História da construção de saberes em enfermagem traumato-ortopédica / History of knowledge construction in trauma and orthopedic nursing care / Historia de la construcción del conocimiento en enfermería traumatológica ortopédica

Objetivo: analisar o desenvolvimento da enfermagem traumato-ortopédica a partir da primeira turma de residentes de um hospital especializado. Método: o estudo seguiu a metodologia histórica com abordagem qualitativa. As fontes foram documentos escritos e orais. Resultados: trabalhar em uma instituição especializada foi o ponto de partida para a busca por especialização de enfermeiras atuantes no cuidado traumato-ortopédico, que perceberam o saber/poder adquirido no trabalho assistencial, além da intenção de qualificar a assistência e elevar o hospital a instituto. Estratégias empregadas reúnem a busca por parcerias com instituições universitárias e associativas, além da criação de uma associação própria. Considerações finais: a enfermagem traumato-ortopédica ampliou seu espaço científico ao criar um curso de especialização com uma unidade acadêmica. Foi possível delimitar o poder acadêmico e institucional da enfermagem na instituição de saúde pela formação de enfermeiras especialistas constituindo um grupo de reconhecido pelo saber científico.

Objective: to analyze the development of trauma and orthopedic nursing care from the very first class of residents of a specialized hospital. Method: historical methodology study with a qualitative approach. The sources consisted of written and oral documents. Results: working in a specialized institution was the starting point for nurses who were seeking specialization in the field of trauma and orthopedic care as they noticed the power-knowledge acquired through care work, plus they were willing to improve assistance and take the hospital up to an institute level. Strategies used include the search for partnerships with universities and associative-type institutions, in addition to creating their own association. Final considerations: trauma and orthopedic nursing care expanded its scientific space by creating a specialization course together with an academic unit. It was possible to define the academic and institutional power of the nursing staff in the health institution by considering the training process of its nurse specialists, who consisted of a group recognized for their scientific knowledge.

Objetivo: analizar el desarrollo de la enfermería traumatológica ortopédica a partir del primer grupo de residentes de un hospital especializado. Método: estudio con metodología histórica con un enfoque cualitativo. Las fuentes fueron documentos escritos y orales. Resultados: el trabajo en una institución especializada fue el punto de partida para la búsqueda de la especialización de las enfermeras que trabajaban en la atención traumatológica ortopédica, quienes notaron el saber/poder adquirido en el trabajo asistencial, además de la intención de cualificar la atención y elevar el hospital al nivel de instituto. Las estrategias empleadas incluyen la búsqueda de alianzas con instituciones universitarias y asociaciones, y la creación de una asociación propia. Consideraciones finales: la enfermería traumatológica ortopédica amplió su espacio científico mediante la creación de un curso de especialización con una unidad académica. Se logró delimitar el poder académico e institucional de la enfermería en la institución de salud a través de la formación de enfermeros especialistas, que es un grupo reconocido por el conocimiento científico.

Upgrading of Quality Control for Herbal Medicine Use in South Korea by Introducing an Accreditation System: a brief report.

Objectives: This study aimed to present a government-led accreditation system for upgrading the quality control of herbal medicine by introducing the process and evaluation standard of external herbal dispensaries (EHDs) of traditional Korean medicine (TKM) clinics in South Korea 2018 to refer to other countries where herbal medicine were used similarly in Korea. Development Process: We organized an EHD accreditation committee for the establishment of an accreditation system. The committee consisted of 9 experts an official of the Ministry of Health and Welfare (MoHW), a professor expert of TKM, a good manufacturing practice expert, a hazard analysis and critical control point expert, and an accreditation system expert. After 3 meetings, a draft of the evaluation standard and evaluation system was established in 2017. Based on the draft, a pilot test was conducted to determine the applicability of the evaluation standards in 2017. Two additional meeting was held to confirm the accreditation standards and was finalized in 2018. Results: The evaluation standard for EHDs was developed. In the case of herbal medicine EHDs, the evaluation standard consisted of 9 evaluation categories, 25 evaluation parts, and 81 evaluation items were developed. The results of the evaluation of the pilot tests are as follows, and the results show that there is a deviation between the EHDs. Conclusion: As a world's first, Korea MoHW successfully launched the accreditation system for upgrading the quality control system of herbal medicine not approved by Korea's Ministry of Food and Drug Safety in 2018. Our report hope to provide a good reference to other countries where having similar herbal medicine system in South Korea hoping to make better quality control of herbal medicines.

