BMJ quality & safety
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BMJ quality & safety · May 2018
Randomized Controlled Trial Multicenter StudyPrecommitting to choose wisely about low-value services: a stepped wedge cluster randomised trial.
Little is known about how to discourage clinicians from ordering low-value services. Our objective was to test whether clinicians committing their future selves (ie, precommitting) to follow Choosing Wisely recommendations with decision supports could decrease potentially low-value orders. ⋯ Clinician precommitment to follow Choosing Wisely recommendations was associated with a small, unsustained decrease in potentially low-value orders for only one of three targeted conditions and may have increased alternate orders.
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BMJ quality & safety · Dec 2017
Multicenter Study Observational StudyPatients' and providers' perceptions of the preventability of hospital readmission: a prospective, observational study in four European countries.
Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority consensus to determine contributing factors that could potentially foresee (preventable) readmissions. ⋯ There is no consensus between readmitted patients, their carers and treating professionals about predictability and preventability of readmissions, nor associated risk factors. A readmitted patient reporting not feeling ready for discharge at index admission was strongly associated with preventability/predictability. Therefore, healthcare workers should question patients' readiness to go home timely before discharge.
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BMJ quality & safety · Nov 2017
Multicenter StudySpeaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents.
Open communication between healthcare professionals about care concerns, also known as 'speaking up', is essential to patient safety. ⋯ Interns and residents commonly observed unprofessional behaviour yet were less likely to speak up about it compared with traditional safety threats even when they perceived high potential patient harm. Measuring SUC-Safe, and particularly SUC-Prof, may fill an existing gap in safety culture assessment.
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BMJ quality & safety · Feb 2017
Multicenter Study Observational StudyThe frequency of intravenous medication administration errors related to smart infusion pumps: a multihospital observational study.
Intravenous medication errors persist despite the use of smart pumps. This suggests the need for a standardised methodology for measuring errors and highlights the importance of identifying issues around smart pump medication administration in order to improve patient safety. ⋯ We identified a high rate of error in the administration of intravenous medications despite the use of smart pumps. However, relatively few errors were potentially harmful. The results of this study will be useful in developing interventions to eliminate errors in the intravenous medication administration process.
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BMJ quality & safety · Nov 2014
Multicenter StudyThe WHO surgical safety checklist: survey of patients' views.
Evidence suggests that full implementation of the WHO surgical safety checklist across NHS operating theatres is still proving a challenge for many surgical teams. The aim of the current study was to assess patients' views of the checklist, which have yet to be considered and could inform its appropriate use, and influence clinical buy-in. ⋯ It is feasible and instructive to capture patients' views of the delivery of safety improvements like the checklist. We have demonstrated strong support for the checklist in a sample of surgical patients, presenting a challenge to those resistant to its use.