Joint Commission journal on quality and patient safety / Joint Commission Resources
-
Jt Comm J Qual Patient Saf · Mar 2013
AHRQ patient safety indicators: time to include hemorrhage and infection during childbirth.
Many Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) partially or completely exclude pregnant women. Both postoperative hemorrhage or hematoma (PSI 9; hemorrhage), and Postoperative Sepsis (PSI 13; infection) appear to be adaptable to pregnancy hospitalizations. ⋯ Although codes and coding practices for pregnancy hospitalizations differ from those used for nonpregnant adults, hospital-level measures of childbirth-associated hemorrhage and infection are feasible, vary widely, and demonstrate considerable opportunity for improvement.
-
Jt Comm J Qual Patient Saf · Mar 2013
The impact of demographic characteristics on nonresponse in an ambulatory patient satisfaction survey.
Despite the increasing use of patient satisfaction data for compensation and comparison of performance, low response rate and potential bias of the respondents pose a significant threat to validity of the data. The demographic profiles of respondents and nonrespondents to a patient satisfaction survey in the ambulatory care setting were compared to explore the impact ofnonresponse bias. ⋯ Nonresponse rates and satisfaction ratings differed by age, language, and insurance type. However, if it is assumed that nonrespondents within these demographic groups have similar satisfaction ratings as respondents, then nonresponse levels appear to have minimal effects on overall satisfaction ratings.
-
Jt Comm J Qual Patient Saf · Mar 2013
Enhancing electronic health record usability in pediatric patient care: a scenario-based approach.
Usability of electronic health records (EHRs) is an important factor affecting patient safety and the EHR adoption rate for both adult and pediatric care providers. A panel of interdisciplinary experts (the authors) was convened by the National Institute of Standards and Technology to generate consensus recommendations to improve EHR usefulness, usability, and patient safety when supporting pediatric care, with a focus on critical user interactions. ⋯ Pediatric patient care has unique dimensions, with great complexity and high stakes for adverse events. The recommendations are anticipated to increase the rate of EHR adoption by pediatric care providers and improve patient safety for pediatric patients. The described methodology might be useful for accelerating adoption and increasing safety in a variety of clinical areas where the adoption of EHRs is lagging or usability issues are believed to reduce potential patient safety, efficiency, and quality benefits.
-
Jt Comm J Qual Patient Saf · Mar 2013
Applying lean methods to improve quality and safety in surgical sterile instrument processing.
Surgical instrument processing is critical to safe, high-quality surgical care but has received little attention in the medical literature. Typical hospitals have inventories in the tens of thousands of surgical instruments organized into thousands of instrument sets. The use of these instruments for multiple procedures per day leads to millions of instrument sets being reprocessed yearly in a single hospital. Errors in the processing of sterile instruments may lead to increased operative times and costs, as well as potentially contributing to surgical infections and perioperative morbidity. ⋯ Surgical instrument processing errors are a barrier to the highest quality and safety in surgical care but are amenable to substantial improvement using Lean techniques.
-
Jt Comm J Qual Patient Saf · Feb 2013
Handoff communication between hospital and outpatient dialysis units at patient discharge: a qualitative study.
Hemodialysis patients are vulnerable to adverse events, including those surrounding hospital discharge. Little is known about how dialysis-specific information is shared with outpatient dialysis clinics for discharged patients, and the applicability of existing models of handoff transitions is unknown. ⋯ Standardizing the communication process between inpatient and outpatient dialysis units when patients are discharged from the hospital has potential to reduce adverse events related to poor communication and improve patient care during this transition. Interprofessional collaboration has potential to create robust solutions to this complex problem and foster a culture of multidisciplinary reflexivity.