BMJ quality & safety
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BMJ quality & safety · Dec 2012
Beliefs and experiences can influence patient participation in handover between primary and secondary care--a qualitative study of patient perspectives.
Communication between healthcare settings at patient transfers between primary and secondary care, 'handover', is a critical and risky process for patients. Patients' views on their roles in these processes are often lacking despite the knowledge that patient participation contributes to enhanced safety and wellbeing. ⋯ Patients participate actively in handovers when they feel a need for involvement to ensure continuity of care, and are less active when they perceive that their contribution is unnecessary or not valued. In acute care settings with short hospital stays and less time to establish a trusting relationship between patients and their providers, discharge encounters may be important enablers for patient engagement in handovers. The advantages of a redundant handover process need to be considered.
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BMJ quality & safety · Dec 2012
Handover training: does one size fit all? The merits of mass customisation.
Experts have recommended training and standardisation as promising approaches to improve handovers and minimise the negative consequences of discontinuity of care. Yet the content and delivery of handover training have been only superficially examined and described in literature. ⋯ The idea of completely standardised handover training is not in line with the identified differences in preferences and recommendations between different handover stakeholders. Mass customisation of training, in which generic training is adapted to local or individual needs, presents a promising solution to address general and specific needs, while containing the financial and time costs of designing and delivering handover training.
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BMJ quality & safety · Dec 2012
Removal of doctors from practice for professional misconduct in Australia and New Zealand.
To examine how disciplinary tribunals assess different forms of misconduct in deciding whether to remove doctors from practice for professional misconduct. ⋯ Tribunals in Australia and New Zealand tend to remove doctors from practice for behaviours indicative of character flaws and lack of insight, rather than behaviours exhibiting errors in care delivery, poor clinical judgement or lack of knowledge. The generalisability of these findings to regulatory regimes for health practitioners in other countries should be tested.
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BMJ quality & safety · Dec 2012
The collaborative communication model for patient handover at the interface between high-acuity and low-acuity care.
Cross-unit handovers transfer responsibility for the patient among healthcare teams in different clinical units, with missed information, potentially placing patients at risk for adverse events. ⋯ The limited common ground reduced the likelihood of correct interpretation of important handover information, which may contribute to adverse events. Collaborative design and use of a shared set of handover content items may assist in creating common ground to enable clinical teams to communicate effectively to help increase the reliability and safety of cross-unit handovers.