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   Table of Contents - Current issue
Coverpage
October-December 2018
Volume 1 | Issue 2
Page Nos. 25-81

Online since Thursday, November 1, 2018

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EDITORIAL  

Research versus quality improvement in healthcare p. 25
Khaled Al-Surimi
DOI:10.4103/JQSH.JQSH_16_18  
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COMMENTARY Top

Lessons to improve quality in oncology practice: Road map to fill the global gaps p. 28
Layth Mula-Hussain, Adele Duimering, Muzahm Al-Khyatt, Khalifa AlKaabi, Wilson Roa, Robert Pearcey
DOI:10.4103/jqsh.JQSH_14_18  
Oncology is a medical branch devoted to the study, diagnosis, treatment, and prevention of cancer. Cancer prevalence is increasing. By 2030, the global cancer burden is expected to grow to 21.7 million new cases and 13 million deaths. Developing as well as developed nations have cancer burden, but there is a gap. Ideally, cancer management involves a multidisciplinary team composed of qualified individuals from different specialties collaborating to optimize the care. This team must follow evidence-based medicine principles, considering three questions: What is the problem? How can we manage it? And why are we selecting this pathway? To fill the gaps in care, we present 10 questions that can help those who are managing patients with cancer globally. We concluded that although there is no “one-size-fits-all” approach, adhering to basic principles can help guide provision of evidence-based patient-centered care and fill some of the gaps in oncology.
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ORIGINAL ARTICLES Top

Involving the family in patient care: A culturally tailored communication model p. 33
Abdul Rahman Jazieh, Susan Volker, Saadi Taher
DOI:10.4103/JQSH.JQSH_3_18  
Background: Family involvement is a critical component of patient‑centered care that impacts the quality of care and patient outcome. Our aim was to develop a patient‑ and family‑based communication model suitable for societies with extended families. Methods: A multidisciplinary team was formed to conduct a situational analysis and review the patterns of family involvement in our patient population. Patient complaints were reviewed also to identify gaps in communication with families. The team proposed a model to facilitate the involvement of the family in the patient's care through the improvement of communication. Results: A communication model was developed keeping the patient in the center of communication but involving the family through identifying the most responsible family member. To assure structured measurable contact, mandatory points of communication were defined. The model streamlines communication with the family but maintaining the patients' rights and autonomy. Conclusion: Our proposed model of communication takes into account the importance of communication with the family in a structured way. The team believes that it is going to be accepted by patients who will be explored in the pilot implementation stage as the next future step
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Implementing a communication model to enhance patient-centered care p. 38
Abdul Rahman Jazieh, Reem Al Sudairy, Mona Al Shami, Abdullah Yaqub, Areej Al Khesaifi, Hasan M Al-Dorzi, Maha Fayad
DOI:10.4103/JQSH.JQSH_15_18  
Background: Family involvement is essential in providing patient-centered care. It is very challenging to adapt into the health-care system. Our project aims at implementing a culturally tailored communication model to systematically involve a family in patient care. Materials and Methods: A multidisciplinary team was established to implement our previously developed communication model. We used rapid plan–do–study–act (PDSA) cycles of improvement to test the set of interventions to incorporate learned lessons into the project activities. The communication model was implemented in stages starting from the emergency department (ED) and expanding to different hospital units. Result: Fifteen PDSA cycles were conducted in the ED, intensive care unit, and inpatient wards. A clear algorithm on how to appoint the most responsible family members was developed and points of communication with the family were identified. Educational materials were developed for patients and families in addition to staff education about the program. There was a strong acceptance of the concept from families and staff, and the process is being implemented into our electronic health records. Conclusion: Our communication model was well accepted by patients, their families, and our staff. The plan is to automate the process for sustainability by making it an integral component of the electronic medical records and to introduce it throughout our system.
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QUALITY IMPROVEMENT IN ACTION Top

Decreasing prolonged waiting times for chemotherapy administration for patients with cancer p. 44
Mervat Mahrous, Emad El Shaer, Lamia Rezik, Samar Taha, Ahmed Yosef
DOI:10.4103/JQSH.JQSH_8_18  
Background: On the basis of our patient satisfaction survey, we initiated a quality improvement project at our institution to decrease waiting times for patients scheduled for chemotherapy. The mean waiting time until a patient started his or her session was 183.5min. Our aim was to reduce the waiting time by 50% (<90min) over a 6-month period and to sustain it. Materials and Methods: We used a multidisciplinary approach to identify the root causes and contributing factors of prolonged waiting times for patients in the chemotherapy unit. We implemented three Plan–Do–Study–Act cycles over a 10-month period (February to December 2016). First, we redesigned the nursing triage process, treatment process, and nursing awareness programs. Second, we improved nursing documentation to ensure accurate tracking of patients who declined their appointment or were overbooked. Third, pharmacy forms and chemotherapy preparation were accomplished with the help of an electronic system. We implemented a department-wide standard of care to provide an early assessment of the patient on arrival, and we activated a specific chemotherapy clinic for patient booking and laboratory tests, which were supervised by a trained qualified oncologist. Results: Median time to chemotherapy administration was reduced by 40% in the first 3 months, 64% in 6 months, and 51% in 18 months. We checked every 2 weeks for sustained action and tracked the time from when the patient checked in until he or she received treatment, guided by electronic pharmacy confirmation. The mean waiting time continued to improve and no complaints were reported during the last 6 months of the post-intervention period. Conclusion: Our project resulted in a 40%–64% reduction in waiting times for patients in the chemotherapy unit over an 18-month period. Our plan is to sustain this improvement by continually monitoring waiting times and addressing any emerging issues.
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ABSTRACTS Top

Conference Proceedings for the International Forum on Quality Cancer Care September 8 and 9, 2018 Keble College Oxford University Oxford, UK p. 49

DOI:10.4103/JQSH.JQSH_00_00  
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REVIEWER ACKNOWLEDGMENTS Top

Reviewer Acknowledgments p. 81

DOI:10.4103/JQSH.JQSH_00_01  
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