Development and Field Test of an Audit Tool and Tracer Methodology for Clinician Assessment of Quality in End-of-Life Care77. Bookbinder M, Hugodot A, Freeman K, Homel P, Santiago E, Riggs A. et al. Development and field test of an audit tool and Tracer methodology for clinician assessment of quality in end-of-life care. J Pain Symptom Manage. 2018;55(2):207-216.e2. doi: https://doi.org/10.1016/j.jpainsymman.2017.08.017.
https://doi.org/10.1016/j.jpainsymman.20...
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Development of an audit tool to assess and trace the quality of care in terminally ill patients. |
The Tracer End of Life Care tool has been validated for use as a method to evaluate the quality of care at the end of life |
An Outpatient Performance Improvement Project: A Baseline Assessment of Adherence to Pain Reassessment Standards88. Ross A, Feider L, Nahm ES, Staggers N. An outpatient performance improvement project: abaseline assessment of adherence to pain reassessment standards. Mil Med. 2017;182(5):e1688-95. doi: https://doi.org/10.7205/MILMED-D-16-00104.
https://doi.org/10.7205/MILMED-D-16-0010...
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Healthcare professionals’ adherence rates to protocols for evaluation and reevaluation of pain. |
The follow-up of 12 cases traced made it possible to assess adherence to the protocols and identify areas for improvement. |
Political contexts and maternal health policy: Insights from a comparison of south Indian states99. Smith SL. Political contexts and maternal health policy: insights from a comparison of south Indian states. Soc Sci Med. 2014;100:46-53. doi: https:// doi.org/10.1016/j.socscimed.2013.
https://doi.org/10.1016/j.socscimed.2013...
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Investigation of the public policy on maternal health at all healthcare levels. |
The Tracer methodology helped identify existing differences, and facilitating aspects for their implementation. |
TRACER: an “eye-opener” to the patient experience across the transition of care in an internal medicine resident program1010. Meade LB, Hall SL, Kleppel RW, Hinchey KT. TRACER: an "eye-opener" to the patient experience across the transition of care in an internal medicine resident program. J Community Hosp Intern Med Perspect. 2015;5(2):26230.doi: https://doi.org/10.3402/jchimp.v5.26230.
https://doi.org/10.3402/jchimp.v5.26230...
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Use of Tracer as an educational strategy on transition from hospital to home care by medical residents. |
Residents learned about care transition through patient tracing after hospital discharge. |
Inclusão da diferença e reinternação psiquiátrica : estudo através de um “ caso traçador
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11. Oliveira LRG, Guljor APF, Verztman JS. Inclusão da diferença e reinternação psiquiátrica: estudo através de um "caso traçador". Rev Latinoam Psicopat Fund. 2015;418(3):504-18. https://doi.org/10.1590/1415-4714.2015v18n3p504.7.
https://doi.org/10.1590/1415-4714.2015v1...
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Impact of users1 bond with their territory on readmissions. |
The user’s path, the lack of care networks and their impact on readmissions were identified. |
Avaliação de resultados da atenção aos agravos cardiovasculares como traçador do princípio de integralidade
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12. Chaves LDP, Jesus BJ, Ferreira JBB, Balderrama P, Tanaka OY. Avaliação de resultados da atenção aos agravos cardiovasculares como traçador do princípio de integralidade. Saude Soc. 2015;24(2):568-77. doi: https://doi.org/10.1590/S0104-12902015000200014.
https://doi.org/10.1590/S0104-1290201500...
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Evaluation of the total outpatient and hospital care delivered for cardiovascular diseases. |
Cardiovascular diseases revealed coordination between the levels of care, regionalization and integral care. |
| The use of the Tracer methodology to assess the quality of care for patients enrolled in Medical Insurance for a New Generation1313. Durán-Arenas L, Muñoz-Hernández O, Hernández-Ramírez LC, Jasso-Gutiérrez L, Flores S, Aldaz-Rodríguez V. et al. The use of the Tracer methodology to assess the quality of care for patients enrolled in Medical Insurance for a New Generation. Salud Publica Mex. 2012;54(Suppl 1):S50-6.
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Assessment of quality by means of chart audits and check of care-related indicators.
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The tracer method allowed the assessment of the quality of care and stressed the points that need improvement. |
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Diagnóstico de la enfermedad renal Crónica como trazador de la capacidade técnica em la atención médica em 20 estados de México
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14. Pacheco-Domínguez RL, Duran-Arenas L, Rojas Russel ME, Escamilla-Santiago RA, López-Cervantes M. Diagnóstico de la enfermedad renal crónica como trazador de la capacidade técnica em la atención médica en 20 estados de México. Salud Publica Mex. 2011;53(suppl 4):s499-505.
