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Quality, performance, safety and outcomes

This section aims to publish studies on healthcare quality practice and improving patient care and its safety. The section also accepts articles on changes in the health status of an individual, group or population resulting from interventions of the health care team.

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  1. Administrative health data are increasingly used to detect adverse drug events (ADEs). However, the few studies evaluating diagnostic codes for ADE detection demonstrated low sensitivity, likely due to narrow ...

    Authors: Bettina Habib, Robyn Tamblyn, Nadyne Girard, Tewodros Eguale and Allen Huang

    Citation: BMC Health Services Research 2021 21:376

    Content type: Research article

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  3. Physician burnout has potentially harmful effects for both physicians and their patients. Despite relationships between physician burnout and lowered patient satisfaction and clinician-rated adverse patient ou...

    Authors: Kashan Yasin Mangory, Lavin Yadgar Ali, Karin Isaksson Rø and Reidar Tyssen

    Citation: BMC Health Services Research 2021 21:369

    Content type: Review

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  4. Traditional discharge processes lack a patient-centred focus. This project studied the implementation and effectiveness of an individualized discharge tool across Ontario hospitals. The Patient Oriented Discha...

    Authors: Shoshana Hahn-Goldberg, Tai Huynh, Audrey Chaput, Murray Krahn, Valeria Rac, George Tomlinson, John Matelski, Howard Abrams, Chaim Bell, Craig Madho, Christine Ferguson, Ann Turcotte, Connie Free, Sheila Hogan, Bonnie Nicholas, Betty Oldershaw…

    Citation: BMC Health Services Research 2021 21:361

    Content type: Research article

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  5. The study sought to evaluate the impact of a Rapid Diagnostic Clinic (RDC) service designed to improve general practitioner (GP) referral processes for patients who do not meet existing referral criteria yet p...

    Authors: Christos Vasilakis and Paul Forte

    Citation: BMC Health Services Research 2021 21:357

    Content type: Research article

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  6. Patient-reported data—satisfaction, preferences, outcomes and experience—are increasingly studied to provide excellent patient-centred care. In particular, healthcare professionals need to understand whether a...

    Authors: Raffaella Gualandi, Cristina Masella, Michela Piredda, Matteo Ercoli and Daniela Tartaglini

    Citation: BMC Health Services Research 2021 21:347

    Content type: Research article

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  7. Process mapping (PM) supports better understanding of complex systems and adaptation of improvement interventions to their local context. However, there is little research on its use in healthcare. This study ...

    Authors: Grazia Antonacci, Laura Lennox, James Barlow, Liz Evans and Julie Reed

    Citation: BMC Health Services Research 2021 21:342

    Content type: Research article

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  8. Many hospitals seek to increase patient safety through interprofessional team-trainings. Accordingly, these trainings aim to strengthen important key aspects such as safety culture and communication. This stud...

    Authors: Jan Schmidt, Nikoloz Gambashidze, Tanja Manser, Tim Güß, Michael Klatthaar, Frank Neugebauer and Antje Hammer

    Citation: BMC Health Services Research 2021 21:341

    Content type: Research article

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  9. Physicians who perform unsafe practices and harm patients may be disciplined. In Norway, there are five types of disciplinary action, ranging from a warning for the least serious examples of malpractice to los...

    Authors: Martin B. Harbitz, Per Steinar Stensland and Birgit Abelsen

    Citation: BMC Health Services Research 2021 21:324

    Content type: Research article

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  10. The persistent fragmentation of home healthcare reflects inadequate coordination between care providers. Still, while factors at the system (e.g., regulations) and organisational (e.g., work environment) level...

    Authors: Nathalie Möckli, Michael Simon, Carla Meyer-Massetti, Sandrine Pihet, Roland Fischer, Matthias Wächter, Christine Serdaly and Franziska Zúñiga

    Citation: BMC Health Services Research 2021 21:306

    Content type: Study protocol

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  11. Advance Care Planning (ACP) enables healthcare professionals to embrace the important process where patients think about their values in life and goals for health care, and discuss their future health care pre...

