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https://www.readbyqxmd.com/read/28643030/hospital-electronic-prescribing-system-implementation-impact-on-discharge-information-communication-and-prescribing-errors-a-before-and-after-study
#1
Pamela Ruth Mills, Anita Elaine Weidmann, Derek Stewart
PURPOSE: The study aimed to test the hypothesis that hospital electronic prescribing and medicine administration system (HEPMA) implementation impacted patient discharge letter quality, nature and frequency of prescribing errors. METHOD: A quasi experimental before and after retrospective case note review was conducted in one United Kingdom district general hospital. The total sample size was 318 (random samples of 159 before and after implementation), calculated to achieve a 10% error reduction with a power of 80% and p < 0...
June 22, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28638509/resident-experiences-with-implementation-of-the-i-pass-handoff-bundle
#2
Maitreya Coffey, Kelly Thomson, Shelly-Anne Li, Zia Bismilla, Amy J Starmer, Jennifer K O'Toole, Rebecca L Blankenburg, Glenn Rosenbluth, F Sessions Cole, Clifton E Yu, Jennifer H Hepps, Theodore C Sectish, Nancy D Spector, Rajendu Srivastava, April D Allen, Sanjay Mahant, Christopher P Landrigan
BACKGROUND: The I-PASS Handoff Study found that introduction of a handoff bundle (handoff and teamwork training for residents, a mnemonic, a handoff tool, a faculty development program, and a sustainability campaign) at 9 pediatrics residency programs was associated with improved communication and patient safety. OBJECTIVE: This parallel qualitative study aimed to understand resident experiences with I-PASS and to inform future implementation and sustainability strategies...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28596445/development-of-a-new-care-model-for-hospitalized-children-with-medical-complexity
#3
Christine M White, Joanna E Thomson, Angela M Statile, Katherine A Auger, Ndidi Unaka, Matthew Carroll, Karen Tucker, Derek Fletcher, David E Hall, Jeffrey M Simmons, Patrick W Brady
Children with medical complexity are a rapidly growing inpatient population with frequent, lengthy, and costly hospitalizations. During hospitalization, these patients require care coordination among multiple subspecialties and their outpatient medical homes. At a large freestanding children's hospital, a new inpatient model of care was developed in an effort to consistently provide coordinated, family-centered, and efficient care. In addition to expanding the multidisciplinary team to include a pharmacist, dietician, and social worker, the team redesign included: (1) medication reconciliation rounds, (2) care coordination rounds, and (3) multidisciplinary weekly handoff with outpatient providers...
June 8, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28582879/measuring-patient-safety-culture-in-pediatric-long-term-care
#4
Amanda J Hessels, Mansi Agarwal, Lisa Saiman, Elaine L Larson
PURPOSE: The purpose of this study was to test the reliability, feasibility and utility of a modified patient safety survey for use in pediatric long term care (pLTC) settings and describe patient safety culture in a sample of providers from pLTC facilities. METHODS: A survey was adapted from the Agency for Healthcare Research and Quality Nursing Home Survey on Patient Safety Culture (PSC-pLTC) and administered to a convenience sample of providers who work in pLTC during an educational workshop in November 2015...
May 17, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/28575417/implications-of-electronic-health-record-downtime-an-analysis-of-patient-safety-event-reports
#5
Ethan Larsen, Allan Fong, Christian Wernz, Raj M Ratwani
Objective: We sought to understand the types of clinical processes, such as image and medication ordering, that are disrupted during electronic health record (EHR) downtime periods by analyzing the narratives of patient safety event report data. Materials and Methods: From a database of 80 381 event reports, 76 reports were identified as explicitly describing a safety event associated with an EHR downtime period. These reports were analyzed and categorized based on a developed code book to identify the clinical processes that were impacted by downtime...
