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Showing results for tags 'Systematic review'.
Found 100 results
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Content ArticleWatts et al. evaluated the effectiveness of audit and communication strategies to reduce diagnostic errors made by clinicians.
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Content ArticleThe Health Foundation commissioned the Institute of Health Equity to examine progress in addressing health inequalities in England, 10 years on from the landmark study Fair Society, Healthy Lives (The Marmot Review). Led by Professor Sir Michael Marmot, the review explores changes since 2010 in five policy objectives: giving every child the best start in life enabling all people to maximise their capabilities and have control over their lives ensuring a healthy standard of living for all creating fair employment and good work for all creating and developing healthy and sustainable places and communities. For each objective the report outlines areas of progress and decline since 2010 and proposes recommendations for future action, setting out a clear agenda at a national, regional and local level.
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Content ArticleThis study, published in Health Services and Delivery Research, identified five key themes that help explain how patient experience data work could lead to quality improvements in acute hospital trusts.
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Content ArticleThis report,from Healthwatch, argues that hospitals, indeed the NHS more broadly, need to shift the mindset on complaints. Reporting needs to look beyond the numbers and response times and focus more on how to effectively demonstrate to patients and the public what has been learnt. This is the only way to give the public confidence that their concerns are being listened to and acted on.
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Content ArticleReadmissions to hospital are increasingly being used as an indicator of quality of care. However, this approach is valid only when we know what proportion of readmissions are avoidable. The authors conducted a systematic review of studies that measured the proportion of readmissions deemed avoidable. This study, published in Canadian Medical Association Journal, examined how such readmissions were measured and estimated their prevalence.
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Content ArticleChildren admitted to paediatric and neonatal intensive care units may be at high risk from medication errors (MEs) and preventable adverse drug events. In this systematic review published in Drug Safety, Alghamdi et al., reviewed empirical studies examining the prevalence and nature of MEs and preventable adverse drug events in paediatric and neonatal intensive care units. They found that medication errors occur frequently in critically ill children admitted to paediatric and neonatal intensive care units and may lead to patient harm. Important targets such as dosing errors and anti-infective medications were identified to guide the development of remedial interventions.
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Content ArticleThis paper, published by the Canadian Journal of Surgery, suggests that the failure to systematically measure patient safety is the reason for limited progress. In addition to defining patient safety outcomes and describing their financial and clinical impact, the authors argue why the failure to implement patient safety measurement systems has compromised the ability to move the agenda forward. They also present an overview of how patient safety can be assessed and the strengths and weaknesses of each method and comment on some of the consequences created by the absence of a systematic measurement system.
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Content ArticleAdverse events in hospitals constitute a serious problem with grave consequences. Many studies have been conducted to gain an insight into this problem, but a general overview of the data is lacking. The authors of this paper, published in BMJ Quality & Safety, performed a systematic review of the literature on in-hospital adverse events.
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Content ArticleThis paper explores how patient-reported experience measures (PREMs) are collected, communicated and used to inform quality improvement (QI) across healthcare settings.
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Content ArticleThis study, summarising evidence from 55 studies, indicates consistent positive associations between patient experience, patient safety and clinical effectiveness for a wide range of disease areas, settings, outcome measures and study designs. It demonstrates positive associations between patient experience and self-rated and objectively measured health outcomes; adherence to recommended clinical practice and medication; preventive care (such as health-promoting behaviour, use of screening services and immunisation); and resource use (such as hospitalisation, length of stay and primary-care visits). There is some evidence of positive associations between patient experience and measures of the technical quality of care and adverse events. Overall, it was more common to find positive associations between patient experience and patient safety and clinical effectiveness than no associations.
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Content ArticleHealthcare provision in the NHS is very safe but on rare occasions when things go wrong, it is important that those involved are properly informed and supported, compensation is paid fairly, unnecessary costs are contained and that we learn in order to improve. Negligence also comes at significant personal and financial cost for the NHS, not all of which is visible. NHS Resolution has conducted a thematic review into learning from suicide related claims with in the NHS.
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Content ArticleThis study, published in BMJ Open, aimed to review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care.
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Content ArticleThis review has examined the commissioning and use of clinical advice by the Parliamentary Health Service Ombudsman’s (PHSO) service during the assessment and investigation of complaints made by (or on behalf of) recipients of NHS care. In establishing findings, conclusions, and recommendations, the author, Liam Donaldson, has asked a series of important questions, including: Does the current process for engaging clinical advice work effectively? What, if any, are the main problems, risks, and areas of dysfunction? Does the process need to be improved and if so why and how?
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Content ArticleThe objective of this systematic review, published by JBI database of systematic reviews and implementation reports, is to synthesise the eligible evidence of patients' experience of engaging and interacting with nurses, in the medical-surgical ward setting.
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Content ArticleThe aim of this systematic review from Lawton et al., published in BMJ Quality & Safety, was to develop a ‘contributory factors framework’ from a synthesis of empirical work which summarises factors contributing to patient safety incidents in hospital settings.
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Content ArticleRecently, there have been a number of advances in technology, including in mobile devices, globalization of companies, display technologies and healthcare, all of which require significant input and evaluation from human factors specialists. Accordingly, this textbook has been completely updated, with some chapters folded into other chapters and new chapters added where needed. The text continues to fill the need for a textbook that bridges the gap between the conceptual and empirical foundations of the field.
