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 · Feb 2016
ReviewGuide to clinical practice guidelines: the current state of play.
Extensive research has been undertaken over the last 30 years on the methods underpinning clinical practice guidelines (CPGs), including their development, updating, reporting, tailoring for specific purposes, implementation and evaluation. This has resulted in an increasing number of terms, tools and acronyms. Over time, CPGs have shifted from opinion-based to evidence-informed, including increasingly sophisticated methodologies and implementation strategies, and thus keeping abreast of evolution in this field of research can be challenging. ⋯ CPG development and implementation have attracted the most international interest and activity, whilst CPG updating, adopting (with or without contextualization), adapting and impact evaluation are less well addressed.
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Int J Qual Health Care · Feb 2016
Reducing excess readmissions: promising effect of hospital readmissions reduction program in US hospitals.
To evaluate the financial penalty effect of the Hospital Readmissions Reduction Program (HRRP) on 30-day inpatient readmissions for pneumonia (PN), acute myocardial infarction (AMI) and heart failure (HF) among hospitals identified as having excess readmissions. ⋯ HRRP to reduce payments to hospitals with excess readmissions had a significant effect on the inpatient readmissions for PN, AMI and HF in US Hospitals.
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Int J Qual Health Care · Feb 2016
Patients' and families' perspectives of patient safety at the end of life: a video-reflexive ethnography study.
The aim of this study was to investigate patients' and families' perspectives of safety and quality in the setting of a life-limiting illness. ⋯ Current approaches to patient safety do not address fully the needs of dying patients and their families. Patients and their families regard poor communication with and by health professionals to be harmful in and of itself.
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Int J Qual Health Care · Feb 2016
ICU physicians are unable to accurately predict length of stay at admission: a prospective study.
To evaluate the accuracy of prediction of intensive care unit length of stay made by physicians at patient admission. ⋯ The intensive care unit length of stay prediction in these oncological intensive care units is inaccurate and, ideally, should not be made at admission.
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Int J Qual Health Care · Feb 2016
ReviewIncident and error reporting systems in intensive care: a systematic review of the literature.
We performed a systematic review to assess (i) to what extent incident reporting systems (IRSs) on the adult intensive care unit (ICU) meet the criteria of the WHO Draft Guidelines for Adverse Event Reporting and Learning Systems, (ii) to what extent the IRSs comply with the four aspects of the iterative quality loop and (iii) whether IRSs have led to improvement measures in clinical practice. ⋯ None of the IRSs completely fulfilled the WHO checklist criteria. With respect to the iterative loop, data input and data collection are well established but not much attention was given to analyzing incidents and to give feedback. This resulted in an administrative report system, rather than the much desired instrument for change of practice and increase of quality as an IRS can only effectively contribute to improve patient safety and quality of care if more attention is given to analyzing incidents and feedback.