May 30, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28574955/safety-culture-in-the-operating-room-variability-among-perioperative-healthcare-workers
#6
Marc Philip T Pimentel, Stephanie Choi, Karen Fiumara, Allen Kachalia, Richard D Urman
INTRODUCTION: Safety culture is defined as the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine an organization's health and safety management. There is a lack of studies assessing patient safety culture in the perioperative setting. OBJECTIVES: We examined safety culture at a single tertiary care hospital, across all types of surgery, using previously collected data from a validated survey tool...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28559465/reducing-unplanned-extubations-in-the-nicu-following-implementation-of-a-standardized-approach
#7
Kevin L Crezeé, Robert J DiGeronimo, Marilyn J Rigby, Rick C Carter, Shrena Patel
BACKGROUND: Unplanned extubations (UEs) have been associated with increased ventilator days, risk of infection, cardiopulmonary resuscitation, and resuscitation medication usage. The UE rate in our level 4 NICU is lower than the national average. Efforts to further reduce UE events at our institution led an interdisciplinary group to define steps to eliminate UEs. Steps included: (1) requiring at least 2 care providers at the bedside for movement of an intubated subject; (2) standardizing head and endotracheal tube (ETT) position; (3) defining a set methodology for ETT securing; (4) introducing a postoperative handoff to improve communication; and (5) implementing a post-UE assessment tool...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28559362/receiving-providers-perceptions-on-information-transmission-during-interfacility-transfers-to-general-pediatric-floors
#8
Jennifer L Rosenthal, Patrick S Romano, Jolene Kokroko, Wendi Gu, Megumi J Okumura
BACKGROUND: Pediatric patients can present to a medical facility and subsequently be transferred to a different hospital for definitive care. Interfacility transfers require a provider handoff across facilities, posing risks that may affect patient outcomes. OBJECTIVES: The goal of this study was to describe the thoroughness of information transmission between providers during interfacility transfers, to describe perceived errors in care at the posttransfer facility, and to identify potential associations between thoroughness of information transmission and perceived errors in care...
June 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28557720/a-family-centered-rounds-checklist-family-engagement-and-patient-safety-a-randomized-trial
#9
Elizabeth D Cox, Gwen C Jacobsohn, Victoria P Rajamanickam, Pascale Carayon, Michelle M Kelly, Tosha B Wetterneck, Paul J Rathouz, Roger L Brown
BACKGROUND AND OBJECTIVES: Family-centered rounds (FCRs) have become standard of care, despite the limited evaluation of FCRs' benefits or interventions to support high-quality FCR delivery. This work examines the impact of the FCR checklist intervention, a checklist and associated provider training, on performance of FCR elements, family engagement, and patient safety. METHODS: This cluster randomized trial involved 298 families. Two hospital services were randomized to use the checklist; 2 others delivered usual care...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28550926/restrictions-on-surgical-resident-shift-length-does-not-impact-type-of-medical-errors
#10
Jamie E Anderson, Laura F Goodman, Guy W Jensen, Edgardo S Salcedo, Joseph M Galante
BACKGROUND: In 2011, resident duty hours were restricted in an attempt to improve patient safety and resident education. With the goal of reducing fatigue, shorter shift length leads to more patient handoffs, raising concerns about adverse effects on patient safety. This study seeks to determine whether differences in duty-hour restrictions influence types of errors made by residents. MATERIALS AND METHODS: This is a nested retrospective cohort study at a surgery department in an academic medical center...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28538463/implementation-of-a-modified-bedside-handoff-for-a-postpartum-unit
#11
Christine A Wollenhaup, Eleanor L Stevenson, Julie Thompson, Helen A Gordon, Gloria Nunn
The most frequent cause of sentinel events is poor communication during the nurse-to-nurse handoff process. Standardized methods of handoff do not fit in every patient care setting. The aims of this quality improvement project were to successfully implement a modified bedside handoff model, with some report outside and some inside the patient's room, in a postpartum unit. A structured educational module and champion nurses were used. The new model was evaluated based on the change in compliance, patient satisfaction, and nursing satisfaction...
June 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28506546/a-model-for-electronic-handoff-between-the-emergency-department-and-inpatient-units
#12
Leon D Sanchez, David T Chiu, Larry Nathanson, Steve Horng, Richard E Wolfe, Mark L Zeidel, Kirsten Boyd, Carrie Tibbles, Shelley Calder, Jane Dufresne, Julius J Yang
BACKGROUND: Patient handoffs between units can introduce risk and time delays. Verbal communication is the most common mode of handoff, but requires coordination between different parties. OBJECTIVE: We present an asynchronous patient handoff process supported by a structured electronic signout for admissions from the emergency department (ED) to the inpatient medicine service. METHODS: A retrospective review of patients admitted to the medical service from July 1, 2011 to June 30, 2015 at a tertiary referral center with 520 inpatient beds and 57,000 ED visits annually...