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Verification of knowledge and skills of primary care physicians in the management of patients at risk of developing chronic kidney failure. |
CKF was successfully used as a "tracer condition” to evaluate technical skills and the Mexican healthcare system. |
Câncer cérvico-uterino como condição marcadora: uma proposta de avaliação da atenção básica
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15. Bottari CM, Vasconcellos MM, Mendonça MHM. Câncer cérvico-uterino como condição marcadora: uma proposta de avaliação da atenção básica. Cad Saúde Pública. 2008 24(suppl 1):s111-22. doi: https://doi.org/10.1590/S0102-? Meireles VC, Labegalini CMG, Baldissera VDA 12 Rev Gaúcha Enferm. 2019;40:e20180142 311X2008001300016.
https://doi.org/10.1590/S0102-?...
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Reflection on the tracer condition "cervical cancer" and evaluation of basic care, with emphasis on preventive actions and early detection. |
The results suggest that cervical cancer is an excellent tracer condition of primary care because it is related to accessibility, coverage, integrality and technical-scientific quality. |
Atenção domiciliar como mudança do modelo tecnoassistencial
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16. Silva KL, Sena RR, Seixas CT, Feuerwerker LCM, Merhy EE. Atenção domiciliar como mudança do modelo tecnoassistencial. Rev Saúde Pública. 2010;44(1):166-76. doi: https://doi.org/10.1590/S0034-89102010000100018.
https://doi.org/10.1590/S0034-8910201000...
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Home care experiences and their coordination in the local health system. The tracing of the "cases" made it possible to monitor the home care delivered by professionals of 4 outpatient services and one home care service. |
The method allowed the process of self-analysis of the team, evaluation of the work process, and the relationship of home care with other services and its potential for the creation of a substitute care network. |
Integralidade no cuidado ao câncer do colo do útero: avaliação do acesso
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17. Brito-Silva K, Bezerra AFB, Chaves LDP, Tanaka OY. Integridade no cuidado ao câncer do colo do útero: avaliação do acesso. Rev Saúde Pública 2014;48(2):1-9. doi: https://doi.org/10.1590/S0034-8910.2014048004852.
https://doi.org/10.1590/S0034-8910.20140...
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It used the tracer condition Cervical Cancer (CC), the delivery of services and the difficulties in the process of prevention, diagnosis and treatment of CC were used in the different levels of health care. |
Primary care: insufficient coverage of oncology cytology, difficult access. In secondary care there was no difficult access. There were problems in recording positive case data. |
Tracer methodology: an appropriate tool for assessing compliance with accreditation standards?33. Bouchard C, Jean O. Tracer methodology: an appropriate tool for assessing compliance with accreditation standards? Int J Health Plann Manage. 2017;32(4):e299-e315. doi: https://doi.org/10.1002/hpm.2376.
https://doi.org/10.1002/hpm.2376...
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To verify the opinion of Accreditation Canada inspectors on the Tracer methodology used since 2008 in the assessment of the quality and safety of health services, and in the assessment of compliance with accreditation standards. |
The Tracer methodology can effectively collect useful and reliable information to assess compliance with standards and processes. One limitation is the short time available for the investigators and often the lack of cooperation during the assessment. |
| Best practices: New York's outpatient mental health clinic licensing reform: using Tracer methodology to improve service1818. Wisdom JP, Knapik S, Holley MW, Van Bramer J, Sederer LI, Essock SM. Best practices: New York's outpatient mental health clinic licensing reform: using Tracer methodology to improve service quality. Psychiatr Serv. 2012;63(5):418-
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Use of the Tracer methodology to trace conformities related to the criteria of the Office of Mental Health (OMH) for the licensing of New York mental health outpatient clinics. |
The Tracer methodology allowed a more accurate evaluation of the follow-up of the clinical issues. Professionals and members of the OMH evaluated positively the methodology. |
The prevalence of Parkinson’s disease in British, Columbia, Canadá, estimated by using drug Tracer methodology1919. Lai BC, Schulzer M, Marion S, Teschke K, Tsui JK. The prevalence of Parkinson’s disease in British Columbia, Canada, estimated by using drug tracer methodology. Parkinsonism Relat Disord. 2003;9(4):233-8. doi: https://doi.org/10.1016/S1353-8020(02)00093-7.
https://doi.org/10.1016/S1353-8020(02)00...
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Use of the tracer drug Levodopa and /or other antiparkinson drugs to estimate the prevalence of Parkinson's disease (PD), and its location in British Columbia and Canada. using the Prescription Database of the College of Pharmacists. |
Using a large database, the authors estimated the prevalence of Parkinson's disease using the "Tracer methodology" of drugs. It was concluded that it is possible to estimate the prevalence of PD in a large population using the number of patients for whom levodopa and other antiparkinsonian drugs were prescribed. |
Evaluation of an EMS (Emergency Medical Service) Regional Referral System Using a Tracer Methodology2020. Egges J, Turnock BJ. Evaluation of an EMS regional referral system using a tracer methodology. Ann Emerg Med. 1980;9(10):518-33. doi: https://doi. org/10.1016/S0196-0644(80)80190-9.
https://doi.org/10.1016/S0196-0644(80)80...