Telestroke Training: Considerations for Expansion of Vascular Neurology Program Requirements.

Telemedicine for stroke (Telestroke) has been a key component to efficient, widespread acute stroke care for many years. The expansion of reimbursement through the Furthering Access to Stroke Telemedicine Act and rapid deployment of telemedicine resources during the COVID-19 public health emergency have further expanded remote care, with practitioners of varying educational backgrounds, and experience providing acute stroke care via telemedicine (Telestroke). Some Telestroke practitioners have not had fellowship-level vascular neurology training and many are without training specific to virtual modalities. While many vascular neurology fellowship programs incorporate Telestroke training into the curriculum, components of this curriculum are not consistent, extent of involvement is variable, and not all fellows receive hands-on training in remote care. Furthermore, the extent of training and evaluation of Telestroke in American Board of Psychiatry and Neurology training requirements and Accreditation Council for Graduate Medical Education assessments for vascular neurology fellowship are not standardized. We suggest that Telestroke be formally incorporated into vascular neurology fellowship curricula and provide considerations for key components of this training and metrics for evaluation.

Cairo Consensus on Accreditation as the Basis for Future-Proofing the ART Laboratory.

An international consensus meeting was convened to discuss globally applicable strategies for 'future-proofing' ART laboratories. The central theme was how the application of the foundational principles of laboratory accreditation enables any centre to create an ethos and framework that will support future-proofing in all regards. Discussions focussed on ART laboratory services from egg retrieval and semen specimen receipt to embryo transfer, as well as pertinent cryobanking activities. Issues related to whether ART treatment should be considered an essential service, overall clinic operations, general patient care, and the provision of clinical treatment, were not included as they fall under the purview of physicians and public health authorities. This report details the 16 core consensus points reached, which are supported by extensive practical recommendations that cover the gamut of ART laboratory operations.

Teaching Hospital Governance Model for Service Quality Performance: Case Study of Indonesian Central General Hospital.

This study aims to investigate the effect of teaching hospital management practices on the quality performance of health services by involving elements such as hospital accreditation standards, quality management, and JCI Academic Hospital-specific standards that are indirectly connected. This study chose a survey-based quantitative approach to clinical professional students in vertical teaching hospitals under the direct management of the Ministry of Health of the Republic of Indonesia. Six proposed hypotheses were tested by Partial Least Square-Structural Equation Modeling (PLS-SEM) analysis. The test results showed a positive influence between hospital teaching governance and hospital accreditation compliance, quality assurance and JCI Academic Hospital standards. Third, compliance with teaching hospital standards was also found to have a significant positive effect on the performance of teaching hospital service quality. Understanding the role of governance in encouraging the performance of teaching hospital service quality can help develop effective managerial strategies in achieving complete service quality for patients and clinical profession participants. This research resulted in contributions to existing practices and literature as governance modeling in dual quality standards charged to teaching hospitals.

[Implementation of edoxaban anti-Xa activity assay in a hospital laboratory and evaluation of its analytical performance]. / Mise en place du dosage de l'activité anti-Xa de l'edoxaban dans un laboratoire hospitalier et évaluation de ses performances analytiques.

Edoxaban is a direct oral anticoagulant available in Europe but not in France. Given the high tourist traffic in France, understanding the pharmacology of edoxaban and the availability of its laboratory testing seemed crucial in emergency situations. The aim of this work was to describe the methodology for measuring the anti-Xa activity of edoxaban, highlighting pre-analytical and analytical aspects, along with essential clinico-biological data for therapeutic guidance. The analysis was performed using the chromogenic method on the STAR-Max analyzer, with the STA®-Liquid ANTI-Xa kit (Diagnostica Stago®). Anti-Xa Edoxaban level measurement has a detection limit of 15 ng/mL, a quantification limit of 20 ng/mL and a linearity limit of 400 ng/mL. Repeatability, intermediate precision, accuracy, and measurement uncertainty studies were conducted to assess method performance, meeting quality requirements. The comparison between two STAR-Max® analyzers showed excellent results with linear regression and a low bias with good precision and no loss of dispersion regardless of edoxaban levels. In conclusion, although the measurement of edoxaban level may be rarely necessary in clinical practice, its implementation is straightforward. The availability of edoxaban in neighboring countries, underscores the importance of having its measurement available in hospital laboratories.

