International journal for quality in health care : journal of the International Society for Quality in Health Care, Jan 8, 2018
To learn the weaknesses and strengths of safety culture as expressed by the dimensions measured b... more To learn the weaknesses and strengths of safety culture as expressed by the dimensions measured by the Hospital Survey on Patient Safety Culture (HSOPSC) at hospitals in the various cultural contexts. The aim of this study was to identify studies that have used the HSOPSC to collect data on safety culture at hospitals; to survey their findings in the safety culture dimensions and possible contributions to improving the quality and safety of hospital care. Medline (via PubMed), Web of Science and Scopus were searched from 2005 to July 2016 in English, Portuguese and Spanish. Studies were identified using specific search terms and inclusion criteria. A total of 33 articles, reporting on 21 countries, was included. Scores were extracted by patient safety culture dimensions assessed by the HSOPSC. The quality of the studies was evaluated by the STROBE Statement. The dimensions that proved strongest were 'Teamwork within units' and 'Organisational learning-continuous improvem...
International Journal of Environmental Research and Public Health
The COVID-19 pandemic led to the implementation of interventions to provide emotional and psychol... more The COVID-19 pandemic led to the implementation of interventions to provide emotional and psychological support to healthcare workers in many countries. This ecological study aims to describe the strategies implemented in different countries to support healthcare professionals during the outbreak. Data were collected through an online survey about the measures to address the impact of the pandemic on the mental health of healthcare workers. Healthcare professionals, researchers, and academics were invited to respond to the survey. Fifty-six professionals from 35 countries contributed data to this study. Ten countries (28.6%) reported that they did not launch any national interventions. Both developed and developing countries launched similar initiatives. There was no relationship between the existence of any type of initiative in a country with the incidence, lethality, and mortality rates of the country due to COVID-19, and per capita income in 2020. The 24 h hotline for psychologi...
Textbook of Patient Safety and Clinical Risk Management, 2020
This chapter describes a comprehensive approach to adverse event investigation and risk assessmen... more This chapter describes a comprehensive approach to adverse event investigation and risk assessment, as well as the characteristics of an integrated system for patient safety and clinical risk management. Drawing on evidence from other industries and healthcare organizations across the globe, the author’s report how such a system can be developed with the active involvement of policy-makers, healthcare managers, health professionals, and patients. Human factors and ergonomics provide the theoretical framework in which the guiding principles, methods, and tools are selected and applied to identify, analyze, and prevent risks related to unsafe care in any healthcare setting.
Resumo: Eventos adversos constituem grave problema relacionado à qualidade do cuidado de saúde. A... more Resumo: Eventos adversos constituem grave problema relacionado à qualidade do cuidado de saúde. A prática odontológica, por ser eminentemente invasiva e implicar contato íntimo e rotineiro com secreções, é potencialmente propícia à ocorrência desses eventos. Diversos estudos em segurança do paciente foram desenvolvidos nas duas últimas décadas, entretanto, em maior número no ambiente hospitalar, em função de sua complexidade organizacional, gravidade de casos, diversidade e especificidade de procedimentos. O objetivo foi identificar e explorar os estudos voltados à segurança do paciente odontológico. Foi realizada revisão integrativa da literatura com consulta ao MEDLINE via PubMed, Scopus via Portal Capes e ao Portal Regional da Biblioteca Virtual de Saúde, utilizando-se os termos segurança do paciente e odontologia nos idiomas inglês, espanhol e português a partir de 2000. Utilizou-se o ciclo de pesquisa em segurança do paciente, proposto pela Organização Mundial da Saúde para cla...
RESUMO - As questões relacionadas com a Segurança do Doente, e em particular, com a ocorrência de... more RESUMO - As questões relacionadas com a Segurança do Doente, e em particular, com a ocorrência de eventos adversos têm constituído, de há uns tempos a esta parte, uma crescente preocupação para as organizações de saúde, para os decisores políticos, para os profissionais de saúde e para os doentes/utentes e suas famílias. Mais recentemente, tem-se assistido a um movimento crescente no sentido de valorizar a investigação na área da segurança do doente e, também, na necessidade de desenvolver e avaliar o impacte de soluções inovadoras que possam acrescentar valor em termos de ganhos clínicos, sociais e económicos. De entre os temas prioritários na investigação em segurança do doente destacam-se: i) o conhecimento epidemiológico (frequência, causas, tipologia e impacte) dos eventos adversos e ii) o desenvolvimento, implementação e avaliação de soluções inovadoras. O objectivo subjacente a essas duas linhas de investigação consiste em obter conhecimento que possibilite a diminuição do ri...
