Journal for healthcare quality : official publication of the National Association for Healthcare Quality
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In 2001, the Committee on Quality in Health Care in America found it took 17 years for evidence from randomized controlled trials to be applied to practice, with little improvement over the last decade. Even abbreviated and summarized evidence fails to be consistently implemented at the bedside. More emphasis needs to be placed on understanding which Implementation Methods are most effective in successfully implementing evidence-based practice at the bedside. ⋯ The 20 Implementation Methods identified as part of this study, represented the vast majority of Implementation Methods used by PICUs.
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Recognizing the inconsistencies in sedation practices, the Society for Pediatric Sedation convened this meeting to begin the process of defining quality as it relates to the field of pediatric sedation. ⋯ The conference findings outlined in this document address the Agency for Healthcare Research and Quality's (AHRQ) mission of improving quality healthcare for all Americans, especially for underrepresented groups such as children. The conference outlines a key next step in defining and achieving quality in pediatric procedural sedation.
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The purpose of our pre-post intervention study was to reduce the number of near-miss events pertaining to wrong-site surgery, including incorrectly sided surgical bookings and incorrectly performed preoperative time-out procedures. Pre- and postintervention, incorrectly booked cases, and improperly performed presurgical time-out procedures were recorded. We then educated each surgeon and their staff regarding the importance of and proper way to perform these tasks. Subsequently, the monthly percentage of incorrectly booked surgical procedures and improperly performed time-outs were significantly decreased. ⋯ A program designed to educate physicians to the importance of decreasing near misses for wrong-site surgery is effective. When analyzing the literature, it is clear that the reduction in near misses observed in this study decreases the likelihood of a wrong-site surgery.
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Patient handoffs are high-risk times associated with sentinel events. Effective handoff processes may enhance patient safety and team member communication. This study assesses the impact of a standardized protocol for handoffs from the cardiac surgery operating room to intensive care unit (ICU). ⋯ A standard checklist-driven handoff process can dramatically improve key data transmission and reduce time of critical patient care steps during the high-risk period of patient handoff in a cardiac surgical ICU.
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The "siloed" approach to healthcare delivery contributes to communication challenges and to potential patient harm when patients transfer between settings. This article reports on the evaluation of a demonstration in 10 rural communities to improve the safety of nursing facility (NF) transfers to hospital emergency departments by forming interprofessional teams of hospital, emergency medical service, and NF staff to develop and implement tools and protocols for standardizing critical interfacility communication pathways and information sharing. We worked with each of the 10 teams to document current communication processes and information sharing tools and to design, implement, and evaluate strategies/tools to increase effective communication and sharing of patient information across settings. ⋯ Study findings showed significant improvement in key areas across the three settings, including infection status and baseline mental functioning. Improvement strategies and performance varied across settings; however, accurate and consistent information sharing of advance directives and medication lists remains a challenge. Study results demonstrate that with neutral facilitation and technical support, collaborative interfacility teams can assess and effectively address communication and information sharing problems that threaten patient safety.