Annelie Khatami and Kristina Rosengren
Purpose - The aim was to describe an improvement project and its effects on decreasing the time from diagnosis to treatment for patients with kidney stones and to reduce the…
Abstract
Purpose
Purpose - The aim was to describe an improvement project and its effects on decreasing the time from diagnosis to treatment for patients with kidney stones and to reduce the negative effects related to untreated stones at one hospital in western Sweden
Design/methodology/approach
Design and methodology - A quantitative descriptive study based on Nolan’s improvement model was used. The quality improvement effects were evaluated using statistical process control (SPC).
Findings
Findings – Extracorporeal shock wave lithotripsy ESWL treatment’s positive effects within 48 hours were described as efficiency (decreased waiting time) from diagnosis to treatment, even if a re-treatment was necessary. The results also showed a reduction in the usage of percutaneous nephropyelostomies as a treatment option.
Research limitations/implications
Research limitations - This study includes data from one department at one hospital in one country. Comparative data include the time from acute radiological examination to final treatment but not total re-treatments, complications or time to up following radiological examination. However, the study was performed over one year and analyzed data from medical records in a systematic way.
Practical implications
Practical implications - This study may inspire measuring and developing routines from diagnosis to treatment for patients who are transferred within different departments at one hospital.
Originality/value
Originality - Studies in improvement projects considering ureteral or kidney stones are generally lacking; thus, this study is important for improving the care of patients with this diagnose.
Annelie Khatami and Kristina Rosengren
– The purpose of this paper is to describe staff experiences in an on-going improvement project regarding patients with ureteral stones.
Abstract
Purpose
The purpose of this paper is to describe staff experiences in an on-going improvement project regarding patients with ureteral stones.
Design/methodology/approach
A qualitative descriptive study based on eight group interviews and 48 narratives, was performed. Data were analysed using qualitative content analysis. Trustworthiness was ensured by using a well-documented improvement process method during six months.
Findings
The results formed three categories: an absent comprehensive view; complexity; and vulnerability within the organisation. A holistic perspective regarding urological care at the micro-, meso- and macro-levels is needed to improve planning and caring processes.
Research limitations/implications
This study includes one team (six members, different health professionals) within the same urology department.
Practical implications
Results show that staff need information, such as guidelines and support throughout the improvement work to deliver high-quality care. Moreover, there is a need for evidence-based guidelines at national level to support improvement work.
Social implications
Healthcare staff need to pay attention to all team member needs to improve urological care. Organisational and managerial aspect are needed to support clear and common goals regarding healthcare improvement work.
Originality/value
Urological improvement projects, generally, are lacking, which is why this study is important to improve nephrolithiasis patient care.