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Y Andersen

Publications and source records attributed to Y Andersen.

At least 19 recordsLinked to original sources
PubMed1995

Quality development based on informatics in health care: steps in the Danish national strategy illustrated by four cases.

The first step for quality development is identification of the quality problem. This should be followed by a set up of criteria and standards and relevant data should be collected to perform quality assessment. The quality-level is evaluated and in cases with non-satisfying results, the problem(s) should be identified and the process repeated [1]. Identification of the best results for continuous quality improvement and professional self-assessment is part of the process [1]. Decentralization of the whole quality development process is an aim. The Ministry of Health is politically responsible for the process and the National Board of Health is responsible for the implementation of the process at the national level. To support continuous quality development, three bills were passed in the government in 1992: 1) Free choice of hospital for the patients; 2) Appropriate local and regional distribution of specialized functions, to ensure optimal treatment of rare and complicated diseases; 3) Coordinated planning and organization of the health services. The strategy for quality development illustrated by four cases. Four projects were identified to illustrate steps in the national strategy for quality development. PROBLEM IDENTIFICATION. ESTEEM [2,3]: Using knowledge-based systems for interpretation of EMG (electromyography) in different laboratories disclosed great variations in clinical usability. The variations could be explained by different examination techniques, test planning protocols, and diagnostic criteria. It was concluded that the use of a EMG-knowledge based system disclosed great problems for standardization of procedures dependent on EMG measurements. QUALITY ASSESSMENT. Hip fracture quality project [unpublished data]: The assumption for the study was that early and active rehabilitation after hip fracture would promote the ability of the patients to cope with activities of daily living (ADL) and prevent development of complications. About 85% of the patients were expected to be able to go home on the 12th day, but this was the case for only 56% of the patients. It was concluded that the pre-set standard was not achieved and that the post-operative care was carried out in an ineffective way. QUALITY IMPROVEMENT. Laboratory quality project [4]: Quality control assessment procedures have been implemented for years in hospital laboratories. The aim of the study was to evaluate the size of analytical bias between two local hospital laboratories using the same reference intervals. The results showed that only a few of the routine analyses meet the goals for acceptance of general reference intervals in a geographical area. The problems were reflected in the quality assessment results but, nevertheless, no action seems to have been taken to minimize the bias. It is concluded that interpretation of quality control data is a great problem. QUALITY MONITORING AND EVALUATION. National databases for health care quality [5]: Principles for development, implementation, and use of national databases has been worked out by The National Board of Health. Clinical departments will get a tool to monitor and improve the daily working routines. National databases for clinical monitoring exist for vascular surgery, laparoscopic surgery, treatment of breast cancer, and surgery for hip fractures.

Denmark↗
PubMed1994

[Quality assurance regarding pressure sores in a Danish hospital population].

Seven hospital departments were enrolled in the first step in a quality assurance process regarding pressure sores. A total of 2317 patients representative of a Danish hospital population were included. At the time of admission 2.2% had pressure sores and 1.1% pressure marks (point prevalence), and during hospitalization 2.9% developed pressure sores pressure sores and 1.1% pressure marks (point prevalence), and during hospitalization 2.9% developed pressure sores and 1.4% pressure marks (absolute incidence). The incidence of pressure sores and pressure marks varied between the department from 0-11.3% and from 0 to 7.7% respectively. The relative risk (RR) of developing pressure sores was highest (RR 11.7) for patients who had pressure marks on admittance. Other significant risk factors were admission to one specific surgical department compared to the reference department (RR 7.9), age > 81 years compared to age < 54 years (RR 6.0), length of stay > 8 days compared to < 8 days (RR 5.9) and the diagnosis fractura partis proximalis femoris compared to other diagnoses (RR 4.7). The longer the duration of surgery the higher the incidence of pressure sores, but there was no significant relation between the waiting time from admission to surgery and incidence of pressure sores. The study documents that the development of pressure sores in Danish hospital patients is not a serious quality problem. However, individual differences between departments show the need for some departments to continue the quality improvement efforts.

Adult↗