Advances in Intelligent Systems and Computing, 2018
To analyse the variation in the rate of AEs between acute hospitals and explore the extent to whi... more To analyse the variation in the rate of AEs between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. Methods - Retrospective cohort study. Binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. A random sample of 4,250 charts, representative of around 180,000 hospital admissions, from 9 acute Portuguese public hospital centres in 2013, was analysed. Results – Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to HAI and surgical procedures; (iii) patient characteristics such as sex, age, admission coded as elective vs urgent and medical vs surgical DRG code, all with p < 0.001, were associated with a greater occurrence of AEs – CCI seems to influence the difference in the rates of AEs; (iv) hospital characteristics such as use of reporting system, being accredited, university status and hospital size, all with p < 0.001, seem to be associated with a higher rate of AEs.
Patient safety has become a core issue for many modern healthcare systems. All healthcare systems... more Patient safety has become a core issue for many modern healthcare systems. All healthcare systems around the world occasionally and unintentionally harm patients whom they are seeking to help. In recognition of this, patient safety has become a fundamental part of the drive to improve quality in many countries. The effects of harming a patient are widespread. There can be devastating emotional and physical consequence for patients and their families. For the staff involved too, incidents can be distressing, while members of their clinical teams can become demoralised and disaffected. Safety incidents also incur costs through litigation and extra treatment. Patient safety is nowadays a serious problem of public health, with several implications in different clinical areas and level of care. It is crucial to establish priorities, hierarchy's interventions and engaged all stakeholders who are involved around this big issue. In other word, it is important to define a strategy that c...
Background: The role of demographic and socio-economic determinants of COVID-19 transmission is s... more Background: The role of demographic and socio-economic determinants of COVID-19 transmission is still unclear and is expected to vary in different contexts and epidemic periods. Exploring such determinants may generate a hypothesis about transmission and aid the definition of prevention strategies. Objectives: To identify municipality-level demographic and socio-economic determinants of COVID-19 in Portugal. Methods: We assessed determinants of COVID-19 daily cases at 4 moments of the first COVID-19 epidemic wave in Portugal, related with lockdown and post-lockdown measures. We selected 60 potential determinants from 5 dimensions: population and settlement, disease, economy, social context, and mobility. We conducted a multiple linear regression (MLR) stepwise analysis (p < 0.05) and an artificial neural network (ANN) analysis with the variables to identify predictors of the number of daily cases. Results: For MLR, some of the identified variables were: resident population and po...
International journal for quality in health care : journal of the International Society for Quality in Health Care, Jan 4, 2018
To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore ... more To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. Retrospective cohort study. Chi-square test for independence and binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. Nine acute Portuguese public hospital centres. A random sample of 4250 charts, representative of around 180 000 hospital admissions in 2013, was analysed. To measure adverse events based on chart review. Rate of AEs. Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to Hospital-Acquired Infection and surgical procedures; (iii) patient characteristics such as sex (female 11%; male 14.4%), age (≥65 y 16.4%; <65 y 8.5%), admission coded as elective vs. urgent (8.6% vs. 14.6%) and medical vs. surgical Diagnosis Related Group code (13.4% vs. 11.7%), all wi...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2003
Interventional cardiology is an example of a medical field in which rapid technological advances ... more Interventional cardiology is an example of a medical field in which rapid technological advances have taken place over a short period of time. In the 26 years since the inception of interventional cardiology, there has been an enormous increase in the volume of cases and the number of operators and sites performing coronary angioplasty. Coupled with this, in the last decade we have witnessed tremendous developments in the techniques, materials and adjunctive therapy associated with percutaneous coronary intervention. Health care interventions are intended to benefit patients, but they can also cause harm. The complex combination of processes, technologies and human interaction that constitutes the modern health care delivery system can bring significant benefits. However, it also involves an inevitable risk of adverse events that can, and too often do, happen. The Joint Commission on Accreditation of Healthcare Organizations has defined quality in health care as "the degree to ...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2010
Quality standards, and subsequently benchmarking, based on patient outcome data are a rational me... more Quality standards, and subsequently benchmarking, based on patient outcome data are a rational means of assessing the quality of health care. However, variation in patients' baseline clinical risk precludes direct comparison of outcomes across operators, institutions and health care plans. In the years since the advent of interventional cardiology, there has been an enormous increase in the volume of activity and number of operators and centers performing percutaneous coronary intervention (PCI), together with considerable developments in the techniques, materials and adjunctive therapy associated with PCI. PCI outcomes depend on various factors, particularly patient characteristics and disease severity. The use of risk adjustment models to quantify differences in patient outcomes in interventional cardiology has been shown to provide a reliable and balanced comparison of performance and to lead to improvements in quality and safety in this area. The aim of this study was to dev...