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Content ArticleThere has been an identified need for greater patient and family member involvement in healthcare. This is particularly relevant in an intensive care unit (ICU), as the family provides a key communicative and practical link between patient and clinician. Family members have been deemed a positive beneficial influence on ICU care and recovery processes, yet they themselves are often emotionally affected after discharge. There has been no standardised evidenced-based approach which explores research on family member involvement and the range and quality of contributions remain unclear. This study from Xyrichis et al. undertook a systematic review to assess the evidence base for interventions designed to promote patient and family member involvement in adult intensive care settings and develop a comprehensive typology of interventions for use by clinicians, patients and carers. The review provides valuable and rigorous insight into the range and quality of interventions available to promote patient and family member involvement in ICU. This is the first step towards addressing the absence of a synthesis of research for this context, and will, in addition, develop a typology of available interventions that will help service users and clinicians make informed decisions about the approaches to patient and family member involvement which they might want to adopt.
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Content ArticleThis systematic review from Willis et al., published in BMJ Leader, set out to understand what leaders and organisational cultures can learn about supporting doctors who experience second victim phenomenon; the types, levels and availability of support offered; and the psychological symptoms experienced.
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Content ArticleThe act of open disclosure of an adverse event alone may not be enough for patients or their families. Patients and patient advocates are asking for increased transparency and a greater role in the process of change. When properly handled, involving patients in post‐event analysis allows risk management professionals to further improve their organisation's systems analysis process while empowering patients to be part of the solution. First published by the US-based Journal of Health Care Risk Management, this article examines the legal and psychological considerations surrounding the involvement of patients in system failure analysis and provides tools for selecting patients who are able to benefit from this process and for adequately preparing patients and caregivers for what lies ahead.
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Content ArticleThe successful implementation of clinical practice guidelines should improve quality of care by decreasing inappropriate variation and expediting the application of effective advances to practice. However, despite wide promulgation, practice guidelines have had limited effect on changing physician behavior. Cabana et al. conducted a systematic review of the barriers to physician adherence to clinical practice guidelines, practice parameters, clinical policies or national consensus statements. They found that physician adherence is dependent on physician awareness (31 examples), agreement (68 examples), self-efficacy (13 examples), outcome expectancy (12 examples), motivation (3 examples), and the absence of external barriers to perform guideline recommendations (62 examples). The findings suggest that studies describing interventions to improve physician adherence may not be generalisable, since barriers in one setting may not be present in another. Using this analysis, the authors propose a framework which describes the barriers that must be overcome to improve physician adherence. This framework can be used (1) as a method to profile barriers or sources of poor adherence and thus (2) as a diagnostic tool to standardise and select appropriate interventions to improve adherence. The selection of interventions to change physician behaviour has been haphazard in the past. This analysis offers a more rational approach towards improving physician adherence to practice guidelines as well as a framework for further research.
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Content ArticlePublished in Systematic Reviews, this paper looks at how organisations need to systematically identify contributory factors (or causes) which impact on patient safety in order to effectively learn from error. Investigations of error have tended to focus on taking a reactive approach to learning from error, mainly relying on incident-reporting systems. Existing frameworks which aim to identify latent causes of error rely almost exclusively on evidence from non-healthcare settings. In view of this, the Yorkshire Contributory Factors Framework (YCFF) was developed in the hospital setting. Eighty-five percent of healthcare contacts occur in primary care. As a result, this review will build on the work that produced the YCFF, by examining the empirical evidence that relates to the contributory factors of error within a primary care setting.
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Content ArticleClinical audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of the structure, processes, and outcomes of care are selected and systematically evaluated against explicit criteria. Where indicated, changes are implemented at an individual, team, or service level and further monitoring is used to confirm improvement in healthcare delivery. This book is written primarily for staff leading clinical audit and clinical governance projects and programmes in the NHS. It should also prove useful to many other people involved in audit projects, large or small and in primary or secondary care.
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Content ArticleReducing the risk of patient harm during the process of healthcare delivery is at the forefront of policy and practice. A considerable number of empirical studies and systematic reviews have examined the prevalence, causes and consequences of patient safety incidents and harms. However, a key limitation in the current patient safety literature is that existing reviews examine patient harm in general but there is less emphasis on understanding the burden of preventable patient harm, which in the interest of improvement is of particular importance. The primary aim of this study from Panagioti et al. was to identify the most common types of preventable patient harm and to examine the prevalence and severity of the identified harm. The authors also aimed to examine differences in the prevalence, types and severity of preventable harm across different healthcare settings and across studies published more recently, using more robust research designs and based in the UK.
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Content ArticlePatient-centeredness is central to healthcare. Hospitals should address patients’ unique needs to improve safety and quality. Patient engagement in healthcare, which may help prevent adverse events, can be approached as an independent patient safety practice (PSP) or as part of a multifactorial PSP. This systematic review by Berger et al., published in BMJ Quality & Safety, examines how interventions encouraging this engagement have been implemented in controlled trials. It found that while patient engagement in safety is appealing, there is insufficient high-quality evidence informing real-world implementation. Further work is needed to evaluate the effectiveness of interventions on patient and family engagement and clarify the added benefit of incorporating engagement in multifaceted approaches to improve patient safety endpoints. In addition, strategies to assess and overcome barriers to patients’ willingness to actively engage in their care should be investigated.
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Content ArticleEvery organisation has a unique culture. There is a widely held view that a positive organisational culture is related to positive patient outcomes. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses statement, Braithwaite et al. systematically reviewed and synthesised the evidence on the extent to which organisational and workplace cultures are associated with patient outcomes.
