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BMJ Quality & Safety

Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
Jane K O'Hara, Karina Aase, Justin Waring
No abstract text is available yet for this article.
May 15, 2018: BMJ Quality & Safety
Elizabeth Cecil, Alex Bottle, Aneez Esmail, Samantha Wilkinson, Charles Vincent, Paul P Aylin
OBJECTIVE: To investigate the association between alerts from a national hospital mortality surveillance system and subsequent trends in relative risk of mortality. BACKGROUND: There is increasing interest in performance monitoring in the NHS. Since 2007, Imperial College London has generated monthly mortality alerts, based on statistical process control charts and using routinely collected hospital administrative data, for all English acute NHS hospital trusts...
May 4, 2018: BMJ Quality & Safety
Viet-Thi Tran, Eugene Messou, Mariam Mama Djima, Philippe Ravaud, Didier K Ekouevi
OBJECTIVE: Patients living with HIV infection (PLWH) in sub-Saharan Africa face an important burden of treatment related to everything they do to take care of their health: doctor visits, tests, regular refills, travels, and so on. In this study, we involved PLWH in proposing ideas on how to decrease their burden of treatment and assessed to what extent these propositions could be implemented in care. METHODS: Adult PLWH recruited in three HIV care centres in Côte d'Ivoire participated in qualitative interviews starting with ' What do you believe are the most important things to change in your care to improve your burden of treatment? ' Two independent investigators conducted a thematic analysis to identify and classify patients' propositions to decrease their burden of treatment...
April 29, 2018: BMJ Quality & Safety
Adi Hirshberg, Katheryne Downes, Sindhu Srinivas
BACKGROUND: Monitoring blood pressure at 72 hours and 7-10 days post partum in women with hypertensive disorders is recommended to decrease morbidity. However, there are no recommendations as to how to achieve this. OBJECTIVE: To compare the effectiveness of text-based blood pressure monitoring to in-person visits for women with hypertensive disorders of pregnancy in the immediate postpartum period. METHODS: Randomised clinical trial among 206 postpartum women with pregnancy-related hypertension diagnosed during the delivery admission between August 2016 and January 2017...
April 27, 2018: BMJ Quality & Safety
Melissa M Garrido, Austin B Frakt
No abstract text is available yet for this article.
April 19, 2018: BMJ Quality & Safety
Elizabeth Dzeng, J Randall Curtis
No abstract text is available yet for this article.
April 18, 2018: BMJ Quality & Safety
Kara Gray-Burrows, Thomas Willis, Robbie Foy, Martin Rathfelder, Pauline Bland, Allison Chin, Susan Hodgson, Gus Ibegbuna, Graham Prestwich, Kirsty Samuel, Laurence Wood, Farhat Yaqoob, Rosemary R C McEachan
BACKGROUND: Patient and public involvement (PPI) is often an essential requirement for research funding. Distinctions can be drawn between clinical research, which generally focuses on patients, and implementation research, which generally focuses on health professional behaviour. There is uncertainty about the role of PPI in this latter field. We explored and defined the roles of PPI in implementation research to inform relevant good practice guidance. METHODS: We used a structured consensus process using a convenience sample panel of nine experienced PPI and two researcher members...
April 17, 2018: BMJ Quality & Safety
Pajaree Mongkhon, Darren M Ashcroft, C Norman Scholfield, Chuenjid Kongkaew
BACKGROUND: Medication non-adherence in ambulatory care has received substantial attention in the literature, but less so as it affects acute care. Accordingly, we aimed to estimate the frequency with which non-adherence to medication contributes to hospital admissions. METHODS: We searched the Cochrane Library, EMBASE, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts and PubMed (until December 2017) to identify prospective observational studies that examined prevalence rates of hospital admissions associated with medication non-adherence...
April 17, 2018: BMJ Quality & Safety
Sarah Alderson, Robbie Foy, Louise Bryant, Shenaz Ahmed, Allan House
There are many challenges in the development, implementation and evaluation of healthcare policy. One challenge is understanding how different stakeholders view a particular policy and what impact these views may have during implementation. Q-methodology is one approach that can be used to help policy makers and researchers actively engage with those who are important in policy implementation, and anticipate their responses. Q-methodology combines qualitative and quantitative research methods to systematically explore and describe the range of viewpoints about a topic...
