Factors affecting the use of patient survey data for quality improvement in the Veterans Health Administration

<p>Abstract</p> <p>Background</p> <p>Little is known about how to use patient feedback to improve experiences of health care. The Veterans Health Administration (VA) conducts regular patient surveys that have indicated improved care experiences over the past decade. The goal of this study was to assess factors that were barriers to, or promoters of, efforts to improve care experiences in VA facilities.</p> <p>Methods</p> <p>We conducted case studies at two VA facilities, one with stable high scores on inpatient reports of emotional support between 2002 and 2006, and one with stable low scores over the same period. A semi-structured interview was used to gather information from staff who worked with patient survey data at the study facilities. Data were analyzed using a previously developed qualitative framework describing organizational, professional and data-related barriers and promoters to data use.</p> <p>Results</p> <p>Respondents reported more promoters than barriers to using survey data, and particularly support for improvement efforts. Themes included developing patient-centered cultures, quality improvement structures such as regular data review, and training staff in patient-centered behaviors. The influence of incentives, the role of nursing leadership, and triangulating survey data with other data on patients' views also emerged as important. It was easier to collect data on current organization and practice than those in the past and this made it difficult to deduce which factors might influence differing facility performance.</p> <p>Conclusions</p> <p>Interviews with VA staff provided promising examples of how systematic processes for using survey data can be implemented as part of wider quality improvement efforts. However, prospective studies are needed to identify the most effective strategies for using patient feedback to improve specific aspects of patient-centered care.</p

Personality and teamwork behavior in context: The cross-level moderating role of collective efficacy

This research examines whether the relationship between an individual's personality and their behavior within a team is contingent on the team's overall perception of its capability. Individuals were peer-rated on the extent to which they displayed interpersonal and performance management teamwork behaviors over the course of an 8 week business simulation. The personality trait of agreeableness predicted interpersonal teamwork behavior, while the personality traits of conscientiousness and core self-evaluation (CSE) predicted performance management behavior. Multilevel analysis showed that collective efficacy influenced the extent to which an individual engaged in both types of behavior, and was also a cross-level moderator of the relationship between agreeableness and interpersonal behavior and the relationship between CSE and performance management behavior. At the team level, interpersonal behavior mediated between collective efficacy and team performance. The study's results show that in team settings the personality and individual behavior relationship may depend on group level confidence perceptions

Common variations in 4p locus are related to male completed suicide

Suicidal behavior is a multifactorial phenomenon, with a significant genetic predisposition. To assess the contribution of genes in the 4p region to suicide risk, we genotyped 36 single nucleotide polymorphisms from a 49Mb region on the chromosome arm 4p11-16 in a total of 288 male suicide victims and 327 healthy male volunteers. The nonsynonymous variants rs1383180 in EVC gene, rs6811863 in TBC1D1 gene, rs362272 in HTT gene, and rs734312 in WFS1 gene were associated to the male completed suicide. However, only EVC polymorphism remained significant after correcting for multiple comparisons (P < .05 after 10 K permutations). The function of these genes is not clear yet. WFS1 and HTT are related to the unfolded protein response and endoplasmic reticulum stress, and TBC1D1 is a GTPase activator. EVC is a protein with transmembrane and leucine zipper domains, its function has not been elucidated yet. Further studies are required in order to reveal the role of these four polymorphisms in the pathoetiology of suicide

Evaluation of ultrasonic parameters as a non-invasive, rapid and in-field indicator of water stress in Citrus plants

Non-Contact Resonant Ultrasound Spectroscopy (NC-RUS) has emerged as a powerful tool to determine plant water status in a non-destructive, non-invasive and rapid way. In this study, ultrasonic parameters directly obtained from experimental measurements in the field using NC-RUS - such as resonant frequency (fres), velocity (v) and Q-factor - were evaluated as potential water stress indicators in Citrus plants. The experiments were carried out in two-year-old mandarin trees (Citrus clementina Hort. ex Tan. ‘Clemenules’) grown in pots in an open greenhouse where two different groups of plants were tested: a Control group (full irrigation) and a Drought Stress group (DS) whose irrigation was withdrawn during 7 days, followed by a 16 days recovery period. Soil water content, leaf water potential (Ψleaf) and the considered ultrasonic parameters were measured in the same leaves. fres detected changes between control and DS at day 7 without irrigation. Conversely, v showed differences after day 3, which were statistically significant at day 7, enabling discrimination between C and DS groups. Hence, Q-factor was the ultrasonic parameter that showed statistically significant differences between C and DS groups at days 3 and 7. Consequently, Signal Intensity in Q during the drought treatment showed a similar evolution to Ψleaf, although with slightly lower performance. However, Q-factor sensitivity excels Ψleaf at each day studied. Finally, a linear correlation (R2=0.57) between Ψleaf and Q-factor of all experimental data measured in DS group plants along the drought treatment was found. In conclusion, the ultrasonic parameters obtained using NC-RUS and in particular the Q-factor, demonstrated to be potential new water stress indicators in Citrus trees, with the novelty of being non-destructive, non-invasive and rapid. Future work should explore its suitability for its use in irrigation scheduling for Citrus tree