    Authors: Sarah Jeong, Tomiko Barrett, Se Ok Ohr, Peter Cleasby, Ryan Davey and Michael David

    Citation: BMC Health Services Research 2021 21:303

    Content type: Research article

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  12. Nurse managers play a critical role in enhancing nursing and patient outcomes. The work of nurse managers, who can be described as middle-managers at health care organizations, is complex and changes on a dail...

    Authors: Anu Nurmeksela, Santtu Mikkonen, Juha Kinnunen and Tarja Kvist

    Citation: BMC Health Services Research 2021 21:296

    Content type: Research article

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  14. This study aimed to explore associations between various elements of primary care, patient satisfaction, and loyalty.

    Authors: Tsunetaka Kijima, Akira Matsushita, Kenju Akai, Tsuyoshi Hamano, Satoshi Takahashi, Kazushige Fujiwara, Yuko Fujiwara, Makoto Sato, Toru Nabika, Kristina Sundquist, Jan Sundquist, Yutaka Ishibashi and Shunichi Kumakura

    Citation: BMC Health Services Research 2021 21:274

    Content type: Research article

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  15. Psychological safety is the concept by which individuals feel comfortable expressing themselves in a work environment, without fear of embarrassment or criticism from others. Psychological safety in healthcare...

    Authors: Ridhaa Remtulla, Arwa Hagana, Nour Houbby, Kajal Ruparell, Nivaran Aojula, Anannya Menon, Santhosh G. Thavarajasingam and Edgar Meyer

    Citation: BMC Health Services Research 2021 21:269

    Content type: Research article

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  16. To implement the “without the need for a second visit” (WNASV) initiative in our hospital by optimizing the outpatient clinic services via an upgraded information system, in order to increase the quality of ou...

    Authors: Jian Shen, Jun Zhang, Qiang He, Haihui Pan, Zhiqiang Wu, Liangming Nie, Hongfang Zhang, Shuning Liu, Yan Sun, Yaoqiang Du and Dongsheng Huang

    Citation: BMC Health Services Research 2021 21:267

    Content type: Research article

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  17. Based on several existing patient-oriented activities, Medicines Use Review (MUR) service was standardized and officially adopted in Slovenia in 2015. Service aims to provide adherence support and ensure safe ...

    Authors: Urška Nabergoj Makovec, Igor Locatelli and Mitja Kos

    Citation: BMC Health Services Research 2021 21:266

    Content type: Research article

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  18. This study explored the rewards and difficulties of raising an adolescent and investigated parents’ level of interest in receiving guidance from healthcare providers on parenting and adolescent health topics. ...

    Authors: Lindsey D. Jones, Randall W. Grout, Amy L. Gilbert, Tracey A. Wilkinson, Tamila Garbuz, Stephen M. Downs and Matthew C. Aalsma

    Citation: BMC Health Services Research 2021 21:253

    Content type: Research article

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  19. Turnover intention is a major cause of reduced team morale and low work efficiency. It hinders work performance and reduces the quality of medical services. This study aimed to investigate the relationship bet...

    Authors: Huosheng Yan, Lingzhi Sang, Hongzhang Liu, Cancan Li, Zijing Wang, Ren Chen, Hong Ding, Zhi Hu and Guimei Chen

    Citation: BMC Health Services Research 2021 21:252

    Content type: Research article

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  20. Caregivers of patients load different kinds of burdens, including emotional distress. Aims of this study were to evaluate both burden and empathy of caregivers who assist patients with schizophrenia spectrum d...

    Authors: Rosaria Di Lorenzo, Anna Girone, Nunzio Panzera, Gianluca Fiore, Margherita Pinelli, Giulia Venturi, Federica Magarini and Paola Ferri

    Citation: BMC Health Services Research 2021 21:250

    Content type: Research article

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  21. Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare t...

