International journal for quality in health care : journal of the International Society for Quality in Health Care
-
Int J Qual Health Care · Apr 2011
A quality improvement initiative to improve adherence to national guidelines for empiric management of community-acquired pneumonia in emergency departments.
The objective of this study was to improve the concordance of community-acquired pneumonia management in Australian emergency departments with national guidelines through a quality improvement initiative promoting concordant antibiotic use and use of a pneumonia severity assessment tool, the pneumonia severity index (PSI). ⋯ Improved uptake of guideline recommendations for community-acquired pneumonia management in emergency departments was documented following a multi-faceted education intervention.
-
Int J Qual Health Care · Apr 2011
Discrepant perceptions of communication, teamwork and situation awareness among surgical team members.
To assess surgical team members' differences in perception of non-technical skills. ⋯ This study shows discrepancies on many aspects in perception between surgeons and other surgical team members concerning communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system.
-
Int J Qual Health Care · Feb 2011
Exploring the relation between process design and efficiency in high-volume cataract pathways from a lean thinking perspective.
To compare process designs of three high-volume cataract pathways in a lean thinking framework and to explore how efficiency in terms of lead times, hospital visits and costs is related to process design. ⋯ The environmental context and operational focus primarily influenced process design of the cataract pathways. When pressed to further optimize their processes, hospitals can use these systematic benchmarking data to decrease the frequency of hospital visits, lead times and costs.
-
Int J Qual Health Care · Feb 2011
Using an enhanced oral chemotherapy computerized provider order entry system to reduce prescribing errors and improve safety.
To reduce the probability of failure in the oral chemotherapy order, review and administration process and to reduce oral chemotherapy-related prescribing errors intercepted by clinical pharmacists prior to reaching the patient. ⋯ Prescribing oral chemotherapy is a failure mode with significant risk of inducing patient harm. CPOE is effective in reducing prescribing errors of oral chemotherapy and should be considered part of a fail-safe process to improve safety.
-
Int J Qual Health Care · Dec 2010
Self-reported familiarity with acute respiratory infection guidelines and antibiotic prescribing in primary care.
Familiarity with guidelines is generally thought to be associated with guideline implementation, adherence and improved quality of care. We sought to determine if self-reported familiarity with acute respiratory infection (ARI) antibiotic treatment guidelines was associated with reduced or more appropriate antibiotic prescribing for ARIs in primary care. ⋯ Self-reported familiarity with an ARI antibiotic treatment guideline was, seemingly paradoxically, associated with increased antibiotic prescribing. Self-reported familiarity with guidelines should not be assumed to be associated with consistent guideline adherence or higher quality of care.