International journal for quality in health care : journal of the International Society for Quality in Health Care, Jan 8, 2018
To learn the weaknesses and strengths of safety culture as expressed by the dimensions measured b... more To learn the weaknesses and strengths of safety culture as expressed by the dimensions measured by the Hospital Survey on Patient Safety Culture (HSOPSC) at hospitals in the various cultural contexts. The aim of this study was to identify studies that have used the HSOPSC to collect data on safety culture at hospitals; to survey their findings in the safety culture dimensions and possible contributions to improving the quality and safety of hospital care. Medline (via PubMed), Web of Science and Scopus were searched from 2005 to July 2016 in English, Portuguese and Spanish. Studies were identified using specific search terms and inclusion criteria. A total of 33 articles, reporting on 21 countries, was included. Scores were extracted by patient safety culture dimensions assessed by the HSOPSC. The quality of the studies was evaluated by the STROBE Statement. The dimensions that proved strongest were 'Teamwork within units' and 'Organisational learning-continuous improvem...
International Journal of Environmental Research and Public Health
The COVID-19 pandemic led to the implementation of interventions to provide emotional and psychol... more The COVID-19 pandemic led to the implementation of interventions to provide emotional and psychological support to healthcare workers in many countries. This ecological study aims to describe the strategies implemented in different countries to support healthcare professionals during the outbreak. Data were collected through an online survey about the measures to address the impact of the pandemic on the mental health of healthcare workers. Healthcare professionals, researchers, and academics were invited to respond to the survey. Fifty-six professionals from 35 countries contributed data to this study. Ten countries (28.6%) reported that they did not launch any national interventions. Both developed and developing countries launched similar initiatives. There was no relationship between the existence of any type of initiative in a country with the incidence, lethality, and mortality rates of the country due to COVID-19, and per capita income in 2020. The 24 h hotline for psychologi...
Textbook of Patient Safety and Clinical Risk Management, 2020
This chapter describes a comprehensive approach to adverse event investigation and risk assessmen... more This chapter describes a comprehensive approach to adverse event investigation and risk assessment, as well as the characteristics of an integrated system for patient safety and clinical risk management. Drawing on evidence from other industries and healthcare organizations across the globe, the author’s report how such a system can be developed with the active involvement of policy-makers, healthcare managers, health professionals, and patients. Human factors and ergonomics provide the theoretical framework in which the guiding principles, methods, and tools are selected and applied to identify, analyze, and prevent risks related to unsafe care in any healthcare setting.
Resumo: Eventos adversos constituem grave problema relacionado à qualidade do cuidado de saúde. A... more Resumo: Eventos adversos constituem grave problema relacionado à qualidade do cuidado de saúde. A prática odontológica, por ser eminentemente invasiva e implicar contato íntimo e rotineiro com secreções, é potencialmente propícia à ocorrência desses eventos. Diversos estudos em segurança do paciente foram desenvolvidos nas duas últimas décadas, entretanto, em maior número no ambiente hospitalar, em função de sua complexidade organizacional, gravidade de casos, diversidade e especificidade de procedimentos. O objetivo foi identificar e explorar os estudos voltados à segurança do paciente odontológico. Foi realizada revisão integrativa da literatura com consulta ao MEDLINE via PubMed, Scopus via Portal Capes e ao Portal Regional da Biblioteca Virtual de Saúde, utilizando-se os termos segurança do paciente e odontologia nos idiomas inglês, espanhol e português a partir de 2000. Utilizou-se o ciclo de pesquisa em segurança do paciente, proposto pela Organização Mundial da Saúde para cla...
RESUMO - As questões relacionadas com a Segurança do Doente, e em particular, com a ocorrência de... more RESUMO - As questões relacionadas com a Segurança do Doente, e em particular, com a ocorrência de eventos adversos têm constituído, de há uns tempos a esta parte, uma crescente preocupação para as organizações de saúde, para os decisores políticos, para os profissionais de saúde e para os doentes/utentes e suas famílias. Mais recentemente, tem-se assistido a um movimento crescente no sentido de valorizar a investigação na área da segurança do doente e, também, na necessidade de desenvolver e avaliar o impacte de soluções inovadoras que possam acrescentar valor em termos de ganhos clínicos, sociais e económicos. De entre os temas prioritários na investigação em segurança do doente destacam-se: i) o conhecimento epidemiológico (frequência, causas, tipologia e impacte) dos eventos adversos e ii) o desenvolvimento, implementação e avaliação de soluções inovadoras. O objectivo subjacente a essas duas linhas de investigação consiste em obter conhecimento que possibilite a diminuição do ri...
