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BMJ Quality & Safety

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https://www.readbyqxmd.com/read/29146681/a-qualitative-study-of-patient-involvement-in-medicines-management-after-hospital-discharge-an-under-recognised-source-of-systems-resilience
#1
Beth Fylan, Gerry Armitage, Deirdre Naylor, Alison Blenkinsopp
INTRODUCTION: There are risks to the safety of medicines management when patient care is transferred between healthcare organisations, for example, when a patient is discharged from hospital. Using the theoretical concept of resilience in healthcare, this study aimed to better understand the proactive role that patients can play in creating safer, resilient medicines management at a common transition of care. METHODS: Qualitative interviews with 60 cardiology patients 6 weeks after their discharge from 2 UK hospitals explored patients' experiences with their discharge medicines...
November 16, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29146680/the-association-between-patient-experience-factors-and-likelihood-of-30-day-readmission-a-prospective-cohort-study
#2
Jocelyn Carter, Charlotte Ward, Deborah Wexler, Karen Donelan
OBJECTIVE: Hospital readmissions comprise nearly a third of US healthcare expenditures. Fifteen to 20 per cent of this spending is considered to be potentially preventable. Risk prediction models have suboptimal accuracy and typically exclude patient experience data. No studies have explored patient perceptions of the likelihood of readmission during index admission. Our objective was to examine associations between patient perceptions of care during index hospital admission and 30-day readmission...
November 16, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29133462/improving-picc-use-and-outcomes-in-hospitalised-patients-an-interrupted-time-series-study-using-magic-criteria
#3
Lakshmi Swaminathan, Scott Flanders, Mary Rogers, Yvonne Calleja, Ashley Snyder, Rama Thyagarajan, Priscila Bercea, Vineet Chopra
BACKGROUND: Although important in clinical care, reports of inappropriate peripherally inserted central catheter (PICC) use are growing. OBJECTIVE: To test whether implementation of the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) can improve PICC use and patient outcomes. DESIGN: Quasi-experimental, interrupted time series design at one study site with nine contemporaneous external controls. SETTING: Ten hospitals participating in a state-wide quality collaborative from 1 August 2014 to 31 July 2016...
November 13, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29133461/ratings-game-an-analysis-of-nursing-home-compare-and-yelp-ratings
#4
Kayla Johari, Caitlyn Kellogg, Katalina Vazquez, Krystle Irvine, Anna Rahman, Susan Enguidanos
BACKGROUND: Two strategies for rating the quality of nursing homes (NHs) in the USA are exemplified by the Nursing Home Compare (NHC) website, launched by the federal Centers for Medicare and Medicaid Services in 1998, and Yelp.com, an online consumer review site that has grown in popularity since its founding in 2004. Both sites feature a 5-star rating system. While much is known about NHC ratings, little is known about NH Yelp ratings. This study examines Yelp ratings for NHs in California and compares these ratings with NHC ratings...
November 13, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29122976/roadmap-for-improving-the-accuracy-of-respiratory-rate-measurements
#5
LETTER
Neil Keshvani, Kimberly Berger, Oanh Kieu Nguyen, Anil N Makam
No abstract text is available yet for this article.
November 9, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29122975/efficiency-and-thoroughness-trade-offs-in-high-volume-organisational-routines-an-ethnographic-study-of-prescribing-safety-in-primary-care
#6
Suzanne Grant, Bruce Guthrie
BACKGROUND: Prescribing is a high-volume primary care routine where both speed and attention to detail are required. One approach to examining how organisations approach quality and safety in the face of high workloads is Hollnagel's Efficiency and Thoroughness Trade-Off (ETTO). Hollnagel argues that safety is aligned with thoroughness and that a choice is required between efficiency and thoroughness as it is not usually possible to maximise both. This study aimed to ethnographically examine the efficiency and thoroughness trade-offs made by different UK general practices in the achievement of prescribing safety...
