Skip to main content


Quality, performance, safety and outcomes

Section edited by Koustuv Dalal and Howard Degenholtz

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.

Page 1 of 20

  1. Content type: Research article

    Environmental impact assessments of pharmaceuticals typically consider only a part of the pharmaceutical supply chain, e.g. tablet formulation. While the environmental impact can be expressed in environmental ...

    Authors: Sam Debaveye, Delphine De Smedt, Bert Heirman, Shane Kavanagh and Jo Dewulf

    Citation: BMC Health Services Research 2019 19:393

    Published on:

  2. Content type: Research article

    When doctors have honest conversations with patients about their illness and involve them in decisions about their care, patients express greater satisfaction with care and lowered anxiety and depression. The ...

    Authors: Tamsin McGlinchey, Stephen Mason, Alison Coackley, Anita Roberts, Maria Maguire, Justin Sanders, Francine Maloney, Susan Block, John Ellershaw and Peter Kirkbride

    Citation: BMC Health Services Research 2019 19:384

    Published on:

  3. Content type: Research article

    In the last years, patients’ empowerment has been increasingly recognized as a crucial dimension of patient-centered healthcare and patient safety. Nevertheless, little work has been done so far in the field o...

    Authors: M. Rimondini, I. M. Busch, M. A. Mazzi, V. Donisi, A. Poli, E. Bovolenta and F. Moretti

    Citation: BMC Health Services Research 2019 19:382

    Published on:

  4. Content type: Research article

    Some health practitioners pose substantial threats to patient safety, yet early identification of them is notoriously difficult. We aimed to develop an algorithm for use by regulators in prospectively identify...

    Authors: Matthew J. Spittal, Marie M. Bismark and David M. Studdert

    Citation: BMC Health Services Research 2019 19:380

    Published on:

  5. Content type: Research article

    The Patient Enablement Instrument (PEI) is an established patient-reported outcome measure (PROM) that reflects the quality of appointments with general practitioners (GPs). It is a six-item questionnaire admi...

    Authors: Elina Tolvanen, Tuomas H. Koskela and Elise Kosunen

    Citation: BMC Health Services Research 2019 19:376

    Published on:

  6. Content type: Research article

    The aim of this study was to assess the accuracy and quality of immunization data on the pentavalent (diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type B (Hib)) and MMR vaccines as the a...

    Authors: Manoochehr Karami, Salman Khazaei, Abbas Babaei, Fatemeh Abdoli Yaghini, Mohammad Mehdi Gouya and Seyed Mohsen Zahraei

    Citation: BMC Health Services Research 2019 19:371

    Published on:

  7. Content type: Research article

    Demographic change concurrent with medical progress leads to an increasing number of elderly patients in intensive care units (ICUs). Antibacterial treatment is an important, often life-saving, aspect of inten...

    Authors: Dominik Beier, Christel Weiß, Michael Hagmann, Ümniye Balaban, Manfred Thiel and Verena Schneider-Lindner

    Citation: BMC Health Services Research 2019 19:367

    Published on:

  8. Content type: Research article

    High performance work systems (HPWSs) are successful work systems in the context of safety climate and patient safety. The 10-item HPWS questionnaire is a validated instrument developed to assess existing HPWS...

    Authors: Juliane Mielke, Sabina De Geest, Sonja Beckmann, Lynn Leppla, Xhyljeta Luta, Raphaelle-Ashley Guerbaai, Sabina Hunziker and René Schwendimann

    Citation: BMC Health Services Research 2019 19:356

    Published on:

  9. Content type: Research article

    Whether patients receive low-value hospital care (care that is not expected to provide a net benefit) may be influenced by unmeasured factors at the hospital they attend or the hospital’s Local Health District...

    Authors: Tim Badgery-Parker, Yingyu Feng, Sallie-Anne Pearson, Jean-Frederic Levesque, Susan Dunn and Adam G. Elshaug

    Citation: BMC Health Services Research 2019 19:345

    Published on:

  10. Content type: Research article

    Health care on equal terms is a cornerstone of the Swedish health care system. Total hip arthroplasty (THA) is considered a success story in Sweden with low frequency of reoperations and restored health-relate...

