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Search results for "Active Errors"
Journal Article > Review
A systematic review to identify the factors that affect failure to rescue and escalation of care in surgery.
Johnston MJ, Arora S, King D, et al. Surgery. 2015;157:752-763.
Failure to rescue—lack of adequate response to patient deterioration—has been associated with adverse patient outcomes, particularly in acute care settings. This systematic review found that high hospital volume and increased patient-to-nurse staffing ratios were associated with failure to rescue, suggesting that addressing these workforce issues may enhance ability to recognize and intervene for deteriorating patients.
Journal Article > Study
Johnston M, Arora S, King D, Stroman L, Darzi A. Surgery. 2014;155:989-994.
This interview study examined escalation of care, the process by which a patient's deteriorating clinical status is recognized and acted upon, among surgical patients. Attending surgeons, trainees, intensivists, and rapid response team members believe that protocols for escalation of care lack clarity and that there is a dearth of supervision from senior clinicians. Similar to studies of handoffs, direct conversation—either in person or via mobile phone—was deemed preferable to hospital paging systems. Participants identified communication training, explicit and clear protocols, and increased supervision as key to improving the care of deteriorating surgical patients. Accompanying editorials highlight the importance of communication and the need for a safety culture that supports multidisciplinary teams.