Prava pacijenata jedan su od standarda kvalitete i važan dio zadanih ciljeva politike KBC-a Sestre milosrdnice. Zbog toga se posebna pažnja posvecuje pritužbama pacijenta. U promatranom ...dvanaestomjesecnom razdoblju u Klinickom bolnickom centru Sestre milosrdnice ucestalost propisno zaprimljenih i obradenih pritužbi pacijenata iznosila je 1,08 slucajeva na 10 000 slucajeva lijecenja. Na kvalitetu interakcije s osobljem i komunikaciju odnosilo se 24 % pritužbi, na lijecenje i skrb o pacijentu i medicinsku dokumentaciju 33 % pritužbi, na dostupnost zdravstvene skrbi u bolnici 31 %, infrastrukturu 6,7 % i ispostavljene bolnicke racune 5,3 %. Rješavanje pritužbi i njihovih opravdanih uzroka mora biti prioritetno i ucinkovito. Odgovor na pritužbu treba biti brz i prijateljski. Pritužbu bi zaposlenici i menadžmenti zdravstvenih ustanova trebali usvojiti kao promotora kvalitete, a ne kao disciplinske alate.
The patients and staff safety is one of the healthcare quality standards listed by "The Rules on quality standards and the method of their application". The healthcare care law implies medical ...procedure safety with the main goal avoiding harmful adverse events. That fact obliges establishing system security by reporting, analyzing and preventing medical errors that can often cause unwanted incidents. By monitoring and analyzing the frequency of certain indicators we can obtain useful information on trends and possible ways to prevent such future events. One of the indicators of patient safety in hospital healthcare system is standardized mortality rate which is used in monitoring specific diagnosis. One of them being acute myocardial heart attack. Mortality rate of acute myocardial heart attack depends not only on the clinical process but also on some other factors that can also be present and affect it. According to the Organisation for Economic Co-operation and Development report, mortality rate for the patients with acute myocardial heart attack within 30 days of hospital admission is 10,8%, while in the Sestre milosrdnice University Hospital Center mortality rate in the year of 2015 was only 9 % which is a good outcome indicator for patient safety management in this hospital.
Hospital healthcare service quality measurement represents an important approach for advancing healthcare systems. This paper presents preliminary results of a research on the quality of healthcare ...services provided by a large, public, university hospital centre in Croatia, based on the Gaps Model of Service Quality and the SERVQUAL instrument. The importance of particular service quality dimensions was analyzed, as well as the gaps between patient perceptions and expectations of healthcare services provided by 18 departments of the university hospital centre. Results revealed the gaps that exist at the level of the university hospital centre as a whole, showing the size variations in different service quality dimensions. The management of the university hospital centre should improve healthcare service quality in all dimensions by paying particular attention to the 'responsiveness' and 'tangibility', where the largest gap was identified.
To assess the differences in the way how Slovenian and Croatian health care professionals (HCPs) confront ethical dilemmas and perceive the role of hospital ethics committees (HECs).
This ...cross-sectional, survey-based study involved HCPs from three Slovenian and five Croatian university medical centers (UMC). The final sample sizes were 308 (244 or 79.2% women) for Slovenia and 485 (398 or 82.1% women) for Croatia.
Compared with Croatian physicians, Slovenian physicians reported a higher share of ethical dilemmas regarding waiting periods for diagnostics or treatment, suboptimal working conditions due to interpersonal relationships in the ward, and end-of-life treatment withdrawal, and a lower share regarding access to palliative care and patient information protection. Compared with Croatian nurses, Slovenian nurses reported a lower share of ethical dilemmas regarding the distribution of limited resources, recognizing the patient's best interests, and access to palliative care. Compared with Croatian other HCPs, Slovenian other HCPs reported a lower burden of ethical dilemmas regarding waiting periods for diagnostics or treatment, distribution of limited resources, and access to palliative care. When encountering an ethical dilemma, all HCPs in both countries would first consult their colleagues. Slovenian and Croatian HCPs recognized the importance of the HECs to a similar extent, but viewed their role differently.
