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Quality and safety in Healthcare

Fiona Kelly, Sara McMillan, Jean Spinks, Emilie Bettington, Amanda J Wheeler
BACKGROUND: Consumers most commonly discard unwanted medicines in household rubbish or drains, however, there are global concerns over the extent, environmental impact and health risks. When consumers procure or store medicines for future use, this can impact negatively on quality use of medicines and consumer safety. We sought greater insight into the extent of these practices by exploring the volume and types of medicines in Australian homes, and self-reported practices related to medicine accumulation, use and disposal...
August 17, 2018: BMC Public Health
Juthaporn Cowan, Sunita Mulpuru, Shawn Aaron, Gonzalo Alvarez, Antonio Giulivi, Vicente Corrales-Medina, Venkatesh Thiruganasambandamoorthy, Kednapa Thavorn, Ranjeeta Mallick, D William Cameron
Background: Chronic obstructive pulmonary disease (COPD) is a chronic progressive inflammatory disease of the airways, associated with frailty, disability, co-morbidity, and mortality. Individuals with COPD experience increased risk and rates of acute exacerbation as their lung disease worsens. Current treatments to prevent acute exacerbation of COPD (AECOPD) are only modestly effective. New therapies are needed to improve the quality of life and clinical outcomes for individuals living with COPD and especially for those prone to frequent recurrent AECOPD...
2018: Pilot and Feasibility Studies
Michael C Grant, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Matthew D McEvoy, Adam B King, Christopher L Wu
Enhanced recovery after surgery protocols for bariatric surgery are increasingly being implemented, and reports suggest that they may be associated with superior outcomes, reduced length of hospital stay, and cost savings. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery. We have conducted an evidence review to select anesthetic interventions that positively influence outcomes and facilitate recovery after bariatric surgery...
August 14, 2018: Anesthesia and Analgesia
Andrew Johnson, Robyn Clay-Williams, Paul Lane
In September 2017, the Royal Australasian College of Medical Administrators adopted a new clinical governance framework that recognised healthcare as a complex adaptive system, and embraced the need for resilient thinking and understanding the differences between work-as-imagined by managers and work-as-done at the front line of patient care. Directors of medical services may soon be implementing the framework in health services across Australia. This perspective describes a new conceptual model that underpins the Royal Australasian College of Medical Administrators framework, and characterises the challenges faced by all healthcare professionals when trying to achieve safe care for patients in an environment of variable complexity and unpredictability...
August 16, 2018: Australian Health Review: a Publication of the Australian Hospital Association
H Bruce Vogt, Jennifer Tinguely, Jill Franken, Shelly Ten Napel
Community health centers (CHCs) are a critical component of the healthcare safety network. The modern era of CHCs began in the mid-1960s although their origin can be traced back as far as the first two decades of the 20th century. Over 24 million people receive their healthcare in CHCs. North and South Dakota are home to nine centers and provided care to nearly 110,000 medical and dental patients in 2017. All CHCs use a uniform data set to report annually on demographics, scope of practice, and clinical measures to assure that they remain true to their original mission to provide quality healthcare to the most vulnerable of our population...
August 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Katherine Smiley, Love Ofori, Cindy Spangler, Rebecca Acquaah-Arhin, Deborah Deh, Juliana Enos, Stephen Manortey, Frank Baiden, Samuel Finlayson, Raymond Price, Marta McCrum
BACKGROUND: The Volta River Authority Hospital (VRAH) is a district hospital associated with a large public works project in Akosombo, Ghana, that has developed a reputation for high-quality care. We hypothesized that this stems from a culture of safety and standardized processes typical of high-risk engineering environments. To investigate this, we evaluated staff and patient perceptions of safety and quality, as well as perioperative process variability. MATERIALS AND METHODS: The Safety Attitudes Questionnaire (SAQ) and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys were used to evaluate staff and patient perceptions of safety...
August 14, 2018: World Journal of Surgery
Lei Qiao, Wenqiang Chen
Traditional Chinese medicine (TCM) has served the Chinese people since antiquity, and is playing an important role in today's healthcare. However, there has been controversy in the use of these traditional herbs due to unclear components and absence of scientific proof. As China plans to modernize traditional medicine, successful attempts to better understand the molecular mechanisms of TCM have been made by focusing on isolating active ingredients from these remedies. In this review, we critically examined the current evidence on atheroprotective effects of bioactive compounds from TCM using in vitro or in vivo models in the past two decades...
