BMJ quality & safety
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BMJ quality & safety · Nov 2011
Characteristics of general practices associated with emergency-department attendance rates: a cross-sectional study.
Strategies are needed to contain emergency-department attendance. Quality of care in general practice might influence the use of emergency departments, including management of patients with chronic conditions and access to consultations. ⋯ Performance as indicated by the quality and outcomes framework did not predict rates of attendance at emergency departments, but satisfaction with telephone access did. Consideration should be given to improving access to some general practices to contain the use of emergency departments.
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BMJ quality & safety · Nov 2011
Usability evaluation of order sets in a computerised provider order entry system.
Computerised provider order entry (CPOE) is an important patient safety intervention that has encountered significant barriers to implementation. The usability of a CPOE system plays a significant role in its acceptance. The authors conducted a heuristic evaluation of a CPOE order set system to uncover existing usability issues prior to implementation. ⋯ The CPOE test order set system had many usability heuristic violations. Many violations were found by a clinician with knowledge of the heuristic evaluation process. Implementation of the CPOE system was deferred and a new user centred design prototype was developed for future study. The authors recommend conducting heuristic evaluations early in the process of designing, selecting and implementing CPOE systems.
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BMJ quality & safety · Nov 2011
Real-time automated paging and decision support for critical laboratory abnormalities.
For patients with critical laboratory abnormalities, timely clinical alerts with decision support could improve management and reduce adverse events. ⋯ The provision of real-time clinical alerts and decision support for critical laboratory abnormalities did not improve clinical management or decrease adverse events.
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BMJ quality & safety · Oct 2011
Randomized Controlled TrialThe ability of a behaviour-specific patient questionnaire to identify poorly performing doctors.
Doctors' ability to communicate with patients varies. Patient questionnaires are often used to assess doctors' communication skills. ⋯ Using a patient-reported questionnaire of doctors' communication skills, favourable assessments of doctors by patients were mostly discordant with the views of expert observers. Only very poor performance identified by patients was in agreement with the views of expert observers. The results suggest that patient reports alone may not be sufficient to identify all doctors whose communication skills need improvement training.
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BMJ quality & safety · Oct 2011
Teamwork and team performance in multidisciplinary cancer teams: development and evaluation of an observational assessment tool.
Team performance is important in multidisciplinary teams (MDTs), but no tools exist for assessment. Our objective was to construct a robust tool for scientific assessment of MDT performance. ⋯ Scientific observational metrics can be reliably used by medical and non-medical observers in cancer MDTs. Such robust assessment tools provide part of a toolkit for team evaluation and enhancement.