BMJ quality & safety
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BMJ quality & safety · Oct 2021
Randomized Controlled TrialEffectiveness of a multifaceted intervention to improve emergency department care of low back pain: a stepped-wedge, cluster-randomised trial.
Overuse of lumbar imaging is common in the emergency department (ED). Few trials have examined interventions to address this. We evaluated the effectiveness of a multifaceted intervention to implement guideline recommendations for low back pain in the emergency department. ⋯ It is uncertain if a multifaceted intervention to implement guideline recommendations for low back pain care decreased lumbar imaging in the ED; however, it did reduce opioid prescriptions without adversely affecting patient outcomes. Trial registration number ACTRN12617001160325.
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BMJ quality & safety · Sep 2021
Randomized Controlled TrialMedical crisis checklists in the emergency department: a simulation-based multi-institutional randomised controlled trial.
Studies carried out in simulated environments suggest that checklists improve the management of surgical and intensive care crises. Whether checklists improve the management of medical crises simulated in actual emergency departments (EDs) is unknown. ⋯ In this multi-institution study, checklists markedly improved local resuscitation teams' management of medical crises simulated in situ, and most personnel reported that they would use the checklists if they had a similar case in reality.
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BMJ quality & safety · Sep 2019
Randomized Controlled Trial Multicenter StudyExposure to incivility hinders clinical performance in a simulated operative crisis.
Incivil behaviour by surgeons in a simulated operating room crisis undermines anaesthesia trainee performance across all domains.
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BMJ quality & safety · Sep 2019
Randomized Controlled TrialElectronic health record-based clinical decision support alert for severe sepsis: a randomised evaluation.
Sepsis remains the top cause of morbidity and mortality of hospitalised patients despite concerted efforts. Clinical decision support for sepsis has shown mixed results reflecting heterogeneous populations, methodologies and interventions. ⋯ An EHR-based severe sepsis alert did not result in a statistically significant improvement in several sepsis treatment performance measures.
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BMJ quality & safety · Sep 2018
Randomized Controlled TrialNext-generation audit and feedback for inpatient quality improvement using electronic health record data: a cluster randomised controlled trial.
Audit and feedback improves clinical care by highlighting the gap between current and ideal practice. We combined best practices of audit and feedback with continuously generated electronic health record data to improve performance on quality metrics in an inpatient setting. ⋯ The trial was registered with ClinicalTrials.gov (NCT02593253).