Differentiating between hospitals according to the “maturity” of quality improvement systems: a new classification scheme in a sample of European hospitals

Aim: This study, part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) research project focusing on cross-border patients in Europe, investigated quality policies and improvement in healthcare systems across the European Union (EU). The aim was to develop a classification scheme for the level of quality improvement (maturity) in EU hospitals, in order to evaluate hospitals according to the maturity of their quality improvement activities. Methods: A web-based questionnaire survey designed to measure quality improvement in EU hospitals was used as the basis for the classification scheme. Items included for the development of an evaluation tool-the maturity index-were considered important contributors to quality improvement. The four-stage quality cycle (plan, do, check and act) was used to determine the level of maturity of the various items. Psychometric properties of the classification scheme were assessed, and validation analyses were performed. Results: A total of 389 hospitals participated in a questionnaire survey; response rates varied by country. For a final sample of 349 hospitals, it was possible to construct a quality improvement maturity index which consisted of seven domains and 113 items. The results of independent analyses sustained the validity of the index, which was useful in differentiating between hospitals in the research sample according to the maturity of their quality improvement system (defined as the total of all quality improvement activities). Discussion: Further research is recommended to develop an instrument which for use in the future as a practical tool to evaluate the maturity of hospital quality improvement systems

Application of quality improvement strategies in 389 European hospitals: results of the MARQuIS project

Context: This study was part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) research project investigating the impact of quality improvement strategies on hospital care in various countries of the European Union (EU), in relation to specific needs of cross-border patients. Aim: This paper describes how EU hospitals have applied seven quality improvement strategies previously defined by the MARQuIS study: organisational quality management programmes; systems for obtaining patients' views; patient safety systems; audit and internal assessment of clinical standards; clinical and practice guidelines; performance indicators; and external assessment. Methods: A web-based questionnaire was used to survey acute care hospitals in eight EU countries. The reported findings were later validated via on-site survey and site visits in a sample of the participating hospitals. Data collection took place from April to August 2006. Results: 389 hospitals participated in the survey; response rates varied per country. All seven quality improvement strategies were widely used in European countries. Activities related to external assessment were the most broadly applied across Europe, and activities related to patient involvement were the least widely implemented. No one country implemented all quality strategies at all hospitals. There were no differences between participating hospitals in western and eastern European countries regarding the application of quality improvement strategies. Conclusions: Implementation varied per country and per quality improvement strategy, leaving considerable scope for progress in quality improvements. The results may contribute to benchmarking activities in European countries, and point to further areas of research to explore the relationship between the application of quality improvement strategies and actual hospital performanc

Symplectic connections and Fedosov's quantization on supermanifolds

A (biased and incomplete) review of the status of the theory of symplectic connections on supermanifolds is presented. Also, some comments regarding Fedosov's technique of quantization are made.Comment: Submitted to J. of Phys. Conf. Se

Nuevos datos geocronológicos 40Ar-39Ar en dos puntos singulares del macizo de Anaga (Tenerife): Punta Poyata e Igueste de San Andrés. Consecuencias de interés

En este trabajo se aportan nuevos datos geocronológicos Ar40-Ar39 en rocas ancaramíticas submarinas localizadas en dos puntos singulares del macizo de Anaga (NE de Tenerife): las ancaramitas submarinas hidrotermalizadas de Punta Poyata (NNW de Anaga) y las lavas submarinas ancaramíticas del Barranco de Igueste (SE de Anaga). Las muestras estudiadas pertenecen a afloramientos pertenecientes a los niveles estratigráficos más inferiores de la secuencia volcánica que conforma el edificio de Anaga. En Punta Poyata se tomaron dos especímenes que dieron edades de 12,2 ± 1,9 Ma and 13,0 ± 1,0 Ma. En el barranco de Igueste los resultados geocronológicos de las muestras tomadas dieron edades de 12,7 ± 1,6 Ma and 9,7 ± 1,0 Ma. Estos datos sugieren que el macizo de Anaga comenzó su desarrollo subaéreo antes de lo que anteriormente se creía, ajustándose dicho período inicial al Mioceno Medio en lugar de al Mioceno tardío como previamente se asumía.This work provides new Ar40-Ar39 geochronological data in submarine ankaramite rocks located in two distant points of Anaga (NE Tenerife): the submarine hydrothermally altered ankaramites of Punta Poyata area (NNW Anaga) and the ankaramitic pillow lavas at Barranco de Igueste (SE Anaga). The studied samples were collected from outcrops of the lowest stratigraphic levels throughout the volcanics that build up the Anaga massif. At Punta Poyata, two collected samples yielded an age of 12,2 ± 1,9 Ma and 13,0 ± 1,0 Ma. At Barranco de Igueste, sample results are of 12,7 ± 1,6 Ma and 9,7 ± 1,0 Ma. These data support the assumption that the Anaga massif began its subaerial growth earlier than that previously was supposed, most likely in the Mid-Miocene Instead of late Miocene as currently believed.Depto. de Geodinámica, Estratigrafía y PaleontologíaFac. de Ciencias GeológicasTRUEpu