August 11, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Sebastian Schneeweiss, Robert J Glynn
Healthcare database analyses (claims, electronic health records) have been identified by various regulatory initiatives, including the 21st Century Cures Act and Prescription Drug User Fee Act ("PDUFA"), as useful supplements to randomized clinical trials to generate evidence on the effectiveness, harm, and value of medical products in routine care. Specific applications include accelerated drug approval pathways and secondary indications for approved medical products. Such real-world data ("RWD") analyses reflect how medical products impact health outside a highly controlled research environment...
May 2018: American Journal of Law & Medicine
Julia Hiromi Hori Okuyama, Tais Freire Galvao, Marcus Tolentino Silva
Objective: To assess the culture of patient safety in studies that employed the hospital survey on patient safety culture (HSOPS) in hospitals around the world. Method: We searched MEDLINE, EMBASE, SCOPUS, CINAHL, and SciELO. Two researchers selected studies and extracted the following data: year of publication, country, percentage of physicians and nurses, sample size, and results for the 12 HSOPS dimensions. For each dimension, a random effects meta-analysis with double-arcsine transformation was performed, as well as meta-regressions to investigate heterogeneity, and tests for publication bias...
2018: TheScientificWorldJournal
Martin de Bock, Sybil A McAuley, Mary Binsu Abraham, Grant Smith, Jennifer Nicholas, Geoff R Ambler, Fergus J Cameron, Jan M Fairchild, Bruce R King, Elizabeth A Geelhoed, Elizabeth A Davis, David Norman O'Neal, Timothy W Jones
INTRODUCTION: Automated insulin delivery (also known as closed loop, or artificial pancreas) has shown potential to improve glycaemic control and quality of life in people with type 1 diabetes (T1D). Automated insulin delivery devices incorporate an insulin pump with continuous glucose monitoring(CGM) and an algorithm, and adjust insulin in real time. This study aims to establish the safety and efficacy of a hybrid closed-loop (HCL) system in a long-term outpatient trial in people with T1D aged 12 -<25 years of age, and compare outcomes with standard therapy for T1D as used in the contemporary community...
August 13, 2018: BMJ Open
Neda Jamalimoghadam, Shahrzad Yektatalab, Marzieh Momennasab, Abbas Ebadi, Najaf Zare
BACKGROUND: The feeling of safety makes an important contribution to the sense of well-being and quality of care for hospitalized adolescents, who are at a higher risk of feeling unsafe. Feeling unsafe during hospitalization may have a negative impact on recovery. Nurses must be sensitive to the possibility that patients feel unsafe, even in the absence of obvious direct physical threat. PURPOSE: This study explores the experiences of hospitalized adolescents to obtain an understanding of psychological safety...
August 11, 2018: Journal of Nursing Research: JNR
David Novillo-Ortiz, Elsy Maria Dumit, Marcelo D'Agostino, Francisco Becerra-Posada, Edward Talbott Kelley, Joan Torrent-Sellens, Ana Jiménez-Zarco, Francesc Saigí-Rubió
In 2005, all WHO Member States pledged to fight for universal health coverage (UHC). The availability of financial, human and technological resources seems to be necessary to develop efficient health policies and also to offer UHC. One of the main challenges facing the health sector comes from the need to innovate efficiently. The intense use of information and communication technologies (ICTs) in the health field evidences a notable improvement in results obtained by institutions, health professionals and patients, principally in developed countries...
July 2018: BMJ Innovations
Christof Schaefer
Drug safety in pregnancy is of utmost importance because prenatal exposure to the unborn child may result in side effects with life-long consequences. Data on their risks in pregnancy are scarce for many drugs. Furthermore, there is often uncertainty how to translate risk data into practice.This article aims to identify tools to improve data ascertainment on exposed pregnancies and their outcome. Using the example of the German Embryotox institute, it is demonstrated how to disseminate drug safety knowledge to healthcare professionals and patients for clinical decision-making...