    Authors: Heidi Snoen Glomsås, Ingrid Ruud Knutsen, Mariann Fossum and Kristin Halvorsen

    Citation: BMC Health Services Research 2021 21:245

    Content type: Research article

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  22. Evidence based practice in health care has become increasingly popular over the last decades. Many guidelines have been developed to improve evidence informed decision making in health care organisations, howe...

    Authors: Kaat Goorts, Janine Dizon and Steve Milanese

    Citation: BMC Health Services Research 2021 21:241

    Content type: Research article

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  23. Pre-Hospital Emergency Care (PEC) is a fundamental property of prevention of Road Traffic Injuries (RTIs). Thus, this sector requires a system for evaluation and performance improvement. This study aimed to de...

    Authors: Saber Azami-Aghdash, Ahmad Moosavi, Hojatolah Gharaee, Ghader Sadeghi, Haleh Mousavi Isfahani, Alireza Ghasemi Dastgerdi and Mohammad Mohseni

    Citation: BMC Health Services Research 2021 21:235

    Content type: Research article

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  24. Hospitals in many countries are encouraged to develop audits to assess and improve the quality of care. Ward audit is a specific form of audit and feedback that is commonly used but little studied. The aim of ...

    Authors: Michael Sykes, Richard Thomson, Niina Kolehmainen, Louise Allan and Tracy Finch

    Citation: BMC Health Services Research 2021 21:226

    Content type: Research article

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  25. In meeting input data requirements for a system dynamics (SD) model simulating the radiotherapy (RT) process, the number of patient care pathways (RT workflows) needs to be kept low to simplify the model witho...

    Authors: Jesper Lindberg, Paul Holmström, Stefan Hallberg, Thomas Björk-Eriksson and Caroline E. Olsson

    Citation: BMC Health Services Research 2021 21:207

    Content type: Research article

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  26. While multidisciplinary teams (MDTs) are now considered an essential part of cancer care decision-making, how they perform varies widely. The authors hypothesised that a comprehensive, multipronged improvement...

    Authors: Lynleigh Evans, Yiren Liu, Brendan Donovan, Terence Kwan, Karen Byth and Paul Harnett

    Citation: BMC Health Services Research 2021 21:203

    Content type: Research article

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  27. People prefer to age in place and not move into a nursing home as long as possible. The prevention of cognitive and functional impairments is feasible to support this goal. Health services play a key role in p...

    Authors: Dominik Domhoff, Kathrin Seibert, Susanne Stiefler, Karin Wolf-Ostermann and Dirk Peschke

    Citation: BMC Health Services Research 2021 21:190

    Content type: Research article

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  28. The communication between health providers and patients influences the quality of medical care. The Communication Skills Assessment (CAT) is a reliable, validated tool, which was developed to assess interperso...

    Authors: Andra Rodica Balanescu, Violeta Claudia Bojinca, Ana-Maria Schweitzer, Bogdan Joca, Denise Ani Mardale, Denisa Badea and Mihai Bojinca

    Citation: BMC Health Services Research 2021 21:184

    Content type: Research article

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  29. This study investigated if the evidence on the success of the Pay for Performance (P4P) schemes in healthcare is changing as the schemes continue to evolve by updating a previous systematic review.

    Authors: Arezou Zaresani and Anthony Scott

    Citation: BMC Health Services Research 2021 21:175

    Content type: Research article

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  30. In 2017, the European Commission’s Joint Research Centre (JRC) started developing a methodological framework for a guideline-based quality assurance (QA) scheme to improve cancer quality of care. During the fi...

    Authors: Elena Parmelli, Miranda Langendam, Thomas Piggott, Jan Adolfsson, Elie A. Akl, David Armstrong, Jeffrey Braithwaite, Romina Brignardello-Petersen, Markus Follmann, Zbigniew Leś, Joerg J. Meerpohl, Luciana Neamtiu, Amir Qaseem, Paolo Giorgi Rossi, Zuleika Saz-Parkinson, Philip J. van der Wees…

    Citation: BMC Health Services Research 2021 21:173

    Content type: Research article

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  31. Although quality indicators are frequently derived from guidelines, there is a substantial gap in collaboration between the corresponding parties. To optimise workflow, guideline recommendations and quality as...

