Qual Saf Health Care
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Qual Saf Health Care · Dec 2010
ReviewQuality assessment of clinical practice guidelines in perioperative care: a systematic appraisal.
Surgical care is an important burden in healthcare, and the complications and harm related to surgery are of special concern. Clinical practice guidelines in perioperative care should provide the opportunity to minimise these risks and improve surgical outcomes, but their quality has not yet been evaluated systematically. ⋯ The quality of guidelines for perioperative care is moderate. Measures should be taken to guarantee that CPGs are based on the best available evidence and rigorously developed and reported. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.
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Qual Saf Health Care · Dec 2010
ReviewCoping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals' psychological well-being.
Previous research has established health professionals as secondary victims of medical error, with the identification of a range of emotional and psychological repercussions that may occur as a result of involvement in error.2 3 Due to the vast range of emotional and psychological outcomes, research to date has been inconsistent in the variables measured and tools used. Therefore, differing conclusions have been drawn as to the nature of the impact of error on professionals and the subsequent repercussions for their team, patients and healthcare institution. A systematic review was conducted. ⋯ It is evident that involvement in a medical error can elicit a significant psychological response from the health professional involved. However, a lack of literature around coping and support, coupled with inconsistencies and weaknesses in methodology, may need be addressed in future work.
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Qual Saf Health Care · Dec 2010
Acute care practices relevant to quality end-of-life care: a survey of Pennsylvania hospitals.
Improving end-of-life care in the hospital is a national priority. ⋯ There is low penetration of hospital practices relevant to quality end-of-life care in Pennsylvania acute care hospitals. Our results may serve to inform the development of future benchmark goals. It is critical to establish a strong evidence base for the practices most associated with improved end-of-life care outcomes and to develop quality measures for end-of-life care to complement existing hospital quality measures that primarily focus on life extension.
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Qual Saf Health Care · Dec 2010
Medication reconciliation in the emergency department: opportunities for workflow redesign.
To examine the role of workflow redesign to improve medication reconciliation at four Washington State community hospital emergency departments. ⋯ Ideas for an optimal workflow to generate a medication list include involving patients and utilising clerical staff to a greater extent in medication information gathering, identifying and flagging patients with missing medication information, and gathering only the medication information needed to make clinical decisions in the emergency department.
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Cardiac surgery (PCS) has a low error tolerance, is dependent upon sophisticated organisational structures and demands high levels of cognitive and technical performance. The aim of the study was to assess the role of intraoperative non-routine events (NREs) and team performance on paediatric cardiac surgery outcomes. The current paper focuses on improving methods for studying teamwork; a companion paper will report on the empirical results. ⋯ PCS is an ideal model to explore team performance. A challenge for the future is to make observations of teamwork in healthcare settings more efficient and robust.