Hospital employees' perception of Joint Commission International Accreditation: effect of re-accreditation.

Joint Commission International (JCI) accreditation is a recognized leader in healthcare accreditation worldwide. It aims to improve quality of care, patient safety, and organizational performance. Many hospitals do not apply for re-accreditation after JCI status expires. Understanding employees' perceptions of JCI accreditation would benefit hospital management. We aimed to examine whether re-accredited hospital employees perceived more significant benefits and were more likely to recommend JCI to other hospitals than ex-accredited employees. This is a prospective cross-sectional study with a comparison group design. Survey questionnaires, developed from a qualitative study, included perceptions of challenges, benefits, and overall rating of JCI accreditation. An electronic-based questionnaire was distributed to physicians, nurses, medical technicians, and administrative staff in five private Obstetrics and Gynecology hospitals in China, March-April 2023. Descriptive and linear regression analyses were performed. The statistically significant level is P-value <.05. Of 2326 employees, 1854 (79.7%) were included in the study after exclusions, 1195 were re-accredited, and 659 were ex-accredited. Perceptions of JCI accreditation were positive, as both groups reported a mean score >4.0 regarding the overall benefits. Adjusted for covariates, re-accredited employees were more willing to recommend JCI accreditation to other hospitals than ex-accredited employees. Re-accredited employees perceived greater benefits of JCI accreditation and were more willing to recommend it to other hospitals, suggesting that perceived benefits contribute to a desire to maintain and sustain JCI accreditation. Employee participation is vital for its effective implementation. Employees' perceived challenges and benefits may provide insights for healthcare leaders considering pursuing and reapplying for JCI accreditation.

The foundation for the microbiology laboratory's essential role in diagnostic stewardship: an ASM Laboratory Practices Subcommittee report.

Diagnostic stewardship (DxS) has gained traction in recent years as a cross-disciplinary method to improve the quality of patient care while appropriately managing resources within the healthcare system. Clinical microbiology laboratorians have been highly engaged in DxS efforts to guide best practices with conventional microbiology tests and more recently with molecular infectious disease diagnostics. Laboratories can experience resistance to their role in DxS, especially when the clinical benefits, motivations for interventions, and underlying regulatory requirements are not clearly conveyed to stakeholders. Clinical laboratories must not only ensure ethical practices but also meet obligatory requirements to steward tests responsibly. In this review, we aim to support clinical microbiology laboratorians by providing the background and resources that demonstrate the laboratory's essential role in DxS. The heart of this review is to collate regulatory and accreditation requirements that, in essence, mandate DxS practices as a long-standing, core element of high-quality laboratory testing to deliver the best possible patient care. While examples of the clinical impact of DxS are plentiful in the literature, here, we focus on the operational and regulatory justification for the laboratory's role in stewardship activities.

Nursing perception towards the impact of JCI accreditation on the quality of care in a university hospital in Palestine: a cross-sectional study.

BACKGROUND: This study investigates nursing staff perceptions regarding the impact of Joint Commission International (JCI) accreditation on the quality of care within a university hospital in Palestine. The research specifically examines how the accreditation process influences nursing practices, patient results, and overall healthcare quality in a challenging environment marked by unique operational and external pressures. METHODS: The study was conducted at An-Najah National University Hospital (NNUH), a university hospital in Palestine, using a cross-sectional survey design. The structured questionnaire employed in the study was based on the Donabedian model, which evaluates the process and outcome dimensions of healthcare quality influenced by JCI accreditation. The questionnaire consisted of 47 items, divided into ten main subsections. These subsections included participants' demographical information (6 items), quality measurement and analysis (4 items), leadership, commitment and support (4 items), use of data (4 items), strategic quality planning (4 items), human resources education and training (4 items), quality management (4 items), quality results (4 items), staff involvement (5 items), and benefits of accreditation (8 items). The questionnaire was rigorously designed to assess both the quality processes and quality results. The eight subscales evaluated various aspects, such as leadership commitment, strategic planning, and staff involvement. To ensure reliability, the internal consistency of the survey was confirmed with a high Cronbach's alpha score, demonstrating the tool's robustness and reliability in capturing the intended data. RESULTS: The study of 180 nurses overwhelmingly supported the positive impact of JCI accreditation on hospital quality improvement processes. More than 90% of respondents acknowledged the role of accreditation in improving resource utilization, meeting population needs, and promoting professional standards and values ​​among staff. Statistical analyses, including Pearson correlation and stepwise regression, highlighted strong positive associations between quality process variables and quality results. In particular, leadership commitment, strategic planning, and staff engagement were found to be significant predictors of improved quality results. CONCLUSIONS: This study's findings demonstrate that JCI accreditation significantly positively impacts nurses' perceptions of care quality at NNUH. The study underscores the importance of international accreditation in driving quality improvements in healthcare, particularly in settings with unique challenges such as those faced in Palestine. These insights are crucial for policymakers and healthcare administrators aiming to enhance care standards through accreditation in similar environments.