    Authors: Linnea Oldsberg, Göran Garellick, Ingrid Osika Friberg, Anke Samulowitz, Ola Rolfson and Szilárd Nemes

    Citation: BMC Health Services Research 2019 19:343

    Published on:

  11. Content type: Research article

    Collaborative learning has been shown to be effective in improving health worker performance, but relatively little is known about the feasibility or acceptability of collaborative learning in youth-friendly h...

    Authors: Galina Lesco, Frances Squires, Viorel Babii, Nadejda Bordian, Olga Cernetchi, Adriane Martin Hilber and Venkatraman Chandra-Mouli

    Citation: BMC Health Services Research 2019 19:339

    Published on:

  12. Content type: Research article

    Of the various types of medication administration error that occur in hospitals, dose omissions are consistently reported as among the most common. It has been suggested that greater involvement from pharmacy ...

    Authors: Elizabeth M. Seston, Darren M. Ashcroft, Elizabeth Lamerton, Lindsay Harper and Richard N. Keers

    Citation: BMC Health Services Research 2019 19:325

    Published on:

  13. Content type: Study protocol

    Innovation has been identified as an important engine for improving the quality, productivity and efficiency of health care. Little is known about how to stimulate innovation capacity in primary health care in...

    Authors: Gunilla Avby and Sofia Kjellström

    Citation: BMC Health Services Research 2019 19:319

    Published on:

  14. Content type: Research article

    One in three colon cancers are diagnosed as an emergency, which is associated with worse cancer outcomes. Chronic conditions (comorbidities) affect large proportions of adults and they might influence the risk...

    Authors: Cristina Renzi, Georgios Lyratzopoulos, Willie Hamilton, Camille Maringe and Bernard Rachet

    Citation: BMC Health Services Research 2019 19:311

    Published on:

  15. Content type: Research article

    Europe’s ageing society leads to an increased demand for long-term care, thereby putting a strain on the sustainability of health care systems. The ‘Identifying best practices for care-dependent elderly by Ben...

    Authors: Henriëtte G. van der Roest, Liza van Eenoo, Lisanne I. van Lier, Graziano Onder, Vjenka Garms-Homolová, Johannes H. Smit, Harriet Finne-Soveri, Pálmi V. Jónsson, Stasja Draisma, Anja Declercq, Judith E. Bosmans and Hein P. J. van Hout

    Citation: BMC Health Services Research 2019 19:310

    Published on:

  16. Content type: Research article

    Smoking in pregnancy causes harm to mother and baby. Despite evidence from trials of what helps women quit, implementation in the real world has been hard to achieve. An evidence-based intervention, babyClear©...

    Authors: Susan Jones, Sharon Hamilton, Ruth Bell, Vera Araújo-Soares, Svetlana V. Glinianaia, Eugene M. G. Milne, Martin White, Martyn Willmore and Janet Shucksmith

    Citation: BMC Health Services Research 2019 19:297

    Published on:

  17. Content type: Study protocol

    Healthcare associated infection (HCAI) is a major cause of morbidity and mortality. In recent years, there have been high profile successes in infection prevention control (IPC), such as the dramatic reduction...

    Authors: John Gammon, Julian Hunt, Sharon Williams, Sharon Daniel, Sue Rees and Sian Matthewson

    Citation: BMC Health Services Research 2019 19:296

    Published on:

  18. Content type: Research article

    To test the validity of the Finnish version of the Bernhard et al.’s Cross-Cultural Competence instrument of Healthcare Professionals (CCCHP).

    Authors: Laura Hietapakka, Marko Elovainio, Karolina Wesolowska, Anna-Mari Aalto, Anu-Marja Kaihlanen, Timo Sinervo and Tarja Heponiemi

    Citation: BMC Health Services Research 2019 19:294

    Published on:

  19. Content type: Research article

    Community pharmacy Common Ailments Services can ease the considerable workload pressures on primary and secondary care services. However, evidence is needed to determine whether there are benefits of extending...