Advances in Intelligent Systems and Computing, 2018
To analyse the variation in the rate of AEs between acute hospitals and explore the extent to whi... more To analyse the variation in the rate of AEs between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. Methods - Retrospective cohort study. Binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. A random sample of 4,250 charts, representative of around 180,000 hospital admissions, from 9 acute Portuguese public hospital centres in 2013, was analysed. Results – Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to HAI and surgical procedures; (iii) patient characteristics such as sex, age, admission coded as elective vs urgent and medical vs surgical DRG code, all with p < 0.001, were associated with a greater occurrence of AEs – CCI seems to influence the difference in the rates of AEs; (iv) hospital characteristics such as use of reporting system, being accredited, university status and hospital size, all with p < 0.001, seem to be associated with a higher rate of AEs.
Patient safety has become a core issue for many modern healthcare systems. All healthcare systems... more Patient safety has become a core issue for many modern healthcare systems. All healthcare systems around the world occasionally and unintentionally harm patients whom they are seeking to help. In recognition of this, patient safety has become a fundamental part of the drive to improve quality in many countries. The effects of harming a patient are widespread. There can be devastating emotional and physical consequence for patients and their families. For the staff involved too, incidents can be distressing, while members of their clinical teams can become demoralised and disaffected. Safety incidents also incur costs through litigation and extra treatment. Patient safety is nowadays a serious problem of public health, with several implications in different clinical areas and level of care. It is crucial to establish priorities, hierarchy's interventions and engaged all stakeholders who are involved around this big issue. In other word, it is important to define a strategy that c...
Background: The role of demographic and socio-economic determinants of COVID-19 transmission is s... more Background: The role of demographic and socio-economic determinants of COVID-19 transmission is still unclear and is expected to vary in different contexts and epidemic periods. Exploring such determinants may generate a hypothesis about transmission and aid the definition of prevention strategies. Objectives: To identify municipality-level demographic and socio-economic determinants of COVID-19 in Portugal. Methods: We assessed determinants of COVID-19 daily cases at 4 moments of the first COVID-19 epidemic wave in Portugal, related with lockdown and post-lockdown measures. We selected 60 potential determinants from 5 dimensions: population and settlement, disease, economy, social context, and mobility. We conducted a multiple linear regression (MLR) stepwise analysis (p < 0.05) and an artificial neural network (ANN) analysis with the variables to identify predictors of the number of daily cases. Results: For MLR, some of the identified variables were: resident population and po...
International journal for quality in health care : journal of the International Society for Quality in Health Care, Jan 4, 2018
To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore ... more To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. Retrospective cohort study. Chi-square test for independence and binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. Nine acute Portuguese public hospital centres. A random sample of 4250 charts, representative of around 180 000 hospital admissions in 2013, was analysed. To measure adverse events based on chart review. Rate of AEs. Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to Hospital-Acquired Infection and surgical procedures; (iii) patient characteristics such as sex (female 11%; male 14.4%), age (≥65 y 16.4%; <65 y 8.5%), admission coded as elective vs. urgent (8.6% vs. 14.6%) and medical vs. surgical Diagnosis Related Group code (13.4% vs. 11.7%), all wi...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2003
Interventional cardiology is an example of a medical field in which rapid technological advances ... more Interventional cardiology is an example of a medical field in which rapid technological advances have taken place over a short period of time. In the 26 years since the inception of interventional cardiology, there has been an enormous increase in the volume of cases and the number of operators and sites performing coronary angioplasty. Coupled with this, in the last decade we have witnessed tremendous developments in the techniques, materials and adjunctive therapy associated with percutaneous coronary intervention. Health care interventions are intended to benefit patients, but they can also cause harm. The complex combination of processes, technologies and human interaction that constitutes the modern health care delivery system can bring significant benefits. However, it also involves an inevitable risk of adverse events that can, and too often do, happen. The Joint Commission on Accreditation of Healthcare Organizations has defined quality in health care as "the degree to ...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2010
Quality standards, and subsequently benchmarking, based on patient outcome data are a rational me... more Quality standards, and subsequently benchmarking, based on patient outcome data are a rational means of assessing the quality of health care. However, variation in patients' baseline clinical risk precludes direct comparison of outcomes across operators, institutions and health care plans. In the years since the advent of interventional cardiology, there has been an enormous increase in the volume of activity and number of operators and centers performing percutaneous coronary intervention (PCI), together with considerable developments in the techniques, materials and adjunctive therapy associated with PCI. PCI outcomes depend on various factors, particularly patient characteristics and disease severity. The use of risk adjustment models to quantify differences in patient outcomes in interventional cardiology has been shown to provide a reliable and balanced comparison of performance and to lead to improvements in quality and safety in this area. The aim of this study was to dev...
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