The European Society of Cardiology quality indicators in atrial fibrillation in centers of excellence in Spain: the SEC-EXCELLENCE in AF registry.

INTRODUCTION AND OBJECTIVES: By 2022, 9 centers had been accredited by the Spanish Society of Cardiology for the atrial fibrillation (AF) process. Our objective was to evaluate the performance of these centers based on the quality indicators (QIs) proposed by the European Society of Cardiology (ESC) in 2020. METHODS: Adults with AF who were attended in the cardiology departments of participating centers during the second week of May 2019 were included in a retrospective registry (n = 797, age 72 ± 11 years, 60% male). Key ESC QIs were assessed. RESULTS: CHA2DS2-VASc, HAS-BLED scores, and serum creatinine levels were documented in 24.9%, 6.1%, and 96.2% of patients, respectively. Anticoagulation was appropriately prescribed in 90.6% of high-risk patients according to the CHA2DS2-VASc score, but was inappropriately prescribed in 57.8% of low-risk patients. Among all patients, 84.1% received high-quality anticoagulation. Inappropriate antiarrhythmic drugs were prescribed in 7.2% of patients with permanent AF, 2.9% of those with structural heart disease, and 0.0% of those with end-stage kidney disease. Catheter ablation was offered to 70% of patients with symptomatic paroxysmal or persistent AF after the failure or intolerance of 1 antiarrhythmic drug. All modifiable risk factors were documented in 59.3% of patients. Rates of all-cause mortality, ischemic stroke or transient ischemic attack, and major bleeding were 8.1, 0.8, and 2.56 per 100 patients/y, respectively. QIs for anticoagulation and outcomes were similar between general cardiology and tertiary referral centers. CONCLUSIONS: Although accredited centers in Spain demonstrated good performance in many of the ESC QIs for AF, there remains room for improvement. These data could serve as a starting point for enhancing the quality of care in this population.

Disease-related data patterns in cerebrospinal fluid diagnostics: medical quality versus analytical quantity.

Cerebrospinal fluid (CSF) diagnostics is characterized by the biologically relevant combination of analytes in order to obtain disease-related data patterns that enable medically relevant interpretations. The necessary change in knowledge bases such as barrier function as a diffusion/CSF flow model and immunological networks of B-cell clones and pleiotropic cytokines is considered. The biophysical and biological principles for data combination are demonstrated using examples from neuroimmunological and dementia diagnostics. In contrast to current developments in clinical chemistry and laboratory medicine, CSF diagnostics is moving away from mega-automated systems with a constantly growing number of individual analyses toward a CSF report that integrates all patient data. Medical training in data sample interpretation in the inter-laboratory test systems ("EQA schemes") has become increasingly important. However, the results for CSF diagnostics (EQAS from INSTAND) indicate a crucially misguided trend. The separate analysis of CSF and serum in different, non-matched assays and extreme batch variations systematically lead to misinterpretations, which are the responsibility of the test providers. The questionable role of expensive accreditation procedures and the associated false quality expectations are discussed. New concepts that reintegrate the medical expertise of the clinical chemist must be emphasized along with the positive side effect of reducing costs in the healthcare system.

Ultrasound Administration and Reimbursement.

One cannot successfully employ point-of-care ultrasound (POCUS) without a process to provide support and guidance. POCUS administration is a multifaceted topic that demands the utmost attention from those responsible for program implementation and long-term execution. This article delves into POCUS administration and is meant to serve as a guide for the practitioner seeking to start, maintain, or augment their POCUS program.

