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BMJ Quality & Safety

John N Mafi, Michael Parchman
No abstract text is available yet for this article.
January 13, 2018: BMJ Quality & Safety
Dawn Goodwin, Jessica Mesman, Marian Verkerk, Suzanne Grant
No abstract text is available yet for this article.
January 13, 2018: BMJ Quality & Safety
Noah M Ivers, Jon Barrett
No abstract text is available yet for this article.
January 9, 2018: BMJ Quality & Safety
Johanna I Westbrook, Magda Raban, Scott R Walter, Heather Douglas
BACKGROUND: Interruptions and multitasking have been demonstrated in experimental studies to reduce individuals' task performance. These behaviours are frequently used by clinicians in high-workload, dynamic clinical environments, yet their effects have rarely been studied. OBJECTIVE: To assess the relative contributions of interruptions and multitasking by emergency physicians to prescribing errors. METHODS: 36 emergency physicians were shadowed over 120 hours...
January 9, 2018: BMJ Quality & Safety
Grace C Huang, Gila Kriegel, Carolyn Wheaton, Scot Sternberg, Kenneth Sands, Jeremy Richards, Katherine Johnston, Mark Aronson
BACKGROUND: Diagnostic errors result in preventable morbidity and mortality. The outpatient setting may be at increased risk, where time constraints, the indolent nature of outpatient complaints and single decision-maker practice models predominate. METHODS: We developed a self-administered diagnostic pause to address diagnostic error. Clinicians (physicians and nurse practitioners) in an academic primary care setting received the tool if they were seeing urgent care patients who had previously been seen in the past two weeks in urgent care...
January 6, 2018: BMJ Quality & Safety
Marit S de Vos, Jaap F Hamming, Perla J Marang-van de Mheen
'The Problem with…' series covers controversial topics related to efforts to improve healthcare quality, including widely recommended, but deceptively difficult strategies for improvement and pervasive problems that seem to resist solution.
January 3, 2018: BMJ Quality & Safety
Carol Sinnott
No abstract text is available yet for this article.
December 26, 2017: BMJ Quality & Safety
Karen R Sepucha, Purva Abhyankar, Aubri S Hoffman, Hilary L Bekker, Annie LeBlanc, Carrie A Levin, Mary Ropka, Victoria A Shaffer, Stacey L Sheridan, Dawn Stacey, Peep Stalmeier, Ha Vo, Celia E Wills, Richard Thomson
BACKGROUND: Patient decision aids (PDAs) are evidence-based tools designed to help patients make specific and deliberated choices among healthcare options. The International Patient Decision Aid Standards (IPDAS) Collaboration review papers and Cochrane systematic review of PDAs have found significant gaps in the reporting of evaluations of PDAs, including poor or limited reporting of PDA content, development methods and delivery. This study sought to develop and reach consensus on reporting guidelines to improve the quality of publications evaluating PDAs...
December 21, 2017: BMJ Quality & Safety
Russell Mannion, Judith Smith
No abstract text is available yet for this article.
December 20, 2017: BMJ Quality & Safety
Cecilia Vindrola-Padros, Bruno Vindrola-Padros
BACKGROUND: The ability to capture the complexities of healthcare practices and the quick turnaround of findings make rapid ethnographies appealing to the healthcare sector, where changing organisational climates and priorities require actionable findings at strategic time points. Despite methodological advancement, there continue to be challenges in the implementation of rapid ethnographies concerning sampling, the interpretation of findings and management of field research. The purpose of this review was to explore the benefits and challenges of using rapid ethnographies to inform healthcare organisation and delivery and identify areas that require improvement...
December 20, 2017: BMJ Quality & Safety
Duncan McNab, Paul Bowie, Alastair Ross, Gordon MacWalter, Martin Ryan, Jill Morrison
BACKGROUND: Pharmacists' completion of medication reconciliation in the community after hospital discharge is intended to reduce harm due to prescribed or omitted medication and increase healthcare efficiency, but the effectiveness of this approach is not clear. We systematically review the literature to evaluate intervention effectiveness in terms of discrepancy identification and resolution, clinical relevance of resolved discrepancies and healthcare utilisation, including readmission rates, emergency department attendance and primary care workload...
