Is the ‘never event’ concept a useful safety management strategy in complex primary healthcare systems?
AbstractWhy is the area important?A sub-group of rare but serious patient safety incidents, known as ‘never events,’ is judged to be ‘avoidable.’ There is growing interest in this concept in international care settings, including UK primary care. However, issues have been raised regarding the well-intentioned coupling of ‘preventable harm’ with zero tolerance ‘never events,’ especia lly around the lack of evidence for such harm ever being totally preventable.What is already known and gaps in knowledge?We consider whether the ideal of reducing preventable harm to ‘never&...
Source: International Journal for Quality in Health Care - January 12, 2021 Category: International Medicine & Public Health Source Type: research

HFE at the frontiers of COVID-19. Human factors/ergonomics to support the communication for safer care in Italy during the COVID-19 pandemic
AbstractItaly was the first country after China to be affected by COVID-19. The wave of the emergency found our country unprepared to cope with the surge of patients going to first aid departments to seek assistance in the almost complete paralysis of community health. Human factors and ergonomics (HFE) can effectively contribute to, and improve the effectiveness of, a pandemic response working on several key areas: training, adapting workflows and processes, restructuring teams and tasks, effective mechanisms and tools for communication, engaging patients and families and learning from failures and successes. In Italy, HF...
Source: International Journal for Quality in Health Care - January 12, 2021 Category: International Medicine & Public Health Source Type: research

Trauma system accreditation and patient outcomes in British Columbia: an interrupted time series analysis
ConclusionsApplying a quasi-experimental design to time series accounting for changes in patient case-mix, our results suggest that accreditation might reduce in-hospital mortality and major complications. However, there was uncertainty around the estimates of accreditation. Further studies looking at clinical processes of care and other outcomes such as patient or health staff satisfaction are needed. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - November 30, 2020 Category: International Medicine & Public Health Source Type: research

Frontiers in human factors: integrating human factors and ergonomics to improve safety and quality in Latin American healthcare systems
ConclusionThere is a real opportunity in LatAm and other LMIC health services to make more rapid and sustainable progress in healthcare-embedded HFE than has been experienced within healthcare services of more developed nations. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - November 28, 2020 Category: International Medicine & Public Health Source Type: research

Will the COVID-19 pandemic transform infection prevention and control in surgery? Seeking leverage points for organizational learning
ConclusionFor achieving sustainable change in IPCS practices in surgery during COVID-19 and beyond we need to enhance organizational learning potentials. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - November 24, 2020 Category: International Medicine & Public Health Source Type: research

Cost impact of introducing a treatment escalation/limitation plan during patients ’ last hospital admission before death
AbstractObjectiveA recent study found that the use of a treatment escalation/limitation plan (TELP) was associated with a significant reduction in non-beneficial interventions (NBIs) and harms in patients admitted acutely who subsequently died. We quantify the economic benefit of the use of a TELP.DesignNBIs were micro-costed. Mean costs for patients with a TELP were compared to patients without a TELP using generalized linear model regression, and results were extrapolated to the Scottish population.SettingMedical, surgical and intensive care units of district general hospital in Scotland, UK.ParticipantsTwo hundred and e...
Source: International Journal for Quality in Health Care - November 18, 2020 Category: International Medicine & Public Health Source Type: research

Evaluation of clinical practice guideline quality: comparison of two appraisal tools
ConclusionsIn addition to being a quality scale, the iCAHE checklist is easy, practical and short to implement. It also helps the users to understand the quality of the guideline in a shorter time. To increase the use of guidelines, it is important that users with little experience and time use the iCAHE scale as a rapid appraisal tool, but more studies are needed to decide the best appraisal tool. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - October 26, 2020 Category: International Medicine & Public Health Source Type: research

Innovating health care: key characteristics of human-centered design
AbstractHuman-centered design is about understanding human needs and how design can respond to these needs. With its systemic humane approach and creativity, human-centered design can play an essential role in dealing with today ’s care challenges. ‘Design’ refers to both the process of designing and the outcome of that process, which includes physical products, services, procedures, strategies and policies. In this article, we address the three key characteristics of human-centered design, focusing on its implementat ion in health care: (1) developing an understanding of people and their needs; (2) engag...
Source: International Journal for Quality in Health Care - October 17, 2020 Category: International Medicine & Public Health Source Type: research

