Journal for healthcare quality : official publication of the National Association for Healthcare Quality
-
The appropriate handover of patients, whereby responsibility and accountability of care is transferred between healthcare providers, is a critical component of quality healthcare delivery. This paper examines data from recent incidents relating to clinical handover in acute care settings, in order to provide a basis for the design and implementation of preventive and corrective strategies. A sample of incidents (n = 459) relating to clinical handover was extracted from an Australian health service's incident reporting system using a manual search function. ⋯ The most prevalent failure detection mechanisms were those of expectation mismatch 35.7% (n = 174), clinical mismatch 26.9% (n = 127), and mismatch with other documentation 24.0% (n = 117). The findings suggest the need for a structured approach to handover with a recording of standardized sets of information to ensure that critical components are not omitted. Limitations of existing reporting processes are also highlighted.
-
Surgical site infections (SSIs) are common, costly, and often preventable. There are no national requirements for measuring or reporting hospital SSI rates and state-level monitoring occurs with little coordination between states. We designed a study to describe the current status of SSI reporting in the United States. ⋯ There is wide variation in state monitoring and reporting of SSI rates. Standardized reporting may be needed so that consumers can make informed health choices based on quality metrics.
-
Dr. David Nash, founder of the original Office of Health Policy in 1990 at Thomas Jefferson University and later the Founding Dean of the Jefferson School of Population Health, is known for his emphasis on measurement and variation in Medical Education. His knowledge and understanding of healthcare policy make this interview timely and relevant.
-
Sepsis is recognized as an often-lethal disease. Recommended guidelines are complex and time sensitive. Response teams (RTs) have demonstrated success in implementation of quality initiatives. The purpose of this study was to evaluate variations in noncompliance with recommended sepsis guidelines overall and between a sepsis-focused RT and standard care. ⋯ Noncompliance is more complex than simple failure to initiate, especially in time-dependent therapies. The development and education of an RT demonstrates improvement in application of sepsis-focused therapies over standard care.