August 9, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Tita Alissa Bach, Lars-Martin Berglund, Eva Turk
Objective: To provide an overview of documented studies and initiatives that demonstrate efforts to manage and improve alarm systems for quality in healthcare by human, organisational and technical factors. Methods: A literature review, a grey literature review, interviews and a review of alarm-related standards (IEC 60601-1-8, IEC 62366-1:2015 and ANSI/Advancement of Medical Instrumentation HE 75:2009/2013) were conducted. Qualitative analysis was conducted to identify common themes of improvement elements in the literature and grey literature reviews, interviews and the review of alarm-related standards...
2018: BMJ Open Quality
Bo-Young Jang, Dong-Mug Kang, Young-Ki Kim, Se-Young Kim, Kyung-Sun Ko
Background: This study aimed to identify the difference of perception about the role of appointing health officers by comparing and analyzing the response of entrustment workplace (EW) and specialized health management institution (SI). This is considered an important aspect of an institutional assessment to improve the quality of health management services. Methods: A survey questionnaire was mailed to 122 SIs and 319 EWs nationwide. The questionnaire survey was about the general characteristics of SIs and EWs and main occupations for each evaluation item...
2018: Annals of Occupational and Environmental Medicine
Karthik Sivashanker, John Fanikos, Allen Kachalia
A lack of access to critical drugs in the USA, either due to exorbitant prices or shortages, has become a troubling norm that threatens the quality and safety of healthcare. In 2017, there were shortages of 146 commonly used drugs including electrolytes, chemotherapy, cardiovascular, and antibiotic agents. For example, there currently exists a shortage in intravenous fluids and injectable opioids (both in chronic short supply for years) that has been respectively ascribed to disruptions in pharmaceutical manufacturing by Hurricane Maria and manufacturing delays...
August 8, 2018: Journal of General Internal Medicine
Nirvani Goolsarran, Carine E Hamo, Susan Lane, Stacey Frawley, Wei-Hsin Lu
BACKGROUND: Although the American Council of Graduate Medical Education (ACGME) mandates formal education in patient safety, there is a lack of standardized educational practice on how to conduct patient safety training. Traditionally, patient safety is taught utilizing instructional strategies that promote passive learning such as self-directed online learning modules or didactic lectures that result in suboptimal learning and satisfaction. METHODS: During the summer of 2015, 76 trainees consisting of internal medicine interns and senior-level nursing students participated in an interactive patient safety workshop that used a flipped classroom approach integrating team based learning (TBL) and interprofessional simulated application exercises...
August 8, 2018: BMC Medical Education
Chih-Hsuan Huang, Hsin-Hung Wu, Cindy Yunhsin Chou, Huayong Dai, Yii-Ching Lee
Background: Physicians and nurses are core staff who are the first points of contact in care provision to patients. We aimed to examine physicians' and nurses' perceptions of patient safety in a case hospital by administering the Chinese Safety Attitude Questionnaire (CSAQ), developed from the Taiwan Joint Commission on Hospital Accreditation, in order to provide the patients with a safe environment and excellent medical service. Methods: An intra-organizational online survey was conducted...
June 2018: Iranian Journal of Public Health
Carlotta Piccardi, Jens Detollenaere, Pierre Vanden Bussche, Sara Willems
BACKGROUND: Patient safety is a quality indicator for primary care and it should be based on individual needs, and not differ among different social groups. Nevertheless, the attention on social disparities in patient safety has been mainly directed towards the hospital care, often overlooking the primary care setting. Therefore, this paper aims to synthesise social disparities in patient safety in the primary care setting. METHODS: The Databases PubMed and Web of Science were searched for relevant studies published between January 1st 2006 and January 31st 2017...
August 7, 2018: International Journal for Equity in Health
Fatima Schera, Michael Schäfer, Anca Bucur, Jasper van Leeuwen, Eric Herve Ngantchjon, Norbert Graf, Haridimos Kondylakis, Lefteris Koumakis, Kostas Marias, Stephan Kiefer
Clinical decision support systems can play a crucial role in healthcare delivery as they promise to improve health outcomes and patient safety, reduce medical errors and costs and contribute to patient satisfaction. Used in an optimal way, they increase the quality of healthcare by proposing the right information and intervention to the right person at the right time in the healthcare delivery process. This paper reports on a specific approach to integrated clinical decision support and patient guidance in the cancer domain as proposed by the H2020 iManageCancer project...
2018: Ecancermedicalscience
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