Croatian and Slovenian HCPs are confronted with different ethical dilemmas and perceive the role of HECs differently.
Benign, atypical, or malignant chondroid syringoma (mixed tumor of the skin) have almost identical clinical presentation with similar histological features, except for infiltrative growth, and ...perineural and vascular invasion in the malignant type. Tumors with borderline features are described as atypical chondroid syringoma. Immunohistochemical profiles in all three types are similar, with the the main difference in the expression of the p16 stain. We present a case of an atypical chondroid syringoma in an 88-year-old female patient with a subcutaneous, painless nodule in the gluteal region and with diffuse, strong nuclear immunohistochemical staining for p16. To our knowledge, this is the first such reported case.
Hospital healthcare service quality measurement represents an important approach for advancing healthcare systems. This paper presents preliminary results of a research on the quality of healthcare ...services provided by a large, public, university hospital centre in Croatia, based on the Gaps Model of Service Quality and the SERVQUAL instrument. The importance of particular service quality dimensions was analyzed, as well as the gaps between patient perceptions and expectations of healthcare services provided by 18 departments of the university hospital centre. Results revealed the gaps that exist at the level of the university hospital centre as a whole, showing the size variations in different service quality dimensions. The management of the university hospital centre should improve healthcare service quality in all dimensions by paying particular attention to the 'responsiveness' and 'tangibility', where the largest gap was identified. Key words: Service quality, Healthcare; Hospital; SERVQUAL; Transitional country; Developing country; Croatia; Sestre milosrdnice University Hospital Centre Mjerenje kvalitete bolnicke zdravstvene usluge cini vaan pristup unaprjedenju zdravstvenog sustava. U radu se iznose preliminarni rezultati istraivanja o kvaliteti zdravstvenih usluga pruenih u velikom javnom klinickom bolnickom centru u Hrvatskoj, temeljenom na Modelu jazova u kvaliteti usluge, a uz koritenje mjernog instrumenta SERVQUAL. Analizirana je vanost pojedinacnih dimenzija kvalitete usluge, kao i jazovi izmedu percepcija pacijenata i njihovih ocekivanja za zdravstvene usluge pruene u 18 klinika/zavoda. Rezultati pokazuju jazove koji postoje na razini klinickog bolnickog centra kao cjeline te razlike u velicini jazova po dimenzijama kvalitete usluge. Uprava bolnice treba poboljati zdravstvene usluge u svim dimenzijama kvalitete, a osobitu pozornost treba pridati dimenzijama odgovornosti i opipljivosti gdje su pronadeni najveci jazovi. Kljucne rijeci: Kvaliteta usluge; Zdravstvo;Bolnica; SERVQUAL; Tranzicijska zemlja; Zemlja u razvoju; Hrvatska; Klinicki bolnicki centar Sestre milosrdnice
Sigurnost bolesnika je važni čimbenik kvalitete zdravstvenog sustava, koji je i zakonski propisan. U Zakonu o kvaliteti zdravstvene zaštite i socijalne skrbi defi nirana je sigurnost zdravstvenog ...postupka, a u Pravilniku o standardima kvalitete zdravstvene zaštite i načinu njihove primjene navedeni su Pokazatelji sigurnosti (Neočekivani neželjeni događaji i Ostali neželjeni događaji). U Ostale neželjene događaje ubraja se i Stopa standardizirane bolničke smrtnosti. Ona je kvantitativni pokazatelj bolesnikove sigurnosti u bolničkom sustavu zdravstvene zaštite i prati se za smrtnost od akutnog infarkta miokarda, moždanog udara i akutnog pankreatitisa unutar 30 dana od prijama u bolnicu. Opisne liste za indikatore sigurnosti propisala je Agencija za kvalitetu u zdravstvu i socijalnoj skrbi. U KBC Sestre milosrdnice se Stope standardizirane bolničke smrtnosti redovito prate i analiziraju. Rezultati upućuju na primjenu dobre kliničke prakse u KBC Sestre milosrdnice i zadovoljavajuću razinu sigurnosti pacijenata od smrtnosti praćene patologije.
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