Qual Saf Health Care
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Qual Saf Health Care · Jun 2010
Patterns of nurse-physician communication and agreement on the plan of care.
Interdisciplinary communication is critically important to provide safe and effective care, yet it has been inadequately studied for hospitalised medical patients. Our objective was to characterise nurse-physician communication and their agreement on patients' plan of care. ⋯ Nurses and physicians did not reliably communicate with one another and were often not in agreement on the plan of care for hospitalised medical patients.
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Qual Saf Health Care · Jun 2010
Multicenter StudyWeekend mortality for emergency admissions. A large, multicentre study.
Several studies have identified higher mortality for patients admitted as emergencies at the weekend compared with emergency admissions during the week, but most have focused on specific conditions or have had a limited sample size. ⋯ This is the largest study published on weekend mortality and highlights an area of concern in relation to the delivery of acute services.
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Qual Saf Health Care · Jun 2010
Endorsing single-unit transfusion combined with a restrictive haemoglobin transfusion threshold after knee arthroplasty.
The utility of single-unit transfusions in the presence of restrictive haemoglobin transfusion thresholds is unknown. ⋯ Restrictive haemoglobin thresholds are a safe, potent frontline strategy for decreasing the rate of blood transfusion. Judicious endorsement of single units is a secondary strategy for reducing the consumption of donor blood when the transfusion haemoglobin trigger is strict.
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Qual Saf Health Care · Jun 2010
A rapid admission protocol to reduce emergency department boarding times.
Prolonged emergency department boarding times (EDBT) are associated with adverse clinical outcomes and longer hospital stays. A rapid admission protocol was designed at our institution to reduce both EDBT and time to admission orders (EDTAO) for patients admitted to the internal medicine service. ⋯ Institution of a rapid admission protocol successfully reduced overall EDBT at our institution, although few gains were noted for patients with a telemetry or ICU destination. In total, the intervention saved 27 884 h, or 1161 emergency department patient-days, over the course of a single year.
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Qual Saf Health Care · Jun 2010
Communication and collaboration: it's about the pharmacists, as well as the physicians and nurses.
Collaboration and communication as dimensions of patient safety climate have been measured in acute care hospital units, and discrepant viewpoints have been documented between different professional groups, particularly between physicians and nurses. In the ambulatory care setting, these groups often work more closely together throughout the day than in acute care settings, thereby enhancing effective collaboration and communication. This study sought to determine if the communication differences that are known to impact patient safety, which are found in acute care, also exist in ambulatory care. ⋯ Collaboration and communication ratings among physicians and nurses appear to be higher in the ambulatory care setting than in the acute care. However, interactions with pharmacists are more problematic, perceived as adversarial. Teamwork training that focuses on specific interactions among professional groups should target these concerns.