    Authors: Gillian Hall, Tania Cork, Simon White, Hayley Berry and Louise Smith

    Citation: BMC Health Services Research 2019 19:285

    Published on:

  20. Content type: Research article

    Pharmaceutical care is the pharmacist’s contribution to the care of individuals to optimize medicines use and improve health outcomes. The primary tool of pharmaceutical care is medication review. Defining and...

    Authors: András Szilvay, Orsolya Somogyi, Attiláné Meskó, Romána Zelkó and Balázs Hankó

    Citation: BMC Health Services Research 2019 19:282

    Published on:

  21. Content type: Research article

    The appropriateness of psychotropic prescriptions in the elderly is a major quality-of-care challenge at hospital. Quality indicators have been developed to prevent inappropriate psychotropic prescriptions. We...

    Authors: Aurélie Petit-Monéger, Vianney Jouhet, Frantz Thiessard, Driss Berdaï, Pernelle Noize, Véronique Gilleron, Guillaume Caridade, Louis-Rachid Salmi and Florence Saillour-Glénisson

    Citation: BMC Health Services Research 2019 19:272

    Published on:

  22. Content type: Research article

    Long length of stays (LOS) in emergency departments (ED) negatively affect quality of care. Ordering of inappropriate diagnostic tests contributes to long LOS and reduces quality of care. One strategy to chang...

    Authors: Welmoed K. van Deen, Edward S. Cho, Kathryn Pustolski, Dennis Wixon, Shona Lamb, Thomas W. Valente and Michael Menchine

    Citation: BMC Health Services Research 2019 19:270

    Published on:

  23. Content type: Research article

    Systems for monitoring effectiveness and quality of rehabilitation services across health care levels are needed. The purpose of this study was to develop and pilot test a quality indicator set for rehabilitat...

    Authors: Inger Johansen, Mari Klokkerud, Audny Anke, Janne-Birgitte Børke, Thomas Glott, Uno Hauglie, Audhild Høyem, Atle Klovning, Karin Anna Lande, Mona Larsen, Jan Egil Nordvik, Sigrid H. Wigers, Irene Øyeflaten, Kaare Birger Hagen and Ingvild Kjeken

    Citation: BMC Health Services Research 2019 19:265

    Published on:

  24. Content type: Research article

    Social media platforms offer unique opportunities for patients and families to provide real-time feedback on their healthcare experiences. Consumer-generated social media ratings of hospitals tend to reflect t...

    Authors: Yue Li, Xueya Cai and Matthew Wang

    Citation: BMC Health Services Research 2019 19:260

    Published on:

  25. Content type: Research article

    Lack of racial concordance between physicians and patients has been linked to health disparities and inequities. Studies show that patients prefer physicians who look like them; however, there are too few unde...

    Authors: Damian Crawford, Suchitra Paranji, Shalini Chandra, Scott Wright and Flora Kisuule

    Citation: BMC Health Services Research 2019 19:247

    Published on:

  26. Content type: Research article

    In 2014, the Department of Veterans Affairs (VA) adopted a screening test policy for hepatitis C virus (HCV) in all “Baby Boomers” - those born between 1945 and 1965. About 1 in 12 Veterans were estimated to b...

    Authors: Vera Yakovchenko, Rendelle E. Bolton, Mari-Lynn Drainoni and Allen L. Gifford

    Citation: BMC Health Services Research 2019 19:236

    Published on:

  27. Content type: Research article

    Use of physical restraint is a common practice in mental healthcare, but is controversial due to risk of physical and psychological harm to patients and creating ethical dilemmas for care providers. Post-incid...

    Authors: Unn Elisabeth Hammervold, Reidun Norvoll, Randi W. Aas and Hildegunn Sagvaag

    Citation: BMC Health Services Research 2019 19:235

    Published on:

  28. Content type: Research article

    Integrated knowledge translation (IKT) can optimize the uptake of research evidence into clinical practice by incorporating knowledge users as equal partners in the entire research process. Although several st...

