A behaviourally anchored rating scale for evaluating the use of the WHO surgical safety checklist: development and initial evaluation of the WHOBARS
Conclusion
We have developed a generic instrument for comprehensively rating the administration of the SSC and informing initiatives to realise its full potential. We have provided data supporting its capacity for discrimination, internal consistency and inter-rater reliability. Further psychometric evaluation is warranted. (Source: BMJ Quality and Safety)
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Devcich, D. A., Weller, J., Mitchell, S. J., McLaughlin, S., Barker, L., Rudolph, J. W., Raemer, D. B., Zammert, M., Singer, S. J., Torrie, J., Frampton, C. M., Merry, A. F. Tags: Original research Source Type: research
Qualitative complaints and their relation to overall hospital rating using an H-CAHPS-derived instrument
Conclusions
This is the first investigation of its type using H-CAHPS-based data in a Canadian context. Through replication of this study, other healthcare organisations may determine the association between open-ended complaints and their own overall experience scores. (Source: BMJ Quality and Safety)
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Kemp, K., Warren, S., Chan, N., McCormack, B., Santana, M., Quan, H. Tags: Original research Source Type: research
The Medicines Advice Service Evaluation (MASE): a randomised controlled trial of a pharmacist-led telephone based intervention designed to improve medication adherence
Conclusions
A telephone intervention, led by a pharmacist and tailored to the individuals’ needs, can significantly improve medication adherence in patients with long-term conditions, using a mail-order pharmacy. Further work is needed to confirm a trend towards improved clinical outcome.
Trial registration number
NCT01864239. (Source: BMJ Quality and Safety)
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Lyons, I., Barber, N., Raynor, D. K., Wei, L. Tags: Editor's choice Original research Source Type: research
Supporting adherence for people starting a new medication for a long-term condition through community pharmacies: a pragmatic randomised controlled trial of the New Medicine Service
Conclusions
The NMS significantly increased the proportion of patients adhering to their new medicine by about 10%, compared with normal practice.
Trial registration numbers
ClinicalTrials.gov trial reference number NCT01635361 (http://clinicaltrials.gov/ct2/show/NCT01635361). Current Controlled trials: trial reference number ISRCTN 23560818 (http://www.controlled-trials.com/ISRCTN23560818/; DOI 10.1186/ISRCTN23560818). UK Clinical Research Network (UKCRN) study 12494 (http://public.ukcrn.org.uk/Search/StudyDetail.aspx?StudyID=12494). (Source: BMJ Quality and Safety)
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Elliott, R. A., Boyd, M. J., Salema, N.-E., Davies, J., Barber, N., Mehta, R. L., Tanajewski, L., Waring, J., Latif, A., Gkountouras, G., Avery, A. J., Chuter, A., Craig, C. Tags: Original research Source Type: research
An embedded checklist in the Anesthesia Information Management System improves pre-anaesthetic induction setup: a randomised controlled trial in a simulation setting
Conclusion
Required use of a pre-induction checklist improves anaesthesiology resident performance in a simulated environment. The PIPS checklist as an integrated part of a departmental AIMS warrant further investigation as a quality measure. (Source: BMJ Quality and Safety)
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Wetmore, D., Goldberg, A., Gandhi, N., Spivack, J., McCormick, P., DeMaria, S. Tags: Original research Source Type: research
Adherence: the Holy Grail?
Adherence to medicines has been identified as a key issue by the Royal Pharmaceutical Society of Great Britain,1 the WHO2 and, most recently, by the UK Academy of Medical Sciences.3 Estimates of adherence vary widely but are often reported to be as low as 50%.4 When a patient does not take their prescribed medicines as intended, they may not derive the expected outcomes. As well as implications for the individual patient, this can result in increased costs associated with patient hospitalisations or avoidable escalation in other costs of care.3 It may also result in unused medicines, the cost of which is estimated at &poun...
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Bond, C. M. Tags: Editorials Source Type: research
Advancing patient safety through the use of cognitive aids
The WHO Surgical Safety Checklist (the WHO SSC)1 has had a profound impact on thinking in respect to the safety and reliability of surgery, in particular, and healthcare, more generally. It is both a cognitive aid and a tool to improve communication and teamwork. The systematic use of cognitive aids has long been embedded in many other industries, notably high-reliability industries such as aviation and the nuclear industry, but has been largely neglected in healthcare until recently. Few (if any) airplane pilots would think of taking off without making a series of important checks, and few would attempt to do this without...
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Merry, A. F., Mitchell, S. J. Tags: Editorials Source Type: research
Response to the letter to the editor by Drs Merchant and Federman
We were pleased to read the letter from Drs Merchant and Federman as we had hoped that our study would prompt deeper thought and further discussion about interprofessional bedside rounds.1 Like Drs Merchant and Federman, we were disappointed that the intervention used on our study, patient-centred bedside rounds (PCBR), did not result in improved patients’ perceptions of shared decision making, activation or satisfaction with care. Merchant and Federman state that prior studies have shown that patients prefer their team conduct rounds at the bedside. We wish to point out that the studies cited to support this stateme...
