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Journal of Patient Safety

Hardeep Singh, Mark L Graber, Timothy P Hofer
Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient...
October 20, 2016: Journal of Patient Safety
David C Classen, William Munier, Nancy Verzier, Noel Eldridge, David Hunt, Mark Metersky, Chesley Richards, Yun Wang, P Jeffrey Brady, Amy Helwig, James Battles
The explicit declaration in the landmark 1999 Institute of Medicine report "To Err Is Human" that, in the United States, 44,000 to 98,000 patients die each year as a consequence of "medical errors" gave widespread validation to the magnitude of the patient safety problem and catalyzed a number of U.S. federal government programs to measure and improve the safety of the national healthcare system. After more than 10 years, one of those federal programs, the Medicare Patient Safety Monitoring System (MPSMS), has reached a level of maturity and stability that has made it useful for the consistent measurement of the safety of inpatient care...
October 20, 2016: Journal of Patient Safety
Deanna Gray-Miceli, Sarah J Ratcliffe, Arwin Thomasson, Patricia Quigley, Kang Li, William Craelius
BACKGROUND: Patients at greatest risk for fall-related injuries are older adults with orthostatic hypotension (OH), a condition which drops blood pressure. This study sought to determine salient demographic and patient-level factors increasing risk for OH among a sample of elderly fallers. METHODS: Data analysis for this retrospective study sought to assess the relationship between various demographic and clinical risk factors and the likelihood of OH. Because fallers could experience multiple falls, generalized estimating equations were used to account for patient-level correlations...
October 20, 2016: Journal of Patient Safety
Kimberly DiGioia, Mohit Nair, Morgan Shields, Vikas Saini
With the aim of better understanding what the public (as opposed to "patients") wants from health care, this study asked people on the street, "What does the right health care mean to you?" Responses ranged from "Caring about me more than just in the appointment" to "That everyone should see exactly what medical treatment costs." A qualitative analysis revealed that all responses fell into 2 overarching categories: health care at the interpersonal level and health care at the system level. Approximately 66...
October 20, 2016: Journal of Patient Safety
Claudia Villanueva, Mathew Doyle, Roneil Parikh, Con Manganas
OBJECTIVES: The aim of this study was to identify the degree of awareness of the current guidelines and common practices for pleural drain insertion. METHODS: A 10-item questionnaire was sent electronically to junior physicians from 4 different hospitals in the South Eastern Sydney and Illawarra Shoalhaven Local Health District. Participants were asked to give their level of experience and management practices for chest drain insertion. RESULTS: A total of 94 junior medical officers from 4 hospitals in the district completed the survey...
September 21, 2016: Journal of Patient Safety
Zara Cooper, Nathanael Hevelone, Mohammad Sarhan, Timothy Quinn, Angela Bader
BACKGROUND: Patient involvement in surgical decisions is formalized in the informed consent process, which should reflect that the patient understands their diagnosis, planned procedure, and the associated risks and benefits before consenting to treatment. If high-quality shared decision making has occurred, the treatment chosen should best match the goals and preferences of the patient. Little information currently exists that analyzes factors associated with decisional quality in surgery...
September 20, 2016: Journal of Patient Safety
Maralyn R Druce, Andrea Hickey, Anthony N Warrens, Olwyn M R Westwood
After a number of high-profile incidents and national reports, it has become clear that all health professionals and all medical students must be able to raise concerns about a colleague's behavior if this behavior puts patients, colleagues, or themselves at risk.Detailed evidence from medical students about their confidence to raise concerns is limited, together with examples of barriers, which impair their ability to do so. We describe a questionnaire survey of medical students in a single-center, examining self-reported confidence about raising concerns in a number of possible scenarios...
September 16, 2016: Journal of Patient Safety
Junya Zhu, Liping Li, Zehui Zhou, Qingqing Lou, Albert W Wu
OBJECTIVES: Patient safety climate is associated with patient outcomes in hospitals around the world. A better understanding of how safety climate varies within and across hospitals will help identify improvement opportunities. We examined variations in safety climate by work area and job category in Chinese hospitals. METHODS: We administered the Chinese Hospital Survey on Patient Safety Climate in 2011 to workers in 6 hospitals in China, with completed surveys from 1464 (86% response)...
September 9, 2016: Journal of Patient Safety
Albert J Boquet, Tara N Cohen, Jennifer S Cabrera, Tracy L Litzinger, Kevin A Captain, Michael A Fabian, Steven G Miles, Scott A Shappell
OBJECTIVES: Historically, health care has relied on error management techniques to measure and reduce the occurrence of adverse events. This study proposes an alternative approach for identifying and analyzing hazardous events. Whereas previous research has concentrated on investigating individual flow disruptions, we maintain the industry should focus on threat windows, or the accumulation of these disruptions. This methodology, driven by the broken windows theory, allows us to identify process inefficiencies before they manifest and open the door for the occurrence of errors and adverse events...
September 9, 2016: Journal of Patient Safety
Mona Krouss, Jumana Alshaikh, Lindsay Croft, Daniel J Morgan
BACKGROUND: Preventable medical harm is a leading cause of death in the United States. Incident reporting systems have been identified as the primary method to capture medical error and harm. Incidents are rarely reported, particularly among physician trainees. METHODS: We conducted a single-center, quasi-experimental study to examine the effect of education on the importance of and how to file an incident report for physician trainees on reporting rates. Trainees were provided laminated plastic instructions, and reporting was reinforced with weekly patient safety rounds...
