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BMJ Quality & Safety

Laura Anselmi, Rachel Meacock, Søren Rud Kristensen, Tim Doran, Matt Sutton
BACKGROUND: Studies finding higher mortality rates for patients admitted to hospital at weekends rely on routine administrative data to adjust for risk of death, but these data may not adequately capture severity of illness. We examined how rates of patient arrival at accident and emergency (A&E) departments by ambulance-a marker of illness severity-were associated with in-hospital mortality by day and time of attendance. METHODS: Retrospective observational study of 3 027 946 admissions to 140 non-specialist hospital trusts in England between April 2013 and February 2014...
October 18, 2016: BMJ Quality & Safety
Kaveh G Shojania, Mary Dixon-Woods
No abstract text is available yet for this article.
October 12, 2016: BMJ Quality & Safety
George Larcos, Mirela Prgomet, Andrew Georgiou, Johanna Westbrook
BACKGROUND: Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. METHODS: We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel)...
October 5, 2016: BMJ Quality & Safety
Ashley N D Meyer, Hardeep Singh
No abstract text is available yet for this article.
September 26, 2016: BMJ Quality & Safety
Marleen Kunneman, Victor M Montori
No abstract text is available yet for this article.
September 26, 2016: BMJ Quality & Safety
Darlene Tad-Y, Heidi L Wald
No abstract text is available yet for this article.
September 21, 2016: BMJ Quality & Safety
Jessica Sheringham, Rachel Sequeira, Jonathan Myles, William Hamilton, Joe McDonnell, Judith Offman, Stephen Duffy, Rosalind Raine
INTRODUCTION: Lung cancer survival is low and comparatively poor in the UK. Patients with symptoms suggestive of lung cancer commonly consult primary care, but it is unclear how general practitioners (GPs) distinguish which patients require further investigation. This study examined how patients' clinical and sociodemographic characteristics influence GPs' decisions to initiate lung cancer investigations. METHODS: A factorial experiment was conducted among a national sample of 227 English GPs using vignettes presented as simulated consultations...
September 20, 2016: BMJ Quality & Safety
Ann-Marie Howell, Elaine M Burns, Louise Hull, Erik Mayer, Nick Sevdalis, Ara Darzi
No abstract text is available yet for this article.
September 12, 2016: BMJ Quality & Safety
Venanzio Vella, Paul P Aylin, Luke Moore, Alice King, Nichola R Naylor, Gabriel J C Birgand, Hannah Lishman, Alison Holmes
BACKGROUND: The study aimed to identify thresholds for hospital bed utilisation which are independently associated with significantly higher risks for Clostridium difficile infections (CDI) in acute hospitals in England. METHOD: A retrospective analysis was carried out on reported data from the English National Health Service (NHS) for the financial year 2013/2014. Reported rates of CDI were used as a proxy for hospital infection rates in acute NHS hospital trusts...
September 6, 2016: BMJ Quality & Safety
Alan J Card
No abstract text is available yet for this article.
September 2, 2016: BMJ Quality & Safety
Louise Isager Rabøl, Ove Gaardboe, Annemarie Hellebek
No abstract text is available yet for this article.
August 24, 2016: BMJ Quality & Safety
Debra L Roter, Jennifer Wolff, Albert Wu, Annegret F Hannawa
No abstract text is available yet for this article.
August 24, 2016: BMJ Quality & Safety
P L Trbovich, Sylvia Hyland
No abstract text is available yet for this article.
August 23, 2016: BMJ Quality & Safety
Andi Shahu, Jennifer Schwartz, Mallory Perez, Susannah M Bernheim, Harlan M Krumholz, Erica S Spatz
No abstract text is available yet for this article.
August 18, 2016: BMJ Quality & Safety
Hardeep Singh, Gordon D Schiff, Mark L Graber, Igho Onakpoya, Matthew J Thompson
Diagnosis is one of the most important tasks performed by primary care physicians. The World Health Organization (WHO) recently prioritized patient safety areas in primary care, and included diagnostic errors as a high-priority problem. In addition, a recent report from the Institute of Medicine in the USA, 'Improving Diagnosis in Health Care', concluded that most people will likely experience a diagnostic error in their lifetime. In this narrative review, we discuss the global significance, burden and contributory factors related to diagnostic errors in primary care...
August 16, 2016: BMJ Quality & Safety
Leti van Bodegom-Vos, Frank Davidoff, Perla J Marang-van de Mheen
Avoiding low value care received increasing attention in many countries, as with the Choosing Wisely campaign and other initiatives to abandon care that wastes resources or delivers no benefit to patients. While an extensive literature characterises approaches to implementing evidence-based care, we have limited understanding of the process of de-implementation, such as abandoning existing low value practices. To learn more about the differences between implementation and de-implementation, we explored the literature and analysed data from two published studies (one implementation and one de-implementation) by the same orthopaedic surgeons...
August 10, 2016: BMJ Quality & Safety
Karina W Davidson, Jonathan Shaffer, Siqin Ye, Louise Falzon, Iheanacho O Emeruwa, Kevin Sundquist, Ifeoma A Inneh, Susan L Mascitelli, Wilhelmina M Manzano, David K Vawdrey, Henry H Ting
BACKGROUND: Many hospital systems seek to improve patient satisfaction as assessed by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. A systematic review of the current experimental evidence could inform these efforts and does not yet exist. METHODS: We conducted a systematic review of the literature by searching electronic databases, including MEDLINE and EMBASE, the six databases of the Cochrane Library and grey literature databases...
August 3, 2016: BMJ Quality & Safety
Susan M Dovey, Sharon Leitch
No abstract text is available yet for this article.
August 2, 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)...
July 29, 2016: BMJ Quality & Safety
Andrew Finkel Beck, Lauren G Solan, Stephanie A Brunswick, Hadley Sauers-Ford, Jeffrey M Simmons, Samir Shah, Jennifer Gold, Susan N Sherman
BACKGROUND: Stress caused by hospitalisations and transition periods can place patients at a heightened risk for adverse health outcomes. Additionally, hospitalisations and transitions to home may be experienced in different ways by families with different resources and support systems. Such differences may perpetuate postdischarge disparities. OBJECTIVE: We sought to determine, qualitatively, how the hospitalisation and transition experiences differed among families of varying socioeconomic status (SES)...
July 28, 2016: BMJ Quality & Safety
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