Conception of a Recognized Accreditation for a Senior-Friendly Hospital: The Accreditation "Hospital Attentive to the Elder".

OBJECTIVES: Consideration of the need to strengthen the commitment of professionals to the good care of the older population in hospitals has been emerging over the last several years. The steering committee of the geriatric sector of the hospitals of our Hospital Consortium (HC) has structured an accreditation project to promote the commitment of professionals to the good care of older adult patients in hospitals: the "Hospital Attentive to the Elder" (HAE) accreditation. This global approach aims to better adapt care to the needs of this population in the hospital and promote positive values (eg, kindness, attentive support). DESIGN: The creation of the HAE accreditation required the creation of an accreditation board, a referential framework, and an accreditation procedure. SETTING AND PARTICIPANTS: The whole process was coordinated by the accreditation board, a multidisciplinary entity, representative of the hospitals of our HC. METHODS: The 5-step approach of the accreditation procedure includes a commitment to the HAE, with the support of the institutional board, and an internal self-assessment phase to guide the creation of action plans, followed by an accreditation cross-evaluation visit. The HAE accreditation is awarded to departments that meet the described criteria. This accreditation process was initially initiated by our HC. RESULTS: In June 2021, 6 of 10 hospitals of our HC and 11 departments, which mobilized 28 medical, paramedical, and quality referents, initiated the process. All 11 departments fulfilled the criteria for the accreditation, and a ceremony to hand out the certificates was organized in December 2023. CONCLUSIONS AND IMPLICATIONS: We envisage that this accreditation process could be offered at the regional and national level to any hospital or group of hospitals with departments that receive patients aged >75 years, regardless of their specialty.

Risk-Based Qualification of Cellular Starting Material Collection Sites: Tools to Determine Scope of Manufacturer Audits and Reduce Duplicative Efforts.

Cellular and Gene Therapy product (CGT product) manufacturers are required by regulations to qualify sites performing cell collection and processing as part of their manufacturing processes. The use of audits to qualify a site is part of the traditional supplier quality models for drug products. Due to the rapid growth of the CGT industry in recent years, healthcare institutions and manufacturers are finding it difficult to manage the increasing workload and resources needed to support audits when they are applied to the provision of Cellular Starting Material (CSM) collection from patients/subjects for the purpose of manufacturing. To alleviate this audit burden, several manufacturers have applied risk-based approaches to determine the needs and scope of audits. The authors of this commentary recommend that all manufacturers utilize a risk-based assessment program when appropriate and explain the use of tools created to facilitate a risk-based approach to streamline and reduce duplicative audits. This approach and tools, created by The NextGen Industry Working Group (IWG) site certification workstream with representation from pharmaceutical and biotech companies, health care institutions, accrediting organizations, and other stakeholders, is aligned with proposals from other multistakeholder groups, including the ASTCT 80/20 Task Force. The tools aim to streamline the site qualification processes performed by each manufacturer, offering a standardized approach to audits or gap analysis assessments. Offering an abbreviated audit model for sites that have already attained accreditation through agencies such as the AABB (Association for the Advancement of Blood & Biotherapies) and FACT (Foundation for the Accreditation of Cellular Therapy), helping the manufacturer to focus on product-specific requirements rather than re-evaluating systems that have already been audited in great detail by other parties.

Clinical effects of accreditation in general practice: a pragmatic randomized controlled study.

BACKGROUND: Accreditation has been implemented in general practice in many countries as a tool for quality improvement. Evidence of the effects of accreditation is, however, lacking. AIM: To investigate the clinical effects of accreditation in general practice. DESIGN AND SETTING: A mandatory national accreditation programme in Danish general practice was rolled out from 2016 to 2018. General practices were randomized to year of accreditation at the municipality level. METHODS: We conducted a pragmatic randomized controlled study with general practices randomized to accreditation in 2016 (intervention group) and 2018 (control group). Data on patients enlisted with these practices were collected at baseline in 2014 (before randomization) and at follow-up in 2017. We use linear and logistic regression models to compare differences in changes in outcomes from baseline to follow-up between the intervention and control groups. The primary outcome was the number of redeemed medications. Secondary outcomes were polypharmacy, nonsteroidal anti-inflammatory drugs (NSAIDs) without proton pump inhibitors, sleeping medicine, preventive home visits, annual controls, spirometry tests, and mortality. RESULTS: We found statistically significant effects of accreditation on the primary outcome, the number of redeemed medications, and the secondary outcome, polypharmacy. No other effects were detected. CONCLUSION: In this first randomized study exploring the effects of accreditation in a primary care context, accreditation was found to reduce the number of redeemed medications and polypharmacy. We conclude that accreditation can be effective in changing behaviour, but the identified effects are small and limited to certain outcomes. Evaluations on the cost-effectiveness of accreditation are therefore warranted.

