{"id":"https://openalex.org/W7213545211","doi":"https://doi.org/10.64898/2026.09.11.26361528","title":"Assessing the Quality of Healthcare Practice: A Risk-Based Approach","display_name":"Assessing the Quality of Healthcare Practice: A Risk-Based Approach","publication_year":2026,"publication_date":"2026-09-17","ids":{"openalex":"https://openalex.org/W7213545211","doi":"https://doi.org/10.64898/2026.09.11.26361528"},"language":"en","primary_location":{"id":"doi:10.64898/2026.09.11.26361528","doi":"https://doi.org/10.64898/2026.09.11.26361528","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.11.26361528","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/17/2026.09.11.26361528.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/17/2026.09.11.26361528.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5079662617","display_name":"Richard Anthony Despott","orcid":"https://orcid.org/0009-0009-0365-1603","observed_orcids":["https://orcid.org/0009-0009-0365-1603"]},"institutions":[{"id":"https://openalex.org/I4210165689","display_name":"St. Luke's Hospital","ror":"https://ror.org/003nj8h62","country_code":"MT","type":"healthcare","lineage":["https://openalex.org/I4210165689"]}],"countries":["MT"],"is_corresponding":true,"raw_author_name":"Richard Anthony Despott","raw_affiliation_strings":["Department for Health Regulation, St Luke\u2019s Hospital, Pjazza San Luqa, Pieta\u2019, Malta"],"raw_orcid":"https://orcid.org/0009-0009-0365-1603","affiliations":[{"raw_affiliation_string":"Department for Health Regulation, St Luke\u2019s Hospital, Pjazza San Luqa, Pieta\u2019, Malta","institution_ids":["https://openalex.org/I4210165689"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5001768611","display_name":"Nadine Delicata","orcid":"https://orcid.org/0009-0004-1474-5414","observed_orcids":["https://orcid.org/0009-0004-1474-5414"]},"institutions":[{"id":"https://openalex.org/I4210165689","display_name":"St. Luke's Hospital","ror":"https://ror.org/003nj8h62","country_code":"MT","type":"healthcare","lineage":["https://openalex.org/I4210165689"]}],"countries":["MT"],"is_corresponding":false,"raw_author_name":"Nadine Delicata","raw_affiliation_strings":["Department for Health Regulation, St Luke\u2019s Hospital, Pjazza San Luqa, Pieta\u2019, Malta"],"raw_orcid":"https://orcid.org/0009-0004-1474-5414","affiliations":[{"raw_affiliation_string":"Department for Health Regulation, St Luke\u2019s Hospital, Pjazza San Luqa, Pieta\u2019, Malta","institution_ids":["https://openalex.org/I4210165689"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5152065852","display_name":"Cynthia Mallia","orcid":"https://orcid.org/0000-0002-0647-3218","observed_orcids":["https://orcid.org/0000-0002-0647-3218"]},"institutions":[{"id":"https://openalex.org/I4210165689","display_name":"St. Luke's Hospital","ror":"https://ror.org/003nj8h62","country_code":"MT","type":"healthcare","lineage":["https://openalex.org/I4210165689"]}],"countries":["MT"],"is_corresponding":false,"raw_author_name":"Cynthia Mallia","raw_affiliation_strings":["Department for Health Regulation, St Luke\u2019s Hospital, Pjazza San Luqa, Pieta\u2019, Malta"],"raw_orcid":"https://orcid.org/0000-0002-0647-3218","affiliations":[{"raw_affiliation_string":"Department for Health Regulation, St Luke\u2019s Hospital, Pjazza San Luqa, Pieta\u2019, Malta","institution_ids":["https://openalex.org/I4210165689"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5003628873","display_name":"Patricia Vella Bonanno","orcid":"https://orcid.org/0000-0002-6064-1323","observed_orcids":["https://orcid.org/0000-0002-6064-1323"]},"institutions":[{"id":"https://openalex.org/I197854408","display_name":"University of Malta","ror":"https://ror.org/03a62bv60","country_code":"MT","type":"education","lineage":["https://openalex.org/I197854408"]},{"id":"https://openalex.org/I4210165689","display_name":"St. Luke's Hospital","ror":"https://ror.org/003nj8h62","country_code":"MT","type":"healthcare","lineage":["https://openalex.org/I4210165689"]}],"countries":["MT"],"is_corresponding":false,"raw_author_name":"Patricia Vella Bonanno","raw_affiliation_strings":["Department for Health Regulation, St Luke\u2019s Hospital, Pjazza San Luqa, Pieta\u2019, Malta","Department of Health Systems Management and Leadership, Faculty of Health Sciences, University of Malta, Msida, Malta"],"raw_orcid":"https://orcid.org/0000-0002-6064-1323","affiliations":[{"raw_affiliation_string":"Department for Health Regulation, St Luke\u2019s Hospital, Pjazza San Luqa, Pieta\u2019, Malta","institution_ids":["https://openalex.org/I4210165689"]},{"raw_affiliation_string":"Department of Health Systems Management and Leadership, Faculty of