.18535/jmscr/v5i2.07]
22. Sajadi HS, Sajadi ZS, Sajadi FA, Hadi M, Zahmatkesh M. The comparison of hospitals' performance indicators before and after the Iran's hospital care transformations plan. J Educ Health Promot. 2017 Oct 4;6:89. [DOI:10.4103/jehp.jehp_134_16]
23. Staiger RD, Schwandt H, Puhan MA, Clavien PA. Improving surgical outcomes through benchmarking. Br J Surg. 2019 Jan 1;106(1):59-64. [DOI:10.1002/bjs.10976]
24. Salluh JIF, Chiche JD, Reis CE, Soares M. New perspectives to improve critical care benchmarking. Ann Intensive Care. 2018 Feb 2;8(1):17. [DOI:10.1186/s13613-018-0363-0]
25. Salluh JIF, Soares M, Keegan MT. Understanding intensive care unit benchmarking. Intensive Care Med. 2017 Nov 1;43(11):1703-7. [DOI:10.1007/s00134-017-4760-x]
26. Omole OB, Torlutter M, Akii AJ. Preanaesthetic assessment and management in the context of the district hospital. S Afr Fam Pract (2004). 2021 Sep 7;63(1):5357. [DOI:10.4102/safp.v63i1.5357]
27. Anguraj S, Ketan P, Sivaradjy M, Shanmugam L, Jamir I, Cherian A, Sastry AS. The effect of hand hygiene audit in COVID intensive care units in a tertiary care hospital in South India. Am J Infect Control. 2021 Oct 1;49(10):1247-51. [DOI:10.1016/j.ajic.2021.07.008]
28. Panditrao A, Shafiq N, Kumar-M P, Sekhon AK, Biswal M, Singh G, Kaur K, Ray P, Malhotra S, Gautam V, Gupta R. Impact of an antimicrobial stewardship and monitoring of infection control bundle in a surgical intensive care unit of a tertiary-care hospital in India. J Glob Antimicrob Resist. 2021;24:260-5. [DOI:10.1016/j.jgar.2021.01.003]
29. Morris R, O'Riordan S. Prevention of falls in hospital. Clin Med. 2017 Aug;17(4):360-2. [DOI:10.7861/clinmedicine.17-4-360]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Site Keywords
Health, Administration, Scientific Article, Iran University of Medical Sciences,
