The International journal of risk & safety in medicine
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Anticipation and planning are essential steps of risk management but the mechanisms of planning behavior are incompletely understood, especially the factors including collective work. The aim of this research is to understand how anesthetists plan safe solution to perform anesthesia. ⋯ Ultra safe performance in highly variable systems cannot be achieved only through standardization but also through the possibility and ability of the subjects to adapt their practices to their own skills and to that of their colleagues. The conditions for the development of this "adaptative safety" are discussed.
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The transfer of care from one provider to another is fraught with potential failures. Unfortunately the consequences of a poorly conducted patient handoff can be quite high. In the last five years there have been many descriptions of this problem as well as suggested solutions. Commonly authors have focused on utilization of a formatted tool for the off-going provider to help improve patient handoffs. While this is certainly a requirement for a high quality transfer of care, it is not the only needed component. ⋯ Early results from pilot testing reveal after designing and testing the dual responsibility model that patient handoffs are increasingly successful and more reliable.
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Public and private payers use drug compendia to make coverage determinations, yet the quality of evidence they contain has received little scrutiny. We examined compendia citations regarding antipsychotic drugs, an important drug class given their substantial costs and widespread use. Nearly three-fold as many off-label indications were recommended for atypical as for typical agents, a difference that did not appear to be due to differences in quality of evidence for typical and atypical off-label indications. Given the important role that compendia play in evidence synthesis, coverage decisions, and ultimately, prescription utilization, these data suggest greater efforts are needed to improve the quality of evidence and transparency of evidence evaluations compendia contain.
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The agricultural industry is the largest economic sector in Palestine and is characterized by extensive and unregulated use of pesticides. The objective of this study was to analyze phone calls received by the Poison Control and Drug Information Center (PCDIC) in Palestine regarding pesticide poisoning. ⋯ Pesticide poisoning is a major health problem in Palestine, and the PCDIC has a clear mission to help in recommending therapy and gathering information.