Health Sciences, University of Malta, Msida, Malta","institution_ids":["https://openalex.org/I197854408"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5079662617"],"corresponding_institution_ids":["https://openalex.org/I4210165689"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.9961000084877014,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.9961000084877014,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.002300000051036477,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11590","display_name":"Primary Care and Health Outcomes","score":0.0007999999797903001,"subfield":{"id":"https://openalex.org/subfields/2714","display_name":"Family Practice"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/healthcare-quality-assessment","display_name":"health care quality assessment","score":0.8870000243186951},{"id":"https://openalex.org/keywords/clinical-risk-management","display_name":"clinical risk management","score":0.972000002861023},{"id":"https://openalex.org/keywords/quality-indicators","display_name":"quality indicators","score":0.8119999766349792},{"id":"https://openalex.org/keywords/performance-indicators","display_name":"performance indicators","score":0.7149999737739563},{"id":"https://openalex.org/keywords/risk-based-approach","display_name":"risk-based approach","score":0.574999988079071},{"id":"https://openalex.org/keywords/stakeholder-requirements","display_name":"stakeholder needs","score":0.6859999895095825},{"id":"https://openalex.org/keywords/institutional-quality-improvement","display_name":"institutional quality improvement","score":0.6290000081062317},{"id":"https://openalex.org/keywords/benchmarking","display_name":"benchmarking","score":0.7570000290870667}],"concepts":[{"id":"https://openalex.org/C86251818","wikidata":"https://www.wikidata.org/wiki/Q816754","display_name":"Benchmarking","level":2,"score":0.8180000185966492},{"id":"https://openalex.org/C2779530757","wikidata":"https://www.wikidata.org/wiki/Q1207505","display_name":"Quality (philosophy)","level":2,"score":0.6148999929428101},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.6136000156402588},{"id":"https://openalex.org/C201305675","wikidata":"https://www.wikidata.org/wiki/Q852998","display_name":"Stakeholder","level":2,"score":0.585099995136261},{"id":"https://openalex.org/C195094911","wikidata":"https://www.wikidata.org/wiki/Q14167904","display_name":"Process management","level":1,"score":0.5202000141143799},{"id":"https://openalex.org/C112930515","wikidata":"https://www.wikidata.org/wiki/Q4389547","display_name":"Risk analysis (engineering)","level":1,"score":0.4603999853134155},{"id":"https://openalex.org/C140781008","wikidata":"https://www.wikidata.org/wiki/Q1221081","display_name":"Service quality","level":3,"score":0.4172999858856201},{"id":"https://openalex.org/C71405471","wikidata":"https://www.wikidata.org/wiki/Q757012","display_name":"Quality management","level":3,"score":0.4025000035762787},{"id":"https://openalex.org/C135510737","wikidata":"https://www.wikidata.org/wiki/Q860554","display_name":"Performance indicator","level":2,"score":0.39430001378059387},{"id":"https://openalex.org/C3018279614","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Healthcare service","level":3,"score":0.39430001378059387},{"id":"https://openalex.org/C14224292","wikidata":"https://www.wikidata.org/wiki/Q13600188","display_name":"Conceptual framework","level":2,"score":0.3783000111579895},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.36959999799728394},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.3546000123023987},{"id":"https://openalex.org/C2780801425","wikidata":"https://www.wikidata.org/wiki/Q5164392","display_name":"Construct (python library)","level":2,"score":0.3546000123023987},{"id":"https://openalex.org/C2780378061","wikidata":"https://www.wikidata.org/wiki/Q25351891","display_name":"Service (business)","level":2,"score":0.3492000102996826},{"id":"https://openalex.org/C67069471","wikidata":"https://www.wikidata.org/wiki/Q1140205","display_name":"IT service continuity","level":2,"score":0.3239000141620636},{"id":"https://openalex.org/C141571065","wikidata":"https://www.wikidata.org/wiki/Q1771949","display_name":"Performance measurement","level":2,"score":0.31700000166893005},{"id":"https://openalex.org/C182306322","wikidata":"https://www.wikidata.org/wiki/Q1779371","display_name":"Order (exchange)","level":2,"score":0.31119999289512634},{"id":"https://openalex.org/C60641444","wikidata":"https://www.wikidata.org/wiki/Q841602","display_name":"Delphi method","level":2,"score":0.30970001220703125},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.3050000071525574},{"id":"https://openalex.org/C2780131953","wikidata":"https://www.wikidata.org/wiki/Q17003063","display_name":"Health