Aljuaid Mohammed, Mannan Fahmida, Chaudhry Zain, Rawaf Salman, Majeed Azeem
Department of Primary Care and Public Health, Imperial College London, London, UK Department of Health Administration, King Saud University, Riyadh, Saudi Arabia.
Faculty of Medicine, Imperial College London, London, UK.
BMJ Open. 2016 Feb 25;6(2):e008988. doi: 10.1136/bmjopen-2015-008988.
To identify the key issues, problems, barriers and challenges particularly in relation to the quality of care in university hospitals in the Kingdom of Saudi Arabia (KSA), and to provide recommendations for improvement.
A systematic search was carried out using five electronic databases, for articles published between January 2004 and January 2015. We included studies conducted in university hospitals in KSA that focused on the quality of healthcare. Three independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their relevant characteristics. All studies were assessed using the Institute of Medicine indicators of quality of care.
Of the 1430 references identified in the initial search, eight studies were identified that met the inclusion criteria. The included studies clearly highlight a need to improve the quality of healthcare delivery, specifically in areas of patient safety, clinical effectiveness and patient-centredness, at university hospitals in KSA. Problems with quality of care could be due to failures of leadership, a requirement for better management and a need to establish a culture of safety alongside leadership reform in university hospitals. Lack of instructions given to patients and language communication were key factors impeding optimum delivery of patient-centred care. Decision-makers in KSA university hospitals should consider programmes and assessment tools to reveal problems and issues related to language as a barrier to quality of care.
This review exemplifies the need for further improvement in the quality of healthcare in university hospitals in KSA. Many of the problems identified in this review could be addressed by establishing an independent body in KSA, which could monitor healthcare services and push for improvements in efficiency and quality of care.
确定关键问题、难题、障碍和挑战，特别是与沙特阿拉伯王国（KSA）大学医院护理质量相关的问题，并提供改进建议。
利用五个电子数据库对2004年1月至2015年1月发表的文章进行系统检索。我们纳入了在KSA大学医院进行的、聚焦于医疗保健质量的研究。三位独立评审员核实这些研究符合纳入标准，评估研究质量并提取其相关特征。所有研究均使用医学研究所的护理质量指标进行评估。
在初步检索中识别出的1430篇参考文献中，有八项研究符合纳入标准。纳入的研究明确凸显了KSA大学医院在改善医疗服务质量方面的必要性，特别是在患者安全、临床疗效和以患者为中心等领域。护理质量问题可能归因于领导力的缺失、更好管理的需求以及在大学医院进行领导力改革的同时建立安全文化的必要性。对患者缺乏指导以及语言沟通是阻碍以患者为中心的护理最佳实施的关键因素。KSA大学医院的决策者应考虑采用相关项目和评估工具，以揭示与语言作为护理质量障碍相关的问题。
本综述例证了KSA大学医院医疗保健质量需要进一步改善。本综述中确定的许多问题可通过在KSA设立一个独立机构来解决，该机构可监督医疗服务并推动提高护理效率和质量。
