Universidad Peruana Cayetano Heredia

Mixed-Methods Assessment of Trauma and Acute Care Surgical Quality Improvement Programs in Peru

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dc.contributor.author LaGrone, Lacey N.
dc.contributor.author Fuhs, Amy K.
dc.contributor.author Egoavil, Eduardo Huaman
dc.contributor.author Rodríguez Castro, Manuel Jorge Augusto
dc.contributor.author Valderrama, Roberto
dc.contributor.author Isquith-Dicker, Leah N.
dc.contributor.author Herrera-Matta, Jaime
dc.contributor.author Mock, Charles N.
dc.date.accessioned 2019-01-25T17:00:26Z
dc.date.available 2019-01-25T17:00:26Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/4929
dc.description.abstract BACKGROUND: Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. METHODS: This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru. RESULTS: Key areas identified for improvement in morbidity and mortality (M&M) conferences were the standardization of case selection, incorporation of evidence from the medical literature into case presentation and discussion, case documentation, and the development of a clear plan for case follow-up. The key barriers to QI program implementation were a lack of prioritization of QI, lack of sufficient human and administrative resources, lack of political support, and lack of education on QI practices. CONCLUSIONS: A national program that makes QI a required part of all health providers' professional training and responsibilities would effectively address a majority of identified barriers to QI programs in Peru. Specifically, the presence of basic QI elements, such as M&M conferences, should be required at hospitals that train pre-graduate physicians. Alternatively, short of this national-level organization, efforts that capitalize on local examples through apprenticeships between institutions or integration of QI into continuing medical education would be expected to build on the facilitators for QI programs that exist in Peru. en_US
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartofseries World Journal of Surgery
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Humans en_US
dc.subject Cross-Sectional Studies en_US
dc.subject Program Development en_US
dc.subject Quality Improvement/organization & administration en_US
dc.subject Process Assessment (Health Care)/standards en_US
dc.subject Wounds and Injuries/therapy en_US
dc.title Mixed-Methods Assessment of Trauma and Acute Care Surgical Quality Improvement Programs in Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1007/s00268-016-3832-3
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.11
dc.relation.issn 1432-2323


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