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      The Impact of Applying Quality Management Practices on Patient Centeredness in Jordanian Public Hospitals: Results of Predictive Modeling

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          Abstract

          Targeting the patient’s needs and preferences has become an important contributor for improving care delivery, enhancing patient satisfaction, and achieving better clinical outcomes. This study aimed to examine the impact of applying quality management practices on patient centeredness within the context of health care accreditation and to explore the differences in the views of various health care workers regarding the attributes affecting patient-centered care. Our study followed a cross-sectional survey design wherein 4 Jordanian public hospitals were investigated several months after accreditation was obtained. Total 829 clinical/nonclinical hospital staff members consented for study participation. This sample was divided into 3 main occupational categories to represent the administrators, nurses, as well as doctors and other health professionals. Using a structural equation modeling, our results indicated that the predictors of patient-centered care for both administrators and those providing clinical care were participation in the accreditation process, leadership commitment to quality improvement, and measurement of quality improvement outcomes. In particular, perceiving the importance of the hospital’s engagement in the accreditation process was shown to be relevant to the administrators (gamma = 0.96), nurses (gamma = 0.80), as well as to doctors and other health professionals (gamma = 0.71). However, the administrator staff (gamma = 0.31) was less likely to perceive the influence of measuring the quality improvement outcomes on the delivery of patient-centered care than nurses (gamma = 0.59) as well as doctors and other health care providers (gamma = 0.55). From the nurses’ perspectives only, patient centeredness was found to be driven by building an institutional framework that supports quality assurance in hospital settings (gamma = 0.36). In conclusion, accreditation is a leading factor for delivering patient-centered care and should be on a hospital’s agenda as a strategy for continuous quality improvement.

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          Knowledge transfer for the management of dementia: a cluster-randomised trial of blended learning in general practice

          Background The implementation of new medical knowledge into general practice is a complex process. Blended learning may offer an effective and efficient educational intervention to reduce the knowledge-to-practice gap. The aim of this study was to compare knowledge acquisition about dementia management between a blended learning approach using online modules in addition to quality circles (QCs) and QCs alone. Methods In this cluster-randomised trial with QCs as clusters and general practitioners (GPs) as participants, 389 GPs from 26 QCs in the western part of Germany were invited to participate. Data on the GPs' knowledge were obtained at three points in time by means of a questionnaire survey. Primary outcome was the knowledge gain before and after the interventions. A subgroup analysis of the users of the online modules was performed. Results 166 GPs were available for analysis and filled out a knowledge test at least two times. A significant increase of knowledge was found in both groups that indicated positive learning effects of both approaches. However, there was no significant difference between the groups. A subgroup analysis of the GPs who self-reported that they had actually used the online modules showed that they had a significant increase in their knowledge scores. Conclusion A blended learning approach was not superior to a QCs approach for improving knowledge about dementia management. However, a subgroup of GPs who were motivated to actually use the online modules had a gain in knowledge. Trial registration Current Controlled Trials ISRCTN36550981.
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            Health sector accreditation research: a systematic review.

            The purpose of this study was to identify and analyze research into accreditation and accreditation processes. A multi-method, systematic review of the accreditation literature was conducted from March to May 2007. The search identified articles researching accreditation. Discussion or commentary pieces were excluded. From the initial identification of over 3000 abstracts, 66 studies that met the search criteria by empirically examining accreditation were selected. DATA EXTRACTION AND RESULTS OF DATA SYNTHESIS: The 66 studies were retrieved and analyzed. The results, examining the impact or effectiveness of accreditation, were classified into 10 categories: professions' attitudes to accreditation, promote change, organizational impact, financial impact, quality measures, program assessment, consumer views or patient satisfaction, public disclosure, professional development and surveyor issues. The analysis reveals a complex picture. In two categories consistent findings were recorded: promote change and professional development. Inconsistent findings were identified in five categories: professions' attitudes to accreditation, organizational impact, financial impact, quality measures and program assessment. The remaining three categories-consumer views or patient satisfaction, public disclosure and surveyor issues-did not have sufficient studies to draw any conclusion. The search identified a number of national health care accreditation organizations engaged in research activities. The health care accreditation industry appears to be purposefully moving towards constructing the evidence to ground our understanding of accreditation.
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              Patient-centered medicine and patient-oriented research: improving health outcomes for individual patients

              Background Patient-centered medicine is developing alongside the concepts of personalized medicine and tailored therapeutics. The main objective of patient-centered medicine is to improve health outcomes of individual patients in everyday clinical practice, taking into account the patient’s objectives, preferences, values as well as the available economic resources. Discussion Patient-centered medicine implies a paradigm shift in the relationship between doctors and patients, but also requires the development of patient-oriented research. Patient-oriented research should not be based on the evaluation of medical interventions in the average patient, but on the identification of the best intervention for every individual patient, the study of heterogeneity and the assignment of greater value to observations and exceptions. The development of information-based technologies can help to close the gap between clinical research and clinical practice, a fundamental step for any advance in this field. Summary Evidence-based medicine and patient centered medicine are not contradictory but complementary movements. It is not possible to practice patient-centered medicine that is not based on evidence, nor is it possible to practice evidence-based medicine at a distance from the individual patient.
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                Author and article information

                Journal
                Inquiry
                Inquiry
                INQ
                spinq
                Inquiry: A Journal of Medical Care Organization, Provision and Financing
                SAGE Publications (Sage CA: Los Angeles, CA )
                0046-9580
                1945-7243
                26 February 2018
                Jan-Dec 2018
                : 55
                : 0046958018754739
                Affiliations
                [1 ]Jordan University of Science and Technology, Irbid, Jordan
                [2 ]The Hashemite University, Zarqa, Jordan
                [3 ]Hamdan Bin Mohammed Smart University, Dubai, UAE
                Author notes
                [*]Heba H. Hijazi, Assistant Professor, Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan. Email: hhhijazi0@ 123456just.edu.jo
                Article
                10.1177_0046958018754739
                10.1177/0046958018754739
                5833210
                29482410
                5f9747aa-1f8b-42c6-bfd3-0647e9a6e318
                © The Author(s) 2018

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 10 February 2017
                : 17 December 2017
                : 22 December 2017
                Categories
                Original Research
                Custom metadata
                January-December 2018

                patient-centered care,accreditation,quality improvement,quality management,patient satisfaction,leadership,jordan

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