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BMJ Quality & Safety

Dov Zohar, Yaron T Werber, Ronen Marom, Bruria Curlau, Orna Blondheim
BACKGROUND: Recent literature reviews lament the paucity of high-quality intervention studies designed to test safety culture improvement in hospitals. The current study adapts an empirically supported strategy developed for manufacturing companies by focusing on patient care and safety messages head nurses communicate during daily conversations with nurses. METHODS: The study was designed as randomised control trial coupled with before-after measurement of outcome variables...
January 12, 2017: BMJ Quality & Safety
Sonya Crowe, Katherine Brown, Jenifer Tregay, Jo Wray, Rachel Knowles, Deborah A Ridout, Catherine Bull, Martin Utley
BACKGROUND: Improving integration and continuity of care across sectors within resource constraints is a priority in many health systems. Qualitative operational research methods of problem structuring have been used to address quality improvement in services involving multiple sectors but not in combination with quantitative operational research methods that enable targeting of interventions according to patient risk. We aimed to combine these methods to augment and inform an improvement initiative concerning infants with congenital heart disease (CHD) whose complex care pathway spans multiple sectors...
January 6, 2017: BMJ Quality & Safety
Jack Needleman
No abstract text is available yet for this article.
December 30, 2016: BMJ Quality & Safety
J Bryan Sexton, Stephanie P Schwartz, Whitney A Chadwick, Kyle J Rehder, Jonathan Bae, Joanna Bokovoy, Keith Doram, Wayne Sotile, Kathryn C Adair, Jochen Profit
BACKGROUND: Improving the resiliency of healthcare workers is a national imperative, driven in part by healthcare workers having minimal exposure to the skills and culture to achieve work-life balance (WLB). Regardless of current policies, healthcare workers feel compelled to work more and take less time to recover from work. Satisfaction with WLB has been measured, as has work-life conflict, but how frequently healthcare workers engage in specific WLB behaviours is rarely assessed. Measurement of behaviours may have advantages over measurement of perceptions; behaviours more accurately reflect WLB and can be targeted by leaders for improvement...
December 22, 2016: BMJ Quality & Safety
Anthony Harris, Lisa Pineles, Eli Perencevich
No abstract text is available yet for this article.
December 21, 2016: BMJ Quality & Safety
Martin Marshall, Debra de Silva, Lesley Cruickshank, Jenny Shand, Li Wei, James Anderson
No abstract text is available yet for this article.
December 16, 2016: BMJ Quality & Safety
Jerome A Leis, Kaveh G Shojania
No abstract text is available yet for this article.
December 16, 2016: BMJ Quality & Safety
Sigall K Bell, Macda Gerard, Alan Fossa, Tom Delbanco, Patricia H Folcarelli, Kenneth E Sands, Barbara Sarnoff Lee, Jan Walker
BACKGROUND: OpenNotes, a national movement inviting patients to read their clinicians' notes online, may enhance safety through patient-reported documentation errors. OBJECTIVE: To test an OpenNotes patient reporting tool focused on safety concerns. METHODS: We invited 6225 patients through a patient portal to provide note feedback in a quality improvement pilot between August 2014 and 2015. A link at the end of the note led to a 9-question survey...
December 13, 2016: BMJ Quality & Safety
Jeff Bezemer, Alexandra Cope, Terhi Korkiakangas, Gunther Kress, Ged Murtagh, Sharon-Marie Weldon, Roger Kneebone
No abstract text is available yet for this article.
December 9, 2016: BMJ Quality & Safety
Kathryn M Kellogg, Zach Hettinger, Manish Shah, Robert L Wears, Craig R Sellers, Melissa Squires, Rollin J Fairbanks
BACKGROUND: Despite over a decade of efforts to reduce the adverse event rate in healthcare, the rate has remained relatively unchanged. Root cause analysis (RCA) is a process used by hospitals in an attempt to reduce adverse event rates; however, the outputs of this process have not been well studied in healthcare. This study aimed to examine the types of solutions proposed in RCAs over an 8-year period at a major academic medical institution. METHODS: All state-reportable adverse events were gathered, and those for which an RCA was performed were analysed...
December 9, 2016: BMJ Quality & Safety
Laura Eyre, Michael Farrelly, Martin Marshall
Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground. In this paper we present a methodological approach, based on the principles of participatory research, that attempts to address this challenge...
December 8, 2016: BMJ Quality & Safety
Su-Yin Hor, Claire Hooker, Rick Iedema, Mary Wyer, Gwendolyn L Gilbert, Christine Jorm, Matthew Vincent Neil O'Sullivan
BACKGROUND: Hospital-acquired infections are the most common adverse event for inpatients worldwide. Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice. METHODS: We report on an interventionist video-reflexive ethnography study that explored how healthcare workers performed IPC in three wards in two hospitals in New South Wales, Australia: an intensive care unit and two general surgical wards...
November 30, 2016: BMJ Quality & Safety
Benjamin D Bray, Adam Steventon
No abstract text is available yet for this article.
November 30, 2016: BMJ Quality & Safety
Carl Macrae
No abstract text is available yet for this article.
November 18, 2016: BMJ Quality & Safety
Reshma Gupta, Christopher Moriates, James D Harrison, Victoria Valencia, Michael Ong, Robin Clarke, Neil Steers, Ron D Hays, Clarence H Braddock, Robert Wachter
BACKGROUND: Organisational culture affects physician behaviours. Patient safety culture surveys have previously been used to drive care improvements, but no comparable survey of high-value care culture currently exists. We aimed to develop a High-Value Care Culture Survey (HVCCS) for use by healthcare leaders and training programmes to target future improvements in value-based care. METHODS: We conducted a two-phase national modified Delphi process among 28 physicians and nurse experts with diverse backgrounds...
October 26, 2016: BMJ Quality & Safety
Jonathan M Snowden, Katy Backes Kozhimannil, Ifeoma Muoto, Aaron B Caughey, K John McConnell
OBJECTIVE: To evaluate whether busy days on a labour and delivery unit are associated with maternal and neonatal complications of childbirth in California hospitals, accounting for weekday/weekend births. DESIGN: This is a population-based retrospective cohort study. SETTING: Linked vital statistics/patient discharge data for California births between 2009 and 2010 from the Office of Statewide Health Planning and Development. PARTICIPANTS: All singleton, cephalic, non-anomalous California births between 2009 and 2010 (N=724 967)...
January 2017: BMJ Quality & Safety
Cecilia Vindrola-Padros, Tom Pape, Martin Utley, Naomi J Fulop
No abstract text is available yet for this article.
January 2017: BMJ Quality & Safety
Jacob Anhøj, Anne-Marie Blok Hellesøe
No abstract text is available yet for this article.
January 2017: BMJ Quality & Safety
James Mountford, Doug Wakefield
No abstract text is available yet for this article.
January 2017: BMJ Quality & Safety
Kelly Ann Schmidtke, Alan J Poots, Juan Carpio, Ivo Vlaev, Ngianga-Bakwin Kandala, Richard J Lilford
OBJECTIVES: Hospital board members are asked to consider large amounts of quality and safety data with a duty to act on signals of poor performance. However, in order to do so it is necessary to distinguish signals from noise (chance). This article investigates whether data in English National Health Service (NHS) acute care hospital board papers are presented in a way that helps board members consider the role of chance in their decisions. METHODS: Thirty English NHS trusts were selected at random and their board papers retrieved...
January 2017: BMJ Quality & Safety
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