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Journal Article > Commentary
Developing and implementing new safe practices: voluntary adoption through statewide collaboratives.
Leape LL, Rogers G, Hanna D, et al. Qual Saf Health Care. 2006;15:289-295.
This study reports on the experiences of a Massachusetts statewide collaborative to improve patient safety. The chosen interventions were medication reconciliation and prompt communication of critical test results, which were selected by an advisory committee of stakeholders advised by national opinion leaders. Each participating hospital sent a multidisciplinary team to four collaborative meetings, at which participants learned Plan-Do-Study-Act (PDSA) methodology and implementation strategies and later returned to share experiences and data. The project successfully enrolled 88% of acute care hospitals in the state, but only 50% of hospitals successfully implemented medication reconciliation, and 65% implemented communication of critical test results. Major barriers to implementation included lack of dedicated staff time and lack of support from hospital management. The investigators also identified problems with the collaborative process itself, chiefly, failure to define clear expectations and failure to emphasize measuring data to monitor efficacy.
Journal Article > Study
Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation.
Benning A, Ghaleb M, Suokas A, et al. BMJ. 2011;342:d195.
The United Kingdom's Safer Patients Initiative (SPI) is a large-scale effort to improve patient safety, with past studies demonstrating positive perceptions of the program among participants. In this phase one study, the SPI focused efforts in 4 hospitals, where a $1.2 million investment was made in each to secure improvements across a wide range of aims, including a 50% reduction in adverse events. The multifaceted interventions targeted organizational factors, such as safety culture and specific clinical issues (e.g., medication errors and communication), through continuous quality improvement methods. The robust program, including this independently requested evaluation, demonstrated a few improvements associated with introduction of SPI, but no additional benefit on many other targeted issues. An accompanying editorial [see link below] discusses the study findings, and emphasizes the continued need to run toward science rather than away from it in evaluating quality improvement efforts.
Journal Article > Study
Odukoya OK, Stone JA, Chui MA. Res Social Adm Pharm. 2014;10:837-852.
The handwritten prescription pad is vanishing from clinical practice, replaced by the proliferation of e-prescribing. There are many advantages to this technology, but prescribing errors still occur at alarming rates. This study explored the approaches community pharmacists and technicians utilize to detect and manage e-prescription errors.