care quality","level":3,"score":0.2980000078678131},{"id":"https://openalex.org/C137992405","wikidata":"https://www.wikidata.org/wiki/Q1137608","display_name":"Health administration","level":3,"score":0.28769999742507935},{"id":"https://openalex.org/C539667460","wikidata":"https://www.wikidata.org/wiki/Q2414942","display_name":"Management science","level":1,"score":0.27639999985694885},{"id":"https://openalex.org/C13606891","wikidata":"https://www.wikidata.org/wiki/Q2623243","display_name":"Conceptual model","level":2,"score":0.26589998602867126},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.2597000002861023},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.25429999828338623},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.2529999911785126}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.09.11.26361528","doi":"https://doi.org/10.64898/2026.09.11.26361528","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.11.26361528","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/17/2026.09.11.26361528.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.09.11.26361528","doi":"https://doi.org/10.64898/2026.09.11.26361528","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.11.26361528","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/17/2026.09.11.26361528.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.8371999859809875}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7213545211.pdf","grobid_xml":"https://content.openalex.org/works/W7213545211.grobid-xml"},"referenced_works_count":10,"referenced_works":["https://openalex.org/W2032480093","https://openalex.org/W2115133509","https://openalex.org/W2607515139","https://openalex.org/W2958795513","https://openalex.org/W3095461765","https://openalex.org/W4288033606","https://openalex.org/W4309360388","https://openalex.org/W4309562991","https://openalex.org/W4321002213","https://openalex.org/W4328096292"],"related_works":["https://openalex.org/W2159746069","https://openalex.org/W2121153278","https://openalex.org/W4243305115","https://openalex.org/W4238635591","https://openalex.org/W3158290441","https://openalex.org/W7097818425","https://openalex.org/W3214524271","https://openalex.org/W2165007042","https://openalex.org/W77575558","https://openalex.org/W2126384054"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"This":[2],"research":[3],"article":[4],"explores":[5],"a":[6,26,40,55,67,163],"novel":[7],"framework":[8,179],"for":[9,29,43,95,120,139],"assessing":[10,121,140],"the":[11,23,30,128,137,186],"Quality":[12],"of":[13,18,25,32,54,59,97,107,113,118,134,155,166,170,188],"Healthcare":[14],"based":[15,35,71],"on":[16,36,72],"principles":[17],"Clinical":[19],"Risk":[20],"Management,":[21],"including":[22],"development":[24],"theoretical":[27],"construct":[28],"quality":[31,88,189],"healthcare":[33,60,175],"services":[34],"stakeholder":[37],"needs,":[38],"and":[39,62,76,86,93,132,146,168,191,198],"conceptual":[41],"model":[42],"managing":[44],"risks":[45,99,141],"at":[46],"an":[47,181],"institutional":[48,87],"level.":[49],"Methodology":[50],"The":[51,177],"study":[52],"consisted":[53,117],"cross-sectional":[56],"secondary":[57],"assessment":[58,96,172],"service":[61],"system-level":[63],"indicators,":[64],"guided":[65],"by":[66],"structured":[68],"decision":[69],"tree":[70],"face,":[73],"construct,":[74],"content,":[75],"criterion":[77],"validity.":[78],"Established":[79],"performance":[80,109,171],"measures":[81,119,173],"identified":[82],"from":[83],"international":[84],"benchmarking":[85],"improvement":[89],"frameworks":[90],"were":[91,111],"classified":[92],"validated":[94],"clinical":[98,124,144],"according":[100],"to":[101,127,161,184,194],"indicator":[102],"type.":[103],"Results":[104],"A":[105],"total":[106],"233":[108],"indicators":[110,135,156,190],"evaluated,":[112],"which":[114],"200":[115],"(86%)":[116],"failures":[122],"in":[123,159,174],"practice.":[125,176],"According":[126],"proposed":[129,178],"framework,":[130],"(30%)":[131],"(14%)":[133],"met":[136],"criteria":[138],"associated":[142],"with":[143],"processes":[145],"organizational":[147],"systems":[148,196],"design":[149,197],"respectively.":[150],"Conclusion":[151],"More":[152],"targeted":[153],"use":[154],"is":[157],"required":[158],"order":[160],"achieve":[162],"greater":[164],"degree":[165],"accuracy":[167],"actionability":[169],"offers":[180],"applied":[182],"method":[183],"enhance":[185],"specificity":[187],"direct":[192],"efforts":[193],"improve":[195],"decision-making":[199],"capability.":[200]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-09-18T00:00:00"}
