BMJ quality & safety
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BMJ quality & safety · Mar 2013
Multicenter StudyProcess evaluation of a tailored multifaceted feedback program to improve the quality of intensive care by using quality indicators.
In multisite trials evaluating a complex quality improvement (QI) strategy the 'same' intervention may be implemented and adopted in different ways. Therefore, in this study we investigated the exposure to and experiences with a multifaceted intervention aimed at improving the quality of intensive care, and explore potential explanations for why the intervention was effective or not. ⋯ Time and resource constraints, difficulties to translate feedback into effective actions and insufficient involvement of other staff members hampered the impact of the intervention. However, our study suggests that a multifaceted feedback program stimulates clinicians to use indicators as input for QI, and is a promising first step to integrating systematic QI in daily care.
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BMJ quality & safety · Mar 2013
Observational StudyCharacterising physician listening behaviour during hospitalist handoffs using the HEAR checklist.
The increasing fragmentation of healthcare has resulted in more patient handoffs. Many professional groups, including the Accreditation Council on Graduate Medical Education and the Society of Hospital Medicine, have made recommendations for safe and effective handoffs. Despite the two-way nature of handoff communication, the focus of these efforts has largely been on the person giving information. ⋯ Using the 'HEAR Checklist', we can characterise hospitalist handoff listening behaviours. While passive listening behaviours are common, active listening behaviours that promote memory retention are rare. Handoffs are often interrupted, most commonly by side conversations. Future handoff improvement efforts should focus on augmenting listening and minimising interruptions.
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BMJ quality & safety · Mar 2013
Comparative StudyThe relationship between commercial website ratings and traditional hospital performance measures in the USA.
Our goal was to compare hospital scores from the most widely used commercial website in the USA to hospital scores from more systematic measures of patient experience and outcomes, and to assess what drives variation in the commercial website scores. ⋯ These data suggest that rater experiences for Yelp and HCAHPS may be similar, and that consumers posting ratings on Yelp may observe aspects of care related to important patient outcomes.