April 12, 2018: BMJ Quality & Safety
Imogen Lyons, Dominic Furniss, Ann Blandford, Gillian Chumbley, Ioanna Iacovides, Li Wei, Anna Cox, Astrid Mayer, Jolien Vos, Galal H Galal-Edeen, Kumiko O Schnock, Patricia C Dykes, David W Bates, Bryony Dean Franklin
INTRODUCTION: Intravenous medication administration has traditionally been regarded as error prone, with high potential for harm. A recent US multisite study revealed few potentially harmful errors despite a high overall error rate. However, there is limited evidence about infusion practices in England and how they relate to prevalence and types of error. OBJECTIVES: To determine the prevalence, types and severity of errors and discrepancies in infusion administration in English hospitals, and to explore sources of variation, including the contribution of smart pumps...
April 7, 2018: BMJ Quality & Safety
Bev Fitzsimons, Jocelyn Cornwell
No abstract text is available yet for this article.
April 5, 2018: BMJ Quality & Safety
Jose F Figueroa, Yevgeniy Feyman, Xiner Zhou, Karen Joynt Maddox
BACKGROUND: Patient experience is a key measure of hospital quality and is increasingly contained in value-based payment programmes. Understanding whether strategies aimed at improving care transitions are associated with better patient experience could help clinical leaders and policymakers seeking to improve care across multiple dimensions. OBJECTIVE: To determine the association of specific hospital care coordination and transition strategies with patient experience...
April 4, 2018: BMJ Quality & Safety
Valerie M Vaughn, Jeffrey A Linder
No abstract text is available yet for this article.
March 24, 2018: BMJ Quality & Safety
David Schwappach, Aline Richard
OBJECTIVES: To determine frequencies of healthcare workers (HCWs) speak up-related behaviours and the association of speak up-related safety climate with speaking up and withholding voice. DESIGN: Cross-sectional survey of doctors and nurses. Data were analysed using multilevel logistic regression models SETTING: 4 hospitals with a total of nine sites from the German, French and Italian speaking part of Switzerland. PARTICIPANTS: Survey data were collected from 979 nurses and doctors...
March 23, 2018: BMJ Quality & Safety
Bethany Danae Hallam, Courtney C Kuza, Kimberly Rak, Jessica C Fleck, Melanie M Heuston, Debjit Saha, Jeremy M Kahn
BACKGROUND: Rounding checklists are an increasingly common quality improvement tool in the intensive care unit (ICU). However, effectiveness studies have shown conflicting results. We sought to understand ICU providers' perceptions of checklists, as well as barriers and facilitators to effective utilisation of checklists during daily rounds. OBJECTIVES: To understand how ICU providers perceive rounding checklists and develop a framework for more effective rounding checklist implementation...
March 23, 2018: BMJ Quality & Safety
Sarah K Pontefract, James Hodson, Ann Slee, Sonal Shah, Alan J Girling, Robin Williams, Aziz Sheikh, Jamie J Coleman
BACKGROUND: In this UK study, we investigated the impact of computerised physician order entry (CPOE) and clinical decision support (CDS) implementation on the rate of 78 high-risk prescribing errors amenable to CDS. METHODS: We conducted a preintervention/postintervention study in three acute hospitals in England. A predefined list of prescribing errors was incorporated into an audit tool. At each site, approximately 4000 prescriptions were reviewed both pre-CPOE and 6 months post-CPOE implementation...
March 23, 2018: BMJ Quality & Safety
Natalie Armstrong
No abstract text is available yet for this article.
March 23, 2018: BMJ Quality & Safety
Allison Brown, Aditya Nidumolu, Alexandra Stanhope, Justin Koh, Matthew Greenway, Lawrence Grierson
BACKGROUND: Quality Improvement (QI) training for health professionals is essential to strengthen health systems. However, QI training during medical school is constrained by students' lack of contextual understanding of the health system and an already saturated medical curriculum. The Program for Improvement in Medical Education (PRIME), an extracurricular offered at the Michael G. DeGroote School of Medicineat McMaster University (Hamilton, Canada), addresses these obstacles by having first-year medical students engage in QI by identifying opportunities for improvement within their own education...
March 19, 2018: BMJ Quality & Safety
Ketan K Mane, Kevin B Rubenstein, Najlla Nassery, Adam L Sharp, Ejaz A Shamim, Navdeep S Sangha, Ahmed Hassoon, Mehdi Fanai, Zheyu Wang, David E Newman-Toker
No abstract text is available yet for this article.
March 17, 2018: BMJ Quality & Safety
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