Qual Saf Health Care
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To describe relationships between teamwork behaviours and errors during neonatal resuscitation. ⋯ Vigilance is an important behaviour for error management. Assertion may have caused errors, or perhaps was an indicator for some other factor that caused errors. Teams may have preferred to resolve errors directly, rather than using errors as opportunities to teach their teammates. These observations raise important questions about the appropriate use of some teamwork behaviours and how to include them in team training programmes.
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Qual Saf Health Care · Feb 2010
The hospital standardised mortality ratio: a powerful tool for Dutch hospitals to assess their quality of care?
To use the hospital standardised mortality ratio (HSMR), as a tool for Dutch hospitals to analyse their death rates by comparing their risk-adjusted mortality with the national average. ⋯ Overall hospital HSMRs and mortality at individual diagnostic group level can be monitored using statistical process control charts to give an early warning of possible problems with quality of care. The use of routine data in a standardised and robust model can be of value as a starting point for improvement of Dutch hospital outcomes. HSMRs have been calculated for several other countries.
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Qual Saf Health Care · Dec 2009
Evidence-based chronic heart failure management programs: reality or myth?
Chronic heart failure management programmes (CHF-MPs) have become part of standard care for patients with chronic heart failure (CHF). ⋯ CHF-MPs are being implemented rapidly throughout Australia. However, many of these programmes do not adhere to expert clinical guidelines for the management of patients with CHF. This poor translation of evidence into practice highlights the inconsistency and questions the quality of health-related outcomes for these patients.
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Qual Saf Health Care · Dec 2009
Patient safety on the otolaryngology service: the role of an established rapid response system.
To study the medical emergencies occurring on a tertiary otolaryngology service identified using a rapid response system (RRS). ⋯ Although otolaryngology care units attempt to prevent adverse events, emergencies still occur. RRSs identify deteriorating otolaryngology patients who are at increased risk for mortality. RRSs are an efficient mechanism of intervention during a medical emergency. RRSs provide a convenient method of identifying medical/system errors and educational opportunities.
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Qual Saf Health Care · Dec 2009
Do managed clinical networks improve quality of diabetes care? Evidence from a retrospective mixed methods evaluation.
System-wide improvement of chronic disease care is challenging because it requires collaboration and communication across organisational and professional boundaries. Managed clinical networks are one potential solution, but there is little evidence of their effectiveness. ⋯ Delivering better care to whole populations across organisational and professional boundaries required sustained work over long periods, and at all levels of the system of care. Past network focus on clinical collaboration has been effective at improving clinical process and outcome, and the network is now prioritising work with managers and patients to support future redesign.