BMJ quality & safety
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BMJ quality & safety · Jan 2014
Randomized Controlled Trial Multicenter StudyEffects of a team-based assessment and intervention on patient safety culture in general practice: an open randomised controlled trial.
The measurement of safety culture in healthcare is generally regarded as a first step towards improvement. Based on a self-assessment of safety culture, the Frankfurt Patient Safety Matrix (FraTrix) aims to enable healthcare teams to improve safety culture in their organisations. In this study we assessed the effects of FraTrix on safety culture in general practice. ⋯ Applied as a team-based instrument to assess safety culture, FraTrix did not lead to measurable improvements in error management. Comparable studies with more positive results had less robust study designs. In future research, validated combined methods to measure safety culture will be required. In addition, more attention should be paid to evaluation of process parameters. Implemented actions and incident reporting may be more appropriate target endpoints.
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BMJ quality & safety · Jan 2014
Multicenter Study Observational StudyCharacterising the complexity of medication safety using a human factors approach: an observational study in two intensive care units.
To examine medication safety in two intensive care units (ICU), and to assess the complexity of medication errors and adverse drug events (ADE) in ICUs across the stages of the medication-management process. ⋯ Understanding the complexity of the vulnerabilities of the medication-management process is important to devise solutions to improve patient safety. Electronic health record technology with computerised physician order entry may be one step necessary to improve medication safety in ICUs. Solutions that target multiple stages of the medication-management process are necessary to address sequential errors.
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BMJ quality & safety · Nov 2013
Multicenter Study Observational StudyA prospective, observational study of the effects of implementation strategy on compliance with a surgical safety checklist.
The reported benefits of using the WHO Surgical Safety Checklist (SSC) are likely to depend on compliance with its correct use. Compliance with SSC administration in centres that have introduced the checklist under a research protocol may differ from centres where the SSC is introduced independently. ⋯ Australian and New Zealand Clinical Trials Registry: Ref: ACTRN12612000135819, http://www.anzctr.org.au/trial_view.aspx?ID=362007.
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BMJ quality & safety · Aug 2013
Multicenter Study Observational StudyInterruptions in emergency department work: an observational and interview study.
Frequent interruptions are assumed to have a negative effect on healthcare clinicians' working memory that could result in risk for errors and hence threatening patient safety. The aim of this study was to explore interruptions occurring during common activities of clinicians working in emergency departments. ⋯ Clinicians were exposed to interruptions most often during information exchange. Relative to its occurrence, preparation of medication was the most common activity to be interrupted, which might increase risk for errors. Interruptions seemed to be perceived as something negative when related to disturbed work processes.
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BMJ quality & safety · Aug 2013
Multicenter Study Observational StudyThe 'time-out' procedure: an institutional ethnography of how it is conducted in actual clinical practice.
The time-out procedure is a critically important communication interaction for the preservation of patient safety in the surgical setting. While previous research has examined influences shaping the time-out procedure, limited information exists on how actual time-out communication is performed by multidisciplinary surgical team members in the clinical environment. ⋯ Patient safety was relegated in importance as productivity, professional and hierarchical discourses configured the communication practices of surgical team members to limit active, open and direct communication. Examining how the time-out procedure was conducted in the clinical environment enables possibilities to emerge for facilitating compliance with hospital and WHO guidelines.