    Authors: Jacqueline Roberge-Dao, Brooks Yardley, Anita Menon, Marie-Christine Halle, Julia Maman, Sara Ahmed and Aliki Thomas

    Citation: BMC Health Services Research 2019 19:230

    Published on:

  29. Content type: Research article

    All healthcare professionals (HCPs) are at high risk of influenza infection. Therefore, immunization is recommended for all HCPs. Due to safety and effectiveness concerns, HCPs have a low vaccination rate. Thi...

    Authors: Thamir M. Alshammari, Kazeem B. Yusuff, Muhammad Majid Aziz and Gehad M. Subaie

    Citation: BMC Health Services Research 2019 19:229

    Published on:

  30. Content type: Research article

    Providing culturally safe health care can contribute to improved health among Aboriginal people. However, little is known about how to make hospitals culturally safe for Aboriginal people. This study assessed ...

    Authors: Thomas Gadsden, Gai Wilson, James Totterdell, John Willis, Ashima Gupta, Alwin Chong, Angela Clarke, Michelle Winters, Kym Donahue, Sonia Posenelli, Louise Maher, Jessica Stewart, Helen Gardiner, Erin Passmore, Aaron Cashmore and Andrew Milat

    Citation: BMC Health Services Research 2019 19:222

    Published on:

  31. Content type: Research article

    Given the increased attention to sepsis at the population level there is a need to assess hospital performance in the care of sepsis patients using widely-available administrative data. The goal of this study ...

    Authors: Jennifer L. Darby, Billie S. Davis, Ian J. Barbash and Jeremy M. Kahn

    Citation: BMC Health Services Research 2019 19:221

    Published on:

  32. Content type: Research article

    Primary care workload is high and increasing in the United Kingdom. We sought to examine the association between rates of primary care consultation and outcomes in England.

    Authors: Sarah Lay-Flurrie, Edouard Mathieu, Clare Bankhead, Brian D. Nicholson, Rafael Perera-Salazar, Tim Holt, F. D. Richard Hobbs and Chris Salisbury

    Citation: BMC Health Services Research 2019 19:219

    Published on:

  33. Content type: Research article

    Hospital infection prevention and control (IPC) programs are designed to minimise rates of preventable healthcare-associated infection (HAI) and acquisition of multidrug resistant organisms, which are among th...

    Authors: Gwendolyn L. Gilbert and Ian Kerridge

    Citation: BMC Health Services Research 2019 19:212

    Published on:

  34. Content type: Research article

    Concerted quality improvement (QI) efforts have been taken to discourage the practice of early elective deliveries (EEDs), but few studies have robustly examined the impact of directed QI interventions in redu...

    Authors: Michael P. Thompson, Ilana Graetz, Caitlin N. McKillop, Peter H. Grubb and Teresa M. Waters

    Citation: BMC Health Services Research 2019 19:208

    Published on:

  35. Content type: Research article

    Outcomes-based policy and administration of public services present a compelling argument for the value of outcomes data. However, there are a number of challenges inherent in collecting these data from people...

    Authors: James Caiels, Stacey Rand, Tanya Crowther, Grace Collins and Julien Forder

    Citation: BMC Health Services Research 2019 19:201

    Published on:

  36. Content type: Research article

    Frequent hospitalizations and dependency on technology and providers place individuals with chronic kidney disease (CKD) at high risk for multiple safety events. Threats to their safety may be physical, emotio...

    Authors: Lucia New, Donna Goodridge, Joanne Kappel, Gary Groot and Roy Dobson

    Citation: BMC Health Services Research 2019 19:199

    Published on:

  37. Content type: Research article

    The relevance of context in implementation science is reflected in the numerous theories, frameworks, models and taxonomies that have been proposed to analyse determinants of implementation (in this paper refe...

