BMJ quality & safety
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BMJ quality & safety · Mar 2012
Quality of in-hospital cardiac arrest calls: a prospective observational study.
To determine the quality and diagnostic accuracy of in-hospital adult clinical emergency calls. ⋯ There is variability in duration and diagnostic accuracy of in-hospital emergency calls. This is associated with delayed activation of the emergency response. The attempt to differentiate between ME and CA is a source of confusion. A single clinical emergency response for CA and ME calls may provide a more focused and timely emergency response.
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Implementation of a surgical checklist depends on many organisational factors and on socio-cultural patterns. The objective of this study was to identify barriers to effective implementation of a surgical checklist and to develop a best use strategy. ⋯ Several of the barriers to the successful implementation of the surgical checklist depended on organisational and cultural factors within each centre. The authors propose a strategy for change for checklist design, use and assessment, which could be used to construct a feedback loop for local team organisation and national initiatives.
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BMJ quality & safety · Mar 2012
The importance of preparation for doctors' handovers in an acute medical assessment unit: a hierarchical task analysis.
To examine the ideal and actual processes of doctors' handovers in an acute medical assessment unit by means of a hierarchical task analysis (HTA) to identify any discrepancies between the ideal shift handover process as described by doctors, and the actual shift handover process as observed by the researcher. ⋯ The pre-handover phase is critical in providing a foundation for a thorough handover meeting and potentially helping doctors who have started a shift to prioritise patient care. These findings suggest that quality improvements for clinical handovers should include a designated time for preparation of care transfer information.
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BMJ quality & safety · Mar 2012
Patient safety in patients who occupy beds on clinically inappropriate wards: a qualitative interview study with NHS staff.
To explore NHS staff members' perceptions and experiences of the contributory factors that may underpin patient safety issues in those who are placed on a hospital ward that would not normally treat their illness (such patients are often called 'outliers' 'sleep outs' or 'boarders'). ⋯ NHS staff report that placement of patients on clinically inappropriate wards is a specific patient safety concern. The application of James Reason's Swiss cheese model of accident causation suggests that placement on an inappropriate ward constitutes a 'latent condition' which may expose patients to contributory factors that underlie adverse events.
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BMJ quality & safety · Mar 2012
Perceptions of junior doctors in the NHS about their training: results of a regional questionnaire.
To explore the views of doctors in training about their current roles and their potential value to the National Health Service (NHS) in improving healthcare quality and productivity. ⋯ Doctors in training have a desire and perceived ability to contribute to improvement in the NHS but do not perceive their working environment as receptive to their skills. Junior doctors who attend leadership training report higher levels of desire and ability to express these skills. This study suggests junior doctors are an untapped NHS resource and that they and their organisations would benefit from more formalised provision of training in leadership.