International journal for quality in health care : journal of the International Society for Quality in Health Care
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Int J Qual Health Care · Aug 2012
Using a logic model to design and evaluate quality and patient safety improvement programs.
Quality improvement programs often pose unique project management challenges, including multi-faceted interventions that evolve over time and teams with few resources for data collection. Thus, it is difficult to report methods and results. We developed a program to reduce central line-associated bloodstream infections (CLABSIs) and improve safety culture in intensive care units (ICUs). ⋯ This success prompted the spread of this program to Spain, England, Peru and across the USA. We developed a logical framework approach (LFA) to guide project management; to incorporate the cultural, clinical and capacity variations among countries; and to ensure early alignment of the project's design and evaluation. In this paper, we describe the use of the LFA to systematically design, implement and evaluate large-scale, multi-faceted, quality improvement programs.
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Int J Qual Health Care · Aug 2012
Investigating patient safety culture across a health system: multilevel modelling of differences associated with service types and staff demographics.
To use multilevel modelling to compare the patient safety cultures of types of services across a health system and to determine whether differences found can be accounted for by staffs' professions, organizational roles, ages and type of patient care provided. ⋯ Differences in staff attitudes have been demonstrated at a macro-level across the type of health services but for the most part, differences could not be explained by staffing composition.
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Int J Qual Health Care · Aug 2012
Using the patient safety indicators to detect potential safety events among US veterans with psychotic disorders: clinical and research implications.
Patients with psychotic disorders often experience poorer health outcomes, but whether they experience increased risks of medical errors/patient safety events is less clear. A single state-level US study found acute care inpatients with schizophrenia were at higher risk of incurring some of the Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSIs). We examined a nationwide sample of US Veteran's Health Administration (VHA) acute care inpatients to determine the rates observed among patients with psychotic disorders for a larger set of PSIs. ⋯ Acute care inpatient veterans with psychotic disorders experienced higher rates of several PSIs, but lower rates of others. Whether lower rates of certain PSIs reflect better or worse care for this population is uncertain.
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Int J Qual Health Care · Aug 2012
Strategies for sustaining a quality improvement collaborative and its patient safety gains.
To identify strategies to facilitate the sustainability of a quality and safety improvement collaborative: the Safer Patients Initiative (SPI) and its successes. ⋯ This study has presented what principle programme coordinators across 20 NHS organizations considered to be the key strategies to sustain their own improvement programme and its successes, during the supported phase of the programme and 1 year on. Recommendations are to consider these practical strategies in order to improve chances of maintaining changes and continuing a quality improvement programme beyond the formal cessation of the intervention.