    Authors: Per Nilsen and Susanne Bernhardsson

    Citation: BMC Health Services Research 2019 19:189

    Published on:

  38. Content type: Research article

    The Tailored Implementation in Chronic Disease (TICD) framework is a comprehensive framework describing the determinants of implementation success that has been used extensively in primary care settings. We ex...

    Authors: Lesli E. Skolarus, Gina M. Neshewat, Lacey Evans, Molly Green, Narmeen Rehman, Zach Landis-Lewis, Jillian Welsh Schrader and Anne E. Sales

    Citation: BMC Health Services Research 2019 19:182

    Published on:

  39. Content type: Research article

    This retrospective process evaluation reports on the application of a 1-year implementation program to increase identification and management of patients at high risk of a hereditary cancer syndrome. The proje...

    Authors: Janet C. Long, Teresa Winata, Deborah Debono, Kim-Chi Phan-Thien, Christine Zhu and Natalie Taylor

    Citation: BMC Health Services Research 2019 19:180

    Published on:

  40. Content type: Research article

    Measuring patients’ perception from health service quality as an important element in the assessment of service quality has attracted much attention in recent years. Therefore, this study was conducted to find...

    Authors: Mohammad Ali Abbasi-Moghaddam, Ehsan Zarei, Rafat Bagherzadeh, Hossein Dargahi and Pouria Farrokhi

    Citation: BMC Health Services Research 2019 19:170

    Published on:

  41. Content type: Research article

    Healthcare-associated infections (HAIs) are common and increase morbidity, mortality, and healthcare costs. Their control continues to be an unresolved issue worldwide. HAIs epidemiology shows sex/gender diffe...

    Authors: Jesús López-Alcalde, Elena Stallings, Sheila Cabir Nunes, Abelardo Fernández Chávez, Mathilde Daheron, Xavier Bonfill Cosp and Javier Zamora

    Citation: BMC Health Services Research 2019 19:169

    Published on:

  42. Content type: Research article

    The medical discharge letter is an important communication tool between hospitals and other healthcare providers. Despite its high status, it often does not meet the desired requirements in everyday clinical p...

    Authors: Christine Maria Schwarz, Magdalena Hoffmann, Petra Schwarz, Lars-Peter Kamolz, Gernot Brunner and Gerald Sendlhofer

    Citation: BMC Health Services Research 2019 19:158

    Published on:

  43. Content type: Research article

    To overcome the limitations of administrative data in adequately adjusting for differences in patients’ risk of readmissions, recent studies have added supplemental data from patient surveys and other sources ...

    Authors: Sarah Zheng, Amresh Hanchate and Michael Shwartz

    Citation: BMC Health Services Research 2019 19:155

    Published on:

  44. Content type: Research article

    Comparison of services and identification of factors important for favourable patient outcomes in emergency medical services (EMS) is challenging due to different organization and quality of data. The purpose ...

    Authors: Kristin Tønsager, Marius Rehn, Kjetil G. Ringdal, Hans Morten Lossius, Ilkka Virkkunen, Øyvind Østerås, Jo Røislien and Andreas J. Krüger

    Citation: BMC Health Services Research 2019 19:151

    Published on:

  45. Content type: Research article

    Organisational performance measurement is a recognised business management tool and essential for survival and success. There is a paucity of methodological studies of organisational performance measurement re...

    Authors: Richard Colbran, Robyn Ramsden, Karen Stagnitti and John W. Toumbourou

    Citation: BMC Health Services Research 2019 19:132

    Published on:

  46. Content type: Study protocol

    At many outpatient departments for psychiatry worldwide, standardized monitoring of the safety of prescribed psychotropic drugs is not routinely performed in daily clinical practice. Therefore it is unclear to...

    Authors: Mirjam Simoons, Henricus G. Ruhé, Eric N. van Roon, Robert A. Schoevers, Richard Bruggeman, Daniëlle C. Cath, Diny Muis, Johan Arends, Bennard Doornbos and Hans Mulder

    Citation: BMC Health Services Research 2019 19:125

    Published on: