Qual Saf Health Care
-
Qual Saf Health Care · Aug 2009
"There is a chain of Chinese whispers ...": empirical data support the call to formally teach handover to prequalification doctors.
Changing patterns of work in the hospital setting mean different teams look after the same group of patients over the course of any given day. Shift handovers, or hand/sign-off, can give rise to miscommunication of critical information, a patient safety issue. How can we best prepare new doctors for handover? ⋯ New doctors feel unprepared for handover and are seen as poor at handing over. Certain skills are required for effective handover, but professional attitudes are also critical. The skills identified reflect those suggested in policy documents based on expert panel views. Poor systems are a barrier to effective learning and practice. Our empirical approach adds to existing knowledge by highlighting that handover is not solely a skills-based task; there are complex interactions between individual and systems factors; and junior doctors should be prepared for handover prequalification. These data can be used to plan optimal handover teaching for medical students.
-
Poor clinical handover creates discontinuities in care leading to patient harm. However, the field of handover research continues to lack standardised definitions and reliable measurement tools to identify factors that would lead to harm reduction and improved safety strategies. ⋯ The paper argues that measurement will identify gaps in knowledge about handover practice and promote rigor in the design and evaluation of interventions to reduce patient harm.
-
Qual Saf Health Care · Aug 2009
What are covering doctors told about their patients? Analysis of sign-out among internal medicine house staff.
To characterise and assess sign-out practices among internal medicine house staff, and to identify contributing factors to sign-out quality. ⋯ Sign-outs are not uniformly comprehensive and include few questions. The findings suggest that several changes may be required to improve sign-out quality, including standardising key content, minimising sign-outs that do not involve the primary team, templating written sign-outs, emphasising the role of sign-out in maintaining patient safety and fostering a sense of direct responsibility for patients among covering staff.
-
Qual Saf Health Care · Aug 2009
Multicenter StudyAdverse events and potentially preventable deaths in Dutch hospitals: results of a retrospective patient record review study.
This study determined the incidence, type, nature, preventability and impact of adverse events (AEs) among hospitalised patients and potentially preventable deaths in Dutch hospitals. ⋯ The incidence of AEs, preventable AEs and potentially preventable deaths in the Netherlands is substantial and needs to be reduced. Patient safety efforts should focus on surgical procedures and older patients.
-
Qual Saf Health Care · Aug 2009
How an educational improvement project improved the summative evaluation of medical students.
At the University of Missouri-Columbia School of Medicine (USA) "commitment to improving quality and safety in healthcare" is one of eight key characteristics set as goals for our graduates. As educators, commitment to continuous improvement in the educational experience has been modelled through improvement of the Medical Student Performance Evaluation (MSPE) letter (formerly the Dean's letter). ⋯ This educational improvement project decreased waste, increased collaboration and developed locally useful knowledge. By applying continuous improvement principles to the construction of the MSPE the overall efficiency of the process could be enhanced, and the MSPE committee was able to spend less cognitive energy on structure and format and focus more on the content of the letters. Four MSPE cycles have been completed using a new Web-based system; after each cycle, additional enhancements were identified and implemented. This work adds to the literature, as it describes the application of continuous improvement principles to an educational system.