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: O'Leary, K. J., Killarney, A., Hansen, L. O., Jones, S., Malladi, M., Marks, K., Shah, H. M. Tags: Electronic pages Source Type: research
Patient-centred bedside rounds--exploring patient preferences before patient-centred care
Dear Editor, It was with great interest that we read the study of O’Leary et al1 published in the December issue of the journal and were quite surprised by their findings that patient centred rounds had no impact on patients’ perceptions of shared decision making, activation and satisfaction with care. Previous studies have shown that patients prefer their rounding team conduct rounds at the bedside2–5 and based on these studies, one would expect that if bedside rounds were conducted, patients would feel more satisfied with their care and be more engaged in medical decision making compared with other form...
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Merchant, N. B., Federman, D. G. Tags: Electronic pages Source Type: research
Response to: 'Statistical analysis of differences in turnover times among operating theatres by Dexter
Interestingly, per Dr Dexter's suggestion, we did not find significant serial correlations from one turnover to the next during exploratory analysis of our baseline period data, but we did see a correlation with the number of simultaneous room turnovers and turnover times.
Furthermore, we ran a number of analyses including an analysis that ‘batched’ cases by time intervals (ie, weekly intervals) during the intervention period. The trends and significance of our turnover time data were unaffected, thus we stand by our conclusion that real-time logistics support provides statistically significant efficiency gains...
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Dowling, O., Overdyk, F. J. Tags: Electronic pages Source Type: research
Statistical analysis of differences in turnover times among operating theatres
Overdyk et al1 used remote video auditing with real-time feedback in a surgical suite. As part of their randomised trial clustered by theatre, they report less turnover times among ‘fast rooms’, those generally including three or greater cases per day. Successive turnover times between scheduled cases within theatres on the same date tend to be correlated (eg, caused by same surgeon, nurses and anaesthetist). This was shown in Dexter et al2 and Austin et al.3 Overdyk et al's description of their statistical model seems not to describe consideration of correlations of turnover times within the same theatre on th...
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Dexter, F. Tags: Electronic pages Source Type: research
Doctors risks of formal patient complaints and the challenge of predicting complaint behaviour
Spittal et al recently presented the readers of this journal with a simple and reliable scoring system for predicting doctors’ risk of becoming the subject of patient complaints.1 Development of such measures can probably promote constructive use of complaint information, decrease patient dissatisfaction, prevent substandard care and target quality improvement interventions. Using patient complaints constructively, however, necessitates consideration of the manifold facets of patient complaints and behaviours related to making complaints. Patients may have rather different motivations and thresholds for complaining a...
Source: BMJ Quality and Safety - September 18, 2016 Category: Journals (General) Authors: Birkeland, S. Tags: Electronic pages Source Type: research
Why 'Universal Precautions are needed for medication lists
The risks associated with healthcare-acquired infections resulted in the adoption of ‘Universal Precautions’1 within the USA to prevent harmful infections due to bloodborne pathogens. In the USA, the Center for Medicare and Medicaid Services has created an incentive programme for electronic health records that requires implementation of ‘Meaningful Use’ core measures. Among these measures is the requirement that physicians and other individuals who prescribe medications maintain current medication lists. This requirement has increased the use of these lists that frequently contain discrepancies or e...
Source: BMJ Quality and Safety - August 16, 2016 Category: Journals (General) Authors: Shane, R. Tags: Viewpoints Source Type: research
The problem with medication reconciliation
‘The Problem with...’ series covers controversial topics related to efforts to improve healthcare quality, including widely recommended but deceptively difficult strategies for improvement and pervasive problems that seem to resist solution. Medication reconciliation: a brief summary of the evidence, and the problem with generalising that evidence Medication reconciliation (‘med rec’, as it is often called) refers to the ‘process of identifying the most accurate list of all medications a patient is taking ... and using this list to provide correct medications for patients anywhere within the h...
Source: BMJ Quality and Safety - August 16, 2016 Category: Journals (General) Authors: Pevnick, J. M., Shane, R., Schnipper, J. L. Tags: The problem with... Source Type: research
Beyond clinical engagement: a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities
Despite taking advantage of established learning from other industries, quality improvement initiatives in healthcare may struggle to outperform secular trends. The reasons for this are rarely explored in detail, and are often attributed merely to difficulties in engaging clinicians in quality improvement work. In a narrative review of the literature, we argue that this focus on clinicians, at the relative expense of managerial staff, has proven counterproductive. Clinical engagement is not a universal challenge; moreover, there is evidence that managers—particularly middle managers—also have a role to play in ...
Source: BMJ Quality and Safety - August 16, 2016 Category: Journals (General) Authors: Pannick, S., Sevdalis, N., Athanasiou, T. Tags: Open access Research and reporting methodology Source Type: research
