International journal for quality in health care : journal of the International Society for Quality in Health Care
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Recently, quality tools have been promoted to improve patient safety and process efficiency in healthcare. While surgeons primarily focused on surgical issues, like infection rates or implant design, we introduced pre-admission and preoperative checklists in the early 2000s. ⋯ The introduction of checklists alone did not in itself guarantee an improved workflow. The introduction must be accompanied by other measures, like written standards and regular training of employees. Otherwise, the positive effect wears off quickly. Nevertheless, we could show that the stringent application of quality tools can induce a sustainable change. Our data further suggest that the clear and traceable delegation of responsibilities is of high importance.
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Int J Qual Health Care · Jun 2016
Observational StudyCohort study for evaluation of dose omission without justification in a teaching general hospital in Bahia, Brazil.
To evaluate the incidence of medication errors due to dose omissions and the reasons for non-administration of medications. ⋯ High incidence of omission errors occurs in our institution. Factors such as the deficit of nursing staff and clinical pharmacists and a weak medication dispensing system, probably contributed to incidence detected. Blinding nursing staff was essential to improve the sensibility of the method for detecting omission errors.
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Int J Qual Health Care · Jun 2016
Development, implementation and evaluation of a patient handoff tool to improve safety in orthopaedic surgery.
To develop, implement and test the effect of a handoff tool for orthopaedic trauma residents that reduces adverse events associated with the omission of critical information and the transfer of erroneous information. ⋯ Preliminary evidence suggests that our resident handoff tool may contribute to a decrease in adverse events in orthopaedic patients.
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Int J Qual Health Care · Jun 2016
Qualitative analysis of US Department of veterans affairs mental health clinician perspectives on patient-centered care.
Enhanced patient involvement in care has the potential to improve patient experiences and health outcomes. As such, large national and global healthcare systems and organizations, including the US Department of Veterans Affairs (VA), have made patient-centered care a primary goal. Little is known about mental health clinician perspectives on, and experiences with, providing patient-centered care. Our main objective was to better understand VA mental health clinicians' perceptions of patient-centered care, and ascertain possible facilitators and barriers to patient-centered practices in mental health settings. ⋯ If patient-centered care is to be practiced fully in mental health settings, healthcare institutions need to develop multimodal strategies to enhance clinician-clinician and clinician-patient collaborations to promote and support a focus on discovery and shared accountability for outcomes.
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Int J Qual Health Care · Jun 2016
A mixed-methods study of the causes and impact of poor teamwork between junior doctors and nurses.
This study aimed to collect and analyse examples of poor teamwork between junior doctors and nurses; identify the teamwork failures contributing to poor team function; and ascertain if particular teamwork failures are associated with higher levels of risk to patients. ⋯ Poor teamwork between junior doctors and nurses is common and places patients at considerable risk. Addressing this problem requires a well-designed complex intervention to develop the team skills of doctors and nurses and foster a clinical environment in which teamwork is supported.