Qual Saf Health Care
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Qual Saf Health Care · Feb 2007
Randomized Controlled Trial Multicenter StudyMultifaceted implementation of stroke prevention guidelines in primary care: cluster-randomised evaluation of clinical and cost effectiveness.
To evaluate clinical and cost effectiveness of implementing evidence-based guidelines for the prevention of stroke. ⋯ Implementation of evidence-based guidelines improved the quality of primary care for atrial fibrillation and TIA. The intervention was feasible and very cost effective. Key components of the model include contextual analysis, strong professional support, clear recommendations based on robust evidence, simplicity of adoption, good communication and use of established networks and opinion leaders.
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Qual Saf Health Care · Feb 2007
Multicenter StudyInfluencing referral practice using feedback of adherence to NICE guidelines: a quality improvement report for dyspepsia.
Rising demand and increasing waiting times for upper gastrointestinal endoscopy (gastroscopy). ⋯ Referral assessment can be successfully introduced and shows promise as a way of improving the quality of referrals and reducing demand. Hospital clinicians are more resistant than GPs to referral assessment but nevertheless responded to the feedback by reducing their endoscopy gastroscopy requests. Most such referrals are generated in hospitals rather than in primary care: this finding has important implications for demand management.
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Qual Saf Health Care · Jun 2005
Multicenter Study Comparative StudyMedication errors in intravenous drug preparation and administration: a multicentre audit in the UK, Germany and France.
Previous studies have identified medication errors in preparing and administering intravenous medicines of 13-84% in hospitals in individual countries. ⋯ Uncontrolled risks in the intravenous systems studied were observed in all three countries. Intravenous therapy must be regarded as a high risk activity where the use of risk management procedures to minimise risk to patients is seen as a high priority by all those involved with these duties. There is a requirement to develop better national (possibly international) procedures for safe intravenous practice.
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Qual Saf Health Care · Sep 2002
Multicenter StudyQuality improvement for patients with hip fracture: experience from a multi-site audit.
The first East Anglian audit of hip fracture was conducted in eight hospitals during 1992. There were significant differences between hospitals in 90-day mortality, development of pressure sores, median lengths of hospital stay, and in most other process measures. Only about half the survivors recovered their pre-fracture physical function. A marked decrease in physical function (for 31%) was associated with postoperative complications. ⋯ While some hospitals had made improvements in care by 1997, others were failing to maintain their level of good practice. This highlights the need for continuous quality improvement by repeating the audit cycle in order to reach and then improve standards. Rehabilitation and long term support to improve functional outcomes are key areas for future audit and research.