Qual Saf Health Care
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Qual Saf Health Care · Oct 2010
Comparative StudyTransitions from neonatal intensive care unit to ambulatory care: description and evaluation of the proactive risk assessment process.
Over 20,000 US neonates annually make the potentially risky transition from the neonatal intensive care unit (NICU) to the care of primary care physicians whom they have never met. The authors describe the use of Health Care Failure Modes and Effects Analysis (HFMEA) to proactively assess the risks of this transition, and present a qualitative evaluation of the HFMEA process. ⋯ While HFMEA holds promise for improving the safety of care transitions, the full effort required to realise the potential benefit requires additional evaluation to confirm its value over less intensive means of achieving safer care transitions.
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Qual Saf Health Care · Oct 2010
Validation of Hospital Administrative Dataset for adverse event screening.
To assess whether the Belgian Hospital Discharge Dataset (B-HDDS) is a valid source for the detection of adverse events in acute hospitals. ⋯ The B-HDDS has the potential to accurately detect some but not all adverse events. Adding a code 'present on admission' and improving the ICD-9-CM codes might already partially improve the correspondence between the B-HDDS and the medical record review.
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Qual Saf Health Care · Oct 2010
Incidence and types of non-ideal care events in an emergency department.
To identify and characterise hazardous conditions in an Emergency Department (ED) using active surveillance. ⋯ A significant number of non-ideal care events occurred during ED visits and involved failures in medication delivery, radiology testing and laboratory testing processes, and resulted in delays and patient harm.
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Qual Saf Health Care · Oct 2010
Rationalising the treatment of anaemia in cardiac surgery: short and mid-term results from a local quality improvement initiative.
Transfusion of red blood cells, while often used for treating blood loss or haemodilution, is also associated with higher infection rates and mortality. The authors implemented an initiative to reduce variation in the number of perioperative transfusions associated with cardiac surgery. ⋯ We report results from a focused quality-improvement initiative to rationalise treatment of perioperative anaemia. Transfusion rates declined significantly across each phase of the project.
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Qual Saf Health Care · Oct 2010
Introduction of a comprehensive management protocol for severe sepsis is associated with sustained improvements in timeliness of care and survival.
Mortality from severe sepsis can be improved by timely diagnosis and treatment. This study investigates the effectiveness of a comprehensive management protocol for recognition and initial treatment of severe sepsis that spans from the emergency department (ED) to the intensive care unit. ⋯ Introduction of a comprehensive management protocol to address early recognition and management of severe sepsis in the ED is associated with sustained improvements in processes of care.