May 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28501113/clinical-acuity-shorthand-system-a-standardized-classification-tool-to-facilitate-handoffs
#13
Brian F Gilmore, Adam K Brys, Neel S Nath, Michael Barfield, Kristy L Rialon, Tracy Truong, Gina-Maria Pomann, John Migaly, Paul J Mosca
BACKGROUND: The handoff of medical information from one provider to another can be inefficient and error prone, potentially undermining patient safety. Although several tools for structuring handoffs exist, none provide a brief, standardized framework for ensuring that patient acuity is efficiently and reliably communicated. We aim to introduce and perform initial testing of the Clinical Acuity Shorthand System (CLASS) (Copyright 2015, Duke University. All rights reserved.) for surgery, a patient classification tool intended to facilitate efficient communication of key patient information during handoffs...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28487461/the-impact-of-duty-cycle-workflow-on-sign-out-practices-a-qualitative-study-of-an-internal-medicine-residency-program-in-maryland-usa
#14
Soo-Hoon Lee, Sanjay V Desai, Phillip H Phan
OBJECTIVES: Although JCAHO requires a standardised approach to handoffs, and while many standardised protocols have been tested, sign-out practices continue to vary. We believe this is due to the variability in workflow during inpatient duty cycle. We investigate the impact of such workflows on intern sign-out practices. DESIGN: We employed a prospective, grounded theory mixed-method design. SETTING: The study was conducted at a residency programme in the mid-Atlantic USA...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28477319/transition-of-care-in-congenital-heart-disease-ensuring-the-proper-handoff
#15
REVIEW
Angela Lee, Barbara Bailey, Geraldine Cullen-Dean, Sandra Aiello, Joanne Morin, Erwin Oechslin
BACKGROUND: With great advances in medical and surgical care, most congenital heart disease patients are living in to adulthood and require lifelong surveillance and expert care for adult onset complications. Care lapse and lack of successful transfer from pediatric to adult care put young adults at risk for increased morbidity and premature death. Hence, transition and transfer from pediatric to adult care is a crucial and critical process to provide access to specialized care and lifelong surveillance...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28470134/standardized-icu-to-or-handoff-increases-communication-without-delaying-surgery
#16
Thomas J Caruso, Juan Luis Sandin Marquez, Melanie S Gipp, Stephen P Kelleher, Paul J Sharek
Purpose No studies have examined preoperative handoffs from the intensive care unit (ICU) to OR. Given the risk of patient harm, the authors developed a standardized ICU to OR handoff using a previously published handoff model. The purpose of this paper is to determine whether a standardized ICU to OR handoff process would increase the number of team handoffs and improve patient transport readiness. Design/methodology/approach The intervention consisted of designing a multidisciplinary, face-to-face handoff between sending ICU providers and receiving anesthesiologist and OR nurse, verbally presented in the I-PASS format...
May 8, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28469889/a-quality-improvement-approach-to-standardization-and-sustainability-of-the-hand-off-process
#17
Craig Fryman, Carine Hamo, Siddharth Raghavan, Nirvani Goolsarran
There is mounting evidence that communication and hand-off failures are a root cause of two-thirds of sentinel events in hospitals. Several studies have shown that non-standardized hand-offs have yielded poor patient outcomes and adverse events. At Stony Brook University Hospital, there were numerous reported adverse events related to poor hand-off during the transfer of patient responsibility from one resident caregiver to the next. A resident-conducted root cause analysis identified lack of a standardized hand-off process and formal training on safe and efficient hand-off among caregivers as key contributing factors...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28468724/in-search-of-a-resident-centered-handoff-tool-discovering-the-complexity-of-transitions-of-care
#18
Meredith Barrett, David Turer, Hadley Stoll, David T Hughes, Gurjit Sandhu
INTRODUCTION: Transfer of a patient's care between providers is a significant potential for medical errors. Given the potential for patient safety breeches we sought to investigate residents' perceptions of handoffs at our institution. METHODS: Residents completed an online survey assessing the effectiveness of handoffs and what they thought was necessary for safe and informative transition communication. Thematic analysis was used to identify critical themes. RESULTS: 78% of residents reported formal training in handoff delivery...
April 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28467104/the-effectiveness-of-standardized-handoff-tool-interventions-during-inter-and-intra-facility-care-transitions-on-patient-related-outcomes-a-systematic-review
#19
Jennifer L Rosenthal, Robert Doiron, Sarah C Haynes, Brock Daniels, Su-Ting T Li
Improving physician handoffs is a patient safety priority. The authors hypothesize that standardized handoff interventions during care transitions improve patient-related outcome measures. PubMed, Cochrane, PsycINFO, CINAHL, Embase, and Web of Science were searched for publications from 2000 to May 2016. Eligible studies compared standardized handoff intervention(s) with no standardized handoff intervention and measured patient-related outcomes. Studies were evaluated independently for eligibility for inclusion by at least 2 authors in a 2-stage process; 14 articles met inclusion criteria...
May 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28455194/improving-medication-information-transfer-between-hospitals-skilled-nursing-facilities-and-long-term-care-pharmacies-for-hospital-discharge-transitions-of-care-a-targeted-needs-assessment-using-the-intervention-mapping-framework
#20
Luiza Kerstenetzky, Matthew J Birschbach, Katherine F Beach, David R Hager, Korey A Kennelty
INTRODUCTION: Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy...
April 7, 2017: Research in Social & Administrative Pharmacy: RSAP
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