Educational research on medical residency programs in Chile: a scoping review and analysis of the impact of the new accreditation policy.

BACKGROUND: Accrediting medical specialties programs are expected to influence and standardize training program quality, align curriculum with population needs, and improve learning environments. Despite global agreement on its necessity, methods vary widely. In the Chilean context, a recent new accreditation criteria includes research productivity in relation to educational research on resident programs, so we aimed to define it. What is the profile of publications in educational research produced by Chilean medical specialty residency programs in the last five years? Based on these results, we intend to analyze the potential impact of the new accreditation policy on medical specialty programs in Chile. METHODS: We performed a preliminary bibliometric search to identify the use of the term "resident" in literature. After that, we conducted a literature search, using a six-step approach to scoping reviews, including the appraisal of the methodological quality of the articles. RESULTS: Between 2019 and 2023, an average of 6.2 articles were published yearly (19%). The bibliometric analysis revealed that the dominant thematic area of the journals was clinical, accounting for 78.1%. Most articles focused on residents (84.38%), with only two articles including graduates as participants. One university was responsible for 62.50% of the articles and participated in all multicenter studies (9.38%). Surgical specialties produced 15 research articles focused on procedural training using simulation. Psychiatry was the second most productive specialty, with 5 articles (15.63%) covering standardized patients, well-being, and mental health assessment. The most frequent research focus within residency programs over the five-year period was teaching and learning methodologies, with 19 articles representing almost 60% of the total analyzed. CONCLUSIONS: Research on medical education in Chile's postgraduate residency programs is limited, with most studies concentrated in a few universities. The new accreditation criteria emphasize educational research, posing challenges for many institutions to meet higher standards. Understanding unexplored areas in educational research and learning from successful programs can enhance research productivity and align efforts with accreditation expectations. Continuous evaluation and new research on residents' satisfaction, skills acquisition, and well-being are needed to ensure training quality and accountability.

Effectiveness of chest pain center accreditation on the hospital outcome of acute aortic dissection: a nationwide study in China.

BACKGROUND: The National Chest Pain Center Program (NCPCP) is a nationwide, quality enhancement program aimed at raising the standard of care for patients experiencing acute chest pain in China. The benefits of chest pain center (CPC) accreditation on acute coronary syndrome have been demonstrated. However, there is no evidence to indicate whether CPC accreditation improves outcomes for patients with acute aortic dissection (AAD). METHODS: We conducted a retrospective observational study of patients with AAD from 1671 hospitals in China, using data from the NCPCP spanning the period from January 1, 2016 to December 31, 2022. The patients were divided into 2 groups: pre-accreditation and post-accreditation admissions. The outcomes examined included in-hospital mortality, misdiagnosis, and Stanford type A AAD surgery. Multivariate logistic regression was employed to explore the relationship between CPC accreditation and in-hospital outcomes. Furthermore, we stratified the hospitals based on their geographical location (Eastern/Central/Western regions) or administrative status (provincial/non-provincial capital areas) to assess the impact of CPC accreditation on AAD patients across various regions. RESULTS: The analysis encompassed a total of 40,848 patients diagnosed with AAD. The post-accreditation group exhibited significantly lower rates of in-hospital mortality and misdiagnosis (12.1% vs. 16.3%, P < 0.001 and 2.9% vs. 5.4%, P < 0.001, respectively) as well as a notably higher rate of Stanford type A AAD surgery (61.1% vs. 42.1%, P < 0.001) compared with the pre-accreditation group. After adjusting for potential covariates, CPC accreditation was associated with substantially reduced risks of in-hospital mortality (adjusted OR 0.644, 95% CI 0.599-0.693) and misdiagnosis (adjusted OR 0.554, 95% CI 0.493-0.624), along with an increase in the proportion of patients undergoing Stanford type A AAD surgery (adjusted OR 1.973, 95% CI 1.797-2.165). Following CPC accreditation, there were significant reductions in in-hospital mortality across various regions, particularly in Western regions (from 21.5 to 14.1%). Moreover, CPC accreditation demonstrated a more pronounced impact on in-hospital mortality in non-provincial cities compared to provincial cities (adjusted OR 0.607 vs. 0.713). CONCLUSION: CPC accreditation is correlated with improved management and in-hospital outcomes for patients with AAD.