Development and psychometric properties of the Caring Behaviors Assessment Tool Nursing Version-Short Form
ConclusionThe structural validity, internal consistency and content validity of the CBAN-SF supported to be a reliable and valid tool for assessment of caring behaviors by nurses. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - October 17, 2020 Category: International Medicine & Public Health Source Type: research

The efficiency –thoroughness trade-off after implementation of electronic medication management: a qualitative study in paediatric oncology
ConclusionsOverall, staff were aware of the competitive interplay between thoroughness and efficiency and reported that introduction of an EMMS had imposed processes that favoured improvements in thoroughness at the expense of efficiency. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - October 16, 2020 Category: International Medicine & Public Health Source Type: research

The effect of electronic audits and feedback in primary care and factors that contribute to their effectiveness: a systematic review
ConclusionThis systematic review included 29 articles examining electronic A&F interventions in primary care, and 76% of the interventions were effective. Our findings suggest electronic A&F is effective in primary care for different conditions such as medication safety and preventive medicine. Some of the benefits of electronic A&F include its scalability and the potential to be cost effective. The use of benchmarks as comparators and feedback based on high-quality evidence are widely used and important features of electronic feedback in primary care. However, other important features such as the cognitive loa...
Source: International Journal for Quality in Health Care - October 15, 2020 Category: International Medicine & Public Health Source Type: research

Perspectives on implementing a quality improvement collaborative to improve person-centered care for maternal and reproductive health in Kenya
ConclusionRespondents were easily able to articulate perceived benefits derived from participation in this QIC, although they were equally able to identify challenges that hindered their ability to consistently provide high-quality PCC to women seeking maternity or FP services. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - October 15, 2020 Category: International Medicine & Public Health Source Type: research

Reengineer healthcare: a human factors and ergonomics framework to improve the socio-technical system
ConclusionTogether with other disciplines, HFE can and must play a determinant role in the reengineering of a human-centered healthcare. HFE must be embedded in healthcare organizations and must demonstrate its value in a more comprehensive way, so that stakeholders become aware of the benefits and feel the need to ask for help. Examples of systemic, practical and comprehensive applications are needed. This framework is a contribution in this direction. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - October 12, 2020 Category: International Medicine & Public Health Source Type: research

Changes in compensation claim contents following reorganization of emergency hospital care
AbstractObjectivesTo study the effects of the reorganization on patient compensation claim contents relating to health care quality and patient safety.Design and settingsDanish emergency care has developed considerably over the past decades, including a major reorganization to improve health care quality and patient safety through ensuring easier access to specialist treatment. Analysis of compensation claim patterns is used to evaluate the effects of such health care system changes.Participants, interventions and main outcome measuresA sample of 1613 compensation claims to the Danish Patient Assurance organization was rev...
Source: International Journal for Quality in Health Care - October 8, 2020 Category: International Medicine & Public Health Source Type: research

Human factors and ergonomics systems approach to the COVID-19 healthcare crisis
AbstractA human factors and ergonomics (HFE) systems approach offers a model for adjusting work systems and care processes in response to a healthcare crisis such as COVID-19. Using the Systems Engineering Initiative for Patient Safety (SEIPS) model of work system and patient safety, we describe various work system barriers and facilitators experienced by healthcare workers during the COVID-19 crisis. We propose a set of five principles based on this HFE systems approach related to novel pandemic: (i) deferring to local expertise, (ii) facilitating adaptive behaviors, (iii) enhancing interactions between system elements an...
Source: International Journal for Quality in Health Care - September 30, 2020 Category: International Medicine & Public Health Source Type: research

Human factors engineering for medical devices: European regulation and current issues
AbstractA large proportion of the patient injuries or deaths attributable to medical device (MD) misuse can be eliminated and/or mitigated by adopting an effective human factors and ergonomics (HFE) approach. The implementation of a usability engineering process is now mandatory for MD manufacturers seeking to obtain the European Union ’s CE Mark. Here, we describe the European Union’s HFE regulation and highlight the challenges faced by (i) manufacturers implementing this regulation and (ii) regulatory bodies charged with assessing the compliance of usability files. In Europe, 95% of MD manufacturers are small...
Source: International Journal for Quality in Health Care - September 30, 2020 Category: International Medicine & Public Health Source Type: research

