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To quantitatively assess key performance indicator changes between selected pre-pandemic and pandemic periods at the Sant’Anna Hospital emergency department (ED) in Como, Italy through the retrospective use of Hospital Surge Preparedness and Response index (HSPRI).
Methods
This study collected the average length of stay (LOS), time-to-physician initial assessment (TPIA), and left-without-being seen (LWBS) rates for 2 pre-pandemic (control group) and 3 pandemic periods (study group) in the COVID ED (C-ED) dedicated to treat COVID-19 patients and the non-COVID ED (NC-ED) dedicated to non-COVID cases. Quantitative analysis was based on hypothesis testing. A retrospective qualitative theme and subtheme analysis based on the HSPRI was conducted on baseline strategies before each pandemic period and on the actions implemented thereafter.
Results
LOS increased across all pandemic periods. TPIA decreased in the first 2 pandemic periods in comparison to pre-pandemic. LWBS decreased between pre-pandemic and pandemic periods. Of the 22 action items listed in the HSPRI, 8 were implemented in the first pandemic period, 8 in the second and 1 in the third, for a total of 17 items.
Conclusions
The HSPRI demonstrated value as a tool for a hospital staff to actively utilize during a pandemic to identify KPI triggers to formulate actions to maintain pre-pandemic care or ameliorate the deterioration of care during the pandemic.
The goal of this chapter is to introduce the reader to the wide range of methods used for performance analysis in healthcare. Specifically, it starts with a brief outline of what the authors refer to as the basic analytics of healthcare performance analysis, with an emphasis on hospitals. Although relatively simple, such basic performance analytics are popular approaches in practice: They are useful for exploring and presenting the data before proceeding with more sophisticated methods, and they provide a bridge for communication between practitioners and academics. To facilitate the discussion, they authors provide brief empirical illustrations using real data sets as well as supply the relevant R codes of the examples. They then briefly describe other major approaches for performance analysis in healthcare as a primer for the following chapters.
This chapter seeks to give an overview of the place of Quality Management (QM) in contemporary fertility practice. It provides the reader with an understanding of the terminology used in QM and explores the definition of quality and success in fertility care. An examination of process modelling in the organisation of services is outlined and an analysis in practical terms as to how QM is applied in practice is provided, covering key issues such as document control, organisational structure and the role of the quality manager. Audit as a tool for improving quality is a fundamental tool and its use within a clinical governance framework including risk management/assessment, and other key responsibilities is detailed. Measuring what we do, analysing performance and setting targets to improve should be fundamental to how we approach our work in contemporary clinical practice.
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