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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 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 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 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 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 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 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 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 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 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 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 ArticlePatients in inpatient mental health settings face similar risks (e.g., medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (e.g., self-harm), and the measures taken to address these (e.g., restraint), may result in further risks to patient safety. The objective of this review from Thibaut et al., published in BMJ Open, was to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology. The authors found that patient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.
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Content ArticleEarly warning scores are widely used prediction models that are often mandated in daily clinical practice to identify early clinical deterioration in hospital patients. In this paper published in the BMJ, Gerry et al. carried out a systematic review and critical appraisal of early warning scores for adult hospital patients. The results found that many early warning scores in clinical use had methodological weaknesses.The study's authors concluded that the early warning scores might not perform as well as expected and therefore they could have a detrimental effect on patient care. “Future work should focus on following recommended approaches for developing and evaluating early warning scores, and investigating the impact and safety of using these scores in clinical practice.”
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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 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 ArticleThis paper, published by BMJ Quality & Safety, looks at the global rise in patient complaints which has been accompanied by growing research to effectively analyse complaints for safer, more patient-centric care. Most patients and families complain to improve the quality of healthcare, yet progress has been complicated by a system primarily designed for case-by-case complaint handling. If healthcare settings are better supported to report, analyse and use complaints data in a standardised manner, complaints could impact on care quality in important ways. This review has established a range of evidence-based, short-term recommendations to achieve this.
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Content ArticlePublic and patient expectations of treatment influence health behaviours and decision-making. This study aimed to understand how the media has portrayed the therapeutic use of ketamine in psychiatry. It found that ketamine treatment was portrayed in an extremely positive light, with significant contributions of positive testimony from key opinion leaders (e.g. clinicians). Positive research results and ketamine's rapid antidepressant effec were frequently emphasised, with little reference to longer-term safety and efficacy. The study concluded that information pertinent to patient help-seeking and treatment expectations is being communicated through the media and supported by key opinion leaders, although some quotes go well beyond the evidence base. Clinicians should be aware of this and may need to address their patients’ beliefs directly.
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Content ArticleSince To Err is Human was published in 1999, the patient safety evidence-base has expanded exponentially in alignment with continued maturity of the field. This publication is the 4th in a series of reports from the Agency for Healthcare Research and Quality (US-based), that reviews research supporting established patient safety practices to reduce patient harms. The current report is being published as updates are finalised to provide recommendation and share strategies highlighted in the literature to drive implementation of the practices discussed in areas such as: opioid stewardship patient and family engagement telehealth implicit bias failure to rescue computerised decision support deprescribing.