Human factors: the pharmaceutical supply chain as a complex sociotechnical system
ConclusionBy partnering with international groups such as Biophorum and Bio Supply Chain Management Alliance, we wish to stimulate discussion about how sociotechnical thinking about HFE may help develop better monitoring and investigative techniques to strengthen global supply chains. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - September 30, 2020 Category: International Medicine & Public Health Source Type: research

Deciding without data: clinical decision-making in pediatric orthopedic surgery
ConclusionsWith increasing emphasis on high value, evidence-based care, understanding the rationale behind physician decision-making can educate physicians, identify common decisions without supporting evidence and help create clinical care pathways in pediatric orthopedic surgery. Decisions based on evidence or consensus between surgeons can inform pathways and national guidelines that minimize unwarranted variation in care and waste. Decision support tools and aids could also be implemented to guide these decisions. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - September 27, 2020 Category: International Medicine & Public Health Source Type: research

Pediatric ambulatory appointment scheduling: a qualitative study of stakeholders ’ perceptions and experiences
ConclusionsStakeholders provided a rich description of the interrelated factors and processes that influenced the scheduling of pediatric ambulatory clinic appointments. Multilevel, experimental interventions are needed to test whether the findings described herein can enhance the structure and function of pediatric ambulatory appointment scheduling. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - September 27, 2020 Category: International Medicine & Public Health Source Type: research

Effect of referral systems on costs and outcomes after hip fracture surgery in Taiwan
AbstractObjectiveTo explore the economic burdens of hip fracture surgery in patients referred to lower-level medical institutions and to evaluate how referral systems affect costs and outcomes of hip fracture surgery.DesignA nationwide population-based retrospective cohort study.SettingAll hospitals in Taiwan.ParticipantsA total of 7500 patients who had received hip fracture surgery (International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic codes 820.0  ∼ 820.9 and procedure codes 79.15, 79.35, 81.52, 81.53) performed in 1997 to 2013.Main outcome measuresTotal cost...
Source: International Journal for Quality in Health Care - September 18, 2020 Category: International Medicine & Public Health Source Type: research

Frontiers in human factors: embedding specialists in multi-disciplinary efforts to improve healthcare
AbstractDespite the application of a huge range of human factors (HF) principles in a growing range of care contexts, there is much more that could be done to realize this expertise for patient benefit, staff well-being and organizational performance. Healthcare has struggled to embrace system safety approaches, misapplied or misinterpreted others, and has stuck to a range of outdated and potentially counter-productive myths even has safety science has developed. One consequence of these persistent misunderstandings is that few opportunities exist in clinical settings for qualified HF professionals. Instead, HF has been ap...
Source: International Journal for Quality in Health Care - September 9, 2020 Category: International Medicine & Public Health Source Type: research

Human factors/ergonomics work system analysis of patient work: state of the science and future directions
ConclusionOur review has demonstrated the value of using the SEIPS family of work systems models to study and improve patient and family contributions to health-related work. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - August 25, 2020 Category: International Medicine & Public Health Source Type: research

French Abstracts
(Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - August 22, 2020 Category: International Medicine & Public Health Source Type: research

Spanish Abstracts
(Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - August 21, 2020 Category: International Medicine & Public Health Source Type: research

Ethical frameworks for quality improvement activities: an analysis of international practice
ConclusionWhere countries fail to provide specific ethics frameworks for quality improvement, guidance is dispersed across several organizations which may lack legal certainty. Our review demonstrates a need for appropriate oversight and responsive infrastructure for quality improvement underpinned by ethical frameworks that build equivalence with research oversight. It outlines aspects of good practice, especially The New Zealand framework that integrates research and quality improvement ethics. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - August 14, 2020 Category: International Medicine & Public Health Source Type: research

Psychometric evaluation of instruments measuring the work environment of healthcare professionals in hospitals: a systematic literature review
ConclusionsWe found a large variety of instruments that measure the professional healthcare environment. Analysis uncovered content diversity and diverse methodological flaws in available instruments. Two succinct, interprofessional instruments scored best on psychometrical quality and are promising for the measurement of the working environment in hospitals. However, further psychometric validation and an evaluation of their content is recommended. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - August 13, 2020 Category: International Medicine & Public Health Source Type: research

