Qual Saf Health Care
-
Qual Saf Health Care · Dec 2010
Comparative StudyAdverse events and comparison of systematic and voluntary reporting from a paediatric intensive care unit.
Little is known of the incidence of adverse events in the paediatric intensive care unit (PICU). Perceived incidence may be dependent on data-collection methods. ⋯ Neither voluntary reporting nor systematic enquiry captures all adverse events. While the two methods both capture some events, systematic reporting captures serious events, while voluntary reporting captures mainly insignificant and minor events.
-
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.
-
Qual Saf Health Care · Dec 2010
The impact of a tele-ICU on provider attitudes about teamwork and safety climate.
To measure teamwork and safety climate in three intensive care units (ICUs) before and after remote monitoring by intensivists using telemedicine technology (tele-ICU). ⋯ Implementation of a tele-ICU was associated with improved teamwork climate and safety climate in some ICUs, especially among nurses. Providers were also more confident about patient coverage and physician accessibility, and did not report unnecessary interruptions.
-
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.
-
Qual Saf Health Care · Dec 2010
Assessing teamwork attitudes in healthcare: development of the TeamSTEPPS teamwork attitudes questionnaire.
The report, To Err is Human, indicated that a large number of deaths are caused by medical error. A central tenet of this report was that patient safety was not only a function of sophisticated healthcare technology and treatments, but also the degree to which healthcare professionals could perform effectively as teams. Research suggests that teamwork comprises four core skills: Leadership, Situation Monitoring, Mutual Support and Communication. In healthcare, team training programmes, such as TeamSTEPPS®, are designed to improve participant knowledge of, attitudes towards, and skills in these core areas. If such training programmes are effective, changes in knowledge, attitudes and skills should be observed. The purpose of this study was to develop and validate the TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ), a measure designed to assess attitudes towards the core components of teamwork in healthcare. ⋯ The T-TAQ provides a useful, reliable and valid tool for assessing individual attitudes related to the role of teamwork in the delivery of healthcare. Issues related to its use and interpretation are discussed.