November 9, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29101293/mortality-of-hospitalised-internal-medicine-patients-bedspaced-to-non-internal-medicine-inpatient-units-retrospective-cohort-study
#7
Anthony D Bai, Siddhartha Srivastava, George A Tomlinson, Christopher A Smith, Chaim M Bell, Sudeep S Gill
OBJECTIVE: To compare inhospital mortality of general internal medicine (GIM) patients bedspaced to off-service wards with GIM inpatients admitted to assigned GIM wards. METHOD: A retrospective cohort study of consecutive GIM admissions between 1 January 2015 and 1 January 2016 was conducted at a large tertiary care hospital in Canada.Inhospital mortality was compared between patients admitted to off-service wards (bedspaced) and assigned GIM wards using a Cox proportional hazards model and a competing risk model...
November 3, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29101292/influencing-organisational-culture-to-improve-hospital-performance-in-care-of-patients-with-acute-myocardial-infarction-a-mixed-methods-intervention-study
#8
Leslie A Curry, Marie A Brault, Erika L Linnander, Zahirah McNatt, Amanda L Brewster, Emily Cherlin, Signe Peterson Flieger, Henry H Ting, Elizabeth H Bradley
BACKGROUND: Hospital organisational culture affects patient outcomes including mortality rates for patients with acute myocardial infarction; however, little is known about whether and how culture can be positively influenced. METHODS: This is a 2-year, mixed-methods interventional study in 10 US hospitals to foster improvements in five domains of organisational culture: (1) learning environment, (2) senior management support, (3) psychological safety, (4) commitment to the organisation and (5) time for improvement...
November 3, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29101291/is-quality-important-to-our-patients-the-relationship-between-surgical-outcomes-and-patient-satisfaction
#9
Kristel Lobo Prabhu, Michelle C Cleghorn, Ahmad Elnahas, Alvina Tse, Azusa Maeda, Fayez A Quereshy, Allan Okrainec, Timothy D Jackson
BACKGROUND: With greater transparency in health system reporting and increased reliance on patient-centred outcomes, patient satisfaction has become a priority in delivering quality care. We sought to explore the relationship between patient satisfaction and short-term outcomes in patients undergoing general surgical procedures. METHODS: Satisfaction surveys were distributed to patients following discharge from the general surgery service at an academic hospital between June 2012 and March 2015...
November 3, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29101290/how-guiding-coalitions-promote-positive-culture-change-in-hospitals-a-longitudinal-mixed-methods-interventional-study
#10
Elizabeth H Bradley, Amanda L Brewster, Zahirah McNatt, Erika L Linnander, Emily Cherlin, Heather Fosburgh, Henry H Ting, Leslie A Curry
BACKGROUND: Quality collaboratives are widely endorsed as a potentially effective method for translating and spreading best practices for acute myocardial infarction (AMI) care. Nevertheless, hospital success in improving performance through participation in collaboratives varies markedly. We sought to understand what distinguished hospitals that succeeded in shifting culture and reducing 30-day risk-standardised mortality rate (RSMR) after AMI through their participation in the Leadership Saves Lives (LSL) collaborative...
November 3, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29097441/value-of-small-sample-sizes-in-rapid-cycle-quality-improvement-projects-2-assessing-fidelity-of-implementation-for-improvement-interventions
#11
REVIEW
Edward Etchells, Thomas Woodcock
No abstract text is available yet for this article.
November 2, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29079641/reorganisation-of-stroke-care-and-impact-on-mortality-in-patients-admitted-during-weekends-a-national-descriptive-study-based-on-administrative-data
#12
Violeta Balinskaite, Alex Bottle, Louise Johanna Shaw, Azeem Majeed, Paul Aylin
OBJECTIVE: To evaluate mortality differences between weekend and weekday emergency stroke admissions in England over time, and in particular, whether a reconfiguration of stroke services in Greater London was associated with a change in this mortality difference. DESIGN, SETTING AND PARTICIPANTS: Risk-adjusted difference-in-difference time trend analysis using hospital administrative data. All emergency patients with stroke admitted to English hospitals from 1 January 2008 to 31 December 2014 were included...
October 27, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29070513/simplifying-care-when-is-the-treatment-burden-too-much-for-patients-living-in-poverty
#13
EDITORIAL
Joseph Nwadiuko, Laura D Sander
No abstract text is available yet for this article.