September 9, 2016: Journal of Patient Safety
Xiao-Di Xu, Yi-Jie Yuan, Li-Ming Zhao, Yang Li, Hui-Zhen Zhang, Hua Wu
OBJECTIVE: To investigate adverse events (AEs) at baseline in a Chinese general hospital using the Institute for Healthcare Improvement (IHI) Global Trigger Tool (GTT) and discuss the feasibility of this tool to detect AEs in China. METHODS: A total of 10 inpatient records from the hospital were sampled randomly half a month in 2014. The records were reviewed to identify AEs according to the second edition of the IHI GTT for measuring AEs. Triggers and AEs were analyzed using Microsoft Excel 2007...
September 8, 2016: Journal of Patient Safety
Eduardo Ensaldo-Carrasco, Milton Fabian Suarez-Ortegon, Andrew Carson-Stevens, Kathrin Cresswell, Raman Bedi, Aziz Sheikh
BACKGROUND: There have been efforts to understand the epidemiology of iatrogenic harm in hospitals and primary care and to improve the safety of care provision. There has in contrast been very limited progress in relation to the safety of ambulatory dental care. OBJECTIVES: To provide a comprehensive overview of the range and frequencies of existing evidence on patient safety incidents and adverse events in ambulatory dentistry. METHODS: We searched MEDLINE and EMBASE for articles reporting events that could have or did result in unnecessary harm in ambulatory dental care...
September 8, 2016: Journal of Patient Safety
Shravya Govindappagari, Amanda Guardado, Dena Goffman, Jeffrey Bernstein, Colleen Lee, Sara Schonfeld, Robert Angert, Andrea McGowan, Peter S Bernstein
OBJECTIVE: Communication failures are consistently seen as a root cause of preventable adverse outcomes in obstetrics. We assessed whether use of an Obstetric Safe Surgery Checklist for cesarean deliveries (CDs), based on the WHO Safe Surgery Checklist, can improve communication; reduce team member confusion about urgency of the case; and decrease documentation discrepancies among nursing, obstetric, anesthesia, and pediatric staff. METHODS: Retrospective review of 600 CDs on our 2 labor and delivery suites before and after the introduction of 2 consecutive versions of our obstetric safe surgery checklist (100 cases in each cohort) was undertaken...
September 8, 2016: Journal of Patient Safety
Eric K Wei, Laura Sarff, Brad Spellberg
No abstract text is available yet for this article.
September 8, 2016: Journal of Patient Safety
Christine J Manta, Jacqueline Ortiz, Benjamin W Moulton, Seema S Sonnad
OBJECTIVE: This study aimed to gather qualitative feedback on patient perceptions of informed consent forms and elicit recommendations to improve readability and utility for enhanced patient safety and engagement in shared decision making. METHODS: Sixty interviews in personal interviews were conducted consisting of a literacy and numeracy assessment, a comprehension quiz to assess retention of key information, and open-ended questions to determine reactions, clarity of information, and suggestions for improvement...
August 3, 2016: Journal of Patient Safety
John Martin, Evan M Benjamin, Christopher Craver, Eugene A Kroch, Eugene C Nelson, Richard Bankowitz
CONTEXT: Current methods for tracking harm either require costly full manual chart review (FMCR) or rely on proxy methods that have questionable accuracy. We propose an administrative measure of harm detection that uses electronically captured data. OBJECTIVE: Determine the level of agreement on harm event occurrence when harm is detected based on an administrative harm measurement tool (AHMT) compared with FMCR. DESIGN: A retrospective chart review was used to measure the level of agreement in harm detection between an AHMT that uses electronically captured data and a FMCR...
September 2016: Journal of Patient Safety
Sam R Watson, Peter J Pronovost
No abstract text is available yet for this article.
September 2016: Journal of Patient Safety
Natasha J Verbakel, Maaike Langelaan, Theo J M Verheij, Cordula Wagner, Dorien L M Zwart
BACKGROUND: Patient safety culture, described as shared values, attitudes and behavior of staff in a health-care organization, gained attention as a subject of study as it is believed to be related to the impact of patient safety improvements. However, in primary care, it is yet unknown, which effect interventions have on the safety culture. OBJECTIVES: To review literature on the use of interventions that effect patient safety culture in primary care. METHODS: Searches were performed in PubMed, EMBASE, CINAHL, and PsychINFO on March 4, 2013...
September 2016: Journal of Patient Safety
Anas Bahnassi
OBJECTIVE: The aim of this study was to investigate pharmacists views and practices in Madinah, Saudi Arabia, through conducting direct interviews including direct questions and hypothetical scenarios. METHODS: A purposeful sample of 150 community pharmacists of different ethnic and educational backgrounds were approached to participate in the study. Semistructured interviews including general questions and 5 hypothetical scenarios were used for the investigation...
September 2016: Journal of Patient Safety
Daniel B Raemer, Steven Locke, Toni Beth Walzer, Roxane Gardner, Lee Baer, Robert Simon
INTRODUCTION: Despite published recommended best practices for full disclosure and apology to patients and families after adverse medical events, actual practice can be inadequate. The use of "cognitive aids" to help practitioners manage complex critical events has been successful in a variety of fields and healthcare. We wished to extend this concept to disclosure and apology events. The aim of this study was to test if a brief opportunity to review a best practice guideline for disclosure and apology would improve communication performance...
September 2016: Journal of Patient Safety
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