Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2022
ReviewQuality improvement and patient safety in China, present and future.
With continued political support and increased health financing, China has achieved great progress in medical and health quality during the two decades. The strategy to improve health in China is built on reliable cross-sectoral information and data sharing along with quality improvement science and safety analytics balancing equitability, accessibility, quality outcomes, and safety in healthcare for everyone. As part of the healthcare system, pediatric anesthesiology has made great efforts to align with the China healthcare strategy to achieve quality outcomes, accessibility, and patient safety, but it still faces many problems such as unbalanced regional development, lack of awareness and relevant knowledge, and increased workload due to insufficient number of anesthesiologists. ⋯ In turn, the major centers educate and collaborate with the district hospitals to empower local improvements in safety and quality. Since the science in QI and patient safety is relatively new to anesthesiology in China, such collaborations must be greatly scaled up to reach the large geography and patient population in China. While the future is promising, there is still a long way to go.
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Paediatric anaesthesia · Nov 2022
ReviewPositive approaches to safety: Learning from what we do well.
Historical and current methodologies in patient safety are based on a deficit-based model, defining safety as the absence of harm. This model is aligned with the human innate negativity bias and the general philosophy of health care: to diagnose and cure illness and to relieve suffering. While this approach has underpinned measurable progress in healthcare outcomes, a common narrative in the healthcare literature indicates that this progress is stalling or slowing. ⋯ More overtly positive approaches are available, specifically focusing on success-both outstanding success and everyday success-including exnovation, appreciative inquiry, learning from excellence and positive deviance. These approaches are not mutually exclusive. The new methods described in this article are not intended as replacements of the current methods, rather they are presented as complementary tools, designed to allow the reader to take a balanced and holistic view of patient safety.
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Paediatric anaesthesia · Nov 2022
Training Clinicians to become Leaders of Complex Change: Lessons from Scotland.
Clinicians are trained to diagnose disease and recommend treatments or procedures. This is the focus of much of undergraduate training, but delivery of healthcare depends on so much more than theoretical knowledge and technical skill. It is a complex environment where professionals from different backgrounds have to work together to deliver safe pathways of care to patients who have very varied backgrounds. ⋯ In turn, this can negatively impact on the experience of patients and staff. Attempting to change this complex environment requires a unique set of skills. This article describes an international fellowship that creates a network of individuals skilled in quality improvement, human factors, service design and leadership.
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Paediatric anaesthesia · Nov 2022
The emergence noise reduction quality improvement initiative to enhance patient safety and quality of care.
Operating room noise levels may hinder staff communication and cause distractions for providers, endangering patient safety. Owing to concerns of unacceptable noise levels during emergence from general anesthesia, our institution developed a quality improvement project. The SMART aim of this initiative was to decrease the average decibel noise level measured during emergence from general anesthesia in our operating rooms from 65.65 to 63 decibels and the maximum decibel noise level from 81.64 to 75 decibels over approximately 3 months. ⋯ This improvement project was associated with a decrease in decibel noise levels during emergence. We enhanced a process and encouraged culture change at an academic pediatric hospital to enhance the safety of our care.