https://www.um.edu.mt/library/oar/handle/123456789/689 2026-10-08T15:31:03Z 2026-10-08T15:31:03Z https://www.um.edu.mt/library/oar/handle/123456789/149795 2026-10-07T09:57:50Z 2026-01-01T00:00:00Z

Title: Assessing the quality of healthcare practice : a risk-based approach Abstract: Background: This research article explores a novel framework for assessing the Quality of Healthcare based on principles of Clinical Risk Management, including the development of a theoretical construct for the quality of healthcare services based on stakeholder needs, and a conceptual model for managing risks at an institutional level. Methodology: The study consisted of a cross-sectional secondary assessment of healthcare service and system-level indicators, guided by a structured decision tree based on face, construct, content, and criterion validity. Established performance measures identified from international benchmarking and institutional quality improvement frameworks were classified and validated for assessment of clinical risks according to indicator type. Results: A total of 233 performance indicators were evaluated, of which 200 (86%) consisted of measures for assessing failures in clinical practice. According to the proposed framework, (30%) and (14%) of indicators met the criteria for assessing risks associated with clinical processes and organizational systems design respectively. Conclusion: More targeted use of indicators is required in order to achieve a greater degree of accuracy and actionability of performance assessment measures in healthcare practice. The proposed framework offers an applied method to enhance the specificity of quality indicators and direct efforts to improve systems design and decision-making capability.

2026-01-01T00:00:00Z Abed, Nida Pérez-Esteve, Clara Knežević-Krajina, Hana Buttigieg, Sandra C. Tella, Susanna Srulovici, Einav Sousa, Paulo Jorge Dos Santos Knezevic, Bojana Mira, Jose J. https://www.um.edu.mt/library/oar/handle/123456789/148439 2026-08-07T08:56:14Z 2026-01-01T00:00:00Z

Title: Strengthening safety for informal caregivers in home care Authors: Abed, Nida; Pérez-Esteve, Clara; Knežević-Krajina, Hana; Buttigieg, Sandra C.; Tella, Susanna; Srulovici, Einav; Sousa, Paulo Jorge Dos Santos; Knezevic, Bojana; Mira, Jose J. Abstract: This scientific letter aims to raise awareness of the critical role informal caregivers play in home care settings and the need to find new approaches to ensure patient safety in this specific environment. With Europe’s aging population, the shift of hospital care to the home, and deinstitutionalization policies, the demand for informal caregiving in developing countries is rapidly rising. Informal care, provided by family members, neighbours, friends, and hired personnel by the families, in maintaining patient safety and well-being, Informal care has been estimated to have an economic value equivalent to 50-90% of the overall cost of long-term care across the European countries. In spite of the alteration towards home-based care, the existing patient safety literature remains focused on formal institutions, creating a major gap in patient safety within the unregulated home care environments.

2026-01-01T00:00:00Z Buttigieg, Sandra C. Soares, Ana Luísa Bak, Bartosz McFadden, Sonya Hughes, Ciara McClure, Patricia Couto, Jose Guilherme Bravo, Isabel https://www.um.edu.mt/library/oar/handle/123456789/148438 2026-08-07T08:52:26Z 2026-01-01T00:00:00Z

Title: Beyond the hospital walls : integrating clinical wisdom and global equity into the circular economy healthcare paradigm - a response to recent commentaries Authors: Buttigieg, Sandra C.; Soares, Ana Luísa; Bak, Bartosz; McFadden, Sonya; Hughes, Ciara; McClure, Patricia; Couto, Jose Guilherme; Bravo, Isabel Abstract: The publication of our foundational analysis, “A Review of the Applicability of Current Green Practices in Healthcare Facilities,” has catalyzed a sophisticated dialogue that transcends operational efficiency. This commentary is a collective insight that fundamentally shifts our strategic focus from mere green practices, often paying lip service to the term, to a systemic regenerative ethos, thereby aligning with the Lancet Commission’s assertion that the climate crisis represents the greatest global health opportunity of the 21st century. It is a response to the six commentaries that are offered by Gan & Kim, Wu & Liang, Weimann, Zanobini et al, von Eiff & von Eiff, and Esmaeili, which constitute a rigorous international scholarly peer review. Our purpose here is to synthesize these diverse perspectives into a cohesive roadmap for future health policy, bridging the gap between theoretical frameworks and actionable realities of healthcare leadership, so as to achieve a revolutionary shift to an environmentally friendly health sector.

2026-01-01T00:00:00Z Quintano, Lucienne Vella Bonanno, Patricia Strametz, Reinhard Klemm, Victoria Buttigieg, Sandra C. https://www.um.edu.mt/library/oar/handle/123456789/147949 2026-07-09T09:35:52Z 2026-01-01T00:00:00Z

Title: The second victim phenomenon in medical practitioners, nurses, and pharmacists : the SeViMa study for Malta Authors: Quintano, Lucienne; Vella Bonanno, Patricia; Strametz, Reinhard; Klemm, Victoria; Buttigieg, Sandra C. Abstract: Aim: To determine the prevalence, distribution, symptom burden, and recovery patterns of the second victim phenomenon (SVP) among healthcare professionals in Malta and to assess demographic, workplace, cultural, and personality-related correlates of SVP risk and symptom severity. Subject and methods: This was a cross-sectional study. Data were collected using a questionnaire that incorporated the English translation of the Second Victims in German-speaking countries (SeViD) instrument, the Big Five Inventory-10, and open-ended questions. The questionnaire was sent to all registered medical practitioners, nurses, and pharmacists in Malta. Analyses examined associations between SVP status/symptom load and professional group, demographic variables, workplace characteristics, and personality traits. Results: The prevalence of SVP was 77.7% among medical practitioners, 69.8% among nurses, and 42.3% among pharmacists. Triggers included patient death, patient harm, and aggression. Emotional and cognitive symptoms predominated, particularly intrusive recollections, self-doubt, and concentration difficulties. Prolonged symptoms were reported by 18.9% of medical practitioners, 14.7% of nurses, and 11.0% of pharmacists. Risk factors differed by profession: fewer years of experience predicted a higher symptom load in medical practitioners; older age increased risk in nurses while experience was protective; and female gender, non-Maltese nationality, and community pharmacy setting were associated with higher symptom severity among pharmacists. Personality traits did not predict SVP status but were associated with symptom severity. Conclusion: SVP is significant in Malta, with profession-specific risk profiles and a substantial symptom burden. Informal support predominates, highlighting the need for structured, targeted measures to reduce SVP impacts across professional groups.

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