Bundle interventions including nontechnical skills for surgeons can reduce operative time and improve patient safety
ConclusionsThe KAIZEN initiative was effective in clinical healthcare settings. In the event of scaling-up this initiative, the educational program for physicians should include project management strategies and leadership skills. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - August 13, 2020 Category: International Medicine & Public Health Source Type: research

Human factors/ergonomics to support the design and testing of rapidly manufactured ventilators in the UK during the COVID-19 pandemic
ConclusionThe documents are part of a wider collection of HFE advice which is available on the CIEHF COVID-19 website (https://covid19.ergonomics.org.uk/). (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - August 11, 2020 Category: International Medicine & Public Health Source Type: research

Hospital accreditation impact on healthcare quality dimensions: a systematic review
ConclusionMainly due to the methodological shortcomings, the positive impact of accreditation on healthcare dimensions should be interpreted with caution. This study provides an up-to-date overview of the main themes examined in the literature, highlighting critical knowledge-gaps and methodological flaws. The findings may provide value to healthcare stakeholders in terms of improving their ability to assess the relevance of accreditation processes. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - August 11, 2020 Category: International Medicine & Public Health Source Type: research

Improving the quality of mortality review equity reporting: Development of an indigenous M āori responsiveness rubric
ConclusionsA shared understanding of equity about mortality is required. Effective implementation of a quality-based rubric into practice requires careful planning and ongoing education and support for staff and committee members at multiple levels. Follow-up support is needed to support its implementation into practice. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - July 27, 2020 Category: International Medicine & Public Health Source Type: research

Variation between hospitals and reviewers in detection of adverse events identified through medical record review in Korea
ConclusionsGiven the level of variation in the identified adverse events, further studies that include more medical institutions in their investigations are needed, and a third-party committee should be involved to address the reliability issues regarding the occurrence and characteristics of the adverse events. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - July 21, 2020 Category: International Medicine & Public Health Source Type: research

The Registry of Senior Australians outcome monitoring system: quality and safety indicators for residential aged care
ConclusionsTwelve quality and safety indicators were developed to monitor aged care provided to older Australians based on the synthesis of existing literature and expert advisory input. These indicators rely on existing data within the aged care and healthcare sectors, therefore creating a pragmatic tool to examine quality and unwarranted care variation. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - July 21, 2020 Category: International Medicine & Public Health Source Type: research

Improving knowledge and confidence in foundation doctors during specialty changeover
AbstractQuality problemFoundation year junior doctors rotate every 4 months into different specialties. They are often expected to manage patients with complex underlying conditions despite inadequate clinical induction.Initial assessmentNo structured induction was offered to junior doctors rotating to hepato-pancreatico-biliary surgery, a complex and highly specialized discipline within general surgery. We hypothesized that junior doctors will be lacking in both knowledge and confidence when managing these patients.Choice of solutionCreate a structured induction programme and evaluate its effectiveness in improving knowle...
Source: International Journal for Quality in Health Care - July 16, 2020 Category: International Medicine & Public Health Source Type: research

Identifying psychiatric diagnostic errors with the Safer Dx Instrument
ConclusionThe revised Safer Dx-Mental Health Instrument has a high reliability for detecting anxiety-related diagnostic errors and deserves testing in additional psychiatric populations and clinical settings. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - July 16, 2020 Category: International Medicine & Public Health Source Type: research

Development of a guideline for the treatment of generalized anxiety disorder with the ADAPTE method
ConclusionsA guideline aimed to improve the quality and effectiveness of the care provided to people with generalised anxiety disorder has been released. The use of adaptation methods has simplified the use of resources and time. This guideline and the process designed for its implementation constitute a suitable collection of resources for the improvement on detection and treatment of GAD in primary health care. Adaptation methods play a key role in the knowledge translation continuum. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - July 1, 2020 Category: International Medicine & Public Health Source Type: research

Implementing a quick Sequential (Sepsis-Related) Organ Failure Assessment sepsis screening tool: an interrupted times series study
ConclusionThe implementation of the qSOFA-based SS tool resulted in early, but not significantly improved, provision of 6-h bundle care. Screening procedures were regularly conducted, but sepsis alerts rarely activated. Further research is needed to better understand the implementation of sepsis care in developing settings. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - July 1, 2020 Category: International Medicine & Public Health Source Type: research

