BMJ quality & safety
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BMJ quality & safety · Apr 2013
Do you have to re-examine to reconsider your diagnosis? Checklists and cardiac exam.
Few studies have investigated whether clinicians can use checklists to verify their diagnostic decisions. Checklists may improve accuracy by prompting clinicians to reconsider or recollect information but might impair decision making by adding to clinicians' cognitive load. This study assessed whether checklists improve cardiac exam diagnostic accuracy, and whether this benefit is dependent on collecting additional information. ⋯ Verifying diagnostic decisions with a checklist improved diagnostic accuracy. This benefit was only seen when more information could be collected. Checklist use was not associated with increased cognitive load.
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BMJ quality & safety · Apr 2013
Estimated nursing workload for the implementation of ventilator bundles.
Ventilator-associated pneumonia is a common healthcare-associated infection with high attributable morbidity and mortality. Prevention strategies, including prevention bundles, have been widely adopted across the USA. However, the nursing resources required to implement these bundles, and their effect on other aspects of intensive care unit patient care, are unknown. ⋯ Our estimates may serve as potentially important inputs for cost-effectiveness and decision analyses related to intensive care unit prevention activities. Further research should include direct observations about nursing time allocation related to prevention activities.
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BMJ quality & safety · Apr 2013
A novel approach to improving emergency department consultant response times.
Emergency department (ED) overcrowding is a threat to patient safety and public health. Availability of specialty consultation to the ED may contribute to overcrowding. We implemented a novel intervention using education, goal setting and real-time performance feedback to improve time to admission for patients referred to general internal medicine (GIM). ⋯ ED throughput for admitted medical patients improved with a quality improvement initiative involving education, goal setting and performance feedback.