Quality criteria and certification for paediatric oncology centres: an international cross-sectional survey.

Quality criteria and certification possibilities for paediatric oncology centres vary between countries and are not widely used. An overview of the type and how quality criteria and certifications are used in countries with highly developed healthcare systems is missing. This international cross-sectional survey investigated the use of quality criteria for paediatric oncology centres and whether certification is possible. We sent an online survey to paediatric oncologists from 32 countries worldwide and analysed the survey results and provided regional or national documents on quality criteria and certification possibilities descriptively. Paediatric oncologists from 28 (88%) countries replied. In most countries, the paediatric oncology centres were partly or completely grown historically (75%), followed by the development based on predefined criteria (29%), and due to political reason (25%), with more than one reason in some countries. Quality criteria are available in 20 countries (71%). We newly identified or specified five quality criteria, in addition to those from a previously performed systematic review. Certification of paediatric oncology centres is possible in 13 countries (46%), with a specific certification for paediatric oncology in seven, and a mandatory certification in three of them. The use of quality criteria and certification possibilities are heterogeneous, with quality criteria being more frequently used than certifications. Our study provides an overview of country-specific documents and links with quality criteria, and centre certification possibilities. It can serve as a reference document for stakeholders and may inform an international harmonization of quality criteria and centre certification between countries with similar healthcare systems.

AAPM Task Group Report 325: MRI static magnetic field homogeneity measurement and evaluation procedures - Guidance and resources.

Measurement of static magnetic field (B0) homogeneity is an essential component of routine MRI system evaluation. This report summarizes the work of AAPM Task Group (TG) 325 on vendor-specific methods of B0 homogeneity measurement and evaluation. TG 325 was charged with producing a set of detailed, step-by-step instructions to implement B0 homogeneity measurement methods discussed in the American College of Radiology (ACR) MRI Quality Control Manual using specific makes and models of MRI scanners. The TG produced such instructions for as many approaches as was relevant and practical on six currently available vendor platforms including details of software/tools, settings, phantoms, and other experimental details needed for a reproducible protocol. Because edits to these instructions may need to be made as vendors enter and exit the market and change available tools, interfaces, and access levels over time, the step-by-step instructions are published as a living document on the AAPM website. This summary document provides an introduction to B0 homogeneity testing in MRI and several of the common methods for its measurement and evaluation. A living document on the AAPM website provides vendor-specific step-by-step instructions for performing these tests to facilitate accurate and reproducible B0 homogeneity evaluation on a routine basis.

A Snapshot of Introductory Pharmacy Practice Experience Program Characteristics.

OBJECTIVE: To provide schools and colleges of pharmacy a snapshot of Introductory Pharmacy Practice Experience (IPPE) program characteristics to generate and share ideas for IPPE program modifications to improve student learning outcomes and comply with Standards 2025. METHODS: A 41-item electronic survey was distributed to 140 Accreditation Council for Pharmacy Education fully accredited schools and colleges of pharmacy in 2023. IPPE program characteristics such as structure, learning activities, assessments, and requirements were described. RESULTS: Eighty-seven programs participated in the survey (62.1% response rate). Notable findings included 64.4% of programs starting IPPEs during the first professional year, 78.6% did not count simulation hours toward Accreditation Council for Pharmacy Education hour requirements, 24.1% incorporated patient care electives, over 90% incorporated various patient care activities, 40.2% exceeded a 2:1 student-to-preceptor ratio, 15.7% incorporated layered learning, 50.0% incorporated interprofessional education, 57.5% used summative assessment rubrics based on Entrustable Professional Activities, and 77.0% used pass/fail grading. CONCLUSION: Owing to evolving accreditation standards, the study provided valuable information about the current state of IPPEs. The study results included examples and components that programs can use to ensure that they comply with Standards 2025.