Attitudes of healthcare providers towards family involvement and presence in adult critical care units in Saudi Arabia : A quantitative study
- Authors: Al Mutair, Abbas , Plummer, Virginia , O'Brien, Anthony , Clerehan, Rosemary
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 23, no. 5-6 (2014), p. 744-755
- Full Text: false
- Reviewed:
- Description: Aims and objectives: To describe healthcare providers' attitudes to family involvement during routine care and family presence during resuscitation or other invasive procedures in adult intensive care units in Saudi Arabia. Background: Previous research has shown that healthcare professionals have revealed a diversity of opinions on family involvement during routine care and family presence during resuscitation or other invasive procedures. Attitude assessment can provide an indication of staff acceptance or rejection of the practice and also help identify key potential barriers that will need to be addressed. It has also been evident that participation in the care has potential benefits for patients and families as well as healthcare providers. Design: A quantitative descriptive design. Methods: A questionnaire was used with a convenience sample of 468 healthcare providers who were recruited from eight intensive care units. Results: The analysis found that healthcare providers had positive attitudes towards family involvement during routine care, but negative attitudes towards family presence during resuscitation or other invasive procedures. Physicians expressed more opposition to the practice than did nurses and respiratory therapists. Staff indicated a need to develop written guidelines and policies, as well as educational programmes, to address this sensitive issue in clinical practice. Conclusion: Family is an important resource in patient care in the context of the critical care environment. Clinical barriers including resources, hospital policies and guidelines, staff and public education should be taken into account to facilitate family integration to the care model. Relevance to clinical practice: The findings can help to develop policies and guidelines for safe implementation of the practice. They can also encourage those who design nursing and other medical curricula to place more emphasis on the role of the family especially in critical care settings. © 2013 John Wiley & Sons Ltd.
Assessing healthcare providers' performance with and without risk adjustment
- Authors: Morales-Silva, Daniel
- Date: 2018
- Type: Text , Thesis , PhD
- Full Text:
- Description: This study focuses on how healthcare data can be used to draw comparisons between healthcare providers (surgeons or hospitals). Depending on the type of access to datasets, these comparisons can be done with or without risk adjustment. For us, risk adjustment refers to the use of patient-level information to explain variation in healthcare spending, resource utilisation and health outcomes. For unadjusted comparisons, we highlight the diagnostic potential that radar plots offer for reporting on outcome indicators. These outcome indicators were obtained from hospital admissions of patients undergoing certain surgical procedures. We address two drawbacks of radar plots: presence of missing information and order of indicators. By introducing a consolidated view at provider level, we define an uncomplicated ranking of providers which can be used to identify potential low and high performers. For risk adjusted comparisons, we introduce a novel and robust methodology that enables comparisons of healthcare providers across multiple hierarchies, namely, surgeons, teams, departments and hospitals, using a consistent approach. Our methodology puts the patient at the centre of the analysis, and thus, can be used for personalised predictions (e.g. expected length of stay, costs and probability of being transferred to intensive care unit). Our findings suggest that the observed variation in selected outcome indicators, such as length of stay and charges of healthcare providers, cannot be explained by patient characteristics alone. Importantly, we have also observed that the perceived performance, on selected outcome indicators, of providers can change substantially following risk adjustment. Healthcare is unique in that clinical expertise is essential in guiding decision making and in informing all statistical models that seek to describe patient outcomes. For future iterations of our models, we will seek greater clinical input.
- Description: Doctor of Philosophy