    Authors: Thomas Piggott, Miranda Langendam, Elena Parmelli, Jan Adolfsson, Elie A. Akl, David Armstrong, Jeffrey Braithwaite, Romina Brignardello-Petersen, Jan Brozek, Jolanta Gore-Booth, Markus Follmann, Zbigniew Leś, Joerg J Meerpohl, Luciana Neamţiu, Monika Nothacker, Amir Qaseem…

    Citation: BMC Health Services Research 2021 21:172

    Content type: Research article

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  32. Reliable benchmarking in Lean healthcare requires widely relevant and applicable domains for outcome metrics and careful attention to contextual levels. These levels have been poorly defined and no framework t...

    Authors: Elina Reponen, Thomas G. Rundall, Stephen M. Shortell, Janet C. Blodgett, Angelica Juarez, Ritva Jokela, Markku Mäkijärvi and Paulus Torkki

    Citation: BMC Health Services Research 2021 21:161

    Content type: Research article

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  33. Implementation of Professional Pharmacy Services (PPSs) requires a demonstration of the service’s impact (efficacy) and its effectiveness. Several systematic reviews and randomised controlled trials (RCT) have...

    Authors: R. Varas-Doval, L. Saéz-Benito, M. A. Gastelurrutia, S. I. Benrimoj, V. Garcia-Cardenas and F. Martinez-Martínez

    Citation: BMC Health Services Research 2021 21:156

    Content type: Research article

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  34. Long waiting times for elective surgery are common to many publicly funded health systems. Inefficiencies in referral systems in high-income countries are more pronounced than lower and middle-income countries...

    Authors: Dimuthu Rathnayake and Mike Clarke

    Citation: BMC Health Services Research 2021 21:155

    Content type: Research article

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  35. There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact o...

    Authors: Lamis R. Karaoui, Elsy Ramia, Hanine Mansour, Nisrine Haddad and Nibal Chamoun

    Citation: BMC Health Services Research 2021 21:151

    Content type: Research article

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  36. Existing comorbidity measures predict mortality among general patient populations. Due to the lack of outcome specific and patient-group specific measures, the existing indices are also applied to non-mortalit...

    Authors: Dasamal Tharanga Fernando, Janneke Berecki-Gisolf, Stuart Newstead and Zahid Ansari

    Citation: BMC Health Services Research 2021 21:149

    Content type: Research article

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  37. In addition to patient evaluations, caregiver evaluations and experiences are important indicators of the quality of health services. The aim of this study was to examine determinants of caregiver satisfaction...

    Authors: Katarina Smejda Kjærandsen, Per Håkan Brøndbo and Marianne Berg Halvorsen

    Citation: BMC Health Services Research 2021 21:139

    Content type: Research article

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  38. Dementia Care Mapping™ (DCM) is a widely used, staff-led, psychosocial intervention to support the implementation of person-centred care. Efficacy evaluations in care homes have produced mixed outcomes, with i...

    Authors: Alys Wyn Griffiths, Olivia C. Robinson, Emily Shoesmith, Rachael Kelley and Claire A. Surr

    Citation: BMC Health Services Research 2021 21:138

    Content type: Research article

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  39. Since October 2014, the Centers for Medicare and Medicaid Services has penalized 25% of U.S. hospitals with the highest rates of hospital-acquired conditions under the Hospital Acquired Conditions Reduction Pr...

    Authors: Olga A. Vsevolozhskaya, Karina C. Manz, Pierre M. Zephyr and Teresa M. Waters

    Citation: BMC Health Services Research 2021 21:131

    Content type: Research article

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  40. Excessive waiting times for cancer elective surgery are a concern in publicly funded healthcare systems. Several countries including Australia have introduced healthcare reforms involving time-based targets an...

    Authors: Khic-Houy Prang, Rachel Canaway, Marie Bismark, David Dunt, Julie A. Miller and Margaret Kelaher

    Citation: BMC Health Services Research 2021 21:129

    Content type: Research article

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  41. Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines in...

    Authors: Anh Ly, Roger Zemek, Bruce Wright, Jennifer Zwicker, Kathryn Schneider, Angelo Mikrogianakis, Alf Conradi, David Johnson, Brenda Clark, Karen Barlow, Joseph Burey, Ash Kolstad and Keith Owen Yeates

    Citation: BMC Health Services Research 2021 21:119

    Content type: Research article

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  42. The supplementation of electronic health records data with administrative claims data may be used to capture outcome events more comprehensively in longitudinal observational studies. This study investigated t...

    Authors: Qinli Ma, Michael Mack, Sonali Shambhu, Kathleen McTigue and Kevin Haynes

    Citation: BMC Health Services Research 2021 21:116

    Content type: Research article

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  43. Patient safety in hospitals is being jeopardized, since too many patients experience adverse events. Most of these adverse events arise from human factors, such as inefficient teamwork and communication failur...

    Authors: Oddveig Reiersdal Aaberg, Marie Louise Hall-Lord, Sissel Iren Eikeland Husebø and Randi Ballangrud

    Citation: BMC Health Services Research 2021 21:114

    Content type: Research article

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  44. To improve their quality, healthcare systems are increasingly focused on value delivered to patients. For perinatal care, the International Consortium for Health Outcomes Measurement (ICHOM) proposed a patient...

    Authors: Anne L. Depla, Neeltje M. Crombag, Arie Franx and Mireille N. Bekker

    Citation: BMC Health Services Research 2021 21:113

    Content type: Research article

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  45. Effective teamwork is essential for delivering safe health care. It is important to increase patient safety in healthcare by conducting interprofessional team training with both healthcare professionals and un...

    Authors: Marie Louise Hall-Lord, Carina Bååth, Randi Ballangrud and Anna Nordin

    Citation: BMC Health Services Research 2021 21:105

    Content type: Research article

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  46. The delivery of high-quality service in nursing homes and homecare requires collaboration and shared understanding among managers, employees, users and policy makers from across the healthcare system. However,...

    Authors: Ingunn Aase, Eline Ree, Terese Johannessen, Torunn Strømme, Berit Ullebust, Elisabeth Holen-Rabbersvik, Line Hurup Thomsen, Lene Schibevaag, Hester van de Bovenkamp and Siri Wiig

    Citation: BMC Health Services Research 2021 21:104

    Content type: Research article

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  47. Inappropriate prescribing of diagnostic procedures leads to overdiagnosis, overtreatment and resource waste in healthcare systems. Effective strategies to measure and to overcome inappropriateness are essentia...

    Authors: Francesco Venturelli, Marta Ottone, Fabio Pignatti, Eletta Bellocchio, Mirco Pinotti, Giulia Besutti, Olivera Djuric and Paolo Giorgi Rossi

    Citation: BMC Health Services Research 2021 21:103

    Content type: Research article

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  48. The Improving Wisely intervention is a peer-to-peer audit and feedback intervention to reduce overuse of Mohs Micrographic Surgery (MMS). The objective of this study was to conduct a process evaluation to eval...

    Authors: Christine Fahim, William E. Bruhn, John G. Albertini and Marty A. Makary

    Citation: BMC Health Services Research 2021 21:100

    Content type: Research article

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  49. Patient Reported Experience Measures (PREMs) are recognized as an important indicator of high quality care and person-centeredness. PREMs are increasingly adopted for paediatric care, but there is little publi...

    Authors: Ilaria Corazza, Kendall Jamieson Gilmore, Francesca Menegazzo and Valts Abols

    Citation: BMC Health Services Research 2021 21:93

    Content type: Research article

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  50. Longer wait time in ambulatory clinics can disrupt schedules and decrease satisfaction. We investigated factors associated with patient wait time (WT, check-in to examination room placement), approximate clini...

    Authors: Daniel Jonathan Kagedan, Stephen B. Edge and Kazuaki Takabe

    Citation: BMC Health Services Research 2021 21:87

    Content type: Research article

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