Improvement in oncology practice performance through voluntary participation in the Quality Oncology Practice Initiative.

PURPOSE: The Quality Oncology Practice Initiative (QOPI) became available to all American Society of Clinical Oncology member physicians in 2006 as a voluntary medical oncology practice-based quality measurement and improvement project. QOPI assesses practice performance for a series of evidence- and consensus-based process measures, relying on practices to complete structured chart reviews and submit data via a secure Web-based portal. METHODS: This analysis focused on the 71 practices that participated in both the March and September 2006 data collections (7,624 charts abstracted in March and 10,240 in September). Among 33 measures common to both collections, five measures were closely correlated, and 28 are included in the final analysis. Composite scores were created for six different domains of care. Statistical significance was tested on both absolute changes and relative changes (relative failure reduction) of quality measures from baseline to follow-up and between the lower quartile and all other quartiles. RESULTS: Practice performance on individual measures varied between 18.8% and 98.6%. Mean overall performance as measured by a composite score increased from 78.7% in March to 82.3% in September (P < .05). Improvement was most marked among practices originally performing in the bottom quartile. Using a composite score, the absolute and relative performance for the bottom quartile improved by 27% and 35%, respectively, statistically superior to that of all others. CONCLUSION: Practices that participated in QOPI demonstrated improved performance in self-reported process measures, with the greatest improvement demonstrated in initially low-performing practices.

Funciones de la enfermera en relacion a la satisfaccion del usuario en el primer nivel de atencion distrito urbano Oruro / sss

La multiplicidad de funciones de la enfermera de area fuera de su rol especifico condiciona a una deficiente calidad en la atencion. Pese a existir el manual de funcionamiento de los servicios de salud, la enfermera no utiliza como guia para el desempeño de sus funciones. La enfermera dispone mas de lamitad de su tiempo entre otras actividades administrativas financiero contable y farmacia, y un tiempo muy reducido que dispone para actividades netamente de enfermeria. La calidad de atencion de enfermeria en los servicios no es integral por que no hay relacion directa entre el paciente y enfermera ya que solo prioriza algunos programas de participacion masiva...

A avaliaçao da aptidao cardiorrespiratória de mulheres praticantes de hidroginástica / The assessment of cardiorespiratory aptitude in women who practice water aerobics

Para avaliar a aptidao física cardiorrespiratória de mulheres que praticam hidroginástica foram estudadas 26 mulheres, sendo 16 alunas de hidroginástica que realizavam duas(n=duas) ou tres(n=2) aulas por semana há, no mínimo, 6 meses, e 10 sedentárias saudáveis(grupo controle). Todas as mulheres foram avaliadas por testes de potência aeróbica, e os resultados nao demonstram diferenças significantes entre o consumo máximo de oxigênio(VO 2max) e o limiar anaeróbico(la) das alunas de hidroginástica em relaçao ao grupo controle, respectivamente, VO 2max(ml/kg/min)34,05+3,27 vs 32,61+4,35 e LA(ml/kg/min)17,78+3,09 VS 16,54+4,53. O gasto energético semanal das aulas de hidroginástica foi determinado de modo indireto pela monitorizaçao dos batimentos cardíacos e foi em média 500,18 kcal, apresentando grande variaçao individual, entre 148 e 383 kcal por semana. Os resultados sugerem que aulas de hidroginástica praticada por mulheres em poucos dias na semana e sem supervisao individualizada nao proporcionam melhora da aptidao física cardiorrespiratória.