BMJ quality & safety
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BMJ quality & safety · Apr 2020
Multicenter Study Observational StudyStudy of a multisite prospective adverse event surveillance system.
We have designed a prospective adverse event (AE) surveillance method. We performed this study to evaluate this method's performance in several hospitals simultaneously. ⋯ This study demonstrated that it is possible to implement prospective surveillance in different settings. Such surveillance appears to be better suited to evaluating hospital safety concerns within rather than between hospitals as we could not definitively rule out whether the observed variation in AE risk was due to population or surveillance factors.
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BMJ quality & safety · Apr 2015
Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems.
Medication computerised provider order entry (CPOE) has been shown to decrease errors and is being widely adopted. However, CPOE also has potential for introducing or contributing to errors. ⋯ Medication error reports provide valuable information for understanding CPOE-related errors. Reports were useful for developing taxonomy and identifying recurring errors to which current CPOE systems are vulnerable. Enhanced monitoring, reporting and testing of CPOE systems are important to improve CPOE safety.
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BMJ quality & safety · Apr 2020
Contribution of primary care organisation and specialist care provider to variation in GP referrals for suspected cancer: ecological analysis of national data.
To examine how much of the variation between general practices in referral rates and cancer detection rates is attributable to local health services rather than the practices or their populations. ⋯ This is the first large-scale finding that a substantial proportion of the variation between general practitioner practices in referrals is attributable to their local healthcare systems. Efforts to reduce variation need to focus not just on individual practices but on local diagnostic service provision and culture at the interface of primary and secondary care.
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BMJ quality & safety · Nov 2019
Comparative StudyNursing roles for in-hospital cardiac arrest response: higher versus lower performing hospitals.
Good outcomes for in-hospital cardiac arrest (IHCA) depend on a skilled resuscitation team, prompt initiation of high-quality cardiopulmonary resuscitation and defibrillation, and organisational structures to support IHCA response. We examined the role of nurses in resuscitation, contrasting higher versus lower performing hospitals in IHCA survival. ⋯ Hospitals that excelled in IHCA survival emphasised mentoring and empowering front-line nurses and ensured clinical competency and adequate nursing training for IHCA care. Though not proof of causation, nurses appear to be critical to effective IHCA response, and how to support their role to optimise outcomes warrants further investigation.
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BMJ quality & safety · Sep 2019
Multicenter StudyVariation in use and outcomes related to midline catheters: results from a multicentre pilot study.
While midline vascular catheters are gaining popularity in clinical practice, patterns of use and outcomes related to these devices are not well known. ⋯ Midline use and outcomes vary widely across hospitals. Although rates of major complications are low, device removal as a result of adverse events is common.