Simpson's paradox: how performance measurement can fail even with perfect risk adjustment
Efforts to measure quality using patient outcomes—whether hospital mortality rates or major complication rates for individual surgery—often become mired in debates over the adequacy of adjustment for case-mix. Some hospitals take care of sicker patients than other hospitals. Some surgeons operate on patients whom other surgeons feel exceed their skill levels. We do not want to penalise hospitals or doctors who accept referrals for more complex patients. Yet, we also do not want to miss opportunities for improvement. Maybe a particular hospital that cares for sicker patients achieves worse outcomes than other ho...
Source: Quality and Safety in Health Care - August 12, 2014 Category: Health Management Authors: Marang-van de Mheen, P. J., Shojania, K. G. Tags: Editorials Source Type: research
Visualising healthcare practice improvement: innovation from within
Rick Iedema, Jessica Mesman and Katherine Carroll have written an important book for those interested in solving the challenge of achieving and sustaining local ‘buy in’ for patient safety and quality improvement (QI). Their highly readable text is delivered in two parts, with the first half of the book introducing a strong theoretical foundation for their novel interventional methodology. The second half presents case studies of that method—video reflexive ethnography (VRE)—applied to real-life safety and QI challenges in clinical environments that range from postoperative recovery room handovers, ...
Source: Quality and Safety in Health Care - July 14, 2014 Category: Health Management Authors: Leslie, M. Tags: Book reviews Source Type: research
A multidisciplinary, multifaceted improvement initiative to eliminate mislabelled laboratory specimens at a large tertiary care hospital
Conclusions
A multidisciplinary unit specific approach using performance improvement methodologies focusing on human factors can reliably and sustainably reduce the rate of mislabelled laboratory specimens in a large tertiary care hospital. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - July 14, 2014 Category: Health Management Authors: Seferian, E. G., Jamal, S., Clark, K., Cirricione, M., Burnes-Bolton, L., Amin, M., Romanoff, N., Klapper, E. Tags: Quality improvement reports Source Type: research
Patient complaints in healthcare systems: a systematic review and coding taxonomy
Conclusions
Rigorous analyses of patient complaints will help to identify problems in patient safety. To achieve this, it is necessary to standardise how patient complaints are analysed and interpreted. Through synthesising data from 59 patient complaint studies, we propose a coding taxonomy for supporting future research and practice in the analysis of patient complaint data. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - July 14, 2014 Category: Health Management Authors: Reader, T. W., Gillespie, A., Roberts, J. Tags: Open access Systematic review Source Type: research
Safety measurement and monitoring in healthcare: a framework to guide clinical teams and healthcare organisations in maintaining safety
Patients, clinicians and managers all want to be reassured that their healthcare organisation is safe. But there is no consensus about what we mean when we ask whether a healthcare organisation is safe or how this is achieved. In the UK, the measurement of harm, so important in the evolution of patient safety, has been neglected in favour of incident reporting. The use of softer intelligence for monitoring and anticipation of problems receives little mention in official policy. The Francis Inquiry report into patient treatment at the Mid Staffordshire NHS Foundation Trust set out 29 recommendations on measurement, more tha...
Source: Quality and Safety in Health Care - July 14, 2014 Category: Health Management Authors: Vincent, C., Burnett, S., Carthey, J. Tags: Open access Narrative review Source Type: research
