Qual Saf Health Care
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Qual Saf Health Care · Dec 2004
Editorial CommentChallenges for an international guidelines collaboration.
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Qual Saf Health Care · Dec 2004
Clinical Trial Controlled Clinical TrialSimulation based teamwork training for emergency department staff: does it improve clinical team performance when added to an existing didactic teamwork curriculum?
To determine if high fidelity simulation based team training can improve clinical team performance when added to an existing didactic teamwork curriculum. ⋯ High fidelity medical simulation appears to be a promising method for enhancing didactic teamwork training. This approach, using a number of patients, is more representative of clinical care and is therefore the proper paradigm in which to perform teamwork training. It is, however, unclear how much simulator based training must augment didactic teamwork training for clinically meaningful differences to become apparent.
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Qual Saf Health Care · Dec 2004
Towards primary care for non-serious 999 callers: results of a controlled study of "Treat and Refer" protocols for ambulance crews.
To develop and evaluate "Treat and Refer" protocols for ambulance crews, allowing them to leave patients at the scene with onward referral or self-care advice as appropriate. ⋯ "Treat and Refer" protocols did not increase the number of patients left at home but were used by crews and were acceptable to patients. The protocols increased job cycle time and some safety issues were identified. Their introduction is complex, and the extent to which the content of the protocols, decision support and training can be refined needs further study.
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Learning in health care is essential if healthcare organisations are to tackle a challenging quality of care agenda. Yet while we know a reasonable amount about the nature of learning, how learning occurs, the forms it can take, and the routines that encourage it to happen within organisations, we know very little about the nature and processes of unlearning. ⋯ There is a difference between routine unlearning (and subsequent re-learning) and deep unlearning--unlearning that requires a substantive break with previous modes of understanding, doing, and being. We argue that routine unlearning merely requires the establishment of new habits, whereas deep unlearning is a sudden, potentially painful, confrontation of the inadequacy in our substantive view of the world and our capacity to cope with that world competently.
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Qual Saf Health Care · Dec 2004
Improving the quality of health care: using international collaboration to inform guideline programmes by founding the Guidelines International Network (G-I-N).
Clinical practice guidelines are regarded as powerful tools to achieve effective health care. Although many countries have built up experience in the development, appraisal, and implementation of guidelines, until recently there has been no established forum for collaboration at an international level. As a result, in different countries seeking similar goals and using similar strategies, efforts have been unnecessarily duplicated and opportunities for harmonisation lost because of the lack of a supporting organisational framework. ⋯ One year later the Network released the International Guideline Library, a searchable database which now contains more than 2000 guideline resources including published guidelines, guidelines under development, "guidelines for guidelines", training materials, and patient information tools. By June 2004, 52 organisations from 27 countries had joined the network including institutions from Oceania, North America, and Europe, and WHO. This paper describes the process that led to the foundation of the G-I-N, its characteristics, prime activities, and ideas on future projects and collaboration.