October 25, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29066616/precommitting-to-choose-wisely-about-low-value-services-a-stepped-wedge-cluster-randomised-trial
#14
Jeffrey Todd Kullgren, Erin Krupka, Abigail Schachter, Ariel Linden, Jacquelyn Miller, Yubraj Acharya, James Alford, Richard Duffy, Julia Adler-Milstein
BACKGROUND: Little is known about how to discourage clinicians from ordering low-value services. Our objective was to test whether clinicians committing their future selves (ie, precommitting) to follow Choosing Wisely recommendations with decision supports could decrease potentially low-value orders. METHODS: We conducted a 12-month stepped wedge cluster randomised trial among 45 primary care physicians and advanced practice providers in six adult primary care clinics of a US community group practice...
October 24, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29066615/quality-of-provider-offered-medicare-advantage-plans
#15
Zoe M Lyon, Yevgeniy Feyman, Garret M Johnson, Austin B Frakt
No abstract text is available yet for this article.
October 24, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29055901/balancing-measures-or-a-balanced-accounting-of-improvement-impact-a-qualitative-analysis-of-individual-and-focus-group-interviews-with-improvement-experts-in-scotland
#16
Madalina Toma, Tobias Dreischulte, Nicola M Gray, Diane Campbell, Bruce Guthrie
BACKGROUND: As quality improvement (QI) programmes have become progressively larger scale, the risks of implementation having unintended consequences are increasingly recognised. More routine use of balancing measures to monitor unintended consequences has been proposed to evaluate overall effectiveness, but in practice published improvement interventions hardly ever report identification or measurement of consequences other than intended goals of improvement. METHODS: We conducted 15 semistructured interviews and two focus groups with 24 improvement experts to explore the current understanding of balancing measures in QI and inform a more balanced accounting of the overall impact of improvement interventions...
October 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29055900/balancing-the-skills-the-need-for-an-improvement-pyramid
#17
EDITORIAL
John Gabbay, Andrée le May, Con Connell, Jonathan H Klein
No abstract text is available yet for this article.
October 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29055899/are-quality-improvement-collaboratives-effective-a-systematic-review
#18
REVIEW
Susan Wells, Orly Tamir, Jonathon Gray, Dhevaksha Naidoo, Mark Bekhit, Don Goldmann
BACKGROUND: Quality improvement collaboratives (QIC) have proliferated internationally, but there is little empirical evidence for their effectiveness. METHOD: We searched Medline, Embase, CINAHL, PsycINFO and the Cochrane Library databases from January 1995 to December 2014. Studies were included if they met the criteria for a QIC intervention and the Cochrane Effective Practice and Organisation of Care (EPOC) minimum study design characteristics for inclusion in a review...
October 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29055898/night-time-communication-at-stanford-university-hospital-perceptions-reality-and-solutions
#19
Andrew Jordan Sun, Libo Wang, Minjoung Go, Zac Eggers, Raymond Deng, Paul Maggio, Lisa Shieh
BACKGROUND: Resident work hour restrictions have led to the creation of the 'night float' to care for the patients of multiple primary teams after hours. These residents are often inundated with acute issues in the numerous patients they cover and are less able to address non-urgent issues that arise at night. Further, non-urgent pages may contribute to physician alarm fatigue and negatively impact patient outcomes. OBJECTIVE: To delineate the burden of non-urgent paging at night and propose solutions...
October 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29018058/impact-of-an-inpatient-electronic-prescribing-system-on-prescribing-error-causation-a-qualitative-evaluation-in-an-english-hospital
#20
Seetal Jheeta Puaar, Bryony Dean Franklin
BACKGROUND: Few studies have applied a systems approach to understanding the causes of specific prescribing errors in the context of hospital electronic prescribing (EP). A comprehensive understanding of underlying causes is essential for developing effective interventions to improve prescribing safety. Our objectives were to explore prescribers' perspectives of the causes of errors occurring with EP and to make recommendations to maximise benefits and minimise risks. METHODS: We studied a large hospital using inpatient EP...
October 10, 2017: BMJ Quality & Safety
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