Showing papers by "Saskatchewan Health published in 2014"

Facility versus unit level reporting of quality indicators in nursing homes when performance monitoring is the goal.

Abstract: Objectives To demonstrate the benefit of defining operational management units in nursing homes and computing quality indicators on these units as well as on the whole facility. Design Calculation of adjusted Resident Assessment Instrument – Minimum Data Set 2.0 (RAI–MDS 2.0) quality indicators for: PRU05 (prevalence of residents with a stage 2–4 pressure ulcer), PAI0X (prevalence of residents with pain) and DRG01 (prevalence of residents receiving an antipsychotic with no diagnosis of psychosis), for quarterly assessments between 2007 and 2011 at unit and facility levels. Comparisons of these risk-adjusted quality indicators using statistical process control (control charts). Setting A representative sample of 30 urban nursing homes in the three Canadian Prairie Provinces. Measurements Explicit decision rules were developed and tested to determine whether the control charts demonstrated improving, worsening, unchanging or unclassifiable trends over the time period. Unit and facility performance were compared. Results In 48.9% of the units studied, unit control chart performance indicated different changes in quality over the reporting period than did the facility chart. Examples are provided to illustrate that these differences lead to quite different quality interventions. Conclusions Our results demonstrate the necessity of considering facility-level and unit-level measurement when calculating quality indicators derived from the RAI–MDS 2.0 data, and quite probably from any RAI measures.

Measurement of quality and safety in healthcare: the past decade and the next.

Abstract: The author calls for a critical assessment of the impact of investments made in the measurement of quality and safety, and reflects on whether a reorientation of some of this investment is required to realize the healthcare quality and safety improvement the system seeks. This article also reflects on several Canadian initiatives that have been typical and draws on the experience of health systems that have used measurement to great effect to suggest how investments in healthcare quality and safety measurement should be focused in the future.

Multilocus sequence typing of Mycobacterium xenopi.

Abstract: Mycobacterium xenopi is an opportunistic mycobacterial pathogen of increasing clinical importance. Surveillance of M. xenopi is hampered by the absence of tools for genotyping and molecular epidemiology. In this study, we describe the development and evaluation of an effective multilocus sequence typing strategy for M. xenopi.

Do prior authorization policies discourage first-line antipsychotic use in patients newly discharged from a hospitalization for schizophrenia in Saskatchewan?

Abstract: Background Drug benefit providers can decrease prescribing of specific medications through p rior authorization policies. In Saskatchewan , certain second generation antipsychotics (SGAs) are recognized as first - line agents to manage schizophrenia ; but , require prior authorization because their coverage is restricted in other conditions. We aimed to determine if the need for prior - authorization substantially diminishes prescribing of first - line SGAs in comparison to unrestricted agents. Objectives To conduct an ecological comparison of SGA prescrib ing with changes in prior - authorization policies between 1997 and 2005 using health - administrative databases in Saskatchewan , Canada . Method Eligible subjects were discharged from hospital with a first - time primary diagnosis of schizophrenia between 199 7 and 2005. SGAs dispensed within 7 days of discharge were used to estimate prescribing preferences for olanzapine and quetiapine relative to risperidone. Percentages of SGA use were age and sex standardized to the 2000 cohort. Results Out of 1,277 eligible patients, 521 (41%) received 564 SGA dispensations within 7 - days of hospital discharge. Between 1997 and 1998, risperidone was the only SGA covered for first - line use and made up 72.6% (82/113) of SGA use while olanzapine made up 27.4% (31/113) fo r a crude preference ratio of 0.38 (27 . 4/72 . 6). Risperidone use decreased to 65.8% in 1999 - 2002 and to 47.4% in 2003 - 2005 as a percentage of SGA dispensations. Correspondingly, the preference ratios for olanzapine and quetiapine increased from 0.40 to 0.57 and from 0.12 to 0.54 in these respective p eriods. Conclusions The requirement for prior - authorization does not appear to substantially diminish prescribing of first - line SGAs for the treatment of schizophrenia in Saskatchewan , Canada .