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Quality and safety in the literature: July 2023
Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, whereas others will highlight unique publications from high-impact medical journals. Key points Despite increased attention to patient safety over the last several decades, adverse events continue to be common in hospitalised patients, occurring in 23.6% of admissions studied. N Engl J M...
Source: Quality and Safety in Health Care - June 19, 2023 Category: Health Management Authors: Youssef, C., Houchens, N., Gupta, A. Tags: Quality & amp; safety in the literature Source Type: research

Hip fracture in the COVID-19 era: what can we say about care and patient outcomes?
Hip fractures remain an important public health issue, being the most common reason for emergency anaesthesia and surgery in older people. Following the start of the COVID-19 pandemic in March 2020, hospitals in many countries observed considerable reductions in admissions for acute medical conditions such as stroke and acute myocardial infarction1 2 but not for falls in older adults.3 Nevertheless, the pandemic greatly affected care for patients with hip fractures in the first wave, both directly for those patients who also were infected with COVID-19 before admission and indirectly, as staff were redeployed to deal with ...
Source: Quality and Safety in Health Care - April 19, 2023 Category: Health Management Authors: Bottle, A., Liddle, A. Tags: COVID-19 Editorials Source Type: research

To RCT or not to RCT? The ongoing saga of randomised trials in quality improvement
Williams et al1 describe a well-conducted cluster randomised trial of a stoke quality improvement (QI) initiative, which aimed to improve two inpatient stroke indicators with strong evidence linking them to improved patient outcomes. They randomised five hospitals to receive a QI intervention, and six to receive only indicator feedback. In aggregate, they found evidence of improvement in one indicator, in the intervention group, relative to the control, but this was not sustained once the intervention period ended. The design, execution and analysis of the study were textbook for a cluster randomised controlled trial (RCT)...
Source: Quality and Safety in Health Care - March 17, 2016 Category: Health Management Authors: Parry, G., Power, M. Tags: BMJQS Noteworthy articles Editorials Source Type: research

Quality and the curate's egg
A famous cartoon in the satirical magazine Punch from the 1890s shows a meek curate assuring his dinner host that his egg is not spoiled. "Parts of it are exceptional", he suggests. We, the knowing reader, appreciate the humour. An egg cannot be good in parts. For those who think about quality, the question of whether care can be good in parts is a tricky one. That a hospital might deliver better care for one clinical service—top notch cardiac surgery, say, but below average stroke care—would not surprise anyone. But, the idea that quality itself, even within a given clinical domain, like cardiac surgery or str...
Source: Quality and Safety in Health Care - June 12, 2014 Category: Health Management Authors: Greaves, F., Jha, A. K. Tags: Editor's choice Editorials Source Type: research

Evaluation of quality of care using registry data: the interrelationship between length-of-stay, readmission and mortality and impact on hospital outcomes.
In this study we aim to disentangle the relationship between mortality, readmission and LOS and propose a way to jointly report the three figures to facilitate insight and evaluation of quality of care. Methods Data from the Global Comparators Project were used, in which 22 hospitals from 5 countries have reconciliated the different coding systems of their administrative admission data to obtain risk-adjusted hospital outcomes. Patients discharged between 2007–2011 were included. Three outcomes were considered: mortality, readmission, and prolonged LOS (>75 percentile). We analyzed all patients, stroke patients a...
Source: Quality and Safety in Health Care - March 17, 2014 Category: Health Management Authors: Marang-van de Mheen, P. J., Lingsma, H. F., Middleton, S., Kievit, J., Steyerberg, E. W. Tags: International Forum on Quality and Safety In Healthcare, Paris, France, 8-11 April 2014 Source Type: research