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 · Jun 2016
Development and testing of the cancer multidisciplinary team meeting observational tool (MDT-MOT).
To develop a tool for independent observational assessment of cancer multidisciplinary team meetings (MDMs), and test criterion validity, inter-rater reliability/agreement and describe performance. ⋯ MDT-MOT demonstrated good criterion validity. Agreement between clinical and non-clinical observers (within one point on the scale) was high but this was inconsistent with reliability coefficients and warrants further investigation. If further validated MDT-MOT might provide a useful mechanism for the routine assessment of MDMs by the local workforce to drive improvements in MDT performance.
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Int J Qual Health Care · Jun 2016
Qualitative analysis of US Department of veterans affairs mental health clinician perspectives on patient-centered care.
Enhanced patient involvement in care has the potential to improve patient experiences and health outcomes. As such, large national and global healthcare systems and organizations, including the US Department of Veterans Affairs (VA), have made patient-centered care a primary goal. Little is known about mental health clinician perspectives on, and experiences with, providing patient-centered care. Our main objective was to better understand VA mental health clinicians' perceptions of patient-centered care, and ascertain possible facilitators and barriers to patient-centered practices in mental health settings. ⋯ If patient-centered care is to be practiced fully in mental health settings, healthcare institutions need to develop multimodal strategies to enhance clinician-clinician and clinician-patient collaborations to promote and support a focus on discovery and shared accountability for outcomes.
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Int J Qual Health Care · Jun 2016
A mixed-methods study of the causes and impact of poor teamwork between junior doctors and nurses.
This study aimed to collect and analyse examples of poor teamwork between junior doctors and nurses; identify the teamwork failures contributing to poor team function; and ascertain if particular teamwork failures are associated with higher levels of risk to patients. ⋯ Poor teamwork between junior doctors and nurses is common and places patients at considerable risk. Addressing this problem requires a well-designed complex intervention to develop the team skills of doctors and nurses and foster a clinical environment in which teamwork is supported.
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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.
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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.