The influence and added value of a Standardized Assessment and Reporting System for functioning outcomes upon national rehabilitation quality reports
ConclusionsA StARS supports the comparison of outcomes assessed with different measures on the same interval-scaled ICF-based common metric. Careful consideration is needed whether an ordinal-scaled or interval-scaled reporting system is applied as the magnitude and precision of reported outcomes is influenced. The StARS ’ ICF basis brings an added value by informing further development of functioning as a relevant indicator for national outcome quality reports in rehabilitation. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - July 1, 2020 Category: International Medicine & Public Health Source Type: research

Optimization strategies for the organization of mental healthcare
AbstractAimThe aim of this paper is to analyse the main issues and obstacles to optimizing the organization of mental healthcare and the strategies that should be applied by presenting the examples from practice.ResultsOutcomes of mental healthcare are in relation with ‘improved legislation’ and the introduction of up-to-date management and economic concepts including continuous treatment model, in addition to the advantages and disadvantages in the provision of mental healthcare within primary and secondary inpatient and outpatient healthcare. Some of these l essons are learned from reforms implemented in Serb...
Source: International Journal for Quality in Health Care - July 1, 2020 Category: International Medicine & Public Health Source Type: research

Can social accountability mechanisms using community scorecards improve quality of pediatric care in rural Cambodia?
AbstractObjectiveTo determine the effect of social accountability strategies on pediatric quality of care.Design and SettingA non-randomized quasi experimental study was conducted in four districts in Cambodia and all operational public health facilities were included.ParticipantsFive patients under 5  years and their caretakers were randomly selected in each facility.InterventionsTo determine the effect of maternal and child health interventions integrating citizen voice and action using community scorecards on quality of pediatric care.Outcome MeasuresPatient observations were conducted to determine quality of scree...
Source: International Journal for Quality in Health Care - June 27, 2020 Category: International Medicine & Public Health Source Type: research

Associations of types of primary care facilities with adult vaccination and cancer screening in Japan
ConclusionsDifferences in the performance of adult vaccination and cancer screening raised concerns about the provision of preventive care at hospital-based compared with clinic-based primary care practices. Efforts to improve preventive care at hospital-based primary care practices should help to promote equalization of the quality of primary care. Further study is needed on the comparisons of other quality indicators among different structures of primary care facilities. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - June 10, 2020 Category: International Medicine & Public Health Source Type: research

Psychometric properties of the Bulgarian version of Hospital Survey on Patient Safety Culture
ConclusionsThe B-HSOPSC had acceptable levels of global and local fits. Its safety culture dimensions were sufficiently distinguishable and correlated with outcome variables. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - May 29, 2020 Category: International Medicine & Public Health Source Type: research

Quality assessment of weekend discharge: a systematic review and meta-analysis
Conclusion In the USA, the 30-day readmission rate was higher in patients who had been discharged on the weekend compared with the weekday. However, interpretation should be cautious because of data limitation and high heterogeneity. Further intervention should be conducted to eliminate any healthcare inequality within the healthcare system and to improve the quality of patient care. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - May 26, 2020 Category: International Medicine & Public Health Source Type: research

Effectiveness of adherence to recommended clinical examinations of diabetic patients in preventing diabetes-related hospitalizations
ConclusionsTight control of patients with diabetes through regular clinical examinations must to be considered the cornerstone of national guidance, national audits and quality improvement incentives schemes. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - October 22, 2019 Category: International Medicine & Public Health Source Type: research

Portuguese Abstracts †
(Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - October 22, 2019 Category: International Medicine & Public Health Source Type: research

More patient data, greater opportunities and higher quality
With the development of electronic health records, digitized patient information has become available, such as medication history, diagnoses, laboratory test information, surgical records, and x-ray data. Greater opportunities for using information technology are being realized so that more patient data can be used to improve clinical quality. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - October 22, 2019 Category: International Medicine & Public Health Source Type: research

Spanish Abstracts †
(Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - October 22, 2019 Category: International Medicine & Public Health Source Type: research

French Abstracts*
(Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - September 6, 2019 Category: International Medicine & Public Health Source Type: research

Layman's summary †
(Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - August 20, 2019 Category: International Medicine & Public Health Source Type: research

Portuguese Abstracts*
(Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - July 24, 2019 Category: International Medicine & Public Health Source Type: research