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Evaluation of the EMS regional reference system by means of "five tracer conditions" to verify if the patients were being referred to the appropriate regional center. |
Only half of the patients with the conditions traced by the study were referred to the appropriate centers. The need for prospective analysis of inconsistent charts was identified as a weakness of the methodology. |
| Assessment of Ambulatory Care: Application of the Tracer Methodology2121. Novick LF, Dickinson K, Asnes R, Lan SM, Lowenstein R. Assessment of ambulatory care: application of the tracer methodology. Med Care. 1976;14(1):1-12.
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Outpatient care received by 100 children with anemia (hemoglobin 11.0gm/ 100mL or less) in a pediatric clinic was traced and evaluated. |
In 52 patients, the low level of hemoglobin was not recognized. Evaluation, diagnosis, treatment and follow-up care were available to only 25 patients, revealing the deficiencies of the use of tracers in the healthcare services. |
| Nurses and the Joint Commission Tracer Methodology2222. Murphy-Knoll L. Nurses and the Joint Commission tracer methodology. J Nurs Care Qual. 2006;21(1):5-7.
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Nurses' update on the Tracer methodology, a tool used to evaluate compliance with patient safety regulations and standards. |
Nurses reported a high level of satisfaction with the new accreditation process, using the Tracer methodology that addresses crucial issues for the prevention of adverse events. |
Our JCAHO Journey: one Emergency Department’s approach to the New Tracer Methodology2323. Wojtkowski JM. Our JCAHO journey: one emergency department's approach to the new tracer methodology. J Emerg Nurs. 2005;31(5):487-9. doi: https://doi. org/10.1016/j.jen.2005.07.007.
https://doi.org/10.1016/j.jen.2005.07.00...
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The educational activities used in an emergency hospital department in the preparation of the team for the evaluation and accreditation process of JACHO were shown. |
Techniques used: Tracer video, weekly bulletin of the team, Jeopardy games of risk factors (4 weeks), false inquiries, list of abbreviations and questionnaires. |
| Acreditation Strategies. Tracer methodology and the New Joint Commission Home Care and Hospice Survey Process2424. Friedman MM. Tracer methodology and the New Joint Commission home care and hospice survey process: part 1. Home Healthc Nurse. 2004;22(10):710-4.. |
Use of the Tracer methodology and description of accreditation strategies as a new tracer method in the research of home care and palliative care. |
The focus of the research on priority areas of home care pre-established by JCAHO and follow-up care received from the beginning of treatment till now. |
| Educating staff on Tracer methodology is a must: survey results depend on it2525. Educating staff on tracer methodology is a must: survey results depend on it. Hosp Peer Rev. 2003;28(12):161-5.
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To prepare and train the hospital staff for JACHO's assessment. At first, the problem areas where employees need improvement should be identified because of their lack of knowledge and inconsistent answers. The types of patients likely to be screened for research should be evaluated. |
Methodology aspects: There is less control during the study, the evaluators investigate the facilities, departments and ancillary services while tracing the path traveled by the users. There are great educational benefits, as all staff members are properly trained to answer the questions of the evaluators, and patient care is discussed with the multidisciplinary team. |
| A case study… what one facility learned from the Tracer Methodology2626. Magnarelli F. A case study... what one facility learned from the tracer methodology. Biomed Instrum Technol. 2005;39(3):202-3.
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The experience of Miami Children's Hospital evaluation by JCAHO using the Tracer methodology is reported. |
Several nonconformities were detected. The use of the Tracer reinforced the importance of using data to make decisions and establish committees as a resource for problem solving. |
Prevalence of Parkinson’s disease in Northwestern Italy: Comparasion of Tracer Methodology and Clinical Ascertainment of Cases2727. Chiò A, Magnani C, Schiffer D. Prevalence of Parkinson's disease in Northwestern Italy: comparison of tracer methodology and clinical ascertainment of cases. Mov Disod. 1998;13(3):400-5.doi: https://doi.org/10.1002/mds.870130305.
https://doi.org/10.1002/mds.870130305...
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Comparison of the prevalence of Parkinson's disease (PD) by means of the drug tracer (levodopa/other antiparkinsonian drugs) and through clinical case-finding in an area of northwestern Italy. |
The prevalence rate of PD was overestimated in elderly and female patients and was underestimated in younger and less severely affected patients using the drug tracer methodology and by comparing the clinical examinations. |
Source: Authors.