Qual Saf Health Care
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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.
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There is limited information in the literature about reasons for discharges against medical advice (DAMA) as supplied by patients and providers. Information about the reasons for DAMA is necessary for identifying workable strategies to reduce the likelihood and health consequences of DAMA. The objective of this study is to identify the reasons for DAMA based on patient and multicategory provider focus-group interviews (FGIs). ⋯ In a large, academic medical centre, the authors find some differences and many similarities across patients and providers in identifying the causes of and solutions to DAMA, many of which relate to communication.