December 16, 2017: BMJ Quality & Safety
Veena S Raleigh, Julia Cream, Richard Murray
No abstract text is available yet for this article.
December 8, 2017: BMJ Quality & Safety
Naomi S Bardach
No abstract text is available yet for this article.
December 7, 2017: BMJ Quality & Safety
Liz Brewster, Carolyn Tarrant, Janet Willars, Natalie Armstrong
OBJECTIVES: Measurement is a vital part of improvement work. While it is known that the context of improvement work influences its success, less is known about how context affects measurement of underlying harms. We sought to explore the use of a harm measurement tool, the NHS Safety Thermometer (NHS-ST), designed for use across diverse healthcare settings in the particular context of community care. METHODS: This is a qualitative study of 19 National Health Service (NHS) organisations, 7 of which had community service provision...
December 2, 2017: BMJ Quality & Safety
Chris Gibbons, Felix Greaves
No abstract text is available yet for this article.
November 29, 2017: BMJ Quality & Safety
Richard J Lilford
No abstract text is available yet for this article.
November 28, 2017: BMJ Quality & Safety
Deborah Weiss, Sandra I Dunn, Ann E Sprague, Deshayne B Fell, Jeremy M Grimshaw, Elizabeth Darling, Ian D Graham, JoAnn Harrold, Graeme N Smith, Wendy E Peterson, Jessica Reszel, Andrea Lanes, Mark C Walker, Monica Taljaard
OBJECTIVES: To assess the effect of the Maternal Newborn Dashboard on six key clinical performance indicators in the province of Ontario, Canada. DESIGN: Interrupted time series using population-based data from the provincial birth registry covering a 3-year period before implementation of the Dashboard and 2.5 years after implementation (November 2009 through March 2015). SETTING: All hospitals in the province of Ontario providing maternal-newborn care (n=94)...
November 24, 2017: BMJ Quality & Safety
Mahima Mangla, Thomas D Cha, Janet M Dorrwachter, Andrew A Freiberg, Lauren J Leavitt, Harry E Rubash, Leigh H Simmons, Emily L Wendell, Karen R Sepucha
OBJECTIVE: To integrate patient decision aid (DA) delivery to promote shared decision-making and provide more patient-centred care within an orthopaedic surgery department for treatment of hip and knee osteoarthritis, lumbar herniated disc and lumbar spinal stenosis. METHODS: Different strategies were used across three distinct phases to promote DA delivery. First, we used a quality improvement bonus to generate awareness and interest in the DAs among specialists...
November 24, 2017: BMJ Quality & Safety
David J Wallace, Kristin N Ray, Abbye Degan, Kristen Kurland, Derek C Angus, Ana Malinow
BACKGROUND: Prior work has not studied the effects of transportation accessibility and patient factors on clinic non-arrival. OBJECTIVES: Our objectives were: (1) to evaluate transportation characteristics and patient factors associated with clinic non-arrival, (2) to evaluate the comparability of bus and car drive time estimates, and (3) to evaluate the combined effects of transportation accessibility and income on scheduled appointment non-arrival. METHODS: We queried electronic administrative records at an urban general pediatrics clinic...
November 24, 2017: BMJ Quality & Safety
Arthur W Baker, Salah Haridy, Joseph Salem, Iulian Ilieş, Awatef O Ergai, Aven Samareh, Nicholas Andrianas, James C Benneyan, Daniel J Sexton, Deverick J Anderson
BACKGROUND: Traditional strategies for surveillance of surgical site infections (SSI) have multiple limitations, including delayed and incomplete outbreak detection. Statistical process control (SPC) methods address these deficiencies by combining longitudinal analysis with graphical presentation of data. METHODS: We performed a pilot study within a large network of community hospitals to evaluate performance of SPC methods for detecting SSI outbreaks. We applied conventional Shewhart and exponentially weighted moving average (EWMA) SPC charts to 10 previously investigated SSI outbreaks that occurred from 2003 to 2013...
November 24, 2017: BMJ Quality & Safety
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